#KeyLIMEPodcast 75: Chronometry to Learn Procedures

It probably comes as no surprise to anyone who knows me that I’m a little (??) bit competitive.  The point was particularly highlighted this holiday season when my son received a cup stacking game (think Anna Kendrick singing “Cups (When I’m gone)”).  Essentially you need to stack and unstack plastic tumblers into particular designs, racing against a clock.  I could not beat my son.  I blamed the ratio of cup size : adult fingers.  I suggested my developing presbyopia impaired depth perception. I wondered whether the table was set at the official speed stacking regulation height.  Still, no wins.  (Did I mention the kid is eight years old.) So, what did I do.

I practiced. I practiced.  I would try different grips, different approaches; all in an effort to shave two extra seconds off the time.

I would love to tell you that all of the practice led to a victory… but… no dice.  I did improve my time.  But competing against a kid who has honed his reflexes playing videogames is a non-starter.

The KeyLIME podcast this week tackles the same psychology that had me up into the late hours of the night playing with plastic cups – chronometry, using the measurement of time to promote learning. Martin Pusic , who has done excellent research on the learning curves and deliberate practice provides a narrative review of the potential learning effects of “using a stop watch.”

As always check out the whole podcast for a more in-depth analysis of the article.

– Jonathan

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KeyLIME Session 75 – Article under review:

Listen to the podcast

View/download the abstract here.

Pusic MV, Brydges R, Kessler D, Szyld D, Nachbar 4, Kalet A. What’s your best time? Chronometry in the learning of medical procedures, Medical Education, May 2014, 48 (5): 479-88

Reviewer: Jonathan Sherbino (@sherbino)

Dr. Karpinski with ipad

Background
Measuring time to complete a task is often incorporated into simulation. Mostly it is used as surrogate marker of competence in simulation-based assessment. In Cook et al.’s landmark systematic review of learning + simulation (KeyLIME Podcast Episode #44) measuring time was rarely used to promote learning. Yet, this seems counterintuitive to how we use time in other “simulations” that are part of our everyday life….video games. The score clock in the corner of my son’s video games, definitely provides incentive to master a task and maximize efficiency.

Purpose
The purpose of this narrative review was to determine if incorporation of measurements of time (i.e. chronometry) improves learner performance.

Type of paper
Narrative review

Key Points on the Methods
The search strategy is reproducible (n=267), but subject to bias, as none of the
PRISMA guidelines were explicitly followed. Essentially it was a simple PubMed
search without safeguards to ensure the reliability of the articles chosen or the data
selected.

Key Outcomes
Chronometrics correlate with learning; time to completion correlates with other
markers of education success. Very few studies incorporate chronometry into
instructional methods to promote learning.

Time may be an effective metric in deliberate practice simulation-based learning.

Positive effects of chronometry for learning
– Increase learner arousal
– Increase motivation
-Promote over learning
-Promote adaptive efficiencies
-Promote metacognition

Positive effects of chronometry for assessment
-Sensitive discrimination
-Determine consistency
-Promote efficiency as a metric

Negative effects of chronometry
– Distraction from core objectives
– May impair developmental arc
– Context specificity

Key Conclusions
The authors conclude…“that chronometry has been underutilized in the learning of
medical procedures. Although faster is not always better in medical procedures,
clinicians are often under time pressure and therefore need to balance accuracy with
speed… [Chronometry] has the potential to improve the conditions for deliberate
practice and self-regulated learning.

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