Does contextual interference impact the retention of complex bimanual laparoscopic skills?


Laparoscopy simulation trainers have increased in accessibility which has encouraged endorsement of evidence-based training protocols. Yet, well-known motor learning effects may not extend to complex bimanual motor skills practiced with these devices. Contextual interference is a robust effect that is also feasible to implement in training. Blocked practice provides low contextual interference through repetition of the same skill over multiple trials before initiating a new skill. High contextual interference is produced through random practice where there is a random switching of practiced skills per trial. Blocked practice has been shown to increase skill performance during acquisition whereas random practice improves skill retention and transfer. We studied contextual interference learning effects during practice using a laparoscopy box trainer and a peg-transfer task. Participants completed fifty-four practice-trials using either blocked or random practice where they transferred pegs between two Maryland forceps to build one of three specified patterns. Participants undergoing blocked practice completed 18-trials of each pattern before proceeding to the next pattern. Participants undergoing random practice pseudo-randomly alternated between the three patterns. After a 10-min delay, all participants built each pattern once as a retention test. An identical retention test was performed after 10-days. Performance was measured by the time required to complete patterns with videos being used to determine duration in seconds. Time-to-completion in both the 10-min and 10-day retention tests did not significantly differ between those in either group. Our results thus far suggest high contextual interference practice schedules do not encourage retention of complex bimanual tasks.