A decade of imaging surgeons' brain function (Part II): a systematic review of applications for technical and non-technical skills assessment
File(s)
Accepted version
Accepted version
Author(s)
Modi, HN
Singh, H
Yang, G
Darzi, A
Leff, D
Type
Journal Article
Abstract
Background: Functional neuroimaging technologies enable assessment of operator brain function, and can deepen our understanding of skills learning, ergonomic optima and cognitive processes in surgeons. Whilst there has been a critical mass of data detailing surgeons’ brain function, this literature has not been systematically reviewed.
Methods: A systematic search of original neuroimaging studies assessing surgeons’ brain function, and published up until November 2016, was conducted using Medline, Embase and PsycINFO databases.
Results: Twenty-seven studies fulfilled the inclusion criteria, including three feasibility studies, fourteen studies exploring the neural correlates of technical skill acquisition, and the remainder investigating brain function in the context of intraoperative decision-making (n=1), neurofeedback training (n=1), robot-assisted technology (n=5), and surgical teaching (n=3). Early stages of learning open surgical tasks (knot-tying) are characterised by prefrontal cortical (PFC) activation which subsequently attenuates with deliberate practice. However, with complex laparoscopic skills (intra-corporeal suturing), PFC engagement requires substantial training and attenuation occurs over a longer time-course, following years of refinement. Neurofeedback and interventions that improve neural efficiency may enhance technical performance and skills learning.
Conclusions: Imaging surgeons’ brain function has identified neural signatures of expertise which might help inform objective assessment and selection processes. Interventions which improve neural efficiency may target skill-specific brain regions and augment surgical performance.
Methods: A systematic search of original neuroimaging studies assessing surgeons’ brain function, and published up until November 2016, was conducted using Medline, Embase and PsycINFO databases.
Results: Twenty-seven studies fulfilled the inclusion criteria, including three feasibility studies, fourteen studies exploring the neural correlates of technical skill acquisition, and the remainder investigating brain function in the context of intraoperative decision-making (n=1), neurofeedback training (n=1), robot-assisted technology (n=5), and surgical teaching (n=3). Early stages of learning open surgical tasks (knot-tying) are characterised by prefrontal cortical (PFC) activation which subsequently attenuates with deliberate practice. However, with complex laparoscopic skills (intra-corporeal suturing), PFC engagement requires substantial training and attenuation occurs over a longer time-course, following years of refinement. Neurofeedback and interventions that improve neural efficiency may enhance technical performance and skills learning.
Conclusions: Imaging surgeons’ brain function has identified neural signatures of expertise which might help inform objective assessment and selection processes. Interventions which improve neural efficiency may target skill-specific brain regions and augment surgical performance.
Date Issued
2017-10-26
Date Acceptance
2017-06-08
Citation
Surgery, 2017, 162 (5), pp.1130-1139
ISSN
1532-7361
Publisher
Elsevier
Start Page
1130
End Page
1139
Journal / Book Title
Surgery
Volume
162
Issue
5
Copyright Statement
2018-10-26
Sponsor
Imperial College Healthcare NHS Trust- BRC Funding
Imperial College Healthcare NHS Trust- BRC Funding
Grant Number
RDB04 79560
RD207
Subjects
1103 Clinical Sciences
Surgery
Publication Status
Published