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The research catalogue is an archive of ESRC-funded grants and outputs. Links, files and other content will no longer be maintained or updated after April 2014.

'Bilateral (Hong Kong):' Gaze strategies of laparoscopy surgeons: Observational learning, implicit knowledge and performance in demanding conditions

Grant reference: RES-000-22-3016

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Journal article details

Implicit motor learning promotes neural efficiency during laparoscopy
An understanding of differences in expert and novice neural behavior can inform surgical skills training. Outside the surgical domain, electroencephalographic (EEG) coherence analyses have shown that during motor performance, experts display less coactivation between the verbal-analytic and motor planning regions than their less skilled counterparts. Reduced involvement of verbal-analytic processes suggests greater neural efficiency. The authors tested the utility of an implicit motor learning intervention specifically devised to promote neural efficiency by reducing verbal-analytic involvement in laparoscopic performance. In this study, 18 novices practiced a movement pattern on a laparoscopic trainer with either conscious awareness of the movement pattern (explicit motor learning) or suppressed awareness of the movement pattern (implicit motor learning). In a retention test, movement accuracy was compared between the conditions, and coactivation (EEG coherence) was assessed between the motor planning (Fz) region and both the verbal-analytic (T3) and the visuospatial (T4) cortical regions (T3-Fz and T4-Fz, respectively). Movement accuracy in the conditions was not different in a retention test (P = 0.231). Findings showed that the EEG coherence scores for the T3-Fz regions were lower for the implicit learners than for the explicit learners (P = 0.027), but no differences were apparent for the T4-Fz regions (P = 0.882). Conclusions Implicit motor learning reduced EEG coactivation between verbal-analytic and motor planning regions, suggesting that verbal-analytic processes were less involved in laparoscopic performance. The findings imply that training techniques that discourage nonessential coactivation during motor performance may provide surgeons with more neural resources with which to manage other aspects of surgery.

Primary contributor

Author Frank Zhu

Additional contributors

Co-author Jamie M. Poolton
Co-author Mark R. Wilson
Co-author Yong Hu
Co-author Jon P. Maxwell
Co-author Rich S.W. Masters

Additional details

01 September 2011
New York, NY
Surgical endoscopy


Zhu_implicit.pdf (.pdf / 286kb)

Cite this outcome


Zhu, Frank et al (2011) Implicit motor learning promotes neural efficiency during laparoscopy. Surgical endoscopy. 25 (9), pp. 2950-2955 New York, NY: Springer.


Zhu Frank et al. Implicit motor learning promotes neural efficiency during laparoscopy. Surgical endoscopy 2011; 25 (9): 2950-2955.