In the high-stakes world of surgery, confidence isn’t just a mindset. It’s the product of consistent practice and preparation. While textbooks and observation provide the foundation of knowledge, it’s repetition and surgical practice that build true fluency and confidence in the operating room.
Behind every smooth suture or decisive clamp lies a powerful neurological process: muscle memory. Far from being a buzzword, muscle memory is rooted in neuroscience and reflects the formation of efficient neural pathways through repeated practice.
This is why simulation-based, hands-on training, especially with tactile, high-fidelity tools, is revolutionizing surgical education. In this article, we’ll explore how repetition builds muscle memory and how tools like the Miya Model create safer practice environments that help develop more skilled and confident surgeons.
What is “Muscle Memory” in Surgery?
We all rely on muscle memory in daily life. From tying shoes to riding a bike or typing on a keyboard, repetition transforms conscious effort into automatic action. Similarly, an experienced surgeon’s hands “remember” how to tie a suture or navigate anatomy without conscious thought. This type of procedural memory is built through repetition. There is no shortcut. Repeating a task over and over allows neural circuits to become ingrained (Cleveland Clinic).
When learning a new surgical skill, a trainee must first think through each step (the cognitive phase). With more practice, they enter the associative phase, where movements become smoother and less effortful. Eventually, with enough repetition, the skill reaches the autonomous phase: the surgeon can execute steps almost automatically. This not only makes procedures more efficient but also frees up mental bandwidth to handle unexpected findings or critical decisions. Under pressure, this shift toward automaticity enables safer and more effective surgeries.
Observation vs. Practice: Active Learning Engages the Brain More
If repetition is key, why does traditional surgical education still rely so heavily on observation? Apprenticeship models have long depended on trainees watching senior surgeons perform procedures. While observation with an experienced surgeon is valuable, it does not activate the brain’s motor regions in the same way as physical practice (National Library of Medicine).
Passive observation simply cannot replace hands-on practice when it comes to developing muscle memory. Research confirms this: surgical residents who trained on a virtual reality simulator until reaching proficiency performed real laparoscopic surgeries much more effectively than those who only had standard training (which included observation). The VR-trained group made three times fewer errors and completed operations 58% faster (National Library of Medicine).
For a deeper look at the differences between observation and practice, see our blog Simulation vs. Observation: Why Hands-On Experience Matters More Than Ever.
Building Surgical Muscle Memory Using the Miya Model
Since surgical muscle memory is critical, training must be accessible and allow for sufficient repetition. That’s why high-fidelity simulators are so valuable. Whether through virtual reality or physical anatomical models, these platforms provide safe environments where residents can practice procedures repeatedly.
The Miya Model is a prime example. Developed by surgeon Dr. Douglas Miyazaki, it was designed to address the gap in gynecology residencies, where trainees often lack sufficient exposure to complex vaginal surgeries. When a learner passes a trocar through the Miya Model’s simulated tissue, they feel the characteristic “pop” as the needle passes, just like in real surgery. That immediate sensory feedback reinforces proper technique in a way observation never could. By practicing on the model repeatedly, trainees engrain the necessary force, angle, and motion into their procedural memory.
Building Lasting Neural Pathways for Life-Saving Skills
Muscle memory is more than convenience. It is the foundation of surgical mastery. Every repetition strengthens neural pathways, turning deliberate movements into instinctive actions. Simulation tools like the Miya Model make this process possible in a safe, controlled environment, ensuring surgeons gain critical hands-on experience before ever entering the operating room.
By investing in high-fidelity simulation, Miyazaki is helping institutions and educators prepare the next generation of surgeons with the skills, confidence, and neural pathways they need to deliver the highest standard of care. Feel free to contact us for more information about the Miya Model or with any questions about how it can support your training program.
