INTRODUCTION Neuroimaging has the potential to illuminate our understanding in areas of surgical training and practice for which there remain on-going challenges and controversies, such as expertise development and skills training1-14. However, assessment of surgeons’ brain function was quiescent until approximately a decade ago, when advances in functional neuroimaging techniques made assessments of operator brain function during surgery both tangible and feasible (see Part I). Our team and other investigators have capitalised on developments that enable subjects to be freely mobile to execute complex manoeuvres and allow assessments of brain function in natural and challenging environments. Moreover, there is a critical mass of published research describing the added value of operator brain function in improving surgical training and enhancing patient safety, but which to date has not been reviewed in detail. The current review seeks to address this gap in the literature, specifically focusing on the following research questions: Are there differences in neuroimaging signals obtained from novice and expert surgeons during technical and non-technical skill performance, in which regions of the brain are these differences observed, and how does skills training influence these signals? How do interventions designed to enhance skill acquisition and/or surgical performance modulate brain signals in surgeons?
INTRODUCTION Neuroimaging has the potential to illuminate our understanding in areas of surgical training and practice for which there remain on-going challenges and controversies, such as expertise development and skills training1-14. However, assessment of surgeons’ brain function was quiescent until approximately a decade ago, when advances in functional neuroimaging techniques made assessments of operator brain function during surgery both tangible and feasible (see Part I). Our team and other investigators have capitalised on developments that enable subjects to be freely mobile to execute complex manoeuvres and allow assessments of brain function in natural and challenging environments. Moreover, there is a critical mass of published research describing the added value of operator brain function in improving surgical training and enhancing patient safety, but which to date has not been reviewed in detail. The current review seeks to address this gap in the literature, specifically focusing on the following research questions: Are there differences in neuroimaging signals obtained from novice and expert surgeons during technical and non-technical skill performance, in which regions of the brain are these differences observed, and how does skills training influence these signals? How do interventions designed to enhance skill acquisition and/or surgical performance modulate brain signals in surgeons?