Mental training in general surgery: a qualitative review of Australian trainee perceptions

Mental training is the cognitive process and pedagogical technique of 'viewing' and 'feeling' a task without physically performing it. Its application is well-established within aviation, elite sports and the arts. While surgical trainees often mentally rehearse prior to operating, this technique is yet to be established for educational and skill acquisition purposes. The aim of this study was to investigate trainee awareness of mental training, the use of mental rehearsal, and explore perceived benefits and barriers to its implementation.

An exploratory qualitative study design was employed, with semi-structured interviews of general surgical trainees across Australia. Interviews were transcribed and thematic analysis undertaken to identify common themes.

A total of 10 General Surgery trainees were interviewed encompassing each Australian state and territory. A consistent finding was that all teaching of operative skills occurs in the clinical environment, without the adjunct of structured practical or cognitive simulation. All trainees reported mentally rehearsing procedures in some capacity as part of personal preparation, and were supportive of implementing formal mental training for surgical skill development. Themes included standardization of training, enhancing training during times of reduced clinical exposure, minimizing anxiety, and improving communication. Implementation was deemed to be most effective through a bank of online mental training resources.

Mental training was supported by General Surgical trainees, with perceived potential benefits in multiple domains. To mitigate the main perceived barrier of time constraints, an online method of delivery was felt to be optimal.