Cognitive load in distributed and massed practice in virtual reality mastoidectomy simulation

Andersen, Steven Arild Wuyts; Mikkelsen, Peter Trier; Konge, Lars; Cayé‐Thomasen, Per; Sørensen, Mads Sølvsten

doi:10.1002/lary.25449

Cited by 66 publications

(67 citation statements)

References 19 publications

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“…Bjerrum et al [10] explored practice distribution, but only with flexible bronchoscopy, and found no significant differences between the 2 groups with regard to their subsequent performance on the simulator. This finding contradicts other studies which have demonstrated that distributing learning over a longer period of time proved highly efficient [45][46][47] . However, the study by Bjerrum et al [10] used only the insensitive simulator metrics, which could explain the negative findings.…”

Section: Discussioncontrasting

confidence: 56%

Simulation-Based Training in Flexible Bronchoscopy and Endobronchial Ultrasound-Guided Transbronchial Needle Aspiration (EBUS-TBNA): A Systematic Review

Naur¹,

Nilsson²,

Pietersen³

et al. 2017

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Background: The use of simulators in a training programme for technically challenging procedures has the advantages of lowering the risk of patient complications while helping the trainees with the initial part of their learning curve. Objectives: The aim of this study was to perform a systematic review of simulation-based training in flexible bronchoscopy and endobronchial ultrasound (EBUS). Methods: We identified 1,006 publications in the PubMed database and included publications on flexible bronchoscopy below the carina and EBUS involving hands-on simulation-based training. Publications were excluded if they were written in languages other than English, if paediatric airways were involved or if they were not journal articles. The screening process was performed by 2 individuals, and a third reviewer made the final decision in case of disagreement. Results: We included 30 publications. The studies included participants of varying experience and most commonly used a virtual reality simulator as a training modality. Assessment of the participants' skills was based on simulator metrics or on an assessment tool. Some studies included performance on patients for assessment of the operator after training on a simulator. Conclusions: Simulation-based training was demonstrated to be more efficient than the traditional apprenticeship model. Physical models and virtual reality simulators complement each other. Simulation-based education should be based on a mastery learning approach and structured as directed self-regulated learning in a distributed training programme.

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Section: Discussioncontrasting

confidence: 56%

Simulation-Based Training in Flexible Bronchoscopy and Endobronchial Ultrasound-Guided Transbronchial Needle Aspiration (EBUS-TBNA): A Systematic Review

Naur¹,

Nilsson²,

Pietersen³

et al. 2017

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“…In contrast to this finding, the cognitive load estimated by reaction time measurement had returned to pretraining levels (distributed practice group: mean pretraining relative reaction time, 1.42 [95% CI, 1.37-1.47]; and massed practice group: mean pretraining relative reaction time, 1.34 [95% CI, 1.28-1.40]). 19 Moreover, the skills of the massed practice group were less consolidated, and the participants in this group seemed to use more time within the allowed timeframe during retention testing to achieve a similar performance. During the retention procedures, the participants in general had a poorer performance compared with end-of-training procedures in adequately defining the outer boundaries of the procedure, often violating the facial nerve, and not exposing the facial recess sufficiently, suggesting that these items could be emphasized in future instructions.…”

Section: Discussionmentioning

confidence: 99%

“…23 In addition, participants were tested on their reaction time while performing a secondary task provided by the simulator at baseline and several times during the procedure to estimate the cognitive load by the increase in reaction time during simulation relative to baseline measurements. 19 The outcomes (final-product performance and relative reaction time for cognitive load estimation) were analyzed as previously described 18 to ensure comparability with previous studies. Supplemental analyses of the volume removed during VR simulation sessions were performed for this study.…”

Section: Discussionmentioning

confidence: 99%

“…16 Several instructional designs can modify the cognitive load 17 ; studies have previously demonstrated that organizing training as distributed practice (practice sessions spaced in time) rather than massed practice (all sessions in 1 day) provides superior learning curves 18 and reduces cognitive load. 19 However, there is a gap in knowledge on whether such an improvement in performance and reduction in cognitive load during performance of the procedure are sustained after the training period. Based on this finding, we hypothesized that different training strategies affect the retention of surgical motor skills and cognitive load during retention performance.…”

mentioning

confidence: 99%

“…13 In our initial study, we found that cognitive load decreased with repeated and distributed practice and not with massed practice. 19 In the present study, we also measured retention of the performance on a secondary reaction time test. The relative reaction time reflects the cognitive load during the procedure, and we found that the cognitive load during the retention procedure had returned almost to the level of the first procedure.…”

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confidence: 99%

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Retention of Mastoidectomy Skills After Virtual Reality Simulation Training

Andersen

Konge

Cayé‐Thomasen

et al. 2016

JAMA Otolaryngol Head Neck Surg

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IMPORTANCEThe ultimate goal of surgical training is consolidated skills with a consistently high performance. However, surgical skills are heterogeneously retained and depend on a variety of factors, including the task, cognitive demands, and organization of practice. Virtual reality (VR) simulation is increasingly being used in surgical skills training, including temporal bone surgery, but there is a gap in knowledge on the retention of mastoidectomy skills after VR simulation training.OBJECTIVES To determine the retention of mastoidectomy skills after VR simulation training with distributed and massed practice and to investigate participants' cognitive load during retention procedures. DESIGN, SETTING, AND PARTICIPANTSA prospective 3-month follow-up study of a VR simulation trial was conducted from February 6 to September 19, 2014, at an academic teaching hospital among 36 medical students: 19 from a cohort trained with distributed practice and 17 from a cohort trained with massed practice.INTERVENTIONS Participants performed 2 virtual mastoidectomies in a VR simulator a mean of 3.2 months (range, 2.4-5.0 months) after completing initial training with 12 repeated procedures. Practice blocks were spaced apart in time (distributed), or all procedures were performed in 1 day (massed). MAIN OUTCOMES AND MEASURESPerformance of the virtual mastoidectomy as assessed by 2 masked senior otologists using a modified Welling scale, as well as cognitive load as estimated by reaction time to perform a secondary task.RESULTS Among 36 participants, mastoidectomy final-product skills were largely retained at 3 months (mean change in score, 0.1 points; P = .89) regardless of practice schedule, but the group trained with massed practice took more time to complete the task. The performance of the massed practice group increased significantly from the first to the second retention procedure (mean change, 1.8 points; P = .001), reflecting that skills were less consolidated. For both groups, increases in reaction times in the secondary task (distributed practice group: mean pretraining relative reaction time, CONCLUSIONS AND RELEVANCE Mastoidectomy skills acquired under time-distributed practice conditions were retained better than skills acquired under massed practice conditions. Complex psychomotor skills should be regularly reinforced to consolidate both motor and cognitive aspects. Virtual reality simulation training provides the opportunity for such repeated training and should be integrated into training curricula.

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Learning functional human anatomy with a new interactive three‐dimensional digital tool

Gallot,

di Rienzo,

Binay

et al. 2024

Anatomical Sciences Ed

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Human anatomy requires understanding spatial relationships among anatomical structures and is often perceived as difficult to learn by students. To overcome this concern, several digital tools exist with some strengths and limitations among which the lack of interactivity especially for complex functional anatomy learning. In this way, a new interactive three‐dimensional tool called Antepulsio was designed. Antepulsio was assessed by comparing three groups of first year kinesiology students to test whether it is likely to favor functional anatomy learning during three training sessions spread over a week. The experiment was conducted during a real academic course. Laterality judgment, 3D spatial abilities and working memory abilities from all participants were previously collected to create three homogeneous groups: the active group (n = 17, 17.76 ± 0.56 years) interacted with Antepulsio, the passive group (n = 18, 17.89 ± 0.83 years) watched videos of Antepulsio while the control group (n = 15, 18.07 ± 0.80 years) performed a neutral activity unrelated to anatomy. Anatomy knowledge was also assessed during pretest, posttest, and retention test (8 weeks after the posttest). The most significant outcome of this study revealed that in case of better working visual memory, the active group outperformed the passive group between pretest and retention test (p < 0.01). In other words, Antepulsio tool is efficient only for students with high visuospatial working memory. These selective benefits of Antepulsio are discussed in terms of cognitive load, training duration and the necessary period of familiarization with the tool.

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Cognitive load in distributed and massed practice in virtual reality mastoidectomy simulation

Abstract: N/A.

Cited by 66 publications

References 19 publications

Simulation-Based Training in Flexible Bronchoscopy and Endobronchial Ultrasound-Guided Transbronchial Needle Aspiration (EBUS-TBNA): A Systematic Review

Simulation-Based Training in Flexible Bronchoscopy and Endobronchial Ultrasound-Guided Transbronchial Needle Aspiration (EBUS-TBNA): A Systematic Review

Retention of Mastoidectomy Skills After Virtual Reality Simulation Training

Learning functional human anatomy with a new interactive three‐dimensional digital tool

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