COGNITIVE SIMULATION  -  For surgeons across specialties


Other benefits

Cognitive simulation, in a broad sense, is like computer software, but a version designed for the human mind. It is a technique that programs the mind to respond in a certain manner. Perforce it has a wide range of applications.

1) Maintaining the level of skill

An experienced surgeon already knows how to execute a particular skill: the goal then is to increase the chances of perfectly executed movements whenever required. For them, the advantage of cognitive simulation is for maximizing the transfer of skills from experience to the actual performance.

2) Examining performance problems

Cognitive simulation goes well beyond mere intellectual activity, the thinking about or attempting to recall an event. When the action scene is 'switched on', the details of the event are activated. Unlike a movie experience, the performer is not just sitting and watching, but is actually experiencing the event. Cognitive simulation becomes a type of instant replay, enabling the performer to closely attend to what was happening. An application of this phenomenon is for the re-experiencing of a procedure that has gone wrong. Surgeons usually have their own take on what transpired during the difficult procedures, and some will be adamant about the accuracy of their recall, until shown a video replay.


A surgeon can scrutinise his below par performance by means of cognitive simulation to determine and detect the potentially confounding factor. He can then focus on why the error occurred and what could have been done to prevent it. It is important for him then to re-visualise the experience and substitute the correct response.

3) Preparing for a surgical procedure

Cognitive simulation can also find an application in preparations for surgical procedure especially if the procedure is uncommon or complex. The mental practice of a well-learned skill prior to an actual performance can influence the motivational system, e.g. to reduce anxiety or boost self-confidence. It could even be used to modify the cognitive system by consolidating the accurate sequencing of a complex series of movements.

4) Practicing psychological skills

The concept of mental skills training is new to surgery, although the importance of being able to cope with adversity has been known for a long time. Surgery involves performing both physically as well as mentally.
Usually surgeons acquire the coping strategies through experience or by trial and error rather than via any formal training. Cognitive simulation can accelerate and enhance the strategy evolving process, by systematically developing appropriate techniques for specific occasions.

5) Hindering the decay of skills

Individual physical ability drops with increasing age. Initially, advancing age is complemented by increased wisdom but eventually even mentation declines. First to wane is strength, then vision, agility, and lastly cognition. Knowledge, experience and reputation can compensate for a long time, and the decline is gradual so the surgeon or his colleagues may not notice the changes until the deficits become glaringly serious. Increasing age makes difficult surgery even more so and risky surgery riskier. Cognitive simulation can help to avoid the decline in performance.

6) Becoming familiar with unknown situations

At the elite levels of international sporting competitions, the venues are photographed for the benefit of competing athletes, who study photographs of the pools, fields, arenas, dressing rooms and even warm-up areas so that they can create effective images and see themselves performing there. This helps in familiarisation with the environment before the actual competition. Similarly, surgeons too can visualize unfamiliar operating theatres where they will be performing in the future.


Surgical Psychology Publishing
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