Thinking Makes It So: Relationship Between Cortical Activity During Mental Imagery and Surgical Skill

Area of Science:

• Medical Education
• Cognitive Neuroscience
• Surgical Skills Training

Background:

• Mental imagery ability is crucial for skill acquisition in various domains.
• Objective assessment of mental imagery's impact on surgical performance is needed.
• Traditional self-report measures may not fully capture imagery's role in procedural learning.

Purpose of the Study:

• To objectively assess the association between mental imagery ability and open suturing performance.
• To explore the relationship between neurophysiological measures of mental imagery and surgical skill acquisition.
• To compare subjective imagery assessments with objective performance outcomes.

Main Methods:

• Surgical novices underwent a comprehensive mental imagery assessment battery.
• Participants engaged in mental imagery of suturing with concurrent electroencephalography (EEG) measurement.
• Objective suturing performance was evaluated through two physical repetitions of the procedure.

Main Results:

• No significant correlation was found between subjective mental imagery assessments and suturing performance.
• Higher cortical activity in prefrontal and premotor cortices during mental imagery was associated with improved suturing performance (R > 0.5, p < 0.05).
• EEG measures of cortical activity during imagery showed a significant link to actual performance.

Conclusions:

• Cortical activity during mental imagery of suturing correlates with actual suturing performance in novices.
• Subjective self-report imagery assessments are not reliable predictors of surgical skill.
• Electroencephalography (EEG) offers a more sensitive measure of mental imagery's impact on procedural performance than self-report.