Complex Skills Research Articles

Speech and Music Therapy in the Treatment of Childhood Apraxia of Speech: An Introduction and a Case Study.

Speech-Music Therapy for Aphasia (SMTA), a method that combines speech therapy and music therapy, is introduced as a treatment method for childhood apraxia of speech (CAS). SMTA will be evaluated in a proof-of-principle study. The first case study is presented herein. SMTA was evaluated in a study with a single-subject experimental design comparing 10 weeks of treatment with 2 months of no treatment. The research protocol included a pretest, baseline phase, treatment phase, posttest, no-treatment phase, and follow-up test. The participant was a boy with CAS aged 5;8 (years;months). Outcome measures were selected to reflect both intelligibility in daily communication as well as features of CAS and speech motor planning and programming. Results on the Intelligibility in Context Scale-Dutch (ICS-Dutch) and in the analysis of a spontaneous speech sample suggest generalization of treatment effects. Improvements were found in measures that reflect complex speech motor skills, that is, the production of consonant clusters and consistency. This case study showed that speech production of the participant improved after treatment with SMTA. Although intelligibility as measured with the ICS-Dutch improved over the study period, objectifying changes at the level of intelligibility in daily communication proved to be difficult. Additional measures may be necessary to gain more insight into treatment effects at this level. Overall, the results of this first case study provide sufficient support and important leads for further evaluation of SMTA in the treatment of CAS in a proof-of-principle study.

Validity evidence supporting clinical skills assessment by artificial intelligence compared with trained clinician raters.

Artificial intelligence (AI) is becoming increasingly used in medical education, but our understanding of the validity of AI-based assessments (AIBA) as compared with traditional clinical expert-based assessments (EBA) is limited. In this study, the authors aimed to compare and contrast the validity evidence for the assessment of a complex clinical skill based on scores generated from an AI and trained clinical experts, respectively. The study was conducted between September 2020 to October 2022. The authors used Kane's validity framework to prioritise and organise their evidence according to the four inferences: scoring, generalisation, extrapolation and implications. The context of the study was chorionic villus sampling performed within the simulated setting. AIBA and EBA were used to evaluate performances of experts, intermediates and novice based on video recordings. The clinical experts used a scoring instrument developed in a previous international consensus study. The AI used convolutional neural networks for capturing features on video recordings, motion tracking and eye movements to arrive at a final composite score. A total of 45 individuals participated in the study (22 novices, 12 intermediates and 11 experts). The authors demonstrated validity evidence for scoring, generalisation, extrapolation and implications for both EBA and AIBA. The plausibility of assumptions related to scoring, evidence of reproducibility and relation to different training levels was examined. Issues relating to construct underrepresentation, lack of explainability, and threats to robustness were identified as potential weak links in the AIBA validity argument compared with the EBA validity argument. There were weak links in the use of AIBA compared with EBA, mainly in their representation of the underlying construct but also regarding their explainability and ability to transfer to other datasets. However, combining AI and clinical expert-based assessments may offer complementary benefits, which is a promising subject for future research.

Students’ Argumentation Performance in Online Learning Environments: Bridging Culture and Gender

Performing complex tasks such as writing an argumentative essay and providing high-quality argumentative peer feedback are challenging for higher education students. This study aims to explore whether and how students’ argumentation performance during peer feedback activities and essay writing is related to their culture and gender. In this exploratory study, 240 students participated from a Dutch university. Since this study was conducted in a Dutch context, students’ culture was categorized as either Dutch or non-Dutch. Both Dutch and non-Dutch students followed an online module for three consecutive weeks and completed three tasks each week. In week one, students wrote an argumentative essay. In week two, students were invited to provide two sets of feedback on two peers’ essays. In week three, students were requested to revise their essays based on the received feedback from peers. Finally, students’ culture and gender were collected. The results showed that non-Dutch students provide higher-quality feedback than Dutch students in terms of justifying the identified problem in the essays. Similarly, non-Dutch students outperformed Dutch students regarding their essay writing performance by providing deeper arguments against the position, justifications for arguments against the position, and responses to counter-arguments. Although the overall differences between Dutch and non-Dutch students in peer feedback and argumentative essays were not significant between males and females, non-Dutch male students provided more affective feedback than Dutch male students. The results of this study provide insights for teachers regarding how to support international students in performing complex skills such as peer feedback and argumentative essay writing.

Effects of an annotation‐supported Socratic questioning approach on students' argumentative writing performance and critical thinking skills in flipped language classrooms

AbstractBackgroundCritical thinking and argumentative writing are considered complex but essential skills for learners. However, few studies have examined how instructions can be designed to optimize the development of such skills simultaneously. Contextualized in flipped language classrooms, this study aimed to develop an instructional innovation for English as a foreign language (EFL) learners.ObjectivesThis study investigated the effects of an annotation‐supported Socratic questioning (ASSQ) approach as a flipped classroom enhancement on students' argumentative writing and critical thinking in an EFL writing course.MethodsFifty students from two classes participated in the study, and they were randomly assigned to an experimental group and a comparison group. Following an 8‐week flipped learning curriculum, the experimental group learned with the proposed ASSQ approach in the enhanced flipped classroom, while the comparison group was exposed to the traditional flipped classroom. Students' argumentative writing performance was evaluated with their argumentative essays using a researcher‐developed writing rubric, and their critical thinking skills were assessed using the California Critical Thinking Skills Test.ResultsBoth groups significantly improved their argumentative writing, and the experimental group also significantly outperformed the comparison group after learning through the proposed approach. While the two groups had no significant difference in critical thinking skills, the within‐group comparison results revealed that the experimental group made significant improvements due to the instructional intervention.ImplicationsThe ASSQ approach could enhance the flipped classroom in regard to the teaching of argumentative writing, whereas it bears only limited impact on critical thinking. Overall, the positive effect of the proposed approach on enhancing English learners' argumentative writing performance was mainly attributed to the combined affordances of Socratic questioning and a social annotation tool to scaffold the students' thinking through verbal articulation, and to visualize their thinking with social annotations throughout the flipped learning process.

Evaluation of Skipping in College Students with and without Autism Spectrum Disorder.

Children with Autism Spectrum Disorder (ASD) demonstrate motor skill deficits in comparison to their neurotypically developing peers. However, it is unknown whether these motor skill deficits persist into adulthood. We evaluated skipping kinematics and motor performance in college students with and without ASD. We collected kinematic data from 20 college students, 10 with ASD and 10 without ASD, using a 12-camera three-dimensional motion capture system while participants completed three skipping trials. We scored skipping performance using Everyone Can! and the Halverson Developmental Sequences for Skipping, and we processed data using Cortex, Visual 3D, and MATLAB. We extracted data for center of mass excursion, peak velocity of joint extension, and peak joint angles of the hip, knee, and ankle of the dominant leg. Independent t-tests and Mann-Whitney U tests were used to examine differences between groups with an alpha level of p 0.05. We found no statistically significant differences for peak sagittal plane joint angles, velocities, or vertical center of mass excursion. However, the ASD group demonstrated greater medio-lateral center of mass displacement (ASD M = .08, SD = .1m; Control M = .03, S = .03m; p = .026) and greater frontal plane knee excursion (ASD M = 11.49, SD = 6.23°; Control M = 5.29, SD = 2.44°; p = .01) than participants without ASD. Similarly, the ASD group performed less proficiently in skipping than the group without ASD, as assessed by the developmental scoring methods (Everyone Can! composite score medians [interquartile range]: ASD M = 10.5, SD = 8; Control M = 15.0, SD = 0, p = .008). Despite many similarities in skipping kinematics between groups, participants with ASD were less proficient in skip performance than participants without ASD. Interventions for individuals with ASD addressing skipping proficiency or the performance of other locomotor skills, such as running and jumping, may promote participation in activities that involve complex motor skills and help individuals with ASD lead more physically active lives.

Handwriting legibility and fluency and their patterns of concurrent relations with spelling, graphomotor, and selective attention skills

Recent research suggests that handwriting comprises two separate subskills: legibility and fluency. It remains unclear, however, how these subskills differ in their relationship to other abilities associated with handwriting, including spelling, graphomotor, and selective attention skills. In this study, we sought to examine the extent and nature of concurrent relationships that may exist among these skills. Children in Year 3 (n = 293), Year 4 (n = 291), and Year 5 (n = 283) completed a large, group-administered battery to assess each of the above skills. Using multigroup structural equation modeling, we found that spelling, graphomotor, and selective attention skills together explained a moderate amount of variance in handwriting legibility (R2 = .37–.42) and fluency (R2 = .41–.58) and that these subskills differed in their concurrent relations. Graphomotor skills accounted for a relatively greater proportion of variance in legibility than did spelling. Conversely, there were relatively stronger contributions from variations in spelling ability to variations in fluency than from graphomotor skills. Furthermore, selective attention predicted handwriting fluency only, and it partially mediated the influence of graphomotor skills. This study further demonstrates that handwriting legibility and fluency are separable and complex skills, each differentially related to spelling, graphomotor, and attentional abilities even during later primary school years.

Development of a novel endoscopic suturing simulator: validation and impact on clinical learning curve (with video)

Background and AimsEndoscopic suturing is a complex skill with broad applications. This study aims to develop and validate a novel endoscopic suturing simulator and scoring system for the pursestring suture pattern. MethodsThis was a prospective study of an endoscopic suturing simulator, which consists of a circular opening representing a dilated gastrojejunal anastomosis of Roux-en-Y gastric bypass with 12 small target holes around its circumference. Pursestring suturing is performed in a counterclockwise fashion. Time allotted is 5 minutes. Each successful bite is awarded 10 points. Participants were divided into the novice, intermediate and experienced groups. Validity evidence based on content, validity evidence based on other variables and validity evidence based on consequences of testing were assessed. Results17 subjects (3 novice, 7 intermediate and 7 experienced) participated in the study. Validity evidence based on content: The content validity index for realism, relevance and representativeness was 0.89, 1.00 and 1.00, respectively. Validity evidence based on other variables: The novice, intermediate and experienced groups scored 30.0±8.2, 57.1±28.1 and 131.2±51.7, respectively (p=0.001). Validity evidence based on consequences of testing: The simulator group required 5±5 transoral outlet reduction cases before being able to independently complete an entire pursestring, while the non-simulator group required 38±11 clinical cases (p<0.0001). ConclusionThis novel endoscopic suturing simulator appears realistic, relevant and representative of the clinical suturing experience. Additionally, it appears effective at objectively assessing suturing skills and shortening the clinical learning curve.

Implementation and assessment of a novel drug interaction tool (TLC-act) in an entry-to-practice doctor of pharmacy program

Background and purposeDrug-drug interaction (DDI) assessment is an important role that pharmacists have in practice. Students often struggle with this complex clinical reasoning skill. TLC-Act is a tool that was created to mirror the steps and clinical checkpoints that pharmacists complete when assessing DDIs. Through integration of TLC-Act in the pharmacy curriculum, students will be better prepared for assessing and evaluating DDIs when in practice. Educational activity and settingFor the 2021–2022 academic year, an asynchronous educational activity to teach students how to use TLC-Act was created and implemented. Five videos that encompassed multiple facets of TLC-Act including an introduction to the tool and how to use it, an example application of the tool to a patient case, and the clinical utility of using TLC-Act in the hospital and community settings. Students were instructed to view all five videos and then complete a patient case that focused on the DDI between ciprofloxacin and metformin. FindingsA pre- and post-activity survey was disseminated to 640 students across the first three years of the program to gather students' perspectives on the educational activity. Overall, survey response rates were 32% for the pre- and 23% for the post-activity surveys. SummaryThe TLC-Act educational activity improved students' skills with managing DDIs.

An Analysis of Student’ Writing Difficulties in Online Learning During COVID-19 Pandemic At 4TH Semester in Muhammadiyah University of Bengkulu

Writing is a complex and essential skill that plays a significant role in communication, education, and professional endeavors. However, many students encounter various difficulties when engaging in writing tasks, especially in covid-19 pandemic. The aim of the research is to find out student’s writing difficulties in online learning during COVID-19 pandemic at 4TH semester in Muhammadiyah University of Bengkulu. The design of this research was descriptive method. The instrument of the research was questionnaire. The result showed that there are four factors that make fourth semester students have writing difficulties in online learning during pandemic Covid 19, namely : organization, content of the text, grammar and vocabulary mastery. The dominant factor of the students writing difficulties is vocabulary mastery. It implies that the students need to practice regularly and set aside dedicated time for writing practice. In addition, the students can seek support if they are still facing persistent challenges in writing, consider seeking additional support from lecturers, counselors, or professionals specializing in learning writing difficulties to help them in personalizing strategies and interventions tailored to the students' specific needs especially enhancing their knowledge about organization, content, grammar and add their vocabularies.&#x0D; &#x0D; Key words: Writing, Online Learning, Writing Difficulties

Learning Physically Simulated Tennis Skills from Broadcast Videos

We present a system that learns diverse, physically simulated tennis skills from large-scale demonstrations of tennis play harvested from broadcast videos. Our approach is built upon hierarchical models, combining a low-level imitation policy and a high-level motion planning policy to steer the character in a motion embedding learned from broadcast videos. When deployed at scale on large video collections that encompass a vast set of examples of real-world tennis play, our approach can learn complex tennis shotmaking skills and realistically chain together multiple shots into extended rallies, using only simple rewards and without explicit annotations of stroke types. To address the low quality of motions extracted from broadcast videos, we correct estimated motion with physics-based imitation, and use a hybrid control policy that overrides erroneous aspects of the learned motion embedding with corrections predicted by the high-level policy. We demonstrate that our system produces controllers for physically-simulated tennis players that can hit the incoming ball to target positions accurately using a diverse array of strokes (serves, forehands, and backhands), spins (topspins and slices), and playing styles (one/two-handed backhands, left/right-handed play). Overall, our system can synthesize two physically simulated characters playing extended tennis rallies with simulated racket and ball dynamics. Code and data for this work is available at https://research.nvidia.com/labs/toronto-ai/vid2player3d/.

The Impact of Semantic Mapping on Reading Comprehension Among Moroccan EFL Students

Research indicates a relationship between vocabulary complexity and reading comprehension skills of EFL learners. Expanding vocabulary can improve comprehension, but increasing the number of words may not be enough. Direct vocabulary instruction is less effective than semantic mapping techniques, which involve creating interconnected maps of vocabulary terms to activate readers’ existing background knowledge. This study investigates the efficacy of semantic mapping as a pre-reading strategy for improving reading comprehension of cultural texts among beginner EFL learners in Morocco. A quasi-experimental research design was used, with experimental and control groups assigned according to the Macmillan’s Language Hub placement test. The experimental group was taught through semantic mapping and the control group received direct vocabulary teaching. The experiment lasted for eight sessions, with a pre-test and post-test administered along with individual interviews. Data were analyzed using SPSS and subjected to a repeated measures ANOVA. Results indicate that semantic mapping yielded significant improvements at the inferential level of reading comprehension, but no significant effects were observed at the literal level. Research implications and future directions are discussed.

Mentoring approaches in a safe surgery program in Tanzania: Lessons learned during COVID-19 and recommendations for the future

BackgroundCOVID-19 has dramatically affected the delivery of health care and technical assistance. This is true in Tanzania, where maternal mortality and surgical infection rates are significantly higher than in high-income countries. This paper describes lessons learned about the optimal application of in-person and virtual mentorship in the Safe Surgery 2020 program to improve the quality of surgical services in Tanzania before and after the COVID-19 pandemic. MethodsFrom January 2018 through December 2020, Safe Surgery 2020 supported 40 health facilities in Tanzania's Lake Zone to improve the quality of surgical care. A blended surgical mentorship model, employing both onsite and virtual mentorship, was central to the program's capacity development approach. With COVID-19, the program pivoted to full virtual mentorship. Through continuous learning and adaptation processes, including a human-centered design workshop, surveys assessing mentors' confidence with different competencies, and focus group discussions with mentors, mentees and safe surgery program staff, the program distilled the optimal use of mentorship models. ResultsDeveloping complex surgical skills, addressing contextual considerations, problem-solving, and building trusting relationships were best suited to in-person mentorship, whereas virtual mentorship was most effective in supporting mentees' quality improvement projects, data use, case discussions, and reinforcing clinical practices. Leading successful virtual learning required enhanced facilitation skills and active engagement of health facility leadership. ConclusionsIn-person and virtual mentorship offer distinct benefits and complement each other when combined. Investing more in-person mentorship at the beginning of programs allows for the establishment of trust that is foundational to effective mentorship.

Perception and knowledge of learners about the use of 3D technologies in manual therapy education – a qualitative study

ObjectivesManual therapy is a specific hands-on approach used and taught by various professions such as physiotherapy and osteopathy. The current paradigm of teaching manual therapy incorporates the traditional ‘See one, do one, teach one’ approach. However, this ‘teacher centred’ approach may not enable learners to develop the complex clinical skills of manual therapy. In this context, 3D technologies such as virtual reality may facilitate the teaching and learning of manual therapy. Hence the aim of the current study was to investigate the perception, knowledge and attitude of manual therapy learners about the use of 3D technologies in manual therapy education.MethodsAn exploratory qualitative research design using semi-structured interviews was used in this study. A total of ten manual therapy (5 physiotherapy and 5 osteopathic) students (mean age = 32; 80% female) enrolled in an appropriate physiotherapy or osteopathic degree provided by a New Zealand recognized institution (e.g., university or polytechnic) participated in this study. Data saturation was achieved after 10 interviews (average duration: 35 min) that provided thick data. A thematic analysis was used for data analysis.ResultsSix factors were identified which appeared to influence participants’ perception of role of technology in manual therapy education. These were (1) the sufficiency of current teaching method; (2) evolution as a learner (a novice to an expert); (3) need for objectivity; (4) tutor feedback; (5) knowledge and (6) barriers and enablers. These six factors influenced the participants’ perception about the role of 3D technologies in manual therapy education with participants evidently taking two distinct/polarized positions (‘no role’ (techstatic) versus a ‘complete role’ (techsavvy)).ConclusionAlthough 3D technology may not replace face-to-face teaching, it may be used to complement the traditional approach of learning/teaching to facilitate the learning of complex skills according to the perceptions of manual therapy learners in our study. The advantage of such an approach is an area of future research.

The development of a marker system for Pharmacists' Behavioural Skills.

Pharmacists increasingly require complex behavioural skills to fulfil enhanced roles within healthcare teams. Behavioural marker systems are used to assess behavioural (or non-technical) skills during immersive simulation. This study aimed to develop a marker system for pharmacists' behavioural skills in patient-focussed care scenarios, and to investigate its content validity. Literature describing existing marker systems and the requisite behavioural skills of pharmacists were presented to two expert panels, alongside video examples of pharmacists in patient-focussed care simulations. The expert panels used this information to develop a new behavioural marker system. A third expert panel assessed the content validity, and the item- and scale-content validity indices were calculated. The resulting tool contains four categories, each with three or four skill elements: situation awareness (gathering information; recognising and understanding information; anticipating, preparing and planning), decision-making and prioritisation (identifying options; prioritising; dealing with uncertainty; implementing or reviewing decisions), collaborative working (involving the patient; information sharing; leadership or followership), self-awareness (role awareness; speaking up; escalating care; coping with stress). The scale-content validity index was 0.95 (ideal) and the only item below the acceptable cut-off was 'leadership or followership' (0.7). This tool is the first marker system designed to assess the behavioural skills of pharmacists in patient-focussed care scenarios. There is evidence of good content validity. It is hoped that once validated, the Pharmacists' Behavioural Skills marker system will enable pharmacy educators to provide individualised and meaningful feedback on simulation participants' behavioural skills.

Script concordance testing in genetic counseling training: Apilot study.

Clinical reasoning is a complex skill that represents a trainee's ability to use their professional knowledge and skills to assess and solve the problems that arise in clinical practice. As an integral tenet of the genetic counseling process, clinical reasoning skills underlie many of the Practice-Based Competencies (2019) across a variety of domains. Despite the long-lasting recognition of the importance of this complex skill in the training of genetic counselors, clinical reasoning has traditionally been difficult to assess in a standardized way in healthcare education. Script concordance testing is a standardized method of assessing clinical reasoning skills in ambiguous clinical situations. The tool has been used to successfully measure the clinical reasoning skills of trainees in various healthcare training programs and has never been used in a genetic counseling training program. We conducted a pilot study to assess the utility of script concordance testing in the field of genetic counseling as an objective measure of clinical reasoning in trainees. The script concordance test was constructed for the field of genetic counseling and administered to 22 second year genetic counseling students in the Joan H. Marks Graduate Program in Human Genetics at Sarah Lawrence College. Twelve genetic counselors served on a panel to provide expert clinical reasoning responses and a scoring grid was developed using the aggregate scores method. The utility of the tool was measured using Cronbach's alpha coefficient, and scores of students and the panel were compared using Hedge's g. Results revealed statistically significant differences between the scores of panelists and students and good reliability. This study shows that script concordance testing can be used to measure clinical reasoning skills in genetic counseling trainees in a way that is reliable, standardized, and easy to use, thereby allowing programs to better assess the clinical reasoning skills of trainees prior to graduation.

Migrant orangutan males use social learning to adapt to new habitat after dispersal

Dispersal has been suggested to be challenging, especially for species that heavily rely on social learning for knowledge acquisition. One of the obstacles that migrants face is learning how to cope with an unfamiliar, new habitat, which may involve learning from resident individuals. So far, only very few studies have looked at social learning in migrants after dispersal. Here we examine how migrant male orangutans use a behavior called “peering” (an indicator of observational social learning), to learn from local individuals. In total, we analyzed 4,009 daily dyadic associations with and without peering events of 77 males of the highly sociable Sumatran orangutans (Pongo abelii) at the Suaq population and 75 males of the less sociable Bornean orangutans (Pongo pygmaeus wurmbii) at the Tuanan population, covering a combined study time of 30 years. Analysis using generalized linear mixed models supported our prediction that migrant males in Suaq preferentially peered at the local adult females. However, in Tuanan, migrants peered mostly at other adult males and local immatures. Migrants’ peering rates were highest shortly after their arrival, and significantly decreased with increasing time spent in the area. Migrants in both sites peered significantly more at peering targets’ feeding on food items that are rarely eaten within the locals’ diet, than at commonly eaten ones and peered significantly more at skill-intense food items than easy-to-process ones. Further, migrants interacted significantly more with the peered-at food item after the peering event, than before, suggesting that they practice the observed behavior. Our results therefore suggest that migrant males use peering to learn new ecological knowledge after dispersal (e.g., where and what to feed on), and continue to learn complex skills even within adulthood, (e.g., how to feed on skill-intense food items). To do so, migrants selectively attend to the most knowledgeable and/or available individuals, practice the new skill afterwards and even flexibly adjust their learning, e.g., when confronted with intolerant locals or when the need for learning decreases. Together, our study provides important evidence that social learning in great apes expands towards adulthood, an ability which critically impacted also human evolution.

Learning Complex Motor Skills for Legged Robot Fall Recovery

Falling is inevitable for legged robots in challenging real-world scenarios, where environments are unstructured and situations are unpredictable, such as uneven terrain in the wild. Hence, to recover from falls and achieve all-terrain traversability, it is essential for intelligent robots to possess the complex motor skills required to resume operation. To go beyond the limitation of handcrafted control, we investigated a deep reinforcement learning approach to learn generalized feedback-control policies for fall recovery that are robust to external disturbances. We proposed a design guideline for selecting key states for initialization, including a comparison to the random state initialization. The proposed learning-based pipeline is applicable to different robot models and their corner cases, including both small-/large-size bipeds and quadrupeds. Further, we show that the learned fall recovery policies are hardware-feasible and can be implemented on real robots.

The Demographic Factors Affecting the Writing Skills of Slovenian Year 6 EFL Students

EFL writing is a complex and difficult productive skill for young learners. National assessment of EFL at the end of Year 6 in Slovenia shows that additional research into the various variables affecting EFL writing is needed. The aim of this study is to predict the relationship between gender, place of living, home possessions, years of schooling and parents’ education, and EFLwriting performance for Year 6 students. A representative sample of 790 pupils completed a demographic e-questionnaire and two writing e-tasks. According to ANOVA , statistically significant factors are home possessions, number of Slovenian and English books, years of learning English and mother’s education. Statistically insignificant factors are gender, place of living and father’s education. Demographic factors predict EFL writing performance by 9.9%.

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.

Learning complex upper-limb movements through practicing movement elements

Upper-limb complex movements constitute a major part of our daily activities. Research shows complex movements are generated by sequences of movement elements represented by a unimodal bell-shaped velocity curve. We utilized this understanding in the field of motor skill acquisition and hypothesized that practicing a movement element of a complex movement trajectory will facilitate the performance on the respective complex movement trajectory. To test this, we designed an experiment where the control group learned a full complex trajectory, whereas the two elemental groups learned two different movement elements of the complex trajectory. The two main outcome measures explaining the performance were accuracy and speed. The elemental groups, after training on movement elements, significantly improved their speed and accuracy when tested on the full complex trajectory. The result illustrated that training on a movement element of a complex trajectory benefited the performance of the full complex trajectory. The two elemental groups showed similar improvements in the performance of the complex motor skill, despite obtaining training on different movement elements of the same complex movement. The findings show that complex movements can be learned by practicing their movement elements.