Cognitive Task Analysis Versus Conventional Training for Invasive Medical Procedures: An Updated Systematic Review and Meta-analysis.

OBJECTIVE: Cognitive task analysis (CTA) has emerged as a structured approach to enhance surgical training by organizing procedural knowledge and decision-making. This study aimed to update the evidence on the effectiveness of CTA-based and other structured cognitive training interventions in surgical education, as well as to conduct a meta-analysis. DESIGN: Systematic review and meta-analysis conducted in accordance with PRISMA guidelines. Randomized controlled trials evaluating CTA-based or other structured cognitive interventions in surgical training were included. Primary outcomes were procedural knowledge and technical performance. Subgroup analyses were performed according to training level and intervention type. SETTING: Surgical and procedural training programs in academic and simulation-based settings. PARTICIPANTS: Fifteen randomized controlled trials were identified; 9 were included in the quantitative synthesis, and 6 were analyzed qualitatively due to insufficient or noncomparable data. Participants were surgical trainees and medical students. RESULTS: CTA-based training significantly improved procedural knowledge among surgical trainees (standardized mean difference [SMD] 2.08, 95% CI 1.46-2.71), with no significant effect among medical students. Overall, cognitive training interventions were associated with improved procedural knowledge (SMD 1.79, 95% CI 1.45-2.14) and technical performance (SMD 1.73, 95% CI 0.82-2.64). Sensitivity analyses demonstrated a consistent direction of effect across studies, supporting the overall stability of the findings. CONCLUSIONS: CTA-based cognitive training improves procedural knowledge and technical performance in surgical education, particularly among surgical trainees, supporting its integration into modern surgical curricula.