Abstract
BackgroundMental Rehearsal (MR) the cognitive act of simulating a task in our heads to pre-experience events imaginatively. It has been used widely to improve individual and collective performance in fields outside healthcare and offers potential for more efficient training in time pressured surgical and medical team contexts. The study aims to review the current systematic review literature to determine the impact of MP on surgical performance and learning.MethodsMedline, Embase, British Educational Index, CINAHL, Web of Science PsycINFO, Cochrane databased were searched in the period 1994–2018. The primary outcomes measure were performance improvements in surgical technical skills, stress reduction, confidence and team performance. Study quality of the Systematic Reviews was assessed using AMSTAR 2, a critical appraisal tool for systematic reviews. The reported impacts of MP in all included studies were mapped onto Kirkpatrick’s framework for the evaluation of educational interventions.ResultsSix Systematic reviews were identified which met the inclusion criteria, of which all reported positive and varying benefits of MP on surgical performance, confidence, and coping strategies. However, reported impacts on a modified Kirkpatrick’s framework did not exceed level 3. Mental practice was described in terms of mental imagery and mental rehearsal with most authors using each of the terms in their search strategies. The impacts on transfer to practice and the long- term acquisition of skills, but also personal uptake of mental practice routines were not reported.ConclusionThe majority of studies demonstrate benefits of MP for technical performance. Overall the systematic reviews were of medium to high quality. However, studies lacked a sufficiently articulated evaluation methodology to examine impacts beyond the immediate experimentations. This is also due to the limitations found in the primary studies. Future research should look at longitudinal mixed method evaluation designs and focus on real clinical teams.
Highlights
Mental Rehearsal (MR) the cognitive act of simulating a task in our heads to pre-experience events imaginatively
We identified systematic reviews of ‘mental practice’ in surgery which, together with the studies included in them provide a comprehensive view of the research literature on the impact of mental practice on surgical teams
A systematic-rapid evidence assessment (SREA) approach retains the advantages of transparency and rigor in the review process compared with non-systematic literature reviews; it reduces the time resources required when undertaking a Locating systematic reviews We searched a range of sources including bibliographic databases (BEI, ERIC, Medline, CINAHL PsycINFO, Web of Science); the internet (Google Scholar); and systematic review organisations, the Cochrane EPOC group, The Best Evidence in Medical Education (BEME) network, and the Joanna Briggs Institute
Summary
Mental Rehearsal (MR) the cognitive act of simulating a task in our heads to pre-experience events imaginatively. It has been used widely to improve individual and collective performance in fields outside healthcare and offers potential for more efficient training in time pressured surgical and medical team contexts. The increased complexity of surgical procedures has heightened interest regarding how to help surgeons attain, enhance and maintain expert performance more effectively. Mental practice (MP) is most commonly described as the ‘symbolic’ mental rehearsal of a task in the absence of actual physical rehearsal [1,2,3]. It is closely aligned with a notion of consciousness entailing the setting up and planning of future goals [4]. The research suggests that the process of MP may be either individual or coordinated with others [8, 11,12,13,14,15]
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