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Cognitive Training for Technical and Non-Technical Skills in Robotic Surgery: A Randomised Controlled Trial

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N Raison, Kamran Ahmed, Takashige Abe, O Brunckhorst, G Novara, Nicolò Maria Buffi, C McIlhenny, H Van der Poel, M Van Hemelrijck, Andrea Gavazzi, P Dasgupta

Original languageEnglish
Pages (from-to)1075-1081
JournalBJU International
Issue number6
Early online date12 Jun 2018
Accepted/In press23 Apr 2018
E-pub ahead of print12 Jun 2018
Published1 Dec 2018


King's Authors


OBJECTIVES: To investigate the effectiveness of motor imagery (MI) for technical and non-technical skills (NTS) training in minimally invasive surgery.

MATERIALS AND METHODS: A single blind, parallel group randomised controlled trial was conducted at the Vattikuti Institute of Robotic Surgery, King's College London. Novice surgeons were recruited by open invitation in 2015. Following basic robotic skills training, participants underwent simple randomisation to either MI training or standard training. All participants completed a robotic urethrovesical anastomosis task within a simulated operating room. In addition to the technical task, participants were required to manage three scripted NTS scenarios. Assessment was performed by 5 blinded expert surgeons and a NTS expert using validated tools for evaluating technical skills (Global Evaluative Assessment of Robotic Skills (GEARS)) and NTS (Non-Technical Skills for Surgeons (NOTSS)). Quality of MI was assessed using a revised Movement Imagery Questionnaire (MIQ).

RESULTS: 33 participants underwent MI training and 29 underwent standard training. Interrater reliability was high, Krippendorff's α = 0.85. Following MI training, mean GEARS score was significantly higher than after standard training (13.1 ± 3.25 vs 11.4 ± 2.97, p = 0.03). There was no difference in mean NOTSS scores (25.8 vs 26.4, p = 0.77). MI training was successful with significantly higher imagery scores than standard training (mean MIQ score 5.1 vs 4.5, p=0.04).

CONCLUSIONS: MI is an effective training tool for improving technical skill in MIS even in novice participants. No beneficial effect for NTS was found. This article is protected by copyright. All rights reserved.

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