The Downsides to Good Training (Part Three)

In the first two parts of this series (my previous two newsletters) I explored the pitfalls of inappropriate or inadequate training that can build false confidence in skill reproduction under stress, and the desensitisation to high stress encounters that can come from reality-based training, and can contribute to a toxic, subconscious accumulation of stress over time. In this final newsletter I will turn the focus onto the importance of skill maintenance.?

Skill maintenance was a topic of hot debate during my time with army special operations. Specifically, how to you determine the rate of skill decay and therefore the duration between refresher training to improve the chances of skills being reproducible in the heat of the moment. It’s a near impossible question to answer and will differ from person to person and skill to skill however, there is some science that underpins the principles of refresher training and informs the intervals between practicing the skills to reduce the chance of losing them.?

Naturally, it would be ideal to be consistently training in every skill that you might require on the job to keep them all fresh, but in high complexity jobs such as many military and first responder roles, compounded by the time required to actually be doing the job, this becomes quickly unrealistic. I remember one discussion with a US Air Force Pararescue Jumper (PJ) on this topic and hearing his frustration at the impossible training load to stay sharp at the roles’ impressive array of skills to help ensure that “others may live”.

While the PJs might be a somewhat extreme example of the need for skill maintenance, every military and first responder role carries with it the need to keep skills sharp with the unique stress of a potentially life or death consequence hanging on the outcome. With that in mind, let’s have a look at the theory.?

What is a skill?

Starting with the fundamentals, a skill is a complex learned behaviour required to respond to a goal-oriented task[i], which is not innate, but rather must be learned, and requires careful coordination of perception, cognition, and action to achieve the required task[ii].?

Skill classification

It’s recognised that different skills decay at different rates, and knowledge of this fact can help to allocate precious training time accordingly to get best bang for buck in skill maintenance. Skills can be differentiated into the following categories[iii]:

Physical vs Cognitive?

Physical skills require manual effort or exertion and tend to decay at a slower rate than cognitive skills, which require perceptual input, mental operations, problem solving, and decision making.?

For example, in my former role as a doctor with army special operations, Care Under Fire drills were at the forefront of our training. In this instance, the initial drag of a combat casualty to an area of relative safety represents a physical skill, with the subsequent assessment and sequential assessment and management of their injuries being a cognitive skill.?

Natural vs Synthetic / Artificial

This differentiation is made based on the environment within which the skill is required. Natural environments represent “real world” environments which are uncontrolled and dynamic.?

Synthetic, or artificial, environments are more controlled with less external stimulus and complexity.?

An example here is of a paramedic operating in the pre-hospital space at a car crash (natural environment) as opposed to assisting with the management of the casualty once they have reached the resuscitation room of an Emergency Department (more synthetic / artificial environment).

It makes sense that natural skills atrophy more quickly than synthetic or artificial ones.?

Closed Loop vs Open Loop

Closed loop skills are those that are managed or controlled by process, with a clear beginning and end point and a fixed set of tasks in between. Open loop skills are not as clearly defined and involve problem solving in response to the stimulus that present in the moment on the task.?

For example, a fighter pilot going through a take-off procedure in their jet will go through a closed loop skills sequence to initiate the machine and get it airborne. The subsequent mission that they fly represents an open loop skill and requires them to respond appropriately to stimuli as they emerge.?

Open loop skills decay more quickly than closed loop ones.

Accuracy vs Speed?

This one is exactly as it seems! Accuracy tasks require precision to be successful whereas speed tasks just need to be quick.?

An example here is the difference between a soldier in combat laying down suppressive fire to facilitate movement (speed skill) as opposed to the sniper in overwatch firing precision shots to neutralise enemy (accuracy skill).?

It’s another no-brainer, but accuracy skills atrophy faster than speed skills.?

This simple skill category differentiation begins the triage process of prioritising refresher training for core occupational skills, focusing on those fundamental open loop and accuracy skills in natural environments.?

Most military and first responder groups will have a good idea of exactly which skills are most critical to their roles. If, however, there is doubt over exactly which skills should be prioritised for initial training and subsequent maintenance, there are tools available to determine that as well. A detailed discussion on that topic is outside the scope of this newsletter, but the book “Skill acquisition and training” by Johnson and Proctor (2016) is a great resource for anyone interested. A snapshot of one of their models is found at Figure 1.?

Skill Decay

Just as a new car begins to lose value the second it’s driven out of the dealership; skills begin to decay quickly after being learned!

The technical term used to define the period of time that a skill can be confidently reproduced is known as the retention interval. Many factors will influence this but, somewhat predictably, the greater the time from training, the greater the skill decay. It’s also recognised that skills don’t decay in a linear fashion, with a generalised skill decay curve over time depicted in Figure 2 [iv]

One study tracking skill decay over time demonstrated a shocking 92% drop in performance of a trained skill over 365 days when no refresher training was conducted [v]!

This is an important point to appreciate, as it can be tempting to delude ourselves into thinking that a skill we have learned in the distant past will still be there for us when we need it most. The studies would suggest otherwise, and this delusion is another way that we can find ourselves at the “peak of Mount Stupid” (characterised by high confidence with low competence - see Figure 3) as beautifully described in the Dunning-Kruger Effect. (The other way to find yourself on the peak of Mount Stupid is by not learning the skill adequately in the first instance. For a deep dive into that, check out my previous newsletter: The Downsides to Good Training (Part One)).?

The same researchers (iv) who demonstrated the dramatic decay in skill proficiency over time illustrated in Figure 2 also determined that the following two factors are fundamental in skill retention:

· ?How the information was initially encoded

· ?The types of cues present at retrieval

It makes sense that optimal training conditions promote better skill retention. One trap to avoid for those running training is over-stressing trainees. The goal at any stage in the training continuum should be to stress trainees to a point just above their current level of skill in that particular skill, without pushing them into overwhelm where performance and encoding of skills drops off significantly.?

This delicate and dynamic point is defined by the Yerkes-Dodson “inverted-U” empirical relationship between stress and performance (see figure 4).

As the trainee becomes more competent in the skill, the stress of the training needs to increase incrementally to push them to the optimal point and further skill acquisition and encoding (see my previous newsletter: ?The Downsides to Good Training (Part Two)).?

Cues present at skill retrieval

Another crucial consideration in the training environment is to create as realistically as possible the cues that are likely to be present when skill retrieval is required. This is the realm of Reality Based Training (RBT) and anyone who has followed me for a while is probably sick of me stressing the importance of RBT!?

RBT is at the heart of the old adage “train as you’re going to fight”. If you’re involved in organising training and can manage to get your hands on a copy, I strongly encourage you to get what I consider the foundational text on this topic “Training at the speed of life” by Kenneth R Murray.?

Training for high consequence roles needs to evolve to be done outside of the classroom!

Once a trainee has mastered the basic component skills required, they need to continue their training in a variety of environments that realistically recreate what they are likely to encounter in their roles. They need to train by day, by night, perhaps in smoke, dust, and dirt, with noise (and maybe gunfire), and with realistic external stimulus.?

Training scenarios need to be varied to encode skill retention through a range of cues to maximise retrieval in real world environments. It cannot be expected, for example, that a correctional officer is going to be able to effectively control the massive bleeding from a prisoner who has self-harmed with a razor in their cell if they have only ever learned the skill theoretically in a classroom! This scenario needs to be rehearsed in a realistic training environment, replicating some of the threat and chaos that surrounds such an incident. Likewise, a police officer or military member who has only ever practiced shooting a bullseye target at a static shooting range is far less likely to be able to reproduce that skill effectively in the complexity of a real world use of force encounter.?

Another point that I strongly advocate for anyone who might find themselves in life and death situations is to train for death.?

As morbid as this might sound, it is the reality of some roles, and a framework for appropriately managing a fatality with confidence and dignity can have a profoundly positive impact on the mental health consequences of such catastrophic occurrences.?

Refresher Training

Now that we’ve addressed the fact that skills decay over time and that different skills decay at different rates, we can start to put a framework around refresher training.?

The goal of refresher training is diagrammatically represented in Figure 5 (Hayes (2014), cited in Woodman et al. 2021).?

It is noted that skill decay is depicted in a linear fashion in Figure 5, as opposed to the curvilinear findings illustrated in Figure 2, however the principle is the same.?

There are two key points to appreciate in Figure 5. Firstly, the green line demonstrating the impact of refresher training in bumping back up the performance of decaying skills over time, and secondly the increasing orange line used by Hayes to indicate that “system performance requirements” increase over time and are not a static construct.?

This is yet another critical point for those responsible for training to appreciate! The battlespace (either literal or metaphorical) evolves and with that comes the requirement for skillsets to evolve accordingly to remain relevant, competent, and safe.?

I saw this firsthand across my tours of Afghanistan with special operations. During my first tour, the IED threat was relatively low and our access to helicopters was limited, which led to predominantly vehicle-mounted operations. By the time of my fourth and final tour, the IED threat was high, and we had lots of aviation support, leading to profound changes to the way we targeted, requiring constant updates in training to remain effective.?

Overlearning

One practice to maximise the chance of skill reproduction under stress is overlearning. As the name suggests, this is the practice of training a skill well past the point that seems logically reasonable for retention. I’ve addressed the neuroscience of overlearning to the point of “unconscious competence” in the first newsletter of this series and won’t repeat it here other than to reinforce that the science supports this practice!

Symbolic Rehearsal

One final technique for consideration is “symbolic rehearsal” or visualisation.?

There’s been a lot of interest in the power of visualisation over the years from the elite sporting world, with some great studies that demonstrate its power. Multiple studies have shown the ability to improve sporting skills through mental rehearsal alone and there is some suggestion that it has a role in attenuating skill decay in the first responder space[vi]. It certainly isn’t a substitute for periodic reality based training but is a technique to consider when ready access to training is not possible.?

I used to use visualisation every time I was on an insertion platform headed out to missions on operations. At the time it was more of a means for me to calm myself through distraction, but my process was to close my eyes, imagine the most likely casualties I might encounter on the mission, and run my hands over the equipment on my chest rig and kit that I would need to treat their injuries, therefore engaging my sense of touch to reinforce the visualisation. When using visualisation, the more senses you can engage during the process the better.?

So, in summary, emphasis needs to be placed on periodic refresher training to negate the impact of skill decay. Higher priority should be placed on open loop and accuracy skills in natural environments, using incrementally challenging reality-based training. Where possible, key skills should be overlearned to the point of unconscious competence and where regular training is not practical, visualisation can be used to mitigate skill decay. Finally, awareness of the evolving operating environment and incorporation of relevant contemporary changes should be incorporated into refresher training to avoid the trap of training to fight the last war!

A full reference list can be found below, however this newsletter is primarily based on the fantastic article titled "Understanding skill decay and skill maintenance in first responders" by Woodman et al. Most of the other references used in newsletter are also referenced in Woodman et al. If you're in the area of training military or first responders, I strongly encourage you to read Woodman et al.?

As always, comments and questions are welcome. If you feel this newsletter might resonate with others in your community, please share it widely.?

Until next time, stay safe, and don’t forget to have some fun!

Cheers,

Dr Dan Pronk

References

[i] Johnson A & Proctor RW 2016, Skill acquisition and training: Achieving expertise in simple and complex tasks, Routledge.

[ii] Kluge A, Frank B, Maafi S & Kuzmanovska A 2016, Does skill retention benefit from retentivity and symbolic rehearsal? Two studies with a simulated process control task. Ergonomics, vol. 59, no. 5, pp.641–656.

[iii] Woodman, S., Bearman, C., & Hayes, P. (2021). Understanding skill decay and skill maintenance in first responders. The Australian Journal of Emergency Management, 36(4), 44–49.

[iv] Stothard C & Nicholson R 2001, Skill acquisition and retention in training: DSTO support to the army ammunition study, DSTO Electronics and Surveillance Research Laboratory.

[v] Arthur W, Bennett Jr W, Stanush PL & McNelly TL 1998, Factors that influence skill decay and retention: A quantitative review and analysis. Human Performance, vol. 11, no. 1, pp.57–101.

[vi] Kluge A, Frank B, Maafi S & Kuzmanovska A 2016, Does skill retention benefit from retentivity and symbolic rehearsal? Two studies with a simulated process control task. Ergonomics, vol. 59, no. 5, pp.641–656.