Background
Implicitly learned motor skills are characterized by minimal conscious knowledge of
the movements involved and stable performance despite stress, fatigue, or multi-tasking.
In contrast, explicitly learned motor skills are characterized by conscious knowledge
of the movements and performance that tends to be less stable under stress, fatigue,
and multi-tasking. We examined the acquisition of a basic surgical skill in three
observational learning treatment conditions designed to accomplish implicit or explicit
motor learning. We then tested performance in conditions that emulated multi-tasking
in the operating theater. Our intention was to elaborate current understanding of
implicit and explicit processes that underpin observational learning in the surgical
environment.
Methods
Thirty-six novice adults were assigned randomly to an observation-only, an instructed-observation,
or a guided-observation treatment condition, in which they learned to perform a suturing
and knot-tying task in a Learning Phase. Their performance during multi-tasking was
then assessed objectively by motion analysis during a Test Phase.
Results
In the Learning Phase, performance improved equally in the treatment conditions throughout
learning, with participants using fewer hand movements and completing the task more
quickly. Participants in the observation-only and the guided-observation treatment
condition, however, reported significantly less movement-related knowledge than participants
in the instructed-observation condition. In the Test Phase, participants in the instructed-observation
condition exhibited slower completion times and more hand movements when they were
required to multi-task, whereas in the observation-only and the guided-observation
treatment condition, participants showed stable performance.
Conclusions
A surgical skill that is learned by observation alone or by observation accompanied
by guidance to reduce the number of errors that are committed tends to be learned
implicitly and to have stable performance during multi-tasking. The efficacy of observation
for acquiring technical skills implies that, at least for some skills, verbal instructions
may not be necessary.
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Article info
Publication history
Published online: November 30, 2007
Accepted:
June 11,
2007
Footnotes
Supported by Seed Funding for Basic Research, awarded to the authors by the University of Hong Kong.
Identification
Copyright
© 2008 Mosby, Inc. Published by Elsevier Inc. All rights reserved.
