ObjectiveRepeated 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.MethodsWe 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.ResultsThe 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.ConclusionSpacing 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.
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The aim of the present study was to find early markers for overreaching that are applicable in sport practice. In a group of elite soccer players aged 15–18, the stress–recovery balance and reaction times before and after exercise were assessed. Overreaching was indicated by an elevated submaximal heart rate during a sport-specific field test. Submaximal changes in heart rate were prospectively monitored by means of monthly Interval Shuttle Run Tests during two competitive seasons. Out of 94 players, seven players with an elevated heart rate of at least one month could be included in the study, together with seven controls, matched for age, body composition, training and performance level. The stress–recovery balance was assessed with the Dutch version of the Recovery Stress Questionnaire (RESTQ-Sport). The soccer players with an elevated heart rate reported a disturbed stress–recovery balance (Mann–Whitney test, P<0.05). An ANOVA for repeated measures of reaction times revealed a significant main effect of time (F 1,12=13.87, P<0.01) indicating an improvement of psychomotor speed. No differences between groups were found. We conclude that soccer players with an elevated submaximal heart rate of at least one month share a disturbed stress–recovery balance, but they could not be distinguished from controls based on reaction time after strenuous exercise.
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Comparisons of visual perception, response-selection, and response-execution performance were made between Type 2 diabetes mellitus patients and a matched nondiabetic control group. 10 well-controlled male patients with Type 2 diabetes without diabetic complications (M age 58 yr.) and an age and IQ-matched non-diabetic control group consisting of 13 male healthy volunteers (M age 57 yr.) were included. Significant differences were found only between the two groups on response-selection performance, which concerns the selection and preparation of an appropriate motor action.
