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  <front>
    <journal-meta />
    <article-meta>
      <title-group>
        <article-title>Conceptualising immersive psychomotor skills training.</article-title>
      </title-group>
      <contrib-group>
        <contrib contrib-type="author">
          <string-name>Khaleel Asyraaf Mat Sanusi</string-name>
        </contrib>
        <contrib contrib-type="author">
          <string-name>Deniz Iren</string-name>
          <email>deniz.iren@ou.nl</email>
          <xref ref-type="aff" rid="aff0">0</xref>
        </contrib>
        <contrib contrib-type="author">
          <string-name>Roland Klemke</string-name>
          <xref ref-type="aff" rid="aff0">0</xref>
        </contrib>
        <contrib contrib-type="author">
          <string-name>Cologne Game Lab</string-name>
        </contrib>
        <contrib contrib-type="author">
          <string-name>TH Köln</string-name>
        </contrib>
        <contrib contrib-type="author">
          <string-name>Cologne</string-name>
        </contrib>
        <contrib contrib-type="author">
          <string-name>Germany</string-name>
        </contrib>
        <aff id="aff0">
          <label>0</label>
          <institution>Open Universiteit</institution>
          ,
          <addr-line>Heerlen</addr-line>
          ,
          <country country="NL">The Netherlands</country>
        </aff>
      </contrib-group>
      <abstract>
        <p>The coordination of psychomotor skills requires deliberate practice and techniques, all of which are typically taught in a physical setting, where instructions and timely feedback are given by the teachers. However, doing so remotely is commonly inefficient and ineffective, therefore, hindering the learner's progress. Sensors and immersive technologies enable the collection of multimodal data and the creation of immersion, respectively. These technologies have been widely used to further improve the learning outcome, especially in the psychomotor domain. In this paper, we present our research on designing an immersive training environment for remote psychomotor skill training and investigating how such an environment can be used for training skills in different psychomotor domains.</p>
      </abstract>
      <kwd-group>
        <kwd>1 Immersive technologies</kwd>
        <kwd>Sensors</kwd>
        <kwd>Multimodal</kwd>
        <kwd>Psychomotor skills</kwd>
      </kwd-group>
    </article-meta>
  </front>
  <body>
    <sec id="sec-1">
      <title>1. Introduction</title>
      <p>
        The global pandemic event of Covid-19 has
affected various learning and teaching activities
acutely. This necessitates the notion of online
learning or e-learning in which web
conferencing tools (e.g., Zoom, Teams) are
widely utilised by teachers and students for
classroom activities. However, this is rarely the
case for psychomotor skills development as
they require hands-on practice. Psychomotor
skills need to be physically executed, in most
cases, repetitively to the extent that the muscle
memory is trained, which will automate the
muscle movements [
        <xref ref-type="bibr" rid="ref1">1</xref>
        ]. Furthermore, the
presence of teachers is needed in order to
explain, demonstrate, and assess certain
procedures. To achieve this, the human learning
model has to be in a structured form where
instructions are well-defined, and feedback can
be given to ensure that the tasks are performed
in a correct manner, which include safety and
effectiveness. Timely and consistent feedback
from the teacher is essential for the learner to
avoid developing improper techniques during
training, thus ensuring the desired goal can be
achieved in a shorter time [
        <xref ref-type="bibr" rid="ref2">2</xref>
        ]. However, doing
so in a remote manner makes the learning
process ineffective and inefficient due to the
lack of modalities such as haptic feedback or
3D full-body perception, hence impeding the
learner’s progress. Due to this, psychomotor
skill learners and teachers have been
substantially affected.
      </p>
      <p>Nowadays, educational technology and
artificial intelligence (AI) researchers are
progressively embedding sensor technologies
for the collection of multimodal data, and
machine learning approaches for tracking
learners' behaviour and progress in authentic
learning contexts. The combination of these
technologies introduces new technological
affordances that can be leveraged in the
psychomotor education, especially in a remote
manner, to further improve the learning
outcome.</p>
      <p>
        Multimodality is a theoretical assumption
that can be applied to provide more structure in
sensors for exploring learning. The general idea
of multimodality in learning comes from the
theory of embodied communication. Based on
this theory, humans use their whole bodies to
communicate with each other, applying various
channels to exchange messages such as
gestures, facial expressions, prosody, etc. [
        <xref ref-type="bibr" rid="ref3">3</xref>
        ].
Subsequently, the trend of multimodality has
been employed in human-computer interaction.
Sensor-based multimodal interfaces allow the
monitoring of different modalities and have
been applied in various domains to improve
learning [[
        <xref ref-type="bibr" rid="ref4">4</xref>
        ], [
        <xref ref-type="bibr" rid="ref5">5</xref>
        ], [
        <xref ref-type="bibr" rid="ref6">6</xref>
        ]].
      </p>
      <p>
        While the multimodal approach helps to
improve the psychomotor learning outcome,
designing virtual training environments adds
immersion to the learning activity. As such,
immersive learning technologies such as virtual
reality (VR), augmented reality (AR) and game
elements enable the creation of virtual training
environments or simulations that typically
consist of nearly, if not entirely, realistic
physical similarity to an actual learning context.
Herrington et al. [
        <xref ref-type="bibr" rid="ref7">7</xref>
        ] stress that the learning
environment and designated tasks create the
conditions for the “True” immersion. Hence, it
can be argued that the instructions and feedback
provided by the learning environment should be
pragmatic for the learners to learn to perform
the tasks in a correct manner; for example,
personalised feedback (human-teacher-like) to
create immersive learning experiences.
Intrinsically, virtual training environments
allow the learner to actively interact with the
ingame objects which may create more
engagement and increase motivation for the
learner when performing tasks.
      </p>
      <p>In this research, we aim to design and
implement an immersive training environment
for psychomotor skills using immersive
technologies which will be integrated with
sensor technologies and AI, in order to deliver
instructions and feedback to learners in a
meaningful manner. Furthermore, we intend to
investigate the effectiveness of the system and
whether it can be applied to train skills in
different psychomotor domains. The
development of this system provides an early
and significant step towards combining
immersive technologies and sensor
technologies in a multi-sensor setup for
collecting multimodal data and giving
immediate feedback in an immersive training
environment in which learners can use to
improve their psychomotor skills
independently.</p>
      <p>The paper is structured as follows. In
Section 2, we present related studies that utilise
sensors for the collection of multimodal data
and immersive training environments for
immersion, and to what extent they are used in
the psychomotor domain. Next, we explain our
research questions in Section 3. Subsequently,
in Section 4, we visualise and describe the
research model and methods of this study.
Finally, in Section 5 we discuss the expected
outcomes of our study in theoretical and
practical implications, followed by the
conclusion.</p>
    </sec>
    <sec id="sec-2">
      <title>2. Related work 2.1.</title>
    </sec>
    <sec id="sec-3">
      <title>Sensors learning in psychomotor</title>
      <p>
        Sensor technologies are increasingly
becoming more portable and increasingly used
in psychomotor training, enabling efficient
methods for the acquisition of performance
data, which allows effective monitoring and
intervention. That being said, such devices have
been explored to provide support in the learning
domain. For example, Schneider et al. [
        <xref ref-type="bibr" rid="ref8">8</xref>
        ]
analysed 82 prototypes found in literature
studies based on Bloom’s taxonomy of learning
domains (psychomotor, cognitive, and
affective). Their research suggests researchers
and educators to consider utilising sensor-based
platforms as reliable learning tools for reducing
the workload of teachers and, therefore,
contribute to the solution of many current
educational challenges.
      </p>
      <p>
        Motion sensors such as accelerometers and
gyroscopes are predominantly used to acquire
motion data to recognize human activities,
especially in the psychomotor domain. These
sensors are commonly combined and used in a
synchronized manner to achieve a higher
accuracy of detecting not only simple but
complex activities as well [
        <xref ref-type="bibr" rid="ref9">9</xref>
        ]. This enables the
collection of multimodal data and provides a
more accurate representation of the learning
process [
        <xref ref-type="bibr" rid="ref10">10</xref>
        ]. Furthermore, multimodal data can
be collected using various sensors such as
wearable sensors, depth camera sensors,
Internet of Things devices, etc.
      </p>
      <p>
        For instance, Schneider et al. [
        <xref ref-type="bibr" rid="ref4">4</xref>
        ] designed a
system to support the development of public
speaking skills using the Kinect v2 depth
camera sensor to track the skeletal joints of the
learner's body and the HoloLens headset to
provide feedback in real-time when mistakes
are detected while presenting. Limbu et al. [
        <xref ref-type="bibr" rid="ref11">11</xref>
        ]
developed a system to teach basic calligraphy
skills, which uses the pen sensor in Microsoft
Surface tablet and EMG sensors in a Myo
armband to provide feedback to learners during
practice. It also allows the calligraphy teacher
to create an expert model, which the learners
can later use to practice and receive guidance
and feedback based on the expert model.
      </p>
      <p>
        To better understand learners’ performance,
educational researchers are progressively using
machine learning approaches to classify
activities based on the multimodal data
collected. For instance, in the medical domain,
Di Mitri et al. [
        <xref ref-type="bibr" rid="ref5">5</xref>
        ] investigated how multimodal
data and Neural Networks can be used for
learning Cardiopulmonary Resuscitation skills
by utilising a multi-sensor system comprising
of a Kinect v2 and a Myo armband. In the sports
domain, Mat Sanusi et al. [
        <xref ref-type="bibr" rid="ref6">6</xref>
        ] applied the same
framework as the previous author by using
built-in accelerometer and gyroscope sensors in
a smartphone and also a Kinect v2 to detect
forehand table tennis strokes during training.
Both study results show a high classification
rate of the activities when combining the
sensors, emphasising the importance of a
multimodal approach in classifying complex
activities.
      </p>
      <p>In this research, we aim to use a
multisensory system (e.g., wearable technologies,
depth cameras) with the help of machine
learning to help learners improve their
psychomotor skills. We intend to have a
theoretical framework that can be used for
training skills in one psychomotor domain and
subsequently applied in multiple domains.</p>
    </sec>
    <sec id="sec-4">
      <title>2.2. Immersive environments training</title>
      <p>Immersive learning technologies such as VR
and AR are progressively becoming a
significant medium for psychomotor training.
Due to the substantial improvement and
development in recent years, such technologies
are being used in various psychomotor
domains, including sports, physical training,
rehabilitation therapy, and much more. These
technologies transport individuals into an
interactive training or learning environment,
either virtually or physically, to replicate the
authentic learning context of a specific skill.</p>
      <p>
        For example, Song et al. [
        <xref ref-type="bibr" rid="ref12">12</xref>
        ] designed and
implemented an immersive VR environment
for teaching tennis using high-definition
stereoscopic display, robust and accurate
hybrid sensor tracking, shader-based skin
deformation, intelligent animation control, and
haptic feedback mechanism. The authors
reported that, through these technologies, a
real-time immersive tennis playing experience
is achieved. Potentially, the system can be
scaled to adapt various application cases such
as other sports game simulations and even
military training simulations.
      </p>
      <p>
        Ali et al. [
        <xref ref-type="bibr" rid="ref13">13</xref>
        ] experimented with multiple
VR fitness applications (e.g., VR Fitness,
VirZOOM, BOXVR) for physical training such
as walking, running, and jogging. In addition,
they implemented a mobile application that
uses built-in sensors such as an accelerometer
and gyroscope for motion detection. As a result,
they achieved up to 82.46% of accuracy and
thus, described the effectiveness of VR
technology in physical training, which is
helpful for the development of psychomotor
skills.
      </p>
      <p>In our research, we aim to incorporate
immersive technologies into the mix for the
creation of immersive training environments to
enhance the immersive experience of the
learner in the learning setting. Our grand vision
is to have a theoretical framework with a
structured human learning model (feedback and
instructions) within these immersive training
environments that can be applied to not only
one but also multiple psychomotor domains.</p>
    </sec>
    <sec id="sec-5">
      <title>3. Research questions</title>
      <p>Based on the problem identified and the
related work analysed, we aim to investigate the
following research questions (RQs):
1. What level of technological support
(technology) is available in the
literature and appropriate for delivering
effective instructions and feedback
(pedagogy) to the
psychomotor training?
learners
in</p>
      <p>Fundamentally, it is crucial to identify the
most promising pedagogical approaches in
psychomotor skills learning that can be applied
in multiple psychomotor domains.
Furthermore, with technologies that have been
widely used to improve the learning outcome in
recent years, we survey the state-of-the-art of
technology that may potentially be helpful for
our research. Therefore, a systematic review
will be carried out for these two processes and
thus, answer our RQ1. The outcome of
answering this question would be the
theoretical framework of the system.</p>
      <p>2. How can we create an immersive and
information-rich (remote/self-learning)
training environment for psychomotor
skills that deliver effective instructions
and meaningful feedback to the
learner?</p>
      <p>Subsequently, we design and implement a
virtual training environment based on the
theoretical framework retrieved from RQ1. The
instruction and feedback systems should be
given in a realistic manner to create immersive
learning experiences. Therefore, it is vital to
research how can we maximise the system’s
effectiveness in providing feedback and
instructions. This includes the framing of
interaction and the appropriate modalities for
instructions and feedback. Consequently, we
can investigate the effectiveness of the system:
can the system help learners improve their
skills during training?
3. To what extent can we generalise our
training framework to multiple
psychomotor domains?</p>
      <p>Finally, we explore if the system can, both
theoretically and practically, be adapted and
applicable in multiple psychomotor domains.
More exercise routines and common mistakes
of the selected applications cases will be
identified to suit the system's needs. Hence, it is
crucial to know what are other possible
application cases that the new system can be
used to train related psychomotor tasks and can
the system effectively help learners learn
different psychomotor skills?</p>
    </sec>
    <sec id="sec-6">
      <title>4. Methodology 4.1.</title>
    </sec>
    <sec id="sec-7">
      <title>Research methods</title>
      <p>
        It is essential for this research to follow a
methodological approach for designing,
developing, testing, and evaluating such a
system. Hence, we conduct our research based
on the Design-based Research (DBR)
approach, a common iterative methodological
approach for prototypical solutions. In the
context of our research, we combined two DBR
models from Amiel &amp; Reeves [
        <xref ref-type="bibr" rid="ref14">14</xref>
        ], and De
Vielliers &amp; Harpur [
        <xref ref-type="bibr" rid="ref15">15</xref>
        ], which are used in the
domain of educational technologies.
      </p>
      <p>Figure 1 shows the phases of the DBR
approach for this research, and the following
subsections explain each of the phases.</p>
      <p>1. Problem analysis: In the first phase, a
systematic literature will be reviewed to
determine the importance of the problem and
identify the current theory on the immersive
multimodal environments in the psychomotor
domain. Furthermore, the selection of
application cases will be made in this phase.
With these approaches, we are analysing the
problem and defining research goals. The
outcome of this step is a detailed research
proposal containing goals and evaluation
criteria.</p>
      <p>2. Design solution: A theoretical framework
is proposed based on the results from the
systematic review, identifying the most
promising pedagogical model in psychomotor
training and the technologies that can be
contributed to such a model. Our conceptual
model (see Figure 2) states how we transfer the
theoretical framework into our system design,
suggesting to address the problem from phase
1.</p>
      <p>3. Develop solution: The next phase is the
implementation of the immersive training
environment that serves the research purpose.
The development of the system is based on the
theoretical framework proposed in phase 2. The
outcome is an innovative and functional
immersive training environment system with
the integration of immersive technologies,
sensor technologies, and AI that aims to address
the challenges of remote psychomotor training
and help us achieve our research goals.
4. Evaluate in practice: Subsequently, in the
next phase, focus group experiments involving
the teachers/experts will be carried out for
qualitative analysis to gather important
details that can be added to the system. Further,
a user test will be conducted to reveal essential
aspects of how the system can be improved.
Additionally, questionnaires and surveys for
the quantitative analysis are helpful to provide
a general idea of how users perceive the
interaction between the system. The refinement
of the system should then be followed involving
the teachers/experts to ensure that the system is
ready to be tested with the learners in the
realworld setting. Then, the data is collected and
analysed to answer the research questions and
to construct design principles.</p>
      <p>5. Reflection, dual outcomes:</p>
      <p>Practical: This phase enhances the
implementation of the solution. As reflection
occurs, new designs can be further developed
and implemented, which leads to an ongoing
sub-cycle of the design-reflection process.</p>
      <p>Theoretical: It is imperative to keep detailed
records during the design research process
concerning how the design outcomes (e.g.,
principles) have worked or have not worked,
how the innovation has been improved, and
what are changes have been made. Through this
documentation, it can be helpful for other
researchers and designers who are interested in
those findings and examine them in relation to
their context and needs.
4.2.</p>
    </sec>
    <sec id="sec-8">
      <title>Solution approach</title>
      <p>
        In learning sciences, a conceptual model is
commonly used to improve explanations and
provide visual representations of abstracts [
        <xref ref-type="bibr" rid="ref16">16</xref>
        ].
Following this theory, we sketched a model for
visualising the overall learning process using
the immersive training environment from the
human learner perspective (see Figure 2).
      </p>
      <p>Based on the model, multimodal data will
be collected by tracking the skeletal points and
capturing the body motion of the human
learner's body. Instructional tasks are ideally
given before the learner performs the specific
tasks. Feedback is typically given in real-time
when mistakes are detected during training and
as visual summative, after training. Instructions
are also given during training to help learners
progress to the next steps or even in the form of
detailed feedback. These two aspects of the
human learning model - instructions and
feedback - can be given in multiple modalities.
In the context of our research, the most
common modalities that can be applied are
visual, audio, and haptic. These modalities form
various types of interaction that can be
potentially used in the immersive training
environment to give instructions and feedback
such as virtual avatars, videos, etc. Finally,
these aspects help validate the effectiveness of
the immersive training environment.</p>
      <p>Since the research is in an early phase, the
conceptual model is still on the abstract level.
However, this constitutes the groundwork of
this research and will be extended into a bigger
model with more aspects in the later phases.</p>
    </sec>
    <sec id="sec-9">
      <title>5. Discussion and conclusion</title>
      <p>The expected outcomes of this research are
divided into two implications: theoretical and
practical. From the theoretical perspective,
systematic literature review findings on
requirements to create immersive training
environments for psychomotor skills will be
delivered. Based on these findings, a
conceptual framework of the immersive
training environment consisting of guidelines
and methodologies on delivering instructions,
providing feedback, and tracking learner's
performance will be constructed. We envision
this framework to constitute the groundwork
for the design. Moreover, it will extend
immersive training environments for
psychomotor skills training in multiple
domains. This framework will potentially be
useful for researchers as a basis for their
theoretical and practical research.</p>
      <p>From the practical perspective, a system for
delivering effective instructions, providing
meaningful feedback, and tracking learner's
performance will be developed. Similarly, as
the theoretical implication, such a system needs
to be adapted in various psychomotor domains
for different skills training. The empirical
studies will be carried out with learners to
measure the effectiveness of the system and the
outcome should deliver promising results.
Consequently, learners and teachers can benefit
from the system to help them with the training.</p>
      <p>This research investigates the effectiveness
of an immersive training environment in the
development of psychomotor skills training.
The proposed theoretical framework integrates
immersive technologies and sensor
technologies for the immersion and multimodal
data, respectively, providing a preliminary yet
significant step towards combining such
technologies in a multi-sensor setup to further
improve the learning outcome in the
psychomotor domain, especially in
remotelearning scenarios.</p>
    </sec>
    <sec id="sec-10">
      <title>6. Acknowledgements</title>
      <p>This research is funded by the Federal
Ministry of Education and Research (BMBF) in
the program of Digital Higher Education for the
project Multimodal Immersive Learning with
Artificial Intelligence for Psychomotor Skills
(MILKI-PSY) with the grant number:
16DHB4013.</p>
    </sec>
    <sec id="sec-11">
      <title>7. References</title>
    </sec>
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