Advances in Health Sciences Education

, Volume 4, Issue 2, pp 123–143 | Cite as

The Effects of Modeling on Learning a Simple Surgical Procedure: See One, Do One or See Many, Do One?

  • Eugène J. F. M. Custers
  • Glenn Regehr
  • Wendy McCulloch
  • Charles Peniston
  • Richard Reznick


The effect of modeling a simple surgical task on the subsequent performance of pre-clinical medical students was investigated. Groups of students read a verbal description of the excision of a skin lesion and closure of the resulting wound. Subsequently, groups watched zero, one, or four videotapes in which expert surgeons demonstrated the task. Finally, students had to perform the task themselves four times. During the performances, students were rated by operating room nurses using a checklist and a global rating scale of surgical performance. Time to perform the task was also recorded. In general, the results showed significant effects of experimental condition and trial number: Subjects who watched either one or four models demonstrated similar performance and performed better than subjects who did not watch any model. Later trials showed better accomplishments than earlier trials, both in terms of the quality of the surgery and speed. For some measures, significant interaction effects were found, suggesting that the advantages of watching a model are reinforced, rather than weakened, by practical experience with the task. The results are discussed with respect to the literature on modeling of motor skill tasks and the practical implications for surgical education.

modeling motor skill learning practice surgical education 


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  1. Adams, J. A. (1971). A Closed-loop Theory of Motor Learning. Journal of Motor Behavior 3: 111–150.Google Scholar
  2. Adams, J. A. (1986). Use of the Model's Knowledge of Results to Increase the Observer's Performance. Journal of Human Movement Studies 12: 89–98.Google Scholar
  3. Annett, J. (1995). Imagery and Motor Processes: Editorial Overview. British Journal of Psychology 86: 161–167.Google Scholar
  4. Bandura, A. (1965). Influence of a Model's Reinforcement Contingencies on the Acquisition of Imitative Responses. Journal of Personality and Social Psychology 1: 589–595.CrossRefGoogle Scholar
  5. Bandura, A. (1969). Principles of Behavior Modification. New York: Holt, Rhinehart & Winston.Google Scholar
  6. Bandura, A. (1986). Social Foundations of Thought and Action: A Social Cognitive Theory. Englewood Cliffs, NJ: Prentice-Hall.Google Scholar
  7. Bandura, A. & Jeffery, R. W. (1973). Role of Symbolic Coding and Rehearsal Processes in Observational Learning. Journal of Personality and Social Psychology 26: 122–130.CrossRefGoogle Scholar
  8. Bandura, A., Jeffery, R. W. & Bachicha, D. L. (1974). Analysis of Memory Codes and Cumulative Rehearsal in Observational Learning. Journal of Research in Personality 7: 295–305.CrossRefGoogle Scholar
  9. Bandura, A. & McDonald, F. J. (1963). Influence of Social Reinforcement and the Behavior of Models in Shaping Children's Moral Judgments. Journal of Abnormal and Social Psychology 57: 274–281.CrossRefGoogle Scholar
  10. Bird, A. M., Ross, D., & Laguna, P. (1983). The Observational Learning of a Timing Task. ERIC # ED 269 370.Google Scholar
  11. Blandin, Y., Proteau, L. & Alain, C. (1994). On the Cognitive Processes Underlying Contextual Interference and Observational Learning. Journal of Motor Behavior 26(1): 18–26.CrossRefGoogle Scholar
  12. Carroll, W. R. & Bandura, A. (1987). Translating Cognition into Action: The Role of Visual Guidance in Observational Learning. Journal of Motor Behavior 19(3): 385–398.Google Scholar
  13. Carroll, W. R. & Bandura, A. (1990). Representational Guidance of Action Production in Observational Learning: A Causal Analysis. Journal of Motor Behavior 22(1): 85–97.Google Scholar
  14. Feltz, D. L. & Landers, D. M. (1983). Effects of Mental Practice on Motor Skill Learning and Performance: A Meta-analysis. Journal of Sport Psychology 5: 25–57.Google Scholar
  15. Feltz, D. L. (1982). The Effects of Age and Number of Demonstrations on Modeling of Form and Performance. Research Quarterly 53(4): 291–296.Google Scholar
  16. Gerst, M. S. (1971). Symbolic Coding Processes in Observational Learning. Journal of Personality and Social Psychology 19: 7–17.CrossRefGoogle Scholar
  17. Hall, E. G. & Erfmeyer, E. S. (1983). The Effect of Visuo-motor Behavior Rehearsal with Videotaped Modeling on Free Throw Accuracy of Intercollegiate Female Basketball Players. Journal of Sport Psychology 5: 343–346.Google Scholar
  18. Juaire, S. & Pargman, D. (1991). Pictures Versus Verbal Instructions to Assist the Learning of a Gross Motor Task. Journal of Human Movement Studies 20: 189–200.Google Scholar
  19. Kohl, R. M. & Shea, C. H. (1992). Observational Learning: Influences on Temporal Response Organization. Human Performance 5(3): 235–244.CrossRefGoogle Scholar
  20. Landers, D. M. (1975). Observational Learning of a Motor Skill: Temporal Spacing of Demonstrations and Audience Presence. Journal of Motor Behavior 7: 281–287.Google Scholar
  21. Lejeune, M., Decker, C. & Sanchez, X. (1994). Mental Rehearsal in Table Tennis Performance. Perceptual & Motor Skills 79 (Special Issue): 627–641.Google Scholar
  22. Lumsdaine, A. A., Sulzer, R. L. & Kopstein, F. F. (1961). The Effect of Animation Cues and Repetition of Examples on Learning from an Instructional Film. In Lumsdaine, A. A. (ed.) Student Response in Programmed Instruction, 241–269. Washington, DC: National Academy of Sciences — National Research Council.Google Scholar
  23. Magill, R. A. (1993). Motor Learning. Concepts and Applications. Fourth Edition. Madison, Wisconsin: Brown & Benchmark.Google Scholar
  24. Magill, R. A., Chamberlin, C. J. & Hall, K. G. (1991). Verbal Knowledge of Results as Redundant Information for Learning an Anticipation Timing Skill. Human Movement Science 10(4): 487–507.CrossRefGoogle Scholar
  25. Magill, R. A. & Schoenfelder-Zohdi, B. (1996). A Visual Model and Knowledge of Performance as Sources of Information for Learning a Rhythmic Gymnastics Skill. International Journal of Sport Psychology 27: 7–22.Google Scholar
  26. Martens, R., Burwitz, L. & Zuckerman, J. (1976). Modeling Effects on Motor Performance. Research Quarterly 47: 277–291.Google Scholar
  27. McCullagh, P. (1993). Modeling: Learning, Developmental, and Social Psychological Considerations. In Singer, R. N, Murphy, M. & Tennant, L. K. (eds.) Handbook of Research on Sport Psychology, 106–126. New York: Macmillan Publishers.Google Scholar
  28. McCullagh, P. & Caird, J. K. (1990). Correct and Learning Models and the Use of the Model Knowledge of Results in the Acquisition and Retention of a Motor Skill. Journal of Human Movement Studies 18: 107–116.Google Scholar
  29. McCullagh, P., Weiss, M. R. & Ross, D. (1989). Modeling Considerations in Motor Skill Acquisition and Performance: An Integrated Approach. In Pandolf, K. B. (ed.) Exercise and Sport Sciences Review, Vol. 17, 475–513. Baltimore, MD: Williams & Wilkins.Google Scholar
  30. McGuire, W. J. (1961). Some Factors Influencing the Effectiveness of Demonstrational Films: Repetition of Instructions, Slow Motion, Distribution of Showings, and Explanatory Narrations. In Lumsdaine, A. A. (ed.) Student Response in Programmed Instruction, 187–208. Washington, DC: National Academy of Sciences/National Research Council.Google Scholar
  31. McTavish, C. L. (1949). Effect of Repetitive Film Showings on Learning (Pennsylvania State University Instructional Film Research Program). Port Washington, NY: U.S. Naval Training Device Center, Office of Naval Research, Technical Report No. SDC 269–7–12, November 1949.Google Scholar
  32. Newell, K. M. (1981). Skill Learning. In Holding, D. (ed.) Human Skills, 203–226. New York: Wiley.Google Scholar
  33. Pollock, B. J. & Lee, T. D. (1992). Effect of the Model's Skill Level on Observational Motor Learning. Research Quarterly for Exercise and Sport 63(1): 25–29.Google Scholar
  34. Poulton, E. C. (1957) On Prediction in Skilled Movements. Psychological Bulletin 54: 467–478.CrossRefGoogle Scholar
  35. Ross, D., Bird, A. M., Doody, S. G. & Zoeller, M. (1985). Effects of Modeling and Video Feedback with Knowledge of Results on Motor Performance. Human Movement Science 4: 149–157.CrossRefGoogle Scholar
  36. Schmidt, R. A. (1975). A Schema Theory of Discrete Motor Skill Learning. Psychological Review 82: 225–260.CrossRefGoogle Scholar
  37. Sheffield, F. N. & Maccoby, N. (1961). Summary and Interpretation of Research on Organizational Principles in Constructing Filmed Demonstrations. In Lumsdaine, A. A. (ed.) Student Response in Programmed Instruction. Washington, DC: National Research Council.Google Scholar
  38. Sheffield, F. N. (1961). Theoretical Considerations in the Learning of Complex Sequential Tasks from Demonstrations and Practice. In Lumsdaine, A. A. (ed.) Student Response in Programmed Instruction, 13–32. Washington DC: National Academy of Sciences, National Research Council.Google Scholar
  39. Starkes, J. L. (1993). Motor Experts: Opening Thoughts. In Starkes, J. L. & Allard, F. (eds.) Cognitive Issues in Motor Expertise, 3–16. Elsevier Science Publishers B.V.Google Scholar
  40. Vogt, S. (1995). On Relations between Perceiving, Imagining and Performing in the Learning of Cyclical Movement Sequences. British Journal of Psychology 86(2): 191–216.Google Scholar
  41. Weeks, D. L. & Choi, J. (1992). Modelling the Perceptual Component of a Coincident-timing Skill: The Influence of Frequency of Demonstration. Journal of Human Movement Studies 23: 201–213.Google Scholar
  42. Weir, P. L. & Leavitt, J. L. (1990). Effects of Model's Skill Level and Model's Knowledge of Results on the Performance of a Dart Throwing Task. Human Movement Science 9: 369–383.CrossRefGoogle Scholar
  43. White, A. & Hardy, L. (1995). Use of Different Imagery Perspectives on the Learning and Performance of Different Motor Skills. British Journal of Psychology 86: 169–180.Google Scholar
  44. Williams, J. G. (1993). Motoric Modeling: Theory and Research. Journal of Human Movement Studies 24: 237–279.Google Scholar

Copyright information

© Kluwer Academic Publishers 1999

Authors and Affiliations

  • Eugène J. F. M. Custers
    • 1
  • Glenn Regehr
    • 1
  • Wendy McCulloch
    • 1
  • Charles Peniston
    • 1
  • Richard Reznick
    • 1
  1. 1.Centre for Research in Education and Department of Surgery, Faculty of MedicineUniversity of TorontoTorontoCanada

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