Le Khang Duy Ricky, Ferdinands Jessica, Fink Kaylah
Department of General Surgical Specialities, The Royal Melbourne Hospital, Melbourne, Victoria, Australia; Geelong Clinical School, Deakin School of Medicine, Deakin University, Geelong, Victoria, Australia.
Department of Surgery, Alfred Health, Melbourne, Victoria, Australia.
J Surg Educ. 2025 May;82(5):103472. doi: 10.1016/j.jsurg.2025.103472. Epub 2025 Feb 22.
The development of surgical skills is a key component of the medical education curriculum. While simulation-based medical education approaches are increasingly adopted to facilitate skills development in a safe, standardized and realistic manner, mental imagery (MI) has been considered as an emerging approach for surgical skills development. MI is defined as the mental rehearsal of tasks without motor performance and has demonstrated effective skills development in industries such as elite sport and aviation. However, its benefit has yet to be explored and utilized in the medical school curriculum. This scoping review seeks to evaluate the current literature to characterize efficacy of MI interventions for the surgical skills development of medical students.
A scoping review was performed following a comprehensive search of Medline, Embase, CINAHL and Emcare databases. Articles evaluating the outcomes related to the impact of MI interventions on the development of technical and nontechnical surgical skills among medical students were included.
MI-based programs among medical students improve certain areas of technical and nontechnical surgical skills performance such as in laparoscopic performance, fluidity and with co-benefits of improved stress management and low cost. However, inconsistencies were observed in findings across studies, with mixed results across the technical and nontechnical surgical skills assessed. This was largely attributed to significant study heterogeneity of the underlying evidence.
Despite the emerging evidence suggesting MI-based programs as an effective adjunct to the current surgical skills development, there are important limitations to the quality of the evidence. Our scoping review highlights the need for prospective research with standardized MI programs assessing surgical skills at the expected scope of competency for medical students to further characterize the utility of MI-based programs in the Accreditation Council for Graduate Medical Education (ACGME) surgical skills curriculum, particularly in areas of medical knowledge, professionalism, interpersonal and communication skills.
外科技能的培养是医学教育课程的关键组成部分。虽然基于模拟的医学教育方法越来越多地被采用，以安全、标准化和现实的方式促进技能发展，但心理意象（MI）已被视为外科技能发展的一种新兴方法。心理意象被定义为在没有运动表现的情况下对任务进行心理演练，并且已在精英运动和航空等行业中证明了有效的技能发展。然而，其益处尚未在医学院课程中得到探索和利用。本范围综述旨在评估当前文献，以描述心理意象干预对医学生外科技能发展的疗效。
在全面检索Medline、Embase、CINAHL和Emcare数据库后进行了范围综述。纳入评估心理意象干预对医学生技术和非技术外科技能发展影响的相关结果的文章。
医学生中基于心理意象的项目可改善技术和非技术外科技能表现的某些方面，如腹腔镜操作表现、流畅性，并具有改善压力管理和低成本的共同益处。然而，各研究结果存在不一致性，在所评估的技术和非技术外科技能方面结果不一。这在很大程度上归因于基础证据的显著研究异质性。
尽管新出现的证据表明基于心理意象的项目是当前外科技能发展的有效辅助手段，但证据质量存在重要局限性。我们的范围综述强调需要进行前瞻性研究，采用标准化的心理意象项目，在医学生预期的能力范围内评估外科技能，以进一步描述基于心理意象的项目在毕业后医学教育认证委员会（ACGME）外科技能课程中的效用，特别是在医学知识、职业素养、人际和沟通技能方面。
