Transcript Psychomotor learning - University of North Texas

Psychomotor
Learning
Kun Huang, PhD
Vanneise Collins, Ph.D.
Center for Learning & Development
UNT Health Science Center
What are some unique challenges
in OMT training?
Issues & challenges
• Lack of application of psychomotor
learning theories and empirical research
• Traditional approach (demonstration
followed by paired practice) lacks feedback
• Teaching fine motor skills
• Low reliability among instructors/
examiners
What are psychomotor skills?
Psychomotor skills
Psycho
Motor
How are psychomotor skills
developed?
Stages of psychomotor skills
Novice
Expert
Stages
Cognitive
Associative
Autonomous
What is being
learned?
Verbal
information &
Procedural rule
Initial errors
Fine tuning
corrected;
psycho-motor
connections; deeper
understanding of
procedural rule
How easy is
knowledge
retrieval?
Labor intensive
& effortful
Still have to think
before retrieval
Effortless; no
conscious retrieval
How good is
performance?
Trial & error;
Erratic
More fluid with
fewer interruptions
Smooth, accuracy
and speed
How to support psychomotor learning
at each developmental stage?
Supporting psychomotor learning
Stages
Cognitive
Associative
Autonomous
Support
Supporting psychomotor learning
Conceptualization
Visualization
Verbalization
Practice
Feedback
Critical element: Practice
Massed
practice
?
Spaced
practice
Massed vs. spaced practice
If the
task
Spaced
Massed
• Is simple, repetitive, or
boring
• Demands intense
concentration
• Is fatiguing
• Demands close attention to
detail
•
•
•
•
Is complex
Has many elements
Requires warm-up
Is a new one for the
performer
Critical element: Practice
Whole
practice
?
Part
practice
Whole vs. part practice
Emphasize wholes
If the task • Has highly dependent
(integrated) parts
• Is simple
• Is not meaningful in
parts
• Is made up of
simultaneously
performed parts
Emphasize parts
• Has highly individual
parts
• Is very complex
• Is made up of individual
skills
• Requires limited work
on parts or different
segments
Critical element: Feedback
Knowledge
of results
Intrinsic
Augmented
• Internal visual, auditory, and
proprioceptive sensations
• Experts can “read” such feedback
and rely a great deal on it
• Novices often cannot rely on it
• Novices often rely on augmented
feedback provided by experts
• Instructor should teach what to look
for
• Provide specific and timely feedback
• Feedback should not be given prematurely; focus on
actual observations
• Provide intermittent instead of constant feedback
Can we establish a consistent,
structured training approach?
“
The standardization of the grading on
practical exams, is quite important but the
process begins at the tables in the OMT labs.
It is during this time that what is being
taught and how it is being taught has to be
standardized amongst table trainers in order
to have clear expectations and objectives for
grading on the practical exam.
Rapacciuolo, Channell, & Cooley (2013)
”
Five-step process in
psychomotor training
1. Overview: why the skill is needed and
how it is used in the delivery of care
2. Silent demonstration
3. Repeat the procedure but explain in detail
4. Students verbally describe the procedure
5. Student perform the skill with preceptor
feedback
George & Doto (2001).
Simplified model in teaching
psychomotor skills
Introductory
Phase
Practice
Perfecting
Phase
Phase
A. Prepare students
for learning the
skill
B. Provide
information
about the skill
C. Require analysis
of the skill
A. Require practice
of the skill
B. Observe student
practice and
prompt when
needed
C. Provide feedback
when needed
A. Require precision
performance
B. Observe and
prompt on details
C. Provide feedback
on fine points
Beal (1991)
Do’s and Don’ts for examiners
• Watch & discuss videos showing
contrasting examiner behaviors
• Compile discussions into do’s and don’ts
• Workshop held before every final practical
Beal (1991)
Standardizing training/
assessment
Rapacciuolo, Channell & Cooley (2013)
Consensus training
• Evaluate subjects, discuss findings and
reach consensus
• Consensus training significantly improved
inter-observer reliability
Degenhardt, Snider, Snider & Johnson (2005)
References & resources
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Aubin, A., Gagnon, K., & Morin, C. (2013). The seven-step palpation method: A proposal
to improve palpation skills. International Journal of Osteopathic Medicine,
doi:10.1016/j.ijosm.2013.02.001.
Beal, M. (1991). The principles of palpatory diagnosis and manipulative technique.
Newark, Ohio: American Academy of Osteopathy.
Browning, S. (2010). Teaching osteopathic students technique: using research to identify
good teaching practice. International Journal of Osteopathic Medicine, 13, 70-73.
Degenhardt, B., Snider, K., Snider, E., & Johnson, J. (2005). JAOA, 105 (10), 465-473.
George, J., & Doto, F. (2001). A simple five-step method for teaching clinical skills.
Family Medicine, 33(8), 577-578.
Kaufman, H., Wiegand, R., & Tunick, R. (1987). Teaching surgeons to operate –
Principles of psychomotor skills training. Acta Neurochir (Wien), 87(1-2):1-7.
Rapacciuolo, J., Channell, M., & Cooley, D. (2013). Standardizing the osteopathic
practical. International Journal of Osteopathic Medicine,
doi:10.1016/j.ijosm.2013.03.001.
Sullivan, M., & Baker, C. (2010). Employ a structured approach to teaching psychomotor
skills to enhance learner performance. American College of Surgeons Residency Assist
Page, http://www.facs.org/education/rap/sullivan1210.html.