Mental practice: effective stress management training for novice surgeons

Area of Science:

• Surgical Education
• Cognitive Psychology
• Stress Physiology

Background:

• Surgeons experience high stress, potentially impairing performance.
• Mental practice (MP) is a strategy used in other high-performance fields to manage anxiety.
• This study explored MP's effectiveness in reducing stress for novice surgeons.

Purpose of the Study:

• To investigate the impact of mental practice on stress levels in novice surgeons.
• To assess if MP can mitigate both subjective and objective stress responses during simulated surgical procedures.

Main Methods:

• Prospective, randomized controlled trial with 20 novice surgeons.
• Participants underwent virtual reality (VR) laparoscopic cholecystectomy (LC) training.
• The intervention group engaged in 30 minutes of MP before each VR LC, while the control group performed an unrelated activity.
• Stress was measured using the State-Trait Anxiety-Inventory (STAI), heart rate (HR), and salivary cortisol.

Main Results:

• Eighteen participants completed the study; no baseline differences were observed.
• The MP group exhibited significantly lower subjective stress (STAI) compared to controls (p < 0.01).
• Objective stress markers were also reduced in the MP group, including average HR (p < 0.0001), maximum HR (p < 0.01), and cortisol levels (p < 0.05).
• Improved mental imagery correlated negatively with stress levels (p < 0.05).

Conclusions:

• A brief period of mental practice effectively reduces subjective, cardiovascular, and neuroendocrine stress responses in novice surgeons using VR simulators.
• Further research is needed to ascertain if these benefits extend to experienced surgeons and translate to real-world operating room performance.