Task sequencing effects for open and closed loop laparoscopic skills.

The present study examined laparoscopic skill acquisition on a simulator for different sequences of open and closed loop tasks. Sixteen medical students were divided into four groups distinguished by their initial training task and subsequent transfer task. Group 1 practiced instrument navigation, an open loop task, and then transferred to grasping, a closed loop task. Group 2 practiced grasping, and then transferred to the instrument navigation task. Group 3 practiced instrument navigation and then transferred to a complex cutting task that involved both open and closed loop components. Group 4 practiced grasping and then transferred to the cutting task. The results showed distinct task sequencing effects in favor of initial practice on a closed loop task. Specifically, task completion times declined significantly when participants practiced the closed loop task followed by the open loop task. The benefits of initial practice on a closed loop task, however, were limited primarily to accuracy measures when participants transferred to the complex cutting task. The findings indicate that task order is important and that training on one task can either facilitate or impede skill acquisition on a subsequent task and that these differences reflect fundamental psychomotor characteristics of the tasks.