Davison Sara, Raison Nicholas, Khan Muhammad S, Dasgupta Prokar, Ahmed Kamran
MRC Centre for Transplantation, Division of Transplantation Immunology and Mucosal Biology, Faculty of Life Sciences and Medicine, King's College London, Guy's Hospital, London, UK.
ANZ J Surg. 2017 Nov;87(11):873-878. doi: 10.1111/ans.14140. Epub 2017 Aug 29.
Pressures on surgical education from restricted working hours and increasing scrutiny of outcomes have been compounded by the development of highly technical surgical procedures requiring additional specialist training. Mental training (MT), the act of performing motor tasks in the 'mind's eye', offers the potential for training outside the operating room. However, the technique is yet to be formally incorporated in surgical curricula. This study aims to review the available literature to determine the role of MT in surgical education.
EMBASE and Medline databases were searched. The primary outcome measure was surgical proficiency following training. Secondary analyses examined training duration, forms of MT and trainees level of experience. Study quality was assessed using Consolidated Standards of Reporting Trials scores or Quality Assessment Tool for Before-After (Pre-Post) Studies with No Control Group.
Fourteen trials with 618 participants met the inclusion criteria, of which 11 were randomized and three longitudinal. Ten studies found MT to be beneficial. Mental rehearsal was the most commonly used form of training. No significant correlation was found between the length of MT and outcomes. MT benefitted expert surgeons more than medical students or novice surgeons.
The majority studies demonstrate MT to be beneficial in surgical education especially amongst more experienced surgeons within a well-structured MT programme. However, overall studies were low quality, lacked sufficient methodology and suffered from small sample sizes. For these reasons, further research is required to determine optimal role of MT as a supplementary educational tool within the surgical curriculum.
限制工作时间以及对手术结果的审查日益严格，给外科教育带来了压力，而需要额外专科培训的高技术外科手术的发展更是雪上加霜。心理训练（MT），即在“脑海中”执行运动任务的行为，为手术室之外的训练提供了可能性。然而，该技术尚未正式纳入外科课程。本研究旨在回顾现有文献，以确定心理训练在外科教育中的作用。
检索了EMBASE和Medline数据库。主要结局指标是训练后的手术熟练程度。次要分析考察了训练时长、心理训练的形式以及受训者的经验水平。使用《报告试验的统一标准》评分或无对照组的前后对照研究质量评估工具对研究质量进行评估。
14项试验共618名参与者符合纳入标准，其中11项为随机试验，3项为纵向试验。10项研究发现心理训练有益。心理预演是最常用的训练形式。未发现心理训练时长与结果之间存在显著相关性。心理训练对专家外科医生的益处大于医学生或新手外科医生。
大多数研究表明，心理训练在外科教育中有益，尤其是在结构完善的心理训练项目中，对经验更丰富的外科医生更是如此。然而，总体研究质量较低，缺乏足够的方法，且样本量较小。基于这些原因，需要进一步研究以确定心理训练作为外科课程中辅助教育工具的最佳作用。
