Haptic Enhancement of Sensorimotor Learning for Clinical Training Applications

Modern surgical training requires radical change with the advent of increasingly complex procedures, restricted working hours, and reduced ‘hands-on’ training in the operating theatre. Moreover, an increased focus on patient safety means there is a greater need to objectively measure proficiency in trainee surgeons. Indeed, the existing evidence suggests that surgical sensorimotor skill training is not adequate for modern surgery. This calls for new training methodologies which can increase the acquisition rate of sensorimotor skill. Haptic interventions offer one exciting possible avenue for enhancing surgical skills in a safe environment. Nevertheless, the best approach for implementing novel training methodologies involving haptic intervention within existing clinical training curricula has yet to be determined. This thesis set out to address this issue. In Chapter 2, the development of two novel tools which enable the implementation of bespoke visuohaptic environments within robust experimental protocols is described. Chapters 3 and 4 report the effects of intensive, long-term training on the acquisition of a compliance discrimination skill. The results indicate that active behaviour is intrinsically linked to compliance perception, and that long-term training can help to improve the ability of detecting compliance differences. Chapter 5 explores the effects of error augmentation and parameter space exploration on the learning of a complex novel task. The results indicate that error augmentation can help improve learning rate, and that physical workspace exploration may be a driver for motor learning. This research is a first step towards the design of objective haptic intervention strategies to help support the rapid acquisition of sensorimotor skill. The work has applications in clinical settings such as surgical training, dentistry and physical rehabilitation, as well as other areas such as sport.