Learning strategy impacts medical diagnostic reasoning in early learners.

Relating learned information to similar yet new scenarios, transfer of learning, is a key characteristic of expert reasoning in many fields including medicine. Psychological research indicates that transfer of learning is enhanced via active retrieval strategies. For diagnostic reasoning, this finding suggests that actively retrieving diagnostic information about patient cases could improve the ability to engage in transfer of learning to later diagnostic decisions. To test this hypothesis, we conducted an experiment in which two groups of undergraduate student participants learned symptom lists of simplified psychiatric diagnoses (e.g., Schizophrenia; Mania). Next, one group received written patient cases and actively retrieved the cases from memory and the other group read these written cases twice, engaging in a passive rehearsal learning strategy. Both groups then diagnosed test cases that had two equally valid diagnoses-one supported by "familiar" symptoms described in learned patient cases, and one by novel symptom descriptions. While all participants were more likely to assign higher diagnostic probability to those supported by the familiar symptoms, this effect was significantly larger for participants that engaged in active retrieval compared to passive rehearsal. There were also significant differences in performance across the given diagnoses, potentially due to differences in established knowledge of the disorders. To test this prediction, Experiment 2 compared performance on the described experiment between a participant group that received the standard diagnostic labels to a group that received fictional diagnostic labels, nonsense words designed to remove prior knowledge with each diagnosis. As predicted, there was no effect of diagnosis on task performance for the fictional label group. These results provide new insight on the impact of learning strategy and prior knowledge in fostering transfer of learning, potentially contributing to expert development in medicine.

What about "space" is important for episodic memory?

Early cognitive neuroscientific research revealed that the hippocampus is crucial for spatial navigation in rodents, and for autobiographical episodic memory in humans. Researchers quickly linked these streams to propose that the human hippocampus supports memory through its role in representing space, and research on the link between spatial cognition and episodic memory in humans has proliferated over the past several decades. Different researchers apply the term "spatial" in a variety of contexts, however, and it remains unclear what aspect of space may be critical to memory. Similarly, "episodic" has been defined and tested in different ways. Naturalistic assessment of spatial memory and episodic memory (i.e., episodic autobiographical memory) is required to unify the scale and biological relevance in comparisons of spatial and mnemonic processing. Limitations regarding the translation of rodent to human research, human ontogeny, and inter-individual variability require greater consideration in the interpretation of this literature. In this review, we outline the aspects of space that are (and are not) commonly linked to episodic memory, and then we discuss these dimensions through the lens of individual differences in naturalistic autobiographical memory. Future studies should carefully consider which aspect(s) of space are being linked to memory within the context of naturalistic human cognition. This article is categorized under: Psychology > Memory.

On the relationship between trait autobiographical episodic memory and spatial navigation.

Influential research has focused on identifying the common neural and behavioural substrates underlying episodic memory (the re-experiencing of specific details from past experiences) and spatial cognition, with some theories proposing that these are supported by the same mechanisms. However, the similarities and differences between these two forms of memory in humans require further specification. We used an individual-differences approach based on self-reported survey data collected in a large online study (n = 7,487), focusing on autobiographical episodic memory and spatial navigation and their relationship to object and spatial imagery abilities. Multivariate analyses replicated prior findings that autobiographical episodic memory abilities dissociated from spatial navigational abilities. Considering imagery, episodic autobiographical memory overlapped with imagery of objects, whereas spatial navigation overlapped with a tendency to focus on spatial schematics and manipulation. These results suggest that trait episodic autobiographical memory and spatial navigation correspond to distinct mental processes.

Older adults with lower autobiographical memory abilities report less age-related decline in everyday cognitive function.

BACKGROUND: Individuals differ in how they remember the past: some richly re-experience specific details of past episodes, whereas others recall only the gist of past events. Little research has examined how such trait mnemonics, or lifelong individual differences in memory capacities, relate to cognitive aging. We specifically examined trait episodic autobiographical memory (AM, the tendency to richly re-experience episodic details of past events) in relation to complaints of everyday cognitive functioning, which are known to increase with age. Although one might predict that individuals reporting higher trait-level episodic AM would be resistant to age-related decline in everyday function, we made the opposite prediction. That is, we predicted that those with lower trait-level episodic AM would be better equipped with compensatory strategies, practiced throughout the lifespan, to cope with age-related memory decline. Those with higher trait-level episodic AM would have enhanced sensitivity to age-related cognitive changes due to their tendency to rely on their perceived above-average memory function. METHODS: We tested these predictions in 959 older adults aged 50-93 using online subjective and objective measures of memory and cognitive function. Our key measures of interest were the Survey of Autobiographical Memory, a measure of autobiographical memory abilities; and the Cognitive Failures Questionnaire, a measure of everyday cognitive function. RESULTS: In keeping with our prediction, we found that complaints of day-to-day memory slips and errors (normally elevated with age) remained stable or even decreased with age among those reporting lower trait-level episodic AM, whereas those reporting higher trait-level episodic AM reported the expected age-related increase in such errors. This finding was specific to episodic AM and not observed for other autobiographical memory capacities (e.g., semantic, spatial). It was further unaccounted for by response bias or objectively assessed cognitive abilities. CONCLUSIONS: Congenitally low trait-level episodic AM may paradoxically confer a functional advantage in aging. This could be due to well-developed non-episodic strategies not present in those with higher abilities, who are more sensitive to age-related memory decline attributable to medial temporal lobe changes. Our findings emphasize the importance of considering individual differences when studying cognitive aging trajectories.

Classification of general and personal semantic details in the Autobiographical Interview.

The Autobiographical Interview (AI) separates internal (episodic) and external (non-episodic) details from transcribed protocols using an exhaustive and reliable scoring system. While the details comprising the internal composite are centered on elements of episodic memory, external details are more heterogeneous as they are meant to capture a variety of non-episodic utterances: general semantics, different types of personal semantics details, metacognitive statements, repetitions, and details about off topic events. Elevated external details are consistently observed in aging and in neurodegenerative diseases. In the present study, we augmented the AI scoring system to differentiate subtypes of external details to test whether the elevation of these details in aging and in frontotemporal lobar degeneration (including mixed frontotemporal/semantic dementia [FTD/SD] and progressive non-fluent aphasia [PNFA]) would be specific to general and personal semantics or would concern all subtypes. Specifically, we separated general semantic details from personal semantic details (including autobiographical facts, self-knowledge, and repeated events). With aging, external detail elevation was observed for general and personal semantic details but not for other types of external details. In frontotemporal lobar degeneration, patients with FTD/SD (but not PNFA) generated an excess of personal semantic details but not general semantic details. The increase in personal but not general semantic details in FTD/SD is consistent with prevalent impairment of general semantic memory in SD, and with the personalization of concepts in this condition. Under standard AI instructions, external details were intended to capture off-topic utterances and were not intended as a direct measure of semantic abilities. Future investigations concerned with semantic processing in aging and in dementia could modify standard instructions of the AI to directly probe semantic content.

Episodic memory contributions to autobiographical memory and open-ended problem-solving specificity in younger and older adults.

Research indicates that episodic memory processes are required to access specific autobiographical events and the details encompassed by a single event for several functions, including remembering and personal problem solving. Since healthy cognitive aging is associated with episodic memory decline, we hypothesized that older adults would be impaired at producing specific autobiographical events and details in service of these two functions. To test this hypothesis, younger and older adults completed two tasks (generation and elaboration) across two experiments (autobiographical memory and problem solving). The generation task required participants to produce multiple specific event memories or solutions to cues within a 90-s time period. The elaboration task required participants to select a single memory or solution to describe in detail. We quantified the number of specific and non-specific responses provided during the generation task and scored the descriptions from the elaboration task for the number of episodic (internal) and non-episodic (external) details. Across experiment, older adults produced fewer specific responses (generation task) and fewer internal details (elaboration task) than younger adults. In addition, older adults generated more non-specific responses and external details than younger adults for the memory but not the problem-solving experiment. A correlational analysis showed that the number of specific responses (generation) and internal details (elaboration) correlated for the memory but not for the problem-solving experiment. These results show that age-related episodic memory decline impairs access to specific autobiographical events and detail information when remembering and problem solving, but that additional cognitive factors impact how these age declines present when solving problems.