Implementation results of a novel comprehensive mental skills curriculum during simulator training.

BACKGROUND Mental skills training refers to the implementation of cognitive performance-enhancing strategies to promote optimal performance. We aimed to develop a surgery-specific mental skills curriculum (MSC) and obtain initial evidence of efficacy. METHODS The developed MSC consisted of 8 proven performance-enhancing modules. Its efficacy was assessed during laparoscopic simulator-based practice by novices using validated instruments of mental skills, workload, and stress, in addition to a skill transfer test to a porcine model. A paired t test was used to analyze the data. RESULTS Nine surgical novices completed the curriculum. Compared with baseline assessment, participants improved significantly their laparoscopic performance and mental skills after completion of the MSC. All participants completed the task in the porcine model without an appreciable change in their perceived stress. During the skill transfer test, 8 participants were observed using mental skills taught in the MSC. CONCLUSIONS A surgery-specific simulator-based MSC was developed, and its efficacy in improving mental skills and surgical performance was supported during a surgical skill transfer test.

[1]  Nick Sevdalis,et al.  Mental Practice Enhances Surgical Technical Skills: A Randomized Controlled Study , 2011, Annals of surgery.

[2]  Nicholas E Anton,et al.  What stress coping strategies are surgeons relying upon during surgery? , 2015, American journal of surgery.

[3]  Jeffrey B. Henriques,et al.  Support for the Reliability and Validity of a Six-Item State Anxiety Scale Derived From the State-Trait Anxiety Inventory , 2009, Journal of Nursing Measurement.

[4]  Nick Sevdalis,et al.  Stress impairs psychomotor performance in novice laparoscopic surgeons , 2010, Surgical Endoscopy.

[5]  Stephanie J. Hanrahan,et al.  Mental skills for musicians: Managing music performance anxiety and enhancing performance , 2012 .

[6]  G. Hanna,et al.  Stress Management Training for Surgeons—A Randomized, Controlled, Intervention Study , 2011, Annals of surgery.

[7]  Jean M. Williams Applied Sport Psychology , 2005 .

[8]  Jane Kidd,et al.  The effects of stress on surgical performance. , 2006, American journal of surgery.

[9]  Warren D. Smith,et al.  Performing laparoscopic surgery is significantly more stressful for the surgeon than open surgery , 2001, Surgical Endoscopy.

[10]  Nick Sevdalis,et al.  Mental practice: effective stress management training for novice surgeons. , 2011, Journal of the American College of Surgeons.

[11]  Christine Le Scanff,et al.  Stress Management for Police Special Forces , 2002 .

[12]  James R Korndorffer,et al.  Closing the gap in operative performance between novices and experts: does harder mean better for laparoscopic simulator training? , 2006, Journal of the American College of Surgeons.

[13]  Marc Immenroth,et al.  Mental Training in Surgical Education: A Randomized Controlled Trial , 2007, Annals of surgery.

[14]  A. H. Roscoe Assessing pilot workload. Why measure heart rate, HRV and respiration? , 1992, Biological Psychology.

[15]  Marc Immenroth,et al.  Mental Training in Surgical Education: A Randomized Controlled Trial , 2007, Annals of surgery.

[16]  Dimitrios Stefanidis,et al.  Increased stress levels may explain the incomplete transfer of simulator-acquired skill to the operating room. , 2010, Surgery.

[17]  James R Korndorffer,et al.  Simulator training for laparoscopic suturing using performance goals translates to the operating room. , 2005, Journal of the American College of Surgeons.

[18]  C. Spielberger State‐Trait Anxiety Inventory , 2010 .

[19]  S. Hart,et al.  Development of NASA-TLX (Task Load Index): Results of Empirical and Theoretical Research , 1988 .

[20]  Aaron Williamon,et al.  Evaluation of a Mental Skills Training Program for Musicians , 2011 .

[21]  Sheila Jennett Churchill Livingstone's dictionary of sport and exercise science and medicine , 2008 .

[22]  J. Gaughan,et al.  Stress training for the surgical resident. , 2013, American journal of surgery.

[23]  Nick Sevdalis,et al.  The impact of stress on surgical performance: a systematic review of the literature. , 2010, Surgery.

[24]  R. Brickenkamp,et al.  D2 Test of Attention , 1998 .

[25]  Daniel J Scott,et al.  Design of a Proficiency-Based Skills Training Curriculum for the Fundamentals of Laparoscopic Surgery , 2007, Surgical innovation.

[26]  Allan Okrainec,et al.  Fundamentals of Laparoscopic Surgery-FLS , 2012 .

[27]  Stephen Cobley,et al.  The Effect of Psychological Skills Training (PST) on Self-Regulation Behavior, Self-Efficacy, and Psychological Skill Use in Military Pilot-Trainees , 2013 .

[28]  G. Fried,et al.  Development and validation of a comprehensive program of education and assessment of the basic fundamentals of laparoscopic surgery. , 2004, Surgery.

[29]  Olle Ljungqvist,et al.  The enhanced recovery after surgery (ERAS) pathway for patients undergoing major elective open colorectal surgery: a meta-analysis of randomized controlled trials. , 2010, Clinical nutrition.

[30]  Patrick R. Thomas,et al.  Test of Performance Strategies (TOPS): Instrument refinement using confirmatory factor analysis , 2010 .

[31]  D. Kern,et al.  Curriculum Development for Medical Education: A Six-Step Approach , 1998 .

[32]  D. Burton,et al.  Smoke and mirrors or wave of the future? Evaluating a mental skills training program for elite cross country skiers. , 2010 .

[33]  Nick Sevdalis,et al.  Development and validation of mental practice as a training strategy for laparoscopic surgery , 2009, Surgical Endoscopy.

[34]  J. Veltman,et al.  Physiological workload reactions to increasing levels of task difficulty. , 1998, Ergonomics.