Multitask training promotes automaticity of a fundamental laparoscopic skill without compromising the rate of skill learning

Abstract

BackgroundA defining characteristic of expertise is automated performance of skills, which frees attentional capacity to better cope with some common intraoperative stressors. There is a paucity of research on how best to foster automated performance by surgical trainees. This study examined the use of a multitask training approach to promote automated, robust laparoscopic skills. MethodsEighty-one medical students completed training of a fundamental laparoscopic task in either a traditional single-task training condition or a novel multitask training condition. Following training, participants’ laparoscopic performance was tested in a retention test, two stress transfer tests (distraction and time pressure) and a secondary task test, which was included to evaluate automaticity of performance. The laparoscopic task was also performed as part of a formal clinical examination (OSCE). ResultsThe training groups did not differ in the number of trials required to reach task proficiency (p = .72), retention of skill (ps > .45), or performance in the clinical examination (p = .14); however, the groups did differ with respect to the secondary task (p = .016). The movement efficiency (number of hand movements) of single-task trainees, but not multitask trainees, was negatively affected during the secondary task test. The two stress transfer tests had no discernable impact on the performance of either training group.ConclusionMultitask training was not detrimental to the rate of learning of a fundamental laparoscopic skill and added value by providing resilience in the face of a secondary task load, indicative of skill automaticity. Further work is needed to determine the extent of the clinical utility afforded by multitask training.

Investigating an errorless learning approach for developing dental operative technique skills: A pilot study

“…When attention demands increased in the multitask transfer test, errorless learners performed more accurate preparations, in terms of length/width, than errorful learners (ie the errorless group cut more conservative preparations). The errorless learning group demonstrated superior ability to perform a secondary task without diminishing performance on the primary cavity preparation task which is consistent with studies in other disciplines (eg surgery and golf) . However, the errorless approach was not associated with more accurate performance for cutting cavity depth under the multitask transfer test.…”

“…For example, Masters et al found that implicit approaches to learning suturing skills in the related discipline of surgery resulted in minimal accrual of verbalisable knowledge about the skill and better performance under multitasking conditions compared to an explicit learning approach. Similar results have been found in training fundamental laparoscopic skills (ie timed peg transfer task involving picking up and transferring six objects located on pegs from left to right and then reversing the procedure); skills learned implicitly were more resilient under secondary task load than skills learned explicitly . Neuropsychological evidence also suggests that learning fundamental laparoscopic skills using implicit approaches promotes neural efficiency (ie similar to experts, reduced coactivation of the verbal‐analytic and motor planning regions was evident in implicit learning participants), by freeing up attention resources to perform concurrent tasks, as is often required by healthcare practitioners …”

“…Future studies ought to examine the effectiveness of other implicit learning approaches; a greater range of approaches should be tested to identify optimal designs for learning high‐speed handpiece manipulation skills. For example, learning skills under dual‐task conditions were found to benefit performance of laparoscopic skill in terms of efficiency of movements, with no increase in learning time needed to achieve the same level of proficiency, compared with a single‐task learning condition . The current pilot study focused on supporting students to learn the initial phase of routine cavity preparation (ie cutting through the enamel to access decayed dentine).…”

“…To optimise students’ development of this core skill, we need a sound evidence base to inform the design of effective learning activities. Evidence from related disciplines shows that paradigms not commonly used in dentistry (ie implicit approaches) may be advantageous, particularly in the early stages of learning complex motor skills …”

Evaluating the effects of social networking sites addiction, task distraction, and self‐management on nurses' performance

“…Task distraction is the lack of ability to concentrate on assigned tasks (Sanders & Baron, ) and employee's attention is diverted towards non‐duty tasks and issues (Baron, ). There are different reasons behind task distraction including overburden (Patel, Zambrana, Walker, Herrmann, & Feinstein, ), lack of required skills for performing job (Poolton et al, ), stress (Nicholls, Levy, Carson, Thompson, & Perry, ), other work engagement (Horrey, Lesch, Garabet, Simmons, & Maikala, ), and SNSs addiction (Min, ). When employees spend most of their time using SNSs, their mental ability to perform job‐related tasks is reduced, which results in low level of concentration required for the assigned job.…”