Repetitive Practice Research Articles

The Janulis Burial

Abstract An amateur 1969 excavation at the Middle Archaic period Janulis site in Ontario unearthed the skeletal remains of three individuals and a dog. One of these, an adult female with an extensive offering, displayed several changes in the bones of her right arm and shoulder caused by the repetitive and intensive practice of an overhand throwing motion. The association of eight projectile points with her skeleton indicates that the activity was projectile throwing, suggesting a strong emphasis on hunting, normally a masculine role. She also had a turtle-shell rattle, an instrument usually associated with men in that time period. In contrast, the presence of two deer styliform bones in the burial point to a feminine role. These anomalies raise the possibility that this individual had adopted a nonbinary gender status, but the paucity of reliable comparative data makes it difficult to precisely define that status.

Altered somatosensory evoked potentials associated with improved reaction time in a simple sensorimotor response task following repetitive practice.

IntroductionRepetitive practice of sensorimotor tasks is widely used for neurorehabilitation; however, it is unknown how practice alters sensory processing (e.g., recognition, discrimination, and attentional allocation) and associated cognitive processing, such as decision‐making. The purpose of this study was to investigate whether long‐latency somatosensory evoked potentials (SEPs) reflecting sensory processing, attention, and decision‐making are altered by sensorimotor learning.MethodsFifteen participants performed a simple sensorimotor response task (thumb opposition in response to surface electrical stimulation), with experimental recording sessions before and after three days of practice. We then compared multiple SEP waveforms and reaction times (RTs) between pre‐ and postpractice trials.ResultsThe RT was reduced after practice of three days, and we found a significant positive correlation between ΔRT and ΔN140lat at F3, Cz, and C3′, ΔRT and ΔN250lat at F3, and there was a significant negative correlation between ΔRT and ΔP300amp at C3′.ConclusionThe present study suggests that motor learning improves somatosensory processing and attentional allocation via neuroplasticity and that these alterations are reflected by specific SEP changes.

Simulation reduces navigational errors in cerebral angiography training

BackgroundSimulation-based medical education (SBME) is growing as a powerful aid in delivering proficient skills training in many specialties. Cerebral angiography (CA), a spatially and navigationally challenging endovascular procedure, can benefit from SBME by training targetable skills outside of the Angiosuite. In order to standardize and specify training requirements, navigational challenges and needs have to be identified. Furthermore, to enable successful adoption of these strategies, simulation adoption barriers, such as necessity of supervisory resources, must be reduced. In this study, we assessed the navigational challenges in simulated CA through a self-guided novice training program.MethodsNovice participants (n = 14) received virtual reality (ANGIO Mentor, Simbionix) diagnostic cerebral angiography training and were tested on a right middle cerebral artery aneurysm case over 8 sessions with a reference instructional outline. The navigational trajectories for the guidewire and catheter were analyzed and rates in erroneous vessel access were analyzed. Participants were given a Mental Rotations Test (MRT) and were analyzed based on MRT performance.ResultsAfter 8 sessions, there was a significant (p < 0.05) reduction on navigational error prevalence. The L-SUB and L-CCA saw the biggest drop in erroneous access, whereas the R-ECA, the biggest consumer of error time, saw no changes in access frequency. Individuals with high MRT score performed much better (p < 0.05) than those with low MRT score.ConclusionsThrough self-guided simulation training, we demonstrated the navigational challenges encountered in simulated CA. To establish better assessments and standards in medical training, we can create self-guided training curricula aimed at correcting errors, enabling repetitive practice, and reducing human resource needs.

631-P: Front-Line Clinician Perspectives on Immediate Self-Care Needs of Patients with Diabetes

Diabetes mellitus (DM) self-care teaching is often provided at point of care, but “clinician-centered” feedback about teaching is lacking. Semi-structured, facilitated interviews of front-line clinicians involved in DM care (e.g., meter, medications, injection technique) were conducted. Clinicians were asked their perspectives on the needs of newly diagnosed DM patients, specifically during transitions of care (e.g., discharge home). Clinicians were also asked to review current DM education materials (training supplies, print handouts) and subsequently developed potential solutions. Interview transcripts were independently coded by 3 coders, using a constant comparative method, to identify themes. MAXQDA software was used. Key themes were additionally audited by a diabetologist. Eleven sessions were conducted with clinicians (N=14, 2 certified DM educators, 4 endocrinology MD fellows, 3 advanced practice providers, 1 DM nurse, 2 pharmacists, 2 internal medicine MDs). The most commonly identified theme across clinician type was simplified, understandable content (8/11 sessions). Participants identified lack of centralization of supplies and education materials as the most significant barrier (9/11 sessions) to optimal care. Other top themes were insurance coverage for diabetes supplies and medications, need for customization, and limited access to diabetes educators. The most preferred solution was use of patient simulation (repetitive practice) [7/11 sessions], followed by teaching videos (5/11 sessions). Clinicians preferred comprehensive but simplified, understandable, customizable, diabetes teaching content. The lack of centralization of supplies and content and insurance coverage for supplies/medications are major barriers for clinicians to deliver optimal DM self-care teaching. These data also suggest that use of simulation could facilitate improvement in DM teaching by front-line clinicians. Disclosure K. Coyne: None. S. Hakimian: None. T. Pollack: None. S. Karam: None. G. Prince: None. E.K. Touma: None. D.W. Gatchell: None. R. Khorzad: None. B. Ankenman: None. J.L. Holl: None. A. Wallia: Research Support; Self; Eli Lilly and Company, Novo Nordisk Inc., UnitedHealth Group. Funding American Diabetes Association (1-13-JF-54 to A.W.); Chicago Center for Diabetes Translation Research/National Institute of Diabetes and Digestive and Kidney Diseases (P30DK092949); Agency for Healthcare Research and Quality (5R18HS026143-02)

Experience of enriched rehabilitation in the chronic phase of stroke

Purpose In this study, we explored the experiences of patients who participated in an enriched task-specific therapy (ETT) program in the chronic phase after stroke. Method Focus group interviews were conducted with twenty participants with a mean time since stroke of 30 months and mean age 61 years, who completed the ETT program including task-specific training and environmental enrichment. ETT was delivered 3.5–6 h per day, 5½ days per week for 3 weeks in a climate suitable for both indoor and outdoor activities. The training consisted of repetitive mass practice of gradually increasing difficulty. Directly after the intervention, qualitative interviews were conducted in six focus groups. The interviews were analysed with qualitative content analysis. Results Three main categories describing the informants’ experiences of the ETT program were identified. These categories were; 1. The program—different and hard – highlighting the participants view of the ETT as strenuous and different in nature; 2. My body and mind learn to know better – describing positive changes in participants’ body function and functional ability as well as behavioural changes experienced throughout the ETT; and 3. The need and trust from others – emphasizing the perceived importance of trust in rehabilitation clinicians and the support of family and other participants. From these categories, a main theme emerged: It’s hard but possible—but not alone! Conclusion A therapy program including task-specific training and environmental enrichment may provide late-phase stroke survivors with perceived improvements in functional ability, knowledge insights, perceptions of rehabilitation needs and enriching emotional impacts. Implications for rehabilitation ETT is feasible and may lead to perceived improvements in function and a change of mindset, even in the chronic phase after stroke. Trust in the competence of the rehabilitation staff is an important factor in compliance with the high-intensity training in the ETT program. Given the lack of stimulation and socialization among many individuals with chronic stroke, the social and physical environment are important components of the ETT program.

Stroke Disability and Physiotherapy Interventions: A Quantitative Evaluation of Physiotherapy Treatment Approaches’ in Zambia

As a result of physical disability after stroke, most of the patients need physiotherapy. Due to different backgrounds, knowledge, clinical experiences, personal preferences, and continually developing clinical practices, physiotherapists use different methods to treat their stroke patients. This study was designed to determine physiotherapists’ perspective on the physiotherapy interventions for stroke patients at the University Teaching Hospital and Levy Mwanawasa University Teaching Hospital in Lusaka. This was a cross-sectional study. Data was collected through a standardized questionnaire with modifications to fit the scope of the study. A total of 36 participants consisting of 23 Physiotherapists and 13 physiotherapy Technologists was considered. The data obtained was analyzed by using descriptive analysis and chi-square test was used to test the association. The results showed that PNF/Brumstrom (92%) was the most taught approach among the respondents in their professional education. The preferred treatment approaches in stroke rehabilitation which are used by Physiotherapists and physiotherapy Technologists are repetitive functional task practice (72%), motor learning (69%) and PNF/Brumstrom (67%). There is need to incorporate the newer physiotherapy treatment approaches into the physiotherapy practice as the scope of practice that reflects the latest evidence base improves the provision of services and contributes to better and cost-effective physiotherapy interventions for stroke patients.

Effect of Adding Motor Imagery to Task Specific Training on Facilitation of Sit to Stand in Hemiparetic Patients

Background: Motor imagery training is a cognitive process in which an internal representation of a movement is activated in working memory. The movement is mentally rehearsed, without any physical activity. Task-specific training emphasizes the repetitive practice of skilled movement to enhance functional abilities in hemiparesis. Objectives: To investigate whether task specific training preceded by motor imagery or task specific training alone was more effective for facilitating sit to stand in patients with stroke. Methods: Thirty male patients with stroke were selected from the Cairo University Outpatient Clinic; the median age of participants was 54.5 ± 3.51 years and they were divided equally into two groups. Patients in study group A (n = 15) received motor imagery training for 15 minutes followed by task specific training for 45 minutes, as well as a selected physical therapy program 3 times per week for 6 weeks. The control group B (n = 15) received task specific training for 45 minutes, as well as a selected physical therapy program 3 times per week for 6 weeks. The Fugl-Meyer section of the lower extremity (FMA-LE), Timed up and go test (TUG), and Biodex Balance system were assessed before and after treatment. Results: The results were highly significant for all variables including FMA-LE, TUG and Biodex Balance system in favor of the study group, post treatment. (P = 0.0004, P = 0.0001 and P = 0.0001, respectively). Conclusions: Motor imagery training results in greater improvement in sit to stand ability when used in conjunction with task specific training, rather than task specific training alone.

Dose and staffing comparison study of upper limb device-assisted therapy.

Neurological injuries cause persistent upper extremity motor deficits. Device-assisted therapy is an emerging trend in neuro-rehabilitation as it offers high intensity, repetitive practice in a standardized setting. To investigate the effects of therapy duration and staff-participant configuration on device-assisted upper limb therapy outcomes in individuals with chronic paresis. Forty-seven participants with chronic upper extremity weakness due to neurological injury were assigned to a therapy duration (30 or 60 min) and a staff-participant configuration (1-to-1 or 1-to-2). Therapy consisted of 3 sessions a week for 6 weeks using the Armeo®Spring device. Clinical assessments were performed at three timepoints (Pre, Post, and 3 month Follow up). Improvements in upper limb impairment, measured by change in Fugl-Meyer score (FM), were observed following therapy in all groups. FM improvement was comparable between 30 and 60 min sessions, but participants in the 1-to-2 group had significantly greater improvement in FM from Pre-to-Post and from Pre-to-Follow up than the 1-to-1 group. Device-assisted therapy can reduce upper limb impairment to a similar degree whether participants received 30 or 60 min per session. Our results suggest that delivering therapy in a 1-to-2 configuration is a feasible and more effective approach than traditional 1-to-1 staffing.

Effects of robot-assisted gait training combined with virtual reality on motor and cognitive functions in patients with multiple sclerosis: A pilot, single-blind, randomized controlled trial.

Studies on robot-assisted gait training rehabilitation in multiple sclerosis have reported positive effects on mobility and quality of life. However, their effects on cognitive functions are difficult to determine because not all trials have included cognition assessments. Virtual reality-based training provides enhanced opportunity for stimulating cognitive abilities by repetitive practice, feedback information, and motivation for endurance practice. To compare the effects of innovative robot-assisted gait training combined with virtual reality versus standard robot-assisted gait training on information processing speed, sustained attention, working memory, and walking endurance in patients with multiple sclerosis. Seventeen outpatients were randomly assigned to receive robot-assisted gait training either with or without virtual reality. The robot assisted gait training + virtual reality group underwent end-effector system training engendered by virtual reality. The standard training group underwent end-effector system training. A blinded rater evaluated patients before and after treatment and at one month follow-up. The outcome measures were the Paced Auditory Serial Addition Test, Phonemic Fluency Test, Novel Task, Digit Symbol, Multiple Sclerosis Quality of Life-54, 2-Minutes Walk Test, 10-Meter Walking Test, Berg Balance Scale, gait analysis, and stabilometric assessment. Between-group comparisons showed a significant change on the 2-Minutes Walk Test (p = 0.023) after treatment in the robot-assisted gait training + virtual reality group. Significant improvement were obtained also in executive functions (p = 0.012). Both gains were maintained at the 1-month follow-up evaluation (p = 0.012, p = 0.012) in the robot-assisted gait training + virtual reality group. Both group improved quality of life after treatment (Multiple Sclerosis Quality of Life-54: Mental Health p = 0.018, Physical Health p = 0.017). Both training lead to positive influenced on executive functions. However larger positive effects on gait ability were noted after robot-assisted gait training engendered by virtual reality with multiple sclerosis. Robot-assisted gait training provides a therapeutic alternative and motivational of traditional motor rehabilitation.

Rethinking repetition in dementia through a cartographic ethnography of subjectivity

This article critically engages with the predominant understandings of repetitive bodily practices within a dementia context. Rather than interpreting such practices as pathological and abnormal, I instead approach them through an ethnographic mapping, paying particular attention to the affective dynamics of repetition. Critically developing Fernand Deligny’s insights and methods of tracing and mapping bodily movements in dialogue with Tim Ingold’s notion of dwelling, I demonstrate affect-underpinned encounters and interactions of repetitive phenomena. I then argue for the extension of recent anthropological discussions about affect, repetition, and subjectivity by suggesting a more productive dialogue among theories of affect, body, atmosphere, cognition, memory, language, and life history.

Choosing Appropriate Retrieval based Learning Elements among Students in Java Programming Course

Effective learning needs consistent and relevant strategies to help students process and maintain new information. This importance is influenced by researchers’ objectives to help students who are able to retain memory in learning, and manage to master learning well. Encoding, learning condition and learning practice are the important elements in Retrieval Based Learning (RBL) strategies. This research aims to decide suitable RBL strategies for students who join Java Programming course at vocational institutions. Research sample consists of 72 DVM students in their first semester for the Data and Web Application Database Management course in four different vocational institutions. Research data were obtained using questionnaire and analysed using the Statistical Package of the Social Sciences (SPSS) software version 22.0. The questionnaire was divided into four sections, encoding, learning condition, retrieval practice and suitable materials to be used in learning. Results from the descriptive analysis showed that the use of encoding through acoustic, visual semantic and elaborative methods has become students’ choices in program learning, while the appropriate learning condition by students with the highest mean value of 4.0694 is through repetitive practices or individual tests to improve memory in learning. The three retrieval practices which are free recall, serial recall and cue recall, receive the highest interpretation other than using hardcopy materials and computer application in learning. Students’ learning approaches were different depending on suitability and comfort. Thus, educators should realize this and the effort of adapting learning between students’ choices and Java Programming course which could create an effective learning environment for all students. The results of the study are hoped to provide important knowledge in improving program learning, generally, and at vocational institutions, specifically, for computer programming courses.

Utilizing multi-user virtual reality to bring clinical therapy into stroke survivors' homes

IntroductionLifespans after the occurrence of a stroke have been lengthening, but most stroke survivors will experience chronic impairment. Directed, repetitive practice may reduce deficits, but clinical access is often limited by a variety of factors, such as transportation. Purpose of the StudyTo introduce a multiuser virtual reality platform that can be used to promote therapist-client interactions when the client is at home. MethodsThe Virtual Environment for Rehabilitative Gaming Exercises encourages exploration of the hand workspace by enabling multiple participants, located remotely and colocated virtually, to interact with the same virtual objects in the shared virtual space. Each user controls an avatar by corresponding movement of his or her own body segments. System performance with stroke survivors was evaluated during longitudinal studies in a laboratory environment and in participants' homes. Active arm movement was tracked throughout therapy sessions for both studies. ResultsStroke survivors achieved considerable arm movement while using the system. Mean voluntary hand displacement, after accounting for trunk displacement, was greater than 350 m per therapy session for the Virtual Environment for Rehabilitative Gaming Exercises system. Compliance for home-based therapy was quite high, with 94% of all scheduled sessions completed. Having multiple players led to longer sessions and more arm movement than when the stroke survivors were trained alone. ConclusionsMultiuser virtual reality offers a relatively inexpensive means of extending clinical therapy into home and enabling family and friends to support rehabilitation efforts, even when physically remote from each other.

Transcranial Direct Current Stimulation of Supplementary Motor Region Impacts the Effectiveness of Interleaved and Repetitive Practice Schedules for Retention of Motor Skills

Interleaved rather than repetitive practice (RP) is associated with superior retention of motor skills. It has been argued that this results from improved post-practice consolidation reflected in greater offline gains following interleaved practice (IP). The magnitude of this offline benefit has been associated with greater recruitment of supplementary motor area (SMA) during encoding. The present study administered anodal or cathodal transcranial direct current stimulation (tDCS) during interleaved or RP respectively in an attempt to modify the activity at SMA and the concomitant retention outcomes commonly associated with these training formats. Sixty-nine participants were assigned to one of four experimental conditions that included: IP-sham, RP-sham, IP-cathodal tDCS, and RP-anodal tDCS. Real or sham stimulation at SMA was administered during practice of three unique 6-key discrete sequence production tasks which lasted approximately 20-min. Tests were administered prior to practice and immediately after practice as well at 6-h, 24-h, and 72-h after practice ended. As anticipated, IP resulted in poorer acquisition but superior offline gain. Enhanced offline gain following interleaved training resulted from rapid stabilization of performance within the first 6-h following encoding and overnight improvement that continued over multiple sleep episodes. Administration of anodal stimulation at SMA during RP improved performance during training compared to sham but this benefit was short lived as forgetting during the first 6-h after practice was consistent with that observed for the sham counterpart. However, supplementing RP with anodal stimulation at SMA did foster overnight offline performance gains not displayed by individuals that experienced RP in the absence of stimulation.

Formal Training Efforts to Develop Simulation Educators: An Integrative Review.

Formal training for educators who use simulation-based education (SBE) is required by standards of best practice, simulation guidelines, regulatory, and accrediting bodies. Training efforts to establish educator competency for SBE are being offered. However, a systematic review of this body of literature has yet to be conducted. The purpose of this integrative review was to appraise formal training efforts of educators who use SBE. The aims were to summarize the training topics, describe the structure of training programs, and explore evaluation methods of educators. The New World Kirkpatrick Model guided the review. A PRISMA search approach yielded 2007 citations of which 38 met inclusion criteria. Analysis supports a formalized training process that uses a combination of didactic material, time for repetitive practice, and ongoing feedback with longitudinal and scaffolded delivery approaches. An identified gap in the literature is threshold levels for determining competency of educators. Recommendations for planning simulation training programs are provided.

Playback: An Investigation of the Discursive Implications and the Pragmatic Functions of Repetition in Traditional Chinese Medical Consultations

The current study examined a role-related difference in the use of playback (one form of repetition) in medical discourse. We adopted a language and social psychology approach and invoked communication accommodation theory (CAT) to explore this discourse. Thirty doctor/older adult dyads were recorded and transcribed verbatim. Findings suggested that the deployment of repetition is a strategy used by the addresser to either complement or converge to the other interlocutor, in order to ensure that the medical instrumental task is efficiently accomplished and interpersonal rapport is established. Our results show that discourse management is the dominant strategy used by speakers when playing back the other’s utterances. Our analysis also demonstrates that CAT strategies work interdependently. We conclude that CAT is a valuable framework to elucidate the dynamics of, and the social psychological processes underlying, the practice of repetition in medical interviews.

Design and validation of a low-cost, high-fidelity model for robotic pyeloplasty simulation training

Owing to restrictions in operative experiences, urology residents can no longer solely rely on 'hands-on' operative time to master their surgical skills by the end of residency. Simulation training could help residents master basic surgical skills and steps of a procedure to maximize time in the operative room. However, simulators can be expensive or tedious to set up, limiting the availability to residents and training programs. The authors sought to develop and validate an inexpensive, high-fidelity training model for robotic pyeloplasty. Pyeloplasty models were created using Dragon Skin® FX-Pro tissue-mimicking silicone cast over 3-dimensional molds. Urology faculty and trainees completed a demographic questionnaire. The participants viewed a brief instructional videoand then independently performed robotic dismembered pyeloplasty on the model. Acceptability and content validity were evaluated via post-task evaluation of the model. Construct validity was evaluated by comparing procedure completion time, the Global Evaluative Assessment of Robotic Skills (GEARS) score, blinded subjective physical evaluation of repair quality (1-10 scale), and flow rate between experts and novices. In total, 5 urology faculty, 6 fellows, and 14 residents participated. The median robotic console experience among faculty, fellows, and residents was 8 years (interquartile range [IQR] = 6-11), 3.5 years (IQR = 2-4 years), and 0 years (IQR = 0-0.5 years), respectively. The median procedure completion time was 29min (IQR = 26-40min), and the median flow rate was 1.11mL/s (IQR = 0-1.34mL/s). All faculty had flow rates >1.25mL/s and procedure times <30min compared with 2 of 6 fellows and none of the residents (P<0.001). All faculty, half of the fellows, and none of the residents achieved a GEARS score ≥20, with a median resident score of 12.5 (IQR = 8-13) (P<0.001). For repair quality, all faculty scored ≥9 (out of 10), all fellows scored ≥8, and the median score among residents was 6 (IQR = 2-6) (P<0.001). The material cost was $1.32/model, and the average production time was 0.12 person-hours/model. This low-cost pyeloplasty model exhibits acceptability and content validity. Construct validity is supported by significant correlation between participant expertise and simulator performance across multiple assessment domains. The model has excellent potential to be used as a training tool in urology and allows for repetitive practice of pyeloplasty skills before live cases.

Online Module Builds Skills for Internal Medicine Interns in Responding to Emotions During Complex Serious Illness Conversations

ContextResponding to emotion cues is an essential skill for communicating with patients and families, but many health care trainees have difficulty applying this skill within the context of a complex conversation. ObjectivesWe created an original online module to facilitate deliberate practice of a three-skill framework for responding to emotion cues during complex or nonlinear serious illness conversations. MethodsOur original online module uses a gamebook format, which prompts trainees to engage in focused and repetitive practice of three well-defined skills for responding to emotion cues in a simulated family conference. We implemented the module as a part of a communication skills curriculum for interns rotating in the intensive care unit. After completing the module, all interns answered an open-ended survey question about their perceived skill acquisition. Results were analyzed by a qualitative method and coded into themes. ResultsAbout 71% of interns (n = 65 of 92) completed the online module and open-ended survey question. About 89% of participants responded that they would use a naming, understanding, respecting, supporting, or exploring statement in response to an emotion cue. Nearly two-thirds of participants articulated their rationale for using naming, understanding, respecting, supporting, or exploring statements (e.g., preparing patients to process complex medical information, eliciting information about patient perspective.) ConclusionOur online emotion cue module is a novel tool for deliberate practice of advanced skills for responding to emotion cues in serious illness conversations. In future studies, we will investigate whether our module's efficacy is enhanced by using it as a part of a flipped classroom curriculum with an in-person simulation session.

Development, Implementation, and Evaluation of a Faculty Development Workshop to Enhance Debriefing Skills Among Novice Facilitators.

IntroductionEffective debriefing during simulation-based training (SBT) is critical to promote learning outcomes. Despite debriefing’s central role in learning and various published debriefing methods and techniques, little is known about faculty development structure for debriefing training among novice facilitators. Continuing medical education courses often use simulation-based methods but provide minimal training in debriefing techniques to novice facilitators. We describe the development, implementation, and evaluation of a structured debriefing training workshop for novice facilitators.MethodsDesigned and conducted by simulation debriefing experts, a debriefing workshop was provided to novice facilitators serving as faculty during the simulation-based Sedation Provider Course (PC) at the 2018 Society of Pediatric Sedation conference. Emphasizing evidence-based key elements of effective debriefing, the workshop was divided into three components: 1) an introductory 30 minute didactic, 2) 75 minutes role modeling of simulated effective and ineffective debriefing 3) 120 minutes repetitive deliberate practice sessions with summative and formative feedback. Effective transfer of learned debriefing skills was assessed during facilitators’ PC debriefing using the Objective Structured Assessment of Debriefing (OSAD) tool, facilitators’ self-efficacy, and PC student learners’ evaluation of facilitator debriefings during the PC.ResultsSixteen facilitators participated in the 4-h workshop and the next day served as PC faculty. The median OSAD score was 31 (13-40) for all facilitators. OSAD components with lowest and highest performance were “Establishing Learning Environment” with a median score of 1 (1-5) and “Engagement of Learners,” with a median score of 4.75 (2.5-5). Facilitators' self- assessment in debriefing significantly improved on the 5-point Likert scale pre- and post-workshop, respectively. PC student learners’ evaluations revealed high degrees of satisfaction with debriefing quality.ConclusionsA proposed model integrating full-length debriefing and repetitive practice paired with summative and formative feedback provides a feasible and effective approach for debriefing training of novice facilitators for simulation-based educational courses.

A Computer Game- Assisted Repetitive Task Practice based Upper Extremity Therapy Program for Children with Spastic Unilateral Cerebral Palsy: A Single Case Study

A case study is to provide evidence of the feasibility, acceptance, and benefits of a computer game-assistedrepetitive task practice platform (G-RTP) in Upper extremity (UE) motor function of a child with CerebralPalsy (CP).Method: 4 year old left spastic CP was provided an individualized game-assisted therapy of 16 weeks.Outcome measures included PDMS-2, QUEST, computerized assessment of a broad range of objectmanipulation tasks.Results: Findings demonstrated the feasibility and acceptability of the G-RTP program for use by childrenwith UE motor impairmentConclusion: The findings are positive and support a future definitive RCT needed to prove the efficacy andapplicability

Practice makes better? Testing a model for training program evaluators in situation awareness

Evaluation approaches should be appropriate for their contexts. Scholars and practitioners alike have widely acknowledged this view for at least four decades, and the ability to respond to context is clearly established as a core evaluator competency. Outside of evaluation, this knowledge of context, known as situation awareness, is seen as a critical feature of good decision making and as a factor that distinguishes experts from novices across a wide range of domains. Yet there are few opportunities for evaluators to explicitly build their skills in situation awareness. This study addressed that gap by examining the potential for one online training program, informed by research on deliberate practice, to accelerate evaluators’ progress towards expertise in situation awareness. Built to align with evidence on developing situation awareness skills, the EvalPractice portal combined (1) an extensive ‘case bank’ of real-world evaluation scenarios, (2) repetitive practice that allowed novice evaluators to practice interpreting these evaluation scenarios, and (3) immediate feedback on the accuracy of these efforts based on events from the real-life version of the scenario. Findings from a small EvalPractice pilot suggest that it may be possible to improve foundational situation awareness skills using deliberate practice, but that further research is required to understand strategies for building higher-level situation awareness skills in evaluation.