Teaching Psychomotor Skills

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Teaching Psychomotor Skills

• Debra A. DaRosa, Ph.D.
• Professor of Surgery
• Vice Chair for Education
• Northwestern University

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What gets in the way of learning?
What enhances the learning of skills?
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Problems in Learning Skills

• Cognitive
• Perceptual
• Coordination
• Chain of motor responses
• Organization of response chains
• Eye hand coordination
• Tension - Relaxation
• Forgotten
• Emotion

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How do we acquire skills?

• A Skill Acquisition Model
• Cognitive
• Associative
• Automatic
• Fitts AM, Posner. Human Performance. Belmont CA
  Brooks-Cole 1967.

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Cognitive Stage

• Rationale, indications, contraindications and
  potential complications for the procedure
• Explain/demonstrate sequential steps
• Ensure learners can articulate sequential steps

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Cognitive Task Analysis

• Arises from Human Factors
• Group of analytical techniques designed to
  capture expert thinking
• Specifies the judgment and technical steps of a
  procedure

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CTA Example

• During the course of a laparoscopic
  cholecystectomy, the surgery resident variously
  strays into the lumen of the gallbladder and the
  parenchyma of the liver.

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Associative Phase

• Active 0bservation
• Diagnose any problems/strengths
• Prescribe (and demonstrate) a plan for
  improvement (feedback)
• Allow practice
• Repeat

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Feedback

• Inherent feedback
• Augmented feedback
• Knowledge of Results (KR)
• Knowledge of Performance (KP)
• FREQUENCY TIMING!!

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Empirical Findings Feedback

• Too much feedback is used as crutch
• KR feedback is better
• Learners learn more when expected to explore and
  evaluate their own errors
• Feedback given too quickly or frequently can
  short-change the learning process.

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Autonomous Stage

• Less intense attention
• Memorized motor movement/instincts
• Influenced less- external cues
• Unconsciously competent

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The Coach Model

• C Clear Performance Model
• O Openness to Learning
• A Assess Performance
• C Communication
• H Help and Follow-up