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PubMed1998

Motor skill acquisition strategies for rehabilitation of low back pain.

Evidence supporting the early use of exercise for the treatment of low back pain continues to grow. We must keep in mind, however, that motor skill learning and exercise are not synonymous. If rehabilitation goals are limited to the improvement of physical parameters (ie., strength, flexibility, endurance), the opportunity to help patients improve the performance of functional activities will be missed. The motor learning literature suggests several strategies for facilitating the acquisition of a motor skill: transfer-appropriate processing, the contextual interference effect, and repetitive self-evaluation. These techniques will cognitively challenge patients, helping them gain skills more quickly and retain them longer. By incorporating these methods into the rehabilitation program, patients will better transfer what they have learned from the rehabilitation environment to their everyday functional activities.

Cognition Disorders↗
PubMedDate not supplied

The development of a course in basic physical examination skills.

Basic clinical skills of most medical school undergraduates continue unobserved and deficiencies have been detected in a significant number of physicians during residency. Nevertheless, our health care system is calling for competent graduates with solid basic clinical skills and a larger representation of qualified generalists in the increasingly important managed care environment. The need for a better introduction to Clinical Skills course was identified by students and clinical faculty at Ponce School of Medicine. In response to these concerns a new curriculum was developed with clear objectives, effective instructional strategies, and performance-based evaluation, with adult learning principles as its framework. The musculoskeletal examination unit of the curriculum was pilot tested and the course evaluation strategies revealed satisfaction with objectives, instructional and evaluation strategies, as well as improved confidence, and sense of usefulness for the learned skills. A curriculum in basic clinical skills that incorporates adult learning principles with solid instructional strategies can increase the confidence and skills of the learners and should lead to improved outcomes.

Adult↗
PubMed2005

Early age-related cognitive impairment in mice lacking cannabinoid CB1 receptors.

The molecular mechanisms contributing to the normal age-related decline of cognitive functions or to pathological learning and memory impairment are largely unknown. We demonstrate here that young mice (6-7 weeks) with a genetic deletion of the cannabinoid CB1 receptor performed as well as WT mice, or often better, in a number of learning and memory paradigms, including animal models of skill-learning, partner recognition, and operant conditioning. In contrast, the performance of mature mice (3-5 months) lacking CB1 receptors was much worse than that of age-matched WT animals. In most tests, these mice performed at the same level as old animals (14-17 months), suggesting that the decline in cognitive functions is accelerated in the absence of CB1 receptors. This rapid decline in CB1-deficient animals is accompanied by a loss of neurons in the CA1 and CA3 regions of the hippocampus.

Aging↗
PubMed1990

Demonstrations and knowledge of results in motor skill acquisition.

In learning motor skills, different types of information can be utilized to reinforce correct execution of the skill. Over the years, augmented information after the movement (i.e., knowledge of results) has been the most widely studied and has received attention as the most important variable for learning. Recently, however, researchers have begun to focus on modeling or providing information prior to movement as another important aspect of skill learning. The present experiment compared a KR 100% condition with a KR 33% condition, with a final modeling plus KR condition on the acquisition and immediate transfer retention of a timing task. The results showed that all groups reached the same performance level by the end of acquisition. However, over the immediate transfer phase, subjects who had received modeling plus KR during acquisition, increased their errors. Delayed retention produced no significant group effects.

Adult↗
PubMed2005

Quantification of motion characteristics and forces applied to tissues during suturing.

BACKGROUND: The quantification of movement processes describes how a movement is generated. These process measures have been shown to be effective sources of feedback to facilitate motor learning and can thus be applied to teach fundamental technical skills in surgery. The aim of this study was to determine, through detailed analyses, whether specific process measures of hand motions and forces imposed on tissues during suturing were sensitive to (1) practice and (2) levels of surgical expertise. METHODS: Six junior surgical residents (PGY-1) and 7 faculty surgeons were required to perform 20 simulated sutures on an artificial artery model, during which time the performers' hand movements were tracked by electromagnetic markers and the quantity of force they applied was measured by a force platform holding the arterial suturing models. The amount of wrist rotation and peak hand velocity produced during the suturing movement, peak and average forces applied to the tissue, the temporal difference between force and wrist rotation onsets, and the total suturing time were evaluated. RESULTS: Surgeons showed greater wrist rotation, higher average forces, shorter force-rotation initiation times, and shorter suturing times than did junior residents. Only the amount of wrist rotation and the time elapsed between force and wrist rotation onsets improved with practice for the junior group. CONCLUSIONS: Although all 4 variables measured can be used to distinguish between expert and novice performances, only the process measures (wrist rotation and force-rotation initiation time) changed as a result of practice for the junior residents. Thus, these measures can be used to facilitate skills learning by serving as a source of detailed structured feedback to trainees.

Clinical Competence↗
PubMed1991

Learning opportunities through camping for mental health nursing.

1. To equip nurses with the skills necessary for working with disturbed people, nurse educators need to be mindful of not watering down the essential skills necessary for nurses to deal with difficult behaviour in all branches of nursing. 2. These components of a mental health clinical experience should equip the graduate to deal with the pressures of dealing with disturbed people in any environment, as the skills learned generalize to any branch of nursing. 3. Universities can combine with traditional hospital services and community mental health services to provide services to clients with mental illness. An additional benefit is in providing students with an intensive clinical learning experience that reinforces the theory taught in the classroom.

Camping↗
PubMed2002

Experience-dependent changes in cerebellar contributions to motor sequence learning.

Studies in experimental animals and humans have stressed the role of the cerebellum in motor skill learning. Yet, the relative importance of the cerebellar cortex and deep nuclei, as well as the nature of the dynamic functional changes occurring between these and other motor-related structures during learning, remains in dispute. Using functional magnetic resonance imaging and a motor sequence learning paradigm in humans, we found evidence of an experience-dependent shift of activation from the cerebellar cortex to the dentate nucleus during early learning, and from a cerebellar-cortical to a striatal-cortical network with extended practice. The results indicate that intrinsic modulation within the cerebellum, in concert with activation of motor-related cortical regions, serves to set up a procedurally acquired sequence of movements that is then maintained elsewhere in the brain.

Adult↗
PubMed1979

Heart rate and blood pressure biofeedback: II. A review and integration of recent theoretical models.

The theoretical models put forth separately by Bremer, Lang, and Schwartz to account for the data on biofeedback and cardiovascular responses are summarized and evaluated in light of recent empirical studies. Although each model makes some use of the idea that learning to control heart rate, particularly heart rate acceleration, is like motor skills learning, each model also emphasizes different sets of factors or variable. An attempted integration of these three models is presented.

Arousal↗
PubMed2006

Assisting pre-registration students in the acquisition of clinical skills utilising computer assisted learning.

Practical nursing skills form the bedrock of nursing practice. In line with Government initiatives, practitioners also need to master skills in information technology. In an attempt to address these issues, funding has been awarded for a nursing led multi-professional development of a Clinical Skills Website at the Florence Nightingale School of Nursing and Midwifery at King's College London. The aim is to provide students with a high quality resource to promote mastery of clinical skills and information technology. It also provides practitioners with easily accessible teaching resources to use in their role as mentors. The following discussion explores the development of this innovative resource as well as the pedagogical underpinning, benefits, challenges and plans for future developments.

Clinical Competence↗
PubMed2005

Fundamental aspects of learning minimally invasive surgical skills.

With the introduction of minimally invasive surgery (MIS) the necessity to develop training methods to learn skills outside the operating room (OR) became clear. Several training simulators have become commercially available. However, fundamental research into the requirements for effective and efficient training in MIS is still lacking. Yet in the literature several learning models have been described that may be used when designing the structure of a training program. While learning skills, three stages can be observed: cognitive, associative and autonomous. The learning cycle also includes different learning styles and, moreover, every trainee has his/her preferred learning style. Furthermore, training should be adapted to the level of behaviour: skill-based, rule-based or knowledge-based. Training of complex skills should include multiple performance objectives, such as just-in-time supportive information and part-task practice. Finally, motivation for training can be created by assessment. In conclusion, several theories on learning can be found in the literature. These theories may help in the development of effective training programs for training MIS skills outside the OR.

Journal Article↗
PubMed2001

Effects of 12-week shooting training and mode of feedback on shooting scores among novice shooters.

The mode of feedback has been shown to have an effect on motor skill learning. This study investigated effects of an intensive 12-week shooting training period, and of the mode of feedback on scores in standing and running target shooting among 30 novices with limited shooting experience. They were divided into one control (no training) and three training groups. One out of the three training groups received only KR (knowledge of results) while the two other groups received KR+KP (knowledge of performance). One of the KR+KP groups received additional visual feedback (FB-II group), which included videos, graphic and written materials about kinematic and kinetic characteristics of their respective shooting techniques compared to performance of international level shooters. Each training group improved their scores in the running target shooting. There were no significant differences between the three training groups in improvements of sum scores (performance outcome). The current study showed that among novice shooters both KR alone and KR+KP improved running target shooting outcome, and that KR and KP together did not lead to a significantly better shooting performance than KR alone.

Adult↗
PubMed2004

Meeting the at-risk challenge: empowering nursing students through mentoring.

Wanting to improve student retention, progression, and graduation, the nursing faculty of the University of Nevada, Las Vegas developed a program for undergraduate students. Designated faculty mentors are available for academically at-risk students, or any student wanting to improve learning skills. Through mentoring sessions, students are helped to assess their learning difficulties, develop individualized prescription plans for learning, gain support during implementation of learning strategies, and evaluate results. Implemented in 2002, the program reflects positive outcomes. Of the 29 students who were referred to the program, only 3 were unsuccessful in passing their nursing courses. Student evaluations of the program reflect the value of the mentoring experience. The program has subsequently developed in the areas of advertising, diagnostic student testing, and student access to support resources.

Adult↗
PubMed1981

Structured experiential learning exercises: a facilitation to more effective learning in clinical settings.

Structured experiential exercises can help to make students more aware of the learning skills required in each of the four phases of experiential learning. These exercises should be structured to increase the trust and communication between the clinical nursing instructor and the students, as well as to assist the students to understand better their own and others' values and group processes. We believe that exercises that fulfill these objectives enable the students to adjust better to the learning styles required in a clinical course. Moreover, students who obtain increased awareness of their own values and those of others may become more effective members of the nursing profession.

Clinical Competence↗
PubMed2005

Observational learning: effects of bandwidth knowledge of results.

The authors investigated whether bandwidth knowledge of results (KR) during observation of a model's performance enhances motor skill learning. Following a pretest, 2 groups of participants (N = 28) observed a model practicing a timing task. The bandwidth group received KR about the model's performance only when his performance fell outside the criteria for a correct response. The yoked group received KR on the same trials as the bandwidth group did but were not told that the KR was only about incorrect performances. In that way, the authors avoided a confound between bandwidth and relative frequency effects on performance and learning. Following the observation phase, both groups of participants performed 10-min and 24-hr retention tests. Bandwidth KR enabled that group to reduce its performance variability and, to a lesser extent, to enhance its performance accuracy. The authors discuss the results with respect to the powerful effect of qualitative KR through observation.

Adult↗
PubMed2006

Frontal regions involved in learning of motor skill--A functional NIRS study.

To investigate cerebral mechanisms underlying learning of motor skill, we assessed serial changes of cortical activation patterns during a pursuit rotor (PR) task in 18 right-handed, healthy subjects using a functional near-infrared spectroscopy (fNIRS) system. Subjects performed the task with the right hand for 30 s alternated with 30-s rest for 8 repetitions (cycle1 to 8). Gains in motor skill were evaluated by time for keeping the stylus on the target (max 30 s), surface EMG patterns and trajectories of the arm. Performance improved with repetitions of the task cycles (12.9/17.1/19.3/20.0/21.1/22.2/23.6/23.9 s on average) and reached plateau at the 7th cycle. Reciprocal EMG patterns and steady trajectories were associated with acquisition of the motor skill. Task-related increases of oxygenated hemoglobin (oxyHb) were observed in the channels covering the sensorimotor cortex (SMC), premotor and prefrontal regions. There were also task-related decreases of deoxygenated hemoglobin (deoxyHb) in these areas although the changes were smaller compared with those of oxyHb. The center of task-related increases of oxyHb was initially located in the presupplementary motor area (preSMA) and shifted caudally to the supplementary motor area (SMA) with cycle repetitions. The ratios of oxyHb changes in preSMA to SMA significantly decreased with task repetitions. DeoxyHb changes confirmed the activation patterns. These data suggest that preSMA plays an important role in the early phase of motor learning while the SMA might be more involved in the late learning phase of the motor skill.

Adult↗
PubMed2003

Schema theory: critical review and implications for the role of cognition in a new theory of motor learning.

This paper is based on a symposium celebrating the 26th anniversary of the publication of "A Schema Theory of Discrete Motor Skill Learning" (Schmidt, 1975) held at the annual conference of the North American Society for the Psychology of Sport and Physical Activity in June 2001. We provide a brief historical context for schema theory and a review of the development of the mechanistic approach to motor learning in general. We explore recent findings in mental practice, observational learning, augmented feedback presentation, and the variability of practice that are inconsistent with schema theory and provide a rationale for the importance of cognitive activity in motor learning.

Child↗