Brain activation during laparoscopic tasks in high- and low-performing medical students: a pilot fMRI study
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Brain activation during laparoscopic tasks in high‑ and low‑performing medical students: a pilot fMRI study Alaina Garbens1 · Bonnie A. Armstrong2 · Marisa Louridas1 · Fred Tam3 · Allan S. Detsky4,5 · Tom A. Schweizer6,7,8 · Simon J. Graham3,9 · Teodor Grantcharov1 Received: 25 July 2019 / Accepted: 11 November 2019 © Springer Science+Business Media, LLC, part of Springer Nature 2019
Abstract Background Up to 20% of medical students are unable to reach competency in laparoscopic surgery. It is unknown whether these difficulties arise from heterogeneity in neurological functioning across individuals. We sought to examine the differences in neurological functioning during laparoscopic tasks between high- and low-performing medical students using functional magnetic resonance imaging (fMRI). Methods This prospective cohort study enrolled North American medical students who were within the top 20% and bottom 20% of laparoscopic performers from a previous study. Brain activation was recorded using fMRI while participants performed peg-pointing, intracorporeal knot tying (IKT), and the Pictorial Surface Orientation (PicSOr) test. Brain activation maps were created and areas of activation were compared between groups. Results In total, 9/12 high and 9/13 low performers completed the study. High performers completed IKT faster and made more successful knot ties than low performers [standing: 23.5 (5.0) sec vs. 37.6 (18.4) sec, p = 0.03; supine: 23.2 (2.5) sec vs. 72.7 (62.8) sec, p = 0.02; number of successful ties supine, 3 ties vs. 1 tie, p = 0.01]. Low performers showed more brain activation than high performers in the peg-pointing task (q
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