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Effects of transcranial direct‐current stimulation on laparoscopic surgical skill acquisition

BACKGROUND: Changes in medical education may limit opportunities for trainees to gain proficiency in surgical skills. Transcranial direct‐current stimulation (tDCS) can augment motor skill learning and may enhance surgical procedural skill acquisition. The aim of this study was to determine the effe...

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Autores principales: Ciechanski, P., Cheng, A., Damji, O., Lopushinsky, S., Hecker, K., Jadavji, Z., Kirton, A.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: John Wiley & Sons, Ltd 2018
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5989997/
https://www.ncbi.nlm.nih.gov/pubmed/29951631
http://dx.doi.org/10.1002/bjs5.43
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author Ciechanski, P.
Cheng, A.
Damji, O.
Lopushinsky, S.
Hecker, K.
Jadavji, Z.
Kirton, A.
author_facet Ciechanski, P.
Cheng, A.
Damji, O.
Lopushinsky, S.
Hecker, K.
Jadavji, Z.
Kirton, A.
author_sort Ciechanski, P.
collection PubMed
description BACKGROUND: Changes in medical education may limit opportunities for trainees to gain proficiency in surgical skills. Transcranial direct‐current stimulation (tDCS) can augment motor skill learning and may enhance surgical procedural skill acquisition. The aim of this study was to determine the effects of tDCS on simulation‐based laparoscopic surgical skill acquisition. METHODS: In this double‐blind, sham‐controlled randomized trial, participants were randomized to receive 20 min of anodal tDCS or sham stimulation over the dominant primary motor cortex, concurrent with Fundamentals of Laparoscopic Surgery simulation‐based training. Primary outcomes of laparoscopic pattern‐cutting and peg transfer tasks were scored at baseline, during repeated performance over 1 h, and again at 6 weeks. Intent‐to‐treat analysis examined the effects of treatment group on skill acquisition and retention. RESULTS: Of 40 participants, those receiving tDCS achieved higher mean(s.d.) final pattern‐cutting scores than participants in the sham group (207·6(30·0) versus 186·0(32·7) respectively; P = 0·022). Scores were unchanged at 6 weeks. Effects on peg transfer scores were not significantly different (210·2(23·5) in the tDCS group versus 201·7(18·1) in the sham group; P = 0·111); the proportion achieving predetermined proficiency levels was higher for tDCS than for sham stimulation. Procedures were well tolerated with no serious adverse events and no decreases in motor measures. CONCLUSION: The addition of tDCS to laparoscopic surgical training may enhance skill acquisition. Trials of additional skills and translation to non‐simulated performance are required to determine the potential value in medical education and impact on patient outcomes. Registration number: NCT02756052 (https://clinicaltrials.gov/).
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spelling pubmed-59899972018-06-27 Effects of transcranial direct‐current stimulation on laparoscopic surgical skill acquisition Ciechanski, P. Cheng, A. Damji, O. Lopushinsky, S. Hecker, K. Jadavji, Z. Kirton, A. BJS Open Original Articles BACKGROUND: Changes in medical education may limit opportunities for trainees to gain proficiency in surgical skills. Transcranial direct‐current stimulation (tDCS) can augment motor skill learning and may enhance surgical procedural skill acquisition. The aim of this study was to determine the effects of tDCS on simulation‐based laparoscopic surgical skill acquisition. METHODS: In this double‐blind, sham‐controlled randomized trial, participants were randomized to receive 20 min of anodal tDCS or sham stimulation over the dominant primary motor cortex, concurrent with Fundamentals of Laparoscopic Surgery simulation‐based training. Primary outcomes of laparoscopic pattern‐cutting and peg transfer tasks were scored at baseline, during repeated performance over 1 h, and again at 6 weeks. Intent‐to‐treat analysis examined the effects of treatment group on skill acquisition and retention. RESULTS: Of 40 participants, those receiving tDCS achieved higher mean(s.d.) final pattern‐cutting scores than participants in the sham group (207·6(30·0) versus 186·0(32·7) respectively; P = 0·022). Scores were unchanged at 6 weeks. Effects on peg transfer scores were not significantly different (210·2(23·5) in the tDCS group versus 201·7(18·1) in the sham group; P = 0·111); the proportion achieving predetermined proficiency levels was higher for tDCS than for sham stimulation. Procedures were well tolerated with no serious adverse events and no decreases in motor measures. CONCLUSION: The addition of tDCS to laparoscopic surgical training may enhance skill acquisition. Trials of additional skills and translation to non‐simulated performance are required to determine the potential value in medical education and impact on patient outcomes. Registration number: NCT02756052 (https://clinicaltrials.gov/). John Wiley & Sons, Ltd 2018-03-13 /pmc/articles/PMC5989997/ /pubmed/29951631 http://dx.doi.org/10.1002/bjs5.43 Text en © 2018 The Authors. BJS Open published by John Wiley & Sons Ltd on behalf of BJS Society Ltd This is an open access article under the terms of the http://creativecommons.org/licenses/by-nc/4.0/ License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited and is not used for commercial purposes.
spellingShingle Original Articles
Ciechanski, P.
Cheng, A.
Damji, O.
Lopushinsky, S.
Hecker, K.
Jadavji, Z.
Kirton, A.
Effects of transcranial direct‐current stimulation on laparoscopic surgical skill acquisition
title Effects of transcranial direct‐current stimulation on laparoscopic surgical skill acquisition
title_full Effects of transcranial direct‐current stimulation on laparoscopic surgical skill acquisition
title_fullStr Effects of transcranial direct‐current stimulation on laparoscopic surgical skill acquisition
title_full_unstemmed Effects of transcranial direct‐current stimulation on laparoscopic surgical skill acquisition
title_short Effects of transcranial direct‐current stimulation on laparoscopic surgical skill acquisition
title_sort effects of transcranial direct‐current stimulation on laparoscopic surgical skill acquisition
topic Original Articles
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5989997/
https://www.ncbi.nlm.nih.gov/pubmed/29951631
http://dx.doi.org/10.1002/bjs5.43
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