Complex Skill Acquisition Research Articles

Gamebrics: Design, implementation and practical evaluation of analytical rubrics in serious game play

AbstractBackgroundComplex skills, like analytical thinking, are essential in preparing students for future professions. Serious games hold potential to stimulate the online acquisition of such professional skills in an active and experiential way.ObjectiveRubrics are proven assessment and evaluation instruments, but were never directly integrated into actual gameplay. We present our approach towards the integration of analytical rubrics into gameplay, the implementation into existing (scenario‐based) serious games, and main findings from a study on learning effects and appreciation of the tooling (dashboard with progress information and reflective feedback).MethodOur experimental research setup randomly allocated 84 participating students into either a control group or an experimental group. The intervention for the control group consisted of an existing serious game with natural feedback as part of the scenario, supporting the gameplay itself. The intervention for the experimental group also provided an additional dashboard with reflective feedback, monitoring the acquisition of analytical skills through gameplay. Learning growth through gameplay was measured by pre‐/post‐test scores on a knowledge test, in‐game performance by means of computer logging, and appreciation of the dashboard and feedback by means of a questionnaire.Results and ConclusionsParticipants receiving reflective feedback show higher learning increases (on a pre‐/post‐knowledge test), and more efficient gameplay behaviour (on performance scores). Participants receiving reflective feedback feel more confident about competence development. These findings appear promising for this approach on integrating formative assessment in serious gameplay to support the acquisition of complex skills.

Features of adaptive training algorithms for improved complex skill acquisition

Training complex skills is typically accomplished by means of a trainer or mediator who tailors instruction to the individual trainee. However, facilitated training is costly and labor intensive, and the use of a mediator is infeasible in remote or extreme environments. Imparting complex skills in applications like long-duration human spaceflight, military field operations, or remote medicine may require automated training algorithms. Virtual reality (VR) is an effective, easily programmable, immersive training medium that has been used widely across fields. However, there remain open questions in the search for the most effective algorithms for guiding automated training progression. This study investigates the effects of responsiveness, personalization, and subtask independence on the efficacy of automated training algorithms in VR for training complex, operationally relevant tasks. Thirty-two subjects (16M/16F, 18–54 years) were trained to pilot and land a spacecraft on Mars within a VR simulation using four different automated training algorithms. Performance was assessed in a physical cockpit mock-up. We found that personalization results in faster skill acquisition on average when compared with a standardized progression built for a median subject (p = 0.0050). The standardized progression may be preferable when consistent results are desired across all subjects. Independence of the difficulty adjustments between subtasks may lead to increased skill acquisition, while lockstep in the progression of each subtask increases self-reported flow experience (p = 0.01), fluency (p = 0.02), and absorption (p = 0.01) on the Flow Short Scale. Data visualization suggests that highly responsive algorithms may lead to faster learning progressions and higher skill acquisition for some subjects. Improving transfer of skills from training to testing may require either high responsiveness or a standardized training progression. Optimizing the design of automated, individually adaptive algorithms around the training needs of a group may be useful to increase skill acquisition for complex operational tasks.

Using e-modules for acquisition of complex diabetes skills in diabetes care providers in Rwanda.

Type 1 Diabetes (T1D) is life-threatening without appropriate treatment. Though pediatric endocrinology care is limited in Rwanda, a decentralized health system allows access to local non-communicable disease (NCD) nurses through a network of 42 district hospitals. Recent rapid expansion of internet access in the country makes virtual diabetes education initiatives possible. We investigated whether Rwandan NCD nurses receiving diabetes education via online e-modules could make similar educational gains in insulin adjustment skills (IAS) compared to NCD nurses educated in a conference-style setting, and whether they would maintain equivalent competency at 1 year after education. We randomized 21 district hospitals and their NCD nurses to participate in a 1.5-day educational conference centered around care of type 1 diabetes (Group 1), while nurses from the remaining 21 hospitals (Group 2) received accommodation and access to equivalent educational materials in e-module form. Both groups were requested to review initial course materials at 4, 8, and 12 months. Ten-point IAS assessments were administered before and after education or review at each time point. Groups 1 and 2 had equal improvement after education (+2.0 vs. +2.0, p = 0.47) and equal final score at baseline (6.0 vs. 6.0, p = 0.74). However, both groups showed a diminishing improvement over time, so that any gains were lost by 4 months in Group 1 and 8 months in Group 2. Group 1 showed greater attrition in participation over time (19% vs 58% continued participation at one year, p = 0.002). Groups did not differ in subjective confidence in IAS after education. Both groups identified existing or potential access barriers to their respective educational method. While further modifications should be trialed to ensure equitable access and to maintain long-term engagement, online education is a feasible method to teach complex subspecialty skills to providers working in low-resource settings.

Computational Model of the Transition from Novice to Expert Interaction Techniques

Despite the benefits of expert interaction techniques, many users do not learn them and continue to use novice ones. This article aims at better understanding if, when and how users decide to learn and ultimately adopt expert interaction techniques. This dynamic learning process is a complex skill-acquisition and decision-making problem. We first present and compare three generic benchmark models, inspired by the neuroscience literature, to explain and predict the learning process for shortcut adoption. Results show that they do not account for the complexity of users’ behavior. We then introduce a dedicated model, Transition, combining five cognitive mechanisms: implicit and explicit learning, decay, planning and perseveration. Results show that our model outperforms the three benchmark models both in terms of model fitting and model simulation. Finally, a post-analysis shows that each of the five mechanisms contribute to goodness-of-fit, but the role of perseveration is unclear regarding model simulation.

Sensor-based augmented visual feedback for coordination training in healthy adults: a scoping review.

Recent advances in sensor technology demonstrate the potential to enhance training regimes with sensor-based augmented visual feedback training systems for complex movement tasks in sports. Sensorimotor learning requires feedback that guides the learning process towards an optimal solution for the task to be learned, while considering relevant aspects of the individual control system-a process that can be summarized as learning or improving coordination. Sensorimotor learning can be fostered significantly by coaches or therapists providing additional external feedback, which can be incorporated very effectively into the sensorimotor learning process when chosen carefully and administered well. Sensor technology can complement existing measures and therefore improve the feedback provided by the coach or therapist. Ultimately, this sensor technology constitutes a means for autonomous training by giving augmented feedback based on physiological, kinetic, or kinematic data, both in real-time and after training. This requires that the key aspects of feedback administration that prevent excessive guidance can also be successfully automated and incorporated into such electronic devices. After setting the stage from a computational perspective on motor control and learning, we provided a scoping review of the findings on sensor-based augmented visual feedback in complex sensorimotor tasks occurring in sports-related settings. To increase homogeneity and comparability of the results, we excluded studies focusing on modalities other than visual feedback and employed strict inclusion criteria regarding movement task complexity and health status of participants. We reviewed 26 studies that investigated visual feedback in training regimes involving healthy adults aged 18-65. We extracted relevant data regarding the chosen feedback and intervention designs, measured outcomes, and summarized recommendations from the literature. Based on these findings and the theoretical background on motor learning, we compiled a set of considerations and recommendations for the development and evaluation of future sensor-based augmented feedback systems in the interim. However, high heterogeneity and high risk of bias prevent a meaningful statistical synthesis for an evidence-based feedback design guidance. Stronger study design and reporting guidelines are necessary for future research in the context of complex skill acquisition.

Neuroanatomical predictors of complex skill acquisition during video game training.

It is known that the outcomes of complex video game (VG) skill acquisition are correlated with individual differences in demographic and behavioral variables, such as age, intelligence and visual attention. However, empirical studies of the relationship between neuroanatomical features and success in VG training have been few and far between. The present review summarizes existing literature on gray matter (GM) and white matter correlates of complex VG skill acquisition as well as explores its relationship with neuroplasticity. In particular, since age can be an important factor in the acquisition of new cognitive skills, we present studies that compare different age groups (young and old adults). Our review reveals that GM in subcortical brain areas predicts complex VG learning outcomes in young subjects, whereas in older subjects the same is true of cortical frontal areas. This may be linked to age-related compensatory mechanisms in the frontal areas, as proposed by The Scaffolding Theory of Aging and Cognition. In the case of plasticity, there is no such relationship – in the group of younger and older adults there are changes after training in both cortical and subcortical areas. We also summarize best practices in research on predictors of VG training performance and outline promising areas of research in the study of complex video game skill acquisition.

Bioethical implications of robotic surgery in urology: a systematic review

Robotic technologies are being increasingly implemented in healthcare, including urology, and holding promises for improving medicine worldwide. However, these new approaches raise ethical concerns for professionals, patients, researchers and institutions that need to be addressed. The aim of this review was to investigate the existing literature related to bioethical issues associated with robotic surgery in urology, in order to identify current challenges and make preliminary suggestions to ensure an ethical implementation of these technologies. We performed a review of the pertaining literature through a systematic search of two databases (PubMed and Web of Science) in August 2020. Our search yielded 76 articles for full-text evaluation and 48 articles were included in the narrative review. Several bioethical issues were identified and can be categorized into five main subjects: 1) robotic surgery accessibility (robotic surgery is expensive, and in some health systems may lead to inequality in healthcare access. In more affluent countries the national distribution of several robotic platforms may influence the centralization of robotic surgery, therefore potentially affecting oncological and functional outcomes in low-volume centers); 2) safety (there is a considerable gap between surgical skills and patients' perception of competence, leading to ethical consequences on modern healthcare. Published incidence of adverse events during robotic surgery in large series is between 2% and 15%, which does not significantly differ amongst open or laparoscopic approaches); 3) gender gap (no data about gap differences in accessibility to robotic platforms were retrieved from our search); 4) costs (robotic platforms are expensive but a key reason why hospitals are willing to absorb the high upfront costs is patient demand. It is possible to achieve cost-equivalence between open and robotic prostatectomy if the volume of centers is higher than 10 cases per week); and 5) learning curve (a validated, structured curriculum and accreditation has been created for robotic surgery. This allows acquisition and development of basic and complex robotic skills focusing on patient safety and short learning curve). Tech-medicine is rapidly moving forward. Robotic approach to urology seems to be accessible in more affluent countries, safe, economically sustainable, and easy to learn with an appropriate learning curve for both sexes. It is mandatory to keep maintaining a critical rational approach with constant control of the available evidence regarding efficacy, efficiency and safety.

One-to-one innervation of vocal muscles allows precise control of birdsong

The motor control resolution of any animal behavior is limited to the minimal force step available when activating muscles, which is set by the number and size distribution of motor units (MUs) and muscle-specific force. Birdsong is an excellent model system for understanding acquisition and maintenance of complex fine motor skills, but we know surprisingly little about how the motor pool controlling the syrinx is organized and how MU recruitment drives changes in vocal output. Here we developed an experimental paradigm to measure MU size distribution using spatiotemporal imaging of intracellular calcium concentration in cross-sections of living intact syrinx muscles. We combined these measurements with muscle stress and an invitro syrinx preparation to determine the control resolution of fundamental frequency (fo), a key vocal parameter, in zebra finches. We show that syringeal muscles have extremely small MUs, with 40%-50% innervating ≤3 and 13%-17% innervating a single muscle fiber. Combined with the lowest specific stress (5mN/mm2) known to skeletal vertebrate muscle, small force steps by the major fo controlling muscle provide control of 50-mHz to 7.3-Hz steps per MU. We show that the song system has the highest motor control resolution possible in the vertebrate nervous system and suggest this evolved due to strong selection on fine gradation of vocal output. Furthermore, we propose that high-resolution motor control was a key feature contributing to the radiation of songbirds that allowed diversification of song and speciation by vocal space expansion.

Mental Practice as an Additional Step Before Simulation Practice Facilitates Training in Bronchoscopic Intubation.

Learning bronchoscopy is challenging for novices, as it requires navigation in a 3-dimensional space under 2-dimensional viewing conditions and execution of complex motor skills with an unfamiliar instrument. Mental practice exercises are based on repeated visualization of motor actions without physically performing them, thereby promoting the learning of skills. We aimed to evaluate whether a teaching intervention including mental practice exercise modules for the acquisition of bronchoscopy skills improves fiberoptic intubation performance of novice learners. In this prospective cohort study, 24 pediatric intensive care trainees and respiratory therapists participating in a bronchoscopy learning curriculum in 2016-2017 attended a theoretical lecture followed by self-guided learning. Subsequently, the learners were randomly assigned to either participating in a teaching intervention including mental practice exercises or not (control group). The primary outcome was time to complete their first bronchoscopic intubation using a virtual reality simulator. Secondary outcomes were the occurrence of "red outs" (ie, the anatomy could no longer be visualized) or collisions with the airway wall. Bayesian Poisson Mixture models were used to estimate the effect of the intervention on outcomes. Furthermore, participation in the teaching intervention was examined in short interviews and with descriptive thematic analysis. Subjects in the intervention group completed the bronchoscopy on average 1.2 times faster (rate ratio 1.2 [95% credible intervals 1.1-1.3]). The posterior probability that the teaching intervention reduced the occurrence of "red outs" by more than half was 86%. No differences were found regarding the odds of colliding with the airway wall. Everyone except 1 trainee in the mental practice group engaged with and found the mental practice modules helpful. A teaching intervention including mental practice exercises represents a valuable additional learning strategy promoting the performance and complex skill acquisition of novice learners in the initial stages of learning bronchoscopy procedures.

Bilingualism is a long-term cognitively challenging experience that modulates metabolite concentrations in the healthy brain

Cognitively demanding experiences, including complex skill acquisition and processing, have been shown to induce brain adaptations, at least at the macroscopic level, e.g. on brain volume and/or functional connectivity. However, the neurobiological bases of these adaptations, including at the cellular level, are unclear and understudied. Here we use bilingualism as a case study to investigate the metabolic correlates of experience-based brain adaptations. We employ Magnetic Resonance Spectroscopy to measure metabolite concentrations in the basal ganglia, a region critical to language control which is reshaped by bilingualism. Our results show increased myo-Inositol and decreased N-acetyl aspartate concentrations in bilinguals compared to monolinguals. Both metabolites are linked to synaptic pruning, a process underlying experience-based brain restructuring. Interestingly, both concentrations correlate with relative amount of bilingual engagement. This suggests that degree of long-term cognitive experiences matters at the level of metabolic concentrations, which might accompany, if not drive, macroscopic brain adaptations.

Effectiveness of Immersive Virtual Reality on Orthopedic Surgical Skills and Knowledge Acquisition Among Senior Surgical Residents

Video learning prior to surgery is common practice for trainees and surgeons, and immersive virtual reality (IVR) simulators are of increasing interest for surgical training. The training effectiveness of IVR compared with video training in complex skill acquisition should be studied. To evaluate whether IVR improves learning effectiveness for surgical trainees and to validate a VR rating scale through correlation to real-world performance. This block randomized, intervention-controlled clinical trial included senior (ie, postgraduate year 4 and 5) orthopedic surgery residents from multiple institutions in Canada during a single training course. An intention-to-treat analysis was performed. Data were collected from January 30 to February 1, 2020. An IVR training platform providing a case-based module for reverse shoulder arthroplasty (RSA) for advanced rotator cuff tear arthropathy. Participants were permitted to repeat the module indefinitely. The primary outcome measure was a validated performance metric for both the intervention and control groups (Objective Structured Assessment of Technical Skills [OSATS]). Secondary measures included transfer of training (ToT), transfer effectiveness ratio (TER), and cost-effectiveness (CER) ratios of IVR training compared with control. Additional secondary measures included IVR performance metrics measured on a novel rating scale compared with real-world performance. A total of 18 senior surgical residents participated; 9 (50%) were randomized to the IVR group and 9 (50%) to the control group. Participant demographic characteristics were not different for age (mean [SD] age: IVR group, 31.1 [2.8] years; control group, 31.0 [2.7] years), gender (IVR group, 8 [89%] men; control group, 6 [67%] men), surgical experience (mean [SD] experience with RSA: IVR group, 3.3 [0.9]; control group, 3.2 [0.4]), or prior simulator use (had experience: IVR group 6 [67%]; control group, 4 [44%]). The IVR group completed training 387% faster considering a single repetition (mean [SD] time for IVR group: 4.1 [2.5] minutes; mean [SD] time for control group: 16.1 [2.6] minutes; difference, 12.0 minutes; 95% CI, 8.8-14.0 minutes; P < .001). The IVR group had significantly better mean (SD) OSATS scores than the control group (15.9 [2.5] vs 9.4 [3.2]; difference, 6.9; 95% CI, 3.3-9.7; P < .001). The IVR group also demonstrated higher mean (SD) verbal questioning scores (4.1 [1.0] vs 2.2 [1.7]; difference, 1.9; 95% CI, 0.1-3.3; P = .03). The IVR score (ie, Precision Score) had a strong correlation to real-world OSATS scores (r = 0.74) and final implant position (r = 0.73). The ToT was 59.4%, based on the OSATS score. The TER was 0.79, and the system was 34 times more cost-effective than control, based on CER. In this study, surgical training with IVR demonstrated superior learning efficiency, knowledge, and skill transfer. The TER of 0.79 substituted for 47.4 minutes of operating room time when IVR was used for 60 minutes. ClinicalTrials.gov Identifier: NCT04404010.

The Spaced Learning Concept Significantly Improves Acquisition of Laparoscopic Suturing Skills in Students and Residents: A Randomized Control Trial.

Spaced learning consists of blocks with highly condensed content that interrupted by breaks during which distractor activities, such as physical activity, are performed. The concept has been shown to be superior in complex motor skill acquisition like laparoscopic suturing and knot tying. Preliminary studies have solely been conducted with medical students. Therefore, it remained unanswered if the spaced learning concept would also work for pediatric surgery residents. The study aimed to evaluate the effectiveness of spaced learning, students, and residents were asked to perform four surgeons' square knots on a bowel model within 30 minutes prior and post 3 hours of hands-on training. To examine the long-term skills, the same subjects were asked to perform a comparable, but more complex task 12 months later without receiving training in the meantime. Total time, knot stability, suture accuracy, knot quality, and laparoscopic performance were assessed. Additionally, motivation was accessed by using the questionnaire on current motivation. Differences were calculated using mixed analysis of variance, Mann-Whitney U test, and multivariate analysis of covariance. A total of 20 medical students and 14 residents participated in the study. After randomization, 18 were trained using the spaced learning concept and 16 via conventional methods. Both groups had comparable baseline characteristics and improved significantly after training in all assessed measures. The spaced learning concept improved procedure performance as well as knot quality and stability in both students and residents. However, residents that trained via spaced learning showed significantly better long-term results regarding knot quality and speed in comparison to students. Although anxiety was significantly reduced in both training groups over time, residents were significantly more interested regarding knot tying than students. This study dispels any remaining doubt that the spaced learning concept might only work for medical students. It appears that the spaced learning concept is very suitable for residents in acquiring complex motor skills. It is superior to conventional training, resulting in improved procedural performance as well as knot quality and speed. Hence, tailored training programs should not only be integrated early on in students' curricula but also in surgical training programs.

An evolutionarily acquired microRNA shapes development of mammalian cortical projections

The corticospinal tract is unique to mammals and the corpus callosum is unique to placental mammals (eutherians). The emergence of these structures is thought to underpin the evolutionary acquisition of complex motor and cognitive skills. Corticospinal motor neurons (CSMN) and callosal projection neurons (CPN) are the archetypal projection neurons of the corticospinal tract and corpus callosum, respectively. Although a number of conserved transcriptional regulators of CSMN and CPN development have been identified in vertebrates, none are unique to mammals and most are coexpressed across multiple projection neuron subtypes. Here, we discover 17 CSMN-enriched microRNAs (miRNAs), 15 of which map to a single genomic cluster that is exclusive to eutherians. One of these, miR-409-3p, promotes CSMN subtype identity in part via repression of LMO4, a key transcriptional regulator of CPN development. In vivo, miR-409-3p is sufficient to convert deep-layer CPN into CSMN. This is a demonstration of an evolutionarily acquired miRNA in eutherians that refines cortical projection neuron subtype development. Our findings implicate miRNAs in the eutherians' increase in neuronal subtype and projection diversity, the anatomic underpinnings of their complex behavior.

Keeping Calm and Carrying On: Relating Affect Spin and Pulse to Complex Skill Acquisition and Adaptive Performance.

The purpose of this laboratory study involving repeated measures of emotion as 214 undergraduates (58.4% male) learned a complex video game was to address the need for empirical research on dynamic personality constructs by examining how two aspects of affect variability—spin and pulse—explain variance in skill acquisition and adaptive performance. Spin refers to within-person fluctuations in affect pleasantness and activation potential. Pulse refers to within-person fluctuations in affect intensity. Despite research showing high affect variability reflects a personality profile of heighted reactivity to emotionally charged events and poor adjustment, little empirical research has examined their relationships with behavioral outcomes, much less aspects of skilled performance. Compared to traditional measures of personality, which yield weak effects for predicting acquisition and adaptive performance, measures of affect variability hold considerable promise because they, like performance, reflect dynamic within-person phenomena. Accordingly, the main question addressed by this study was whether spin and pulse incrementally explain acquisition and adaptive performance beyond Big Five measures of personality. In general, we expected harmful, incremental effects for both spin and pulse, and hypothesized two mechanisms for these harmful effects: (1) by undermining effort and (2) by undermining the effort-performance relationship. Using a task-change paradigm and discontinuous growth modeling that disentangled adaptation from acquisition, results showed that affect variability, independent of the Big Five, produced harmful effects via both hypothesized mechanisms. Participants higher in affect spin and pulse showed less sustained effort across performance sessions and exhibited lower performance. Furthermore, the harmful effects of spin and pulse were stronger in adaptation compared to acquisition, with pulse showing stronger direct effects on performance during adaptation and spin moderating the effort-performance relationship such that effort was only beneficial during adaptation for those lower in spin. In light of these results, one might question the common advice “keep calm and carry on,” which may not be viable for persons high in affect variability. Accordingly, results are discussed in terms of the need to better understand the specific mediating processes by which high affect variability undermines success across a variety of learning and performance contexts.

What are the characteristics of the best type 1 diabetes patient education programmes (from diagnosis to long-term care), do they improve outcomes and what is required to make them more effective?

The last 20 years have witnessed a marked change in approaches to the management of type 1 diabetes in the UK. This is exemplified by National Institute of Health and Care Excellence (NICE) guidance which acknowledges that reaching and maintaining target glucose depends on people with type 1 diabetes effectively implementing flexible intensive insulin therapy. The guidance emphasizes that successful self-management requires the acquisition of complex skills and is best achieved by participation in high-quality structured education. Controlled trials and other research have shown that programmes teaching self-management can lower glucose levels while reducing hypoglycaemia, improve psychological outcomes and are highly cost-effective. An important principle of successful programmes is therapeutic education in which learning becomes a partnership between the professional and the person with diabetes who learns to fit diabetes into his/her everyday life. Other recommended elements of programmes include a written curriculum, group teaching by a professional multidisciplinary team and quality assurance. Yet many participants struggle post-course to implement and maintain skills, and overall HbA1c levels, particularly in the UK, remain far from target. Recent studies have identified the barriers to sustained effective self-management and concluded that even high-quality programmes generally lack critical components. These include incorporating evidence from behaviour change research, exploiting the promise of new technologies in reducing the burden of self-management, and providing structured professional support once people have completed the training. Studies are currently underway to evaluate structured training courses which have added these elements and examine whether they can lower glucose to levels closer to target without impairing quality of life.

Improved Complex Skill Acquisition by Immersive Virtual Reality Training: A Randomized Controlled Trial.

There has been limited literature on immersive virtual reality (VR) simulation in orthopaedic education. The purpose of this multicenter, blinded, randomized controlled trial was to determine the validity and efficacy of immersive VR training in orthopaedic resident education. Nineteen senior orthopaedic residents (resident group) and 7 consultant shoulder arthroplasty surgeons (expert group) participated in the trial comparing immersive VR with traditional learning using a technical journal article as a control. The examined task focused on achieving optimal glenoid exposure. Participants completed demographic questionnaires, knowledge tests, and a glenoid exposure on fresh-frozen cadavers while being examined by blinded shoulder arthroplasty surgeons. Training superiority was determined by the outcome measures of the Objective Structured Assessment of Technical Skills (OSATS) score, a developed laboratory metric, verbal answers, and time to task completion. Immersive VR had greater realism and was superior in teaching glenoid exposure than the control (p = 0.01). The expert group outperformed the resident group on knowledge testing (p = 0.04). The immersive VR group completed the learning activity and knowledge tests significantly faster (p < 0.001) at a mean time (and standard deviation) of 11 ± 3 minutes than the control group at 20 ± 4 minutes, performing 3 to 5 VR repeats for a reduction in learning time of 570%. The immersive VR group completed the glenoid exposure significantly faster (p = 0.04) at a mean time of 14 ± 7 minutes than the control group at 21 ± 6 minutes, with superior OSATS instrument handling scores (p = 0.03). The immersive VR group scored equivalently in surprise verbal scores (p = 0.85) and written knowledge scores (p = 1.0). Immersive VR demonstrated substantially improved translational technical and nontechnical skills acquisition over traditional learning in senior orthopaedic residents. Additionally, the results demonstrate the face, content, construct, and transfer validity for immersive VR. This adequately powered, randomized controlled trial demonstrated how an immersive VR system can efficiently (570%) teach a complex surgical procedure and also demonstrate improved translational skill and knowledge acquisition when compared with a traditional learning method.

Exercise-induced fatigue impairs visuomotor adaptability in physical education students

Purpose: Physical exercise has been shown to exert various effects on visuomotor processing and motor learning. The present study aimed to examine the impact of exercise with progressively increased physical load on consecutive stages of perceptual-motor learning. We compared the effectiveness of visuomotor adaptability in four subsequent trials during a complex coordination task performed in different conditions, including under conditions of progressively increased physical load, and in non-exercise resting control conditions. Material: Twenty-seven physical education university students participated in this study. Participants were randomly assigned to one of two group: (1) an exercise experimental group (n = 14), or (2) a non-exercise resting control group (n = 13). Methods: Participants in the experimental group performed three 10-minute effort-tests with increasing intensity on a cycloergometer. Each participant was assigned individual workload values below the lactate threshold (40% VO2max), at the lactate threshold (60% VO2max), and above the lactate threshold (80% VO2max). Four sessions of the two-hand coordination test included in the Vienna Test System were used to examine visuomotor adaptability variation. The total time duration, total error duration, and coordination difficulty were analyzed. Results: There was a significant interaction between number of test repetitions and group (experimental, control) for total duration ( F (3,75) = 3.54, p = 0.018). In particular, there was a significant reduction ( p = 0.006) in duration in the control group after fourth test repetitions as compared to the baseline. In the experimental group, in contrast, there was a tendency for duration to increase after exercise above the lactate threshold intensity. There was also a significant interaction between test repetitions and group for total error duration ( F (3,75) = 3.14, p = 0.03). Conclusions: The results suggest that high intensity exercise can disrupt visuomotor processing during complex skill acquisition. These findings highlight the interplay between exercise intensity and motor control and learning, which in turn, has practical implications for developing and improving motor training and physical education programs.

The joint influence of intelligence and practice on skill development throughout the life span

The relative importance of different factors in the development of human skills has been extensively discussed. Research on expertise indicates that focused practice may be the sole determinant of skill, while intelligence researchers underline the relative importance of abilities at even the highest level of skill. There is indeed a large body of research that acknowledges the role of both factors in skill development and retention. It is, however, unknown how intelligence and practice come together to enable the acquisition and retention of complex skills across the life span. Instead of focusing on the 2 factors, intelligence and practice, in isolation, here we look at their interplay throughout development. In a longitudinal study that tracked chess players throughout their careers, we show that both intelligence and practice positively affect the acquisition and retention of chess skill. Importantly, the nonlinear interaction between the 2 factors revealed that more intelligent individuals benefited more from practice. With the same amount of practice, they acquired chess skill more quickly than less intelligent players, reached a higher peak performance, and arrested decline in older age. Our research demonstrates the futility of scrutinizing the relative importance of highly intertwined factors in human development.

Maternal influence on the development of nut-cracking skills in the chimpanzees of the Taï forest, Côte d'Ivoire (Pan troglodytes verus).

Chimpanzees' (Pan troglodytes) nut-cracking behavior represents one of the most complex forms of tool-use known among nonhuman animals. Given the close phylogenetic relationship between these apes and humans, investigating how such complex behavior develops in immatures can reveal the evolutionary roots of the cognitive processes that enabled the evolution of outstanding technological skills in our lineage. In this study, we investigated whether maternal behavior directly enhanced nut-cracking skills in immature individuals. We analyzed the behavior of 11 immatures and their mothers (N = 8) during nut-cracking activity, spanning over three consecutive nut-cracking seasons in the Taï National Park, Côte d'Ivoire. We used generalized linear mixed models to (a) obtain values of maternal scaffolding (defined as provision of learning opportunities) and active nut-sharing behavior of each mother according to the age of their offspring, and their average nut-cracking efficiency; (b) to test whether these variables enhanced immatures' nut-cracking skills; and (c) to test whether immatures' features (age, sex, and begging behavior) influenced maternal behavior as observed in our videos. Although the predicted values of maternal scaffolding and active nut-sharing did not obviously affect immatures' skills, they were positively influenced by the average maternal efficiency and by sharing hammers with their mothers. In addition, our observations showed that mothers were more likely to share nuts with their sons than with their daughters, and the more their offspring begged. Concurrently, male immatures were also found to beg more often than females. Our results add evidence on the ontogenetic pathway leading to the full acquisition of nut-cracking in wild chimpanzees and on the effect that maternal behavior can have in promoting the acquisition of this complex tool-use behavior. Moreover, our study strengthens the importance of naturalistic observations to understand complex skill acquisition. Finally, we suggest future avenues for investigating the maternal influence on learning.

Developing creative and research skills through an open and interprofessional inquiry-based learning course

BackgroundBiomedicine needs innovative professionals. Inquiry-based learning (IBL) aims to develop higher order thinking skills, such as creativity and research. Stimulatory techniques and interprofessional education, which requires students from different fields to collaborate, also enhances creativity. In this study, the effectiveness of an interprofessional IBL course that introduces a creativity workshop based on stimulatory techniques to develop creative and research skills is examined.Methods529 undergraduate human biology and medical students performed the interprofessional IBL course, 198 with the creativity workshop and 331 without. Students’ perceptions of learning processes and outcomes were assessed in surveys and focus groups by the authors of this study. As well, the final learning results from both groups of students were analyzed by the teachers of the course and the researchers.ResultsThe results show that the open IBL approach promoted the development of these skills, interprofessionality acted as a creativity enhancer and stimulatory techniques contributed to improve the learning outcomes.ConclusionsThis study provides insight into how open interprofessional IBL fosters acquisition of complex skills and knowledge, pointing out the benefits and limitations of this approach in health sciences studies.