Academic Journal
Προβολή σε EDS
Συνδεδεμένο Πλήρες Κείμενο

Effect of transcranial direct current stimulation on psychomotor skill acquisition during laparoscopic training: a randomized controlled trial.

Λεπτομέρειες βιβλιογραφικής εγγραφής
Τίτλος: Effect of transcranial direct current stimulation on psychomotor skill acquisition during laparoscopic training: a randomized controlled trial.
Συγγραφείς: Lepka P; Department of Oncological Gynecology, Lower Silesian Oncology, Pulmonology and Hematology Center, Wroclaw, Poland. piotr.lepka@umw.edu.pl.; Clinical Department of Gynaecological Oncology, Department of Oncology, Faculty of Medicine, Wroclaw Medical University, Wrocław, Poland. piotr.lepka@umw.edu.pl., Szcześniak D; Division of Psychotherapy and Psychosomatic Diseases, Department of Psychiatry, Faculty of Medicine, Wroclaw Medical University, Wrocław, Poland., Sikora Z; Wroclaw Medical University, Wroclaw, Poland., Matkowski R; Department of Oncological Gynecology, Lower Silesian Oncology, Pulmonology and Hematology Center, Wroclaw, Poland.; Division of Surgical Oncology, Department of Oncology, Faculty of Medicine, Wrocław Medical University, Wrocław, Poland.
Πηγή: Surgical endoscopy [Surg Endosc] 2026 Oct; Vol. 40 (10), pp. 8412-8420. Date of Electronic Publication: 2026 Jul 13.
Τύπος έκδοσης: Journal Article; Randomized Controlled Trial
Γλώσσα: English
Στοιχεία περιοδικού: Publisher: Springer Country of Publication: Germany NLM ID: 8806653 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1432-2218 (Electronic) Linking ISSN: 09302794 NLM ISO Abbreviation: Surg Endosc Subsets: MEDLINE
Imprint Name(s): Publication: 1992- : New York : Springer
Original Publication: [Berlin] : Springer International, c1987-
Ιατρικοί όροι (MeSH): Laparoscopy*/education , Psychomotor Performance*/physiology , Transcranial Direct Current Stimulation*/methods , Simulation Training*/methods , Clinical Competence*, Humans ; Female ; Prospective Studies ; Male ; Young Adult ; Adult ; Motor Skills
Περίληψη: Background: Acquisition of laparoscopic psychomotor skills is essential for safe minimally invasive surgery but is associated with a steep learning curve. Simulation-based training improves proficiency; however, additional strategies to accelerate skill acquisition are sought. Transcranial direct current stimulation (tDCS) has been shown to facilitate motor learning, but its effect on laparoscopic training remains uncertain.
Methods: In this prospective, sham-controlled trial, 33 medical students without prior laparoscopic experience were allocated to active tDCS (n = 16) or sham stimulation (n = 17) during laparoscopic simulation training. Stimulation was delivered using the Halo Sport system (1.4 mA, 20 min) over bilateral primary motor cortices. Baseline psychomotor abilities were assessed using the Vienna Test System (Motor Performance Series, 2HAND, and 3D spatial ability tests). Laparoscopic skills were evaluated using the Laparoscopic Skills Testing and Training (LASTT) model, including camera navigation (CN), hand-eye coordination (HE), and bimanual coordination (Bi), on days 1, 3, 5, and 7. Group differences in final performance (day 7) were analyzed using linear models and ANCOVA, adjusting for baseline performance and prespecified covariates.
Results: Both groups demonstrated significant improvement across all laparoscopic tasks over time (all p < 0.001). Active tDCS was independently associated with higher final bimanual coordination performance compared with sham stimulation (adjusted ANCOVA: F (1,13) = 14.92, p = 0.002). No independent effect of tDCS was observed for camera navigation (p = 0.581) or hand-eye coordination (p = 0.439). Baseline visuospatial ability (3D test) was an independent predictor of final performance in camera navigation and hand-eye coordination (both p < 0.01). Positive correlations were found between 3D scores and CN (r = 0.397) and HE (r = 0.390), as well as between 2HAND and HE (r = 0.341).
Conclusions: Bihemispheric tDCS applied during laparoscopic simulation selectively enhanced acquisition of bimanual coordination, while performance in camera navigation and hand-eye coordination was primarily determined by baseline visuospatial ability. These findings support a task-specific role for neuromodulation as an adjunct to simulation-based laparoscopic training and highlight the importance of visuospatial profiling for personalized training strategies.
(© 2026. The Author(s).)
Competing Interests: Declarations. Disclosures: Piotr Lepka, Dorota Szcześniak, Zofia Sikora, Rafał Matkowski have no conflicts of interest or financial ties to disclose. Ethical approval: The study protocol was approved by the Bioethics Committee at Wroclaw Medical University (approval No. KB-423/2019). All procedures were conducted in accordance with the Declaration of Helsinki and institutional guidelines. Consent to participate: All participants provided written informed consent prior to enrollment and study procedures. Consent for publication: No individually identifiable data (including images) are included in this manuscript. Consent for publication of anonymized aggregate data was obtained at enrollment.
References: Neuroimage. 2008 Jul 15;41(4):1382-94. (PMID: 18486490)
Neuroimage. 2013 Feb 15;67:283-97. (PMID: 23194819)
J Surg Educ. 2018 Mar - Apr;75(2):458-464. (PMID: 28918007)
Sci Rep. 2023 Aug 23;13(1):13731. (PMID: 37612337)
Data Brief. 2021 Feb 23;35:106905. (PMID: 33732823)
Clin Neurophysiol. 2017 Jan;128(1):56-92. (PMID: 27866120)
Ginekol Pol. 2018;89(10):529-535. (PMID: 30393839)
Brain Stimul. 2020 May - Jun;13(3):863-872. (PMID: 32289719)
BMC Neurosci. 2008 Oct 28;9:103. (PMID: 18957075)
J Neurosci. 2014 Jan 15;34(3):1037-50. (PMID: 24431461)
Brain Res. 2021 Nov 15;1771:147656. (PMID: 34508672)
Sci Rep. 2017 Mar 28;7(1):480. (PMID: 28352100)
J Endourol. 2006 Apr;20(4):281-3. (PMID: 16646658)
J Neurosci. 2017 Aug 2;37(31):7500-7512. (PMID: 28674174)
Obstet Gynecol. 2013 Mar;121(3):578-584. (PMID: 23635621)
Brain Stimul. 2011 Jul;4(3):169-74. (PMID: 21777878)
Trends Cogn Sci. 2004 Jan;8(1):18-25. (PMID: 14697399)
Proc Natl Acad Sci U S A. 2009 Feb 3;106(5):1590-5. (PMID: 19164589)
J Neurosci. 2012 Oct 17;32(42):14617-21. (PMID: 23077047)
J Physiol. 2000 Sep 15;527 Pt 3:633-9. (PMID: 10990547)
BMC Surg. 2018 Nov 7;18(1):94. (PMID: 30404634)
Ann Surg. 2013 Feb;257(2):224-30. (PMID: 23013806)
Grant Information: SUBZ.C280.26.041 Uniwersytet Medyczny im. Piastów Slaskich we Wroclawiu
Contributed Indexing: Keywords: Bimanual coordination; Laparoscopy training; Psychomotor skills; Randomized controlled trial; Transcranial direct current stimulation; Visual–spatial ability
Entry Date(s): Date Created: 20260713 Date Completed: 20261002 Latest Revision: 20261008
Update Code: 20261008
PubMed Central ID: PMC13633295
DOI: 10.1007/s00464-026-12992-2
PMID: 42443692
Βάση Δεδομένων: MEDLINE
FullText Links:
  – Type: other
    Url: https://resolver.ebsco.com:443/public/rma-ftfapi/ejs/direct?AccessToken=43EB8E27EFA42771DF97&Show=Object
Text:
  Availability: 0
CustomLinks:
  – Url: https://dx.doi.org/doi:10.1007/s00464-026-12992-2
    Name: EDS - Springer Nature Journals (s7799221)
    Category: fullText
    Text: View record at Springer
Header DbId: cmedm
DbLabel: MEDLINE
An: 42443692
AccessLevel: 3
PubType: Academic Journal
PubTypeId: academicJournal
PreciseRelevancyScore: 0
IllustrationInfo
Items – Name: Title
  Label: Title
  Group: Ti
  Data: Effect of transcranial direct current stimulation on psychomotor skill acquisition during laparoscopic training: a randomized controlled trial.
– Name: Author
  Label: Authors
  Group: Au
  Data: &lt;searchLink fieldCode=&quot;AU&quot; term=&quot;%22Lepka+P%22&quot;&gt;Lepka P&lt;/searchLink&gt;; Department of Oncological Gynecology, Lower Silesian Oncology, Pulmonology and Hematology Center, Wroclaw, Poland. piotr.lepka@umw.edu.pl.; Clinical Department of Gynaecological Oncology, Department of Oncology, Faculty of Medicine, Wroclaw Medical University, Wrocław, Poland. piotr.lepka@umw.edu.pl.&lt;br /&gt;&lt;searchLink fieldCode=&quot;AU&quot; term=&quot;%22Szcześniak+D%22&quot;&gt;Szcześniak D&lt;/searchLink&gt;; Division of Psychotherapy and Psychosomatic Diseases, Department of Psychiatry, Faculty of Medicine, Wroclaw Medical University, Wrocław, Poland.&lt;br /&gt;&lt;searchLink fieldCode=&quot;AU&quot; term=&quot;%22Sikora+Z%22&quot;&gt;Sikora Z&lt;/searchLink&gt;; Wroclaw Medical University, Wroclaw, Poland.&lt;br /&gt;&lt;searchLink fieldCode=&quot;AU&quot; term=&quot;%22Matkowski+R%22&quot;&gt;Matkowski R&lt;/searchLink&gt;; Department of Oncological Gynecology, Lower Silesian Oncology, Pulmonology and Hematology Center, Wroclaw, Poland.; Division of Surgical Oncology, Department of Oncology, Faculty of Medicine, Wrocław Medical University, Wrocław, Poland.
– Name: TitleSource
  Label: Source
  Group: Src
  Data: &lt;searchLink fieldCode=&quot;JN&quot; term=&quot;%228806653%22&quot;&gt;Surgical endoscopy&lt;/searchLink&gt; [Surg Endosc] 2026 Oct; Vol. 40 (10), pp. 8412-8420. &lt;i&gt;Date of Electronic Publication: &lt;/i&gt;2026 Jul 13.
– Name: TypePub
  Label: Publication Type
  Group: TypPub
  Data: Journal Article; Randomized Controlled Trial
– Name: Language
  Label: Language
  Group: Lang
  Data: English
– Name: TitleSource
  Label: Journal Info
  Group: Src
  Data: &lt;i&gt;Publisher: &lt;/i&gt;&lt;searchLink fieldCode=&quot;PB&quot; term=&quot;%22Springer%22&quot;&gt;Springer &lt;/searchLink&gt;&lt;i&gt;Country of Publication: &lt;/i&gt;Germany &lt;i&gt;NLM ID: &lt;/i&gt;8806653 &lt;i&gt;Publication Model: &lt;/i&gt;Print-Electronic &lt;i&gt;Cited Medium: &lt;/i&gt;Internet &lt;i&gt;ISSN: &lt;/i&gt;1432-2218 (Electronic) &lt;i&gt;Linking ISSN: &lt;/i&gt;&lt;searchLink fieldCode=&quot;IS&quot; term=&quot;%2209302794%22&quot;&gt;09302794 &lt;/searchLink&gt;&lt;i&gt;NLM ISO Abbreviation: &lt;/i&gt;Surg Endosc &lt;i&gt;Subsets: &lt;/i&gt;MEDLINE
– Name: PublisherInfo
  Label: Imprint Name(s)
  Group: PubInfo
  Data: &lt;i&gt;Publication&lt;/i&gt;: 1992- : New York : Springer&lt;br /&gt;&lt;i&gt;Original Publication&lt;/i&gt;: [Berlin] : Springer International, c1987-
– Name: SubjectMESH
  Label: MeSH Terms
  Group: Su
  Data: &lt;searchLink fieldCode=&quot;MM&quot; term=&quot;%22Laparoscopy%22&quot;&gt;Laparoscopy*&lt;/searchLink&gt;/&lt;searchLink fieldCode=&quot;MM&quot; term=&quot;%22Laparoscopy+education%22&quot;&gt;education&lt;/searchLink&gt; &lt;br /&gt;&lt;searchLink fieldCode=&quot;MM&quot; term=&quot;%22Psychomotor+Performance%22&quot;&gt;Psychomotor Performance*&lt;/searchLink&gt;/&lt;searchLink fieldCode=&quot;MM&quot; term=&quot;%22Psychomotor+Performance+physiology%22&quot;&gt;physiology&lt;/searchLink&gt; &lt;br /&gt;&lt;searchLink fieldCode=&quot;MM&quot; term=&quot;%22Transcranial+Direct+Current+Stimulation%22&quot;&gt;Transcranial Direct Current Stimulation*&lt;/searchLink&gt;/&lt;searchLink fieldCode=&quot;MM&quot; term=&quot;%22Transcranial+Direct+Current+Stimulation+methods%22&quot;&gt;methods&lt;/searchLink&gt; &lt;br /&gt;&lt;searchLink fieldCode=&quot;MM&quot; term=&quot;%22Simulation+Training%22&quot;&gt;Simulation Training*&lt;/searchLink&gt;/&lt;searchLink fieldCode=&quot;MM&quot; term=&quot;%22Simulation+Training+methods%22&quot;&gt;methods&lt;/searchLink&gt; &lt;br /&gt;&lt;searchLink fieldCode=&quot;MM&quot; term=&quot;%22Clinical+Competence%22&quot;&gt;Clinical Competence*&lt;/searchLink&gt;&lt;br /&gt;&lt;searchLink fieldCode=&quot;MH&quot; term=&quot;%22Humans%22&quot;&gt;Humans&lt;/searchLink&gt; ; &lt;searchLink fieldCode=&quot;MH&quot; term=&quot;%22Female%22&quot;&gt;Female&lt;/searchLink&gt; ; &lt;searchLink fieldCode=&quot;MH&quot; term=&quot;%22Prospective+Studies%22&quot;&gt;Prospective Studies&lt;/searchLink&gt; ; &lt;searchLink fieldCode=&quot;MH&quot; term=&quot;%22Male%22&quot;&gt;Male&lt;/searchLink&gt; ; &lt;searchLink fieldCode=&quot;MH&quot; term=&quot;%22Young+Adult%22&quot;&gt;Young Adult&lt;/searchLink&gt; ; &lt;searchLink fieldCode=&quot;MH&quot; term=&quot;%22Adult%22&quot;&gt;Adult&lt;/searchLink&gt; ; &lt;searchLink fieldCode=&quot;MH&quot; term=&quot;%22Motor+Skills%22&quot;&gt;Motor Skills&lt;/searchLink&gt;
– Name: Abstract
  Label: Abstract
  Group: Ab
  Data: Background: Acquisition of laparoscopic psychomotor skills is essential for safe minimally invasive surgery but is associated with a steep learning curve. Simulation-based training improves proficiency; however, additional strategies to accelerate skill acquisition are sought. Transcranial direct current stimulation (tDCS) has been shown to facilitate motor learning, but its effect on laparoscopic training remains uncertain.&lt;br /&gt;Methods: In this prospective, sham-controlled trial, 33 medical students without prior laparoscopic experience were allocated to active tDCS (n = 16) or sham stimulation (n = 17) during laparoscopic simulation training. Stimulation was delivered using the Halo Sport system (1.4&#160;mA, 20&#160;min) over bilateral primary motor cortices. Baseline psychomotor abilities were assessed using the Vienna Test System (Motor Performance Series, 2HAND, and 3D spatial ability tests). Laparoscopic skills were evaluated using the Laparoscopic Skills Testing and Training (LASTT) model, including camera navigation (CN), hand-eye coordination (HE), and bimanual coordination (Bi), on days 1, 3, 5, and 7. Group differences in final performance (day 7) were analyzed using linear models and ANCOVA, adjusting for baseline performance and prespecified covariates.&lt;br /&gt;Results: Both groups demonstrated significant improvement across all laparoscopic tasks over time (all p &amp;lt; 0.001). Active tDCS was independently associated with higher final bimanual coordination performance compared with sham stimulation (adjusted ANCOVA: F (1,13) = 14.92, p = 0.002). No independent effect of tDCS was observed for camera navigation (p = 0.581) or hand-eye coordination (p = 0.439). Baseline visuospatial ability (3D test) was an independent predictor of final performance in camera navigation and hand-eye coordination (both p &amp;lt; 0.01). Positive correlations were found between 3D scores and CN (r = 0.397) and HE (r = 0.390), as well as between 2HAND and HE (r = 0.341).&lt;br /&gt;Conclusions: Bihemispheric tDCS applied during laparoscopic simulation selectively enhanced acquisition of bimanual coordination, while performance in camera navigation and hand-eye coordination was primarily determined by baseline visuospatial ability. These findings support a task-specific role for neuromodulation as an adjunct to simulation-based laparoscopic training and highlight the importance of visuospatial profiling for personalized training strategies.&lt;br /&gt; (&#169; 2026. The Author(s).)
– Name: Abstract
  Label: Competing Interests
  Group: Ab
  Data: Declarations. Disclosures: Piotr Lepka, Dorota Szcześniak, Zofia Sikora, Rafał Matkowski have no conflicts of interest or financial ties to disclose. Ethical approval: The study protocol was approved by the Bioethics Committee at Wroclaw Medical University (approval No. KB-423/2019). All procedures were conducted in accordance with the Declaration of Helsinki and institutional guidelines. Consent to participate: All participants provided written informed consent prior to enrollment and study procedures. Consent for publication: No individually identifiable data (including images) are included in this manuscript. Consent for publication of anonymized aggregate data was obtained at enrollment.
– Name: Ref
  Label: References
  Group: RefInfo
  Data: Neuroimage. 2008 Jul 15;41(4):1382-94. (PMID: &lt;searchLink fieldCode=&quot;PM&quot; term=&quot;%2218486490%22&quot;&gt;18486490)&lt;/searchLink&gt;&lt;br /&gt;Neuroimage. 2013 Feb 15;67:283-97. (PMID: &lt;searchLink fieldCode=&quot;PM&quot; term=&quot;%2223194819%22&quot;&gt;23194819)&lt;/searchLink&gt;&lt;br /&gt;J Surg Educ. 2018 Mar - Apr;75(2):458-464. (PMID: &lt;searchLink fieldCode=&quot;PM&quot; term=&quot;%2228918007%22&quot;&gt;28918007)&lt;/searchLink&gt;&lt;br /&gt;Sci Rep. 2023 Aug 23;13(1):13731. (PMID: &lt;searchLink fieldCode=&quot;PM&quot; term=&quot;%2237612337%22&quot;&gt;37612337)&lt;/searchLink&gt;&lt;br /&gt;Data Brief. 2021 Feb 23;35:106905. (PMID: &lt;searchLink fieldCode=&quot;PM&quot; term=&quot;%2233732823%22&quot;&gt;33732823)&lt;/searchLink&gt;&lt;br /&gt;Clin Neurophysiol. 2017 Jan;128(1):56-92. (PMID: &lt;searchLink fieldCode=&quot;PM&quot; term=&quot;%2227866120%22&quot;&gt;27866120)&lt;/searchLink&gt;&lt;br /&gt;Ginekol Pol. 2018;89(10):529-535. (PMID: &lt;searchLink fieldCode=&quot;PM&quot; term=&quot;%2230393839%22&quot;&gt;30393839)&lt;/searchLink&gt;&lt;br /&gt;Brain Stimul. 2020 May - Jun;13(3):863-872. (PMID: &lt;searchLink fieldCode=&quot;PM&quot; term=&quot;%2232289719%22&quot;&gt;32289719)&lt;/searchLink&gt;&lt;br /&gt;BMC Neurosci. 2008 Oct 28;9:103. (PMID: &lt;searchLink fieldCode=&quot;PM&quot; term=&quot;%2218957075%22&quot;&gt;18957075)&lt;/searchLink&gt;&lt;br /&gt;J Neurosci. 2014 Jan 15;34(3):1037-50. (PMID: &lt;searchLink fieldCode=&quot;PM&quot; term=&quot;%2224431461%22&quot;&gt;24431461)&lt;/searchLink&gt;&lt;br /&gt;Brain Res. 2021 Nov 15;1771:147656. (PMID: &lt;searchLink fieldCode=&quot;PM&quot; term=&quot;%2234508672%22&quot;&gt;34508672)&lt;/searchLink&gt;&lt;br /&gt;Sci Rep. 2017 Mar 28;7(1):480. (PMID: &lt;searchLink fieldCode=&quot;PM&quot; term=&quot;%2228352100%22&quot;&gt;28352100)&lt;/searchLink&gt;&lt;br /&gt;J Endourol. 2006 Apr;20(4):281-3. (PMID: &lt;searchLink fieldCode=&quot;PM&quot; term=&quot;%2216646658%22&quot;&gt;16646658)&lt;/searchLink&gt;&lt;br /&gt;J Neurosci. 2017 Aug 2;37(31):7500-7512. (PMID: &lt;searchLink fieldCode=&quot;PM&quot; term=&quot;%2228674174%22&quot;&gt;28674174)&lt;/searchLink&gt;&lt;br /&gt;Obstet Gynecol. 2013 Mar;121(3):578-584. (PMID: &lt;searchLink fieldCode=&quot;PM&quot; term=&quot;%2223635621%22&quot;&gt;23635621)&lt;/searchLink&gt;&lt;br /&gt;Brain Stimul. 2011 Jul;4(3):169-74. (PMID: &lt;searchLink fieldCode=&quot;PM&quot; term=&quot;%2221777878%22&quot;&gt;21777878)&lt;/searchLink&gt;&lt;br /&gt;Trends Cogn Sci. 2004 Jan;8(1):18-25. (PMID: &lt;searchLink fieldCode=&quot;PM&quot; term=&quot;%2214697399%22&quot;&gt;14697399)&lt;/searchLink&gt;&lt;br /&gt;Proc Natl Acad Sci U S A. 2009 Feb 3;106(5):1590-5. (PMID: &lt;searchLink fieldCode=&quot;PM&quot; term=&quot;%2219164589%22&quot;&gt;19164589)&lt;/searchLink&gt;&lt;br /&gt;J Neurosci. 2012 Oct 17;32(42):14617-21. (PMID: &lt;searchLink fieldCode=&quot;PM&quot; term=&quot;%2223077047%22&quot;&gt;23077047)&lt;/searchLink&gt;&lt;br /&gt;J Physiol. 2000 Sep 15;527 Pt 3:633-9. (PMID: &lt;searchLink fieldCode=&quot;PM&quot; term=&quot;%2210990547%22&quot;&gt;10990547)&lt;/searchLink&gt;&lt;br /&gt;BMC Surg. 2018 Nov 7;18(1):94. (PMID: &lt;searchLink fieldCode=&quot;PM&quot; term=&quot;%2230404634%22&quot;&gt;30404634)&lt;/searchLink&gt;&lt;br /&gt;Ann Surg. 2013 Feb;257(2):224-30. (PMID: &lt;searchLink fieldCode=&quot;PM&quot; term=&quot;%2223013806%22&quot;&gt;23013806)&lt;/searchLink&gt;
– Name: GrantInfo
  Label: Grant Information
  Group: Grant
  Data: SUBZ.C280.26.041 Uniwersytet Medyczny im. Piast&#243;w Slaskich we Wroclawiu
– Name: SubjectMinor
  Label: Contributed Indexing
  Group:
  Data: &lt;i&gt;Keywords: &lt;/i&gt;Bimanual coordination; Laparoscopy training; Psychomotor skills; Randomized controlled trial; Transcranial direct current stimulation; Visual–spatial ability
– Name: DateEntry
  Label: Entry Date(s)
  Group: Date
  Data: &lt;i&gt;Date Created: &lt;/i&gt;20260713 &lt;i&gt;Date Completed: &lt;/i&gt;20261002 &lt;i&gt;Latest Revision: &lt;/i&gt;20261008
– Name: DateUpdate
  Label: Update Code
  Group: Date
  Data: 20261008
– Name: PubmedCentralID
  Label: PubMed Central ID
  Group: ID
  Data: PMC13633295
– Name: DOI
  Label: DOI
  Group: ID
  Data: 10.1007/s00464-026-12992-2
– Name: AN
  Label: PMID
  Group: ID
  Data: 42443692
PLink https://search.ebscohost.com/login.aspx?direct=true&site=eds-live&db=cmedm&AN=42443692
RecordInfo BibRecord:
  BibEntity:
    Identifiers:
      – Type: doi
        Value: 10.1007/s00464-026-12992-2
    Languages:
      – Code: eng
        Text: English
    PhysicalDescription:
      Pagination:
        StartPage: 8412
    Subjects:
      – SubjectFull: Humans
        Type: general
      – SubjectFull: Female
        Type: general
      – SubjectFull: Prospective Studies
        Type: general
      – SubjectFull: Male
        Type: general
      – SubjectFull: Young Adult
        Type: general
      – SubjectFull: Adult
        Type: general
      – SubjectFull: Motor Skills
        Type: general
      – SubjectFull: Laparoscopy education
        Type: general
      – SubjectFull: Psychomotor Performance physiology
        Type: general
      – SubjectFull: Transcranial Direct Current Stimulation methods
        Type: general
      – SubjectFull: Simulation Training methods
        Type: general
      – SubjectFull: Clinical Competence
        Type: general
    Titles:
      – TitleFull: Effect of transcranial direct current stimulation on psychomotor skill acquisition during laparoscopic training: a randomized controlled trial.
        Type: main
  BibRelationships:
    HasContributorRelationships:
      – PersonEntity:
          Name:
            NameFull: Lepka P
      – PersonEntity:
          Name:
            NameFull: Szcześniak D
      – PersonEntity:
          Name:
            NameFull: Sikora Z
      – PersonEntity:
          Name:
            NameFull: Matkowski R
    IsPartOfRelationships:
      – BibEntity:
          Dates:
            – D: 01
              M: 10
              Text: 2026 Oct
              Type: published
              Y: 2026
          Identifiers:
            – Type: issn-electronic
              Value: 1432-2218
          Numbering:
            – Type: volume
              Value: 40
            – Type: issue
              Value: 10
          Titles:
            – TitleFull: Surgical endoscopy
              Type: main
ResultId 1