Contextual Interference Effect in Learning of Simulated Laparoscopic Tasks

Abstract

Laparoscopy, a minimally invasive surgical technique involving fine motor movements of the hands and fingers, has proven to be an invaluable tool in surgical care. Expediting the learning process of surgeons to reach proficiency in this surgical technique directly impacts patient outcomes, recovery times, and time management in hospitals [1]. Within motor learning, blocked and random practice has been identified as having correspondingly low or high levels of contextual interference, with different effects on learning and retention of motor skills. Contextual interference can be described as the level of mental interference created during the practice of motor skills. So far, research has been equivocal in identifying the best practice schedule for optimizing the acquisition and retention of fine and gross motor skills. This study examines the role of contextual interference in the acquisition, short-term retention (10-minute), and long-term retention (10-day) of three variations of a simulated laparoscopic task in 60 adults aged 18-65, 30 males and 30 females. The index of performance was represented by the total time taken to complete each task using curved laparoscopic graspers. Results showed that both blocked and random practice groups significantly improved acquisition performance over 54 acquisition trials. Participants undergoing a blocked practice schedule improved their pattern time-to-completion by 46%, retaining most of their performance in the 10-minute retest while maintaining their skill as well after 10 days. The random practice group improved acquisition performance by 38%, maintaining most of their performance in the short-term retention test, with only a slight decrease in speed in the long-term retention test. No statistically significant differences in the efficiency of blocked versus random practice schedules were found for both acquisition and retention, suggesting that both practice schedules can be viable options for learning and retention of simulated laparoscopic surgical tasks. We suggest tailoring training programs to individual skill levels to provide each learner with the optimal amount of contextual interference to reach their optimal challenge point according to subjective task difficulty experienced.