Healthcare Practitioners Taking Short Breaks

By Bonnie Hutchinson

Who hasn’t crammed long and hard before an exam?

Who hasn’t been told that one key to successful learning is study and practice for long hard hours?

But “long hard hours” may not be the best way to learn. A 2019 National Institutes of Health (NIH) research report suggests what may be a surprising approach: Take many breaks, early and often.

NATIONAL INSTITUTES OF HEALTH: REST IS AS IMPORTANT AS PRACTICE

“Everyone thinks you need to ‘practice, practice, practice’ when learning something new,” says Leonardo G. Cohen, M.D., Ph.D.  Dr. Cohen is a senior investigator at NIH’s National Institute of Neurological Disorders. He’s also a senior author of a paper published in the journal Current Biology.

The paper reports a conclusion that surprised the researchers and may surprise you too. Dr. Cohen says, “We found that resting, early and often, may be just as critical to learning as practice.”[1]

The study was led by Marlene Bönstrup, M.D., a postdoctoral fellow in Dr. Cohen’s lab. Like many scientists, she held the general belief that our brains need long periods of rest, such as a good night’s sleep, to strengthen the memories formed while practicing a newly learned skill. But after looking at brain waves recorded from healthy volunteers in learning and memory experiments at the NIH Clinical Centre, she started to question that idea.

AT FIRST RESULTS SEEMED TYPICAL UNTIL…

The study recorded brain waves from right-handed volunteers with a highly sensitive scanning technique called magnetoencephalography. The subjects sat in a chair facing a computer screen and under a long cone-shaped brain scanning cap. The experiment began when they were shown a series of numbers on a screen and asked to type the numbers as many times as possible with their left hands for 10 seconds. Then they took a 10 second break. They repeated the trial cycle of alternating practice and rest 35 more times.

This practice-and-rest strategy is regularly used in trials to reduce any complications that could arise from fatigue or other factors. The researchers didn’t realize that the strategy would help them discover an intriguing pattern.

The speed at which volunteers correctly typed the numbers improved dramatically during the first few trials. Then it leveled off around the 11th cycle. So far, nothing unexpected. However, when Dr. Bönstrup looked at the volunteers’ brain wave patterns she observed something interesting.

…AN UNEXPECTED PATTERN EMERGED

“I noticed that participants’ brain waves seemed to change much more during the rest periods than during the typing sessions,” said Dr. Bönstrup. “This gave me the idea to look much more closely for when learning was actually happening. Was it during practice or during rest?”

By re-analyzing the data, she and her colleagues made two key findings.

  1. They found that the volunteers’ performance improved primarily during the short rests, and not during typing. The improvements made during the rest periods added up to the overall gains the volunteers made that day. Further, these gains were much greater than the ones seen after the volunteers returned the next day to try again. This suggests that the early breaks played as critical a role in learning as the practice itself.
  2. By looking at the brain waves, Dr. Bönstrup found activity patterns that suggested the volunteers’ brains were consolidating, or solidifying, memories during the rest periods. Specifically, they found that the changes in the size of brain waves, called beta rhythms, correlated with the improvements the volunteers made during the rests.

CAN THE FINDINGS BE GENERALIZED?

The study was not carried out to learn more about skill learning in general. “Our ultimate hope is that the results of our experiments will help patients recover from the paralyzing effects caused by strokes and other neurological injuries by informing the strategies they use to ‘relearn’ lost skills,” says Dr. Cohen.

He continues, “Our results suggest that it may be important to optimize the timing and configuration of rest intervals when implementing rehabilitative treatments in stroke patients or when learning to play the piano in normal volunteers. Whether these results apply to other forms of learning and memory formation remains an open question.”

Fair enough. We don’t want to add two and two and get five.

However…

This National Health Institute study is not the only research that supports the idea of shorter times of practice interspersed with rest times.

Dr. K. Anders Ericsson is one of the world’s foremost experts in mastery learning – how to achieve peak performance in any field.

In his research paper, “The Role of Deliberate Practice in the Acquisition of Expert Performance,”[2] Ericsson and his colleagues shared their discovery that top performers, no matter what their area of expertise, kept a similar practice regimen. The all used brief but intense daily or semi-weekly solo practice sessions. These consistent, intense bursts of effort are key to maintaining momentum in building expertise.

Ericsson has said practice sessions don’t need to be long. Depending on the type of skill that is being practiced, even 10 to 15 minutes at a time might be sufficient.

Because this kind of deliberate practice requires your full attention, with maximum mental and/or physical effort, it can only be sustained for a short period of time. Laboratory studies of extended practice have capped the optimal time at one hour per day, three to five days a week. Real-life studies have seen reduced benefits when practice sessions exceed two hours.[3]

The level of intensity and focus makes recovery time important. Ericsson has observed that many of the top performers he studied benefited from napping. It’s important to offset the intense effort of deliberate practice to avoid mental or physical fatigue.[4]

LEARN IN SHORT BURSTS

If you’re a student, you’re probably interested in learning and improving your skills as effectively as possible. If you’re a registered healthcare practitioner, you know that on-going research continues to identify new procedures to improve patient care. You probably want to keep learning new skills to keep pace with changes in your field.

When you begin to pick up a new skill or learn anything new, it’s easy to want to binge-learn and work on it obsessively. But spreading out learning with breaks between sessions is known to be a better approach to learning.[5] It’s how our brains are wired.

“Breaks are important to minimize interference. When your hippocampus is forced to store many new (and often similar) patterns in a short space of time, it can get them jumbled up,” writes David Cox of The Guardian.[6]

Taking breaks after short intense times of learning or practice has proven to work better for the brain as it changes and consolidates the new information.

“…Changes in the brain allow for faster, stronger signalling between neurons as the brain gains new skills. But the best way to speed up those signals is to introduce new information to our noggins — slowly,” explains neuroscientist Hadley Bergstrom.[7]

Learning in short bursts allows links between neurons to strengthen steadily.

So – the next time you’re wondering if it’s appropriate to spend less time practicing and more time on breaks, you have a great answer. As Dr. Bönstrup observed in her study of actual brain waves, performance improves primarily during rest periods, not during practice time.

Of course the practice time needs to happen. But your brain integrates the learning during breaks, not during practice. If you take frequent breaks, you’re not being lazy, you’re supporting your brain!

HONE CUE RECOGNITION

One set of skills of special importance to healthcare practitioners is diagnostic expertise in the first few minutes of patient contact.

Hone’s CUE recognition virtual simulation training is a resource that can help you prepare for times when you need to use these expert skills in high-pressure situations. You can download training modules to your smartphone or tablet, and practice whenever it’s convenient for you.

Short bursts of practice with frequent breaks? Totally within your control.

To find out more, visit www.honevirtualeducation.com where you can…

Learn more about Hone Cue Recognition virtual simulation training;

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Apply to be a beta tester as new modules are developed for healthcare practitioners in high pressure environments.

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Bonnie Hutchinson is a writer and lifelong learner with degrees in Education and Whole Systems Design as well as extensive training and experience in adult learning and teaching. As an organizational and evaluation consultant, she’s worked with many healthcare and healthcare practitioner organizations. She’s bestselling author of Transitions: Pathways to the Life and World Your Soul Desires.

 

[1]  National Institutes of Health (April 12, 2019), “Want to learn a new skill? Take some short breaks,” https://www.nih.gov/news-events/news-releases/want-learn-new-skill-take-some-short-breaks
All quotes and other information about the National Institute of Neurological Disorders and Stroke study are from this NIH article which is based on…
M. Bönstrup, I. Iturrate, R. Thompson, G. Cruciani, N. Censor, L. Cohen, et al. (March 28, 2019), “A Rapid Form of Offline Consolidation in Skill Learning,” Current Biology, https://www.ncbi.nlm.nih.gov/pubmed/22154521

[2]  K. Anders Ericcson, Ralf T. Krampe, Clemens Tesch-Römer (1993), “The Role of Deliberate Practice in the Acquisition of Expert Performance,” Psychological Review, Vol 100(3), Jul 1993, 363-406.

[3] Janie Kliever (May 30, 2017), “Get Better at Anything: 6 Steps of Deliberate Practice,” https://medium.com/the-crossover-cast/get-better-at-anything-6-steps-of-deliberate-practice-19830bfc9460

[4]    Janie Kliever (May 30, 2017), op. cit

[5] Thomas Oppong (April 18, 2019), “Want to learn a new skill faster? Take short breaks early and often (Secrets from New Research)”. https://medium.com/kaizen-habits/want-to-learn-a-new-skill-faster-take-short-breaks-early-and-often-secrets-from-new-research-f2c07c48af65?source=userActivityShare-1cb4db6f3ca2-1557625767&_branch_match_id=383906034655183620

[6]  Quoted in Thomas Oppong (April 18, 2019), op. cit.

[7] Quoted in Thomas Oppong (April 18, 2917), op. cit.

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