Use of neuroimaging to measure neurocognitive engagement in health professions education: a scoping review

Figures & data

Figure 1. PRISMA flow diagram.

Table 1. Characteristics of articles included in the scoping review

Characteristic	N	Percent
Year of publication
2007 to 2014	20	30
2015 to 2020	47	70
Country of origin
Brazil	1	1.5
Canada	10	15.0
China	3	4.5
Denmark	1	1.5
Germany	1	1.5
Hong Kong	1	1.5
Ireland	2	3.0
Italy	2	3.0
Japan	4	6.0
Korea	1	1.5
Netherlands	2	3
Singapore	1	1.5
Spain	1	1.5
Turkey	1	1.5
UK	15	22.4
USA	21	31.3
Study design
Non-experimental	50	74.6
Non-randomized controlled	2	3.0
Randomized crossover	2	3.0
Randomized controlled trial	8	11.9
Review	5	7.5
Specialty/learner group
Anesthesiology	1	1.5
Cardiology & pulmonology	1	1.5
Gastroenterology	3	4.5
Internal medicine	7	10.4
Medical students	7	10.4
Health sciences learners	4	6.0
Pediatrics	1	1.5
Psychiatry	1	1.5
Radiation oncology	1	1.5
Surgery	41	61.2
Skill of interest
Clinical reasoning	15	22.0
Cognitive/emotional control	1	1.5
Crisis event management	1	1.5
Clinical knowledge	4	6.0
Fatigue	2	3.0
Psychomotor skills	38	57.0
Well-being, stress, burnout	2	3.0
Visuospatial development	4	6.0
Neuroimaging modality
EEG	18	26.8
fMRI	22	32.8
fNIRS/OT	20	29.9
Review – NA	5	7.5
Other*	2	3.0

EEG, electroencephalogram; fMRI, functional magnetic resonance imaging; fNIRS, functional near-infrared spectroscopy; NA, not applicable; OT, optical topography.

* Other included positron emission tomography (PET) [23] and a real time brain electric activity monitoring system developed by the researchers [30].

Figure 2. Cumulative number of studies that used each of the three main neuroimaging modalities by year. fMRI, functional magnetic resonance imaging; fNIRS, functional near-infrared spectroscopy; EEG, electroencephalography.

Table 2. Skill of interest and modality

Skill	Modality					Total
	EEG	fMRI	fNIRS	Other*	Review
Psychomotor skills	13 (34)	6 (16)	12 (32)	2 (5)	5 (13)	38
Clinical reasoning	2 (13.3)	11 (73.4)	2 (13.3)	–	–	15
Declarative clinical knowledge	2 (50)	2 (50)	–	–	–	4
Visuospatial skills	–	1 (25)	3 (75)	–	–	4
Fatigue	–	–	2 (100)	–	–	2
Well-being	1 (50)	1 (50)	–	–	–	2
Cognitive/emotional control	–	1 (100)	–	–	–	1
Crisis event management	–	–	1 (100)	–	–	1

All data are shown as n (%).

Abbreviations: EEG, electroencephalogram; fMRI, functional magnetic resonance imaging; fNIRS, functional near-infrared spectroscopy.

* Other included positron emission tomography (PET) [23] and a real time brain electric activity monitoring system developed by the researchers [30].

Table 3. Characteristics of neuroimaging modalities

Modality	How it works	Best applications	Advantages [86]	Disadvantages [86]
fMRI	Captures hemodynamic response/regional activated neuroanatomy	Clinical reasoning Declarative knowledge	High spatial resolution (3–4 mm) Can assess deep brain regions	Cost Not usable in clinical environment possible false positive rate longer temporal resolution 3–6 sec)
fNIRS	Captures hemodynamic response through optical intensity/regional brain blood flow	Psychomotor skills	Intermediate temporal resolution (3–6 sec) portable	Limited to superficial brain regions Lower spatial resolution (10–20 mm)
EEG	Electrical activity of the brain showing wavelength and areas of activation Event-related potentials	Psychomotor skills	High temporal resolution (1–100 ms) Portable Lowest cost	Lower spatial resolution (10–20 mm)

Abbreviations: EEG, electroencephalogram; fMRI, functional magnetic resonance imaging; fNIRS, functional near-infrared spectroscopy.

Table

PubMed
#1	(‘Neuroimaging’[Mesh] OR ‘Electroencephalography’[Mesh] OR FMRI[tiab] OR EEG[tiab] OR ERP[tiab] OR fnirs[tiab] OR neuroimag*[tiab] OR ‘brain imaging’[tiab] OR ‘functional mri’[tiab] OR ‘functional magnetic resonance spectroscopy’[tiab] OR electroencephalography[tiab] OR ‘event related potentials’[tiab] OR ‘functional neuroimaging’[tiab] OR ‘Functional near infrared spectroscopy’[tiab])
#2	(‘Clinical Competence’[Mesh] OR ‘Psychomotor Performance’[Mesh] OR ‘Burnout, Psychological’[Mesh] OR ‘Burnout, Professional’[Mesh] OR ‘Sleepiness’[Mesh] OR ‘cognitive load’[tiab] OR clinical skill*[tiab] OR ‘clinical expertise’[tiab] OR ‘skills learning’[tiab] OR ‘skill acquisition’[tiab] OR surgical skill*[tiab] OR ‘clinical reasoning’[tiab] OR psychomotor skill*[tiab] OR procedural skill*[tiab] OR technical skill*[tiab] OR ‘diagnostic thinking’[tiab] OR ‘diagnostic reasoning’[tiab] OR ‘visual expertise’[tiab] OR burnout[tiab] OR sleepiness[tiab] OR fatigue[tiab] OR performance[tiab] OR competenc*[tiab] OR ‘mental workload’[tiab] OR memory[tiab] OR ‘problem solving’[tiab] OR medical error*[tiab] OR ‘patient safety’[tiab])
#3	(‘Surgeons’[MeSH] OR ‘Physicians’[MeSH] OR ‘Students, Medical’[Mesh] OR ‘Internship and Residency’[Mesh] OR ‘Clinical Clerkship’[Mesh] OR ‘premedical’[tiab] OR ‘pre-medical’[tiab] OR ‘clinical clerkship’[tiab] OR ‘resident’[tiab] OR ‘residents’[tiab] OR ‘residency’[tiab] OR PGY*[tiab] OR ‘post graduate year’[tiab] OR ‘postgraduate year’[tiab] OR ‘trainee’[tiab] OR ‘intern’[tiab] OR ‘interns’[tiab] OR ‘internship’[tiab] OR ‘house officer’[tiab] OR ‘house officers’[tiab] OR ‘houseofficer’[tiab] OR ‘house staff’[tiab] OR ‘housestaff’[tiab] OR ‘fellowship’[tiab] OR ‘fellow’[tiab] OR ‘fellows’[tiab] OR ‘undergraduate medical’[tiab] OR ‘medical student’[tiab] OR ‘medical students’[tiab] OR ‘Schools, Medical’[Mesh] OR medical school*[tiab] OR health science*[tiab] OR clinician*[tiab] OR surgeon*[tiab] OR physician[tiab] OR physicians[tiab] OR ‘health profession’[tiab] OR ‘health professionals’[tiab] OR ‘health professions’[tiab] OR doctor[tiab] OR doctors[tiab])
#4	(‘Education, Medical’[Mesh] OR ‘Education’[Mesh] OR educate[tiab] or education[tiab] OR educated[tiab] OR educational[tiab] OR curricula*[tiab] OR curriculum[tiab] OR train*[tiab] OR teach*[tiab] OR instruct*[tiab] OR mentor*[tiab] OR program*[tiab] OR pedagog*[tiab] OR workshop*[tiab] OR initiative*[tiab] OR seminar*[tiab] OR electives[tiab] OR ‘CME’[tiab] OR ‘faculty development’[tiab])
#5	#1 AND #2 AND #3 AND #4
Cochrane
#1	(‘Neuroimaging’[Mesh] OR ‘Electroencephalography’[Mesh] OR FMRI OR EEG OR ERP OR fnirs OR neuroimag* OR ‘brain imaging’ OR ‘functional mri’ OR ‘functional magnetic resonance spectroscopy’ OR electroencephalography OR ‘event related potentials’ OR ‘functional neuroimaging’ OR ‘Functional near infrared spectroscopy’)
#2	(‘Clinical Competence’[Mesh] OR ‘Psychomotor Performance’[Mesh] OR ‘Burnout, Psychological’[Mesh] OR ‘Burnout, Professional’[Mesh] OR ‘Sleepiness’[Mesh] OR ‘cognitive load’ OR clinical skill* OR ‘clinical expertise’ OR ‘skills learning’ OR ‘skill acquisition’ OR surgical skill* OR ‘clinical reasoning’ OR psychomotor skill* OR procedural skill* OR technical skill* OR ‘diagnostic thinking’ OR ‘diagnostic reasoning’ OR ‘visual expertise’ OR burnout OR sleepiness OR fatigue OR performance OR competenc* OR ‘mental workload’ OR memory OR ‘problem solving’ OR medical error* OR ‘patient safety’)
#3	(‘Surgeons’[MeSH] OR ‘Physicians’[MeSH] OR ‘Students, Medical’[Mesh] OR ‘Internship and Residency’[Mesh] OR ‘Clinical Clerkship’[Mesh] OR ‘premedical’ OR ‘pre-medical’ OR ‘clinical clerkship’ OR ‘resident’ OR ‘residents’ OR ‘residency’ OR PGY* OR ‘post graduate year’ OR ‘postgraduate year’ OR ‘trainee’ OR ‘intern’ OR ‘interns’ OR ‘internship’ OR ‘house officer’ OR ‘house officers’ OR ‘houseofficer’ OR ‘house staff’ OR ‘housestaff’ OR ‘fellowship’ OR ‘fellow’ OR ‘fellows’ OR ‘undergraduate medical’ OR ‘medical student’ OR ‘medical students’ OR ‘Schools, Medical’[Mesh] OR medical school* OR health science* OR clinician* OR surgeon* OR physician OR physicians OR ‘health profession’ OR ‘health professionals’ OR ‘health professions’ OR doctor OR doctors)
#4	(‘Education, Medical’[Mesh] OR ‘Education’[Mesh] OR educate or education OR educated OR educational OR curricula* OR curriculum OR train* OR teach* OR instruct* OR mentor* OR program* OR pedagog* OR workshop* OR initiative* OR seminar* OR electives OR ‘CME’ OR ‘faculty development’)
#5	#1 AND #2 AND #3 AND #4
Web of Science
#1	TS = (FMRI OR EEG OR ERP OR fnirs OR neuroimag* OR ‘brain imaging’ OR ‘functional mri’ OR ‘functional magnetic resonance spectroscopy’ OR electroencephalography OR ‘event related potentials’ OR ‘functional neuroimaging’ OR ‘Functional near infrared spectroscopy’)
#2	TS = (‘cognitive load’ OR clinical skill* OR ‘clinical expertise’ OR ‘skills learning’ OR ‘skill acquisition’ OR surgical skill* OR ‘clinical reasoning’ OR psychomotor skill* OR procedural skill* OR technical skill* OR ‘diagnostic thinking’ OR ‘diagnostic reasoning’ OR ‘visual expertise’ OR burnout OR sleepiness OR fatigue OR performance OR competenc* OR ‘mental workload’ OR memory OR ‘problem solving’ OR medical error* OR ‘patient safety’)
#3	TS = (‘premedical’ OR ‘pre-medical’ OR ‘clinical clerkship’ OR ‘resident’ OR ‘residents’ OR ‘residency’ OR PGY* OR ‘post graduate year’ OR ‘postgraduate year’ OR ‘trainee’ OR ‘intern’ OR ‘interns’ OR ‘internship’ OR ‘house officer’ OR ‘house officers’ OR ‘houseofficer’ OR ‘house staff’ OR ‘housestaff’ OR ‘fellowship’ OR ‘fellow’ OR ‘fellows’ OR ‘undergraduate medical’ OR ‘medical student’ OR ‘medical students’ OR ‘medical school*’ OR ‘health science*’ OR clinician* OR surgeon* OR physician OR physicians OR ‘health profession’ OR ‘health professionals’ OR ‘health professions’ OR doctor OR doctors)
#4	TS = (educate OR education OR educated OR educational OR curricula* OR curriculum OR train* OR teach* OR instruct* OR mentor* OR program* OR pedagog* OR workshop* OR initiative* OR seminar* OR electives OR CME OR ‘faculty development’)
#5	#1 AND #2 AND #3 AND #4
Embase
#1	‘neuroimaging’/exp OR ‘electroencephalography’/exp OR (FMRI OR EEG OR ERP OR fnirs OR neuroimag* OR ‘brain imaging’ OR ‘functional mri’ OR ‘functional magnetic resonance spectroscopy’ OR electroencephalography OR ‘event related potentials’ OR ‘functional neuroimaging’ OR ‘Functional near infrared spectroscopy’):ti,ab
#2	‘clinical competence’/exp OR ‘psychomotor performance’/exp OR ‘burnout’/exp OR (‘cognitive load’ OR ‘clinical skill*’ OR ‘clinical expertise’ OR ‘skills learning’ OR ‘skill acquisition’ OR ‘surgical skill*’ OR ‘clinical reasoning’ OR ‘psychomotor skill*’ OR ‘procedural skill*’ OR ‘technical skill*’ OR ‘diagnostic thinking’ OR ‘diagnostic reasoning’ OR ‘visual expertise’ OR burnout OR sleepiness OR fatigue OR performance OR competenc* OR ‘mental workload’ OR memory OR ‘problem solving’ OR ‘medical error*’ OR ‘patient safety’):ti,ab
#3	‘medical education’/exp OR ‘surgeon’/exp OR ‘physician’/exp OR ‘health student’/exp OR ‘resident’/exp OR (premedical OR pre-medical OR ‘clinical clerkship’ OR resident OR residents OR residency OR PGY* OR ‘post graduate year’ OR ‘postgraduate year’ OR trainee OR intern OR interns OR internship OR ‘house officer’ OR ‘house officers’ OR ‘houseofficer’ OR ‘house staff’ OR housestaff OR fellowship OR fellow OR fellows OR ‘undergraduate medical’ OR ‘medical student’ OR ‘medical students’ OR ‘medical school*’ OR ‘health science*’ OR clinician* OR surgeon* OR physician OR physicians OR ‘health profession’ OR ‘health professionals’ OR ‘health professions’ OR doctor OR doctors):ti,ab
#4	‘medical education’/exp OR ‘education’/exp OR (educate OR education OR educated OR educational OR curricula* OR curriculum OR train* OR teach* OR instruct* OR mentor* OR program* OR pedagog* OR workshop* OR initiative* OR seminar* OR electives OR CME OR ‘faculty development’):ti,ab
#5	#1 AND #2 AND #3 AND #4
ERIC
#1	(FMRI OR EEG OR ERP OR fnirs OR neuroimag* OR ‘brain imaging’ OR ‘functional mri’ OR ‘functional magnetic resonance spectroscopy’ OR electroencephalography OR ‘event related potentials’ OR ‘functional neuroimaging’ OR ‘Functional near infrared spectroscopy’)
#2	(DE ‘Medical Evaluation’) OR (DE ‘Psychomotor Skills’) OR (DE ‘Burnout’) OR ‘cognitive load’ OR ‘clinical skill*’ OR ‘clinical expertise’ OR ‘skills learning’ OR ‘skill acquisition’ OR ‘surgical skill*’ OR ‘clinical reasoning’ OR ‘psychomotor skill*’ OR ‘procedural skill*’ OR ‘technical skill*’ OR ‘diagnostic thinking’ OR ‘diagnostic reasoning’ OR ‘visual expertise’ OR burnout OR sleepiness OR fatigue OR performance OR competenc* OR ‘mental workload’ OR memory OR ‘problem solving’ OR ‘medical error*’ OR ‘patient safety’)
#3	(DE ‘Medical Education’) OR (DE ‘Medical Schools’) OR (DE ‘Physicians’) OR (DE ‘Medical Students’) OR ‘premedical’ OR ‘pre-medical’ OR ‘clinical clerkship’ OR resident OR residents OR residency OR PGY* OR ‘post graduate year’ OR ‘postgraduate year’ OR trainee OR intern OR interns OR internship OR ‘house officer’ OR ‘house officers’ OR houseofficer OR ‘house staff’ OR housestaff OR fellowship OR fellow OR fellows OR ‘undergraduate medical’ OR ‘medical student’ OR ‘medical students’ OR ‘medical school*’ OR ‘health science*’ OR clinician* OR surgeon* OR physician OR physicians OR ‘health profession’ OR ‘health professionals’ OR ‘health professions’ OR doctor OR doctors)
#4	(DE ‘Medical Education’) OR (DE ‘Education’) OR educate or education OR educated OR educational OR curricula* OR curriculum OR train* OR teach* OR instruct* OR mentor* OR program* OR pedagog* OR workshop* OR initiative* OR seminar* OR electives OR ‘CME’ OR ‘faculty development’)
#5	#1 AND #2 AND #3 AND #4

Table

Authors	Year	Country	Primary Author Institution	Design	Neuroimaging Modality	Specialty	Skill
Aggarwal et al.	2008	UK	Department of Biosurgery & Surgical Technology, Imperial College London	Review	N/A	surgery	REVIEW psychomotor skill
Akimoto et al.	2015	Japan	Center for Advanced Medical Initiatives, Kyushu University	Non-experimental	Other *	surgery	psychomotor skill
Aksoy et al.	2019	Turkey	Department of Biomedical Device Technology, Acıbadem Mehmet Ali Aydınlar University	Non-experimental	fNIRS	healthcare professionals	psychomotor skill
Anderson et al.	2019	Canada	Department of Community Health Sciences, Cumming School of Medicine, University of Calgary	RCT	EEG	health sciences students	declarative clinical knowledge
Andreu-Perez et al.	2016	UK	The Hamlyn Centre, Imperial College London	Non-experimental	fNIRS/OT	surgery	psychomotor skill
Bahrami et al.	2014	Canada	Institute of Biomaterials and Biomedical Engineering, University of Toronto	Non-experimental	fMRI	surgery	psychomotor skill
Bahrami et al.	2011	Canada	Institute of Biomaterials and Biomedical Engineering, University of Toronto, and Keenan Research Centre of the Li Ka Shing Knowledge Institute at St. Michael’s Hospital, Toronto	Non-experimental	fMRI	surgery	psychomotor skill
Bernier et al.	2016	Canada	Sherbrooke University Hospital Center (CHUS)	Non-experimental	fMRI	medical students	declarative clinical knowledge
Bhatt et al.	2016	Ireland	Department of Surgery, University of Dublin, Trinity College, at the Adelaide and Meath Hospital	Review	N/A	surgery	REVIEW effects of aging on surgeons
Bocci et al.	2013	Italy	Department of Neuroscience, Unit of Neurology, Pisa University Medical School	Non-experimental	EEG	surgery	psychomotor skill
Brod et al.	2016	Germany	The Center for Lifespan Psychology, Max Planck Institute for Human Development	Non-experimental	fMRI	medical students	declarative clinical knowledge
Chang et al.	2016	South Korea	Department of Medical Humanities, Korea University College of Medicine	Non-experimental	fMRI	medical students	clinical reasoning
Ciechanski et al.	2019	Canada	Faculty of Medicine and Dentistry, University of Alberta	RCT	EEG	surgery	psychomotor skill
Crewther et al.	2016	UK	The Hamlyn Centre for Robotic Surgery, Imperial College London	Non-experimental	fNIRS	surgery	psychomotor skill
De Andrade et al.	2016	Brazil	Faculty of Medicine, Department of Paediatric, University of Sao Paulo	Non-experimental	fMRI	pediatrics	well-being
Downar et al.	2011	USA	Human Neuroimaging Laboratory, Virginia Tech Carilion Research Institute and Department of Physics, Virginia Tech	Non-experimental	fMRI	non-surgical physicians	clinical reasoning
Durning et al.	2013	USA	Department of Medicine, Uniformed Services University of the Health Sciences	Non-experimental	fMRI	internal medicine	clinical reasoning
Durning et al.	2014	USA	Department of Medicine, Uniformed Services University of the Health Sciences	Non-experimental	fMRI	internal medicine	clinical reasoning
Durning et al.	2015	USA	Department of Medicine, Uniformed Services University of the Health Sciences	Non-experimental	fMRI	internal medicine	clinical reasoning
Durning et al.	2016	USA	Department of Medicine, Uniformed Services University of the Health Sciences	Non-experimental	fMRI	internal medicine	clinical reasoning
Durning et al.	2013	USA	Department of Medicine, Uniformed Services University of the Health Sciences	Non-experimental	fMRI	internal medicine	clinical reasoning
Durning et al.	2012	USA	Department of Medicine, Uniformed Services University of the Health Sciences	Non-experimental	fMRI	internal medicine	clinical reasoning
Durning et al.	2015	USA	Department of Medicine, Uniformed Services University of the Health Sciences	Non-experimental	fMRI	internal medicine	clinical reasoning
Duty et al.	2012	USA	Institute for Urology and Center of Neurosciences, Feinstein Institute for Medical Research North Shore–Long Island Jewish Health System	Non-experimental	PET	surgery	psychomotor skill
Garbens et al.	2019	Canada	Department of Surgery, St. Michael’s Hospital, University of Toronto	Non-experimental	fMRI	surgery	psychomotor skill
Guru et al.	2015	USA	Department of Urology, Roswell Park Cancer Institute, Brain Computer Interface Laboratory, Department of Mechanical & Aerospace Engineering, University at Buffalo	Non-experimental	EEG	surgery	psychomotor skill
Guru et al.	2015	USA	Department of Urology, Applied Technology Laboratory for Advanced Surgery (ATLAS) Program at Roswell Park Cancer Institute	Non-experimental	EEG	surgery	psychomotor skill
Hruska et al.	2015	Canada	Department of Community Health Sciences, Cumming School of Medicine, University of Calgary	Non-experimental	fMRI	gastroenterology	diagnostic thinking
Hruska et al.	2015	Canada	Department of Community Health Sciences, Cumming School of Medicine, University of Calgary	Non-experimental	fMRI	gastroenterology	diagnostic thinking
Hussein et al.	2016	USA	Applied Technology Laboratory for Advanced Surgery (ATLAS) Program, Roswell Park Cancer Institute, Buffalo	Non-experimental	EEG	surgery	psychomotor skill
James et al.	2011	UK	Department of Surgery and Cancer & Hamlyn Centre for Robotic Surgery, Imperial College	Non-experimental	fNIRS	gastroenterology	visuospatial skill
Kahol et al.	2011	USA	Human Machine Symbiosis Laboratory, School of Biological and Health Systems Engineering, Arizona State University	Non-experimental	EEG	surgery	psychomotor skill
Karabanov et al.	2019	Denmark	Danish Research Centre for Magnetic Resonance, Centre for Functional and Diagnostic Imaging and Research, Copenhagen University Hospital	RCT	fMRI	surgery	psychomotor skill
Khoe et al.	2020	Singapore	Yong Loo Lin School of Medicine, National University of Singapore	RCT	fNIRS	surgery	psychomotor skill
Leff et al.	2008	UK	Royal Wolfson Image Computing Laboratory and Department of Biosurgery and Surgical Technology, Imperial College London	Non-experimental	fNIRS	surgery	psychomotor skill
Leff et al.	2015	UK	Hamlyn Centre for Robotic Surgery, Imperial College London	Randomized crossover	fNIRS/OT	surgery	visuospatial skill
Leff et al.	2008	UK	Royal Wolfson Image Computing Laboratory and Department of Biosurgery and Surgical Technology, Imperial College London	Review	N/A	surgery	REVIEW psychomotor skill
Leff et al.	2008	UK	Royal Wolfson Image Computing Laboratory and Department of Biosurgery and Surgical Technology, Imperial College London	Non-experimental	fNIRS	surgery	psychomotor skill
Leff et al.	2010	UK	Royal Wolfson Image Computing Laboratory and Department of Biosurgery and Surgical Technology, Imperial College London	Non-experimental	fNIRS	surgery	fatigue
Leff et al.	2017	UK	Hamlyn Centre for Robotic Surgery, Department of Biosurgery and Surgical Technology, Imperial College London	Non-experimental	fNIRS/OT	surgery	clinical reasoning
Li et al.	2020	China	Spinal Division of Orthopedic and Traumatology Center, Affiliated Hospital of Guangdong Medical University	Non-experimental	EEG	surgery	psychomotor skill
Maddox et al.	2015	USA	Department of Urology, Tulane University School of Medicine	Non-experimental	EEG	surgery	psychomotor skill
Mazur et al.	2017	USA	Department of Radiation Oncology, University of North Carolina	Non-experimental	EEG	radiation oncology	clinical reasoning
Mazur et al.	2016	USA	Department of Radiation Oncology, University of North Carolina	Non-experimental	EEG	medical trainees	psychomotor skill
Miura et al.	2015	Japan	Department of Modern Mechanical Engineering, Waseda University	Non-experimental	fNIRS	surgery	visuospatial skill
Modi et al.	2019	UK	Department of Surgery and Cancer & Hamlyn Centre for Robotic Surgery, Imperial College London	Non-experimental	fNIRS	surgery	psychomotor skill
Modi et al.	2018	UK	Department of Surgery and Cancer & Hamlyn Centre for Robotic Surgery, Imperial College London	Non-experimental	fNIRS	surgery	psychomotor skill
Modi et al.	2017	UK	Department of Surgery and Cancer & Hamlyn Centre for Robotic Surgery, Imperial College London	Review	N/A	surgery	REVIEW psychomotor skill
Modi et al.	2017	UK	Department of Surgery and Cancer & Hamlyn Centre for Robotic Surgery, Imperial College London	Review	N/A	surgery	REVIEW psychomotor skill
Morales et al.	2019	Spain	Mind, Brain, and Behavior Research Center, University of Granada	Non-experimental	EEG	surgery	psychomotor skill
Morris et al.	2015	Ireland	Education Division and Department of Surgery, School of Medicine, Trinity College	Non-experimental	fMRI	surgery	psychomotor skill
Ndaro et al.	2018	China	Department of Biomedical Engineering, School of Medical Instrument and Food Engineering, University of Shanghai for Science and Technology	Non-experimental	EEG	surgery	psychomotor skill
Nemani et al.	2018	USA	Rensselaer Polytechnic Institute	RCT	fNIRS	surgery	psychomotor skill
Nishida et al.	2017	Japan	Department of Psychiatry, Jichi Medical University & Faculty of Sports Science, Waseda University	Randomized crossover	fNIRS	psychiatry	fatigue
Ohuchida et al.	2009	Japan	Department of Advanced Medical Initiatives, Faculty of Medical Sciences, Kyushu University	Non-experimental	fNIRS	surgery	psychomotor skill
Pelizzo et al.	2020	Italy	Department of Pediatric Surgery, ‘Vittore Buzzi’ Children’s Hospital, University of Milano	RCT	fMRI	surgery	psychomotor skill
Rotgans et al.	2019	Netherlands	Institute of Medical Education Research Rotterdam, Erasmus Medical Center, Rotterdam	Non-experimental	fNIRS	medical students –	clinical reasoning
Rourke et al.	2016	Canada	Department of Medicine, University of Alberta	Non-randomized controlled	EEG	cardiology and pulmonology	clinical reasoning
Shafiei et al.	2018	USA	Department of Urology, Applied Technology Laboratory for Advanced Surgery (ATLAS) Program at Roswell Park Cancer Institute	Non-experimental	EEG	surgery	psychomotor skill
Shetty et al.	2016	UK	Hamlyn Centre for Robotic Surgery, Imperial College London	Non-experimental	fNIRS	surgery	psychomotor skill development
Shewokis et al.	2017	USA	Nutrition Sciences Department, College of Nursing and Health Professions, School of Biomedical Engineering, Science and Health Systems, Drexel University	RCT	fNIRS	surgery	psychomotor skill
Turk et al.	2018	USA	VA Boston Healthcare System & Boston University School of Medicine	Non-experimental	EEG	medical students	declarative clinical knowledge
Veroude et al.	2013	Netherlands	Department of Educational Neuroscience, Faculty of Psychology and Education VU University Amsterdam	Non-experimental	fMRI	medical students	cognitive/emotional control
Wanzel et al.	2007	Canada	Department of Surgery, University of Toronto	Non-experimental	fMRI	surgery	visuospatial skill
Xu et al.	2018	China	Department of Military Psychology, Army Medical University, Chongqing, China.	RCT	EEG	medical students	well-being
Xu et al.	2019	USA	Center for Research and Innovation in Systems Safety, Vanderbilt University Medical Center	Non-experimental	fNIRS	anesthesiology	crisis event management team skills
Zhu et al.	2011	Hong Kong	Institute of Human Performance, The University of Hong Kong	Non-randomized controlled	EEG	surgery	psychomotor skill

EEG, electroencephalogram; fMRI, functional magnetic resonance imaging; fNIRS, functional near-infrared spectroscopy; NA, not applicable; OT, optical topography; RCT, randomized controlled trial.

* Other: Brain electric activity monitoring system designed by the researchers

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