the Use of Mental Imagery in Health Professions Education

abstract:-
The overarching goal of this chapter was to obtain a better grasp of the use of mental
imagery. This was accomplished through a scoping review. A scoping review examines the
scope, breadth, and character of research activity and identifies research gaps in the current
literature. To guarantee that all relevant publications were discovered, the review was done
utilising a search approach across different databases. The articles were then picked based on
a predetermined criterion. Following the collection of articles, the pertinent information was
plotted using a data charting spreadsheet created by two raters. The data graphic was
evaluated and summarised numerically. To arrange the data and draw comparisons among the
research, a theme analysis was also undertaken. This was accomplished by classifying each
article based on its kind. The data graphing approach was used to extract emerging patterns
from each category. Approximately half of the experimental research studies and comments
revealed an improvement in skill performance following mental imagery when compared to a
control or an alternate method of practise. Mental imaging produced the same outcomes as
physical practise, the control condition, or an other type of practise. Many of the studies also
mentioned using visualisation techniques to increase task preparedness and minimise stress
and anxiety. After imaging practise, imagery ability was demonstrated to improve.
Introduction:-
Changes in patient care delivery have made it difficult for students of all levels to
practise new skills on patients (Aggarwal & Darzi, 2006). When enabling students to try new
abilities, patient safety must be considered. Alternative strategies for addressing these issues
in medical education include the use of simulators, clinical skills laboratories, and
standardised patients. To better these alternative methodologies, concepts derived from
Kinesiology and Psychology have been used to the study of clinical skill education in
medicine (Dubrowski & Backstein, 2004; Dubrowski, Backstein, Abughaduma, Leidl, &
Carnahan, 2005; Elliott, Grierson, Hayes, & Lyons, 2011). Another topic from that sector that
deserves more attention is the use of mental imagery to improve technical skill learning.
Mental imaging is the cognitive practise of a motor activity without engaging in the task's
actual action (Driskell, Copper, & Moran, 1994). Other words for this description include
mental practise, mental motions, and motor imagery (Schuster et al., 2011). In this chapter,
mental imagery will be utilised to express various additional concepts that may define a
motor task's cognitive practise. When acquiring a motor skill in medicine, mental
visualisation has been found to be an effective alternative to physical exercise (Arora et al.,
2010). When mentally imitating an activity, the common brain representation of doing the
action itself is activated (Jeannerod, 1994; Jeannerod, 1999). Wohldmann, Healy, and Bourne
(2008) used a typing task to investigate the differences between mental imagery practise and
physical practise. They discovered that mental practise was better to physical practise and
resulted in more skill transfer in their study. This was owing in part to an interference effect
generated by physical practise of new motor tasks compromising previous motor behaviours.
Mental imaging research is important because it may be more cost efficient and easier
to use as a substitute or addition to physical practise when teaching clinical skills to health
practitioners. Mental imagery is a valuable tool for athletes, but it may also have a significant
economic impact for health educators. Health professions educators and skill labs are both
expensive. However, mental imagery is a low-cost resource and a reasonably affordable form
of learning that may be utilised as an alternative to or in addition to physical exercise. There
might be a substantial potential to lower the costs of health professions education. A greater
knowledge of how mental imaging is used or might be utilised is required in order to design
more effective training strategies that may involve mental imagery.
To acquire a better knowledge of the present usage of mental imagery in health
professions education, a scoping review of the literature was undertaken. The scoping study
also looked at the topic of mental imagery abilities in the literature. That is, the goal of this
scoping review was to describe the present literature on the use of mental imagery in health
professions education rather than to evaluate the quality of existing research.
Depending on the nature and shape, mental imagery may be explained in a variety of
ways. Paivio (1985) defined mental imagery in terms of the individual's aim. He classified
mental images into four categories based on its intended use. Mental imagery can be used to
promote physiological arousal and the related emotions for motivating purposes. The
motivational-generic element of imaging is used by people who envision the stimulation of
happy or negative emotions linked with broad circumstances. Those who imagine the
stimulation of reactions to a certain goal or goal-oriented behaviours serve the motivational
element of visualisation. Mental imagery can also be used for cognitive purposes, such as
actively practising behavioural skills. Individuals can utilise cognitive imagery particularly to
practise motor abilities.
Mental Imagery across Disciplines
In sports psychology, mental imagery has been studied to enhance athletic
performance and confidence (Rogers, 2006; Hall et al., 2009), in business to improve job
interviewing abilities (Knudstrup, Segrest, & Hurley, 2003), and in rehabilitation (Weiss et
al., 1994). Mental imagery was shown to be employed by runners, football players, gymnasts,
and in general exercise routines to boost performance in a review by Rogers (2006). Schuster
et al. (2011) examined motor imagery training aspects in five fields: education, medicine,
music, psychology, and sports. The review focused on the physical, environmental, temporal,
task, learning, emotional, and viewpoint components of the mental imagery training session.
The duration periods and number of repetitions of the training sessions were also examined
by the scientists. They discovered that positive mental imagery therapies included motor
focused tasks, live comprehensive aural instructions, supervised sessions, and participants
closing their eyes to visualise. The physical practise component of the mental imagery
training session was also evaluated in Schuster et al(2011) .'s review. The authors described
the beneficial effect of mental imagery when combined with physical practise and compared
the order of the mental imagery trial versus the physical practise trial, as well as whether
mental imagery practise was more beneficial when combined with or embedded in physical
practise. They discovered that effective mental imagery therapies included mental imagery
trials added to and done following physical practise. Mental imaging has been proved to be a
beneficial strategy for rehearsing technical abilities without physically doing the skills. It is
also clear that the effectiveness of mental images may be influenced by a variety of things. In
the psychological literature, successful mental imagery training sessions were most prevalent
(Schuster et al., 2011). The majority of the literature in the field of education featured
participants in the health professions.
Mental Imagery in Medical Education
Mental imagery is a strategy used in medical education to teach fundamental surgical
skills as well as more advanced abilities such as laparoscopic surgery (Sanders et al., 2004).
(Arora et al., 2010; Arora et al., 2011). Another study looked at the use of mental imagery to
help freshly graduated registered nurses transition into practise (Boehm & Tse, 2013). There
has also been research on the use of mental imagery with dentistry students (Walsh,
Hannebrink, & Heckman, 1984; Welk et al., 2007). The benefits of mental imagery in skill
development may be extended to all health professions where clinical skills are required and
should not be confined to one health profession, as demonstrated by the research described
above. However, as compared to the sciences of psychology and medicine, mental imagery in
health professions education has received little attention (Schuster et al., 2011).
A number of studies have found that mental imagery may be used to instruct health
care providers. Arora et al. (2011) compared rookie surgeons who received mental imagery
training utilising a mental imagery script to a control group who saw an online lecture in
addition to physical practise on a simulator. According to professional raters, Arora et al.
(2011) discovered that the mental imagery group improved their quality of laparoscopic
performance on a virtual reality laparoscopic cholecystectomy compared to the control group.
Komesu et al. (2009) discovered that gynaecology residents who received mental imagery
training performed better on performance metrics than a control group that read a textbook.
However, Komesu et al. (2009) found no evidence of this.
While mental imaging has been found to be useful in the research mentioned above,
there are instances in the literature when mental imagery did not result in improved skill
development. In Doheny's (1993) study, nursing students were separated into four groups: a
control group, a mental imagery only group, a relaxation group, and a combined mental
imagery and relaxation group. The mental imagery group was told to envision giving an
intramuscular injection, while the control group was taught treatment procedures and the
relaxation group was taught muscle relaxation techniques. There were no significant
variations in intramuscular injection performance scores between the groups.
The Scoping Review
A scoping review, according to the methodological framework developed by Arksey
and O'Malley (2005), serves the following purposes: examining the extent, range, and nature
of research activity; determining the value of conducting a full systematic review;
summarising and disseminating research findings; and identifying research gaps in the
existing literature. Scoping reviews, unlike systematic reviews, do not normally assess the
quality of a research (Levac, Colquhoun, & O'Brien, 2010). In this study, the scoping review
was chosen for the goals outlined by Arksey and O'Malley and employed the five steps of the
methodological framework (Arksey & O'Malley, 2005; Levac et al., 2010). The five stages
are as follows:

1. Formulation of the research question

2. Identifying relevant studies
3. Study Choice
4. Data visualisation
5. Gathering, summarising, and reporting results
Analyses
Following the charting of selected articles, the data was examined, compiled, and
summarised into a numerical summary. The numerical summary's objective was to
summarise the features of the included papers, such as the various categories of study, the
year of publication, and the place of origin of each article (Levac et al., 2010). One rater then
undertook a thematic analysis to detect any gaps in the literature, draw comparisons between
studies, and identify any contradicting findings. In the scoping review, theme analysis is
utilised as a stage in compiling, summarising, and reporting the results (Arksey & O'Malley,
2005). The initial stage in theme analysis was to categorise each item based on its kind. The
data charting approach was then used to extract the developing trends in the research within
each category. The following trends were considered based on mental imagery principles
reported in the sports literature: the method of mental imagery delivery, the inclusion of a
mental imagery ability component, the clinical domain, the skill involved, the inclusion of
physical practise, the study population, the number of participants, the success of mental
imagery, the key findings, and the main conclusions. These patterns were retrieved and
compiled as they applied to each investigation.
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