MP35-11 MENTAL TRAINING AND ITS EFFECT ON PROCEDURAL AND COGNITIVE LEARNING – LONGTERM OUTCOMES AFTER 1-YEAR OF FOLLOW-UP

Abstract

INTRODUCTION AND OBJECTIVES: The training of residents is increasingly limited by a demand for cost‐containment without compromising highest quality of care (outcome quality/patient safety). Although it has been shown that a lack of surgical exposure can partly be overcome by mental training (MT) exercises, only short‐term effects have been reported so far. METHODS: We did longitudinal assessments before, 2 and 14 days, and 16 months in 24 medical students who were randomized as 1) controls 2) video training, 3) MT group. MT consisted of the identification of procedural key steps, relaxation, mental vocalization and mental imaging techniques over a course of 2 weeks after one initial supervised training session. All groups completed a basic training in 2 standardized laparoscopic exercises (PEG transfer, cutting a circle) before intervention (video training, video training+mental training). Primary endpoints were scores in a global rating scale (GRS), procedural time and error rates. Additionally, participants completed several theoretical tests examining spatial differentiation, theoretical knowledge and a test of performance strategies (TOPS). Statistical analyses included ANOVA and general linear models with repeated measures. RESULTS: All group baseline characteristics were homogeneous after randomization (p>0.05). The mental training group maintained significantly better GRS scores at 12 months for both, peg transfer (mean score 24.6 =95% CI: 21‐28.25]) and cutting a circle exercises (mean score 22.5 [18.4‐26.6]) (both p<0.01) and had a significantly better performance time in the cutting a circle exercise (261 seconds [Std Dev 116] vs. 427 s [SD 132] vs 368 s [SD 78]) compared to the other groups (p=0.004). Longitudinally, we found a significant effect of mental training on the test score in performance strategies (TOPS, see figure 1) and time to complete the exercise 'cutting a circle' (Figure 2) (p<0.001 and p=0.005, respectively. CONCLUSIONS: In addition to short time efficacy, our study is one of few to ascertain that a simple mental training may enhance and maintain a significant learning effect regarding performance strategies and manual skills over an extended period of time. Ideally, mental training may be an effective and inexpensive tool as an integrated part of residents curricula to help attenuate the effects of cost‐containment and surgical exposure.