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1. Psychomotor Domain


Having a background in philosophy I am extremely comfortable looking at the cognitive domain. There's two reasons for this. The first is that the cognitive domain concerns knowledge and my PhD examined the conditions under which one can properly make a claim to knowledge. The second reason that I'm comfortable with the cognitive domain is that philosophy does not really require one to engage in psychomotor activity. On a good philosophical day one might do nothing more than sit and think with only the very occasional movement to make a cup of coffee.

There are three well known versions of the psychomotor domain and we are going to look briefly at each.

The psychomotor domain described by Simpson (Simpson, 1972) includes physical movement, coordination, and use of the motor-skill areas. Development of these skills requires practice and is measured in terms of speed, precision, distance, procedures, or techniques in execution. The seven major categories in Simpson's psychomotor domain are listed from the simplest behavior to the most complex:

1.1 Simpson's Psychomotor Domain


Elizabeth Simpson's interpretation of the Psychomotor domain differs from Dave's chiefly because it contains extra two levels prior to the initial imitation or copy stage. Arguably for certain situations, Simpson's first two levels, 'Perception' and 'Set' stage are assumed or incorporated within Dave's first 'Imitation' level, assuming that you are dealing with fit and healthy people (probably adults rather than young children), and that 'getting ready' or 'preparing oneself' is part of the routine to be taught, learned or measured. If not, then the more comprehensive Simpson version might help ensure that these two prerequisites for physical task development are checked and covered. As such, the Simpson model or the Harrow version is probably preferable than the Dave model for the development of young children.

psychomotor_domain.jpg

The skills in Simpson's psychomotor domain have been described as follows (Clark, 2009):

Perception: The ability to use sensory cues to guide motor activity. This ranges from sensory stimulation, through cue selection, to translation.
Set: Readiness to act. It includes mental, physical, and emotional sets. These three sets are dispositions that predetermine a person's response to different situations (sometimes called mindsets).
Guided Response: The early stages in learning a complex skill that includes imitation and trial and error. Adequacy of performance is achieved by practicing.
Mechanism: This is the intermediate stage in learning a complex skill. Learned responses have become habitual and the movements can be performed with some confidence and proficiency.
Complex Overt Response: The skillful performance of motor acts that involve complex movement patterns. Proficiency is indicated by a quick, accurate, and highly coordinated performance, requiring a minimum of energy. This category includes performing without hesitation, and automatic performance. For example, players are often utter sounds of satisfaction or expletives as soon as they hit a tennis ball or throw a football, because they can tell by the feel of the act what the result will produce.
Adaptation: Skills are well developed and the individual can modify movement patterns to fit special requirements.
Origination: Creating new movement patterns to fit a particular situation or specific problem. Learning outcomes emphasize creativity based upon highly developed skills.

1.2 Dave's Psychomotor Domain


The Dave version of the Psychomotor Domain is featured most prominently here because in my view it is the most relevant and helpful for work- and life-related development, although the Psychomotor Domains suggested by Simpson and Harrow are more relevant and helpful for certain types of adult training and development, as well as the teaching and development of young people and children, so do explore them all. Each has its uses and advantages. Dave's Psychomotor domain (Clark, 2009):

Dave's (1975):
Imitation: Observing and patterning behavior after someone else. Performance may be of low quality. Example: Copying a work of art.
assemble
follow
reproduce
attempt
mimic
respond
begin
move
sketch
calibrate
copy
start
carry out
organize
try
construct
practice
volunteer
dissect
proceed
duplicate
repeat

Manipulation: Being able to perform certain actions by following instructions and practicing. Example: Creating work on one's own, after taking lessons, or reading about it.
acquire
operate
assemble
execute
pace
complete
improve
perform
conduct
maintain
produce
do
make
progress
use
manipulate

Precision: Refining, becoming more exact. Few errors are apparent. Example: Working and reworking something, so it will be "just right."
automatize
reach
transcend
achieve
exceed
refine
accomplish
excel
succeed
advance
master
surpass

Articulation: Coordinating a series of actions, achieving harmony and internal consistency. Example: Producing a video that involves music, drama, color, sound, etc.
adapt
excel
revise
alter
rearrange
surpass
change
reorganize
transcend

Naturalization: Having high level performance become natural, without needing to think much about it. Examples: Michael Jordan playing basketball, Nancy Lopez hitting a golf ball, etc.
arrange
construct
transcend
combine
create
originate
compose
design
refine

Dave's taxonomy for the psychomotor domain seems relatively easy to understand and can be applied readily to practice in, for example, nursing (VickyRN, 2009). As we shall see below, the way in which students might progress through the domain seems to accord more readily with the theory of skill acquisition in medical and health sciences (Seels & Glasgow, 1990).

1.3 Harrow's Psychomotor Domain

Harrow's interpretation of the Psychomotor domain is strongly biased towards the development of physical fitness, dexterity and agility, and control of the physical 'body', to a considerable level of expertise. Anita Harrow's taxonomy for the psychomotor domain is organized according to the degree of coordination including involuntary responses as well as learned capabilities. Simple reflexes begin at the lowest level of the taxonomy, while complex neuromuscular coordination make up the highest levels

Harrow's (1972):

Reflex movements - Reactions that are not learned.
flexion
extension
stretch
postural adjustments.

Fundamental movements - Basic movements such as walking, or grasping.
walking
running
pushing
twisting
gripping
grasping
manipulating

Perception - Response to stimuli such as visual, auditory, kinesthetic, or tactile discrimination.
jumping rope
punting
catching

Physical abilities - Stamina that must be developed for further development such as strength and agility.
all activities which require
a) strenuous effort for long periods of time;
b) muscular exertion;
c) a quick, wide range of motion at the hip joints; and
d) quick, precise movements.

Skilled movements - Advanced learned movements as one would find in sports or acting.
all skilled activities obvious in sports, recreation, and dance.

No discursive communication - Effective body language, such as gestures and facial expressions.
body postures
gestures
facial expressions efficiently executed in skilled dance movement and choreographic

2. Clinical Skill Acquisition


I am certainly not an expert in the subject area of skills acquisition. However, I was involved in an interesting project looking at clinical skills acquisition (Doherty, 2008). More specifically, we were looking at simulated learning for male and female catheter insertion. The videos below will give you an idea of the sorts of skills required to carry out these procedures. The work that I did around this project has given me a basic understanding of the end state of the learner in clinical skills acquisition. The project also gave me some insight into theories about clinical skill acquisition.

Male Catheter Insertion


Female Catheter Insertion


An initial review of the simulation literature provided us with the widely accepted three stage theory of motor skill acquisition (Reznick & MacRae, 2007) which suggests that there are three stages to skill acquisition: a cognitive stage during which the learner intellectualizes the task; an integrative stage consisting of practice and feedback during which the conceptual knowledge is translated into appropriate motor behaviour; and an autonomous stage in which continued practice has led to “automatic” performance. Given the perceived learning benefits of deliberate practice (Good, 2003; Park et al., 2007) together with immediate feedback for skill acquisition (Issenberg, Gordon, Gordon, Safford, & Hart, 2001;Issenberg et al., 2007; Kneebone, 2003;Maran & Glavin, 2003; Reznick & MacRae, 2007) the hypothesis that repeated use of a simulator for male and female catheter insertion would lead to increased student confidence and improved competency seemed to be a reasonable one.

3. Acquiring Skill and the Psychomotor Domain


In the section above we saw a theory of motor skill acquisition that was divided into three stages: intellectualizing the task; practicing the task; and automatic performance in which one can routinely perform the task. We can consider these three stages in relation to Simpson's psychomotor domain:

  1. Intellectualizing the task does not seem to readily find a place in Simpson's psychomotor processes;
  2. The integrative stage would fall under guided response because guided response includes imitation and trial and error and because adequacy of performance is achieved by practicing;
  3. The autonomous stage corresponds most readily to Simpson's mechanistic stage because in that stage learned responses have become habitual and the movements can be performed with some confidence and proficiency.
  4. In the case of learning from a simulation we might also include Simpson's complex overt response and adaptation. We would include complex over response because we would want the trainee to be able to perform a clinical skill quickly and accurately. We would include adaptation because we would want a trainee to be able to respond appropriately should something go wrong.
  5. The category of origination would not be included because the purpose of the simulation is to teach basic clinical skills.

4. Acquiring Skill and Learning Objectives


The rather obvious point with respect to the skills in the psychomotor domain is that one might write ones' learning objectives with respect to the skill levels. For example, the learning outcomes around clinical skills might include being able to quickly and accurately perform a procedure but the learning outcome would not include any statement with respect to adding a new dimension to the skill. The second point with respect to the skills in the psychomotor domain is that we can say something concrete about the state of the learner who has learned the new skills. The learner is able to perform tasks and to carry out procedures that could not be performed or carried out prior to the learning. In this case learning is constituted by the learner being able to do something that could not be done prior to learning.

5. References


books.gifArmstrong, R. J. (Ed.). (1970). Developing and Writing Behavioural Objectives. Tucson, Arizona: Educational Innovators Press.

image_add_48.pngClark, D. (2009). Bloom's Taxonomy of Learning Domains - The Three Types of Learning. Retrieved 28th September, 2009.
http://www.nwlink.com/~Donclark/hrd/bloom.html

image_warning_48.pngDoherty, I., Hansen, M., McCann, L., Oosthuizen, G., McHardy, K., Greig, S., et al. (2008). Simulated Learning for Clinical Skill Acquisition and Retention: Report on a Research Project with Trainee Medical Interns. Paper presented at the ED-MEDIA 2008--World Conference on Educational Multimedia, Hypermedia & Telecommunications, Vienna, Austria. Available from http://www.editlib.org/index.cfm?fuseaction=Reader.ViewAbstract&paper_id=29197

image_warning_48.pngGood, M. L. (2003). Patient Simulation for training basic and advanced clinical skills. Medical Education, 37, 14-21.
books.gifHarrow, A. J. (1972). A Taxonomy of the Psychomotor Domain: A Guide for Developing Behavioral Objectives. New York: David McKay Co.

image_warning_48.pngIssenberg, S. B., Gordon, M. S., Gordon, D. L., Safford, R. E., & Hart, I. R. (2001). Simulation and new learning technologies. Medical Teacher, 23(1), 16-23.

image_warning_48.pngIssenberg, S. B., McGaghie, W. C., Hart, I. R., Mayer, J. W., Felner, J. M., Petrusa, E. R., et al. (2007). Simulation technology for health care professional skills training and assessment. The Journal of the American Medical Association, 282(871-866).

image_warning_48.pngKneebone, R. (2003). Simulation in surgical training: educational issues and practical implications. Medical Education, 37, 267-277.

image_warning_48.pngMaran, N. J., & Glavin, R. J. (2003). Low to high fidelity simulation - a continuum of medical education? Medical Education, 37, 22-28.

image_warning_48.pngPark, J., MacRae, H., Musselman, L. J., Rossos, P., Hamstra, S. J., Wolman, S., et al. (2007). Randomized controlled trial of virtual reality simulator training: transfer to live patients. The American Journal of Surgery, 194(2), 205-211.

image_warning_48.pngReznick, R. R., & MacRae, H. (2007). Teaching surgical skills - Changes in the wind. The New England Journal of Medicine, 355(25), 2664-2669.

books.gifSimpson E. J. (1972). The Classification of Educational Objectives in the Psychomotor Domain. Washington, DC: Gryphon House.

image_add_48.pngVickyRN. (2009). The Psychomotor Domain. Retrieved 11th October, 2009, from http://allnurses.com/nursing-blogs/the-psychomotor-domain-396527.html