Psychomotor Skills

Psychomotor skills are skills in which the processes involved are primarily muscular or are described in
glandular or in muscular terms. Examples include typing skills and other motion derived skills

PHASES OF PSYCHOMOTOR SKILL LEARNING

 Imitation
o Student repeats what is done by the instructor
o “See one, do one”
o Avoid modeling wrong behavior because the student will do as you do
o Some skills are learned entirely by observation, with no need for formal instruction
 Manipulation
o Using guidelines as a basis or foundation for the skill (skill sheets)
o May make mistakes
a. Making mistakes and thinking through corrective actions is a significant way to
learn
o Perfect practice makes perfect
a. Practice of a skill is not enough, students must perform the skill correctly
o The student begins to develop his or her own style and techniques
a. Ensure students are performing medically acceptable behaviors
 Precision
o The student has practiced sufficiently to perform skill without mistakes
o Student generally can only perform the skill in a limited setting
 Articulation
o The student is able to integrate cognitive and affective components with skill
performance
a. Understands why the skill is done a certain way
b. Knows when the skill is indicated
o Performs skill proficiently with style
o Can perform skill in context
 Naturalization
o Mastery level skill performance without cognition
o Also called "muscle memory"
o Ability to multitask effectively
o Can perform skill perfectly during scenario, simulation, or actual patient situation
ATTENTION FEEDBACK PRACTICE
 Use self-assessment
o Ask students to self-assess, providing them with self-assessment criteria or helping them
to develop their own.
o Ensures students take responsibility for their own learning, focuses attention on criteria
for success, and increases effort and persistence.
 Give learning-centered feedback
o Medal – for what the student can do or has done well. Effort persistence and other
good study habits can be included in the criteria.
o Mission – what the student needs to do to improve. This can be an improvement to the
existing work, or a target (feed-forward task) for the next piece of work.
 Tasks
o Provide positive comments on the completion of tasks, strengths, criterion-referenced
achievement etc.
o Mastery tasks – provides opportunities to give positive feedback to the lowest attainers.
 Meeting Personal Targets
o If students are encouraged to self-assess and set targets for improvement, then the
teacher can comment on a student’s progress towards these targets.
 Improvements
o Effected by the student can be positively commented on.
 Mastery Learning
o This is a series of easy tests on key material set every four or six weeks, with retests for
those students who do not pass. It takes time to set this up, but it works very well. See
the ‘Mastery Learning’ chapter in Teaching Today.
 Formative teaching methods
o That find faults, fix, and follow up’ see the handout called ‘formative teaching methods

MENTAL PRACTICE
 The symbolic rehearsal of a physical activity in the absence of any gross muscular movement
(Richardson, 1967)
 Achieved through the use of mental imagery
 Mental practice can be used for error detection and modifications to our technique.
 Research evidence suggests mentally practicing a skill prepares our minds and bodies to actually
perform the skill.
 Another explanation suggests it’s a matter of properly focusing our attention.
Learning Psychomotor Skills
PHASES OF SKILL LEARNING
 COGNITIVE PHASE
o The learner is a novice
o The novice begins to acquire the verbal information and procedural rule components of
the skill
o This phase is guided by trial and error and performance is erratic
o Retrieval of knowledge is labor-intensive and effortful
o Explanations and demonstrations are required to achieve the cognitive learning
requirements of psychomotor skills.
 ASSOCIATIVE PHASE
o Two things happens:
 Error in the initial understanding of the skill are gradually detected and
eliminated.
 The connections among the various steps of the procedure are strengthened.
o The learner is able to associate the cognitive knowledge of the skill with the muscular
movements required to perform the skill successfully.
 AUTONOMOUS PHASE
o With repeated practice, the skill fine-tuned, gains speed of execution, and ultimately
loss of conscious access.
o Practice and feedback allow the learner to progress from the jerky or fumbling efforts of
the novice to the smooth, controlled, and apparently effortless actions that characterize
the expert performance of a psychomotor skill.

Teaching Skills
A SIMPLE FIVE METHODS FOR TEACHING
STEP 1

 Overview: To be motivated to learn a skill, the learner must understand why the skill is needed
and how it is used in the delivery of care.

STEP 2

 The teacher should demonstrate the skill exactly as it should be done without talking through
the procedure.
 This image is important since students will use this picture to self-evaluate their own
performance when practicing the skill.
STEP 3

 The teacher then repeats the procedure but takes time to describe in detail each step in the
process. This will help students see how each step fits into the optimal sequence and will allow
time for students to ask questions or seek clarification of a step or a procedure.

STEP 4

 Students talk through the skill. By asking students to describe step by step how to do the skill.
 This will also help the students commit the process to memory so they can recall steps as they
move to the next procedure.

STEP 5

 The students perform the skill. Now students are ready to do their first attempt at the skill with
the teacher carefully observing and providing feedback or coaching as needed. Following a
successful attempt, students should continue to practice until they reach the desired level of
proficiency.

ASSESSMENT OF PSYCHOMOTOR SKILL LEARNING

 Assess performance—Observe performance and computerized performance rating.
 Provide feedback and remediation—Dispense suggestions on how to perform the skill and help
 Learner understands what to do next.

Promoting and Assessing Critical Thinking

CRITICAL THINKING EXERCISES:
1. What is special about the following sequence of numbers?
8 5 4 9 1 7 6 10 3 2 0
o The numbers are in alphabetical order.
(eight, five, four, nine, one, seven, six, ten, three, two, zero)
2. A rooster lays an egg at the very top of a slanted roof. Which side of the egg going to roll off on?
o Neither, roosters don't lay eggs.
3. You are the bus driver. At your first stop, you pick up 29 people. On your second stop, 18 of
those 29 people get off, and at the same time 10 new passengers arrive. At your next stop, 3 of
those 10 passengers get off, and 13 new passengers come on. On your fourth stop 4 of the
remaining 10 passengers get off, 6 of those new 13 passengers get off as well, and then 17 new
passengers get on. What is the color of the bus driver's eyes?
o The eye color of the reader of this problem. The first sentence is the key: "You are the
bus driver"
What is Critical Thinking?

1. “A composite (something composed of different parts) of attitude of inquiry; knowledge of the

nature of valid inferences, abstractions, and generalizations: and skills in employing and
applying those attitudes and this knowledge. – Watson and Glaser (1964)
2. Critical thinking can be defined as being able to examine an issue by breaking it down, and
evaluating it in a conscious manner, while providing arguments/evidence to support the
evaluation.
3. Critical thinking approach views learning as a shared responsibility between the teacher and the
learner.

ASPECTS OF CRITICAL THINKING

 REFLECTION – the process of purposefully thinking back or recalling situations to discover their
purpose or meaning
 LANGUAGE - ability to use language is closely associated with the ability to think meaningfully
 INTUITION – the direct understanding of particulars in a situation without conscious
deliberation

Distinguishing Critical Thinking from other Technology Concepts

 Critical thinking is essential to better decide which recommendations to incorporate into clinical
practice.
 There is a modern emphasis on evidence based medicine. In fact, much is based on clinical
anecdotes, uncontrolled investigations, and expert opinion.
 New technology often gets used without sufficient assessment due to medical interest, patient
demand for the technology, and sometimes financial incentives for health care providers.
 The advancement of technology is so rapid that it often exceeds its assessment.
 Many physicians are inadequately trained to think critically. Few residency and fellowship
programs incorporate research into their curriculum and few emphasize the importance of
critical thinking skills.

Ways We Inhibit the Critical Thinking of Medical Technology Students

 Formal/informal writing assignments or brief case studies

 Questions that involve reasoning skills and the ability to organize and articulate knowledge;
 Dialoging on complex problems. Identify the problem clearly and accurately. Elaborate or
illustrate only that which must be further explained for clarity, and eliminate irrelevant
information.
 Let students look back in their experiences and think of how they dealt with them.
 Let students ask more questions instead of giving an answer right away.
Strategies that Enhance Critical Thinking

1. DISCUSSION
 It is an oral exploration of a topic, object, concept or experience
 It is the Highest Level of Teaching
2. ASKING EFFECTIVE QUESTIONS
 Socratic Method
o Is a way of questioning where the teacher respond to all questions or comment
with more questions?
o It is intended to help the student seek to understand various points of view or
perspective.
 Structured Controversy
o Relies heavily on effective questioning
o Controversy is deliberately introduced and used to critical thinking
3. IN TEXT INTERACTION
 The students analyze, scrutinize and interact with the content of the reading materials
instead of just reading the article or textbook.
4. PROBLEM BASED LEARNING
 An approach to learning that expose the students to real life problems and working
together in small groups, analyze the case, decide what information they need and then
solve the problems.
5. CONCEPT MAPPING
 It involves drawings or diagrams which shows the mental connections on associations
that students make between a major or central concept that the teacher focuses on and
other concepts that a students have already learned.
 IT ALLOWS THE STUDENT TO:
o Examine their conceptual networks
o Compare their maps with their peers and experts
o Make explicit (definite) changes

ASSESSING CRITICAL THINKING

 Asks relevant questions.
 Analyses and evaluates key information and alternative points of view clearly and precisely.
 Fair-mindedly examines beliefs, assumptions, and opinions and weighs them against facts.
 Draws insightful, reasonable conclusions.
 Justifies inferences and opinions.
 Thoughtfully addresses and evaluates major alternative points of view.
 Thoroughly explains assumptions and reasons