Acquisition, retention and transfer of simulated laparoscopic tasks using fNIR and a contextual interference paradigm

Patricia A Shewokis; Faiz U Shariff; Yichuan Liu; Hasan Ayaz; Andres Castellanos; D Scott Lind

doi:10.1016/j.amjsurg.2016.11.043

Acquisition, retention and transfer of simulated laparoscopic tasks using fNIR and a contextual interference paradigm

Am J Surg. 2017 Feb;213(2):336-345. doi: 10.1016/j.amjsurg.2016.11.043. Epub 2016 Dec 1.

Authors

Patricia A Shewokis¹, Faiz U Shariff², Yichuan Liu³, Hasan Ayaz⁴, Andres Castellanos⁵, D Scott Lind⁶

Affiliations

¹ Nutrition Sciences Department, College of Nursing and Health Professions, Drexel University, Philadelphia, PA 19102, USA; School of Biomedical Engineering, Science and Health Systems, Drexel University, Philadelphia, PA 19104, USA. Electronic address: pas38@drexel.edu.
² Department of Surgery, Drexel University College of Medicine, Philadelphia, PA 19102, USA. Electronic address: fizashariff@gmail.com.
³ School of Biomedical Engineering, Science and Health Systems, Drexel University, Philadelphia, PA 19104, USA. Electronic address: yl565@drexel.edu.
⁴ School of Biomedical Engineering, Science and Health Systems, Drexel University, Philadelphia, PA 19104, USA; Department of Family and Community Health, University of Pennsylvania, Philadelphia, PA 19104, USA; Division of General Pediatrics, Children's Hospital of Philadelphia, Philadelphia, PA 19104, USA. Electronic address: hasan.ayaz@drexel.edu.
⁵ Department of Surgery, Drexel University College of Medicine, Philadelphia, PA 19102, USA. Electronic address: andres.castellanos@drexelmed.edu.
⁶ Department of Surgery, Drexel University College of Medicine, Philadelphia, PA 19102, USA. Electronic address: david.lind@jax.ufl.edu.

PMID: 28041606
DOI: 10.1016/j.amjsurg.2016.11.043

Abstract

Background: Using functional near infrared spectroscopy, a noninvasive, optical brain imaging tool that monitors changes in hemodynamics within the prefrontal cortex (PFC), we assessed performance and cognitive effort during the acquisition, retention and transfer of multiple simulated laparoscopic tasks by novice learners within a contextual interference paradigm.

Methods: Third-year medical students (n = 10) were randomized to either a blocked or random practice schedule. Across 3 days, students performed 108 acquisition trials of 3 laparoscopic tasks on the LapSim^® simulator followed by delayed retention and transfer tests. Performance metrics (Global score, Total time) and hemodynamic responses (total hemoglobin (μm)) were assessed during skill acquisition, retention and transfer.

Results: All acquisition tasks resulted in significant practice schedule X trial block interactions for the left medial anterior PFC. During retention and transfer, random performed the skills in less time and had lower total hemoglobin change in the right dorsolateral PFC than blocked.

Conclusions: Compared with blocked, random practice resulted in enhanced learning through better performance and less cognitive load for retention and transfer of simulated laparoscopic tasks.

Keywords: Contextual interference; Laparoscopic skill acquisition; Simulation; fNIR.

MeSH terms

Educational Measurement / methods*
Hemoglobins / analysis
Humans
Laparoscopy / education*
Learning
Prefrontal Cortex / diagnostic imaging*
Random Allocation
Retention, Psychology
Simulation Training*
Spectroscopy, Near-Infrared*

Substances

Hemoglobins