Exploring the use of metacognitive monitoring cues following a diagram completion intervention.

Studying texts constitutes a significant part of student learning in health professions education. Key to learning from text is the ability to effectively monitor one's own cognitive performance and take appropriate regulatory steps for improvement. Inferential cues generated during a learning experience typically guide this monitoring process. It has been shown that interventions to assist learners in using comprehension cues improve their monitoring accuracy. One such intervention is having learners to complete a diagram. Little is known, however, about how learners use cues to shape their monitoring judgments. In addition, previous research has not examined the difference in cue use between categories of learners, such as good and poor monitors. This study explored the types and patterns of cues used by participants after being subjected to a diagram completion task prior to their prediction of performance (PoP). Participants' thought processes were studied by means of a think-aloud method during diagram completion and the subsequent PoP. Results suggest that relying on comprehension-specific cues may lead to a better PoP. Poor monitors relied on multiple cue types and failed to use available cues appropriately. They gave more incorrect responses and made commission errors in the diagram, which likely led to their overconfidence. Good monitors, on the other hand, utilized cues that are predictive of learning from the diagram completion task and seemed to have relied on comprehension cues for their PoP. However, they tended to be cautious in their judgement, which probably made them underestimate themselves. These observations contribute to the current understanding of the use and effectiveness of diagram completion as a cue-prompt intervention and provide direction for future research in enhancing monitoring accuracy.

Twelve tips for applying the think-aloud method to capture cognitive processes.

The think-aloud method is an established technique for studying human thought (cognitive) processes. Problem-solving and decision-making are essential skills for medical professionals, and the cognitive processes underlying these skills are complex. Studying these thought processes would enable educators, clinicians, and researchers to modify or refine their approaches and interventions. The think-aloud method has been utilized for capturing cognitive processes in a variety of fields, including computer usability, sports and cognitive psychology. Medical education also recognizes thought processes as valuable data for research and education. This article aims to guide researchers and educators through the preparation and implementation of a think-aloud method to record participants' thought processes during an activity.

Combining Support and Assessment in Health Professions Education: Mentors' and Mentees' Experiences in a Programmatic Assessment Context.

Introduction: Mentors in programmatic assessment support mentees with low-stakes feedback, which often also serves as input for high-stakes decision making. That process potentially causes tensions in the mentor-mentee relationship. This study explored how undergraduate mentors and mentees in health professions education experience combining developmental support and assessment, and what this means for their relationship. Methods: The authors chose a pragmatic qualitative research approach and conducted semi-structured vignette-based interviews with 24 mentors and 11 mentees that included learners from medicine and the biomedical sciences. Data were analyzed thematically. Results: How participants combined developmental support and assessment varied. In some mentor-mentee relationships it worked well, in others it caused tensions. Tensions were also created by unintended consequences of design decisions at the program level. Dimensions impacted by experienced tensions were: relationship quality, dependence, trust, and nature and focus of mentoring conversations. Mentors and mentees mentioned applying various strategies to alleviate tensions: transparency and expectation management, distinguishing between developmental support and assessment, and justifying assessment responsibility. Discussion: Combining the responsibility for developmental support and assessment within an individual worked well in some mentor-mentee relationships, but caused tensions in others. On the program level, clear decisions should be made regarding the design of programmatic assessment: what is the program of assessment and how are responsibilities divided between all involved? If tensions arise, mentors and mentees can try to alleviate these, but continuous mutual calibration of expectations between mentors and mentees remains of key importance.

The effect of hearing loss on age-related differences in neural distinctiveness.

Age differences in cognitive performance have been shown to be overestimated if age-related hearing loss is not taken into account. Here, we investigated the role of age-related hearing loss on age differences in functional brain organization by assessing its impact on previously reported age differences in neural differentiation. To this end, we analyzed the data of 36 younger adults, 21 older adults with clinically normal hearing, and 21 older adults with mild-to-moderate hearing loss who had taken part in a functional localizer task comprising visual (i.e., faces, scenes) and auditory stimuli (i.e., voices, music) while undergoing functional magnetic resonance imaging. Evidence for reduced neural distinctiveness in the auditory cortex was observed only in older adults with hearing loss relative to younger adults, whereas evidence for reduced neural distinctiveness in the visual cortex was observed both in older adults with normal hearing and in older adults with hearing loss relative to younger adults. These results indicate that age-related dedifferentiation in the auditory cortex is exacerbated by age-related hearing loss.

The Association between Academic Schedule and Physical Activity Behaviors in University Students.

BACKGROUND: University students sit too much, which is detrimental to their physical and mental health. Academic schedules, including scheduled education time and self-study time, may influence their physical activity behaviors. OBJECTIVES: To investigate (1) the association between scheduled education time and students' physical activity levels during weekdays; (2) the association between self-study time and students' physical activity levels during the weekdays and weekends. METHODS: 126 (68 Maastricht University (UM); 58 KU Leuven (KUL)) first-year undergraduate students in biomedical sciences (mean ± SD age: 19.3 ± 1.0, BMI: 22.0 ± 3.0, 17% men, 83% women) completed a demographics questionnaire and reported their academic activities with a 7-day logbook. Furthermore, their physical activity behavior was measured with the activPAL monitor for 7 days. Linear mixed models were used to examine the associations between university (UM versus KUL), academic activities (scheduled education time and self-study time), and students' activity levels. RESULTS: During weekdays, each hour of scheduled education time per day was significantly associated with a 1.3 min decrease of moderate to vigorous physical activity (MVPA) per day. Scheduled education time was not significantly associated with the sedentary time, light-intensity physical activity (LPA), and active sedentary behavior ratio. Each hour of self-study per day was significantly associated with 8 min more of sedentary time per day, 6 min less LPA per day, and 1.3 min less MVPA per day. Self-study time was not significantly associated with active sedentary behavior ratio. During the weekend, each hour of self-study time per day was associated with an additional 17.8 min of sedentary time per day and a reduction of 15.2 min of LPA per day. Self-study time was not significantly associated with the time spent doing MVPA and active sedentary behavior ratio. CONCLUSIONS: It could be more effective to change students' physical activity behaviors during self-study than during scheduled education time. Therefore, offering a study environment that reduces sedentary behavior and promotes light-intensity physical activity, is crucial.

Effects of breaking up sitting with light-intensity physical activity on cognition and mood in university students.

BACKGROUND: University students often exhibit high levels of sedentary behavior that is negatively associated with cognition and mood. On the other hand, light-intensity physical activity (LIPA) may improve cognitive performance and mood. Therefore, this study investigated the acute effect of LIPA breaks during prolonged sitting on attention, executive functioning, and mood. METHODS: A randomized crossover design was used in this study. In total, 21 healthy adults (15 women, age = 24 ± 3 years, BMI = 23 ± 2 kg/m2 ) completed three prolonged sitting conditions: (1) without a demanding cognitive task (SIT), (2) with a demanding cognitive task (COGN), and (3) with every 25 min sitting interrupted by a 5-minute walk (INTERRUPT). Attention, executive function (response inhibition, task shifting, and working memory updating), and mood were assessed before and after each condition. RESULTS: Linear mixed models analyses showed that prolonged sitting frequently interrupted by LIPA (INTERRUPT) or with cognitively demanding activities (COGN) significantly improved task shifting compared to SIT. However, INTERRUPT did not significantly improve task shifting compared with COGN. No significant acute effects on attention, response inhibition, working memory updating, or mood were found. CONCLUSIONS: Frequent LIPA breaks or cognitively demanding activities have a selective, acute positive impact on one aspect of cognitive performance compared to idle sitting. No evidence was found that LIPA breaks have an acute improvement in attention, executive function, and mood compared to sitting with cognitive loading. To further investigate the effect of PA on cognitive performance, it is necessary to consider cognitive loading and control for the cognitive activity during sitting in the experimental design.

Assessment of changes in gaze patterns during training in point-of-care ultrasound.

BACKGROUND: Point-of-care ultrasound (POCUS) is a core skill in emergency medicine (EM), however, there is a lack of objective competency measures. Eye-tracking technology is a potentially useful assessment tool, as gaze patterns can reliably discriminate between experts and novices across medical specialties. We aim to determine if gaze metrics change in an independent and predictable manner during ultrasound training. METHODS: A convenience sample of first-year residents from a single academic emergency department was recruited. Participants interpreted 16 ultrasound videos of the focused assessment with sonography for trauma (FAST) scan while their gaze patterns were recorded using a commercially available eye-tracking device. The intervention group then completed an introductory ultrasound course whereas the control group received no additional education. The gaze assessment was subsequently repeated. The primary outcome was total gaze duration on the area of interest (AOI). Secondary outcomes included time to fixation, mean duration of first fixation and mean number of fixations on the AOI. RESULTS: 10 EM residents in the intervention group and 10 non-EM residents in the control group completed the study. After training, there was an 8.8 s increase in the total gaze time on the AOI in the intervention group compared to a 4.0 s decrease in the control group (p = .03). EM residents were also 3.8 s quicker to fixate on the AOI whereas the control group became 2.5 s slower (p = .04). There were no significant interactions on the number of fixations (0.43 vs. 0.18, p = .65) or duration of first fixation on the AOI (0.02 s vs. 0.06 s, p = .63). CONCLUSIONS: There are significant and quantifiable changes in gaze metrics, which occur with incremental learning after an ultrasound course. Further research is needed to validate the serial use of eye-tracking technology in following a learner's progress toward competency in point-of-care ultrasound image interpretation.

Mentoring is in the 'I' of the beholder: supporting mentors in reflecting on their actual and preferred way of mentoring.

BACKGROUND: An important strategy to support the professional development of mentors in health professions education is to encourage critical reflection on what they do, why they do it, and how they do it. Not only the 'how' of mentoring should be covered, but also the implicit knowledge and beliefs fundamental to the mentoring practice (a mentor's personal interpretative framework). This study analyzed the extent to which mentors perceive a difference between how they actually mentor and how they prefer to mentor. METHODS: The MERIT (MEntor Reflection InstrumenT) survey (distributed in 2020, N = 228), was used to ask mentors about the how, what, and why of their mentoring in two response modes: (1) regarding their actual mentoring practice and (2) regarding their preferred mentoring practice. With an analysis of covariance, it was explored whether potential discrepancies between these responses were influenced by experience, profession of the mentor, and curriculum-bound assessment requirements. RESULTS: The averaged total MERIT score and averaged scores for the subscales 'Supporting Personal Development' and 'Monitoring Performance' were significantly higher for preferred than for actual mentoring. In addition, mentors' experience interacted significantly with these scores, such that the difference between actual and preferred scores became smaller with more years of experience. CONCLUSIONS: Mentors can reflect on their actual and preferred approach to mentoring. This analysis and the potential discrepancy between actual and preferred mentoring can serve as input for individual professional development trajectories.

Physician Training for Electrocardiogram Interpretation: A Systematic Review and Meta-Analysis.

PURPOSE: Using electrocardiogram (ECG) interpretation as an example of a widely taught diagnostic skill, the authors conducted a systematic review and meta-analysis to demonstrate how research evidence on instruction in diagnosis can be synthesized to facilitate improvement of educational activities (instructional modalities, instructional methods, and interpretation approaches), guide the content and specificity of such activities, and provide direction for research. METHOD: The authors searched PubMed/MEDLINE, Embase, Cochrane CENTRAL, PsycInfo, CINAHL, ERIC, and Web of Science databases through February 21, 2020, for empirical investigations of ECG interpretation training enrolling medical students, residents, or practicing physicians. They appraised study quality with the Medical Education Research Study Quality Instrument and pooled standardized mean differences (SMDs) using random effects meta-analysis. RESULTS: Of 1,002 articles identified, 59 were included (enrolling 17,251 participants). Among 10 studies comparing instructional modalities, 8 compared computer-assisted and face-to-face instruction, with pooled SMD 0.23 (95% CI, 0.09, 0.36) indicating a small, statistically significant difference favoring computer-assisted instruction. Among 19 studies comparing instructional methods, 5 evaluated individual versus group training (pooled SMD -0.35 favoring group study [95% CI, -0.06, -0.63]), 4 evaluated peer-led versus faculty-led instruction (pooled SMD 0.38 favoring peer instruction [95% CI, 0.01, 0.74]), and 4 evaluated contrasting ECG features (e.g., QRS width) from 2 or more diagnostic categories versus routine examination of features within a single ECG or diagnosis (pooled SMD 0.23 not significantly favoring contrasting features [95% CI, -0.30, 0.76]). Eight studies compared ECG interpretation approaches, with pooled SMD 0.92 (95% CI, 0.48, 1.37) indicating a large, statistically significant effect favoring more systematic interpretation approaches. CONCLUSIONS: Some instructional interventions appear to improve learning in ECG interpretation; however, many evidence-based instructional strategies are insufficiently investigated. The findings may have implications for future research and design of training to improve skills in ECG interpretation and other types of visual diagnosis.

The effects of standing in tutorial group meetings on learning: A randomized controlled trial.

BACKGROUND: Standing desks have been brought into the education environment to reduce sedentary behavior among students. The current study explored the effects of standing in tutorial group meetings on learning among undergraduate students. METHODS: Ninety-six participants were randomly allocated to a Sit or Stand group, with 2 h tutorial group meetings scheduled, once or twice per week, for nine weeks. Learning was analyzed using exam grades, concept maps, and tutorial interactions. RESULTS: Overall, the Sit and Stand groups did not differ from each other in terms of learning, measured through their exam, concept map, and the use of learning-oriented interactions. CONCLUSION: Standing in tutorial group meetings neither enhanced nor compromised learning. Considering the health risks associated with prolonged sedentary behavior, offering standing tutorial group meetings to undergraduate students is a recommended solution to break up prolonged sedentary behavior and encourage more physical activity, while maintaining the learning performance of students.

MERIT: a mentor reflection instrument for identifying the personal interpretative framework.

BACKGROUND: Essential to the professional development of mentors is making explicit and critically challenging the knowledge and beliefs underpinning their mentoring practice. This paper reports on the development of a survey instrument called MERIT, MEntor Reflection InstrumenT, which was designed to support mentors' systematic reflection on the how, what and why of their practice. METHODS: In 2019, a twenty-item survey instrument was developed and piloted. Initial validation data (N = 228) were collected by distributing the survey through the authors' network. An exploratory factor analysis (EFA) was conducted and internal consistency reliability coefficients were calculated. RESULTS: The Principal Axis EFA with Direct Oblimin rotation (Delta = 0) resulted in four factors: 1) supporting personal development, 2) modelling professional development, 3) fostering autonomy, and 4) monitoring performance. The four factors explained 43% of the total variance of item scores. The Cronbach's alphas for the subscale scores were between .42 and .75. CONCLUSIONS: The MERIT can help mentors reflect on their beliefs and professional knowhow. These reflections can serve as input for the faculty development initiatives mentors undertake, which may ultimately improve their knowledge and skills as a mentor.

The effects of standing tutorial meetings on physical activity behavior in undergraduates: A randomized controlled trial.

This study explored the effects of using standing desks in tutorial meetings on the physical activity behavior (PAB) of undergraduate students. Standing desks have been introduced to minimize the detrimental health effects of prolonged sedentary behavior (SB). The effectiveness of using standing desks has not been explored among undergraduate students - a population showing high SB. Ninety-six undergraduate students were randomly assigned to a sitting or standing tutorial group that ran for nine weeks, and their PAB was monitored using the activPAL3™ triaxial activity monitor. To check for potential compensatory or other covarying behaviors, the students' PAB was monitored on tutorial and non-tutorial days. PAB monitoring was conducted in week 4-5, and a follow-up measurement was conducted in week 9 to examine longer-term effects. In week 4-5, the stand group (n = 41) showed less SB (ß = -0.092, SE = 0.044, 95% CI: -0.179, -0.006) and more moderate-to-vigorous physical activity (ß = 0.320, SE = 0.160, 95% CI: 0.004, 0.635) compared to the sit group (n = 36). On tutorial days, the stand group showed more light physical activity (LPA) than the sit group (p < .001, d = 1.04). In week 9, there was an exam on the last day of that week. Nonetheless, the stand group (n = 37) showed less SB (p < .001, d = 0.378) and more LPA (p = .008, d = 0.725), while breaking up prolonged SB more frequently (p = .007, d = 0.696) on the tutorial day compared to the sit group (n = 32). Overall, undergraduates attending standing tutorial meetings showed less SB and more LPA than those attending conventional, seated tutorial meetings. Standing tutorial meetings can contribute to a more active lifestyle for undergraduates.

Proactive motor control within and between hands: Effects of age, motor set, and cue type.

Several studies have reported that proactive motor control in a cued four-finger choice reaction task proceeds more efficiently with a 2-hands motor set (two fingers on each hand) than with a 1-hand motor set (four fingers on one hand). According to the Grouping Model, this is because the 2-hands motor set recruits distinct left and right hand representations located in separate cerebral hemispheres, whereas the 1-hand motor set recruits partially overlapping neural areas grouped together in one hemisphere. The latter neural organization increases neuromotor noise, thereby complicating proactive motor selection. The present study examined the effect of older age on the 2-hands motor selection advantage. A group of young and a group of older adults performed two proactive motor tasks-the procue task and the anticue task-with two motor sets: a 2-hands and 1-hand set. Predictive cues preceded the target signal at five different time intervals (100-850 ms), allowing advance selection of 2 out of 4 fingers. Older adults showed longer reaction times and smaller cueing benefits compared to younger adults. Overall, cueing benefits were greater, and accrued faster, with the 2-hands than with the 1-hand motor set, reflecting the beneficial impact of the neuroanatomical hand distinction. Importantly, the 2-hands advantage was substantially greater in the older age group, suggesting that the hand distinction might abate age-related neural dedifferentiation. These findings highlight the impact of cortical representational distinctiveness in proactive motor control, especially in older age.

The Neural Correlates of Visual and Auditory Cross-Modal Selective Attention in Aging.

Age-related deficits in selective attention have been demonstrated to depend on the sensory modality through which targets and distractors are presented. Some of these investigations suggest a specific impairment of cross-modal auditory selective attention. For the first time, this study is taking on a whole brain approach while including a passive perception baseline, to investigate the neural underpinnings of selective attention across age groups, and taking the sensory modality of relevant and irrelevant (i.e., distracting) stimuli into account. Sixteen younger (mean age = 23.3 years) and 14 older (mean age = 65.3 years), healthy participants performed a series of delayed match-to-sample tasks, in which participants had to selectively attend to visual stimuli, selectively attend to auditory stimuli, or passively view and hear both types of stimuli, while undergoing 3T fMRI. The imaging analyses showed that areas recruited by cross-modal visual and auditory selective attention in both age groups included parts of the dorsal attention and frontoparietal control networks (i.e., intraparietal sulcus, insula, fusiform gyrus, anterior cingulate, and inferior frontal cortex). Most importantly, activation throughout the brain did not differ across age groups, suggesting intact brain function during cross-modal selective attention in older adults. Moreover, stronger brain activation during cross-modal visual vs. cross-modal auditory selective attention was found in both age groups, which is consistent with earlier accounts of visual dominance. In conclusion, these results do not support the hypothesized age-related deficit of cross-modal auditory selective attention. Instead, they suggest that the underlying neural correlates of cross-modal selective attention are similar in younger and older adults.

Academic Schedule and Day-to-Day Variations in Sedentary Behavior and Physical Activity of University Students.

Students starting at university tend to adopt unhealthy behaviors. With students expected to sit during classes, their academic schedule may be responsible for their activity patterns. The aim of the current study was to investigate the relationship between university students' academic schedule and day-to-day variations in sedentary behavior (SB) and physical activity (PA). The activity of 317 first-year undergraduate students (mean age 19.6 ± 1.4 years, 69.4% female, 30.0% male, and 0.6% other) was measured with the activPAL3™ triaxial monitor for seven consecutive days. Each class hour was found to be associated with 9.0 additional minutes of SB (95% CI [4.9, 13.1]), 54 additional seconds of moderate-to-vigorous PA (MVPA; 95% CI [12, 96]), and 12.2 min less time in bed (95% CI [-16.6, -7.8]). Active SB ratio (total duration of SB bouts < 30 min divided by total SB duration) decreased by 0.011 per hour of class scheduled for the students (95% CI [-0.016, -0.006]). Light PA (LPA) was not significantly associated with class duration. Students tend to cycle more on days with classes. Seated transportation was not significantly related to whether the students had classes or not. Overall, the academic schedule is associated with SB and PA in students.

Mentors' Beliefs About Their Roles in Health Care Education: A Qualitative Study of Mentors' Personal Interpretative Framework.

PURPOSE: How mentors shape their mentoring is strongly influenced by their personal beliefs about the goals and purpose of mentoring, the possible activities associated with it, who decides on the focus of the mentoring relationship, and the strategies mentors choose to enact these beliefs in practice. In accordance with the personal interpretative framework, the authors operationalized mentors' beliefs as professional self-understanding (the what) and subjective educational theory (the how) of teaching and sought to identify different mentoring positions. METHOD: Using a qualitative approach, the authors conducted semistructured interviews between December 2017 and January 2018 with 18 undergraduate mentors from Maastricht University in Maastricht, the Netherlands. The aim of the interviews was to reconstruct their personal interpretative framework. Before building a general pattern of explanation in a cross-case analysis, the authors performed a within-case analysis of the data, analyzing individual mentors. RESULTS: This approach resulted in the identification and description of 4 mentoring positions: the (1) facilitator (service providing and responsive), (2) coach (development supporting and responsive), (3) monitor (signaling and collaborative), and (4) exemplar (service providing or development supporting and directive). Each position represents a coherent pattern of normative beliefs about oneself as a mentor (professional self-understanding) and how to enact these beliefs in practice (subjective educational theory). CONCLUSIONS: Awareness of their mentoring position can help mentors understand why they act the way they do in certain situations and how this behavior affects their mentees' learning and development. It can also help mentors identify personal learning needs and, consequently, provide opportunities for faculty development.

Productive failure as an instructional approach to promote future learning.

Productive failure is an instructional approach that requires learners to struggle as they attempt to generate solutions to problems before, rather than after, receiving direct instruction on a targeted concept. Studies demonstrate that productive failure prepares students for later learning of new, related knowledge. Our study explored the effectiveness of productive failure as an instructional intervention in health professions education with respect to (a) acquisition and application of a novel concept, and (b) learners' preparation for future learning of new, related content. Forty year-one students enrolled in the Doctor of Pharmacy program at the University of Toronto were randomly assigned to a productive failure (i.e. attempt to generate solutions before receiving instruction) or direct instruction only learning condition. After a practice phase, participants completed a series of tests designed to measure knowledge acquisition, knowledge application, and preparation for future learning (new learning is required for successful problem solving). As expected, no difference in performance was seen between participants on the acquisition and application tests. However, participants in the productive failure condition outperformed those in the direct instruction condition on the preparation for future learning test. These results emphasize the role of struggle in learning and support the theory that engaging students in solving problems that are beyond their abilities can be a productive exercise in failure. The results suggest that productive failure assists learners in acquiring the conceptual knowledge needed to facilitate learning in the future.

Practice makes perfect: High performance gains in older adults engaged in selective attention within and across sensory modalities.

Selective attention has been found to decline with aging, possibly depending on the sensory modality through which targets and distractors are presented. We investigated the capacity of older adults to improve performance on visual and auditory selective attention tasks. 31 younger (mean age = 22.8 years, SD = 2.1) and 29 older participants (mean age = 69.5 years, SD = 5.8) performed visual and auditory tasks with and without unimodal and cross-modal distraction across five practice sessions. Reaction time decreased with practice in both age groups. Strikingly, this performance improvement was similar across the age groups. Moreover, distractor modality did not affect performance gains in either age group. Older adults were disproportionally affected by cross-modal visual distraction, however, corroborating previous studies. This age-related effect was mitigated during the practice sessions. Finally, there was no transfer of practice to neuropsychological test performance. These results suggest a high capacity of older individuals to improve selective attention functions within and across sensory modalities.

Both facilitatory and inhibitory impairments underlie age-related differences of proactive cognitive control across the adult lifespan.

We investigated two components of proactive cognitive control, response facilitation and response inhibition, in an adult lifespan sample (N=544, age range=18-91years) by administering two response-preparation tasks: a procue task, primarily involving facilitation, and an anticue task, involving both facilitation and inhibition. Cues in both tasks corresponded with the index and middle fingers of either the left or right hand. After a random preparation interval (PI) of 100-850ms following the onset of the cue signal, a single-target stimulus indicated the required response. Where procues were spatially aligned with the two fingers of the responding hand, anticues consistently indicated the two fingers of the opposite hand, requiring a remapping of cue location and response hand. This remapping requires inhibition to suppress the automatic activation of the ipsilateral responses. Previous research revealed typical reaction time (RT) profiles for procues and anticues as a function of PI. Whereas procues generate RT benefits (relative to a neutral-cue condition) already at short PIs, which increase with longer PIs, anticues generate RT costs at short PIs and RT benefits at longer PIs. Our results showed that, in the anticue task, older participants needed more preparation time to turn RT costs into RT benefits than younger participants, revealing an age-related deficit of response inhibition. Moreover, in both tasks, older participants were less able to increase RT benefits with longer PIs, revealing a deficit of response facilitation. We conclude that both facilitatory and inhibitory impairments contribute to age-related deficiencies in proactive cognitive control.

Disregarding hearing loss leads to overestimation of age-related cognitive decline.

Aging is associated with cognitive and sensory decline. While several studies have indicated greater cognitive decline among older adults with hearing loss, the extent to which age-related differences in cognitive processing may have been overestimated due to group differences in sensory processing has remained unclear. We addressed this question by comparing younger adults, older adults with good hearing, and older adults with poor hearing in several cognitive domains: working memory, selective attention, processing speed, inhibitory control, and abstract reasoning. Furthermore, we examined whether sensory-related cognitive decline depends on cognitive demands and on the sensory modality used for assessment. Our results revealed that age-related cognitive deficits in most cognitive domains varied as a function of hearing loss, being more pronounced in older adults with poor hearing. Furthermore, sensory-related cognitive decline was observed across different levels of cognitive demands and independent of the sensory modality used for cognitive assessment, suggesting a generalized effect of age-related hearing loss on cognitive functioning. As most cognitive aging studies have not taken sensory acuity into account, age-related cognitive decline may have been overestimated.