Mental skills curriculum

An interdisciplinary team of master surgical educators, performance psychologists and experts in curriculum design have developed a mental skills curriculum for surgeons to teach surgeons skills to manage stress effectively in the operating room so they may optimize their performance. The curriculum, which has been studied rigorously and received an award for Excellence in Innovation in Surgical Education from the Association for Surgical Education, has repeatedly demonstrated that learning these skills helps surgical trainees effectively manage stressful situations to prevent performance impediments.

Mental Skills Workbook cover on a grey background

Curriculum

Our curriculum includes eight modules focused on core mental skills such as imagery, attention management and goal setting. It is currently offered to general surgery residents at IU School of Medicine.

Interactive courses combine didactic instruction with applied training and are available to practicing surgeons and healthcare providers at IU School of Medicine and IU Health. Courses may also be offered to external organizations.

Curriculum overview

Mental skills collaborative group

Our team has recently established a collaborative mental skills working group among performance psychologists, researchers and surgical faculty from institutions across the United States. The purpose of this working group is to leverage the collective interest and motivation of the team to identify opportunities to integrate mental skills at our various institutions, identify and overcome barriers to mental skills implementation and identify opportunities to pursue extramural funding. The group is open to academic professionals with a shared interest in mental skills curriculum development.

For more information, contact Nick Anton

Evidence of Effectiveness

Our curriculum has been studied rigorously, and our team has obtained a significant amount of evidence related to its effectiveness to reduce stress and mitigate performance impediments under heightened stress.

Check out some notable references from our work:

Anton NE, Mizota T, Whiteside J, Myers E, Bean E, Stefanidis D. Mental Skills Training Limits Operative Skill Decay Under Stressful Conditions: Results of a Multi-Site Randomized-Controlled Study. Surgery, 2019;165:1059-1064.
Anton NE, Bean EA, Myers E, Stefanidis D. Optimizing learner engagement during mental skills training: A pilot study of small group vs. individualized training. American Journal of Surgery, 2020;219:335-339.
Anton NE, Beane J, Yurco, A, Howley L, Bean E, Myers EM, Stefanidis D. Mental skills training effectively minimizes operative performance deterioration under stressful conditions: Results of a randomized controlled study. American Journal of Surgery, 2018;215:214-21.
Anton NE, Howley LD, Davis CK, Brown C, Stefanidis D. Minimizing deterioration of simulator-acquired skills during transfer to the operating room: A Novel Approach. Current Surgery Reports, 2017;5(8):16.
Stefanidis D, Anton NE, Howley LD, Bean E, Yurco A, Pimentel ME, Davis CK. Effectiveness of a comprehensive mental skills curriculum in enhancing surgical performance: Results of a randomized controlled trial. American Journal of Surgery, 2017;213(2):318-24.
Stefanidis D, Anton NE, Howley L, Pimentel M, Davis C, Brown C. Implementation results of a mental skills curriculum during simulator training. American Journal of Surgery, 2017;213(2):353-61.
Anton NE, Howley LD, Pimentel M, Davis CK, Brown C, Stefanidis D. Effectiveness of a mental skills curriculum to reduce novices' stress. Journal of Surgical Research, 2016;206(1):199-205.
Anton NE, Whiteside JA, Cha J, Perkins LA, Martin M, Stefanidis D. Characterizing robotic surgical expertise: an exploratory study of neural activation during mental imagery of robotic suturing. American Journal of Surgery, 2021;222(6):1131-1138.
Anton NE, Athanasiadis DI, Karipidis T, Keen AY, Karim A, Cha J, Walke N, Stefanidis D. Surgeon stress negatively affects their non-technical skills in the operating room. American Journal of Surgery, 2021;222(6):1154-1157.
Anton NE, Lebares C, Karipidis T, Stefanidis D. Mastering stress: mental skills and emotional regulation for surgical performance and life. Journal for Surgical Research, 2021;263:A1-A12.
Anton NE, Rendina MA, Hennings JM, Stambro R, Stanton-Maxey KJ, Stefanidis D. Association of medical students’ stress and coping skills with simulation performance. Simulation in Healthcare, 2021;16(5):327-333.
Anton N, Mizota T, Timsina L, et al. Attentional selectivity, automaticity, and self-efficacy predict simulator-acquired skill transfer to the clinical environment. American Journal of Surgery, 2019;217:266-71.
Anton NE, Stefanidis D. Making Average Performance Excellent: Mental Skills for Performance Enhancement. Resources in Surgical Education. October 2018.
Anton NE, Mulji N, Howley LD, Yurco AM, Tobben D, Bean E, Stefanidis D. Effects of a novel mental skills curriculum on surgical novices' attention. Journal of Surgical Research, 2017;219:86-91.
Anton NE, Bean EA, Hammonds SC, Stefanidis D. Application of mental skills training in surgery: A review of its effectiveness and proposed next steps. Journal of Laparoendoscopic & Advanced Surgical Techniques, 2017;27(5):459-69.
Anton NE, Montero P, Howley L, Brown C, Stefanidis D. What stress-coping strategies are surgeons relying upon during surgery? American Journal of Surgery, 2015;210(5):846-51.

Dimitrios Stefanidis MD, PhD, FACS, FASMBS, FSSH

Dr. Stefanidis is a tenured professor of surgery at IU School of Medicine, where he serves as vice chair of education and chief of minimally invasive and bariatric surgery. He directs both education and simulation research for the department and clinical research within his division, and is surgical director of the IU ACS-AEI accredited institute.

A national leader in surgical education, he is president of the Association for Surgical Education and serves on multiple boards, including SAGES and the American College of Surgeons (Indiana Chapter). His research portfolio exceeds $3 million in funding, with more than 250 peer-reviewed publications.

Nicholas Anton, MS

Nicholas Anton is a surgical skills coach at IU School of Medicine and a PhD student in human factors at Purdue University. He specializes in training surgical residents in mental performance skills to enhance focus, resilience and surgical outcomes.

With a foundation in sport psychology, Anton applies evidence-based mental skills training to healthcare. He has received a Novice Researcher Grant from the Society for Simulation in Healthcare and has published extensively on stress and performance. He also leads national workshops and developed a train-the-trainer program to expand mental skills training across institutions.

Learn more

If you are interested in learning more about our curriculum, please reach out to our surgical skills coach, Nicholas Anton.

Contact Nick

Acknowledgments

This project was made possible by funding from the Agency of Healthcare Research and Quality, Indiana University Health Values- Education Fund, the Society for Simulation in Healthcare and Cook Medical.

Special thank you to Charlie Brown, PhD, Lisa Howley, PhD, and Eric Bean, PhD, for their contributions to the creation of this mental skills curriculum.