Shewokis Patricia A, Shariff Faiz U, Liu Yichuan, Ayaz Hasan, Castellanos Andres, Lind D Scott
Nutrition Sciences Department, College of Nursing and Health Professions, Drexel University, Philadelphia, PA 19102, USA; School of Biomedical Engineering, Science and Health Systems, Drexel University, Philadelphia, PA 19104, USA.
Department of Surgery, Drexel University College of Medicine, Philadelphia, PA 19102, USA.
Am J Surg. 2017 Feb;213(2):336-345. doi: 10.1016/j.amjsurg.2016.11.043. Epub 2016 Dec 1.
Using functional near infrared spectroscopy, a noninvasive, optical brain imaging tool that monitors changes in hemodynamics within the prefrontal cortex (PFC), we assessed performance and cognitive effort during the acquisition, retention and transfer of multiple simulated laparoscopic tasks by novice learners within a contextual interference paradigm.
Third-year medical students (n = 10) were randomized to either a blocked or random practice schedule. Across 3 days, students performed 108 acquisition trials of 3 laparoscopic tasks on the LapSim simulator followed by delayed retention and transfer tests. Performance metrics (Global score, Total time) and hemodynamic responses (total hemoglobin (μm)) were assessed during skill acquisition, retention and transfer.
All acquisition tasks resulted in significant practice schedule X trial block interactions for the left medial anterior PFC. During retention and transfer, random performed the skills in less time and had lower total hemoglobin change in the right dorsolateral PFC than blocked.
Compared with blocked, random practice resulted in enhanced learning through better performance and less cognitive load for retention and transfer of simulated laparoscopic tasks.
使用功能近红外光谱技术，一种监测前额叶皮质（PFC）内血流动力学变化的无创光学脑成像工具，我们在情境干扰范式下评估了新手学习者在多个模拟腹腔镜任务的获取、保留和转移过程中的表现及认知努力程度。
将三年级医学生（n = 10）随机分为集中练习组或随机练习组。在3天时间里，学生们在LapSim模拟器上对3项腹腔镜任务进行108次获取试验，随后进行延迟保留和转移测试。在技能获取、保留和转移过程中评估表现指标（整体评分、总时间）和血流动力学反应（总血红蛋白（μm））。
所有获取任务在左内侧前额叶皮质均产生了显著的练习计划X试验组块交互作用。在保留和转移过程中，随机练习组完成技能的时间更短，且右侧背外侧前额叶皮质的总血红蛋白变化低于集中练习组。
与集中练习相比，随机练习通过更好的表现以及在保留和转移模拟腹腔镜任务时更低的认知负荷，带来了更好的学习效果。
