Journal of Surgical Simulation 2021; 8: A: 19 - 19

Published: 30 June 2021


Meeting abstract

Special Issue: Cognitive task analysis-based training in surgery: a systematic review and meta-analysis

Alexander W. Coombs, Thomas C. Edwards, Bartosz Szyszka, Kartik Logishetty and Justin P. Cobb
Corresponding author: Alexander W Coombs, MSk Lab, Imperial College London, UK. Email:


Reduced learning opportunities inside the operating theatre has made the acquirement of cognitive skills in surgery increasingly challenging for modern trainees. Cognitive task analysis-based training (CTA-based training) has been investigated as a potential solution to gain these skills, through the use of courses and procedural simulation methods such as interactive multimedia tools. This systematic review aims to evaluate if CTA-based training is effective at teaching surgical procedures to novices. A systematic review designed in accordance with PRISMA guidelines, used four databases including OVID, EMBASE, Web of Science and Cochrane (CENTRAL) to search for relevant articles. The discovered articles were evaluated for study inclusion by two independent reviewers. All studies meeting the full eligibility criteria were assessed for methodological rigor and risk of bias using RoB 2, ROBINS-I and MERSQI tool. Meta-analyses were performed using the random-effects model. Twelve articles met the review’s pre-defined inclusion criteria. Surgical trainees who were enrolled into CTA-based training groups had enhanced procedural knowledge (standardized mean difference [SMD] 1.36, 95% confidence intervals [CI] 0.67-2.05, p < 0.001) and superior technical performance (SMD 2.06, 95% CI 1.17-2.96, p < 0.001) in comparison with groups that used conventional training. Simulation methods of delivering CTA-based training using multimedia web-based tools and mobile phone applications were the predominant choice for study investigators after 2014. The quality of included studies was moderate-to-high with a mean MERSQI score of 13.3 (out of 18).


cognitive skills; cognitive task analysis; surgical training; CTA-based training

Additional Information

This presentation was given at the SES 2020 online conference, 4 July 2020.