Practice schedules for surgical skills: the role of task characteristics and proactive interference on psychomotor skills acquisition.

OBJECTIVE Although break periods during training sessions are desirable, it is unclear what learners should do during these breaks. Some educators recommend that learners abstain from all task-related practice; however, it is possible that switching to an alternate exercise during break periods can also be effective. The construct of proactive interference (PI) posits that new learning is disrupted by prior learning. PI can be "released" when the nature of the task is changed after several practice trials. In this study, we examined the existence of PI in motor learning under 5 training conditions that differed in contrast to a target exercise. DESIGN Preclinical medical students (n = 75) performed 1 trial of peg transfer as a pretest. Participants were then randomly assigned to 1 of 5 training conditions: mass practice, similar exercise (laparoscopic bean transfer), dissimilar exercise (open suturing), observation, or rest. Participants in the mass practice condition practiced peg transfer in 3 training blocks of 15 minutes, each separated by a 5-minute break. Participants in the other conditions performed 3 training blocks consisting of 15 minutes of peg transfer followed by an interspersed alternate exercise. On completion of 3 training blocks, participants performed 1 additional peg transfer trial as a posttest. RESULTS Despite having trained for the same amount of time on the target task, Analysis of Covariance on posttest scores using pretest scores as the covariate indicated a significant main effect for training condition (p = 0.009). Participants engaging in mass practice performed significantly worse than participants in the dissimilar (p = 0.012), observation (p = 0.022), and rest (p < 0.001) conditions. Additionally, participants in the similar exercise condition performed worse than participants in the rest condition (p = 0.03). CONCLUSIONS When learning a laparoscopic task, a break comprised of dissimilar practice or unrelated activities is effective in releasing PI and improving performance.

[1]  G. Fried,et al.  Development of a model for training and evaluation of laparoscopic skills. , 1998, American journal of surgery.

[2]  S. Tesfay,et al.  Implementation, construct validity, and benefit of a proficiency-based knot-tying and suturing curriculum. , 2008, Journal of surgical education.

[3]  A. Bilodeau,et al.  Motor-Skills Learning , 1961 .

[4]  Nellie L. Perkins.  THE VALUE OF DISTRIBUTED REPETITIONS IN ROTE LEARNING , 1914 .

[5]  The effects of practice trials and prior learning on motor memory. , 1971, Journal of motor behavior.

[6]  H. Loess,et al.  Short-term memory, word class, and sequence of items. , 1967, Journal of experimental psychology.

[7]  George E. Stelmach,et al.  Prior positioning responses as a factor in short-term retention of a simple motor task. , 1969 .

[8]  D. Wickens,et al.  Semantic as opposed to acoustic encoding in STM , 1968 .

[9]  J Dickinson,et al.  Release from proactive and retroactive interference in motor short-term memory. , 1977, Journal of motor behavior.

[10]  D. Wickens,et al.  Proactive inhibition and item similarity in short-term memory , 1963 .

[11]  Alan D. Baddeley,et al.  The influence of length and frequency of training session on the rate of learning to type. , 1978 .

[12]  R. Schmidt,et al.  Intertrial intervals and motor short-term memory. , 1970, Research quarterly.

[13]  R. Eason,et al.  Effects of Proactive Interference on Learning the Tennis Backhand Stroke , 1989 .

[14]  M. T. Turvey,et al.  Contextual change and release from proactive interference in short-term verbal memory , 1969 .

[15]  R. Schmidt,et al.  Proactive interference in short-term motor retention. , 1969, Journal of motor behavior.

[16]  Delos D. Wickens,et al.  Encoding Categories of Words: An Empirical Approach to Meaning. , 1970 .

[17]  Richard A. Schmidt,et al.  Motor Learning and Performance , 1991 .

[18]  W. S. Husak,et al.  Distributed and Massed Practice Effects on Motor Performance and Learning of Autistic Children , 1989, Perceptual and motor skills.

[19]  J. Dickinson,et al.  Note on Absence of Proactive Interference in Motor Long-Term Memory , 1980 .

[20]  D. B. Reutener,et al.  Background, symbolic, and class shift in short-term memory / , 1969 .

[21]  W. Montague,et al.  Intertrial interval and proactive interference in short-term motor memory. , 1968, Canadian journal of psychology.

[22]  Wayne A. Wickelgren,et al.  Acoustic similarity and retroactive interference in short-term memory , 1965 .

[23]  J. L. Craft.  A two-process theory for the short-term retention of motor responses. , 1973, Journal of experimental psychology.