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Principles derived from the study of simple skills do not generalize to complex skill learning.

We review research related to the learning of complex motor skills with respect to principles developed on the basis of simple skill learning. Although some factors seem to have opposite effects on the learning of simple and of complex skills, other factors appear to be relevant mainly for the learning of more complex skills. We interpret these apparently contradictory findings as suggesting that situations with low processing demands benefit from practice conditions that increase the load and challenge the performer, whereas practice conditions that result in extremely high load should benefit from conditions that reduce the load to more manageable levels. The findings reviewed here call into question the generalizability of results from studies using simple laboratory tasks to the learning of complex motor skills. They also demonstrate the need to use more complex skills in motor-learning research in order to gain further insights into the learning process.

Attention↗

A neuropsychological theory of motor skill learning.

This article describes a neuropsychological theory of motor skill learning that is based on the idea that learning grows directly out of motor control processes. Three motor control processes may be tuned to specific tasks, thereby improving performance: selecting spatial targets for movement, sequencing these targets, and transforming them into muscle commands. These processes operate outside of awareness. A 4th, conscious process can improve performance in either of 2 ways: by selecting more effective goals of what should be changed in the environment or by selecting and sequencing spatial targets. The theory accounts for patterns of impairment of motor skill learning in patient populations and for learning-related changes in activity in functional imaging studies. It also makes a number of predictions about the purely cognitive, including accounts of mental practice, the representation of motor skill, and the interaction of conscious and unconscious processes in motor skill learning.

Amnesia↗

The relationship between medical students' attitudes towards communication skills learning and their demographic and education-related characteristics.

INTRODUCTION: The General Medical Council (GMC) has stressed the importance of medical students' attitudes towards learning. However, few studies have explored medical students' attitudes towards communication skills learning. This study explores the relationship between the attitudes of medical students at two different schools and their demographic and education-related characteristics. METHODS: A total of 490 medical students from the Universities of Nottingham (Years 1 and 2) and Leicester (Year 1) completed the 26-item Communication Skills Attitude Scale (CSAS) and a personal details questionnaire satisfactorily. The relationships between students' attitudes and their demographic and education-related characteristics were analysed separately for Nottingham and Leicester students using both univariate and multivariate statistics. RESULTS: The attitudes of Nottingham and Leicester medical students towards communication skills learning were significantly associated with a number of demographic and education-related characteristics. Both Nottingham and Leicester students with more positive attitudes towards communication skills learning tended to be female, tended to think their communication skills needed improving and tended not to have parents who were doctors. Both Nottingham and Leicester students with more negative attitudes towards communication skills learning tended to think their communication skills did not need improving. DISCUSSION: The results indicate that medical students' attitudes towards communication skills learning are associated with their demographic and education-related characteristics. These findings have a number of implications for educational practice and further research and these are discussed in this paper.

Adult↗

Implicit memory in parkinsonian patients: evidence for deficient skill learning.

The aim of this study was to investigate procedural learning in idiopathic Parkinson's disease (PD) patients. For this purpose, 18 nondemented PD patients and 20 age-matched healthy subjects were trained to learn a visuoperceptual skill (mirror reading) and a cognitive skill with a motor demand (puzzle assembly task). In 3-day sessions, the patients were requested to perform with repeated and unrepeated stimuli, in order to distinguish between pure procedural learning and skill learning at least partially supported by explicit memory retrieval. In the mirror reading task, the PD patients showed normal improvement in reading times for repeated words but no improvement at all for unrepeated stimuli. In the puzzle assembly task, PD patients did not show any significant learning either for repeated or unrepeated stimuli. These results, which document deficient learning of procedures in parkinsonians, are discussed in the light of conflicting data reported regarding implicit memory in PD.

Aged↗

Mirror reading in Alzheimer's disease: normal skill learning and acquisition of item-specific information.

Alzheimer's disease (AD) is characterized by severe explicit memory deficits and sparing of procedural learning. Most studies of skill learning in AD have been restricted to motor skills. This experiment was aimed at extending these studies to the domain of perceptual-verbal skills. Thirteen AD patients and 9 normal elderly controls were administered several explicit memory tests and a mirror reading paradigm with both unique and repeated word triads. In this last task, AD patients showed normal learning for unique word triads, that is, normal acquisition of the skill. Moreover, they benefitted from repeated triads to the same extent as did normal controls, although they were impaired in discriminating these repeated words from distractors at later recognition. These data demonstrate that patients with AD: (a) are able to learn and retain a perceptual-verbal skill at a normal rate; (b) can learn item-specific information (repeated triads) at a normal rate, even though their explicit memory is severely impaired. It is hypothesized that learning of item-specific information relies on repetition priming effects rather than on explicit memory processes.

Affect↗

Unilateral sensorimotor cortex lesions in adult rats facilitate motor skill learning with the "unaffected" forelimb and training-induced dendritic structural plasticity in the motor cortex.

In humans and other animals, sufficient unilateral damage to the sensorimotor cortex can cause impairments in the opposite forelimb and the development of a hyper-reliance on the nonimpaired limb. This hyper-reliance is adaptive to the extent that it contributes to functional compensation for lesion-induced impairments. We have found that unilateral lesions of the forelimb region of the sensorimotor cortex (FLsmc) in rats, or callosal transections, cause neurons of the opposite motor cortex to become exceptionally responsive to changes in forelimb behavior. This enhanced responsiveness might facilitate learning of compensatory strategies with the nonimpaired forelimb after unilateral FLsmc lesions. The possibility that these lesions facilitate learning with the nonimpaired forelimb was addressed in this study. Rats were required to learn a skilled forelimb reaching task after either unilateral FLsmc lesions or sham operations. The trained limb in animals with lesions was the nonimpaired limb. Compared with shams, rats with unilateral lesions had a greater rate of acquisition and asymptotic performance level on the task, which was especially evident on more difficult trials. Quantitative measures of microtubule associated protein-2 (MAP2) immunostained dendrites indicated an enhancement of training-induced dendritic cytoskeletal changes in the motor cortex opposite lesions. Thus, unilateral FLsmc lesions facilitate learning of at least some types of motor skills using the nonimpaired forelimb as well as some of the neuronal changes associated with this learning. This facilitation could be a substrate underlying behavioral compensation for unilateral FLsmc damage and may contribute to the phenomenon of learned nonuse of the impaired limb.

Adaptation, Physiological↗

Examining the personal experience of student skill learning: a narrative perspective.

Examining the meaning of student skill learning from the learner's perspective is a valued but understudied topic in physical education. This paper investigated the learner's perspective as a storied experience and used narrative theory to interpret the meanings students derived from their learning experiences. Four narrative accounts were presented involving university students enrolled in a beginning level bowling class. The narratives centered on describing student goals and the conflicts and resolution of conflicts experienced by these students during skill learning. Two sources of generating meaning from experience were delineated: (a) an individual's active construction of meaning and (b) the enculturing influence of the social context. These narratives provided an opportunity for teachers and researchers to examine the realities constructed by students as a result of their learning experiences.

Adaptation, Psychological↗

Characterizing the neural mechanisms of skill learning and repetition priming: evidence from mirror reading.

The changes in brain activity related to skill learning and repetition priming in a mirror-reading task were examined using functional MRI. Subjects exhibited significant learning across five training sessions and this learning generalized significantly to different spatial transformations (inverted-mirror reversed text and normal letters spelled backwards). Mirror reading, compared with reading normal text, was associated with extensive activation in occipital, temporal, parietal and frontal regions. Learning to read mirror-reversed (MR) text was associated with increased activation in left inferior temporal, striatal, left inferior prefrontal and right cerebellar regions and with decreased activity in the left hippocampus and left cerebellum. Short-term repetition priming was associated with reduced activity in many of the regions active during mirror reading and extensive item-specific practice (long-term repetition priming) resulted in a virtual elimination of activity in those regions. Short- and long-term repetition priming thus appeared to rely upon common neural mechanisms. Nearly all of the regions exhibiting significant learning-related changes also exhibited increased repetition priming effects, suggesting common neural substrates for priming and skill learning in this task. Comparison of MR items with other spatially transformed typographies showed that the learning-related changes were general to all of the spatial transformations. The results confirm the importance of striatofrontal neural networks for the acquisition of skills, and suggest that skill learning and repetition priming may have common substrates within a particular task.

Adult↗

Functional reorganization of the rat motor cortex following motor skill learning.

Functional reorganization of the rat motor cortex following motor skill learning. J. Neurophysiol. 80: 3321-3325, 1998. Adult rats were allocated to either a skilled or unskilled reaching condition (SRC and URC, respectively). SRC animals were trained for 10 days on a skilled reaching task while URC animals were trained on a simple bar pressing task. After training, microelectrode stimulation was used to derive high resolution maps of the forelimb and hindlimb representations within the motor cortex. In comparison with URC animals, SRC animals exhibited a significant increase in mean area of the wrist and digit representations but a decrease in elbow/shoulder representation within the caudal forelimb area. No between-group differences in areal representation were found in either the hindlimb or rostral forelimb areas. These results demonstrate that motor skill learning is associated with a reorganization of movement representations within the rodent motor cortex.

Animals↗

Lesions of the Basal forebrain cholinergic system impair task acquisition and abolish cortical plasticity associated with motor skill learning.

The contribution of the basal forebrain cholinergic system in mediating plasticity of cortical sensorimotor representations was examined in the context of normal learning. The effects of specific basal forebrain cholinergic lesions upon cortical reorganization associated with learning a skilled motor task were investigated, addressing, for the first time, the functional consequences of blocking cortical map plasticity. Results demonstrate that disrupting basal forebrain cholinergic function disrupts cortical map reorganization and impairs motor learning. Cholinergic lesions do not impair associative fear learning or overall sensorimotor function. These results support the hypothesis that the basal forebrain cholinergic system may be specifically implicated in forms of learning requiring plasticity of cortical representations.

Acetylcholine↗

Habit and skill learning in schizophrenia: evidence of normal striatal processing with abnormal cortical input.

Different forms of nondeclarative learning involve regionally specific striatal circuits. The motor circuit (involving the putamen) has been associated with motor-skill learning and the dorsolateral prefrontal cortex (DLPFC) circuit (involving the caudate) has been associated with cognitive-habit learning. Efforts to differentiate functional striatal circuits within patient samples have been limited. Previous studies have provided mixed results regarding striatal-dependent nondeclarative learning deficits in patients with schizophrenia. In this study, a cognitive-habit learning task (probabilistic weather prediction) was used to assess the DLPFC circuit and a motor-skill learning task (pursuit rotor) was used to assess the motor circuit in 35 patients with schizophrenia and 35 normal controls. Patients with schizophrenia displayed significant performance differences from controls on both nondeclarative tasks; however, cognitive-habit learning rate in patients did not differ from controls. There were performance and learning-rate differences on the motor-skill learning task between the whole sample of patients and controls, however, analysis of a subset of patients and controls matched on general intellectual level eliminated learning rate differences between groups. The abnormal performance offset between patients with schizophrenia and controls in the absence of learning rate differences suggests that abnormal cortical processing provides altered input to normal striatal circuitry.

Adult↗

Central mechanisms of motor skill learning.

Recent studies have shown that frontoparietal cortices and interconnecting regions in the basal ganglia and the cerebellum are related to motor skill learning. We propose that motor skill learning occurs independently and in different coordinates in two sets of loop circuits: cortex-basal ganglia and cortex-cerebellum. This architecture accounts for the seemingly diverse features of motor learning.

Animals↗

Cognitive skill learning and schizophrenia: implications for cognitive remediation.

The ability to acquire a motor and cognitive skill was investigated in 26 patients with schizophrenia and 26 normal participants using repeated testing on the Tower of Toronto puzzle. Seven patients with defective performance were retested using additional trials and immediate feedback designed to facilitate problem solving. A component analysis of performance was used based on J. R. Anderson's (1987) model of cognitive skill learning. Patients exhibited a performance deficit on both motor and cognitive skills. However, their acquisition rate was similar to that of normal participants on most parameters, indicating that skill learning suffered little or no impairment. Performance deficit was accounted for by poor problem-solving ability, explicit memory, and general intellectual capacities. It was remediable in some, but not all, patients. Remediation failure was also related to severe defects of cognitive functions.

Adult↗

Practice with sleep makes perfect: sleep-dependent motor skill learning.

Improvement in motor skill performance is known to continue for at least 24 hr following training, yet the relative contributions of time spent awake and asleep are unknown. Here we provide evidence that a night of sleep results in a 20% increase in motor speed without loss of accuracy, while an equivalent period of time during wake provides no significant benefit. Furthermore, a significant correlation exists between the improved performance overnight and the amount of stage 2 NREM sleep, particularly late in the night. This finding of sleep-dependent motor skill improvement may have important implications for the efficient learning of all skilled actions in humans.

Adolescent↗

Aberrant brain activation following motor skill learning in schizophrenic patients as shown by functional magnetic resonance imaging.

BACKGROUND: Motor skill learning may be impaired in schizophrenia. While functional brain imaging studies have shown reduced activation during motor task performance in schizophrenic patients, brain activity changes with motor skill learning in these patients have not been studied by functional imaging. METHODS: A sequential complex motor task involving the right hand was performed by nine medicated schizophrenic patients and 10 age-matched healthy controls. Functional magnetic resonance images were obtained using a gradient echo, echoplanar imaging (EPI) pulse sequence before and after 1 week of training in performing the task. RESULTS: Bilaterally, patients showed significantly less blood oxygenation level-dependent (BOLD) signal response in the premotor area (PMA) before beginning motor training than controls. BOLD signal response increased in the left PMA of schizophrenic patients after 1 week of motor training; in contrast, the signal decreased in the left PMA of control subjects. Training effects concerning the number of finger movement sequences achieved did not differ between groups. Daily neuroleptic dose did not significantly affect changes with training in BOLD signal response in the PMA. CONCLUSIONS: These preliminary results suggest that schizophrenic patients have dysfunction of neural networks in areas including the PMA that are involved in executing a complex motor task. In terms of brain activity, motor learning may be less efficient or slower in the patients than in healthy subjects.

Adolescent↗

Sleep and the time course of motor skill learning.

Growing evidence suggests that sleep plays an important role in the process of procedural learning. Most recently, sleep has been implicated in the continued development of motor-skill learning following initial acquisition. However, the temporal evolution of motor learning before and after sleep, the effects of different training regimens, and the long-term development of motor learning across multiple nights of sleep remain unknown. Here, we report data for subjects trained and retested on a sequential finger-tapping task across multiple days. The findings demonstrate firstly that following initial training, small practice-dependent improvements are possible before, but not following the large practice-independent gains that develop across a night of sleep. Secondly, doubling the quantity of initial training does not alter the amount of subsequent sleep-dependent learning that develops overnight. Thirdly, the amount of sleep-dependent learning does not correlate with the amount of practice-dependent learning achieved during training, suggesting the existence of two discrete motor-learning processes. Finally, whereas the majority of sleep-dependent motor-skill learning develops during the first night of sleep following training, additional nights of sleep still offer continued improvements.

Adult↗

Temperament, behavior problems, and learning skills in very low birth weight preschoolers.

The relationship between temperament, behavior problems, and learning skill abilities in preschool children who were born with very low birth weight (VLBW) is described. Subjects were 37 4-year-olds who weighed less than 1,500 grams at birth, were appropriate for gestational age, and free from congenital anomalies (M birth weight = 1,201 grams). Data were gathered when the children were 48 months chronological age and analyzed using point biserial and Pearson product moment correlation, chi square, and MANOVA. Temperament characteristics of rhythmicity, intensity, and persistence were related to behavior problems and learning skill abilities. Mothers reported more children with behavior problems than expected in the general population. Children with four or more behavior problems had significantly lower skill achievement scores than children with fewer behavior problems.

Child Behavior Disorders↗

Hidden Markov model approach to skill learning and its application to telerobotics.

In this paper, we discuss the problem of how human skill can be represented as a parametric model using a hidden Markov model (HMM), and how an HMM-based skill model can be used to learn human skill. HMM is feasible to characterize a doubly stochastic process--measurable action and immeasurable mental states--that is involved in the skill learning. We formulated the learning problem as a multidimensional HMM and developed a testbed for a variety of skill learning applications. Based on "the most likely performance" criterion, the best action sequence can be selected from all previously measured action data by modeling the skill as an HMM. The proposed method has been implemented in the teleoperation control of space station robot system, and some important implementation issues have been discussed. The method allows a robot to learn human skill in certain tasks and to improve motion performance.

Algorithms↗