A decade of imaging surgeons' brain function (Part II): a systematic review of applications for technical and non-technical skills assessment

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Title: A decade of imaging surgeons' brain function (Part II): a systematic review of applications for technical and non-technical skills assessment
Authors: Modi, HN
Singh, H
Yang, G
Darzi, A
Leff, D
Item 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.
Issue Date: 26-Oct-2017
Date of Acceptance: 8-Jun-2017
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/Funder: Imperial College Healthcare NHS Trust- BRC Funding
Imperial College Healthcare NHS Trust- BRC Funding
Funder's Grant Number: RDB04 79560
Keywords: 1103 Clinical Sciences
Publication Status: Published
Appears in Collections:Faculty of Engineering
Division of Surgery
Faculty of Medicine

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