Department of Education and Development - GAPS Simulation & Skills Centre, St George's University Hospitals NHS Foundation Trust, London, UK.
Ben Gabbott Trauma and Orthopaedic Department, St George's University Hospitals NHS Foundation Trust, London, UK.
BMC Med Educ. 2020 Jul 14;20(1):221. doi: 10.1186/s12909-020-02131-3.
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 study aims to review the current systematic review literature to determine the impact of MP on surgical performance and learning.
Medline, 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.
Six 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.
The 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.
心理演练（MR）是一种在我们的头脑中模拟任务的认知行为，以便富有想象力地预先体验事件。它已被广泛用于提高医疗保健领域以外的个人和集体绩效，并为在时间紧迫的手术和医疗团队环境中进行更高效的培训提供了潜力。本研究旨在回顾当前的系统评价文献，以确定心理演练对手术表现和学习的影响。
1994 年至 2018 年期间，在 Medline、Embase、英国教育索引、CINAHL、Web of Science PsycINFO 和 Cochrane 数据库中进行了搜索。主要结局指标是手术技术技能、减轻压力、信心和团队表现的提高。使用 AMSTAR 2 评估系统评价的质量，这是一种用于系统评价的关键评估工具。对所有纳入研究中报告的心理演练的影响进行映射，以纳入 Kirkpatrick 教育干预评估框架。
确定了 6 项符合纳入标准的系统评价，其中所有研究均报告了心理演练对手术表现、信心和应对策略的积极且不同的益处。然而，根据修改后的 Kirkpatrick 框架报告的影响并未超过第 3 级。心理演练在心理意象和心理演练方面进行了描述，大多数作者在其搜索策略中使用了这两个术语。没有报告对实践转移和技能的长期习得的影响，也没有报告个人对心理演练常规的接受程度。
大多数研究都表明心理演练对技术表现有好处。总体而言，系统评价的质量为中等到高质量。然而，研究缺乏足够明确的评估方法来检查超出即时实验的影响。这也是由于主要研究中的局限性造成的。未来的研究应着眼于纵向混合方法评估设计，并专注于实际的临床团队。
