Mental Imagery and Mental Practice Applications in Surgery: State of the Art and Future Directions

This chapter aims to provide a state-of-the-art review of the application of mental imagery and mental practice (or motor imagery) within surgical contexts. We first explain the terms “mental imagery” (a form of cognitive simulation) and “mental practice” (or the covert rehearsal of an action in one’s imagination without executing the actual movements involved) and summarise the main theories of mental practice effects. We then propose some important similarities between the skilled performance of surgeons and that of elite athletes, and we review the current status of surgical training—highlighting the growing popularity of simulation methods as a cost-effective alternative to the traditional apprenticeship model whereby novice surgeons hone their skills through repeated supervised experience of operating. Next, we review available empirical research on the efficacy of mental practice interventions in training surgical skills—with special emphasis on the key methodological issues afflicting research in this field. Finally, we present our conclusions and identify some fruitful avenues for further research on mental practice in surgery and surgical training.