Cognitive Training for Performance Enhancement in Robotic Surgery: A Systematic Review of RCTs

IF 2.2 3区医学 Q1 EDUCATION, SCIENTIFIC DISCIPLINES

Journal of Surgical Education Pub Date : 2026-04-01 Epub Date: 2026-02-10 DOI:10.1016/j.jsurg.2026.103882

Samy Castillo-Flores MD , Andres A. Abreu MD , Patricia Viana MD , Maria Meritxell Roca Mora MD , Isabella Faria MD , Patricio M. Polanco MD

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引用次数: 0

Abstract

Objective

To evaluate the effect of cognitive training (CT) compared to standard non-cognitive training on surgical performance in robotic surgery.

Design

A systematic search of PubMed, Embase, ScienceDirect, and PsycINFO was conducted in accordance with PRISMA and Cochrane Handbook guidelines. Only randomized controlled trials (RCTs) were included. Risk of bias was assessed using the RoB 2 tool.

Setting

All studies took place in institutional training environments using simulation platforms.

Participants

One hundred fifty four surgical trainees (medical students, residents, and fellows) were included. Of these, 78 participants (50.6%) received CT through mental rehearsal or computer-based training.

Results

Four randomized controlled trials (RCTs) were included. CT improved technical skills in 3 out of 4 studies. Reported benefits included a 52% reduction in tissue piercing (p < 0.001), superior knot-tying task performance (p = 0.01), and higher GEARS scores (CT group: mean of 13.1, SD 3.25; control group: mean of 11.4, SD 2.97; p = 0.03). NOTSS score showed no improvement (CT group: mean of 25.8, SD 7.34; control group: mean of 26.4, SD 9.13; p = 0.77). In contrast, an augmented mental rehearsal approach improved imagery and visuospatial ability (augmented CT group: mean of 20.1, SD 4.0; control group: mean of 14.6, SD 3.9; p = 0.02), whereas computer-based CT produced no improvement.

Conclusions

CT, particularly mental rehearsal, may improve technical skills in robotic simulation among novice trainees. However, the certainty of this evidence is limited by small, heterogeneous studies, and all findings come from simulation settings. Finally, the impact of CT in more advanced learners and in real operating rooms remains uncertain.

查看原文本刊更多论文

认知训练在机器人手术中的应用：随机对照试验的系统回顾。

目的：比较认知训练（CT）与标准非认知训练对机器人手术效能的影响。设计：系统检索PubMed、Embase、ScienceDirect和PsycINFO，并按照PRISMA和Cochrane Handbook指南进行。仅纳入随机对照试验（rct）。使用RoB 2工具评估偏倚风险。环境：所有的研究都是在使用模拟平台的机构培训环境中进行的。参与者：包括154名外科实习生（医学生、住院医师和研究员）。其中78名参与者（50.6%）通过心理预演或计算机训练接受CT。结果：纳入4项随机对照试验（RCTs）。4项研究中有3项CT提高了技术技能。报告的益处包括组织穿刺减少52% (p < 0.001)，更好的打结任务表现（p = 0.01）和更高的GEARS评分（CT组：平均13.1,SD 3.25；对照组：平均11.4,SD 2.97; p = 0.03）。NOTSS评分无明显改善（CT组：平均25.8分，SD 7.34分；对照组：平均26.4分，SD 9.13分；p = 0.77分）。相反，增强心理预演方法改善了图像和视觉空间能力（增强CT组：平均20.1,SD 4.0；对照组：平均14.6,SD 3.9; p = 0.02），而基于计算机的CT没有改善。结论：CT，特别是心理演练，可以提高新手机器人模拟的技术技能。然而，这一证据的确定性受到小型异质研究的限制，并且所有的发现都来自模拟设置。最后，CT对高级学习者和实际手术室的影响仍不确定。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Journal of Surgical Education EDUCATION, SCIENTIFIC DISCIPLINES-SURGERY

CiteScore

5.60

自引率

10.30%

发文量

261

审稿时长

48 days

期刊介绍： The Journal of Surgical Education (JSE) is dedicated to advancing the field of surgical education through original research. The journal publishes research articles in all surgical disciplines on topics relative to the education of surgical students, residents, and fellows, as well as practicing surgeons. Our readers look to JSE for timely, innovative research findings from the international surgical education community. As the official journal of the Association of Program Directors in Surgery (APDS), JSE publishes the proceedings of the annual APDS meeting held during Surgery Education Week.