Learning through observation: a combination of expert and novice models favors learning

Enhancing motor imagery practice using synchronous action observation

In this paper, we discuss a variety of ways in which practising motor actions by means of motor imagery (MI) can be enhanced via synchronous action observation (AO), that is, by AO + MI. We review the available research on the (mostly facilitatory) behavioural effects of AO + MI practice in the early stages of skill acquisition, discuss possible theoretical explanations, and consider several issues related to the choice and presentation schedules of suitable models. We then discuss considerations related to AO + MI practice at advanced skill levels, including expertise effects, practical recommendations such as focussing attention on specific aspects of the observed action, using just-ahead models, and possible effects of the perspective in which the observed action is presented. In section "Coordinative AO + MI", we consider scenarios where the observer imagines performing an action that complements or responds to the observed action, as a promising and yet under-researched application of AO + MI training. In section "The dual action simulation hypothesis of AO + MI", we review the neurocognitive hypothesis that AO + MI practice involves two parallel action simulations, and we consider opportunities for future research based on recent neuroimaging work on parallel motor representations. In section "AO + MI training in motor rehabilitation", we review applications of AO, MI, and AO + MI training in the field of neurorehabilitation. Taken together, this evidence-based, exploratory review opens a variety of avenues for future research and applications of AO + MI practice, highlighting several clear advantages over the approaches of purely AO- or MI-based practice.

Guidelines for reporting action simulation studies (GRASS): Proposals to improve reporting of research in motor imagery and action observation

Researchers from multiple disciplines have studied the simulation of actions through motor imagery, action observation, or their combination. Procedures used in these studies vary considerably between research groups, and no standardized approach to reporting experimental protocols has been proposed. This has led to under-reporting of critical details, impairing the assessment, replication, synthesis, and potential clinical translation of effects. We provide an overview of issues related to the reporting of information in action simulation studies, and discuss the benefits of standardized reporting. We propose a series of checklists that identify key details of research protocols to include when reporting action simulation studies. Each checklist comprises A) essential methodological details, B) essential details that are relevant to a specific mode of action simulation, and C) further points that may be useful on a case-by-case basis. We anticipate that the use of these guidelines will improve the understanding, reproduction, and synthesis of studies using action simulation, and enhance the translation of research using motor imagery and action observation to applied and clinical settings.

Flexible Cultural Learning Through Action Coordination

The cultural transmission of technical know-how has proven vital to the success of our species. The broad diversity of learning contexts and social configurations, as well as the various kinds of coordinated interactions they involve, speaks to our capacity to flexibly adapt to and succeed in transmitting vital knowledge in various learning contexts. Although often recognized by ethnographers, the flexibility of cultural learning has so far received little attention in terms of cognitive mechanisms. We argue that a key feature of the flexibility of cultural learning is that both the models and learners recruit cognitive mechanisms of action coordination to modulate their behavior contingently on the behavior of their partner, generating a process of mutual adaptation supporting the successful transmission of technical skills in diverse and fluctuating learning environments. We propose that the study of cultural learning would benefit from the experimental methods, results, and insights of joint-action research and, complementarily, that the field of joint-action research could expand its scope by integrating a learning and cultural dimension. Bringing these two fields of research together promises to enrich our understanding of cultural learning, its contextual flexibility, and joint action coordination.

Temporal and Spatial Accuracy of Reaching Movements do not Improve Off-line

Consolidation has been associated with performance gains without additional practice (i.e., off-line learning). However, the movement characteristics improving off-line remain poorly understood. To investigate this question, participants were trained to produce a sequence of planar reaching movements toward four different visual targets. The training session with feedback required them to learn the relative time of the movements, the total movement time and aim accurately at each target. The retention test was performed either 10-min or 24-h after. Results revealed that a 24-h consolidation interval did not result in better temporal or spatial accuracy. This finding suggests that off-line learning may be restricted to sequence production tasks in which the different segments must be regrouped ("chunked") together to accelerate their execution.

Examining Learner-Controlled Role-Switching in Dyad Practice for the Learning of a Speed Cup-Stacking Task

Dyad practice has proven to be an efficient, and in some cases, a more effective method of promoting motor learning compared to individual practice. Further, providing individuals control over their own or another learner's practice environment has also been shown to be superior for skill learning relative to individuals without control. The purpose of the experiment was to assess learner-controlled role-switching in dyad practice conditions. In dyads, partners either alternated actor and observer roles on a trial-to-trial basis, or under novel learner-controlled conditions wherein either the actor or the observer was given control over when the partners should switch roles. Participants practiced a speed cup-stacking task and learning was assessed in 24-h retention and transfer tests. Although there were no learning differences between dyad conditions, paired learners effectively chose when to switch roles with their partner, without undermining learning. The results also highlight the dynamic nature of dyad practice as the observers chose to switch roles more frequently than the actors, yet both dyad groups adopted comparable switching strategies by alternating roles following relatively 'good' and 'bad' trials. This experiment provides further support for dyad practice as an efficient and effective method of skill learning.

Effectiveness of a Program Based on Action-Observation Training (AOT) on Motor, Functional and Cognitive Aspects in Patients with Cognitive Impairment: A Non-Randomized Controlled Trial

Cognitive impairment is frequent in elderly subjects. It is associated with motor impairment, a limitation in quality of life and frequently, institutionalization. The aim of this work is to test the efficacy of a therapeutic group program based on action-observation learning.

METHODS

a non-randomized controlled trial study was conducted. We included 40 patients with cognitive impairment from a nursing home who were categorized into mild and moderate cognitive impairment and divided separately into a control and experimental group. Experimental group performed a 4-week group work, in which each patient with mild cognitive impairment was paired with a patient with moderate cognitive impairment. Thus, patients with mild cognitive impairment observed a series of functional exercises performed by their peers and replicated them. Simultaneously, the patients with moderate cognitive impairment replicated the movement after observing it performed by a patient with mild cognitive impairment. The control group continued to receive their usual care at the center. The upper limb function, cognitive level and function in basic activities of human daily life were measured before and after the intervention and compared with the control group.

RESULTS

statistically significant differences were found in the functionality of basic activities of daily living, in the functionality of the upper limb and in the cognitive level in all patients in the experimental group regardless of the initial cognitive level. No statistically significant differences were found in the control group.

CONCLUSIONS

the implementation of a group, peer-based, action-observation learning therapeutic program is effective in improving the basic activities of human daily life, cognitive level and upper limb functionality in patients with mild and moderate dementia.

The effect of action observation combined with high-definition transcranial direct current stimulation on motor performance in healthy adults: A randomized controlled trial

Action observation (AO) can improve motor performance in humans, probably via the human mirror neuron system. In addition, there is some evidence that transcranial direct current stimulation (tDCS) can improve motor performance. However, it is yet to be determined whether AO combined with tDCS has an enhanced effect on motor performance. We investigated the effect of AO combined with high-definition tDCS (HD-tDCS) targeting the inferior parietal lobe (IPL) and inferior frontal gyrus (IFG), the main aggregates of the human mirror neuron system, on motor performance in healthy adults and compared the immediate vs. 24-h retention test effects (anodal electrodes were placed over these regions of interest). Sixty participants were randomly divided into three groups that received one of the following single-session interventions: (1) observation of a video clip that presented reaching movement sequences toward five lighted units + active HD-tDCS stimulation (AO + active HD-tDCS group); (2) observation of a video clip that presented the same reaching movement sequences + sham HD-tDCS stimulation (AO + sham HD-tDCS group); and (3) observation of a video clip that presented neutral movie while receiving sham stimulation (NM + sham HD-tDCS group). Subjects' reaching performance was tested before and immediately after each intervention and following 24 h. Subjects performed reaching movements toward units that were activated in the same order as the observed sequence during pretest, posttest, and retest. Occasionally, the sequence order was changed by beginning the sequence unexpectedly with a different activated unit. Outcome measures included mean Reaching Time and difference between the Reaching Time of the unexpected and expected reaching movements (Delta). In the posttest and retest, Reaching Time and Delta improved in the AO + sham HD-tDCS group compared to the NM + HD-sham tDCS group. In addition, at posttest, Delta improved in the AO + active HD-tDCS group compared to the NM + sham HD-tDCS group. It appears that combining a montage of active HD-tDCS, which targets the IPL and IFG, with AO interferes with the positive effects of AO alone on the performance of reaching movement sequences.

Who to Observe and Imitate in Humans and Robots: The Importance of Motivational Factors

Imitation is a vital skill that humans leverage in various situations. Humans achieve imitation by observing others with apparent ease. Yet, in reality, it is computationally expensive to model on artificial agents (e.g., social robots) to acquire new skills by imitating an expert agent. Although learning through imitation has been extensively addressed in the robotic literature, most studies focus on answering the following questions: what to imitate and how to imitate. In this conceptual paper, we focus on one of the overlooked questions of imitation through observation: who to imitate. We present possible answers to the who-to-imitate question by exploring motivational factors documented in psychological research and their possible implementation in robotics. To this end, we focus on two critical instances of the who-to-imitate question that guide agents to prioritize one demonstrator over another: outcome expectancies, viewed as the anticipated learning gains, and efficacy expectations, viewed as the anticipated costs of performing actions, respectively.

Video feedback with error-focused or correct-focused examples in surgical skills distance learning: A randomized trial

BACKGROUND

Although it seems natural that surgical trainees would learn from demonstrations of a correct performance, evidence outside of surgical education has suggested that error-focused examples may promote error detection and improved procedural task performance. We hypothesized that feedback through error-focused videos would improve procedural learning more than correct-focused videos.

METHODS

We conducted a randomized controlled trial of video feedback comparing error-focused versus correct-focused examples. The participants were interviewees at our general surgery residency program in December 2020. All of the interviewees performed suturing and knot tying tasks on their interview day (baseline), with 70 common errors identified. For each error, we created an instructional feedback video in two formats: one video demonstrating the error and another demonstrating correct performance. The study participants received feedback videos based on baseline performance errors, with the format randomly assigned. Two blinded raters assessed the baseline and postintervention performances.

RESULTS

Thirty-seven interviewees enrolled and 17 submitted postintervention videos. The postintervention mean performance scores were significantly higher (P = .02) in the error-focused than the correct-focused example group (suturing [maximum score 18]: 16.9 vs 13.9 [difference 2.9; 95% CI 0.7, 5.1]; knot-tying [maximum score 24]: 21.6 vs 17.8 [difference 3.8; 95% CI 0.5, 7.0]). We found no between-group differences in performance time ([error-focused versus correct-focused] suturing: 246 vs 256 s; knot-tying: 170 vs 138 s; P = .08). Mean satisfaction with feedback was similar between groups (error-focused: mean = 5.3 versus correct-focused: mean = 5.2, out of 7; P = .95).

CONCLUSION

Feedback that highlights errors is associated with better learning of surgical skills than feedback demonstrating correct performance, confirming our hypothesis.

The Effects of Virtual Reality Nonphysical Mental Training on Balance Skills and Functional Near-Infrared Spectroscopy Activity in Healthy Adults

CONTEXT

Athletic skills such as balance are considered physical skills. However, these skills may not just improve by physical training, but also by mental training. The purpose of this study was to investigate the effects of mental training programs on balance skills and hemodynamic responses of the prefrontal cortex.

DESIGN

Randomized controlled trial.

METHODS

Fifty-seven healthy adults (28 females, 29 males), aged between 18-25 years, participated in this study. Participants were randomly assigned to 3 groups: virtual reality mental training (VRMT) group, conventional mental training (CMT) group, and control group. The training program included action observation and motor imagery practices with balance exercise videos. The VRMT group trained with a VR head-mounted display, while the CMT group trained with a non-immersive computer screen, for 30 minutes, 3 days per week for 4 weeks. At baseline and after 4 weeks of training, balance was investigated with stabilometry and Star Excursion Balance Test (SEBT). Balance tests were performed with simultaneous functional near-infrared spectroscopy (fNIRS) imaging to measure prefrontal cortex oxygenation.

RESULTS

For the stabilometry test, at least 1 variable improved significantly in both VRMT and CMT groups but not in the control group. For SEBT, composite reach distance significantly increased in both VRMT and CMT groups but significantly decreased in the control group. For separate directional scores, reach distance was significantly increased in both mental training groups for nondominant leg posterolateral and posteromedial directions, and dominant leg posterolateral direction, while nondominant posteromedial score was significantly increased only in the VRMT group. Between-group comparisons showed that dominant leg posteromedial and posterolateral score improvements were significantly higher than control group for both mental training groups, while nondominant leg improvements were significantly higher than control group only for the VRMT group. The fNIRS oxyhemoglobin levels were not significantly changed during stabilometry tests. However, oxyhemoglobin levels significantly reduced only in the control group during SEBT.

CONCLUSIONS

Our findings suggest that both mental training interventions can significantly improve balance test results. Additionally, VRMT may have some advantages over CMT. These findings are promising for the use of mental training in prevention and rehabilitation for special populations such as athletes and older adults.

The Effects of Virtual Reality Nonphysical Mental Training on Coordination and Skill Transfer in Healthy Adults

CONTEXT

Mental training is a promising method to improve motor skills. However, transfer of these improvements to different skills or functional activities is still unclear. The purpose of this study was to investigate the effects of mental balance training programs on motor coordination and skill transfer.

DESIGN

Randomized controlled trial.

METHODS

Fifty-seven healthy adults (28 females and 29 males) aged between 18 and 25 years participated in this study. Participants were randomly assigned to 3 groups: virtual reality (VR) mental training group, conventional mental training group, and control group. The training program included action observation and motor imagery practice with balance exercise videos. The VR mental training group trained with a VR head-mounted display and the conventional mental training group trained with a nonimmersive computer monitor for 30 minutes, 3 days per week, for 4 weeks. Coordination skills were tested with 2 separate custom-made obstacle course tests (OCT-1 and OCT-2). OCT tests included crouching, turning, leaning, stepping over, changing direction, walking on various surfaces, or using repeated hand and arm movement tasks. OCT-1 was used to investigate the effects of mental exercises on coordination skills, and OCT-2 to investigate transfer effects for novel tasks. Test time (total and corrected) and error types (minor, major, and total) were recorded. Touching an obstacle without changing its position was classified as a minor error, and changing its position was a major error.

RESULTS

OCT-1 test time and number of errors significantly decreased in the VR mental training and conventional mental training groups, but not in the control group. The number of minor errors was only decreased in the VR mental training group. For OCT-2, total and corrected time were not significantly different between the groups. However, both training groups were significantly superior to the control group for all types of errors.

CONCLUSIONS

Our findings suggest that both training interventions can significantly improve coordination and skill transfer test results. In addition, VR mental training may have some advantages over conventional mental training. These findings are promising for the use of mental training for prevention and rehabilitation in special populations.

Observing errors in a combination of error and correct models favors observational motor learning

Background

Imitative learning is highly effective from infancy to old age; however, little is known about the effects of observing errors during imitative learning. This study aimed to examine how observing errors affected imitative learning performance to maximize its effect.

Methods

In the pre-training session, participants were instructed to pinch at a target force (8 N) with auditory feedback regarding generated force while they watched videos of someone pinching a sponge at the target force. In the pre-test, participants pinched at the target force and did not view a model or receive auditory feedback. In Experiment 1, in the main training session, participants imitated models while they watched videos of pinching at either the incorrect force (error-mixed condition) or target force (correct condition). Then, the exact force generated was measured without receiving auditory feedback or viewing a model. In Experiment 2, using the same procedures, newly recruited participants watched videos of pinching at incorrect forces (4 and 24 N) as the error condition and the correct force as the correct condition.

Results

In Experiment 1, the average force was closer to the target force in the error-mixed condition than in the correct condition. In Experiment 2, the average force in the correct condition was closer to the target force than in the error condition.

Conclusion

Our findings indicated that observing error actions combined with correct actions affected imitation motor learning positively as error actions contained information on things to avoid in the target action. It provides further information to enhance imitative learning in mixed conditions compared to that with correct action alone.

The effect of action observation on aesthetic preference of Chinese calligraphy: An fMRI study

INTRODUCTION

There is some evidence suggesting that movement perception has an effect on aesthetic experience. However, the neural mechanisms underlying the observation of creators' creative action (the process that calligraphers create calligraphy) remain unclear.

METHODS

In this study, participants were scanned with fMRI while performing aesthetic judgments on Chinese calligraphy images with/without action observation.

RESULTS

Behavioral results showed that both the work by the expert and novice with action observation were rated significantly higher on aesthetic preference than those without action observation. Imaging results showed that brain regions associated with perceptual, cognitive, and emotional processing were commonly activated by calligraphy images with/without action observation. However, compared with no action observation, aesthetic judgments of calligraphy images with action observation elicited stronger activation in the anterior cingulate cortex and the bilateral insula. Meanwhile, the superior parietal lobe which is associated with relevant inner action imitation, was also activated when observing the creator's action.

CONCLUSIONS

Brain activation in the superior parietal lobe, anterior cingulate cortex, and the bilateral insula indicated that observing the creative action of the creators contributed to the aesthetic experience of the observer.

An enhanced approach to simulation-based mastery learning: optimising the educational impact of a novel, National Postgraduate Medical Boot Camp

BACKGROUND

Simulation-based mastery learning (SBML) is an effective, evidence-based methodology for procedural skill acquisition, but its application may be limited by its resource intensive nature. To address this issue, an enhanced SBML programme has been developed by the addition of both pre-learning and peer learning components. These components allowed the enhanced programme to be scaled up and delivered to 106 postgraduate doctors participating in a national educational teaching programme.

METHODS

The pre-learning component consisted of an online reading pack and videos. The peer learning component consisted of peer-assisted deliberate practice and peer observation of assessment and feedback within the SBML session. Anonymised pre- and post-course questionnaires were completed by learners who participated in the enhanced programme. A mixture of quantitative and qualitative data was obtained.

RESULTS

Questionnaires were distributed to and completed by 50 learners. Both sections of the pre-learning component were highly rated on the basis of a seven-point Likert scale. The peer learning component was also favourably received following a Likert scale rating. Peer observation of the performance and assessment process was rated similarly by first and second learners. The thematic analysis of the reasons for which peer-assisted deliberate practice was considered useful showed that familiarisation with equipment, the rehearsal of the procedure itself, the exchange of experiences and sharing of useful tips were important. The thematic analysis of the reasons why peer observation during 'performance, assessment and feedback' was useful highlighted that an ability to compare a peer's performance to their own and learning from observing a peer's mistakes were particularly helpful.

CONCLUSION

The SBML programme described has been enhanced by the addition of pre-learning and peer learning components which are educationally valued and allow its application on a national scale.

Perception of Purposeful and Recreational Smartphone Use in Physiotherapy: Randomized Controlled Trial

Background

Many people constantly use their smartphones in all kinds of situations. Often smartphones are used in a meaningful and targeted way, but frequently they are used as a pastime without any purpose. This also applies to patients and therapists in treatment situations.

Objective

The aim of this study was to investigate how purposeful smartphone use compared with recreational smartphone use (by a physiotherapist or by a patient) influenced the perception of a physiotherapeutic treatment situation. We examined the impact of smartphone use during a physiotherapy session on the perception of the physiotherapist, evaluation of attentiveness, and evaluation of smartphone use in physiotherapy in general.

Methods

Members of various music and sports clubs were invited to participate in an online randomized controlled trial. Participants were randomly assigned to one of four conditions. They watched a video in which a physiotherapeutic treatment was shown and in which a smartphone was used or not used in the following four different ways: (1) therapeutically purposeful use, (2) recreational use by the physiotherapist (looking at the phone from time to time with no therapeutic purpose), (3) recreational use by the patient, and (4) no smartphone use (control condition). After watching the video, the participants indicated their perception of the physiotherapist’s professional competence, social competence, and empathetic behavior. They also rated the physiotherapist’s and patient’s attentiveness and evaluated the usage of smartphones generally in physiotherapy.

Results

The analysis included 118 participants (63 women and 55 men). When the physiotherapist used the smartphone in a purposeful way, the physiotherapist was perceived as more professionally competent (P=.007), socially competent (P=.03), and empathetic (P=.04) than if the physiotherapist used it with no therapeutic purpose. These effects occurred because recreational smartphone use by the physiotherapist was evaluated more negatively than the behavior in the control condition (professional competence: P=.001; social competence: P=.03; empathy: P=.04). Moreover, when the physiotherapist used the smartphone in a recreational way, the physiotherapist was perceived as being less attentive (P<.001). Likewise, when the patient used the smartphone in a recreational way, the patient was perceived as being less attentive (P<.001). Finally, smartphone use in physiotherapy was rated as more positive in general when the smartphone was used in a purposeful way compared with the conditions in which the physiotherapist or patient looked at the smartphone with no therapeutic purpose (P<.001). This positive evaluation occurred because purposeful use led to a more positive rating than no smartphone use (P<.001, R=0.42).

Conclusions

Smartphones are only appropriate for therapists and patients if they are used directly for a therapeutic purpose. Otherwise, it is better not to use smartphones during treatment.

Trial Registration

AsPredicted (aspredicted.org) #24740; https://aspredicted.org/blind.php?x=vv532i

Varied speeds of video demonstration do not influence the learning of a dance skill

The effects of slow-motion and real time video speed demonstration, under mixed-modeling conditions (skilled model plus self-observation), were examined to identify whether there was an optimal demonstration speed, or combination thereof, for learning the dance pirouette en dehors skill. Fifty-one participants were randomly assigned to one of three groups with different video demonstration speeds: (1) slow-motion, (2) real-time, or (3) a combination of slow-motion and real-time. Following a pre-test, participants completed eight blocks of nine training trials (comprised of five physical and four observational practice trials). Physical performance and cognitive representation assessments revealed that participants' scores significantly improved for both assessments throughout acquisition (p's < 0.05), as well as from pre- to post-test (p's < 0.001), indicating learning of the skill. There were no significant differences, however, between the three experimental groups. These findings suggest that both real-time and slow-motion video demonstration, or their combined presentation, do not yield differences in motor learning outcomes related to the pirouette en dehors.

Distribution of Practice Combined with Observational Learning Has Time Dependent Effects on Motor Skill Acquisition

Studies of the benefits of a distributed practice schedule on motor skill acquisition have typically found that distribution of practice results in better learning. However, less research has focused on how the benefits of distributed practice are impacted by timing during acquisition. To examine how timing of skill acquisition interacts with distribution of practice we had two groups of participants complete either an extensive massed or distributed training schedule to learn a speed stacking sequence across ten sessions. For participants in both groups, we provided observational learning to facilitate skill acquisition. Analysis of speed stacking time on a retention test revealed an overall benefit for the distributed relative to the massed practice group. Interestingly, our analysis of the benefits of distributed practice during training only showed performance benefits in the early session (session one) and later sessions (sessions eight, nine, and ten) of skill acquisition but not mid-way through it (sessions two through seven). Our results support previous findings highlighting the learning benefits of a distributed practice schedule but suggest that these benefits occur differentially throughout acquisition. Our work also replicates research demonstrating that observational learning is more beneficial when it is yoked to actual practice.

Revisiting the Applied Model for the Use of Observation: A Review of Articles Spanning 2011-2018

Purpose: To provide a review of current articles that have used observation interventions to enhance motor skill acquisition or performance of applied tasks, and to situate the research within the Applied Model for the Use of Observation (AMUO) with the goal of forming a basis for evidence-based guidelines for practitioners. Method: Key words (e.g., observation/modeling) were searched in varied data bases (e.g., Google Scholar/PubMed), along with a citation search of the relevant AMUO article, to generate a pool of articles for possible review. Selection criteria included publication between 2011 and 2018, and that the research focus was on the effects of an observation intervention on the acquisition or performance of an applied motor task. Results: Forty-eight articles were reviewed, with 21 of these targeting the basic question of whether observation is effective, and the remaining pertaining to the What, When, Who, and How features of the AMUO. The effectiveness of observation interventions was not only affirmed, but also extended to a wider scope of populations and settings. Greater insight into the necessary information with respect to the demonstration (what) and whether it should be before, after, or during physical practice (when) was obtained. As well, advantages of combining model types (who) and providing control to the learner (how) were reported. Conclusions: While more clarity was brought to certain features of the AMUO that could be used to provide evidence-based guidelines, more research is needed to fully inform practitioners for the effective use of observation interventions.

The Effects of Instruction Manipulation on Motor Performance Following Action Observation

The effects of action observation (AO) on motor performance can be modulated by instruction. The effects of two top-down aspects of the instruction on motor performance have not been fully resolved: those related to attention to the observed task and the incorporation of motor imagery (MI) during AO. In addition, the immediate vs. 24-h retention test effects of those instruction’s aspects are yet to be elucidated. Forty-eight healthy subjects were randomly instructed to: (1) observe reaching movement (RM) sequences toward five lighted units with the intention of reproducing the same sequence as fast and as accurate as possible (Intentional + Attentional group; AO+At); (2) observe the RMs sequence with the intention of reproducing the same sequence as fast and as accurate as possible and simultaneously to the observation to imagine performing the RMs (Intentional + attentional + MI group; AO+At+MI); and (3) observe the RMs sequence (Passive AO group). Subjects’ performance was tested before and immediately after the AO and retested after 24 h. During each of the pretest, posttest, and retest, the subject performed RMs toward the units that were activated in the same order as the observed sequence. Occasionally, the sequence order was changed by beginning the sequence with a different activated unit. The outcome measures were: averaged response time of the RMs during the sequences, difference between the response time of the unexpected and expected RMs and percent of failures to reach the target within 1 s. The averaged response time and the difference between the response time of the unexpected and expected RMs were improved in all groups at posttest compared to pretest, regardless of instruction. Averaged response time was improved in the retest compared to the posttest only in the Passive AO group. The percent of failures across groups was higher in pretest compared to retest. Our findings suggest that manipulating top-down aspects of instruction by adding attention and MI to AO in an RM sequence task does not improve subsequent performance more than passive observation. Off-line learning of the sequence in the retention test was improved in comparison to posttest following passive observation only.

Learning How to Throw Darts. Effects of Modeling Type and Reflection on Novices' Dart-Throwing Skills

In this study, we investigated the effects of modeling type and reflection on the acquisition of dart-throwing skills, self-efficacy beliefs and self-reaction scores by conceptually replicating a study by Kitsantas, Zimmerman, and Cleary (2000). Participants observing a novice model were expected to surpass participants observing an expert model who in turn were expected to outperform participants who learned without a model. Reflection was hypothesized to have a positive effect. 156 High school and university students were tested three times: in a pretest, after a modeling intervention, and after a practice round. Contrary to what was expected, we found no main effects of modeling type and reflection. No interaction effects were found either. There was an effect of testing moment, indicating that participants improved dart-throwing skills, self-efficacy beliefs, and self-reaction scores over time. With these findings, we are not able to replicate Kitsantas et al. From our study, we conclude that observational learning, irrespective of the model's skill level, combined with physical practice, yields similar results as mere physical practice.

The Role of Active Engagement of Peer Observation in the Acquisition of Surgical Skills in Virtual Reality Tasks for Novices

OBJECTIVE

Peer-assisted learning has been regarded as an adjunct to teaching modalities. It remains inconclusive regarding the benefits of peer observation in skills learning. Hence, we investigated whether the active engagement (AE) of peer observation in addition to expert demonstration would facilitate the performance in the virtual reality (VR) tasks.

SETTING/DESIGN

The programs involved 4 VR tasks including basic (camera targeting), intermediate (energy dissection and energy switching), and advanced (suture sponge) tasks in the da Vinci Skills Simulators, which were set up in the operating room at Taipei Medical University Hospital. Fifty medical students participated in the study. The AE of the participants was defined as the total number of peer observations in addition to expert observation before their performance. We assessed the correlations between AE and surgical task performance using Pearson correlation and the concept of learning analytics.

PARTICIPANTS

Medical students (sixth-year students in Taiwan, equivalent to fourth-year students in the US system) from Taipei Medical University were recruited.

RESULTS

AE was correlated with the energy dissection task (r = 0.329, p = 0.02) and marginally associated with the energy switching task (r = 0.271, p = 0.057). However, AE was not correlated with either task scores for camera targeting (r = 0.096, p = 0.509) or task scores for suture sponge (r = -0.091, p = 0.529).

CONCLUSIONS

Our findings suggest that AE of peer observation may facilitate learning energy dissection task, which is an intermediate-level task, but not in other basic or advanced tasks in a VR context. The study highlights the potential effect of AE of peer observation on surgical learning based on a distinct level of tasks. Tasks that fit the learners' level are recommended. Nevertheless, the effectiveness of peer observation on surgical training still has to be explored to ensure favorable results and optimal learning outcomes.

Superimposed Skilled Performance in a Virtual Mirror Improves Motor Performance and Cognitive Representation of a Full Body Motor Action

Feedback is essential for skill acquisition as it helps identifying and correcting performance errors. Nowadays, Virtual Reality can be used as a tool to guide motor learning, and to provide innovative types of augmented feedback that exceed real world opportunities. Concurrent feedback has shown to be especially beneficial for novices. Moreover, watching skilled performances helps novices to acquire a motor skill, and this effect depends on the perspective taken by the observer. To date, however, the impact of watching one's own performance together with full body superimposition of a skilled performance, either from the front or from the side, remains to be explored. Here we used an immersive, state-of-the-art, low-latency cave automatic virtual environment (CAVE), and we asked novices to perform squat movements in front of a virtual mirror. Participants were assigned to one of three concurrent visual feedback groups: participants either watched their own avatar performing full body movements or were presented with the movement of a skilled individual superimposed on their own performance during movement execution, either from a frontal or from a side view. Motor performance and cognitive representation were measured in order to track changes in movement quality as well as motor memory across time. Consistent with our hypotheses, results showed an advantage of the groups that observed their own avatar performing the squat together with the superimposed skilled performance for some of the investigated parameters, depending on perspective. Specifically, for the deepest point of the squat, participants watching the squat from the front adapted their height, while those watching from the side adapted their backward movement. In a control experiment, we ruled out the possibility that the observed improvements were due to the mere fact of performing the squat movements—irrespective of the type of visual feedback. The present findings indicate that it can be beneficial for novices to watch themselves together with a skilled performance during execution, and that improvement depends on the perspective chosen.

Action Observation Combined With Conventional Training Improves the Rugby Lineout Throwing Performance: A Pilot Study

Combining action observation (AO) and physical practice contributes to motor skill learning, and a number of studies pointed out the beneficial role of AO training in improving the motor performance and the athletes' movement kinematics. The aim of this study was to investigate if AO combined with immediate conventional training was able to improve motor performance and kinematic parameters of a complex motor skill such as the lineout throw, a gesture that represents a key aspect of rugby, that is unique to this sport. Twenty elite rugby players were divided into two groups. The AO group watched a 5-min video-clip of an expert model performing the lineout throw toward a target at 7 m distance and, immediately after the AO, this group executed the conventional training, consisting of six repetitions x five blocks of throws. The CONTROL group performed only the conventional lineout training. Intervention period lasted 4 weeks, 3 sessions/week. The AO group showed significant improvements in throwing accuracy (i.e., number of throws hitting the target), whilst no significant changes were observed in the CONTROL group. As concerns kinematic parameters, hooker's arm mean velocity significantly increased in both groups, but the increase was higher in AO group compared to CONTROL group. Ball velocity significantly increased only in the AO group, whereas ball angle release and ball spinning significantly decreased in both groups, with no differences between groups. Finally, no significant changes in knee and elbow angles were observed. Our results showed that the combination of AO and conventional training was more effective than a conventional training alone in improving the performance of elite rugby players, in executing a complex motor skill, such as the lineout. This combined training led to significant improvements in throwing accuracy and in hooker's and ball's kinematic parameters. Since AO can be easily implemented in combination with conventional training, the results of this study can encourage coaches in designing specific lineout training programs, which include AO cognitive training.

The influence of robotic guidance on error detection and correction mechanisms

New technologies have expanded the available methods to help individuals learn or re-learn motor skills. Despite equivocal evidence for the impact of robotic guidance for motor skill acquisition (Marchal-Crespo, McHughen, Cramer, & Reinkensmeyer, 2010), we have recently shown that robotic guidance mixed with unassisted practice can significantly improve the learning of a golf putting task (Bested & Tremblay, 2018). To understand the mechanisms associated with this new mixed approach (i.e., unassisted and robot-guided practice) for the learning of a golf putting task, the current study aimed to determine if such mixed practice extends to one's ability to detect errors. Participants completed a pre-test, an acquisition phase, as well as immediate, delayed (24-h), and transfer post-tests. During the pre-test, kinematic data from the putter was converted into highly accurate, consistent, and smooth trajectories delivered by a robot arm. During acquisition, 2 groups performed putts towards 3 different targets with robotic guidance on either 0% or 50% of acquisition trials. Only the 50% guidance group significantly reduced ball endpoint distance and variability, as well as ball endpoint error estimations, between the pre-test and the post-tests (i.e., immediate retention, 24-h retention, and 24-h transfer). The current study showed that allowing one to experience both robotic guidance and unassisted (i.e., errorful) performances enhances one's ability to detect errors, which can explain the beneficial motor learning effects of a mixed practice schedule.

Observing different model types interspersed with physical practice has no effect on consolidation or motor learning of an elbow flexion-extension task

We compared varied model types and their potential differential effects on learning outcomes and consolidation processes when observational practice was interspersed with physical practice. Participants (N = 75) were randomly assigned to one of five groups: (1) unskilled model observation, (2) skilled model observation, (3) mixed-model observation, (4) physical practice only, and (5) no observational or physical practice (control). All were tasked with learning a waveform-matching task. With exception of the control group not involved in acquisition sessions, participants were involved in one pre-test, two acquisition sessions, four retention tests (immediate-post acquisition 1, 24hr post acquisition 1, immediate-post acquisition 2, and approximate 7-day retention), as well as an approximate 7-day transfer test. No differences were demonstrated in consolidation processes or learning outcomes as all groups showed the same pattern of retention and transfer data. Our conclusion is that motor memory processes were not impacted differentially when different models types were used in observational practice that was intermixed with physical practice for the learning of a movement pattern with low task difficulty, and thus similar learning outcomes emerged for all groups.

The Application of Observational Practice and Educational Networking in Simulation-Based and Distributed Medical Education Contexts

INTRODUCTION

Research has revealed that individuals can improve technical skill performance by viewing demonstrations modeled by either expert or novice performers. These findings support the development of video-based observational practice communities that augment simulation-based skill education and connect geographically distributed learners. This study explores the experimental replicability of the observational learning effect when demonstrations are sampled from a community of distributed learners and serves as a context for understanding learner experiences within this type of training protocol.

METHODS

Participants from 3 distributed medical campuses engaged in a simulation-based learning study of the elliptical excision in which they completed a video-recorded performance before being assigned to 1 of 3 groups for a 2-week observational practice intervention. One group observed expert demonstrations, another observed novice demonstrations, and the third observed a combination of both. Participants returned for posttesting immediately and 1 month after the intervention. Participants also engaged in interviews regarding their perceptions of the usability and relevance of video-based observational practice to clinical education.

RESULTS

Checklist (P < 0.0001) and global rating (P < 0.0001) measures indicate that participants, regardless of group assignment, improved after the intervention and after a 1-month retention period. Analyses revealed no significant differences between groups. Qualitative analyses indicate that participants perceived the observational practice platform to be usable, relevant, and potentially improved with enhanced feedback delivery.

CONCLUSIONS

Video-based observational practice involving expert and/or novice demonstrations enhances simulation-based skill learning in a group of geographically distributed trainees. These findings support the use of Internet-mediated observational learning communities in distributed and simulation-based medical education contexts.

PLAViMoP: How to standardize and simplify the use of point-light displays

The study of biological point-light displays (PLDs) has fascinated researchers for more than 40 years. However, the mechanisms underlying PLD perception remain unclear, partly due to difficulties with precisely controlling and transforming PLD sequences. Furthermore, little agreement exists regarding how transformations are performed. This article introduces a new free-access program called PLAViMoP (Point-Light Display Visualization and Modification Platform) and presents the algorithms for PLD transformations actually included in the software. PLAViMoP fulfills two objectives. First, it standardizes and makes clear many classical spatial and kinematic transformations described in the PLD literature. Furthermore, given its optimized interface, PLAViMOP makes these transformations easy and fast to achieve. Overall, PLAViMoP could directly help scientists avoid technical difficulties and make possible the use of PLDs for nonacademic applications.

The Effects of Self-Observation When Combined With a Skilled Model on the Learning of Gymnastics Skills

In this experiment, we examined whether self-observation, via video replay, coupled with the viewing of a skilled model was better for motor skill learning than the use of self-observation alone. Twenty-one female gymnasts participated in a within design experiment in which two gymnastics skills were learned. One skill was practiced in conjunction with the self-observation/skilled model pairing and the other with only self-observation. The experiment unfolded over five sessions in which pre-test, baseline, acquisition, retention, and post-test scores were obtained. Analysis of the physical performance scores revealed a significant Condition ×Session interaction in which it was shown that there were no differences between the intervention conditions at baseline and early in acquisition; but, later in acquisition, those skills practiced with the self-observation/skilled model pairing were executed significantly better than those with only self-observation. Also, an error identification test showed that participants had significantly higher response sensitivity scores for those skills learned with the paired intervention compared to self-observation alone. These results suggest that pairing self-observation with a skilled model is better in a gymnastic setting than self-observation alone.

Observational Learning During Simulation-Based Training in Arthroscopy: Is It Useful to Novices?

OBJECTIVE

Observing experts constitutes an important and common learning experience for surgical residents before operating under direct guidance. However, studies suggest that exclusively observing experts may induce suboptimal motor learning, and watching errors from non-experts performing simple motor tasks may generate better performance. We investigated whether observational learning is transferrable to arthroscopy learning using virtual reality (VR) simulation.

SETTING/DESIGN

In our surgical simulation laboratory, we compared students learning basic skills on a VR arthroscopy simulator after watching an expert video demonstration of VR arthroscopy tasks or a non-expert video demonstration of the same tasks to a Control group without video demonstration. Ninety students in 3 observing groups (expert, non-expert, and Control) subsequently completed the same procedure on a VR arthroscopy simulator. We hypothesized the non-expert-watching group would outperform the expert-watching group, and both groups to outperform the Control group. We examined performance pretest, posttest, and 1 week later.

PARTICIPANTS

Participants were recruited from the final year of medical school and the very early first year of surgical residency training programs (orthopaedic surgery, urology, plastic surgery, and general surgery) at Western University (Ontario, Canada).

RESULTS

All participants improved their overall performance from pretest to retention (p < 0.001). At initial retention testing, non-expert-watching group outperformed the other groups in camera path length p < 0.05 and time to completion, p < 0.05, and both the expert/non-expert groups surpassed the Control group in camera path length (p < 0.05).

CONCLUSION

We suggest that error-observation may contribute to skills improvement in the non-expert-watching group. Allowing novices to observe techniques/errors of other novices may assist internalization of specific movements/skills required for effective motor performances. This study highlights the potential effect of observational learning on surgical skills acquisition and offers preliminary evidence for peer-based practice (combined non-experts and experts) as a complementary surgical motor skills training strategy.

Enhancing technical skill learning through interleaved mixed-model observational practice

A broad foundation of behavioural (Hayes et al. in Exp Brain Res 204(2): 199-206, 2010) and neurophysiological (Kohler et al. in Science 297(5582): 846-848, 2002) evidence has revealed that the acquisition of psychomotor skills, including those germane to clinical practice (Domuracki et al. in Med Educ 49(2): 186-192, 2015), can be facilitated through observational practice. Interestingly, research also reveals that learning via observation is greatest when the learner has the opportunity to view both error-free expert demonstrations and flawed novice demonstrations (Rohbanfard and Proteau in Exp Brain Res 215: 183-197, 2011). In this study, we explored whether the learning that results from the combined viewing of experts and novices is greater when the demonstrations are presented under observation schedules characterized by higher levels of contextual interference. To do so, we engaged participants in an observational learning study of the Fundamentals of Laparoscopic Surgery pots-and-beans task: a simulated procedure in which performers must move objects under precision constraints in the minimal access surgery environment. Each participant was randomized to one of three groups that engaged in identical physical and mixed-model observational practice of this skill, with the only difference being that one group's observation was presented in blocked fashion (low interference) while the other two groups' observations were presented in semi-interleaved (medium interference) and interleaved (high interference) fashions. Total errors and time-to-complete measures taken during physical practice blocks revealed that all three groups improved over the intervention. Further analyses revealed that the low interference group performed better immediately following the physical and observational practice intervention, but that the medium- and high-interference groups were conveyed a performance advantage in a transfer test conducted after a period of retention that challenged participants to perform in the opposite direction. The results are discussed with respect to the classic contextual interference effect (Shea and Morgan in J Exp Psychol 5(2): 179-187, 1979) and with particular relevance to clinical skills education.

Motor Skill Learning and the Development of Visual Perception Processes Supporting Action Identification

This study examined physical training and observational training influences on motor learning and the development of visual discrimination processes. Participants were trained on a bimanual task (relative phase of +90°) defined by a visual training stimulus. There were 2 observational contexts: 1) model-only, watch a learning model, and 2) stimulus-only, watch the visual training stimulus. After 2 d of training, the learning models performed the +90° pattern with reduced error in 2 retention tests. Each observer group showed improvement in performance of the +90° pattern, with the stimulus-only group characterized by a more significant improvement. The learning models and observer groups were characterized by an improvement in visually discriminating 2 features of the trained pattern, relative phase and hand-lead. Overall, physical practice (learning models) established a stronger link between the action and visual discrimination processes compared with the observational contexts. The results show that the processes supporting action production and the visual discrimination of actions are modified in ways specific to the trained action following both physical and observational training.

The effect of observing novice and expert performance on acquisition of surgical skills on a robotic platform

BACKGROUND

Observational learning plays an important role in surgical skills training, following the traditional model of learning from expertise. Recent findings have, however, highlighted the benefit of observing not only expert performance but also error-strewn performance. The aim of this study was to determine which model (novice vs. expert) would lead to the greatest benefits when learning robotically assisted surgical skills.

METHODS

120 medical students with no prior experience of robotically-assisted surgery completed a ring-carrying training task on three occasions; baseline, post-intervention and at one-week follow-up. The observation intervention consisted of a video model performing the ring-carrying task, with participants randomly assigned to view an expert model, a novice model, a mixed expert/novice model or no observation (control group). Participants were assessed for task performance and surgical instrument control.

RESULTS

There were significant group differences post-intervention, with expert and novice observation groups outperforming the control group, but there were no clear group differences at a retention test one week later. There was no difference in performance between the expert-observing and error-observing groups.

CONCLUSIONS

Similar benefits were found when observing the traditional expert model or the error-strewn model, suggesting that viewing poor performance may be as beneficial as viewing expertise in the early acquisition of robotic surgical skills. Further work is required to understand, then inform, the optimal curriculum design when utilising observational learning in surgical training.

Learning to tie the knot: The acquisition of functional object representations by physical and observational experience

Here we examined neural substrates for physically and observationally learning to construct novel objects, and characterized brain regions associated with each kind of learning using fMRI. Each participant was assigned a training partner, and for five consecutive days practiced tying one group of knots (“tied” condition) or watched their partner tie different knots (“watched” condition) while a third set of knots remained untrained. Functional MRI was obtained prior to and immediately following the week of training while participants performed a visual knot-matching task. After training, a portion of left superior parietal lobule demonstrated a training by scan session interaction. This means this parietal region responded selectively to knots that participants had physically learned to tie in the post-training scan session but not the pre-training scan session. A conjunction analysis on the post-training scan data showed right intraparietal sulcus and right dorsal premotor cortex to respond when viewing images of knots from the tied and watched conditions compared to knots that were untrained during the post-training scan session. This suggests that these brain areas track both physical and observational learning. Together, the data provide preliminary evidence of engagement of brain regions associated with hand-object interactions when viewing objects associated with physical experience, and with observational experience without concurrent physical practice.

Effects of model types in observational learning on implicit sequential learning

This study investigated whether implicit learning of sequence by observation occurred in a serial reaction time task and whether the learning effects were modulated by model behavioral type. In Experiment 1, we let 20 participants perform a sequence for 12 blocks and chose the best and worst performance models based on reaction time and errors. In Experiment 2, new observers viewed a movie clip chosen from the following three: the best model performing the sequential task in the first (the first six blocks) or second session (the last six blocks), or the worst model performing the task in the first session. Then, the observers performed the observed sequence, a test sequence and awareness test. We found that (1) implicit sequential learning occurred by observation regardless of model behavior type, (2) the learning effects were not susceptible to model behavior type and (3) speed index reflecting reaction time became larger even in the test session when the observers viewed the best model performing the second session. Overall, observers developed general motor representations through action-observation. In addition, their responses were also contagious; if the model performed the sequence faster, the observer might be able to perform the sequence faster.

A safety mechanism for observational learning

This empirical article presents the first evidence of a "safety mechanism" based on an observational-learning paradigm. It is accepted that during observational learning, a person can use different strategies to learn a motor skill, but it is unknown whether the learner is able to circumvent the encoding of an uncompleted observed skill. In this study, participants were tested in a dyadic protocol in which an observer watched a participant practicing two different motor sequences during a learning phase. During this phase, one of the two motor sequences was interrupted by a stop signal that precluded motor learning. The results of the subsequent retention test revealed that both groups learned the two motor sequences, but only the physical practice group showed worse performance for the interrupted sequence. The observers were consequently able to use a safety strategy to learn both sequences equally. Our findings are discussed in light of the implications of the action observation network for sequence learning and the cognitive mechanisms of error-based observation.

Are young children able to learn exploratory strategies by observation?

New competencies may be learned through active experience (experiential learning or learning by doing) or observation of others' experiences (learning by observation). Observing another person performing a complex action facilitates the observer's acquisition of the same action. The present research is aimed at analyzing if the observation of specific explorative strategies adopted in a constrained environment, such as the Radial Arm Maze (RAM), could help young children to explore the maze and to build a cognitive spatial map of the explored environment. To this aim young children were randomly assigned to three groups: children who performed the RAM task following the observation of an actor solving the same maze by putting into action a highly structured exploratory strategy; children who performed the RAM task following the observation of the actor solving the same maze by putting into action a less structured exploratory strategy; children who directly performed the RAM task without any observation. The main result of the present research is that the children who observed the highly structured and correct exploratory strategy spent less time, made fewer errors, exhibited a longer spatial span, and thus they explored the maze more efficiently than the children who directly performed the RAM task without any observation. This finding indicates that when the observed explorative procedure is structured, sequential and repetitive the action understanding and information storage processes are more effective. Importantly, the observation of specific spatial strategies helped the children to build the cognitive spatial map of the explored environment and consequently to acquire/enrich the declarative knowledge of the environment.

Serial practice impairs motor skill consolidation

Recent reports have revealed that motor skill learning is impaired if two skills are practiced one after the other, that is before the first skill has had the time to become consolidated. This suggests that motor skills should be practiced in isolation from one another to minimize interference. At the moment, little is known about the effect of practice schedules high in contextual interference on motor skill consolidation. In Experiment 1, we investigated whether a serial practice schedule impairs motor skill consolidation. Participants had to learn two distinct sequences of finger movements (A and B) under either a blocked practice schedule or a serial practice schedule before being retested the following day. A control group also practiced Sequence A only. Our results revealed that a blocked practice schedule led to no interference between the sequences, whereas a serial practice schedule impaired the consolidation of Sequence B. In Experiment 2, we investigated the origin of the interference caused by a serial practice schedule by replacing the physical practice of Sequence A with either the observation of a model performing Sequence A or by asking participants to produce random finger movements. Our results revealed that both tasks interfered with the consolidation of Sequence B. Thus, we suggest that a serial practice schedule impairs motor skill consolidation through a conflict in the brain networks involved in the acquisition of the cognitive representation of the sequence and its execution.

The effect of modeled absolute timing variability and relative timing variability on observational learning

There is much evidence to suggest that skill learning is enhanced by skill observation. Recent research on this phenomenon indicates a benefit of observing variable/erred demonstrations. In this study, we explore whether it is variability within the relative organization or absolute parameterization of a movement that facilitates skill learning through observation. To do so, participants were randomly allocated into groups that observed a model with no variability, absolute timing variability, relative timing variability, or variability in both absolute and relative timing. All participants performed a four-segment movement pattern with specific absolute and relative timing goals prior to and following the observational intervention, as well as in a 24h retention test and transfers tests that featured new relative and absolute timing goals. Absolute timing error indicated that all groups initially acquired the absolute timing, maintained their performance at 24h retention, and exhibited performance deterioration in both transfer tests. Relative timing error revealed that the observation of no variability and relative timing variability produced greater performance at the post-test, 24h retention and relative timing transfer tests, but for the no variability group, deteriorated at absolute timing transfer test. The results suggest that the learning of absolute timing following observation unfolds irrespective of model variability. However, the learning of relative timing benefits from holding the absolute features constant, while the observation of no variability partially fails in transfer. We suggest learning by observing no variability and variable/erred models unfolds via similar neural mechanisms, although the latter benefits from the additional coding of information pertaining to movements that require a correction.

Observational Learning: Tell Beginners What They Are about to Watch and They Will Learn Better

Observation aids motor skill learning. When multiple models or different levels of performance are observed, does learning improve when the observer is informed of the performance quality prior to each observation trial or after each trial? We used a knock-down barrier task and asked participants to learn a new relative timing pattern that differed from that naturally emerging from the task constraints (Blandin et al., 1999). Following a physical execution pre-test, the participants observed two models demonstrating different levels of performance and were either informed of this performance prior to or after each observation trial. The results of the physical execution retention tests of the two experiments reported in the present study indicated that informing the observers of the demonstration quality they were about to see aided learning more than when this information was provided after each observation trial. Our results suggest that providing advanced information concerning the quality of the observation may help participants detect errors in the model's performance, which is something that novice participants have difficulty doing, and then learn from these observations.

The impacts of observing flawed and flawless demonstrations on clinical skill learning

OBJECTIVES

Clinical skills expertise can be advanced through accessible and cost-effective video-based observational practice activities. Previous findings suggest that the observation of performances of skills that include flaws can be beneficial to trainees. Observing the scope of variability within a skilled movement allows learners to develop strategies to manage the potential for and consequences associated with errors. This study tests this observational learning approach on the development of the skills of central line insertion (CLI).

METHODS

Medical trainees with no CLI experience (n = 39) were randomised to three observational practice groups: a group which viewed and assessed videos of an expert performing a CLI without any errors (F); a group which viewed and assessed videos that contained a mix of flawless and errorful performances (E), and a group which viewed the same videos as the E group but were also given information concerning the correctness of their assessments (FA). All participants interacted with their observational videos each day for 4 days. Following this period, participants returned to the laboratory and performed a simulation-based insertion, which was assessed using a standard checklist and a global rating scale for the skill. These ratings served as the dependent measures for analysis.

RESULTS

The checklist analysis revealed no differences between observational learning groups (grand mean ± standard error: [20.3 ± 0.7]/25). However, the global rating analysis revealed a main effect of group (d.f.2,36 = 4.51, p = 0.018), which describes better CLI performance in the FA group, compared with the F and E groups.

CONCLUSIONS

Observational practice that includes errors improves the global performance aspects of clinical skill learning as long as learners are given confirmation that what they are observing is errorful. These findings provide a refined perspective on the optimal organisation of skill education programmes that combine physical and observational practice activities.

Kinematic and kinetic improvements associated with action observation facilitated learning of the power clean in Australian footballers

This study investigated the effectiveness of action observation (AO) on facilitating learning of the power clean technique (kinematics) compared with traditional strength coaching methods and whether improvements in performance (kinetics) were associated with an improvement in lifting technique. Fifteen subjects (age, 20.9 ± 2.3 years) with no experience in performing the power clean exercise attended 12 training and testing sessions over a 4-week period. Subjects were assigned to 2 matched groups, based on preintervention power clean performance and performed 3 sets of 5 repetitions of the power clean exercise at each training session. Subjects in the traditional coaching group (TC; n = 7) received the standard coaching feedback (verbal cues and physical practice), whereas subjects in the AO group (n = 8) received similar verbal coaching cues and physical practice but also observed a video of a skilled model before performing each set. Kinematic data were collected from video recordings of subjects who were fitted with joint center markings during testing, whereas kinetic data were collected from a weightlifting analyzer attached to the barbell. Subjects were tested before intervention, at the end of weeks 2 and 3, and at after intervention at the end of week 4. Faster improvements (3%) were observed in power clean technique with AO-facilitated learning in the first week and performance improvements (mean peak power of the subject's 15 repetitions) over time were significant (p < 0.001). In addition, performance improvement was significantly associated (R = 0.215) with technique improvements. In conclusion, AO combined with verbal coaching and physical practice of the power clean exercise resulted in significantly faster technique improvements and improvement in performance compared with traditional coaching methods.

Consistently modeling the same movement strategy is more important than model skill level in observational learning contexts

The experiment undertaken was designed to elucidate the impact of model skill level on observational learning processes. The task was bimanual circle tracing with a 90° relative phase lead of one hand over the other hand. Observer groups watched videos of either an instruction model, a discovery model, or a skilled model. The instruction and skilled model always performed the task with the same movement strategy, the right-arm traced clockwise and the left-arm counterclockwise around circle templates with the right-arm leading. The discovery model used several movement strategies (tracing-direction/hand-lead) during practice. Observation of the instruction and skilled model provided a significant benefit compared to the discovery model when performing the 90° relative phase pattern in a post-observation test. The observers of the discovery model had significant room for improvement and benefited from post-observation practice of the 90° pattern. The benefit of a model is found in the consistency with which that model uses the same movement strategy, and not within the skill level of the model. It is the consistency in strategy modeled that allows observers to develop an abstract perceptual representation of the task that can be implemented into a coordinated action. Theoretically, the results show that movement strategy information (relative motion direction, hand lead) and relative phase information can be detected through visual perception processes and be successfully mapped to outgoing motor commands within an observational learning context.

Observation learning of a motor task: who and when?

Observation contributes to motor learning. It was recently demonstrated that the observation of both a novice and an expert model (mixed observation) resulted in better learning of a complex spatiotemporal task than the observation of either a novice or an expert model. In experiment 1, we aimed to determine whether mixed observation better promotes learning due to the information that can be gained from two models who exhibit different skill levels or simply because multiple models, regardless of their level of expertise, better promote learning than would a single model. The results revealed that the observation of both an expert and a novice model resulted in better short-term retention than the observation of either two novice or two expert models. In experiment 2, we wanted to determine whether these benefits would last longer if physical practice trials were interspersed with observation. Mixed and (to some extent) expert observations resulted in better long-term retention than observation of a novice model. We suggest that alternating mixed/expert observation with physical practice trials makes one's error more salient than when all observation trials are completed before one first starts performing the experimental task, which increases activation of the action observation network.