title: Acquisition, retention and transfer of simulated laparoscopic tasks using fNIR and a contextual interference paradigm.
abstract: BACKGROUND
  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.
  
  
  METHODS
  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.
  
  
  RESULTS
  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.
  
  
  CONCLUSIONS
  Compared with blocked, random practice resulted in enhanced learning through better performance and less cognitive load for retention and transfer of simulated laparoscopic tasks.
authors.affiliation: 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. Electronic address: pas38@drexel.edu.
authors.forename: Patricia A
authors.initials: PA
authors.lastname: Shewokis
authors.affiliation: Department of Surgery, Drexel University College of Medicine, Philadelphia, PA 19102, USA. Electronic address: fizashariff@gmail.com.
authors.forename: Faiz U
authors.initials: FU
authors.lastname: Shariff
authors.affiliation: School of Biomedical Engineering, Science and Health Systems, Drexel University, Philadelphia, PA 19104, USA. Electronic address: yl565@drexel.edu.
authors.forename: Yichuan
authors.initials: Y
authors.lastname: Liu
authors.affiliation: School of Biomedical Engineering, Science and Health Systems, Drexel University, Philadelphia, PA 19104, USA; Department of Family and Community Health, University of Pennsylvania, Philadelphia, PA 19104, USA; Division of General Pediatrics, Children's Hospital of Philadelphia, Philadelphia, PA 19104, USA. Electronic address: hasan.ayaz@drexel.edu.
authors.forename: Hasan
authors.initials: H
authors.lastname: Ayaz
authors.affiliation: Department of Surgery, Drexel University College of Medicine, Philadelphia, PA 19102, USA. Electronic address: andres.castellanos@drexelmed.edu.
authors.forename: Andres
authors.initials: A
authors.lastname: Castellanos
authors.affiliation: Department of Surgery, Drexel University College of Medicine, Philadelphia, PA 19102, USA. Electronic address: david.lind@jax.ufl.edu.
authors.forename: D Scott
authors.initials: DS
authors.lastname: Lind
mesh_terms: D004521:Educational Measurement / Q000379:methods*; D006454:Hemoglobins / Q000032:analysis; D006801:Humans; D010535:Laparoscopy / Q000193:education*; D007858:Learning; D017397:Prefrontal Cortex / Q000000981:diagnostic imaging*; D011897:Random Allocation; D012153:Retention, Psychology; D000066908:Simulation Training; D019265:Spectroscopy, Near-Infrared
chemical_list: D006454:Hemoglobins
keywords: Contextual interference; Laparoscopic skill acquisition; Simulation; fNIR