Does mental imagery prior to cystoscopy make a difference? A randomized controlled trial

Objective: We sought to determine whether mental imagery improves surgical performance of residents novice to cystoscopy. Study Design: We performed a multicenter randomized controlled trial. Residents who had performed ≤ 3 cystoscopies were randomized to preoperative mental imagery sessions or reading a book chapter describing cystoscopy. The primary outcome was comparison of groups' surgical performance scores. Secondary outcomes were measurements of operative times and resident ratings of helpfulness of their preparation. Scores were compared using 2-factor analysis of variance. Results: In all, 68 residents were randomized; 33 to imagery and 35 to control groups. Groups did not differ in age, cystoscopic experience, residency level, or sex. The imagery group's surgical assessment scores were 15.9% higher than controls (P = .03). Operative times did not differ between groups. Imagery residents rated imagery preparation as more helpful than controls (P < .0001). Conclusion: Residents considered mental imagery to be a more useful preoperative preparation. The mental imagery group's surgical performance was superior to controls.