Choice Type Impacts Human Reinforcement Learning.

In reinforcement learning (RL) experiments, participants learn to make rewarding choices in response to different stimuli; RL models use outcomes to estimate stimulus-response values that change incrementally. RL models consider any response type indiscriminately, ranging from more concretely defined motor choices (pressing a key with the index finger), to more general choices that can be executed in a number of ways (selecting dinner at the restaurant). However, does the learning process vary as a function of the choice type? In Experiment 1, we show that it does: Participants were slower and less accurate in learning correct choices of a general format compared with learning more concrete motor actions. Using computational modeling, we show that two mechanisms contribute to this. First, there was evidence of irrelevant credit assignment: The values of motor actions interfered with the values of other choice dimensions, resulting in more incorrect choices when the correct response was not defined by a single motor action; second, information integration for relevant general choices was slower. In Experiment 2, we replicated and further extended the findings from Experiment 1 by showing that slowed learning was attributable to weaker working memory use, rather than slowed RL. In both experiments, we ruled out the explanation that the difference in performance between two condition types was driven by difficulty/different levels of complexity. We conclude that defining a more abstract choice space used by multiple learning systems for credit assignment recruits executive resources, limiting how much such processes then contribute to fast learning.

Impulsivity Relates to Multi-Trial Choice Strategy in Probabilistic Reversal Learning.

Impulsivity is defined as a trait-like tendency to engage in rash actions that are poorly thought out or expressed in an untimely manner. Previous research has found that impulsivity relates to deficits in decision making, in particular when it necessitates executive control or reward outcomes. Reinforcement learning (RL) relies on the ability to integrate reward or punishment outcomes to make good decisions, and has recently been shown to often recruit executive function; as such, it is unsurprising that impulsivity has been studied in the context of RL. However, how impulsivity relates to the mechanisms of RL remains unclear. We aimed to investigate the relationship between impulsivity and learning in a reward-driven learning task with probabilistic feedback and reversal known to recruit executive function. Based on prior literature in clinical populations, we predicted that higher impulsivity would be associated with poorer performance on the task, driven by more frequent switching following unrewarded outcomes. Our results did not support this prediction, but more advanced, trial-history dependent analyses revealed specific effects of impulsivity on switching behavior following consecutive unrewarded trials. Computational modeling captured group-level behavior, but not impulsivity results. Our results support previous findings highlighting the importance of sensitivity to negative outcomes in understanding how impulsivity relates to learning, but indicate that this may stem from more complex strategies than usually considered in computational models of learning. This should be an important target for future research.

The Display of Medical Information: Content, Format, and Subjective Experience.

OBJECTIVES: To address a gap in the literature by investigating the subjective experience of participants to the form and content of medical information displayed in a healthcare setting. BACKGROUND: Artwork can enhance the experience of patients, but much less is known about how individuals react to displays of medical information in the form of posters or pamphlets, especially those about unsettling conditions (e.g., skin cancer). METHODS: In a 2 × 2 × 2 between-subjects design, researchers investigated the content of medical information (skin cancer vs. skin care) that was on display in a simulated exam room, whether the form was a pamphlet or a poster, and reason for the visit (routine annual skin check or evaluating a mole) on measures of subjective experience, including anxiety. RESULTS: Viewing material about skin cancer produced greater anxiety and greater arousal than did viewing material about sunscreen, and given the choice of four images (pamphlet and poster for sunscreen, pamphlet and poster for skin cancer), the sunscreen poster was recommended to improve the patient's experience and lower stress. In terms of display format, posters are judged to provide more visual engagement than are pamphlets. CONCLUSIONS: Exam rooms should offer multiple opportunities for visual engagement without images that produce anxiety. More research is needed to understand the subjective experience of the patient's interaction with the content and format of medical information.

Magnitude Matters: Art Image Size and Waiting Time Impact Perceived Quality of Care.

OBJECTIVE: The study fills a gap in the literature by examining the size of the art displayed and waiting time in an exam office on patients' judgments of the quality of care they are likely to receive. BACKGROUND: A body of research shows that the content of art in healthcare settings has an impact on patients' well-being, yet no work has empirically systematically examined the size of the art displayed on perceived healthcare outcomes. METHOD: A fully crossed 4 ×2 between-subjects experimental design examined the impact of exposure to images in an outpatient exam room that varied in the size of what was displayed (a landscape scene: small, medium, large, and control-blank wall) crossed by the time waiting for the physician (10 vs. 45 min). The Dependent Variables were the reported anxiety and various measures of satisfaction with the healthcare visit. RESULTS: The size of the art had a significant effect on the majority of the dependent variables; specifically, the large image had a more positive impact than the other sizes; longer waits were also negatively evaluated by patients and affected anxiety and judgments of room spaciousness. CONCLUSIONS: Identifying the recommended content of art displayed is necessary but not sufficient; the size of the art in its context has the potential to impact a range of important perceptions related to healthcare. When the size does not match the available wall space (i.e., the canonical size was not utilized), a variety of ratings of the healthcare environment (including the practitioner) were negatively affected.