npj Science of Learning, Published online: 24 October 2026; doi:10.1038/s41539-026-00459-x
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npj Science of Learning, Published online: 27 October 2026; doi:10.1038/s41539-026-00461-3
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Surgical motor skill acquisition requires prolonged training and durable retention, yet standard behavioral metrics capture performance changes without revealing the neural mechanisms of learning. Here, we validate directed functional connectivity (dFC)—computed from electroencephalography across five cortical regions using nonlinear Granger causality—as a brain-based biomarker for tracking motor learning and retention. Twenty-five trainees completed a 15-day laparoscopic suturing program followed by six-week retention testing; an untrained control group (n = 27) and 15 expert surgeons served as behavioral and autonomous-stage references. dFC was evaluated using subtask-level decomposition, change-point detection, and a one-dimensional convolutional neural network benchmarked against the Fundamentals of Laparoscopic Surgery (FLS) score. dFC classified pre- versus post-training trials with 94.4% accuracy, outperforming the FLS-based classifier (84.5%), while matching FLS on pre-…
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