**7. Limitations**

The ability to imagine a motor task and generate that mental image and maintain it while doing deliberate practice was difficult to assess. The use of the motor imagery questionnaire (MIQ ) to measure this ability was simplistic. A qualitative approach, such as interview or focus group discussions with participants, would have produced much richer and more authentic data on the quality of motor imagery and the use of a focus group of experts and novices for script validation. Also, the compliance of self-directed use of the mental script for motor imagery was difficult to control and measure.

In the experimental part of the study, the main challenge was to prevent the control group from indirectly practicing motor imagery and mental practice. This was built into the study by excluding sports and musical performers in the control group [43]. The adherence of the experimental group to the instructions on mental practice before the deliberate practice sessions could not be verified. The small sample size of the participants is an obvious limiting factor, as generalizability is not possible with such a small size.

The role of confounding factors such as periods of rest before task performance, different levels of innate fine motor skills, subconscious use of motor imagery, and practice in the control group were not considered in this research. This research was confined to a laboratory and a very structured and small motor task. The generalisability of these results to more complex motor tasks has yet to be determined. This study also did not look at the other competencies required of a master surgeon, including but not confined to diagnostics and decision making, team development, and communication skills.
