Influence of Visual and Haptic Cues on Motor Learning: Insights from Tennis Skill Acquisition in Children

Underdevelopment of cognitive abilities in children, such as memory and attention, may make the use of verbal instructions difficult for learning new motor skills. The objective of this study was to evaluate whether visual and haptic cues which emphasize certain instructions facilitate skill acquisition in young tennis players. Twenty children were distributed in 2 groups: experimental (EXP) and control (CON). EXP received a racket with visual and haptic cues while CON trained with a classic racket. The task consisted of playing 30 consecutive forehands during a pretest and 16 weeks post-intervention. EXP displayed a larger improvement both in their technique (better ready position, more balls hit in front and to the side of the body) and in their performance (more points scored), highlighting the positive impact of visual and haptic cues during the early stage of motor learning.

Effectiveness of Video Modeling in Improving Technical Skills in Young Novice Basketball Players: A Quasi-Experimental Study

(1) Objective: This is a quasi-experimental study that investigated the effect of four weeks of training sessions using video modeling (VM) on individual and collective technical skills in young novice basketball players. (2) Method: 20 players were equally assigned to either a control group (CG, n = 10; 12 ± 0.7 years) or a video modeling group (VMG, n = 10; 12.5 ± 0.5 years; visualizing videos before each session) were assessed before and after the four-week training period using the Basketball Skill Test of the American Alliance for Health, Physical Education, Recreation and Dance for individual techniques and three vs. three small-sided games for collective aspects. (3) Results: For the passing test, VMG induced higher performance than CG (p = 0.021; d = 0.87). For offensive balls post-intervention, higher values were recorded for VMG compared to CG (p = 0.003; d = 1.81). In addition, the number of attack balls index post-intervention was higher for VMG compared to CG (p = 0.001; d = 0.28). For losing the ball, VMG induced lower values than CG after the training intervention (p < 0.001; d = -3.23). The efficiency index was higher post-training compared to pre-training for VMG (p = 0.013; d = 1.24). (4) Conclusion: The study highlighted the importance of using video modeling as an effective strategy to improve technical skills and collective performance in novice young basketball players.

Simulation and social network analysis provide insight into the acquisition of tool behaviour in hybrid macaques

The pathways through which primates acquire skills are a central focus of cultural evolution studies. The roles of social and genetic inheritance processes in skill acquisition are often confounded by environmental factors. Hybrid macaques from Koram Island (Thailand) provide an opportunity to examine the roles of inheritance and social learning to skill acquisition within a single ecological setting. These hybrids are a cross between tool-using Burmese long-tailed (Macaca fascicularis aurea) and non-tool-using common long-tailed macaques (Macaca fascicularis fascicularis). This population provides an opportunity to explore the roles of social learning and inheritance processes while being able to exclude underlying ecological factors. Here, we investigate the roles of social learning and inheritance in tool use prevalence within this population using social network analysis and simulation. Agent-based modelling (ABM) is used to generate expectations for how social/asocial learning and inheritance structure the patterning in a social network. The results of the simulation show that various transmission mechanisms can be differentiated based on associations between individuals in a social network. The results provide an investigative framework for discussing tool use transmission pathways in the Koram social network. By combining ABM, network analysis, and behavioural data from the field we can investigate the roles social learning and inheritance play in tool acquisition of wild primates.

Changes in Perceived Mental Load and Motor Performance during Practice-to-Learn and Practice-to-Maintain in Basketball

BACKGROUND

Attentional resource allocation during sports practice is associated with the players' perceived mental load. However, few ecological studies address this problem by considering the players' characteristics (e.g., practice experience, skill and cognition). Therefore, this study aimed to analyse the dose-response effect of two different types of practice, each with different learning objectives, on mental load and motor performance by using a linear mixed model analysis.

METHOD

Forty-four university students (age 20.36 ± 3.13 years) participated in this study. Two sessions were conducted, one based on a standard rules 1 × 1 basketball situation ("practice to maintain") and one with motor, temporal and spatial restrictions in 1 × 1 tasks ("practice to learn").

RESULTS

"Practice to learn" produced a higher perceived mental load (NASA-TLX scale) and a worse performance than "practice to maintain", but was moderated by experience and inhibition (p = 0.001). The same happens in the most demanding restriction (i.e., temporal, p < 0.0001).

CONCLUSION

The results showed that increasing the difficulty of 1 × 1 situations through restrictions harmed the player's performance and increased their perceived mental load. These effects were moderated by previous basketball experience and the player's inhibition capacity, so the difficulty adjustment should be based on the athletes themselves.

Differential mastery criteria impact sight word acquisition and maintenance: Application to individual operants and teaching trial doses

We compared the effects of different "mastery" criteria and doses on the acquisition and maintenance of sight words for 4 second graders with and without disabilities. First, we replicated Set Analysis and Operant Analysis conditions where participants were taught sight words in 20-trial (4 operants, 5 opportunities) sessions. Acquisition criteria were applied to a set of 4 operants or to individual operants, respectively. Second, we extended the literature by evaluating a lower dose of the Operant Analysis condition in a 12-trial session (4 operants, 3 opportunities). Thus, we compared 3 conditions-Set Analysis 5, Operant Analysis 5, and Operant Analysis 3. All participants acquired novel sight words fastest and required far fewer teaching trials to maintain each sight word under Operant Analysis 3 compared with Set Analysis 5 and Operant Analysis 5 conditions. Implications for arranging acquisition criteria and the interaction with trial-dosages are discussed.

Improvement of the ability to recover balance through versatile kinesthetic learning experiences

The purpose of the present study was to compare learners' movement variability while maintaining balance and the ability to recover balance using the kinesthetic-experiential learning (KEL) method of implicit learning and the model-mastery learning (MML) method of explicit learning. The participants were 29 healthy university students. They were randomly divided into two groups (KEL and MML). They were required to balance both knees on an exercise ball. The balancing time and the ability to recover their balance were measured using motion capture. Results indicated that balancing time was significantly improved for both learning methods. Regarding the learners' movements while maintaining balance, they maintained balance while moving in the KEL method, whereas they maintained balance by keeping the entire body stationary in the MML method. Concerning the ability to recover, the KEL method improved the balance recovery ability more effectively than the MML method. Therefore, we concluded that using the KEL method at the initial stage of learning improves learners' balance recovery ability and increases movement variability.

Ability and Nonability Predictors of Real-World Skill Acquisition: The Case of Rubik's Cube Solving

Most research on skilled performance is correlational, with skill and predictors measured at a single point in time, making it difficult to draw conclusions about the acquisition of skill. By contrast, in this study, we trained novice participants (N = 79) to solve Rubik's Cubes using a 7-step solution method. Participants also completed measures of fluid intelligence (Gf), working memory capacity (WMC), and nonability factors (grit, growth mindset, NFC, and the "big five"). Overall, higher Gf (but not WMC) was predictive of efficient and accurate Rubik's cube skill. No nonability variables were associated with skill. Our results provide compelling evidence for the importance of intellectual talent (cognitive ability) in developing expertise in a complex task.

The Effects of a Weighted Football Intervention on Ball Velocity of a Standard Football Place-Kick among Elite Gaelic Football Goalkeepers: A Single-Subject Designed Study

Weighted football place-kicking acutely enhances the ball velocity (BV) of subsequent standard football place-kicks. However, there is a dearth of research examining the long-term effects of such interventions, with less evidence in existence among elite athlete cohorts. Therefore, the purpose of this study was to investigate the individual effects of a 4 week, eight-session weighted Gaelic football intervention on BV of standard Gaelic football place-kicks among six elite male Gaelic football goalkeepers. This research design was based on a pre-, mid-, post-, and retention-test design. A linear mixed model analysis was employed, with time and participants as fixed effects, and the number of place-kicks per testing session as a random effect. Post hoc tests revealed significant changes in BV for five of the six participants (p < 0.05), with three participants experiencing significant BV increases from pre-test to post-test (p < 0.05), while no significant differences were found between post-test and retention-test. The remaining three participants experienced no significant BV differences from pre-test to post-test and retention-test. These findings suggest that a weighted football place-kicking intervention can be a time-efficient means of maintaining and enhancing BV and, thus, kick distance, among elite goalkeepers during pre-season and in-season phases.

Kick proficiency and skill adaptability increase from an Australian football small-sided game intervention

This investigation is the first to explore the effect of a 4 week small-sided game (SSG) and traditional training intervention on player kick proficiency and player adaptability in Australian football. Twenty-two amateur Australian football players (mean ± SD; age 22.3 ± 2.46; height 182.4 ± 5.25; weight 82.1 ± 6.10; years playing senior amateur football 3.86 ± 3.09) were randomly selected into either a traditional training group (n = 11) or a SSG group (n = 11). Traditional training involved activities where skills were generally executed in isolation and with minimal contact (e.g., kicking lane drill or possession football). The SSG training group participated in 5v6 competitive games on varied shaped areas (approximately 272 m² per player) and changing constraints (e.g., game tempo, game rules). All players participated in the team training sessions; however, the SSG group participated in a 4 × 3min training protocol, with 60 seconds recovery, in the last 20-min of the session. The SSG group participated in these alternative sessions twice a week for 4 weeks. Results indicated only the SSG enhanced their kick proficiency (17%) and were found to be more adaptable. The intervention group executed more kicks over longer distances (i.e., 20-40 m), made quicker decisions (e.g., executing more kicks in < 1s), applied more pressure to the opposition when they were executing a skill and were more likely to "take the game on" by decreasing the amount of times a skill was executed from a stationary position. The results of this study can be used by coaches when designing and implementing training programs as different training strategies will elicit different player behavioral adaptations.

Decreased Dorsomedial Striatum Direct Pathway Neuronal Activity Is Required for Learned Motor Coordination

It has been suggested that the dorsomedial striatum (DMS) is engaged in the early stages of motor learning for goal-directed actions, whereas at later stages, control is transferred to the dorsolateral striatum (DLS), a process that enables learned motor actions to become a skill or habit. It is not known whether these striatal regions are simultaneously active while the expertise is acquired. To address this question, we developed a mouse "Treadmill Training Task" that tracks changes in mouse locomotor coordination during running practice and simultaneously provides a means to measure local neuronal activity using photometry. To measure change in motor coordination over treadmill practice sessions, we used DeepLabCut (DLC) and custom-built code to analyze body position and paw movements. By evaluating improvements in motor coordination during training with simultaneous neuronal calcium activity in the striatum, we found that DMS direct pathway neurons exhibited decreased activity as the mouse gained proficiency at running. In contrast, direct pathway activity in the DLS was similar throughout training. Pharmacological blockade of D1 dopamine receptors in these subregions during task performance demonstrated that dopamine neurotransmission in the direct pathway activity is necessary for efficient motor coordination learning. These results provide new tools to measure changes in fine motor skills with simultaneous recordings of brain activity and reveal fundamental features of the neuronal substrates of motor learning.

Grip position affects upper limb kinematic chain during tennis double-handed backhand topspin strokes: considerations for transitioning tennis grip position technique

The purpose of this study was to compare the upper limb kinematic chain of tennis players using either an eastern or continental non-dominant grip position during the forward swing of the double-handed backhand stroke. Sixteen right-handed tennis players performed backhands using two non-dominant grip positions (eastern and continental), aiming for two cross-court zones (deep and short). Trajectory data were captured using sixty reflective markers attached to the upper limb and racket using a 12-camera Vicon motion capture system (250 Hz). Peak angular velocity was significantly greater for multiple joint rotations at the dominant shoulder and entire non-dominant limb in the eastern grip. Subsequently, greater peak racket head angular velocity and post-impact ball speed were generated by the eastern grip, while shot accuracy was similar between grip types. There was delayed dominant shoulder peak adduction angular velocity for the continental grip, possibly due to a lack of skill familiarity causing changes in coordinative patterns. Collectively, the non-dominant grip position appears to influence proximal and distal upper limb movement. Future research should explore upper limb segment coordination comparing preferred and non-preferred double-handed backhand techniques and complete inter-disciplinary investigations to understand what grip positions are most effective for individuals to learn double-handed backhands.

An Examination of the Contextual Interference Effect and the Errorless Learning Model during Motor Learning

The purpose of this study was to investigate the combined effects of random and block practice, with errorless and errorful conditions, on motor learning. One hundred-twenty participants (all male, Mage = 21.19 ± 1.4 years) were randomly assigned to one of eight groups. Participants completed a dart throwing task across the experimental phases. In the retention test, evidence supporting the CI effect was found in the 'errorless' conditions, but not in the 'errorful' conditions. In the transfer tests, the findings indicated that the impact of errorless and errorful conditions on participants' automation levels depends on the structure of practice. Participants in the Random-Errorless group performed better in the transfer tests than those in the Random group and the Random-Errorful group, suggesting greater automation levels following errorless practice.

Factors Facilitating and Hindering the Use of Newly Acquired Positioning Skills in Clinical Practice: A Longitudinal Survey

Background

After learning new skills, healthcare professionals do not always apply them in practice, despite being motivated. This may be referred to as an intention-behavior gap. One example is the positioning of immobilized and disabled patients in hospitals, nursing homes, or neurorehabilitation clinics. Positioning is crucial to prevent complications such as pressure sores, pneumonia, and deep vein thrombosis. However, it is often not carried out optimally even when professionals have completed education programs. The LiN-method is a positioning procedure involving a special focus on aligning and stabilizing body parts, which has been shown to have advantages over conventional positioning. We assess which factors may facilitate or hinder the use of LiN in clinical practice after participants complete training.

Methods

A longitudinal survey with 101 LiN-course participants was conducted in Germany. Each participant completed a questionnaire directly after the course and 12 weeks later, including a report of the frequency of use in practice. They also completed a questionnaire which surveyed 23 aspects that might facilitate or hinder use of the new skills, covering the workplace, socio-collegial factors, motivation, self-confidence, and mindset.

Results

Most assessed aspects were associated with LiN-use, with the highest correlations found for confidence with the method, perceived ease of application, sufficient time, assessing one's skills as sufficient, remembering the relevant steps, and a work environment open to advanced therapeutic concepts. To reduce data complexity, the questionnaire was subjected to a factor analysis, revealing six factors. A regression analysis showed that four factors predicted use 12 weeks after course completion, in the following order of importance: (1) subjective aspects/confidence, (2) access to materials, (3) work context, and (4) competent support in the workplace.

Conclusion

Numerous aspects are associated with the use of recently acquired clinical or nursing skills, such as LiN. Many of these can be improved by appropriately setting up the workplace. The aspects most associated with use, however, are confidence with the method and self-perceived competence of healthcare professionals. While causality still needs to be demonstrated, this suggests that education programs should support participants in developing confidence and foster a mindset of continuous learning.

The effect of mental schema evolution on mental workload measurement: an EEG study with simulated quadrotor UAV operation

OBJECTIVE

Mental workload is the result of the interactions between the demands of an operation task and the skills, behavior and perception of the performer. Working under a high mental workload can significantly affect an operator's ability to choose optimal decisions. However, the effect of mental schema, which reflects the level of expertise of an operator, on mental workload remains unclear. Here, we propose a theoretical framework for describing how the evolution of mental schema affects mental workload from the perspective of cognitive processing.

APPROACH

we recruited 51 students to participate in a 10-day simulated UAV flight training. The EEG PSD metrics were used to investigate the changes in neural responses caused by variations in the mental workload at different stages of mental schema evolution.

MAIN RESULTS

It was found that mental schema evolution influenced the direction and change trends of the frontal theta PSD, parietal alpha PSD, and central beta PSD. Initially, before the mental schema was formed, only the frontal theta PSD increased with increasing task difficulty; when the mental schema was initially being developed, the frontal theta PSD and the parietal alpha PSD decreased with increasing task difficulty, while the central beta PSD increased with increasing task difficulty. Finally, as the mental schema gradually matured, the trend of the three indicators did not change with increasing task difficulty. However, differences in the frontal PSD became more pronounced across task difficulty levels, while differences in the parietal PSD narrowed.

SIGNIFICANCE

Our results describe the relationship between the EEG power spectrum and the mental workload of UAV operators as the mental schema evolved. This suggests that EEG indicators can not only provide more accurate measurements of mental workload but also provide insights into the development of an operator's skill level.

The contribution of skills to the effectiveness of dialectical behavioral therapy

OBJECTIVE

The present study investigated the effectiveness of dialectical behavioral therapy (DBT) and the effect of improvement in DBT skills on clinical outcomes.

METHOD

Participants included 57 adults who attended a community mental health service and underwent one of two modes of DBT. Twenty-six adults had been diagnosed with borderline personality disorder (BPD) and participated in comprehensive DBT (DBT-C; including group skills training, individual therapy, and phone coaching). Thirty-one adults had BPD traits and participated in DBT skills training (DBT-S; group skills training only). In the present study, the DBT skills examined were mindfulness, emotion regulation, and interpersonal effectiveness; the clinical outcomes examined were borderline symptoms, psychological distress, and quality of life.

RESULTS

Six 2 × 2 analysis of covariances indicated significant improvements in psychological distress, quality of life, mindfulness, and interpersonal effectiveness (but not borderline symptoms and emotion regulation), over a 6-month period. Mode of delivery of DBT did not impact on the improvement in DBT skills and clinical outcomes over the 6-month period. Hierarchical multiple regression results indicated that improvement in DBT skills (mindfulness, emotion regulation, and interpersonal effectiveness) were associated with reductions in borderline symptoms and psychological distress, with emotion regulation the only skill uniquely associated with improvements in clinical outcomes.

CONCLUSIONS

The results of the present study support the effectiveness of DBT and the specific role of emotion regulation for favorable clinical outcomes over a 6-month period, independent of the mode of delivery of DBT.

Learn to Turn: Does Spotting Foster Skill Acquisition in Pirouettes?

Purpose: The spotting technique (i.e., independent head from torso movement) has been revealed as the single feature that differentiates highly skilled from less-skilled dancers. In the current intervention study, the potential of a specific spotting training in novice dancers for learning double pirouettes was tested. Method: Novice dancers trained pirouettes in an experimental group and an active control group over a period of eight weeks by receiving either specific spotting instructions or technical instructions only. Pirouette performance was examined in a pretest, and a one-week-delayed retention test. In a further control test, effects of explicitly instructing how to perform the pirouettes (i.e., either with or without spotting) were investigated. Results: Different than expected, in the retention test, only few participants from the experimental group showed the spotting technique. Moreover, the spotting group did not perform better than the control group. Rather, the balance measure revealed that, while the control group improved over learning, the experimental group remained at the baseline values and showed a slight advantage for orientation only. In the control test, all groups showed inferior performance as compared to the retention test. Conclusion: In sum, the current findings show that-at least for beginners-the spotting technique is not suitable to be implemented in applied training settings. Moreover, in line with the expert performance approach, this study suggests to investigate the implementation of expert skills in applied training routines experimentally.

Experiences from leading parental education groups: Perceived difficulties and rewards as an indication of skill acquisition

Developing skills in a professional setting is linked to practical experience. The relationship between experience and acquisition of skills can be seen as a transition from novice to expert. In a nursing setting, this has been studied using the Dreyfus model of skill acquisition. The aim was to investigate how experience influences midwives' and child healthcare nurses' views of difficulties and rewards in working with parental education groups. The study has a cross-sectional design with a mixed methods approach. A total of 437 midwives and child healthcare nurses answered a web-based survey. First, a qualitative analysis was carried out, and then patterns of experience were analysed. The results showed that less experience as a leader corresponds to a greater focus on one's own role and on personal benefits from working with parents, but not on the specific context of the group. With experience, leaders had a greater focus on the group itself and rewards of making it function well. Not being able to take the current group and the specific context into account when working as a leader reduces possibilities of achieving a well-functioning group and the goals of the parental education.

An extended challenge-based framework for practice design in sports coaching

The challenge-point framework as a model for thinking about motor learning was first proposed in 2004. Although it has been well-cited, surprisingly this framework has not made its way into much of the applied sport science literature. One of the reasons for this omission is that the original framework had not been encapsulated into a paper accessible for sports practitioners. The framework had mostly a theoretical focus, providing a mechanistic summary of motor learning research. Our aims in this paper were to explain and elaborate on the challenge point framework to present an applied framework guiding practice design. We connect the framework to other theories that involve predictive coding, where information is attended when it disconfirms current predictions, providing a strong signal for learning. We also consider how two new dimensions (learners' motivation and practice specificity) need to be considered when designing practice settings. By moving around the different dimensions of functional difficulty, motivation, and specificity, coaches can optimize practice to achieve different learning goals. Specifically, we present three general "types" of practice: practice to learn, to transfer to competition, and to maintain current skills. Practical examples are given to illustrate how this framework can inform coach practice.

Implications of Optimal Feedback Control Theory for Sport Coaching and Motor Learning: A Systematic Review

Best practice in skill acquisition has been informed by motor control theories. The main aim of this study is to screen existing literature on a relatively novel theory, Optimal Feedback Control Theory (OFCT), and to assess how OFCT concepts can be applied in sports and motor learning research. Based on 51 included studies with on average a high methodological quality, we found that different types of training seem to appeal to different control processes within OFCT. The minimum intervention principle (founded in OFCT) was used in many of the reviewed studies, and further investigation might lead to further improvements in sport skill acquisition. However, considering the homogenous nature of the tasks included in the reviewed studies, these ideas and their generalizability should be tested in future studies.

Deliberate Practice and Motor Learning Principles to Underpin the Design of Training Interventions for Improving Lifting Movement in the Occupational Sector: A Perspective and a Pilot Study on the Role of Augmented Feedback

Spine posture during repetitive lifting is one of the main risk factors for low-back injuries in the occupational sector. It is thus critical to design appropriate intervention strategies for training workers to improve their posture, reducing load on the spine during lifting. The main approach to train safe lifting to workers has been educational; however, systematic reviews and meta-analyses have shown that this approach does not improve lifting movement nor reduces the risk of low back injury. One of the main limitations of this approach lies in the amount, quality and context of practice of the lifting movement. In this article, first we argue for integrating psychologically-grounded perspectives of practice design in the development of training interventions for safe lifting. Principles from deliberate practice and motor learning are combined and integrated. Given the complexity of lifting, a training intervention should occur in the workplace and invite workers to repeatedly practice/perform the lifting movement with the clear goal of improving their lifting-related body posture. Augmented feedback has a central role in creating the suitable condition for achieving such intervention. Second, we focus on spine bending as risk factor and present a pilot study examining the benefits and boundary conditions of different feedback modalities for reducing bending during lifting. The results showed how feedback modalities meet differently key requirements of deliberate practice conditions, i.e., feedback has to be informative, individualized and actionable. Following the proposed approach, psychology will gain an active role in the development of training interventions, contributing to finding solutions for a reduction of risk factors for workers.

"Train how you play": Using representative learning design to train amateur cricketers

Training task design with amateur female cricketers has typically comprised of deconstructed and monotonous approaches which may not maximise skill development. Clear guidelines to improve these practices in this cohort are lacking. The training environment should provide the same sources of information, decisions and variability as matches in order to prepare players for the match environment, which can be achieved through representative learning design (RLD). An RLD training intervention designed to promote skill development was performed over five weeks with two amateur female cricket teams to provide a framework for community coaches at the foundation stage of cricket. Skill development was recorded as changes in skilled actions for batting and bowling, with cognitions coded as themes for each skill during training. Six of ten batters and seven of eight bowlers exhibited increases in skill development ranging between 7-49%. Changes in batting and bowling behaviour improved substantially between moderately and extensively designed sessions. Batters' thoughts shifted from their own skill execution to objectives, while bowlers focused on their opponent's execution. Moderate to extensive RLD appears to promote skill development in amateur cricketers, making it a viable option for coach education and training design at the foundation level of cricket.

Repetition without Repetition or Differential Learning of Multiple Techniques in Volleyball?

A variety of approaches have been proposed for teaching several volleyball techniques to beginners, ranging from general ball familiarization to model-oriented repetition to highly variable learning. This study compared the effects of acquiring three volleyball techniques in parallel with three approaches. Female secondary school students (N = 42; 15.6 ± 0.54 years) participated in a pretest for three different volleyball techniques (underhand pass, overhand pass, and overhead serve) with an emphasis on accuracy. Based on their results, they were parallelized into three practice protocols, a repetitive learning group (RG), a differential learning group (DG), and a control group (CG). After a period of six weeks with 12 intervention sessions, all participants attended a posttest. An additional retention test after two weeks revealed a statistically significant difference between DG, RG, and CG for all single techniques as well as the combined multiple technique. In each technique-the overhand pass, the underhand pass, the overhand service, and the combination of the three techniques-DG performed best (each p < 0.001).

Associations Between Binocular Depth Perception and Performance Gains in Laparoscopic Skill Acquisition

The ability to perceive differences in depth is important in many daily life situations. It is also of relevance in laparoscopic surgical procedures that require the extrapolation of three-dimensional visual information from two-dimensional planar images. Besides visual-motor coordination, laparoscopic skills and binocular depth perception are demanding visual tasks for which learning is important. This study explored potential relations between binocular depth perception and individual variations in performance gains during laparoscopic skill acquisition in medical students naïve of such procedures. Individual differences in perceptual learning of binocular depth discrimination when performing a random dot stereogram (RDS) task were measured as variations in the slope changes of the logistic disparity psychometric curves from the first to the last blocks of the experiment. The results showed that not only did the individuals differ in their depth discrimination; the extent with which this performance changed across blocks also differed substantially between individuals. Of note, individual differences in perceptual learning of depth discrimination are associated with performance gains from laparoscopic skill training, both with respect to movement speed and an efficiency score that considered both speed and precision. These results indicate that learning-related benefits for enhancing demanding visual processes are, in part, shared between these two tasks. Future studies that include a broader selection of task-varying monocular and binocular cues as well as visual-motor coordination are needed to further investigate potential mechanistic relations between depth perceptual learning and laparoscopic skill acquisition. A deeper understanding of these mechanisms would be important for applied research that aims at designing behavioral interventions for enhancing technology-assisted laparoscopic skills.

The learning curve of robotic coronary arterial bypass surgery: A report from the STS database

BACKGROUND

There is limited data to inform minimum case requirements for training in robotically assisted coronary artery bypass grafting (RA-CABG). Current recommendations rely on nonclinical endpoints and expert opinion.

OBJECTIVES

To determine the minimum number of RA-CABG procedures required to achieve stable clinical outcomes.

METHODS

We included isolated RA-CABG in the Society of Thoracic Surgeons (STS) registry performed between 2014 and 2019 by surgeons without prior RA-CABG experience. Outcomes were approach conversion, reoperation, major morbidity or mortality, and procedural success. Case sequence number was used as a continuous variable in logistic regression with restricted cubic splines with fixed effects. Outcomes were compared between operations performed earlier versus later in case sequences using unadjusted and adjusted metrics.

RESULTS

There were 1195 cases performed by 114 surgeons. A visual inflection point occurs by a surgeon's 10th procedure for approach conversion, major morbidity or mortality, and overall procedural success after which outcomes stabilize. There was a significant decrease in the rate of approach conversion (7.7% and 2.5%), reoperation (18.9% and 10.8%), and major morbidity or mortality (21.7% and 12.9%), as well as an increase in the rate of procedural success (72.9% and 85.3%) with increasing experience between groups. In a multivariable logistic regression model, case sequences of >10 were an independent predictor of decreased approach conversion (odds ratio [OR]: 0.27; 95% confidence interval [CI]: 0.09-0.84) and increased rate procedural success (OR: 1.96; 95% CI: 1.00-3.84).

CONCLUSIONS

The learning curve for RA-CABG is initially steep, but stable clinical outcomes are achieved after the 10th procedure.

Optimizing Feedback Frequency in Motor Learning: Self-Controlled and Moderate Frequency KR Enhance Skill Acquisition

The purpose of this study was to compare the relative effects of self-controlled knowledge of results (SCKR) to other KR schedules of varying relative frequency (25%, 50%, and 100% of acquisition trials) on motor skill learning. Participants received basic instructions on the soccer overhead throw and then performed 50 acquisition trials, during which KR was provided according to the assigned schedule, followed by a retention test, during which no KR was provided. Retention scores were highest for the SCKR and 50% KR frequency groups who shared comparable absolute KR frequency and distribution relative to successful versus unsuccessful trials. These results indicated that both self-control and moderate frequency feedback enhanced learning, supporting an inverted U-shaped effect of feedback frequency on skill acquisition.