Motor learning is particularly challenging in neurological rehabilitation: patients who suffer from neurological diseases experience both physical limitations and difficulties of cognition and communication that affect and/or complicate the motor learning process. Therapists (e.g.,, physiotherapists and occupational therapists) who work in neurorehabilitation are therefore continuously searching for the best way to facilitate patients during these intensive learning processes. To support therapists in the application of motor learning, a framework was developed, integrating knowledge from the literature and the opinions and experiences of international experts. This article presents the framework, illustrated by cases from daily practice. The framework may assist therapists working in neurorehabilitation in making choices, implementing motor learning in routine practice, and supporting communication of knowledge and experiences about motor learning with colleagues and students. The article discusses the framework and offers suggestions and conditions given for its use in daily practice.
There is a wide range of literature suggesting that implicit learning is more effective than explicit learning when acquiring motor skills. However, the acquisition of nursing skills in educational settings continues to rely heavily on detailed protocols and explicit instructions. This study aimed to examine the necessity for comprehensive protocols in the acquisition of nursing skills. In the context of bandaging techniques, three studies were conducted to investigate whether students who practiced with an instruction card containing minimal instructions (implicit group) performed comparably to the students who practiced with a protocol containing step-by-step instructions (explicit group). Study 1 was designed to determine whether both groups performed equally well in applying a bandage during training. Study 2 and 3 were designed to determine if both groups performed equally well during a retention and transfer (multitasking) test, administered after a series of three training sessions. In comparison with the explicit group, the implicit group demonstrated comparable performance with their practice attempts in Study 1 and performed equally well during the retention and transfer test in Study 2. Furthermore, several results from Study 3 indicated better performance of the implicit group. In conclusion, the use of protocols with explicit step-by-step instructions may not be essential for the acquisition of nursing skills. Instead, instructional methods that facilitate implicit learning may be preferable, as students in the implicit group demonstrated at least comparable performance in all studies and tended towards greater consistency when multitasking.
Background: Motor learning is central to domains such as sports and rehabilitation; however, often terminologies are insufficiently uniform to allow effective sharing of experience or translation of knowledge. A study using a Delphi technique was conducted to ascertain level of agreement between experts from different motor learning domains (i.e., therapists, coaches, researchers) with respect to definitions and descriptions of a fundamental conceptual distinction within motor learning, namely implicit and explicit motor learning. Methods: A Delphi technique was embedded in multiple rounds of a survey designed to collect and aggregate informed opinions of 49 international respondents with expertise related to motor learning. The survey was administered via an online survey program and accompanied by feedback after each round. Consensus was considered to be reached if $70% of the experts agreed on a topic. Results: Consensus was reached with respect to definitions of implicit and explicit motor learning, and seven common primary intervention strategies were identified in the context of implicit and explicit motor learning. Consensus was not reached with respect to whether the strategies promote implicit or explicit forms of learning. Discussion: The definitions and descriptions agreed upon may aid translation and transfer of knowledge between domains in the field of motor learning. Empirical and clinical research is required to confirm the accuracy of the definitions and to explore the feasibility of the strategies that were identified in research, everyday practice and education.
