Cognitive Neuroscience Foundations of Surgical and Procedural Expertise: Focus on Theory

  • Pamela AndreattaEmail author
Living reference work entry


This chapter describes the cognitive processes and associated neuroscientific manifestations of expertise in surgery and other specialties where procedural acumen encompasses a component of expertise, and considers the processes by which health professions’ educators may leverage this knowledge to support the development of expertise in procedural domains. Three primary dimensions of procedural performance are considered, including perceptual expertise (the ability to accurately recognize and differentiate patterns from perceptual inputs), cognitive expertise (the ability to accurately interpret, differentiate, and render decisions in complex environments), and psychomotor expertise (the ability to anticipate and execute accurate motor responses). The foundational elements of expertise are embedded in long-term memory, and the development of expertise requires significant investment by individuals to rigorously engage in the content domain for significant periods of time. Once acquired, expertise appears to be effortless; however, neuroscience confirms that experts’ brains are highly stimulated; they are simply stimulated in different areas than novices, because they have developed different strategies for working within their expertise domain. Importantly, expertise in one domain does not transfer to another domain, primarily because of the very neuroscientific mechanisms by which expertise is developed. If domain patterns alter (e.g., open surgical procedures become laparoscopic procedures), expertise may need to be reacquired to accommodate the changes in the performance domain.


Cognitive processing surgical expertise Cognitive neuroscience surgical expertise Acquisition of surgical expertise Developing surgical expertise Expert surgeons Surgical performance acquisition Maintenance of surgical expertise Procedural expertise Developing procedural expertise Cognitive neuroscience procedural expertise Cognitive processing procedural expertise Procedural performance acquisition Procedural mastery Surgical mastery 


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Copyright information

© Springer Nature Singapore Pte Ltd. 2020

Authors and Affiliations

  1. 1.Department of SurgeryUniformed Services University & the Walter Reed National Military Medical Center “America’s Medical School”BethesdaUSA

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