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Letter: The importance of memory traces of motor efferent discharges for learning skilled movements.
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Imaging brain plasticity during motor skill learning.
The search for the neural substrates mediating the incremental acquisition of skilled motor behaviors has been the focus of a large body of animal and human studies in the past decade. Much less is known, however, with regard to the dynamic neural changes that occur in the motor system during the different phases of learning. In this paper, we review recent findings, mainly from our own work using fMRI, which suggest that: (i) the learning of sequential finger movements produces a slowly evolving reorganization within primary motor cortex (M1) over the course of weeks and (ii) this change in M1 follows more dynamic, rapid changes in the cerebellum, striatum, and other motor-related cortical areas over the course of days. We also briefly review neurophysiological and psychophysical evidence for the consolidation of motor skills, and we propose a working hypothesis of its underlying neural substrate in motor sequence learning.
The associative-memory basis of cognitive skill learning: adult age differences.
It has been established that memorizing common problems and their solutions underlies cognitive skill development, and that there are substantial age deficits in the rate of this learning. In a between-groups design, the authors compared learning rates for the same set of problems in skill (SK) training and paired-associate (PA) training. The authors found main effects due to condition (PA problems were acquired earlier) and to age (older adults' learning was delayed), but no condition-by-age interaction. The authors concluded that the age deficit in SK can be accounted for by the age deficit in associative memory; no further explanation is needed. The authors also analyzed fast and slow retrieves in SK and PA, and found that the frequency of fast retrieves did not differ in the two conditions. The overall advantage of PA was due to the occurrence of slow retrieves, which were absent in SK presumably because the skill algorithm displaces slow, explicit memory search in SK, but not fast, familiarity-based retrieval.
Lifelong learning: skills and online resources.
OBJECTIVE: Advances in information technology enable the practicing psychiatrist's quest to keep up-to-date with new discoveries in psychiatry, as well as to meet recertification requirements. However, physicians' computer skills do not always keep up with technology, nor do they take advantage of online search and continuing education services. This article describes the rationale for using electronic databases and training, as well as basic computer skills, computer equipment, and important online resources for psychiatrists to meet their continuing education and recertification needs quickly, easily, and conveniently. METHOD: A literature review was performed using PUBMED and Google to find articles related to recertification, physician's technology adoption and computer skills, evidence-based medicine, and basic approaches to lifelong learning using computers and the Internet, and resources for lifelong learning. RESULTS: Psychiatrists are required to master a discrete set of information for board certification, and to maintain that knowledge for recertification. Surveys have shown that although most physicians use computers, the majority use them for personal or business purposes, and not for accessing Continuing Medical Education (CME) programs (1). The Council on Graduate Medical Education requires the acquisition of medical informatics skills for the Undergraduate Medical Education for the 21st Century (UME-21) curriculum project (2). There is a growing body of literature outlining basic computer skills and competencies for physicians to access online textbooks, databases, journals, and CME programs. CONCLUSIONS: Psychiatrists can benefit from learning how to use computers and the Internet to keep current with the advances in the field. Skills now being taught in medical school and residency are equally important for practicing psychiatrists to learn and master.
Virtual reality as a metric for the assessment of laparoscopic psychomotor skills. Learning curves and reliability measures.
BACKGROUND: The objective assessment of the psychomotor skills of surgeons is now a priority; however, this is a difficult task because of measurement difficulties associated with the assessment of surgery in vivo. In this study, virtual reality (VR) was used to overcome these problems. METHODS: Twelve experienced (>50 minimal-access procedures), 12 inexperienced laparoscopic surgeons (<10 minimal-access procedures), and 12 laparoscopic novices participated in the study. Each subject completed 10 trials on the Minimally Invasive Surgical Trainer; Virtual Reality (MIST VR). RESULTS: Experienced laparoscopic surgeons performed the tasks significantly (p < 0.01) faster, with less error, more economy in the movement of instruments and the use of diathermy, and with greater consistency in performance. The standardized coefficient alpha for performance measures ranged from a = 0.89 to 0.98, showing high internal measurement consistency. Test-retest reliability ranged from r = 0.96 to r = 0.5. CONCLUSION: VR is a useful tool for evaluating the psychomotor skills needed to perform laparoscopic surgery.
Relative frequency of knowledge of performance and motor skill learning.
This study examined the effects of variations in relative frequency of knowledge of performance (KP) on acquisition, retention, and transfer of form for a multilimb closed sport skill. Two groups received either 100% relative frequency of KP or 33% relative frequency of KP while learning the soccer throw-in skill. Participants were boys between the ages of 11 and 14 years who were unfamiliar with the skill. Participants performed a 30-trial acquisition phase in which KP was provided about one of eight aspects of form. Following acquisition, five trial retention and transfer (to a target at a different distance than experienced in acquisition) tests were administered at 5 min, 24 hr, and 72 hr. Although no group differences were found for accuracy scores, the 33% group had higher form scores in acquisition and all retention and transfer tests. It was concluded that reducing the relative frequency of KP eliminated a dependency on KP to guide performance in acquisition, which was beneficial for maintaining form in conditions in which KP was absent.
Impaired skill learning in children with heavy prenatal alcohol exposure.
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Effect of learner strategies with modular versus traditional instruction on motor skill learning and retention.
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Early boost and slow consolidation in motor skill learning.
Motorskill learning is a dynamic process that continues covertly after training has ended and eventually leads to delayed increments in performance. Current theories suggest that this off-line improvement takes time and appears only after several hours. Here we show an early transient and short-lived boost in performance, emerging as early as 5-30 min after training but no longer observed 4 h later. This early boost is predictive of the performance achieved 48 h later, suggesting its functional relevance for memory processes.
A study of error and modeling in skills learning.
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Overview of the skill learning process.
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Retention of interviewing skills learned by first-year medical students: a longitudinal study.
A pilot interviewing course was offered as an elective to first-year medical students in the spring of 1985. A quasi-experimental pre-test/post-test control group demonstrated that students who took the course exhibited a significant increase in interviewing skills. Subjects, 15 in the experimental group and 11 in the control group, were assessed in each of the following 3 years. Data consisted of five 10-minute videotaped interviews with real or stimulated patients for each subject and subject's responses on a degree of confidence, familiarity and anxiety scale. Interviews were rated on 43 behaviours by two independent coders with a 90% simple agreement. The experimental group did not maintain their scores on interviewing skills and both groups showed a significant decline in nine skills comprising empathy. The only significant difference between the groups in fourth year was on the degree of confidence experienced. While interviewing skills can be learned they decline in the clinical years as students learn medical problem-solving. If medical students are to graduate with their original empathy intact, a follow-up course in fourth year is indicated.
The effects of practice and delay on motor skill learning and retention.
The present study assessed the effects of amount of practice and length of delay on the learning and retention of a timed motor sequence task. Participants learned to reproduce ten-element visual sequences by tapping in synchrony with the stimulus. Participants were randomly assigned to a varied-practice condition or a varied-delay condition. In the varied-practice condition, participants received either one, three, or six blocks of practice followed by a fixed 4-week delayed-recall. In the varied-delay condition, participants received three blocks of practice followed by a varied delay of either 3 days, or 2, 4, or 8 weeks. Learning was assessed by changes in accuracy, response variance, and percent response asynchrony. Our results showed that amount of practice per se did not affect learning and retention of the task. Rather, distribution of practice over several days was the most important factor affecting learning and retention. We hypothesize that passage of time is essential for a maximum benefit of practice to be gained, as the time delay may allow for consolidation of learning, possibly reflecting plastic changes in motor cortical representations of the skill. With regards to delay, our findings suggest that explicit and motoric components of a motor sequence are likely to be learned and maintained in separate but interacting systems. First, only the longest delay group showed decrements in percent correct, indicating that longer lengths of delay might hinder retrieval of explicit aspects of the task. Second, all groups showed a decrement in percent response asynchrony, suggesting that synchronization may be a more difficult parameter to maintain because it relies heavily on sensorimotor integration.
Generalization of object manipulation skills learned without limb motion.
Recent work suggests that human subjects may learn mappings between object motion and exerted torque during manipulation of freely pivoting or unstable objects. In the present work, we studied an object manipulation task involving no arm movement to determine how subjects internally represent the force-motion relationship of an object during a skilled manipulation task. Human subjects learned to balance a simulated inverted pendulum. The simulation was controlled by pressing on a fixed force sensor, and applied forces resulted in motion of the simulated pendulum on a computer screen according to its equation of motion. Each subject initially learned the task in one arm posture and was tested 1 d later in a new arm posture. In one test condition, the effects of arm torque were matched to the original task, and in the other test condition, the simulation was unchanged. The pattern of skill transfer to different arm postures suggested that subjects had learned joint torque responses rather than a general model of the object interface forces. A second experiment showed that the advantage of training with matched arm torques was object specific, because torque-matched training on a tracking task involving similar forces was not a substitute for training in the balancing task.
Variability of Practice and Contextual Interference in Motor Skill Learning.
The purpose of this study was to investigate whether learning benefits in multiple-task learning situations are a result of contextual interference or of schema enhancement related to the amount of variability in the practice session. Two experiments were designed that replicated and extended the experiment reported by Wulf and Schmidt (1988). In a 2 (same vs. different relative time) x 2 (blocked vs. random practice schedule) design, 48 right-handed subjects were randomly assigned to one of four experimental conditions. A tapping task was employed that required a right-handed tap of three small brass plates arranged in a diamond pattern. Each segment had a specific time requirement. Target times and response times were provided on a computer screen directly in front of the subject. Each subject participated in two acquisition sessions (i.e., 198 practice trials) and was tested for learning on several different retention and transfer tests. In Experiment 2, a control group was added that received no acquisition phase. Results of both experiments showed a typical contextual interference effect, with depressed scores by the random groups during acquisition but significantly better scores than the blocked groups on several retention and transfer tests. Certain characteristics of the tests were found to influence the demonstration of the practice schedule effects. These results were consistent with predictions from Magill and Hall (1990) that the learning benefits of contextual interference are more likely to occur when skill variations are from different classes of movement and that the amount of variability in practice is more influential when the to-be-learned tasks are parameter modifications of the same generalized motor program.
Specific plasticity of parallel fiber/Purkinje cell spine synapses by motor skill learning.
New synapse formation may underlie learning and memory. To examine specific synaptic plasticity by motor learning, we conducted quantitative analysis of synapses between parallel fibers and Purkinje cell dendritic spines in cerebella of rats trained to complete various obstacle courses. Synapses between parallel fibers and Purkinje cell spines were classified into single synapse boutons, multiple synapse boutons, and multiple synapse spines by their different contact features. Acrobat-trained animals had more single and multiple synaptic boutons, without change of multiple synapse spines, than motor control animals. These results may suggest that motor learning induces specific synaptogenesis and Purkinje cell spines are primary sites in motor learning-dependent cerebellar synaptic plasticity.
Improvements in the signal-to-noise ratio of motor cortex cells distinguish early versus late phases of motor skill learning.
There are numerous experience-driven changes in cortical circuitry that correlate with improved performance. Improved motor performance on a reach-to-grasp task in rodents is associated with changes in long-term potentiation (LTP), synaptogenesis, and movement representations in primary motor cortex (M1) by training days 3, 7, and 10, respectively. We recorded single-cell activity patterns in M1 during reach-to-grasp training to test how neural-spiking properties change with respect to LTP, synaptogenesis, and motor map changes. We also tested how neural-spiking changes relate directly to improved performance by monitoring muscle activity patterns. We found that signal-to-noise ratios (SNRs) of M1 spiking were significantly improved with practice but only after 7-12 d. Three sources of noise were assessed: signal-dependent noise exemplified by the slope of the relationship between mean spike count and count variance per burst, signal-independent noise exemplified by the offset of this relationship, and background firing rates before and after bursts. Signal-independent noise and pre-burst firing rates were reduced with practice. Early performance gains (days 1-6) were dissociated from SNR improvements, whereas later performance gains (day 7-12) were related directly to the magnitude of improvement in both muscle recruitment reliability and success rates. With training, an increased number of cells exhibited firing rates that were correlated with muscle recruitment patterns, with lags suggesting a primary direction of influence from M1 to muscles. These results suggest a functional linkage from local synaptogenesis in M1 to improved spiking reliability of M1 cells to more reliable recruitment of muscles and finally to improved behavioral performance.