The influence of different training schedules on the learning of psychomotor skills for endoscopic surgery

BackgroundPsychomotor skills for endoscopic surgery can be trained with virtual reality simulators. Distributed training is more effective than massed training, but it is unclear whether distributed training over several days is more effective than distributed training within 1 day. This study aimed to determine which of these two options is the most effective for training endoscopic psychomotor skills.MethodsStudents with no endoscopic experience were randomly assigned either to distributed training on 3 consecutive days (group A, n = 10) or distributed training within 1 day (group B, n = 10). For this study the SIMENDO virtual reality simulator for endoscopic skills was used. The training involved 12 repetitions of three different exercises (drop balls, needle manipulation, 30° endoscope) in differently distributed training schedules. All the participants performed a posttraining test (posttest) for the trained tasks 7 days after the training. The parameters measured were time, nontarget environment collisions, and instrument path length.ResultsThere were no significant differences between the groups in the first training session for all the parameters. In the posttest, group A (training over several days) performed 18.7% faster than group B (training on 1 day) (p = 0.013). The collision and path length scores for group A did not differ significantly from the scores for group B.ConclusionThe distributed group trained over several days was faster, with the same number of errors and the same instrument path length used. Psychomotor skill training for endoscopic surgery distributed over several days is superior to training on 1 day.

[1]  J. S. Altman,et al.  A silver intensification method for cobalt-filled neurones in wholemount preparations , 1977, Brain Research.

[2]  Timothy D. Lee,et al.  Distribution of Practice in Motor Skill Acquisition: Learning and Performance Effects Reconsidered , 1988 .

[3]  E. Bizzi,et al.  Consolidation in human motor memory , 1996, Nature.

[4]  T. Brashers-Krug,et al.  Functional Stages in the Formation of Human Long-Term Motor Memory , 1997, The Journal of Neuroscience.

[5]  J. J. Donovan,et al.  A meta-analytic review of the distribution of practice effect: Now you see it, now you don't. , 1999 .

[6]  Ezey M. Dar-Ei,et al.  Human learning : from learning curves to learning organizations , 2000 .

[7]  H. Lönroth,et al.  The transfer of basic skills learned in a laparoscopic simulator to the operating room , 2002, Surgical Endoscopy And Other Interventional Techniques.

[8]  Otmar Bock,et al.  Conditions for interference versus facilitation during sequential sensorimotor adaptation , 2001, Experimental Brain Research.

[9]  R. Satava,et al.  Virtual Reality Training Improves Operating Room Performance: Results of a Randomized, Double-Blinded Study , 2002, Annals of surgery.

[10]  R. Stickgold,et al.  Practice with Sleep Makes Perfect Sleep-Dependent Motor Skill Learning , 2002, Neuron.

[11]  A Darzi,et al.  Practice distribution in procedural skills training: a randomized controlled trial. , 2002, Surgical endoscopy.

[12]  Teodor P Grantcharov,et al.  Learning curves and impact of previous operative experience on performance on a virtual reality simulator to test laparoscopic surgical skills. , 2003, American journal of surgery.

[13]  R. M. Satava,et al.  Discriminative validity of the Minimally Invasive Surgical Trainer in Virtual Reality (MIST-VR) using criteria levels based on expert performance , 2004, Surgical Endoscopy And Other Interventional Techniques.

[14]  M Schijven,et al.  Construct validity: experts and novices performing on the Xitact LS500 laparoscopy simulator. , 2003, Surgical endoscopy.

[15]  A. Duffy,et al.  Construct validity for the LAPSIM laparoscopic surgical simulator , 2005, Surgical Endoscopy And Other Interventional Techniques.

[16]  R. Satava,et al.  Virtual Reality Simulation for the Operating Room: Proficiency-Based Training as a Paradigm Shift in Surgical Skills Training , 2005, Annals of surgery.

[17]  J. Krakauer,et al.  Adaptation to Visuomotor Transformations: Consolidation, Interference, and Forgetting , 2005, The Journal of Neuroscience.

[18]  J. Dankelman,et al.  Validation of a new basic virtual reality simulator for training of basic endoscopic skills , 2006, Surgical Endoscopy And Other Interventional Techniques.

[19]  J. Windsor,et al.  The laparoscopic performance of novice surgical trainees: testing for acquisition, loss, and reacquisition of psychomotor skills. , 2005, Surgical endoscopy.

[20]  R. Stickgold,et al.  Sleep-dependent motor memory plasticity in the human brain , 2005, Neuroscience.