Journal of Surgical Education最新文献

{"title":"Surgical Coaching for Performance Optimization: Perceptual-Cognitive Expertise Displayed During Surgical Peer Coaching Intervention","authors":"Sarah E. Bradley PhD ,&nbsp;Mary E. Byrnes PhD, MUP ,&nbsp;Evan Monge BS ,&nbsp;Jordan Boyce-Suwanabol ,&nbsp;Pasithorn A. Suwanabol MD, MS ,&nbsp;Justin B. Dimick MD, MPH ,&nbsp;John C. Byrn MD ,&nbsp;Calista M. Harbaugh MD ,&nbsp;Lauren A. Szczygiel PhD","doi":"10.1016/j.jsurg.2026.103890","DOIUrl":"10.1016/j.jsurg.2026.103890","url":null,"abstract":"<div><h3>Introduction</h3><div>Surgeons rely heavily on perceptual-cognitive skills—such as pattern recognition, anticipatory reasoning, and real-time decision-making—to navigate complex intraoperative environments. While these skills are honed during training, few structured opportunities exist for continued development once in independent practice. Surgical peer coaching has emerged as a promising model for fostering professional growth, but its potential to support cognitive skill refinement remains underexplored.</div></div><div><h3>Methods</h3><div>Thirteen practicing surgeons participated in a longitudinal, video-based group peer coaching program embedded within a statewide surgical quality collaborative. Across nine recorded sessions held over four years, participants reviewed operative videos, offered structured peer feedback, and engaged in facilitated group discussion. Transcripts were analyzed using interaction analysis, an approach focused on understanding complex tasks in social contexts. The analysis aimed to identify how perceptual-cognitive skills were surfaced, shared, and practiced during feedback interactions.</div></div><div><h3>Results</h3><div>Three key perceptual-cognitive skills were practiced consistently throughout the sessions: (1) pattern recognition—such as identifying distorted anatomy or procedural flow; (2) situational probability assessment—anticipating likely intraoperative events or complications; and (3) cue identification—detecting real-time signals to guide decisions. Participants verbalized their own reasoning and used shared video review to compare mental models, assess alternative approaches, and reflect on judgment under uncertainty. These exchanges made expert thinking visible and teachable, demonstrating that cognitive skills can be collaboratively refined through structured discussion.</div></div><div><h3>Conclusion</h3><div>Video-based peer coaching offers a feasible and scalable model for promoting deliberate practice among experienced surgeons. By enabling reflective discussion and shared reasoning, this format supports the development of perceptual cognitive expertise, skills which are critical for surgical safety and performance. These findings underscore the value of integrating cognitive coaching into continuing surgical education and broader quality improvement efforts.</div></div>","PeriodicalId":50033,"journal":{"name":"Journal of Surgical Education","volume":"83 5","pages":"Article 103890"},"PeriodicalIF":2.1,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146192978","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Using Human Centered Design to Evaluate the Implementation of a National Trauma Informed Care Curriculum Pilot at an Urban, Level 1 Trauma Center","authors":"Jonathan Freise MD, MS ,&nbsp;Maxwell Presser MD, MPH ,&nbsp;Adrienne Greer MPH ,&nbsp;Marianna G. Salvatori BS ,&nbsp;Lara Z. Chehab MPH ,&nbsp;Christiana D. von Hippel ScD, MPH ,&nbsp;Marissa A. Boeck MD, MPH ,&nbsp;Amanda Sammann MD, MPH","doi":"10.1016/j.jsurg.2025.103855","DOIUrl":"10.1016/j.jsurg.2025.103855","url":null,"abstract":"<div><h3>Background</h3><div>Trauma-informed care (TIC) is a strengths-based framework aimed at preventing retraumatization in healthcare, particularly within trauma centers. However, barriers to effective TIC training hinder its adoption.</div></div><div><h3>Study Design</h3><div>An exploratory prospective study was performed between November 2023 and March 2024 using Human-Centered Design (HCD) methodology to evaluate a previously implemented trauma-informed care curriculum (TICC) pilot. This study focused on the “Inspiration Phase” of HCD which included semi-structured interviews with course participants and instructors to identify limitations of TIC curricular content and implementation barriers. Data was inductively analyzed to identify themes, insight statements and design opportunities.</div></div><div><h3>Results</h3><div>Semi-structured interviews were conducted with 18 individuals (11 course instructors and 7 participants). Twenty themes were identified that led to the generation of 8 insight statements and corresponding design opportunities that were sorted into curricular content or implementation strategies. Curricular content insights highlighted the need for clearer definitions and protocols for TIC, practical and actionable guidance for learners, content that is both relevant and adaptable, and greater utilization of lived experience experts. Implementation insights identified that success requires institutional support, recognizing clinician empathy as a strength that is susceptible to vicarious trauma, and prioritizing flexible delivery while creating psychologically safe learning environments.</div></div><div><h3>Conclusions</h3><div>Using a HCD approach, this study represents the “Inspiration Phase” of this work and identifies the need to address educational didactics and implementation strategy. These insight statements and design opportunities set the stage for the “Ideation Phase” to support prototyping and piloting a revised curriculum with the goal of creating a user-informed TIC training implementation guide that can be disseminated for national use.</div></div>","PeriodicalId":50033,"journal":{"name":"Journal of Surgical Education","volume":"83 5","pages":"Article 103855"},"PeriodicalIF":2.1,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146192938","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Creating a Needs Based Curriculum to Support General Surgery Preliminary Residents","authors":"Shannon Barter MD,&nbsp;Cynthia K. Shortell MD,&nbsp;Alisan Fathalizadeh MD, MPH,&nbsp;Katharine L. Jackson MBBS","doi":"10.1016/j.jsurg.2026.103878","DOIUrl":"10.1016/j.jsurg.2026.103878","url":null,"abstract":"<div><h3>Objective</h3><div>To understand the needs of non-designated preliminary residents (NDPRs) at our general surgery residency program and develop a support program to address their needs.</div></div><div><h3>Design</h3><div>A needs-based peer support program was piloted for NDPR.</div></div><div><h3>Setting</h3><div>A single academic institution with 6 preliminary first-year resident positions (2 designated, 4 undesignated) and the option for preliminary second-year positions.</div></div><div><h3>Methods</h3><div>NDPR residents from the last 7 years were asked to share their positive and negative experiences. The topics discussed were recruitment, clinical rotations, support, mentors, letters of recommendation, and finding a subsequent position. Input was solicited regarding visa concerns, differences in treatment from categorical residents, and suggestions on how to improve the NDPR experience. Responses were reviewed to develop a year-long curriculum that involved protected meeting time for the residents.</div></div><div><h3>Results</h3><div>Nine of 17 former NDPR residents provided feedback on their experience in person, by phone, or by email. Areas identified to better support NDPR residents included tailored schedules to allow exposure to specialties of interest and obtaining letters of recommendation before the application cycle. A recurrent theme was transparency, both in the expectations of the NDPR resident role and the likelihood of becoming a categorical resident. Mentorship from previous NDPR residents and supportive faculty was one of the driving factors in creating a curriculum to provide formalized support. This curriculum featured monthly meetings for the first 3 months, followed by alternate months to foster peer support and faculty leadership check-ins. Sessions covered orientation to the preliminary year, a networking event with key faculty, obtaining letters, selecting programs, feedback for the program, and a year-end celebration.</div></div><div><h3>Conclusions</h3><div>NDPR residents play a crucial role in surgery programs and, in exchange, warrant the support and mentorship from the institution to promote success in their future careers. We present a piloted NDPR resident support program that can be individualized to residency programs specific needs.</div></div>","PeriodicalId":50033,"journal":{"name":"Journal of Surgical Education","volume":"83 5","pages":"Article 103878"},"PeriodicalIF":2.1,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146192937","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Feasibility and Utility of Vascular Surgery Entrustable Professional Activities: A Multi-InstitutionalPilot Study","authors":"Thomas Serena DO ,&nbsp;M. Libby Weaver MD ,&nbsp;Ting Sun PhD ,&nbsp;Kristyn Mannoia MD ,&nbsp;Michael C. Soult MD ,&nbsp;Yana Etkin MD ,&nbsp;Raghu Motaganahalli MD ,&nbsp;Brigitte K. Smith MD, MHPE","doi":"10.1016/j.jsurg.2026.103885","DOIUrl":"10.1016/j.jsurg.2026.103885","url":null,"abstract":"&lt;div&gt;&lt;h3&gt;Objective&lt;/h3&gt;&lt;div&gt;Entrustable professional activities (EPAs) have been embraced by the medical education community as a framework to guide competency-based education systems. The Vascular Surgery Board and Association for Program Directors in Vascular Surgery collaborated on the development of 15 vascular surgery EPAs, covering the core clinical activities of a vascular surgeon. We sought to explore engagement and perceptions of feasibility and utility of EPA assessment implementation for participants in a national, multi-institutional pilot.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Design&lt;/h3&gt;&lt;div&gt;Faculty assessment and trainee self-assessment of 15 vascular surgery EPAs were rated on a 4-point entrustment scale: 1 = limited participation, 2 = direct supervision, 3 = indirect supervision, and 4 = practice-ready, with accompanying behavioral anchors describing the actions expected of a learner at each level. Following an introductory webinar, the American Board of Surgery EPA Application assessment tool (delivered via SIMPL) was provided to all participating programs. Surveys evaluating the perceived feasibility and utility of the EPAs were developed. The surveys were distributed to pilot participants via email in June 2024 and responses were collected using Qualtrics. For Likert-scale items, descriptive statistics were calculated. For open-ended responses, thematic analysis was conducted to explore perceptions of respondents. This retrospective cohort study received an exemption determination from the University of Utah Institutional Review Board prior to the initiation of study procedures.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Setting&lt;/h3&gt;&lt;div&gt;This was a national, multi-institutional study. Participating programs included both academic, community, and hybrid programs.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Participants&lt;/h3&gt;&lt;div&gt;Thirty institutions (22 fellowship, 27 residency programs) participated in the pilot. Post-pilot surveys were completed by 89 participants, including 22 program directors (Response rate 73%), 13 program managers (Response rate 43%), 26 trainees, and 28 faculty.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Results&lt;/h3&gt;&lt;div&gt;A total of 2746 EPA assessments were completed by faculty and trainees during the pilot. Regarding ease of integration of EPA assessments into perioperative workflow, 92% of trainees and 96% of faculty had neutral or positive responses. Eight four percent of trainees agreed that they were comfortable initiating EPA assessments. Seventy seven percent of trainees felt that EPA data would help them to set learning goals and 77% felt that EPA assessments helped them identify areas for improvement. For faculty, 74% felt the EPA assessments helped them identify topics on which to provide feedback.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Conclusions&lt;/h3&gt;&lt;div&gt;This study demonstrates the feasibility and utility of EPA workplace-based assessment implementation at a diverse subset of vascular surgery training programs. Integration into usual clinical workflow was viewed as easy by both faculty and trainee","PeriodicalId":50033,"journal":{"name":"Journal of Surgical Education","volume":"83 5","pages":"Article 103885"},"PeriodicalIF":2.1,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146192939","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Generative AI as Librarian: A New Model for Surgical Education","authors":"Jack A. Olmstead PhD ,&nbsp;Andrew Yousef MD ,&nbsp;Peter Eskander MD ,&nbsp;Deborah Watson MD","doi":"10.1016/j.jsurg.2025.103862","DOIUrl":"10.1016/j.jsurg.2025.103862","url":null,"abstract":"<div><div>Generative artificial intelligence (GAI) is anticipated to transform medical education, and many studies have already been published reporting its effectiveness, accuracy, and feasibility as a “tutor” to help medical students learn in different didactic contexts. This perspective reviews this literature and highlights an understudied use-case for GAI: helping medical students to prepare for context-specific intraoperative learning during surgical clerkships. We propose a “librarian,” rather than tutor, method for GAI deployment in undergraduate medical education, where students dictate their learning objectives and receive specific direction to guide their individualized preparation, instead of the passive reception of didactic information which defines tutor-GAI use. We describe the librarian-GAI model in practical terms, providing template queries and prompt-engineering guidance for learners.</div></div>","PeriodicalId":50033,"journal":{"name":"Journal of Surgical Education","volume":"83 4","pages":"Article 103862"},"PeriodicalIF":2.1,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146121338","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Getting It Done and Done Well: A Mixed-Methods Analysis of the Pitfalls and Success Factors for Professional Development Experiences During Surgical Residency","authors":"Nathan A. Coppersmith MD ,&nbsp;Emily Flom MD ,&nbsp;Andrew C. Esposito MD ,&nbsp;Christina Bailey MD ,&nbsp;Nicole Brooks MD ,&nbsp;Michael Goodman MD ,&nbsp;Donald Hess MD ,&nbsp;Patrick Jackson MD ,&nbsp;Stephen Kavic MD ,&nbsp;Tara Kent MD ,&nbsp;Gurjit Sandhu PhD ,&nbsp;Natalie Wall MD ,&nbsp;Paul Wise MD ,&nbsp;Erin M. White MD ,&nbsp;Peter S. Yoo MD","doi":"10.1016/j.jsurg.2025.103858","DOIUrl":"10.1016/j.jsurg.2025.103858","url":null,"abstract":"<div><h3>Objective</h3><div>This report characterizes the scholarship undertaken during surgical trainee professional development time (PDT), identifies factors that promote and impede success, and develops recommendations to guide planning the PDT.</div></div><div><h3>Design</h3><div>This study utilized a mixed-methods approach. A novel survey instrument was distributed to 11 university-based institutions. Descriptive statistics were performed and 2 questions with an open-ended response were analyzed through inductive coding. A series of virtual semi-structured interviews of 1 or more surgical resident(s) were also conducted. Each interview was thematically analyzed by 2 coders and a thematic-phenomenological approach was used to understand the experiences of the trainees.</div></div><div><h3>Setting</h3><div>11 university-based institutions.</div></div><div><h3>Participants</h3><div>Surgical trainees who completed at least 1 year of PDT.</div></div><div><h3>Results</h3><div>The survey achieved a response rate of 30.1% (59/196). Nearly a quarter (24.6%) of respondents completed 10+ first-author publications, and 19.3% produced 1. Most mentors and trainees agreed on a PDT timeline (63.2%). Over half the trainees have projects<strong>/</strong>manuscripts from their PDT they planned to finish while clinical and have since abandoned (50.9%). The 8 themes identified from the qualitative analysis were framework, mentorship, PDT epistemological stance, project identification, change in projects, project management, research challenges, and return to clinical work. A resulting evidence-based rubric of recommendations to maximize the PDT is detailed.</div></div><div><h3>Conclusions</h3><div>The majority of trainees re-enter clinical time with research projects remaining and many of these projects are ultimately abandoned. This mixed-methods study provides the basis for improving planning of the PDT, thereby allowing enhancement of both productivity and satisfaction.</div></div>","PeriodicalId":50033,"journal":{"name":"Journal of Surgical Education","volume":"83 4","pages":"Article 103858"},"PeriodicalIF":2.1,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146080854","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Augmenting Surgical Preparation: How Learners Use Artificial Intelligence to Prepare for the Operating Room","authors":"Gunseli Wallace ,&nbsp;Kelsey Eaton ,&nbsp;Chelsey Witsberger ,&nbsp;Lauren A. Bohm","doi":"10.1016/j.jsurg.2025.103861","DOIUrl":"10.1016/j.jsurg.2025.103861","url":null,"abstract":"<div><h3>Introduction</h3><div>Surgical trainees are increasingly using large language models (LLMs) for clinical and surgical preparation. However, there has been less discussion about the specific ways learners are utilizing artificial intelligence in pursuit of surgical competence. Adding challenge, the rapid pace of advancement has made it difficult for educators to remain aware of the different systems available and the best practices for their utilization.</div></div><div><h3>Methods</h3><div>Using relevant surgical preparation scenarios, we discuss several custom learning tools that can be created by LLMs today. We then demonstrate three principles for success using specific examples: selecting the “best” LLM, having clear learning goals, and providing sufficient context. Finally, we discuss current limitations of working with LLMs including hallucinations, bias, and sycophancy.</div></div><div><h3>Conclusions</h3><div>Effective LLM utilization transforms the interaction from simple informational exchange to an active learning experience. By providing clear examples and approaches, we hope to both make these systems more approachable for educators, as well as inspire learners to create their own custom tools.</div></div>","PeriodicalId":50033,"journal":{"name":"Journal of Surgical Education","volume":"83 4","pages":"Article 103861"},"PeriodicalIF":2.1,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146115371","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"How You Say It Matters: Using Growth Mindset to Improve Faculty Feedback And Resident Motivation","authors":"Michael J. Furey DO, MSMED ,&nbsp;Jamaica A. Westfall-Snyder MD ,&nbsp;Jennifer Fieber MD ,&nbsp;Mohsen Shabahang MD, PhD ,&nbsp;Christie Buonpane MD ,&nbsp;BobbieAnn White EdD, MA ,&nbsp;Rahul Kashyap MBBS, MBA ,&nbsp;Rebecca L. Hoffman MD, MSCE","doi":"10.1016/j.jsurg.2025.103825","DOIUrl":"10.1016/j.jsurg.2025.103825","url":null,"abstract":"<div><h3>BACKGROUND</h3><div>“Satisfaction with faculty feedback” scored the lowest on the 2024 ACGME survey nationally. Providing meaningful feedback to residents remains a hurdle, with limited research focusing specifically on language. Yet, growth mindset language (GML) defined as language implying intelligence and skills can be developed with effort, has been shown to enhance students’ intrinsic motivation. The aims of this study were to understand resident and faculty language preferences for GML and fixed mindset language (FML) in FS and characterize the impact of GML and FML statements on resident motivation.</div></div><div><h3>METHODS</h3><div>A multi-institutional study of surgical residents and faculty was conducted using a three-part survey. In parts 1-2, FS pairs contrasting GML and FML commonly encountered within trainee written and verbal feedback were presented. Statements were designed based on previously encountered FS provided to trainees. In part 1, residents were asked to select phrases presented in the way they would most like to receive it, and faculty were asked to select phrases presented in the way they thought learners would be most receptive to. In part 2, all participants were presented with GML and FML phrases and asked to select the phrases that encouraged the most growth and improvement. In part 3, participants responded to FS, which included both GML and FML, by indicating their emotions triggered and rating each statement’s impact on their motivation. Descriptive statistics and univariate analyses were performed.</div></div><div><h3>RESULTS</h3><div>A total of 152 surveys were completed by 84 residents (PGY 1-8, 63.1% males, mean age 30.3 ± 2.5), and 68 faculty (ranging from &lt;5 to 20+ years practicing, 64.7% males) across multiple states and programs. In 100% of juxtaposed GML/FML statements, the GML statement was chosen by both faculty and residents. Faculty and residents found FS using GML to encourage the most growth/improvement. Statements with GML generated the highest levels of motivation. Approximately two-thirds of residents and faculty felt strongly about the importance of FS language. Overall, participants selected that FS language affects motivation for learning (R-85.7%, F-97.1%), mood/wellbeing (R-89.3%, F-86.8%), and relationships with faculty (R-82.1%, F-89.7%).</div></div><div><h3>CONCLUSION</h3><div>To our knowledge, this is the first study evaluating perceptions of feedback using GML and FML in surgery residents and attending surgeons, and to link the use of GML to trainee motivation. Our results suggest that GML was greatly preferred over FML in FS by both residents and attendings specifically because of factors including motivation for learning, impact on wellbeing and improving relationships with faculty. Faculty development on the utilization of GML can be undertaken with confidence given the positive perceived effect on motivation.</div></div>","PeriodicalId":50033,"journal":{"name":"Journal of Surgical Education","volume":"83 4","pages":"Article 103825"},"PeriodicalIF":2.1,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146039682","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cognitive Training for Performance Enhancement in Robotic Surgery: A Systematic Review of RCTs","authors":"Samy Castillo-Flores MD ,&nbsp;Andres A. Abreu MD ,&nbsp;Patricia Viana MD ,&nbsp;Maria Meritxell Roca Mora MD ,&nbsp;Isabella Faria MD ,&nbsp;Patricio M. Polanco MD","doi":"10.1016/j.jsurg.2026.103882","DOIUrl":"10.1016/j.jsurg.2026.103882","url":null,"abstract":"<div><h3>Objective</h3><div>To evaluate the effect of cognitive training (CT) compared to standard non-cognitive training on surgical performance in robotic surgery.</div></div><div><h3>Design</h3><div>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.</div></div><div><h3>Setting</h3><div>All studies took place in institutional training environments using simulation platforms.</div></div><div><h3>Participants</h3><div>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.</div></div><div><h3>Results</h3><div>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 &lt; 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.</div></div><div><h3>Conclusions</h3><div>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.</div></div>","PeriodicalId":50033,"journal":{"name":"Journal of Surgical Education","volume":"83 4","pages":"Article 103882"},"PeriodicalIF":2.1,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146168740","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Educational Impact of Automated Feedback Systems in Surgical Training: A Systematic Review With Quantitative Synthesis","authors":"Gauri Harshawardhan Godbole MSc ,&nbsp;Daniel Hawkins MSc ,&nbsp;Kingsley Ewool MBcHB, MSc, MRCS ,&nbsp;Mauro Henrique Batista Camacho MD, MSc ,&nbsp;Rezaul Karim MBBS, MRCS, MSc ,&nbsp;Bijendra Patel MBBS, MS, FRCS","doi":"10.1016/j.jsurg.2026.103879","DOIUrl":"10.1016/j.jsurg.2026.103879","url":null,"abstract":"<div><h3>Objective</h3><div>To evaluate the impact of automated feedback systems (AFS) on technical surgical skill acquisition in individuals undergoing surgical skills training.</div></div><div><h3>Design</h3><div>PRISMA-guided systematic review of studies published between May 2013 and December 2024. Four databases were searched. Eligible studies compared AFS with no feedback or assessed the impact of AFS on technical skill. Risk of bias was assessed using ROB-2 and ROBINS-I, and certainty of evidence with GRADE. The review was prospectively registered with PROSPERO (CRD420251058650).</div></div><div><h3>Setting</h3><div>Simulation-based training environments, including bench models and virtual reality simulators.</div></div><div><h3>Participants</h3><div>Fourteen studies involving 814 trainees were included.</div></div><div><h3>Results</h3><div>All studies reported improvement in technical skills with AFS; 9 demonstrated significant within-group gains, with a mean improvement of 38.1% (p = 0.0046). Six studies contributed to pooled analysis, showing a moderate-to-large benefit (Hedges’ <em>g</em> = 0.81, 95% CI: 0.45-1.00, p &lt; 0.0001). Secondary outcomes consistently favored AFS: learner satisfaction increased by 60% (MD = 1.16, 95% CI: 0.65-1.67, p &lt; 0.01), path length decreased by 41% (95% CI: 10.3%-71.7%, p = 0.02), speed improved by 9.4% (MD = 3.1 mm/s, 95% CI: 0.4-5.8, p = 0.04), and applied force was reduced by 11.8% (95% CI: 4.5%-19.2%, p = 0.01).</div></div><div><h3>Conclusions</h3><div>AFS are associated with moderate-to-large improvements in technical performance, particularly for foundational repetitive surgical tasks. While gains are often task-specific and largely confined to simulation settings, evidence supports AFS as a valuable adjunct to early surgical training. Integration into structured programmes, alongside expert oversight and contextual teaching, is essential to maximize benefit and ensure safe transferability to clinical practice. Small study numbers, task-specific designs, and heterogeneity limit interpretation.</div></div>","PeriodicalId":50033,"journal":{"name":"Journal of Surgical Education","volume":"83 4","pages":"Article 103879"},"PeriodicalIF":2.1,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146168678","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}