Effectiveness of a comprehensive mental skills curriculum in enhancing surgical performance: Results of a randomized controlled trial.

INTRODUCTION: We hypothesized that the implementation of a novel mental skills curriculum (MSC) during laparoscopic simulator training would improve mental skills and performance, and decrease stress.

METHODS: Sixty volunteer novices were randomized into intervention and control groups. All participants received FLS training while the intervention group also participated in the MSC. Skill transfer and retention were assessed on a live porcine model after training and 2 months later, respectively. Performance was assessed using the Test of Performance Strategies-2 (TOPS-2) for mental skills, FLS metrics for laparoscopic performance, and the State Trait Anxiety Inventory (STAI-6) and heart rate (HR) for stress.

RESULTS: Fifty-five participants (92%) completed training and the transfer test, and 46 (77%) the retention test. There were no significant differences between groups at baseline. Compared to controls the intervention group significantly improved their mental skill use, demonstrated higher laparoscopic skill improvement during retention, and reported less stress during the transfer test.

CONCLUSIONS: The MSC implemented in this study effectively enhanced participants' mental skill use, reduced cognitive stress in the operating room with a small impact on laparoscopic performance.