This study aimed to evaluate the effectiveness of mental practice (MP) in improving procedural performance among surgical trainees learning to describe an ulnar shortening osteotomy using a non-biological simulator.

Fourteen level-1 and level-2 surgical residents were randomly assigned to a Naive Practice (NP) or Mental Practice (MP) group. All participants watched a standardized surgical video and performed three consecutive verbal descriptions of the procedure. The NP group watched the video before each trial, while the MP group received structured feedback and practiced mentally without rewatching the video. Performance was scored using a 55-point checklist, and the duration of each description was also recorded.

At baseline (Trial 1), no significant score difference was found between the groups (p = 0.87). By Trial #3, the MP group achieved significantly higher scores (mean = 44.43) than the NP group (mean = 31.29; p = 0.0044), indicating a superior learning effect from mental practice. Overall duration in describing the procedure between groups did not differ significantly (p = 0.30). However, only the MP group showed a significant evolution in duration across trials (p = 0.0486), suggesting improved fluency with repeated mental rehearsal, whereas the NP group did not (p = 0.605).

Mental practice significantly enhanced procedural understanding and performance compared to repeated passive video observation. These findings support the integration of structured mental rehearsal into surgical training, particularly when access to hands-on practice is limited.