PMID- 31953730 OWN - NLM STAT- MEDLINE DCOM- 20210521 LR - 20210525 IS - 1432-2218 (Electronic) IS - 0930-2794 (Linking) VI - 34 IP - 12 DP - 2020 Dec TI - Use of prefrontal cortex activity as a measure of learning curve in surgical novices: results of a single blind randomised controlled trial. PG - 5604-5615 LID - 10.1007/s00464-019-07331-7 [doi] AB - BACKGROUND: Neurobiological feedback in surgical training could translate to better educational outcomes such as measures of learning curve. This work examined the variation in brain activation of medical students when performing laparoscopic tasks before and after a training workshop, using functional near-infrared spectroscopy (fNIRS). METHODS AND PROCEDURES: This single blind randomised controlled trial examined the prefrontal cortex activity (PFCA) differences in two groups of novice medical students during the acquisition of four laparoscopic tasks. Both groups were shown a basic tutorial video, with the "Trained-group" receiving an additional standardised one-to-one training on the tasks. The PFCA was measured pre- and post-intervention using a portable fNIRS device and reported as mean total oxygenated hemoglobin (HbOmicrom). Primary outcome of the study is the difference in HbOmicrom between post- and pre-intervention readings for each of the four laparoscopic tasks. The pre- and post-intervention laparoscopic tasks were recorded and assessed by two blinded individual assessors for objective scores of the performance. RESULTS: 16 Trained and 16 Untrained, right-handed medical students with an equal sex distribution and comparable age distribution were recruited. Trained group had an attenuated left PFCA in the "Precision cutting" (p = 0.007) task compared to the Untrained group. Subgroup analysis by sex revealed attenuation in left PFCA in Trained females compared to Untrained females across two laparoscopic tasks: "Peg transfer" (p = 0.005) and "Precision cutting" (p = 0.003). No significant PFCA attenuation was found in male students who underwent training compared to Untrained males. CONCLUSION: A standardised laparoscopic training workshop promoted greater PFCA attenuation in female medical students compared to males. This suggests that female and male students respond differently to the same instructional approach. Implications include a greater focus on one-to-one surgical training for female students and use of PFCA attenuation as a form of neurobiological feedback in surgical training. FAU - Khoe, Howard C H AU - Khoe HCH AUID- ORCID: 0000-0002-8012-4884 AD - Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore. howardkhoe@gmail.com. FAU - Low, Jun Wei AU - Low JW AD - Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore. FAU - Wijerathne, Sujith AU - Wijerathne S AD - Minimally Invasive Surgery Centre, National University Hospital, Singapore, Singapore. FAU - Ann, Lui Su AU - Ann LS AD - Minimally Invasive Surgery Centre, National University Hospital, Singapore, Singapore. FAU - Salgaonkar, Hrishikesh AU - Salgaonkar H AD - Minimally Invasive Surgery Centre, National University Hospital, Singapore, Singapore. FAU - Lomanto, Davide AU - Lomanto D AD - Minimally Invasive Surgery Centre, National University Hospital, Singapore, Singapore. FAU - Choi, JongKwan AU - Choi J AD - OBELAB, Inc, Seoul, South Korea. FAU - Baek, JiYeong AU - Baek J AD - OBELAB, Inc, Seoul, South Korea. FAU - Tam, Wilson W AU - Tam WW AD - Alice Lee Centre for Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore. FAU - Pei, Ho AU - Pei H AD - University Surgical Cluster, Department of Cardio-Thoracic & Vascular Surgery, National University Hospital, Singapore, Singapore. FAU - Ho, Roger C M AU - Ho RCM AD - Institute for Health Innovation & Technology (iHealthtech), National University of Singapore (NUS), Singapore, 117599, Singapore. AD - Centre of Excellence in Behavioral Medicine, Nguyen Tat Thanh University (NTTU), Ho Chi Minh City, 70000, Vietnam. AD - Faculty of Education, Huaibei Normal University, 100 Dongshan Road, Huaibei, 235000, Anhui, China. AD - Department of Psychological Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, 119228, Singapore. LA - eng PT - Journal Article PT - Randomized Controlled Trial DEP - 20200117 PL - Germany TA - Surg Endosc JT - Surgical endoscopy JID - 8806653 SB - IM MH - Adult MH - Clinical Competence MH - Female MH - Humans MH - Laparoscopy MH - *Learning Curve MH - Male MH - Prefrontal Cortex/*physiopathology MH - Single-Blind Method MH - *Students, Medical MH - Surgical Procedures, Operative/*education MH - Young Adult OTO - NOTNLM OT - Cortical activation OT - Functional near-infrared spectroscopy (fNIRS) OT - Laparoscopic skill OT - Medical education OT - Prefrontal cortex OT - Sex differences EDAT- 2020/01/19 06:00 MHDA- 2021/05/22 06:00 CRDT- 2020/01/19 06:00 PHST- 2019/07/09 00:00 [received] PHST- 2019/12/24 00:00 [accepted] PHST- 2020/01/19 06:00 [pubmed] PHST- 2021/05/22 06:00 [medline] PHST- 2020/01/19 06:00 [entrez] AID - 10.1007/s00464-019-07331-7 [pii] AID - 10.1007/s00464-019-07331-7 [doi] PST - ppublish SO - Surg Endosc. 2020 Dec;34(12):5604-5615. doi: 10.1007/s00464-019-07331-7. Epub 2020 Jan 17.