Role of knowledge and reasoning processes as predictors of resident physicians' susceptibility to anchoring bias in diagnostic reasoning: a randomised controlled experiment.

BACKGROUND: Diagnostic errors have been attributed to reasoning flaws caused by cognitive biases. While experiments have shown bias to cause errors, physicians of similar expertise differed in susceptibility to bias. Resisting bias is often said to depend on engaging analytical reasoning, disregarding the influence of knowledge. We examined the role of knowledge and reasoning mode, indicated by diagnosis time and confidence, as predictors of susceptibility to anchoring bias. Anchoring bias occurs when physicians stick to an incorrect diagnosis triggered by early salient distracting features (SDF) despite subsequent conflicting information. METHODS: Sixty-eight internal medicine residents from two Dutch university hospitals participated in a two-phase experiment. Phase 1: assessment of knowledge of discriminating features (ie, clinical findings that discriminate between lookalike diseases) for six diseases. Phase 2 (1 week later): diagnosis of six cases of these diseases. Each case had two versions differing exclusively in the presence/absence of SDF. Each participant diagnosed three cases with SDF (SDF+) and three without (SDF-). Participants were randomly allocated to case versions. Based on phase 1 assessment, participants were split into higher knowledge or lower knowledge groups. MAIN OUTCOME MEASUREMENTS: frequency of diagnoses associated with SDF; time to diagnose; and confidence in diagnosis. RESULTS: While both knowledge groups performed similarly on SDF- cases, higher knowledge physicians succumbed to anchoring bias less frequently than their lower knowledge counterparts on SDF+ cases (p=0.02). Overall, physicians spent more time (p<0.001) and had lower confidence (p=0.02) on SDF+ than SDF- cases (p<0.001). However, when diagnosing SDF+ cases, the groups did not differ in time (p=0.88) nor in confidence (p=0.96). CONCLUSIONS: Physicians apparently adopted a more analytical reasoning approach when presented with distracting features, indicated by increased time and lower confidence, trying to combat bias. Yet, extended deliberation alone did not explain the observed performance differences between knowledge groups. Success in mitigating anchoring bias was primarily predicted by knowledge of discriminating features of diagnoses.

Comparing instructional strategies to support student teachers' learning to prepare an open-minded citizenship education lesson.

Open-mindedness is defined as one's willingness and ability to consider opposing beliefs and perspectives and give them a serious, impartial consideration by setting aside one's commitment towards one's own beliefs and perspectives. Learning to prepare and teach open-minded lessons is a crucial skill for student teachers because it fosters an atmosphere in which pupils feel free to express their own views and to learn about the views of others. The aim of this experiment was to examine which instructional strategy best supports student teachers' learning to prepare an open-minded citizenship education lesson. Therefore, participants (n = 176) processed an instruction on how to prepare an open-minded citizenship education lesson through learning by teaching on video, preparing to teach, or re-study (control condition), and as a post-test designed a lesson plan. We examined the completeness and accuracy of the explanations of the instructional content, feelings of social presence and arousal, open-mindedness levels, the completeness and accuracy of the lesson plans, and the conceptual knowledge of the instructional content. In addition, the lesson plans were graded on overall quality. Results showed that all participants scored higher on open-mindedness as measured with the Actively Open-minded Thinking scale after the experiment than before the experiment. Participants in the control condition prepared significantly more accurate and complete open-minded lessons than participants in the other two conditions, suggesting they have gained better understanding of the instructional content. There were no significant differences between the conditions on the other outcome measures.

Effects of Cognitively Engaging Physical Activity on Preschool Children's Cognitive Outcomes.

Research combining physical activity with the training of cognitive skills such as executive functions is emerging as a novel and fruitful intervention approach for children. Purpose: This study aimed to examine the impact of an intervention program including cognitively engaging physical activity on preschool children's cognitive outcomes and physical activity. Methods: Children (N = 144, 65 female; Mage = 4.41 years, SD = 0.61), randomly assigned to one of three groups: cognitively engaging physical activity (CPA; i.e., storytelling, cognitive activities, and motor tasks, n = 55), cognition (i.e., storytelling and cognitive activities without motor tasks, n = 48), or control (i.e., traditional storytelling, n = 41). Sessions lasted approximately 17 minutes, conducted twice a week, for 6 weeks. Children's executive function, self-regulation, and related outcomes (i.e., numeracy) were assessed at baseline and again-along with perceived enjoyment-at the end of the program. Accelerometers measured children's physical activity during each session. Teachers completed a logbook for each session, and two fidelity checks per preschool took place by the researcher. Main analyses used linear mixed models adjusted for covariates (age, sex) and clustering at the preschool level. Results: Results showed no significant group by time interaction for executive function, self-regulation, numeracy, enjoyment. During the sessions, children in the CPA group were more physically active than children in the cognition and control groups. Conclusion: While we did not find the expected amplified cognitive benefits, making storytelling more active has the potential to meet two needs (increase cognitive stimulation and physical activity levels) in one deed.

Effects of finger and mouse pointing on learning from online split-attention examples.

BACKGROUND: Self-management of cognitive load is a recent development in cognitive load theory. Finger pointing has been shown to be a potential self-management strategy to support learning from spatially separated, but mutually referring text and pictures (i.e., split-attention examples). AIMS: The present study aimed to extend the prior research on the pointing strategy and investigated the effects of finger pointing on learning from online split-attention examples. Moreover, we examined an alternative pointing strategy using the computer mouse, and a combination of finger pointing and computer-mouse pointing. SAMPLE: One-hundred and forty-five university students participated in the present study. METHOD: All participants studied an online split-attention example about the human nervous system and were randomly allocated to one of four conditions: (1) pointing with the index finger, (2) pointing with the computer mouse, (3) pointing with the index finger and the computer mouse and (4) no pointing. RESULTS: Results confirmed our main hypothesis, indicating that finger pointing led to higher retention performance than no pointing. However, the mouse pointing strategy and the combined finger and mouse pointing strategy did not show supportive effects. CONCLUSIONS: Finger pointing can be used as a simple and convenient self-management strategy in online learning environments. Mouse pointing may not be as effective as finger pointing.

Pupillometric and blink measures of diverse task loads: Implications for working memory models.

BACKGROUND: Inconsistent observations of pupillary response and blink change in response to different specific tasks raise questions regarding the relationship between eye measures, task types and working memory (WM) models. On the one hand, studies have provided mixed evidence from eye measures about tasks: pupil size has mostly been reported to increase with increasing task demand while this expected change was not observed in some studies, and blink rate has exhibited different trends in different tasks. On the other hand, a WM model has been developed to integrate a component to reconcile recent findings that the human motor system plays an important role in cognition and learning. However, how different tasks correlate with WM components has not been experimentally examined using eye activity measurements. AIMS: The current study uses a four-dimensional task load framework to bridge eye measures, task types and WM models. SAMPLE: Twenty participants (10 males, 10 females; Age: M = 25.8, SD = 7.17) above 18 years old volunteered. All participants had normal or corrected to normal vision with contact lenses and had no eye diseases causing obvious excessive blinking. METHODS: We examined the ability of pupil size and blink rate to index low and high levels of cognitive, perceptual, physical and communicative task load. A network of the four load types and WM components was built and analysed to verify the necessity of integrating a physical task-related component into the WM model. RESULTS: Results demonstrate that pupil size can index cognitive load and communicative load but not perceptual or physical load. Blink rate can index the level of cognitive load but is best at discriminating perceptual tasks from other types of tasks. Furthermore, pupil size measurement of the four task types was explained better during structural and factor analysis by a WM model that integrates a movement-related component. CONCLUSIONS: This research provides new insights into the relationship between eye measures, task type and WM models and provides a comprehensive understanding from which to predict pupil size and blink behaviours in more complex and practical tasks.

Harsh Physical Discipline and Externalizing Behaviors in Children: A Systematic Review.

There is growing debate in the parenting literature as to whether using physical punishment to discipline children is an effective strategy or leads to the development of aggressive behaviors and other antisocial attributes. The aim of the current literature review is to examine the association between harsh physical discipline and the development of externalizing behaviors in children, as well as the suggested moderators of this relationship. Secondly, the findings regarding the effects of harsh physical discipline on children's educational outcomes are reviewed. Articles were selected from relevant databases while maintaining an inclusion and exclusion criteria, with a total of 22 articles included in this review. Strong associations between parental corporal punishment and a range of child behaviors were indicated by the literature, and cultural normativeness was implicated as a moderator of these effects. Results regarding the role of parental warmth as a moderator did not provide a firm conclusion. Finally, the findings suggest that when a child is subjected to physical discipline in the home, their life at school may be adversely affected by impaired cognitive performance, peer isolation, and behavioral problems. The primary limitation of the studies reviewed is the use of self-report data and correlational analyses, ruling out the possibility of inferring causal relations. Nonetheless, the results indicate the necessity of encouraging parents and caregivers to avoid physical punishment as a disciplinary tactic while providing them with the tools to explore alternative practices.

Ace Your Self-Study: A Mobile Application to Support Self-Regulated Learning.

Without guidance, students typically overestimate their understanding and memory of learning materials, which can have detrimental effects on the learning process. However, most students do not receive guidance or instruction about how to study. Moreover, students are largely unaware of strategies to self-regulate their learning and study effectively. Research has shown that prompting both cognitive and metacognitive strategies is effective to support self-regulated learning (SRL). Therefore we developed a mobile application, the Ace your self-study app, to prompt both cognitive and metacognitive strategies to support learning processes. In this article a theoretical background, description of the app's features and design choices are presented. Also, data from the application in presented to give provide an idea of how the app has been used.

A new application of the temporal contiguity effect in designing narrated slideshows.

We investigated whether the temporal contiguity effect, which holds that information sources, such as visual information and narration need to be temporally coordinated for learning to be effective, can also be found in narrated slideshows. A concurrent presentation-key point format (CPK), in which visual information sequentially appeared as key points on the slide with corresponding narration, was compared to a concurrent presentation-whole format (CPW), in which visual information was shown all at once on the slide with corresponding narration, and a sequential presentation format (SP), in which the narration was played first before all the corresponding visual information was presented at once. Ninety-nine undergraduates were randomly divided across the CPK, CPW and SP conditions. Results revealed that participants in the CPK group had higher post-test performance and learning efficiency than participants in the CPW and SP conditions. Performance in the CPW condition was higher than in the SP conditions, but only in terms of learning efficiency. The results suggested that the occurrence of the temporal contiguity effect not only depends on whether the presentation of narration and visual information in narrated slideshows is concurrent or not, but also on how concurrent it is.

A Systematic Scoping Review of Pre-School Self-Regulation Interventions from a Self-Determination Theory Perspective.

Self-regulation (SR) is considered foundational in early life, with robust evidence demonstrating a link between early self-regulation and longer-term outcomes. This has been the impetus for a growing body of intervention research into how best to support early SR development, yet approaches and effects are diverse, which complicates an understanding of the critical characteristics for effective early SR intervention. Using Self-Determination Theory (SDT) as a guiding framework, we present a scoping review of early SR-intervention research to identify the characteristics of pre-school interventions that show significant and strong effects on young children's SR. Studies from peer-reviewed journal articles were included if they evaluated a SR intervention with pre-school children, were published between 2010 and 2020, written in English, and included a SR outcome measure. This yielded 19 studies, each reporting the efficacy of a different SR intervention. Results showed that content factors (what interventions do) interacted with their implementation (how, when, and by whom interventions are implemented) to discriminate the more versus less efficacious interventions. Through the lens of SDT, results further suggested that targeting competence through encouragement and feedback, and nurturing children's autonomy distinguished more from less effective interventions. Relatedness was least able to discriminate intervention efficacy.

Restorative Effects of Observing Natural and Urban Scenery after Working Memory Depletion.

According to attention restoration theory observing nature has restorative effects on cognitive components, such as working memory, after a cognitive depleting task. Additionally, urban environments are thought to have no effect or even a negative effect on cognitive restoration. Previous research has confirmed that observing actual, as well as digitally presented nature sceneries leads to more restoration of working memory capacity (WMC) than observing (digital) urban sceneries. To further investigate these findings, we conducted an experiment with 72 university students as participants. After a WMC depleting task, participants observed either digitally presented nature scenery, urban scenery or no scenery, and subsequently performed a digit span test, which was used to measure restoration of WMC. Results indicated significant higher performance on the digit span test for those who observed nature scenery in comparison to those who observed urban scenery or no scenery, thereby replicating results from previous research. Observing urban scenery was neither harmful nor helpful in terms of cognitive restoration compared to observing no scenery. These findings provide a foundation for implementing a brief intervention of observing nature in academic settings to facilitate the restoration of WMC.

Executive Function and Self-Regulation: Bi-Directional Longitudinal Associations and Prediction of Early Academic Skills.

Despite a tendency to study executive function (EF) and self-regulation (SR) separately, parallel lines of research suggest considerable overlap between the two abilities. Specifically, both show similar developmental trajectories (i.e., develop rapidly in the early years), predict a broad range of overlapping outcomes across the lifespan (e.g., academic success, mental and physical health, and social competence), and have overlapping neural substrates (e.g., prefrontal cortex). While theoretical frameworks diverge in how they reconcile EF and SR - ranging from treating the two as functionally synonymous, to viewing them as related yet distinct abilities - there is no consensus and limited empirical evidence on the nature of their relationship and how this extends developmentally. The current study examined bi-directional longitudinal associations between early EF and SR, and their longitudinal associations with subsequent early academic skills, in a sample of 199 3- to 5-year-old pre-school children. The adopted measures permitted EF and SR to be modelled as composite indices for these analyses, thereby decreasing task-specific components of these associations. Early academic skills were captured by a standardized direct assessment. Bi-directional associations between EF and SR were found, with both accounting for unique variance in early academic skills 7 and 19months later. The current results provide important evidence to distinguish between EF and SR abilities, yet also for their reciprocal influence in situ and across early development.

Parents' and Early Childhood Educators' Perceptions on Movement and Learning Program Implementation.

There is currently limited evidence on parents' and early childhood educators' perspectives on implementing programs that combine cognitive and motor tasks in early childhood. An online survey was distributed across Australia through social network platforms and emails at preschool centres, asking 65 parents of preschool children and early childhood educators about their preferences on program delivery, duration, and mode. Responses from the survey were evaluated in order to develop and pilot a 4 week home-based (n = 5 parents) and a 6 week school-based program (n = 5 educators) including cognitively engaging physical activity, requesting parents' and educators' perspectives, respectively, about the program components. Results from the online survey showed a preference for programs with online (e.g., video-based) compared to traditional delivery (e.g., books), emphasising the potential benefits on children's physical activity levels, sleep, and cognitive function. However, after piloting the program, educators preferred to use the book version instead of the video. This program has the potential to become part of daily regular practice. Barriers reported include logistics issues (i.e., book size), connectivity issues with internet, and the need for varying activities.

The Validity of Physiological Measures to Identify Differences in Intrinsic Cognitive Load.

A sample of 33 experiments was extracted from the Web-of-Science database over a 5-year period (2016-2020) that used physiological measures to measure intrinsic cognitive load. Only studies that required participants to solve tasks of varying complexities using a within-subjects design were included. The sample identified a number of different physiological measures obtained by recording signals from four main body categories (heart and lungs, eyes, skin, and brain), as well as subjective measures. The overall validity of the measures was assessed by examining construct validity and sensitivity. It was found that the vast majority of physiological measures had some level of validity, but varied considerably in sensitivity to detect subtle changes in intrinsic cognitive load. Validity was also influenced by the type of task. Eye-measures were found to be the most sensitive followed by the heart and lungs, skin, and brain. However, subjective measures had the highest levels of validity. It is concluded that a combination of physiological and subjective measures is most effective in detecting changes in intrinsic cognitive load.

Five Strategies for Optimizing Instructional Materials: Instructor- and Learner-Managed Cognitive Load.

Researchers of cognitive load theory and the cognitive theory of multimedia learning have identified several strategies to optimize instructional materials. In this review article we focus on five of these strategies or solutions to problematic instructional designs in multimedia learning: (a) the multimedia principle (use visualizations and drawings to complement texts); (b) the split-attention effect or spatial contiguity principle (show texts contiguously or integrated with visualizations); (c) the redundancy effect, alike the coherence principle (remove nonessential learning information); (d) the signaling principle (cue or signal essential learning information); and (e) the transient information effect or segmenting principle (segment or control the pace of animations and videos). Usually, both cognitive theories have investigated solutions that instructors, teachers, and designers should pursue to optimize students' learning. Here, in a novel approach, we show that these strategies can also be used by learners who want to self-manage their cognitive load and learning process. We provide several examples of both instructor- and learner-managed solutions aligned with these strategies. When assessing which agent, either the instructor or the learner, was most effective, we observed mixed results in the literature. However, the expertise reversal effect may help predict the direction of these effects: novice students may learn better under instructor-managed conditions, whereas more expert students may learn more under learner-managed conditions.

Effects of an Acute Physical Activity Break on Test Anxiety and Math Test Performance.

(1) Background: Test anxiety has been found to negatively affect students' mental health and academic performance. A primary explanation for this is that anxiety-related thoughts occupy working memory resources during testing that cannot be used for test-related processes (such as information retrieval and problem-solving). The present intervention study investigated whether physical activity could decrease anxiety levels and improve maths test performance in sixth-grade children. (2) Methods: Sixty-eight children of 11-12 years from two primary schools in New South Wales, Australia were categorised as low or high anxious from their scores on a trait-anxiety questionnaire. After this assessment, they were randomly assigned to the activity break condition, in which they had to do several physical activities of moderate intensity (i.e., star jumps) for 10 min, or the control condition, in which they played a vocabulary game for 10 min. The outcome measures were children's anxiety levels at the beginning, during, and at the end of the test, invested mental effort, perceived task difficulty and maths test performance. (3) Results: Results showed that regardless of the condition, low anxious students performed better on the maths test than high anxious children. No differences were found for any of the variables between the activity break condition and the control condition. (4) Conclusions: Although test anxiety was not reduced as expected, this study showed that short physical activity breaks can be used before examinations without impeding academic performance.

Does gesture strengthen sensorimotor knowledge of objects? The case of the size-weight illusion.

Co-speech gestures have been proposed to strengthen sensorimotor knowledge related to objects' weight and manipulability. This pre-registered study (https://www.osf.io/9uh6q/) was designed to explore how gestures affect memory for sensorimotor information through the application of the visual-haptic size-weight illusion (i.e., objects weigh the same, but are experienced as different in weight). With this paradigm, a discrepancy can be induced between participants' conscious illusory perception of objects' weight and their implicit sensorimotor knowledge (i.e., veridical motor coordination). Depending on whether gestures reflect and strengthen either of these types of knowledge, gestures may respectively decrease or increase the magnitude of the size-weight illusion. Participants (N = 159) practiced a problem-solving task with small and large objects that were designed to induce a size-weight illusion, and then explained the task with or without co-speech gesture or completed a control task. Afterwards, participants judged the heaviness of objects from memory and then while holding them. Confirmatory analyses revealed an inverted size-weight illusion based on heaviness judgments from memory and we found gesturing did not affect judgments. However, exploratory analyses showed reliable correlations between participants' heaviness judgments from memory and (a) the number of gestures produced that simulated actions, and (b) the kinematics of the lifting phases of those gestures. These findings suggest that gestures emerge as sensorimotor imaginings that are governed by the agent's conscious renderings about the actions they describe, rather than implicit motor routines.

Co-thought gesturing supports more complex problem solving in subjects with lower visual working-memory capacity.

During silent problem solving, hand gestures arise that have no communicative intent. The role of such co-thought gestures in cognition has been understudied in cognitive research as compared to co-speech gestures. We investigated whether gesticulation during silent problem solving supported subsequent performance in a Tower of Hanoi problem-solving task, in relation to visual working-memory capacity and task complexity. Seventy-six participants were assigned to either an instructed gesture condition or a condition that allowed them to gesture, but without explicit instructions to do so. This resulted in three gesture groups: (1) non-gesturing; (2) spontaneous gesturing; (3) instructed gesturing. In line with the embedded/extended cognition perspective on gesture, gesturing benefited complex problem-solving performance for participants with a lower visual working-memory capacity, but not for participants with a lower spatial working-memory capacity.

Establishing a Scientific Consensus on the Cognitive Benefits of Physical Activity.

Research suggests that physical activity can be used as an intervention to increase cognitive function. Yet, there are competing views on the cognitive effects of physical activity and it is not clear what level of consensus exists among researchers in the field. The purpose of this study was two-fold: Firstly, to quantify the scientific consensus by focusing on the relationship between physical activity and cognitive function. Secondly, to investigate if there is a gap between the public's and scientists' interpretations of scientific texts on this topic. A two-phase study was performed by including 75 scientists in the first phase and 15 non-scientists in the second phase. Participants were asked to categorize article abstracts in terms of endorsement of the effect of physical activity on cognitive function. Results indicated that there was a 76.1% consensus that physical activity has positive cognitive effects. There was a consistent association between scientists' and non-scientists' categorizations, suggesting that both groups perceived abstracts in a similar fashion. Taken together, this study provides the first analysis of its kind to evaluate the level of consensus in almost two decades of research. The present data can be used to inform further research and practice.

Comparing Cognitive Control Performance During Seated Rest and Self-Paced Cycling on a Desk Bike in Preadolescent Children.

BACKGROUND: Although active workstations, such as desk bikes, have proven to be beneficial for health, there is limited information regarding their effects on children's acute cognitive performance during self-paced exercise. METHODS: This study used a within-subjects, fully counterbalanced design with a sample of 38 preadolescent children (mean age = 12.50 y, SD = 0.62; 43% male), who performed cognitive tests while being seated or while cycling for 45 minutes with a 7-day interval. Effects of using a desk bike were evaluated on cognitive control: verbal and visuospatial working memory capacities were tested, and inhibition was assessed using a modified flanker task. In addition, subjective task experience was explored using self-report measures. RESULTS: Cognitive control performance was not degraded but also not improved with the short-term use of desk bikes. Because of the null effects, there is no direction and magnitude of the outcomes to discuss. CONCLUSIONS: These findings suggest that schools can successfully implement desk bikes to increase physical activity and reduce sedentary time among children without compromising cognitive control processes necessary for academic achievement.

The role of gesture as simulated action in reinterpretation of mental imagery.

In two experiments, we examined the role of gesture in reinterpreting a mental image. In Experiment 1, we found that participants gestured more about a figure they had learned through manual exploration than about a figure they had learned through vision. This supports claims that gestures emerge from the activation of perception-relevant actions during mental imagery. In Experiment 2, we investigated whether such gestures have a causal role in affecting the quality of mental imagery. Participants were randomly assigned to gesture, not gesture, or engage in a manual interference task as they attempted to reinterpret a figure they had learned through manual exploration. We found that manual interference significantly impaired participants' success on the task. Taken together, these results suggest that gestures reflect mental imaginings of interactions with a mental image and that these imaginings are critically important for mental manipulation and reinterpretation of that image. However, our results suggest that enacting the imagined movements in gesture is not critically important on this particular task.