Creating an Effective Simulation Environment.

Simulation is a teaching and learning strategy that is used commonly in healthcare education in academia and practice settings. Nurses at the bedside may recall times in their formal education where simulation was used as a form of clinical learning or evaluation of their performance. It is possible that with the rise of nurse residency programs and in situ simulation that bedside nurses are experiencing simulation regularly within the workplace as a means of professional development. This article will set the stage for educators to develop high-quality simulation experiences.

Understanding Others' Distress Through Past Experiences: The Role of Memory Engram Cells in Observational Fear.

For individuals to survive and function in society, it is essential that they recognize, interact with, and learn from other conspecifics. Observational fear (OF) is the well-conserved empathic ability of individuals to understand the other's aversive situation. While it is widely known that factors such as prior similar aversive experience and social familiarity with the demonstrator facilitate OF, the neural circuit mechanisms that explicitly regulate experience-dependent OF (Exp OF) were unclear. In this review, we examine the neural circuit mechanisms that regulate OF, with an emphasis on rodent models, and then discuss emerging evidence for the role of fear memory engram cells in the regulation of Exp OF. First, we examine the neural circuit mechanisms that underlie Naive OF, which is when an observer lacks prior experiences relevant to OF. In particular, the anterior cingulate cortex to basolateral amygdala (BLA) neural circuit is essential for Naive OF. Next, we discuss a recent study that developed a behavioral paradigm in mice to examine the neural circuit mechanisms that underlie Exp OF. This study found that fear memory engram cells in the BLA of observers, which form during a prior similar aversive experience with shock, are reactivated by ventral hippocampal neurons in response to shock delivery to the familiar demonstrator to elicit Exp OF. Finally, we discuss the implications of fear memory engram cells in Exp OF and directions of future research that are of both translational and basic interest.

Inequivalent and uncorrelated response priming in motor imagery and execution.

Introduction: Theoretical considerations on motor imagery and motor execution have long been dominated by the functional equivalence view. Previous empirical works comparing these two modes of actions, however, have largely relied on subjective judgments on the imagery process, which may be exposed to various biases. The current study aims to re-examine the commonality and distinguishable aspects of motor imagery and execution via a response repetition paradigm. This framework aims to offer an alternative approach devoid of self-reporting, opening the opportunity for less subjective evaluation of the disparities and correlations between motor imagery and motor execution. Methods: Participants performed manual speeded-choice on prime-probe pairs in each trial under three conditions distinguished by the modes of response on the prime: mere observation (Perceptual), imagining response (Imagery), and actual responses (Execution). Responses to the following probe were all actual execution of button press. While Experiment 1 compared the basic repetition effects in the three prime conditions, Experiment 2 extended the prime duration to enhance the quality of MI and monitored electromyography (EMG) for excluding prime imagery with muscle activities to enhance specificity of the underlying mechanism. Results: In Experiment 1, there was no significant repetition effect after mere observation. However, significant repetition effects were observed in both imagery and execution conditions, respectively, which were also significantly correlated. In Experiment 2, trials with excessive EMG activities were excluded before further statistical analysis. A consistent repetition effect pattern in both Imagery and Execution but not the Perception condition. Now the correlation between Imagery and Execution conditions were not significant. Conclusion: Findings from the current study provide a novel application of a classical paradigm, aiming to minimize the subjectivity inherent in imagery assessments while examining the relationship between motor imagery and motor execution. By highlighting differences and the absence of correlation in repetition effects, the study challenges the functional equivalence hypothesis of imagery and execution. Motor representations of imagery and execution, when measured without subjective judgments, appear to be more distinguishable than traditionally thought. Future studies may examine the neural underpinnings of the response repetition paradigm to further elucidating the common and separable aspects of these two modes of action.

Dreaming for two: A systematic review of mental sleep activity during pregnancy.

Changes in sleep and dreams are often observed during pregnancy. Dreaming may represent privileged access to the inner world of individuals, providing relevant information about their well-being. For this reason, a growing but heterogeneous literature has investigated dream experiences of pregnant women. The present paper aimed to systematically review the available evidence on the relationship between pregnancy and oneric activity, focusing on dream and nightmare frequency, dream contents, and emotional features. Moreover, dream changes between pre-partum and post-partum periods and the impact of previous pregnancy-related adverse events on dreaming have been summarized. Overall, 17 studies have been examined. The reviewed evidence suggests that women tend to have an abundant production of dreams and nightmares during pregnancy, and some results support the view that a high rate of dream recall is associated with poor sleep quality. Most studies have shown a high presence of pregnancy-related dream content, likely reflecting waking experiences and concerns. Additionally, dreaming may promote psychological preparation and activation of functional coping strategies to face life changes after childbirth.

Neural mechanisms of costly helping in the general population and mirror-pain synesthetes.

It has been argued that experiencing the pain of others motivates helping. Here, we investigate the contribution of somatic feelings while witnessing the pain of others onto costly helping decisions, by contrasting the choices and brain activity of participants that report feeling somatic feelings (self-reported mirror-pain synesthetes) against those that do not. Participants in fMRI witnessed a confederate receiving pain stimulations whose intensity they could reduce by donating money. The pain intensity could be inferred either from the facial expressions of the confederate in pain (Face condition) or from the kinematics of the pain-receiving hand (Hand condition). Our results show that self-reported mirror-pain synesthetes increase their donation more steeply, as the intensity of the observed pain increases, and their somatosensory brain activity (SII and the adjacent IPL) was more tightly associated with donation in the Hand condition. For all participants, activation in insula, SII, TPJ, pSTS, amygdala and MCC correlated with the trial by trial donation made in the Face condition, while SI and MTG activation was correlated with the donation in the Hand condition. These results further inform us about the role of somatic feelings while witnessing the pain of others in situations of costly helping.

Viral simulations in dreams: The effect of the COVID-19 pandemic on threatening dream content in a Finnish sample of diary dreams.

Previous research indicates that the COVID-19 pandemic has affected dreaming negatively. We compared 1132 dreams collected with prospective two-week dream diary during the pandemic to 166 dreams collected before the pandemic. We hypothesized that the pandemic would increase the number of threatening events, threats related to diseases, and the severity of threats. We also hypothesized that dreams that include direct references to the pandemic will include more threatening events, more disease-related threats, and more severe threats. In contradiction with our hypotheses, results showed no differences between pandemic and pre-pandemic samples in the number of threats, threats related to diseases, or severe threats. However, dreams with direct references to the pandemic had more threats, disease-related threats, and severe threats. Our results thus do not suggest a significant overall increase in nightmarish or threatening dream content during the pandemic but show a more profound effect on a minority of dreams.

Is there a continuum of agentive awareness across physical and mental actions? The case of quasi-movements.

While humans routinely distinguish between physical and mental actions, overt movements (OM) and kinesthetically imagined movements (IM) are often viewed as forming a continuum of activities. Here, we theoretically conceptualized this continuum hypothesis for agentive awareness related to OM and IM and tested it experimentally using quasi-movements (QM), a little studied type of covert actions, which is considered as an inner part of the OM-IM continuum. QM are performed when a movement attempt is minimized down to full extinction of overt movement and muscle activity. We asked participants to perform OM, IM and QM and collected their electromyography data. According to participants' reports, they experienced QM as OM in terms of intentions and expected sensory feedback, while the verbal descriptors were independent from muscle activation. These results do not fit the OM-QM-IM continuum and suggest qualitative distinction for agentive awareness between IM and QM/OM.

Dreaming during the COVID-19 pandemic: Support for the threat simulation function of dreams.

Evolutionary theories suggest that dreams function as a world simulator of events that maximizes our ability to surmount social and threat-related challenges critical to survivorship and reproduction. Here, in contrast to the incorporation continuity hypothesis, we test the (1) social bias hypothesis, which states that dreams will overrepresent positive social interactions relative to waking life, (2) the mutually exclusive threat bias hypothesis, the idea that dream content will be negative relative to waking life, (3) the strengthening hypothesis, which states that dreams will rehearse more positive interactions with individuals the self is familiar with relative to waking life, and (4) the compensation hypothesis, which states that social contents in dreams increases during periods of social seclusion. Dream (n = 168) and wake (n = 184) reports were collected through a standardized online survey from 24 undergraduate students. Recalls were analyzed using the Social Content Scale. Generalized linear mixed effects models were used, and the following fixed-effects were considered for the study; the number of reports contributed, report state, biological sex, stress, social support, and media exposures. Results showed support for the threat bias hypothesis, we found that dreams were more negative and featured more unfamiliar individuals in contrast to waking life. Additionally, we found partial support for the social bias and the strengthening hypotheses, however no support was shown for the compensation hypothesis. Overall, these results demonstrate support for the threat simulation function of dreams.

The synchronous group virtual simulation experience: Associate degree nursing students' perceptions.

The use of virtual simulations exponentially increased as nursing schools experienced an urgent need to integrate online educational technologies during the COVID-19 pandemic. This qualitative descriptive study was conducted to explore associate degree nursing students' perceptions about the comprehensive Synchronous Group Virtual Simulation educational strategy. This strategy was developed based on the National League for Nursing Jeffries Simulation Theory (JST) and the Healthcare Simulation Standards of Best PracticeTM, including structured synchronous prebriefing and debriefing stages. Content analysis revealed 12 recurrent themes, from which 10 positive themes strongly correlated with concepts of the JST. Our findings support the effectiveness of a high-quality synchronous virtual simulation-guided by an empirically supported simulation theoretical framework and evidence-based simulation best practice standards-can be realistic, experiential, interactive, collaborative, learner-centered, and promote simulation participant outcomes.

When the timing is right: The link between temporal coupling in dyadic interactions and emotion recognition.

Affective states can be understood as dynamic interpersonal processes developing over time and space. When we observe emotional interactions performed by other individuals, our visual system anticipates how the action will unfold. Thus, it has been proposed that the process of emotion perception is not only a simulative but also a predictive process - a phenomenon described as interpersonal predictive coding. The present study investigated whether the recognition of emotions from dyadic interactions depends on a fixed spatiotemporal coupling of the agents. We used an emotion recognition task to manipulate the actions of two interacting point-light figures by implementing different temporal offsets that delayed the onset of one of the agent's actions (+0 ms, +500 ms, +1000 ms or + 2000 ms). Participants had to determine both the subjective valence and the emotion category (happiness, anger, sadness, affection) of the interaction. Results showed that temporal decoupling had a critical effect on both emotion recognition and the subjective impression of valence intensity: Both measures decreased with increasing temporal offset. However, these effects were dependent on which emotion was displayed. Whereas affection and anger sequences were impacted by the temporal manipulation, happiness and sadness were not. To further investigate these effects, we conducted post-hoc exploratory analyses of interpersonal movement parameters. Our findings complement and extend previous evidence by showing that the complex, noncoincidental coordination of actions within dyadic interactions results in a meaningful movement pattern and might serve as a fundamental factor in both detecting and understanding complex actions during human interaction.

Frameworks for the design, implementation, and evaluation of simulation-based nursing education: A scoping review.

This scoping review was conducted to identify and describe constructs of frameworks and theories used to guide the design, implementation, and evaluation of simulation in nursing education globally, with a focus on their applicability in low-resource settings. Six electronic databases, three of which were on EBSCO Host (CINAHL, MEDLINE, ERIC), PubMed, Scopus, and ProQuest, as well as Google Scholar, were searched to retrieve studies published in the English language between 2012 and February 2022. The review adhered to the Preferred Reporting Items for Systematic Reviews and Meta-Analysis extension for Scoping Reviews (PRISMA-ScR) checklist, and was guided by Arksey and O'Malley's five-step scoping review methodological framework. Data were extracted from five studies (four frameworks and a theory) and narratively synthesized. Hence, seven constructs were identified and described: context, background, simulation design, educational practices, facilitator, participant, and outcomes. The four frameworks and theory were developed in the context of developed countries, which reveals the lack of a context-specific framework to guide the design, implementation, and evaluation of simulation in nursing education in low-resource settings. Given resource limitations and the apparent gaps in applying simulation-based framework(s) developed in developed countries to low-resource settings, the findings of this review underscored the need for a context-specific framework that is locally tailored to the needs and resources of low-resource settings, to promote access to and use of simulation in enhancing student learning, and the development of clinical competence.

Dissociated Effects of Age and Recent Troubling Experiences on Nightmares, Threats and Negative Emotions in Dreams.

Several studies have highlighted associations between adverse life events and the dysphoric character of dream experiences. This degree of continuity between waking-life and dream content seems partly attributed to the emotional and personal attachment linked to the incorporated waking experiences. Numerous changes in the processing of emotion-related stimuli are also reported across different human developmental stages. Therefore, we were interested in testing whether age would modulate the impact of recent troubling experiences on dream characteristics. Two hundred sixty participants, evenly distributed in five developmental stages, matched for gender and their exposure to a troubling experience, were selected from a large sample collected for a previous normative study of dreams of Canadians. Participants completed a dream questionnaire from which independent judges subsequently scored the dreams. We observed no interactions between the experience of troubling events and age. However, individuals who experienced a recent troubling event reported a higher frequency of nightmares and their dreams were more emotionally negative. Participants who experienced a moderately severe troubling event were also more likely to experience a dream whose maximal threat severity was of moderate intensity. Adolescents and young adults had dreams with a higher level of oneiric threats compared to older adults (>40 years old). Young adults also reported a higher frequency of nightmares compared to older adults. Our findings have implications for modern dream theories. They also suggest that dysphoric dreams might serve as potential proxies of mental health status and developmental stages. Future studies are now needed to explore the implications of these findings for psychological adaptation.

Presleep Ruminating on Intrusive Thoughts Increased the Possibility of Dreaming of Threatening Events.

This study investigated whether ruminating on an intrusive thought before sleeping led to an increased likelihood of dreaming of threatening events. One hundred and forty-six participants were randomly assigned to a rumination condition (a rumination on an intrusive thought for 5 min before sleeping; N = 73) and a control condition (think about anything for 5 min before sleeping; N = 73). Participants completed a dream diary upon waking. The result showed that presleep ruminating on an intrusive thought increased the frequency of both threatening dreams and negative emotions in dreams. In addition, dreams with threatening events were more emotional and negative than dreams without threatening events. These results may support the threat simulation theory of dreaming. In addition, these results may give some insight into a mathematical model for the continuity hypothesis of dreaming.

Hypomimia May Influence the Facial Emotion Recognition Ability in Patients with Parkinson's Disease.

BACKGROUND: Hypomimia is a clinical feature of Parkinson's disease (PD). Based on the embodied simulation theory, the impairment of facial mimicry may worsen facial emotion recognition; however, the empirical results are inconclusive. OBJECTIVE: We aimed to explore the worsening of emotion recognition by hypomimia. We further explored the relationship between the hypomimia, emotion recognition, and social functioning. METHODS: A total of 114 participants were recruited. The patients with PD and normal controls (NCs) were matched for demographic characteristics. All the participants completed the Mini-Mental State Examination and the Chinese Multi-modalities Emotion Recognition Test. In addition to the above tests, the patients were assessed with the Movement Disorder Society-Unified Parkinson's Disease Rating Scale and Parkinson's Disease Social Functioning Scale (PDSFS). RESULTS: Patients with PD with hypomimia had worse recognition of disgust than NCs (p = 0.018). The severity of hypomimia was predictive of the recognition of disgust (ß= -0.275, p = 0.028). Facial emotion recognition was predictive of the PDSFS score of PD patients (ß= 0.433, p = 0.001). We also found that recognizing disgust could mediate the relationship between hypomimia and the PDSFS score (ß= 0.264, p = 0.045). CONCLUSION: Patients with hypomimia had the worst disgust facial recognition. Hypomimia may affect the social function of PD patients, which is related to recognizing the expression of disgust. Emotion recognition training may improve the social function of patients with PD.

'No Man is an Island': Effects of social seclusion on social dream content and REM sleep.

Based on the Social Simulation Theory of dreaming (SST), we studied the effects of voluntary social seclusion on dream content and sleep structure. Specifically, we studied the Compensation Hypothesis, which predicts social dream contents to increase during social seclusion, the Sociality Bias - a ratio between dream and wake interactions - and the Strengthening Hypothesis, which predicts an increase in familiar dream characters during seclusion. Additionally, we assessed changes in the proportion of REM sleep. Sleep data and dream reports from 18 participants were collected preceding (n = 94), during (n = 90) and after (n = 119) a seclusion retreat. Data were analysed using linear mixed-effects models. We failed to support the Compensation Hypothesis, with dreams evidencing fewer social interactions during seclusion. The Strengthening Hypothesis was supported, with more familiar characters present in seclusion dreams. Dream social interactions maintained the Sociality Bias even under seclusion. Additionally, REM sleep increased during seclusion, coinciding with previous literature and tentatively supporting the proposed attachment function for social REM sleep.

Are children's judgments of another's accuracy linked to their metacognitive confidence judgments?

The world can be a confusing place, which leads to a significant challenge: how do we figure out what is true? To accomplish this, children possess two relevant skills: reasoning about the likelihood of their own accuracy (metacognitive confidence) and reasoning about the likelihood of others' accuracy (mindreading). Guided by Signal Detection Theory and Simulation Theory, we examine whether these two self- and other-oriented skills are one in the same, relying on a single cognitive process. Specifically, Signal Detection Theory proposes that confidence in a decision is purely derived from the imprecision of that decision, predicting a tight correlation between decision accuracy and confidence. Simulation Theory further proposes that children attribute their own cognitive experience to others when reasoning socially. Together, these theories predict that children's self and other reasoning should be highly correlated and dependent on decision accuracy. In four studies (N = 374), children aged 4-7 completed a confidence reasoning task and selective social learning task each designed to eliminate confounding language and response biases, enabling us to isolate the unique correlation between self and other reasoning. However, in three of the four studies, we did not find that individual differences on the two tasks correlated, nor that decision accuracy explained performance. These findings suggest self and other reasoning are either independent in childhood, or the result of a single process that operates differently for self and others. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1007/s11409-021-09263-x.

No evidence for somatosensory attenuation during action observation of self-touch.

The discovery of mirror neurons in the macaque brain in the 1990s triggered investigations on putative human mirror neurons and their potential functionality. The leading proposed function has been action understanding: Accordingly, we understand the actions of others by 'simulating' them in our own motor system through a direct matching of the visual information to our own motor programmes. Furthermore, it has been proposed that this simulation involves the prediction of the sensory consequences of the observed action, similar to the prediction of the sensory consequences of our executed actions. Here, we tested this proposal by quantifying somatosensory attenuation behaviourally during action observation. Somatosensory attenuation manifests during voluntary action and refers to the perception of self-generated touches as less intense than identical externally generated touches because the self-generated touches are predicted from the motor command. Therefore, we reasoned that if an observer simulates the observed action and, thus, he/she predicts its somatosensory consequences, then he/she should attenuate tactile stimuli simultaneously delivered to his/her corresponding body part. In three separate experiments, we found a systematic attenuation of touches during executed self-touch actions, but we found no evidence for attenuation when such actions were observed. Failure to observe somatosensory attenuation during observation of self-touch is not compatible with the hypothesis that the putative human mirror neuron system automatically predicts the sensory consequences of the observed action. In contrast, our findings emphasize a sharp distinction between the motor representations of self and others.

An analysis of the reading habits of autistic adults compared to neurotypical adults and implications for future interventions.

BACKGROUND: While research has consistently highlighted the usefulness of narrative texts for social development, this has not been fully explored with autistic adults. It has long been assumed that autistic individuals lack the social understanding to contemplate fiction, preferring non-fiction. This study aimed to explore the self-reported reading habits of autistic adults compared to neurotypical adults, accounting for higher education demands. METHODS: A qualitative design was used, with 43 participants (22 autistic; 21 neurotypical) completing a reading habits questionnaire and subsequent semi-structured interview. RESULTS: Neurotypical participants tended to prefer fiction, with autistic participants showing no preference between fiction and non-fiction. Four themes were identified from interview data (1) reading material choices; (2) text investment; (3) in-text social understanding; and (4) reading as a social learning device. Both groups reported evidence of empathising, perspective-taking and social understanding while reading. The autistic group additionally reported social learning outcomes from reading. DISCUSSION: Findings contradict prior assumptions that autistic individuals lack the social understanding required by fiction. Instead, findings show that social benefits of narrative texts extend to autistic readers, providing important social learning experiences.

Utilizing the Variability of Practice in Physical Execution, Action Observation, and Motor Imagery: Similar or Dissimilar Mechanisms?

The simulation theory argues that physical execution, action observation, and imagery share similar underlying mechanisms. Accordingly, applying a high-level psychological variable (variability of practice) should have a similar effect on all three modes. To test this theory, a total of 90 right-handed students participated in this study and were randomly divided into variable versus constant groups in three practice conditions, including physical, observational, and imagery. After a pretest (10 random trials of the putting task), the participants completed 50 practice trials. The groups performed/observed/imagined the task in the variable (different distances to different goals) or constant (fixed distance and goal) practice conditions. Also, there was an extra variable group in the physical and observational conditions, deprived of watching the feedback from the action. The participants completed a retention test 24 hr after the training. The effect of practice variability was observed in physical and observational conditions, but was not seen in the imagery condition. The no-feedback groups did not perform significantly differently from the imagery groups. The reason could be the lack of actual visual feedback during imagery.

Extended difficulties with counterfactuals persist in reasoning with false beliefs: Evidence for teleology-in-perspective.

Increasing evidence suggests that counterfactual reasoning is involved in false belief reasoning. Because existing work is correlational, we developed a manipulation that revealed a signature of counterfactual reasoning in participants' answers to false belief questions. In two experiments, we tested 3- to 14-year-olds and found high positive correlations (r = .56 and r = .73) between counterfactual and false belief questions. Children were very likely to respond to both questions with the same answer, also committing the same type of error. We discuss different theories and their ability to account for each aspect of our findings and conclude that reasoning about others' beliefs and actions requires similar cognitive processes as using counterfactual suppositions. Our findings question the explanatory power of the traditional frameworks, theory theory and simulation theory, in favor of views that explicitly provide for a relationship between false belief reasoning and counterfactual reasoning.