Differences in practice behaviours between expert musicians and non-musicians when learning a basic surgical skill


  • Gilles Comeau University of Ottawa
  • Jillian Beacon University of Ottawa
  • Erin Dempsey University of Ottawa
  • Mikael Swirp University of Ottawa
  • Fady Balaa University of Ottawa
  • Kuan-chin Jean Chen University of Ottawa
  • Donald Russell Carleton University




Background: Researchers have hypothesized that years of daily practice on a musical instrument may lead to increased efficiency in practice behaviours during the learning of other fine motor skills [1]. Practice strategies in music have also been considered a suitable model for surgical training [2] and some believe that surgical outcomes might be improved by adopting musicians’ practice strategies [3].

Objective: This study examines the practice behaviours of expert musicians attempting to learn a basic surgical skill, as a way to detect possible transfer of practice habits across domains. This paper investigates whether musicians differ from a control group in their selection and application of practice strategies, whether there are relationships between the choice of practice behaviours and performance scores, whether musicians progress more rapidly through the different phases of learning and, whether relationships exist between those who reach automaticity sooner and their choice of practice behaviours.

Methods: Participants’ practice sessions during a knot-tying task (taught via instructional video) were video-recorded and treated according to the method of thematic analysis [4]. Coding was performed by two evaluators through an iterative process and statistical and descriptive analyses were conducted on practice behaviours. Information was also collected on instructional video navigation so that the use of replay, pause, rewind or fast-forward could be investigated.

Results: Musicians and the control group participants favoured different practice behaviours; this was demonstrated in their choice of strategies, the importance they gave to each strategy, and the way they used the strategies over the two practice sessions. There was evidence that the group of expert musicians applied better practice strategies as the choice of practice behaviours correlated positively with performance scores and their capacity to reach automaticity.

Conclusion: Our results suggest that music experts may be applying practice strategies developed during their music studies when learning a novel surgical skill. This raised the possibility that practice skills developed through years of dedicated work at their musical instrument, might be transferable when learning a motor skill in a different domain.


Krings T, Topper R, Foltys H, et al. Cortical activation patterns during complex motor tasks in piano players and control subjects: A functional magnetic resonance imaging study. Neurosci Lett. 2000: 278(3): 189-193.

McCaskie AW, Kenny DT, Deshmukh S. How can surgical training benefit from theories of skilled motor development, musical skill acquisition and performance psychology? Med J Aust. 2011: 194(9): 463-465.

Rui M, Lee JE, Vauthey JN, Conrad C. Enhancing surgical performance by adopting expert musicians’ practice and performance strategies. Surg. 2018: 163(4): 894-900.

Huberman AM, Miles MB. The qualitative researcher's companion. London, ENG: Sage; 2002.

Hond P. The hippocratic overture. Columbia Magazine. 2015, spring; 1-5. Available at: http://magazine.columbia.edu/features/spring-2015/hippocratic-overture

Hughes DT, Forest SJ, Foitl R, Chao E. Influence of medical students' past experiences and innate dexterity on suturing performance. Am J Surg. 2014: 208(2): 302-306.

Adams JA. Historical Review and Appraisal of Research on the Learning, Retention, and Transfer of Human Motor Skills. Psychol Bull. 1987: 10(1): 41-74.

Comeau G, Chen KC, Swirp M, et al. From music to medicine: Are pianists at an advantage when learning surgical skills? Music and Medicine. 2019:

Singer RN. Motor Skills and Learning Strategies. In: O’Neil HF, ed. Learning Strategies. New York, NY: Academic Press; 1978: 79-106.

Krampe R, Ericsson KA. Maintaining excellence: Deliberate practice and elite performance in younger and older pianists. J Exp Psychol Gen. 1996: 125(4): 331-359.

Duvivier RJ, van Dalen J, Muijtjens AM, Moulaert VRMP, van der Vleuten CPM, Scherpbier AJJA. The role of deliberate practice in the acquisition of clinical skills. BMC Med Educ. 2011: 11(1): 101.

Ericsson KA. Deliberate practice and the acquisition and maintenance of expert performance in medicine and related domains. Acad Med. 2004: 79(10): S70-S81.

Ericsson KA. Deliberate practice and acquisition of expert performance: A general overview. Acad Emerg Med. 2008: 15(11): 988-994.

Ericsson KA. Enhancing the development of professional performance: Implications from the study of deliberate practice. In: Ericsson KA ed. The development of professional expertise: Toward measurement of expert performance and design of optimal learning environments New York, NY: Cambridge University Press: 2009: 405-431.

Pear TH. Professor Bartlett on skill. Occup Psychol. 1948: 22: 92-93.

Ackerman PL. Individual differences in skill learning: An integration of psychometric and information processing perspectives. Psychol Bull. 1987: 102(1): 3-27.

Ungerleider LG, Doyon J, Karni A. Imaging brain plasticity during motor skill learning. Behav Neural Biol. 2002: 78(3): 553-564.

Fitts PM, Posner MI. Human performance. Belmont, CA: Brooks/Cole Publishing Company; 1969.

Logan GD. Toward an instance theory of automatization. Psychol Rev. 1988: 95(4): 492-527.

Shiffrin RM, Schneider W. Controlled and automatic human information processing: II. Perceptual learning, automatic attending and a general theory. Psychol Rev. 1977: 84(2): 127.

Ackerman PL. New Developments in Understanding Skilled Performance. Curr Dir Psychol Sci. 2007: 16(5): 235-239.

Spruit EN, Band GP, Hamming JF, Ridderinkhof KR. Optimal training design for procedural motor skills: a review and application to laparoscopic surgery. Psychol Res. 2014: 78(6): 878-891.

Gluck MA, Mercado E, Myers CE. Learning and Memory; From Brain to Behavior. New York, NY: Worth Publishers; 2013.

Bernstein N. The Co-ordination and Regulation of Movements. Oxford, ENG: Pergammon Press, 1967.

Lee TD, Swanson LR, Hall AL. What is repeated in a repetition? Effects of practice conditions on motor skill acquisition. Phys Ther. 1991: 71(2): 150-6.

Williamon A, Valentine E. Quantity and quality of musical practice as predictors of performance quality. Br J Psychol. 2000: 91(3): 353-376.

Miksza P. Relationships among achievement goal motivation, impulsivity, and the music practice of collegiate brass and woodwind players. Psychol Music. 2011: 39(1): 50-67.

Duke RA, Simmons AL, Cash CD. It’s not how much; it’s how: Characteristics of practice behavior and retention of performance skills. Journal of Research in Music Education. 2009: 56(4): 310-321.

McPherson GE. From child to musician: Skill development during the beginning stages of learning an instrument. Psychol Music. 2005: 33(1): 5-35.

Geringer JM, Kostka MJ. An analysis of practice room behavior of college music students. Contributions to Music Education. 1984: 1(11): 24-7.

Ginsborg J. Classical singers learning and memorising a new song: An observational study. Psychol Music. 2002: 30(1): 58-101.

Hallam S. The development of metacognition in musicians: Implications for education. Brit J Music Educ. 2001: 18(1): 27-39.

Maynard LM. The role of repetition in the practice sessions of artist teachers and their students. Bulletin of the Council for Research in Music Education. 2006: 1:61-72.

McPherson GE, Renwick JM. A longitudinal study of self-regulation in children's musical practice. Music Education Research. 2001: 3(2): 169-86.

Nielsen SG. Learning strategies in instrumental music practice. Brit J Music Educ. 1999: 16(3): 275-91.

Smith BP. The role of selected motivational beliefs in the process of collegiate instrumental music practice. PhD diss. 2002.

Killian JN, Henry ML. A comparison of successful and unsuccessful strategies in individual sight-singing preparation and performance. Journal of Research in Music Education. 2005: 53(1): 51-65.

Miksza P. Relationships among impulsiveness, locus of control, sex, and music practice. Journal of Research in Music Education. 2006: 54(4): 308-23.

Miksza P. Effective practice: An investigation of observed practice behaviors, self-reported practice habits, and the performance achievement of high school wind players. Journal of Research in Music Education. 2007: 55(4): 359-375.

Miksza, P. A review of research on practicing: Summary and synthesis of the extant research with implications for a new theoretical orientation. Bulletin of the Council for Research in Music Education. 2011: 190: 51-92.

Wulf G, Mornell A. Insights about practice from the perspective of motor learning: A review. Music Performance Research. 2008: 2: 1-25.

Bann S, Darzi A. Selection of individuals for training in surgery. Am J Surg. 2005:190(1): 98-102.

Lee JY, Kerbl DC, McDougall EM, Mucksavage P. Medical students pursuing surgical fields have no greater innate motor dexterity than those pursuing nonsurgical fields. J Surg Educ. 2012: 69(3): 360-3.

Masud D, Undre S, Darzi A. Using manual dexterity to predict the quality of the final product in the small bowel anastomosis after a period of training. Am J Surg. 2012 Jun: 203(6): 776-81.

Stefanidis D, Korndorffer Jr JR, Black FW, Dunne JB, Sierra R, Touchard CL, Rice DA, Markert RJ, Kastl PR, Scott DJ. Psychomotor testing predicts rate of skill acquisition for proficiency-based laparoscopic skills training. Surg. 2006: 140(2): 252-62.

Strenge H, Niederberger U, Seelhorst U. Correlation between tests of attention and performance on grooved and Purdue pegboards in normal subjects. Percept Mot Skills. 2002: 95(2): 507-14.

Van Herzeele I, O'donoghue KG, Aggarwal R, Vermassen F, Darzi A, Cheshire NJ. Visuospatial and psychomotor aptitude predicts endovascular performance of inexperienced individuals on a virtual reality simulator. J Vasc Surg. 2010: 51(4): 1035-42.

Causby R, Reed L, McDonnell M, Hillier S. Use of objective psychomotor tests in health professionals. Percept Mot Skills. 2014: 118(3): 765-804.

Orpet RE. Frostig movement skills test battery. Consulting Psychologists Press; 1972.

Bandura, A. Vicarious and self-reinforcement processes. In: Glaser R, Ed. The nature of reinforcement. New York, NY: Academic Press; 1971: 228-278.

Bandura A. Self-efficacy: Toward a unifying theory of behavioural change. Psychol Rev. 1977: 84: 191-215.

Wulf G, Shea CH. Principles derived from the study of simple skills do not generalize to complex skill learning. Psychon Bull Rev. 2002: 9(2): 185-211.

Landers DM, Landers DM. Teacher versus peer models: Effects of model’s presence and performance level on motor behavior. J Mot Behav. 1973: 5(3): 129-39.

Zimmerman BJ, Rosenthal TL. Conserving and retaining equalities and inequalities through observation and correction. Dev Psychol. 1974: 10(2): 260.

Knoblauch H, Schnettler B. Videography: Analysing video data as a ‘focused’ ethnographic and hermeneutical exercise. Qualitative Research. 2012: 12(3): 334-356.

Boyce BA, Coker CA, Bunker LK. Implications for variability of practice from pedagogy and motor learning perspectives: finding a common ground. Quest. 2006: 58(3): 330-343.

Proteau L, Blandin Y, Alain C, Dorion A. The effects of the amount and variability of practice on the learning of a multi-segmented motor task. Acta Psychol. 1994: 85(1): 61-74.

Wulf G, Schmidt RA. Variability of practice and implicit motor learning. J Exp Psychol Learn Mem Cogn. 1997: 23(4): 987.

Catalano JF, Kleiner BM. Distant transfer in coincident timing as a function of variability of practice. Perceptual and motor Skills. 1984: 58(3): 851-856.

Rohwer D, Polk J. Practice behaviors of eighth-grade instrumental musicians. Journal of Research in Music Education. 2006: 54(4): 350-62.

Schmidt RA. A schema theory of discrete motor skill learning. Psychol Rev. 1975: 82: 225-260.

Ericsson KA, Krampe RT, Tesch-Römer C. The role of deliberate practice in the acquisition of expert performance. Psychol Rev. 1993: 100(3), 363.

Barry NH. A comparison of advanced student musicians' and professional musicians' practice attitudes and strategies. Southeastern Journal of Music Education. 1991: 3: 32-41.

Keele SW. Movement control in skilled motor performance. Psychol bull. 1968: 70(6): 387-403.

Logan GD. Automatic control: How experts act without thinking. Psychol Rev. 2018: 125(4): 453-485.

Healy AF, Clawson DM, McNamara DS, et al. The Long-Term Retention of Knowledge and Skills. Psychol Learn Motiv. 1993: 30: 135-64.

Dunlosky J, Rawson KA, Marsh EJ, Nathan MJ, Willingham DT. Improving students’ learning with effective learning techniques. Psychological Science in the Public Interest. 2013: 14(1): 4-58.





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