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  <front>
    <journal-meta />
    <article-meta>
      <title-group>
        <article-title>Leveraging Feedback Through Personalized Recommendations within Intelligent Tutoring Systems for Psychomotor Skill Development</article-title>
      </title-group>
      <contrib-group>
        <contrib contrib-type="author">
          <string-name>Gianluca Romano</string-name>
        </contrib>
        <contrib contrib-type="author">
          <string-name>Jan Schneider</string-name>
        </contrib>
        <aff id="aff0">
          <label>0</label>
          <institution>Leibniz Institute of Research and Information in Rostocker Straße 6</institution>
          ,
          <addr-line>60323 Frankfurt am Main</addr-line>
        </aff>
      </contrib-group>
      <abstract>
        <p>In recent years, Intelligent Tutoring Systems (ITS) have been developed for psychomotor skill training. However, we see three main problems. First, the feedback provided is not enough, and there is no real evidence in terms of long-term studies to support the efectiveness of the presented systems. Second, the underlying model is evaluated instead of the whole ITS. Third, and consequently, task, student, and teacher models are not explicitly defined. That is why we present organizing exercises within a hierarchy of domain-specific and generic skills that is used to recommend personalized workouts within dimensions to cover abilities that, in consequence, improve psychomotor skill development.</p>
      </abstract>
      <kwd-group>
        <kwd>eol&gt;Intelligent Tutoring System</kwd>
        <kwd>Psychomotor</kwd>
        <kwd>Skill Training</kwd>
      </kwd-group>
    </article-meta>
  </front>
  <body>
    <sec id="sec-1">
      <title>1. Introduction</title>
      <p>
        The integration of Intelligent Tutoring Systems (ITS) in psychomotor skill training has shown
promise in enhancing learning outcomes. Motion capturing systems, cameras, or other sensors
are used to digitize human performances [
        <xref ref-type="bibr" rid="ref1 ref2 ref3 ref4 ref5">1, 2, 3, 4, 5</xref>
        ]. Machine Learning techniques are applied
to make sense of those and consequently provide instructed feedback [
        <xref ref-type="bibr" rid="ref1 ref4 ref5">1, 5, 4</xref>
        ]. ITS are applied in
various fields such as medicine, i.e. training of surgical skills [
        <xref ref-type="bibr" rid="ref6">6</xref>
        ] or emergency procedures [
        <xref ref-type="bibr" rid="ref5">5</xref>
        ],
or sports, i.e. dancing [
        <xref ref-type="bibr" rid="ref1 ref3 ref4">1, 4, 3</xref>
        ], or table tennis [
        <xref ref-type="bibr" rid="ref2">2</xref>
        ]. We are aware that the presented literature is
not enough for solid statements, but to the best of our knowledge, we have consistently seen the
following shortcomings across the research field. Also note that we have to restrict the number
of references due to the page limit. Existing studies, for example, have low sample sizes [
        <xref ref-type="bibr" rid="ref6">6</xref>
        ], or
evaluate mostly the underlying model [
        <xref ref-type="bibr" rid="ref4 ref6">4, 6</xref>
        ] making it hard to understand the true impact of these
solutions. Furthermore, the provided feedback often revolves around distinguishing between
experts and novices [
        <xref ref-type="bibr" rid="ref3 ref4 ref6">4, 3, 6</xref>
        ] which at most addresses the imitation of various psychomotor
taxonomies for learning goals like Dave’s [
        <xref ref-type="bibr" rid="ref7">7</xref>
        ]. Consequently, it remains unclear how to efectively
leverage feedback to drive meaningful progress in skill acquisition. The feedback provided by
existing solutions is not efective, according to [
        <xref ref-type="bibr" rid="ref8">8</xref>
        ] because it misses the "Where to next?" aspect.
With our concept, we believe we can address this issue by recommending exercises based on
past performances, hence explicitly stating where to go next. We further believe that the nature
of evaluating machine learning solutions yield ITS with a view of task models that is too narrow
to reflect the domain of psychomotor skill training.
      </p>
      <p>In this article, we suggest modeling psychomotor skill training with a hierarchy of skills
that is used to provide feedback and workout plans for micro, meso, and macro training cycles.
Specifically, we interpret skill training as a combination of technique and ability. We highlight
the need for comprehensive, longer-term studies that investigate the true learning outcomes
facilitated by these systems.</p>
      <p>Understanding that abilities are influenced by genetic predispositions but can be developed
through training, our proposed approach involves the system recommending exercises tailored
to specific abilities such as strength, flexibility, and coordination. By adopting this broader
framework, we aim to foster a more comprehensive and efective approach to psychomotor
skill development.</p>
      <p>In conclusion, this article highlights the need for a paradigm shift in feedback mechanisms
within ITS for psychomotor skill training. It emphasizes the necessity of moving beyond
comparisons and generic instructions and instead exploring the potential of ability-driven
exercise recommendations. By bridging the gap between technique and ability, we believe
that ITS can provide more meaningful support for learners, enabling them to enhance their
psychomotor skills in a holistic and sustainable manner.</p>
    </sec>
    <sec id="sec-2">
      <title>2. Hierarchy of Psychomotor skills</title>
      <p>A fundamental distinction within this hierarchy lies between generic skills and domain-specific
skills. Generic skills encompass exercises that have broad applicability and can be considered
foundational to psychomotor development. A prime example of a generic skill is the classic
push-up exercise, which involves coordinated movements of the upper body and requires core
strength and stability.</p>
      <p>In contrast, domain-specific skills are exercises that are tailored to a particular field or
discipline. For instance, in martial arts, punches are specific to the domain and require precise
coordination of the arms, shoulders, and torso. Similarly, in the context of running, arm swings
play a crucial role in maintaining balance and rhythm during the locomotion process.</p>
      <p>It is important to note that training generic abilities serves as a pathway to enhance the
acquisition of domain-specific skills. By targeting and refining fundamental physical and
cognitive capacities, individuals can lay a solid foundation for the development of more complex
psychomotor skills. This process facilitates the transfer of skills from generic abilities to the
execution of domain-specific skills, leading to enhanced overall psychomotor performance.</p>
      <p>Understanding the hierarchical structure of exercises for psychomotor skill development
provides valuable insights into the systematic progression of training programs. By recognizing
the distinction between generic and domain-specific skills, educators and practitioners can
design targeted interventions that address the specific needs of learners in various domains.
Furthermore, by emphasizing the training of basic abilities, instructors can optimize the
acquisition and mastery of generic skills, thereby fostering the development of proficient psychomotor
abilities in academic and practical contexts.</p>
      <sec id="sec-2-1">
        <title>2.1. Dimensions of Psychomotor Skill Training</title>
        <p>
          In a top-down approach, skills in various dimensions have been extensively examined in
the existing literature. The first dimension, strength, is essential for skills training as it is
strongly associated with improved force-time characteristics that contribute to overall athletic
performance [
          <xref ref-type="bibr" rid="ref9">9</xref>
          ]. Greater muscular strength allows athletes to perform general sport skills
such as jumping, sprinting, and change of direction tasks more efectively [
          <xref ref-type="bibr" rid="ref10">10</xref>
          ]. Research also
indicates that stronger athletes produce superior performances during sport-specific tasks
[
          <xref ref-type="bibr" rid="ref11">11</xref>
          ]. In addition to enhancing performance, greater muscular strength also reduces the risk of
injury [
          <xref ref-type="bibr" rid="ref12">12</xref>
          ]. Therefore, the first dimension, strength, encompasses three distinct aspects: static,
dynamic, and explosive strength. Static strength refers to the maximum amount of weight
an individual can lift or support without movement. Dynamic strength, also referred to as
endurance, measures the individual’s ability to sustain the movement of a weight over a given
period of time. Finally, explosive strength is characterized by the ability to swiftly move as
much weight as possible.
        </p>
        <p>
          The second dimension, flexibility, comprises two key components: static and dynamic
flexibility. Static flexibility refers to the capacity to maintain a stretched position without any
movement. On the other hand, dynamic flexibility involves introducing movement while
maintaining flexibility. Flexibility is an important component of sports skill training. It allows
for a greater range of motion around joints and muscles, which is essential for many athletic
movements [
          <xref ref-type="bibr" rid="ref13">13</xref>
          ].
        </p>
        <p>
          The third dimension, coordination, encompasses technique, body, balance, and rhythm.
Technique refers to domain-specific coordination, such as arm swings in running. Body coordination
involves the synchronization of actions, like hand-eye or hand-foot coordination. Balance
refers to the ability to maintain equilibrium while performing exercises. Rhythm introduces
a sense of musicality and harmonious movement in coordinated actions. Coordination is of
great importance in sports skill training. It is defined as the ability to perform complex motor
skills and includes abilities such as reaction, rhythm, balance, kinesthetic diferentiation, and
space-time orientation [
          <xref ref-type="bibr" rid="ref14">14</xref>
          ]. Developing coordination abilities is necessary during childhood
and adolescence as part of additional technique training [
          <xref ref-type="bibr" rid="ref15">15</xref>
          ].
        </p>
        <p>Moving on to the dimension of speed, it includes three aspects: reaction, orientation, and
velocity. Reaction speed involves responding swiftly to external stimuli, such as reacting to a
thrown ball. Orientation denotes the ability to rapidly determine the appropriate direction to
take, as exemplified in situations like receiving a pass in football and quickly deciding which
direction to move in. Velocity refers to the speed at which an individual executes their decision.
Speed is a crucial skill in sports training, as it sets athletes apart from their competition and
determines their performance level [16]. Speed is expressed by the ratio of space to time and
incorporates elements such as reaction time, frequency of motion, and running level [17]. The
relationship between strength and speed is important for optimizing training and preventing
injuries in sports [18].</p>
        <p>The dimension of team encompasses communication and tactics. Communication within a
team, as observed in sports like soccer, plays a crucial role in coordinating actions with fellow
team members. Tactics involve being aware of both one’s own strategies and those of team
members and opponents. Team skills training is important for sports skills development as it
contributes to the improvement of team performance and efectiveness [ 19]. Team building,
on the other hand, is not efective without prior team skills training [ 20]. In team sports,
decision-making is a crucial aspect of performance, and the use of intuitive decision-making
and shared configurations of play have been found to be efective [21].</p>
        <p>The final dimension, mental, consists of focus, stability, and endurance. Focus is the ability
to concentrate and dedicate oneself to the current moment, minimizing distractions. Stability
refers to maintaining a steady state of mind without faltering. Endurance, in the context of
mental skills, entails sustaining stability for the longest possible duration. Mental training is
important for sports skill development [22, 23, 24, 25]. It has been shown to improve athletes’
performance by enhancing their psychological skills, such as anxiety control, confidence, and
concentration [26].</p>
        <p>By considering these multifaceted dimensions of skills, researchers can gain a
comprehensive understanding of the various components that contribute to human performance and
achievement in academic and athletic contexts.</p>
      </sec>
    </sec>
    <sec id="sec-3">
      <title>3. Implementation</title>
      <p>Based on the previous section, we created an Entity Relationship Model (ERM) that is shown in
ifgure 1. The ERM is not complete and showcases only how entities and relations are organized.
For the creation process we followed some principles when creating knowledge bases [27]. We
formulated a set of keywords and questions the knowledge base should address. For instance,
"What dimensions of psychomotor skill training does a student focus on in his micro cycle?", or
"What generic and domain specific exercises can be trained for which sport?".</p>
      <p>In the knowledge base, a user can have multiple workout plans for micro, meso, macro
cycles. A workout plan focuses on one or multiple psychomotor skill domains, such as strength
or flexibility. Furthermore, a workout plan consists of exercises that are either generic or
specific. Generic exercises are applied to multiple psychomotor skills. For example, push-ups
are generally part of workout plans for all kinds of sports. Specific exercises are used in one
sport. For example, a boxing drill exercise is not part of the workout plans for dancing. Every
exercise targets one or more psychomotor skill domains. For example, push-ups target strength
for the most part, and kicking exercises can also target flexibility. Moreover, exercises afect
diferent body parts. For example, push-ups mostly afect the chest and arms.</p>
      <p>ERMs are used in practice to show entities and the relationships between them. In practice,
an ERM can be implemented diferently. Both relational and graph databases have emerged as
prominent solutions to implement ERM models. Each approach possesses distinct characteristics
that ofer unique advantages and disadvantages. This section presents a comparison of relational
and graph databases, highlighting their respective strengths and limitations.</p>
      <p>Relational databases excel in structured and tabular data management, performance
optimization, and ACID compliance. However, they face challenges related to inflexible schemas,
complex relationships, and hierarchical data. On the other hand, graph databases thrive in
eficiently handling complex relationships, providing flexibility in schema design, and enabling
real-time recommendations and analysis. Nevertheless, limitations regarding tabular data,
increased complexity, scalability, and tooling must be considered when evaluating their suitability
for specific use cases. Understanding these nuances empowers researchers and practitioners to
make informed decisions when selecting the most appropriate database technology for their
specific data management requirements.</p>
    </sec>
    <sec id="sec-4">
      <title>4. Workout Planning</title>
      <sec id="sec-4-1">
        <title>4.1. Feedback</title>
        <p>
          Traditionally, providing feedback meant giving simple instructions or comparing novice and
expert executions. However, this does not cover the "Where to next" component of efective
feedback. [
          <xref ref-type="bibr" rid="ref8">8</xref>
          ]. Undoubtedly, the provision of efective feedback plays a pivotal role in facilitating
meaningful learning experiences. Descriptive feedback accompanied by Key Performance
Indicators (KPIs) can be employed to evaluate skill performance. KPIs, such as exerted force or
execution time for specific actions like punching, can serve as valuable metrics for assessing
skill proficiency. Moreover, we suggest utilizing these KPIs to identify potential areas for
improvement and recommend personalized exercises, thus fostering a tailored learning path
and goal for individuals. Potential areas of improvement directly relate to the dimensions of
psychomotor skills, such as strength or flexibility.
        </p>
        <p>Based on the identified potential for improvement, the framework generates personalized
exercise recommendations. These recommendations, grounded in the hierarchical structure of
skills, guide learners towards exercises that target the specific dimensions requiring
improvement. By aligning exercises with the identified learning goals, learners embark on a personalized
learning path tailored to their individual needs and areas of growth.</p>
        <p>
          Furthermore, these exercise recommendations cover an integral component of efective
feedback, guiding learners on what to do next [
          <xref ref-type="bibr" rid="ref8">8</xref>
          ]. By providing learners with a clear roadmap and
actionable steps, instructors empower them to actively engage in their skill development journey.
This personalized learning path enhances motivation and self-eficacy as learners witness
tangible progress in the dimensions where they have the greatest potential for improvement.
        </p>
        <p>In conclusion, leveraging descriptive feedback with KPIs in psychomotor skill training opens
up new avenues for personalized learning paths. By quantifying skill performance and
identifying areas for growth, instructors can recommend exercises that align with learners’ specific
learning goals. This framework enhances the efectiveness of feedback and promotes
individualized skill development, fostering a more engaging and rewarding learning experience. As the
ifeld of educational technologies continues to evolve, incorporating personalized learning paths
based on descriptive feedback and KPIs holds immense potential for optimizing psychomotor
skill training in diverse academic and practical contexts.</p>
      </sec>
      <sec id="sec-4-2">
        <title>4.2. Micro vs. Meso vs. Macro Cycle</title>
        <p>In the realm of psychomotor skill training, the formulation of structured workout plans is
crucial for fostering progressive skill development. This article delves into the construction of
efective workout plans that encompass short-term (micro), mid-term (meso), and long-term
(macro) goals. By aligning recommended exercises with specific dimensions and adjusting the
focus across these cycles, a comprehensive and targeted approach to skill improvement can be
achieved.</p>
        <p>Recommended exercises serve as the building blocks for developing workout plans. These
exercises are carefully selected based on personalized recommendations derived from
performance assessments through KPIs and the individual’s potential for improvement. Assembling
these exercises into a structured plan ensures a systematic approach to skill development.</p>
        <p>Workout plans are organized into micro, meso, and macro cycles, each serving a distinct
purpose in the overall training program [28, 29]. Micro cycles correspond to short-term goals
and focus on specific recommended exercises. They provide a detailed framework for practicing
and refining specific skills, targeting dimensions such as strength, flexibility, coordination, or
speed. More specifically, micro cycle workout plans encompass a set of exercises for one training
session.</p>
        <p>Meso cycles represent the mid-term goals within the workout plan. In these cycles, the focus
shifts from specific exercises to the type of dimension to emphasize. While the specific exercises
within the micro cycles may vary, the meso cycles outline the overarching dimension that
learners should concentrate on during a specific phase of their training. For example, a meso
cycle may emphasize coordination, while a micro cycle predominantly recommends diferent
exercises within this dimension.</p>
        <p>Macro cycles encompass long-term goals and multiple dimensions of skill development. These
cycles aim to create a balanced training regimen by incorporating exercises that target various
aspects, such as strength, coordination, and flexibility. While the focus may shift during the
meso cycles, the macro cycles ensure that multiple dimensions remain present throughout
the training program, providing a comprehensive and holistic approach to skill improvement.
For example, a macro cycle focuses on strength, flexibility, and coordination. The macro cycle
contains three meso cycle workout plans that separately focus on strength, flexibility, and
coordination. For every meso cycle, there are multiple micro cycle workout plans with explicit
exercises that target the domain of psychomotor skill training of the respective meso cycle.</p>
        <p>By integrating micro, meso, and macro cycles into workout plans, instructors can design
personalized and progressive training programs for individuals. The micro cycles focus on
ifne-tuning specific skills, the meso cycles guide the emphasis on dimensions within specific
phases, and the macro cycles ensure a well-rounded and diverse skill development journey.</p>
        <p>In conclusion, the development of workout plans plays a vital role in psychomotor skill
training. By incorporating micro, meso, and macro cycles, instructors can create structured and
efective training programs. The micro cycles provide specificity and precision in practicing
recommended exercises, while the meso cycles guide the emphasis on dimensions within each
phase. Lastly, the macro cycles ensure a comprehensive approach by encompassing multiple
dimensions throughout the training program. By embracing this framework, educators and
practitioners can optimize skill acquisition and facilitate meaningful progress in psychomotor
skill development for academic and practical purposes.</p>
      </sec>
    </sec>
    <sec id="sec-5">
      <title>5. Conclusion</title>
      <p>In the past, ITS started to be a choice for the implementation of psychomotor skill training with
increasing levels of technology. However, the underlying model that, for example, distinguishes
novices from experts is often evaluated instead of the ITS as a whole. Consequently, the student,
task, and teacher models are not specified explicitly. Furthermore, the nature of machine learning
solutions introduces a focus on domain-specific implementation, neglecting the bigger picture
of psychomotor skill development. Hence, we present ideas to implement ITS for psychomotor
skill development, considering it as a whole. We highlight the importance of acquiring abilities,
which we introduce as dimensions inherently important to skill development, such as strength
or coordination. We suggest organizing exercises within these domains in a hierarchy of
domainspecific and generic skills and opting for an implementation with relational databases until
exhausted. Therefore, we presented a preliminary ERM to organize the knowledge base. We are
aware that the ERM needs to be evaluated and think that it can be evaluated by fitting online
available workout plans with the model and comparing fitted and unfitted workout plans with
coaches. Finally, we imagine using the hierarchy as an anchor to address the "Where to next"
aspect of efective feedback by recommending personalized exercises and workout plans based
on potential areas of improvement derived from KPIs. We envision that this will change how
we think about implementing ITS and providing feedback for psychomotor skill development.
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