Background: How to optimally integrate simulation into a surgical training program is relatively unknown. We studied the effect of varying the practice schedule into either blocked or random patterns (termed contextual interference) on the long-term retention and transfer of surgical skills. Methods: 36 participants were randomized to practice 4 tasks from the Fundamental of Laparoscopic Surgery (FLS) program using one of three training schedules (blocked, random, no training). Skill was assessed using FLS scoring and hand-motion efficiency scores. Results: A positive benefit of training was seen over the controls for all 4 tasks (p<0.05). No difference was seen between the blocked and random groups in the amount of skill acquired, skill learned, or transfer of skill. Conclusion: The application of contextual interference was unable to differentiate between the blocked and random training groups. This could be due to the complexity of the tasks and/or the inexperience of the learners.

Neuromuscular fatigue, even that caused by light submaximal exercise, impairs motor performance and alters motor planning. This impairment is evident in muscle reaction time, force production capacity and joint position sense as well as in more complex tasks such as postural stability. When an individual is fatigued their postural sway increases and they are less able to recover from unexpected postural perturbations. Although a large number of work-related falls are caused by fatigue every year, the mechanisms behind the instability are not well understood. Since postural control does not require a large amount of muscular strength it is unclear whether the post-fatigue changes in posture are due to impairment within the muscle fibers or are a central modification of the motor plan used to execute the movement task. In order to better understand neuromuscular fatigue researchers have labeled fatigue occurring within the muscles ‘peripheral fatigue’ and that occurring within the central nervous system ‘central fatigue’. At the onset of a muscular contraction peripheral and central fatigue develop simultaneously, making it difficult to clearly articulate the role that they each play in the decreased motor performance found post-fatigue. Techniques such as transcranial magnetic and electrical nerve stimulation quantify the contribution of central fatigue to the decreased maximal force production but the impact on motor planning is still not well understood. Therefore, the primary aim of this doctoral dissertation was to isolate central fatigue from peripheral muscle fatigue and to compare the influence that it may have on dynamic postural control to the changes caused by general fatigue of the local postural muscles. This overarching research goal was accomplished through five separate studies. The first study in this dissertation determined that at least seven postural trials needed to be performed to ensure that the participants had fully adapted to the postural task before the fatigue protocol was implemented. Experiment 2 characterized the fatigue produced by bilateral, isometric ankle muscle contractions and examined the recovery of the central and peripheral changes throughout a ten-minute post-fatigue recovery period. The results demonstrated that the alternating maximal ankle plantar and dorsiflexor contractions created central and peripheral fatigue. Central fatigue recovered within the first two minutes post-fatigue while peripheral fatigue lasted throughout the ten-minute post-fatigue period. Experiment 3 analyzed the impact of this ankle muscle fatigue protocol on the postural response to a continual, externally driven, sinusoidal oscillation of the support platform. In this study the fatigued participants were able to stabilize their center of mass displacement using two different anticipatory postural responses to the backwards perturbation whereas all of the participants used the same anticipatory response to the forwards perturbation. All three postural responses became progressively more conservative throughout the ten-minute post-fatigue period, despite the rapid recovery of the ankle force production capacity. The final two studies characterized the fatigue produced during a continuous, isometric forearm contraction and assessed the impact on ankle motor performance (Experiment 4) and on postural control (Experiment 5). Peripheral fatigue created in the forearm muscles during this contraction remained throughout the post-fatigue testing session. Central fatigue and a decreased maximal force production capacity were quantified in both the forearm and ankle plantarflexor muscles immediately after the forearm contraction, indicating that central fatigue created during the forearm exercise crossed over to the distal and unrelated ankle plantarflexor muscles. The influence of the central fatigue created during the forearm contraction affected the anticipatory postural response in a similar way to the fatigue created by the ankle fatigue protocol. The post-fatigue modification of the postural response dissipated as the central fatigue recovered. Taken together, these five studies extend the current understanding of how exercise induced neuromuscular fatigue modifies the central nervous system’s control of complex motor tasks.

Background: How to optimally integrate simulation into a surgical training program is relatively unknown. We studied the effect of varying the practice schedule into either blocked or random patterns (termed contextual interference) on the long-term retention and transfer of surgical skills. Methods: 36 participants were randomized to practice 4 tasks from the Fundamental of Laparoscopic Surgery (FLS) program using one of three training schedules (blocked, random, no training). Skill was assessed using FLS scoring and hand-motion efficiency scores. Results: A positive benefit of training was seen over the controls for all 4 tasks (p<0.05). No difference was seen between the blocked and random groups in the amount of skill acquired, skill learned, or transfer of skill. Conclusion: The application of contextual interference was unable to differentiate between the blocked and random training groups. This could be due to the complexity of the tasks and/or the inexperience of the learners.

No description available.

Research paper (M.A.) -- Cardinal Stritch College -- Milwaukee, 1970. / A research paper submitted in partial fulfillment of the requirements for the degree of Master of Arts in Education (Education of Mentally Handicapped). Includes bibliographical references (p. [35-38]).

Thesis (Ph. D.)--Ohio State University, 1977. / Includes bibliographical references (leaves 210-219). Available online via OhioLINK's ETD Center.

Thesis (Ed.D.)--Teachers College, Columbia University, 1985. / Typescript; issued also on microfilm. Sponsor: J. R. Higgins. Dissertation Committee: A. M. Gentile. Includes bibliographical references: (leaves 48-52).

Thesis (Ed.D.)--Teachers College, Columbia University, 1970. / Typescript; issued also on microfilm. Sponsor: Antoinette M. Gentile. Dissertation Committee: Louis Forsdale, Bernard Gutin. Includes bibliographical references (leaves 89-92).

Thesis (Ph. D.)--University of Wisconsin--Madison, 1957. / Typescript. Abstracted in Dissertation abstracts, v. 17 (1957) no. 3, p. 678. Vita. eContent provider-neutral record in process. Description based on print version record. Includes bibliographical references (leaves 58-59).

Thesis (Ph. D.)--University of Wisconsin--Madison, 1969. / Typescript. Vita. eContent provider-neutral record in process. Description based on print version record. Includes bibliographical references.