Journal of Surgical Simulation 2017; 4: B: 2 - 2

Published: 11 May 2017


Oral presentation

Special Issue: Cognitive simulation

Uttam Shiralkar and Sonia Bathla
Corresponding author: Sonia Bathla, St Helens and Knowsley Hospital NHS Trust, Warrington Road, Prescot. L35 5DR, UK. Email:


Cognitive simulation is an elite method of improving surgical skills, both in, and out of the operating theatre. It is an effective approach to reduce errors in procedures and a smart way to learn and teach operative techniques. Although it may be new in surgery, it is an established method of training in athletics.

To gain operative expertise surgeons need to invest considerable time, money and effort, and they are at the mercy of opportunity. If one chooses to invest time in understanding cognitive simulation, the only things needed are an open mind and a critical eye.

This approach has been shown to sharpen surgical skills, enhance performance and reduce stress. Moreover, it optimises every operative training experience a surgeon gets in an operating theatre or simulation centre, thereby aiding development when training time and exposure is so restricted.

Research in cognitive psychology has enhanced our understanding of surgical performance.  It has revealed why in spite of performing a procedure many times, some surgeons do not achieve expertise. It has also highlighted what can be done to make the most of training and how to shorten the surgical trainee's learning curve.

This innovative training offers evidence-based guidance that is applicable to any surgical specialty and is useful to a surgeon at any stage of a career.


cognitive simulation; mental rehearsal; surgical; training; skills

Additional Information

This presentation was given at a one day symposium: Current Approaches to Understanding Surgical Error, University of Leeds, Leeds, UK, on 9 December 2016.

Conflicts of interest: none declared.

Author affiliations
Uttam Shiralkar: Worcestershire Health and Care NHS Trust, UK.
Sonia Bathla: St Helens and Knowsley Hospital NHS Trust, Warrington Road, Prescot. L35 5DR, UK