Recent developments in neurorehabilitation have spawned numerous new robotic rehabilitation therapies. However, many of the concepts upon which these therapies are based are not fully understood and it may be necessary to explore some of the motor learning principles that apply to the use of haptics for motor learning in non-clinical scenarios/populations. We conducted a review of studies that utilized a haptic training paradigm teaching healthy participants to perform a motor skill involving the upper extremities. We discuss studies in the context of four important motor learning concepts: performance versus learning, feedback, observational learning, and functional task difficulty. Additionally, we note that the proliferation of research in haptic training has led to an extensive vocabulary of terms, some of which may be misnomers or redundant. We propose a classification of terms describing haptic training in an effort to provide clarity and further contextualize the studies. We believe that making connections to motor learning principles and clarifying meanings will facilitate a fuller understanding of the outcomes of studies in basic science research and allow for more directed applications of these training techniques to clinical populations.
Researchers in the domain of haptic training are now entering the long-standing debate regarding whether or not it is best to learn a skill by experiencing errors. Haptic training paradigms provide fertile ground for exploring how various theories about feedback, errors and physical guidance intersect during motor learning. Our objective was to determine how error minimizing, error augmenting and no haptic feedback while learning a self-paced curve-tracing task impact performance on delayed (1 day) retention and transfer tests, which indicate learning. We assessed performance using movement time and tracing error to calculate a measure of overall performance – the speed accuracy cost function. Our results showed that despite exhibiting the worst performance during skill acquisition, the error augmentation group had significantly better accuracy (but not overall performance) than the error minimization group on delayed retention and transfer tests. The control group’s performance fell between that of the two experimental groups but was not significantly different from either on the delayed retention test. We propose that the nature of the task (requiring online feedback to guide performance) coupled with the error augmentation group’s frequent off-target experience and rich experience of error-correction promoted information processing related to error-detection and error-correction that are essential for motor learning.
Background: Most preoperative surgical training programs experience challenges with the availability of expert surgeons to teach trainees. Some research suggests that trainees may benefit from being allowed to actively shape their learning environments, which could alleviate some of the time and resource pressures in surgical training. The purpose of this study was to investigate the effects of self-directed or prescribed practice schedules (random or blocked) on learning suturing skills. Methods:Participants watched an instructional video for simple interrupted, vertical mattress and horizontal mattress suturing then completed a pretest to assess baseline skills. Participants were assigned to 1 of 4 practice groups: self-directed practice schedule, prescribed blocked practice schedule, prescribed random practice schedule or matched to the self-directed group (control). Practice of the skill was followed by a delayed (1 h) posttest. Improvement from pretest to posttest was determined based on differences in performance time and expert-based assessments.Results: Analyses revealed a significant effect of group for difference in performance time of the simple interrupted suture. Random practice did not show the expected advantage for skill learning, but there was an advantage of self-directed practice. Conclusion:Self-directed practice schedules may be desirable for optimal learning of simple technical skills, even when expert instruction is available. Instructors must also take into account the interaction between task difficulty and conditions of practice to develop ideal training environments.Contexte : La plupart des programmes de formation préopératoire en chirurgie ont du mal à trouver des experts pour enseigner la chirurgie aux stagiaires. Selon certaines recherches, il pourrait être utile de permettre aux stagiaires de structurer eux-mêmes leurs milieux d'apprentissage, ce qui pourrait se révéler avantageux compte tenu des contraintes de temps et de ressources. Le but de cette étude était de mesurer les effets de différents horaires d'exercices, autodirigés ou prescrits (aléatoires ou fixes), sur l'apprentissage des techniques de sutures. Résultats : Les analyses ont révélé un effet significatif selon le groupe en ce qui a trait aux différences de temps d'exécution pour la suture simple interrompue. Les horaires d'exercices aléatoires ne se sont pas accompagnés de l'avantage attendu pour ce qui est de l'apprentissage de la technique, mais on a noté un avantage associé aux horaires d'exercices autodirigés. Méthodes Conclusion :Les horaires d'exercices autodirigés pourraient être souhaitables pour un apprentissage optimal des habiletés techniques simples, même lorsqu'un enseignement par les experts est disponible. Les instructeurs doivent aussi tenir compte de l'interaction entre la difficulté de la tâche et les conditions dans lesquelles se font les exercices pour améliorer les milieux de formation.
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