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.

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.

The purpose of this research was to examine whether a transition schedule of contextual interference facilitated learning in retention and transfer equal to or better than random and blocked schedules among children. The author selected participants from the central coast of California and from youth activity leagues. The author selected children between the ages of 10 to 13 with a mean age of 11.5. There were a total of 36 subjects, half male and half female. Unfortunately, due to computer error, only data from 15 subjects were saved and available for analysis. Researchers randomly assigned participants to one of three groups: the random group, the blocked group, or the transition group. Each group performed 60 trials during the acquisition phase and practiced a total of 3 different arm patterns. All three groups practiced each pattern a total of 20 times during acquisition. The random group practiced each pattern in random fashion such that no one pattern was repeated more than twice in a row. The blocked group performed 20 trials of the green pattern, followed by 20 trials of the blue pattern, and lastly 20 trials of the red pattern. The transition group performed the first 24 trials in a blocked fashion, that is 8 trials of the green pattern were practiced, followed by 8 trials of the blue pattern, and then 8 trials of the red pattern. The group then practiced smaller blocks and performed 5 trials of each color. Another 9 trials were performed in a blocked fashion with 3 trials of each pattern. The final 12 trials were presented randomly to this group. Following acquisition, participants took an immediate retention test that was counter balanced following a 10 minute rest. The retention test consisted of 9 random trials of the three various patterns. Researchers gave a transfer test following the retention test, which consisted of six trials of a novel (white) pattern. Researchers tested all three groups one week later with a delayed retention and transfer test similar to the tests described above. One-way ANOVA analysis of the data revealed a significant movement time difference (F=4.28; P=.039) during the delayed retention test. The follow up Tukey test demonstrated that the transition group had a significantly faster movement time than the blocked group but that random group was not significantly different from either the blocked or transition group. The other retention and transfer tests revealed no significance, however the trend in the data suggest that with a bigger sample size, the transition group would demonstrate learning equal to or better than both random and blocked groups. Further research is needed in the area of transition practice schedules.

In their challenge-point framework (CPF) Guadagnoli and Lee’s (2004) argue that learning is maximized when a person faces an optimal level of challenge during practice. It is suggested that challenge level can be manipulated through the combination of different practice variables. The purpose of this study was to investigate how practice schedule and self-controlled feedback frequency manipulations affect performance and learning of motor skills. Participants (n=96) attempted to learn three versions of a key-pressing task. The task consisted of pressing five computer keys in specified sequences in a goal criterion time. Participants were assigned to either a blocked practice schedule with self-controlled feedback (BLK-SC), a random practice schedule with self-controlled feedback (RND-SC), a blocked practice schedule with yoked feedback (BLK-YK), a random practice schedule with yoked feedback (RND-YK), a blocked practice schedule and 100 percent feedback (BLK-100), or a random practice schedule with 100 percent feedback (RND-100). Participants in the blocked conditions practiced 30 trials of each task according to a blocked practice schedule. Participants in the random conditions practiced 30 trial of each task according to a random practice schedule. Participants in the self-controlled feedback condition were allowed to choose whether or not to receive feedback on each trial. Yoked participants had their feedback schedule matched to a participant with similar characteristics in the self-control condition. Participants in the 100% feedback condition received feedback after every trial. Participants were also asked to complete the NASA Task Load Index (Hart & Staveland, 1988) and an adapted Perceived Competence for Learning scale (adapted from Williams & Deci, 1996) after the completion of the 5th and 90th trial. After 24 hr participants performed a retention test. The results indicated no difference between groups during retention or for the NASA-TLX and PCL scores. The feedback frequency analysis indicated no differences between BLK-SC and RND-SC groups. In general, the findings of the present study show that the effects of practice schedule conditions can be offset by self-controlled feedback manipulations. They also suggest that a number of different combinations of practice schedules and feedback frequencies can lead to similar challenge levels.