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BMC Medical Education Mar 2023Repeated practice, or spacing, can improve various types of skill acquisition. Similarly, virtual reality (VR) simulators have demonstrated their effectiveness in...
OBJECTIVE
Repeated practice, or spacing, can improve various types of skill acquisition. Similarly, virtual reality (VR) simulators have demonstrated their effectiveness in fostering surgical skill acquisition and provide a promising, realistic environment for spaced training. To explore how spacing impacts VR simulator-based acquisition of surgical psychomotor skills, we performed a systematic literature review.
METHODS
We systematically searched the databases PubMed, PsycINFO, Psychology and Behavioral Sciences Collection, ERIC and CINAHL for studies investigating the influence of spacing on the effectiveness of VR simulator training focused on psychomotor skill acquisition in healthcare professionals. We assessed the quality of all included studies using the Medical Education Research Study Quality Instrument (MERSQI) and the risk of bias using the Cochrane Collaboration's risk of bias assessment tool. We extracted and aggregated qualitative data regarding spacing interval, psychomotor task performance and several other performance metrics.
RESULTS
The searches yielded 1662 unique publications. After screening the titles and abstracts, 53 publications were retained for full text screening and 7 met the inclusion criteria. Spaced training resulted in better performance scores and faster skill acquisition when compared to control groups with a single day (massed) training session. Spacing across consecutive days seemed more effective than shorter or longer spacing intervals. However, the included studies were too heterogeneous in terms of spacing interval, obtained performance metrics and psychomotor skills analysed to allow for a meta-analysis to substantiate our outcomes.
CONCLUSION
Spacing in VR simulator-based surgical training improved skill acquisition when compared to massed training. The overall number and quality of available studies were only moderate, limiting the validity and generalizability of our findings.
Topics: Humans; Clinical Competence; Motor Skills; Psychomotor Performance; Simulation Training; User-Computer Interface; Virtual Reality
PubMed: 36907871
DOI: 10.1186/s12909-023-04046-1 -
Annals of Vascular Surgery Jul 2023The widespread introduction of minimally invasive endovascular techniques in cardiovascular surgery has necessitated a transition in the psychomotor skillset of trainees... (Review)
Review
BACKGROUND
The widespread introduction of minimally invasive endovascular techniques in cardiovascular surgery has necessitated a transition in the psychomotor skillset of trainees and surgeons. Simulation has previously been used in surgical training; however, there is limited high-quality evidence regarding the role of simulation-based training on the acquisition of endovascular skills. This systematic review aimed to systematically appraise the currently available evidence regarding endovascular high-fidelity simulation interventions, to describe the overarching strategies used, the learning outcomes addressed, the choice of assessment methodology, and the impact of education on learner performance.
METHODS
A comprehensive literature review was performed in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement using relevant keywords to identify studies evaluating simulation in the acquisition of endovascular surgical skills. References of review articles were screened for additional studies.
RESULTS
A total of 1,081 studies were identified (474 after removal of duplicates). There was marked heterogeneity in methodologies and reporting of outcomes. Quantitative analysis was deemed inappropriate due to the risk of serious confounding and bias. Instead, a descriptive synthesis was performed, summarizing key findings and quality components. Eighteen studies were included in the synthesis (15 observational, 2 case-control and 1 randomized control studies). Most studies measured procedure time, contrast usage, and fluoroscopy time. Other metrics were recorded to a lesser extent. Significant reductions were noted in both procedure and fluoroscopy times with the introduction of simulation-based endovascular training.
CONCLUSIONS
The evidence regarding the use of high-fidelity simulation in endovascular training is very heterogeneous. The current literature suggests simulation-based training leads to improvements in performance, mostly in terms of procedure and fluoroscopy time. High-quality randomized control trials are needed to establish the clinical benefits of simulation training, sustainability of improvements, transferability of skills and its cost-effectiveness.
Topics: Humans; High Fidelity Simulation Training; Treatment Outcome; Learning; Simulation Training; Computer Simulation; Clinical Competence
PubMed: 36906131
DOI: 10.1016/j.avsg.2023.02.025 -
International Journal of Environmental... Mar 2023Children and adolescents with developmental disabilities are often impaired with motor function, and motor skills are related to the performance of daily living... (Review)
Review
Children and adolescents with developmental disabilities are often impaired with motor function, and motor skills are related to the performance of daily living activities, and their defects may limit social participation and reduce the quality of life. With the progress of information technology, virtual reality is used as an emerging and alternative intervention method for the intervention of its motor skills. However, the application of this field is still limited in our country, so it is of great significance to systematically analyze the foreign intervention in this field. The research used Web of Science, EBSCO, PubMed, and other databases to search the literature published in the past ten years on the application of virtual reality technology in the motor skill intervention of people with developmental disabilities, and analyzed the demographic characteristics, intervention target behavior, intervention time, intervention effect, and statistical methods. The advantages and disadvantages of research in this field are summarized, and on this basis, the reflection and prospects for follow-up intervention research are put forward.
Topics: Child; Adolescent; Humans; Motor Skills; Developmental Disabilities; Quality of Life; Virtual Reality; Technology
PubMed: 36901629
DOI: 10.3390/ijerph20054619 -
International Journal of Environmental... Feb 2023Previous literature shows the beneficial effects of an external focus of attention on various sports skills in young adults. The objective of this systematic review is... (Review)
Review
Previous literature shows the beneficial effects of an external focus of attention on various sports skills in young adults. The objective of this systematic review is to evaluate the effects of external and internal focus of attention on motor performance in healthy older adults. The literature search was conducted in five electronic databases (PsycINFO, PubMed, SPORTDiscus, Scopus, and Web of Science). Eighteen studies that met the inclusion criteria were evaluated. Most of the motor tasks targeting older adults were related to postural control and gait. Over 60% of the included studies reported that the effect of an external focus was superior to that of an internal focus on motor performance in older adults. An external focus generally results in better motor performance than an internal focus among healthy older adults. However, the advantage of an external focus on locomotion may not be as significant as those illustrated in previous attentional focus studies. A challenging cognitive task may allow more automatic motor control than an external focus. Practitioners might provide clear instruction cues guiding performers to divert their attention away from their body and towards the movement effect for better performance, particularly in balancing tasks.
Topics: Young Adult; Humans; Aged; Gait; Attention; Locomotion; Cues; Sports; Motor Skills
PubMed: 36901070
DOI: 10.3390/ijerph20054047 -
NeuroImage Apr 2023Neurofeedback training (NFT) refers to a training where the participants voluntarily aim to manipulate their own brain activity using the sensory feedback abstracted... (Meta-Analysis)
Meta-Analysis
Neurofeedback training (NFT) refers to a training where the participants voluntarily aim to manipulate their own brain activity using the sensory feedback abstracted from their brain activity. NFT has attracted attention in the field of motor learning due to its potential as an alternative or additional training method for general physical training. In this study, a systematic review of NFT studies for motor performance improvements in healthy adults and a meta-analysis on the effectiveness of NFT were conducted. A computerized search was performed using the databases Web of Science, Scopus, PubMed, JDreamIII, and Ichushi-Web to identify relevant studies published between January 1st, 1990, and August 3rd, 2021. Thirty-three studies were identified for the qualitative synthesis and 16 randomized controlled trials (374 subjects) for the meta-analysis. The meta-analysis, including all trials found in the search, revealed significant effects of NFT for motor performance improvement examined at the timing after the last NFT session (standardized mean difference = 0.85, 95% CI [0.18-1.51]), but with the existence of publication biases and substantial heterogeneity among the trials. Subsequent meta-regression analysis demonstrated the dose-response gradient between NFTs and motor performance improvements; more than 125 min of cumulative training time may benefit for the subsequent motor performance. For each motor performance measure (e.g., speed, accuracy, and hand dexterity), the effectiveness of NFT remains inconclusive, mainly due to its small sample sizes. More empirical NFT studies for motor performance improvement may be needed to show beneficial effects on motor performance and to safely incorporate NFT into real-world scenarios.
Topics: Adult; Humans; Neurofeedback; Psychomotor Performance
PubMed: 36870431
DOI: 10.1016/j.neuroimage.2023.120000 -
Journal of Neurology Jun 2023Motor-cognitive training in Parkinson's disease (PD) can positively affect gait and balance, but whether motor-cognitive (dual-task) performance improves is unknown.... (Meta-Analysis)
Meta-Analysis Review
Motor-cognitive training in Parkinson's disease (PD) can positively affect gait and balance, but whether motor-cognitive (dual-task) performance improves is unknown. This meta-analysis, therefore, aimed to establish the current evidence on the effects of motor-cognitive training on dual-task performance in PD. Systematic searches were conducted in five databases and 11 studies with a total of 597 people (mean age: 68.9 years; mean PD duration: 6.8 years) were included. We found a mean difference in dual-task gait speed (0.12 m/s (95% CI 0.08, 0.17)), dual-task cadence (2.91 steps/min (95% CI 0.08, 5.73)), dual-task stride length (10.12 cm (95% CI 4.86, 15.38)) and dual-task cost on gait speed (- 8.75% (95% CI - 14.57, - 2.92)) in favor of motor-cognitive training compared to controls. The GRADE analysis revealed that the findings were based on high certainty evidence. Thus, we can for the first time systematically show that people with PD can improve their dual-task ability through motor-cognitive training.
Topics: Humans; Aged; Task Performance and Analysis; Parkinson Disease; Cognitive Training; Gait; Walking Speed
PubMed: 36820916
DOI: 10.1007/s00415-023-11610-8 -
Neuroscience and Biobehavioral Reviews Apr 2023Living in a social world requires social monitoring, i.e., the ability to keep track of others' actions and mistakes. Here, we demonstrate the good reliability of the... (Review)
Review
Living in a social world requires social monitoring, i.e., the ability to keep track of others' actions and mistakes. Here, we demonstrate the good reliability of the behavioral and neurophysiological indexes ascribed to social monitoring. We also show that no consensus exists on the cognitive bases of this phenomenology and discuss three alternative hypotheses: (i) the direct matching hypothesis, postulating that observed errors are processed through automatic simulation; (ii) the attentional hypothesis, considering errors as unexpected events that take resources away from task processing; and (iii) the goal representation hypothesis, which weighs social error monitoring depending on how relevant the other's task is to the observer's goals. To date, evidence on the role played by factors that could help to disentangle these hypotheses (e.g., the human vs. non-human nature of the actor, the error rate, and the reward context) is insufficient, although the goal representation hypothesis seems to receive more support. Theory-driven experimental designs are needed to enlighten this debate and clarify the role of error monitoring during interactive exchanges.
Topics: Humans; Interpersonal Relations; Reproducibility of Results; Social Environment; Psychomotor Performance
PubMed: 36758826
DOI: 10.1016/j.neubiorev.2023.105077 -
Environmental Research Apr 2023The field of greenspace and bluespace research in relation to cognitive outcomes is rapidly growing. Several systematic reviews have already been published on this topic... (Review)
Review
BACKGROUND
The field of greenspace and bluespace research in relation to cognitive outcomes is rapidly growing. Several systematic reviews have already been published on this topic but none of them are specific to cognitive outcomes in the entire age range of children. Moreover, only a few of them have examined the effects of bluespace in addition to greenspace. Also, theses reviews are focused either only on observational studies or experimental studies. Our systematic review focuses on cognitive outcomes in relation to greenspace and bluespace in children and adolescents aged 0-18; it captures both observational and experimental studies. Cognitive outcomes are presented according to an evidence-based taxonomy of human cognitive abilities: the Cattell-Horn-Carroll (CHC) theory.
METHODS
We conducted searches in the PubMed and PsychInfo databases, from their inception dates to 17 December 2021. We used three-text terms related to outcome, exposure, and population as well as MeSH terms for outcome and population. Further, the reference lists and existing reviews were searched ("snowball" search) until 21 April 2022 to detect additional studies. For the results reporting, we followed the updated guidelines of the Preferred Reporting Items for Systematic reviews and Meta Analyses (PRISMA). We included observational and experimental studies on greenspace or bluespace exposure in relation to cognitive functioning, published in English, German, or Polish. Two reviewers independently checked study eligibility and extracted data. Two reviewers evaluated the risk of bias according to the Office of Health Assessment and Translation (OHAT) tool. At all stages, discrepancies between the two reviewers were solved via discussion with a third reviewer.
RESULTS
Records identified from PubMed (n = 2030) and PsycINFO (n = 1168) were deduplicated and screened. Twenty one reports were first selected. The "snowball" search revealed 16 additional reports. Altogether, 39 studies (17 experimental and 22 observational) published in 37 reports were qualified. The data extraction showed that the methodology used in the studies was heterogenous and the findings were inconsistent. The majority of the studies investigated attentional functioning, which we subdivided into two categories according to the CHC theory: attentional control and reaction and decision speed (12 studies) and attentional control and processing speed (10 studies). Eleven studies investigated working memory and/or short-term memory that we categorized as CHC working memory capacity. Nine studies investigated intellectual functioning, which we categorized as CHC general ability, fluid reasoning, and comprehension-knowledge. Two studies investigated visual-spatial skills, which we categorized as CHC visual processing and psychomotor speed. One study measured parent-reported attention; two studies examined early childhood/cognitive development; three studies examined decision-making and self-regulation, which can be categorized as several CHC theory abilities.
DISCUSSION
The heterogeneity of the included studies does not permit clear conclusions for our review. In accordance with previous systematic reviews, greenspace and bluespace were not more strongly related to a particular domain of cognitive functioning than other cognitive domains, and no effects of age or type of exposure assessment on the association between nature and cognition were detected. Further research is needed, including state-of-the-art of assessment of cognitive outcomes and diverse exposure assessment methods within both observational and experimental approaches. Expertise will be required in several domains, such as environmental epidemiology, cognitive psychology, and neuropsychology. Systematic review registration number (INPLASY): 202220018.
Topics: Adolescent; Humans; Child; Child, Preschool; Parks, Recreational; Cognition; Memory, Short-Term; Processing Speed
PubMed: 36731600
DOI: 10.1016/j.envres.2023.115340 -
EClinicalMedicine Feb 2023Catatonia is a psychomotor syndrome that has a wide range of aetiologies. Determining whether catatonia is due to a medical or psychiatric cause is important for...
BACKGROUND
Catatonia is a psychomotor syndrome that has a wide range of aetiologies. Determining whether catatonia is due to a medical or psychiatric cause is important for directing treatment but is clinically challenging. We aimed to ascertain the performance of the electroencephalogram (EEG) in determining whether catatonia has a medical or psychiatric cause, conventionally defined.
METHODS
In this systematic review and meta-analysis of diagnostic test accuracy (PROSPERO CRD42021239027), Medline, EMBASE, PsycInfo, and AMED were searched from inception to May 11, 2022 for articles published in peer-reviewed journals that reported EEG findings in catatonia of a medical or psychiatric origin and were reported in English, French, or Italian. Eligible study types were clinical trials, cohort studies, case-control studies, cross-sectional studies, case series, and case reports. The reference standard was the final clinical diagnosis. Data extraction was conducted using individual patient-level data, where available, by two authors. We prespecified two types of studies to overcome the limitations anticipated in the data: larger studies ( ≥ 5), which were suitable for formal meta-analytic methods but generally lacked detailed information about participants, and smaller studies ( < 5), which were unsuitable for formal meta-analytic methods but had detailed individual patient level data, enabling additional sensitivity analyses. Risk of bias and applicability were assessed with the QUADAS-2 tool for larger studies, and with a published tool designed for case reports and series for smaller studies. The primary outcomes were sensitivity and specificity, which were derived using a bivariate mixed-effects regression model.
FINDINGS
355 studies were included, spanning 707 patients. Of the 12 larger studies (5 cohort studies and 7 case series), 308 patients were included with a mean age of 48.2 (SD = 8.9) years. 85 (52.8%) were reported as male and 99 had catatonia due to a general medical condition. In the larger studies, we found that an abnormal EEG predicted a medical cause of catatonia with a sensitivity of 0.82 (95% CI 0.67-0.91) and a specificity of 0.66 (95% CI 0.45-0.82) with an of 74% (95% CI 42-100%). The area under the summary ROC curve offered excellent discrimination (AUC = 0.83). The positive likelihood ratio was 2.4 (95% CI 1.4-4.1) and the negative likelihood ratio was 0.28 (95% CI 0.15-0.51). Only 5 studies had low concerns in terms of risk of bias and applicability, but a sensitivity analysis limited to these studies was similar to the main analysis. Among the 343 smaller studies, 399 patients were included, resulting in a sensitivity of 0.76 (95% CI 0.71-0.81), specificity of 0.67 (0.57-0.76) and AUC = 0.71 (95% CI 0.67-0.76). In multiple sensitivity analyses, the results were robust to the exclusion of reports of studies and individuals considered at high risk of bias. Features of limbic encephalitis, epileptiform discharges, focal abnormality, or status epilepticus were highly specific to medical catatonia, but features of encephalopathy had only moderate specificity and occurred in 23% of the cases of psychiatric catatonia in smaller studies.
INTERPRETATION
In cases of diagnostic uncertainty, the EEG should be used alongside other investigations to ascertain whether the underlying cause of catatonia is medical. The main limitation of this review is the differing thresholds for considering an EEG abnormal between studies.
FUNDING
Wellcome Trust, NIHR Biomedical Research Centre at University College London Hospitals NHS Foundation Trust.
PubMed: 36636294
DOI: 10.1016/j.eclinm.2022.101808 -
PloS One 2022Augmented feedback, including that provided using technology, can elicit multifaceted benefits on perceptual-motor learning and performance of sporting skills. However,... (Meta-Analysis)
Meta-Analysis
Augmented feedback, including that provided using technology, can elicit multifaceted benefits on perceptual-motor learning and performance of sporting skills. However, current considerations of the applied value in supporting learning and teaching cricket skill is limited. This systematic review with meta-analysis aimed to understand the role and effectiveness of feedback-involved interventions on skill-based performance outcomes in cricket-related research. Six electronic databases were searched (SPORTDiscus, CINAHL, MEDLINE, Scopus, Web of Science and PsycINFO). Of 8,262 records identified, 11 studies met inclusion criteria; five of which were included in meta-analyses. Given no studies with an isolated feedback intervention-arm were identified, the two meta-analyses explored anticipation-based studies consisting of an intervention that included augmented feedback; positioned with respect to the key motor skill concepts of perception (anticipation accuracy) and action (performance success). Despite results highlighting improved performance outcomes for the feedback-involved intervention groups, with a large effect size for improved anticipation accuracy (Hedge's g = 1.21, 95% CIs [-0.37, 2.78]) and a medium effect size for overall performance success (Hedge's g = 0.55, 95% CIs [-0.39, 1.50]), results were not statistically significant and should be interpreted with caution given the wide confidence intervals. Considering the small number of studies available, in addition to the lack of isolated feedback protocols, further research is warranted to thoroughly explore the impact of augmented feedback on skill-based performance in cricket. Beyond the meta-analyses, the review also explored all included studies from an ecological dynamics perspective; presenting future avenues of research framed around evaluating the applied value of using augmented feedback (mediated with or without technology) for learning and teaching skill in cricket. Trial registration The protocol was preregistered with Open Science Framework (osf.io/384pd).
Topics: Feedback; Learning; Motor Skills; Clinical Competence; Technology
PubMed: 36525446
DOI: 10.1371/journal.pone.0279121