Abstract
BackgroundSimulation‐based training in medical education has become a common method to develop both technical and non‐technical skills in teams. Mental rehearsal (MR) is the cognitive act of simulating a task in our heads to pre‐experience tasks 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. This study aimed to review the available literature to determine the impact of MR on team performance and non‐technical skills in healthcare.MethodsMEDLINE, Embase, British Educational Index, CINAHL, Web of Science, PsycInfo and Cochrane databases were searched for the period 1994–2018. The primary outcome measure was improvement in team performance and non‐technical skills. Study quality of RCTs was assessed using the Medical Education Research Quality Instrument. The reported impacts of MR in all included studies were mapped on to the Kirkpatrick framework for evaluation of educational interventions.ResultsEight studies with 268 participants were identified that met the inclusion criteria, of which there were six randomized trials, one prospective pragmatic trial and one qualitative study. Three studies found MR to be effective in improving team non‐technical skills. MR practices were varied and often poorly defined. MR benefited team non‐technical skills when it was specifically designed to do so, but was not an automatic consequence of technical MR alone. The majority of studies demonstrated benefits of MR for technical performance, but only three showed positive impacts on teamwork. Overall the studies were of low quality and lacked sufficient discriminatory focus to examine impacts on teamwork dynamics.ConclusionMR can improve technical performance, but the benefits on non‐technical skills are less clear. Future research should look at longitudinal mixed‐method evaluation designs and focus on real clinical teams.
Highlights
Successful surgical procedures are the product of a combination of sustained technical skills, effective non-technical skills (NTS) and ongoing professional education
Three further studies were excluded as the full text was not available after contacting the author for one, and two others focused on mental models rather than Mental rehearsal (MR) (Table S1, supporting information)
This systematic review analysed RCTs and prospective trials assessing the impact of MR on teamwork and NTS in surgical education and medical team training
Summary
Successful surgical procedures are the product of a combination of sustained technical skills, effective non-technical skills (NTS) and ongoing professional education. Surgical team members often need to coordinate rapidly with other professionals with whom they may never have worked, to undertake procedures they may never have performed In these challenging conditions, there is a need to determine how to provide effective educational support for surgical teams, at all levels of experience. Simulation-based training in medical education has become a common method to develop both technical and non-technical skills in teams. This study aimed to review the available literature to determine the impact of MR on team performance and non-technical skills in healthcare.
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