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 authors present the design of the shipping simulation SEL and its integration in the MSP Challenge Simulation Platform. This platform is designed to give policymakers and planners insight into the complexity of Maritime Spatial Planning (MSP) and can be used for interactive planning support. It uses advanced game technology to link real geo- and marine data with simulations for ecology, energy and shipping. The shipping sector is an important economic sector with influential stakeholders. SEL calculates the (future) impact of MSP decisions on shipping routes. This is dynamically shown in key performance indicators (e.g. route efficiencies) and visualised in heat maps of ship traffic. SEL uses a heuristic-based graph-searching algorithm to find paths from one port to another during each simulated month. The performance of SEL was tested for three sea basins: the firth of Clyde, Scotland (smallest), North Sea (with limited data) and Baltic Sea regions (largest, with most complete data). The behaviour of the model is stable and valid. SEL takes between 4 and 17 seconds to generate the desired monthly output. Experiences in 20 sessions with 302 planners, stakeholders and students indicate that SEL is a valuable addition to MSP Challenge, and thereby to MSP.
