M1 transcranial direct current stimulation augments laparoscopic surgical skill acquisition

The acquisition of basic surgical skills is a key component of medical education and trainees in laparoscopic surgery typically begin developing their skills using simulation box trainers. However, despite the advantages of simulation surgical training, access can be difcult for many trainees. One technique that has shown promise to enhance the deliberate practice of motor skills is transcranial electric stimulation (tES). The purpose of this study was to assess the impact of transcranial direct current stimulation (tDCS) on training induced improvements and retention of traditional time and kinematic based laparoscopic surgical skill metrics. Forty-nine medical students were randomly allocated to a neurostimulation or sham group and completed 5 training sessions of a bead transfer and threading laparoscopic task. Participants in both the sham and stimulation groups signifcantly improved their time and kinematic performance on both tasks following training. Although we did fnd that participants who received M1 tDCS saw greater performance benefts in response to training on a bead transfer task compared to those receiving sham stimulation no efect of neurostimulation was found for the threading task. This fnding raises new questions regarding the efect that motor task complexity has on the efcacy of neurostimulation to augment training induced improvement and contributes to a growing body of research investigating the efects of neurostimulation on the sensory-motor performance of laparoscopic surgical skill.