Learning to diagnose X-rays: a neuroscientific study of practice-related activation changes in the prefrontal cortex

Diagnosis ◽  
2021 ◽  
Vol 0 (0) ◽  
Author(s):  
Jerome I. Rotgans
Keyword(s):  
Prefrontal Cortex ◽  
Medical Students ◽  
Response Time ◽  
Diagnostic Accuracy ◽  
Test Phase ◽  
Learning Phase ◽  
X Rays ◽  
Far Transfer ◽  
Near Transfer ◽  
System 2

Abstract Objectives Medical expertise manifests itself by the ability of a physician to rapidly diagnose patients. How this expertise develops from a neural-activation perspective is not well understood. The objective of the present study was to investigate practice-related activation changes in the prefrontal cortex (PFC) as medical students learn to diagnose chest X-rays. Methods The experimental paradigm consisted of a learning and a test phase. During the learning phase, 26 medical students were trained to diagnose four out of eight chest X-rays. These four cases were presented repeatedly and corrective feedback was provided. During the test phase, all eight cases were presented together with near- and far-transfer cases to examine whether participants’ diagnostic learning went beyond simple rote recognition of the trained X-rays. During both phases, participants’ PFC was scanned using functional near-infrared spectroscopy. Response time and diagnostic accuracy were recorded as behavioural indicators. One-way repeated measures ANOVA were conducted to analyse the data. Results Results revealed that participants’ diagnostic accuracy significantly increased during the learning phase (F=6.72, p<0.01), whereas their response time significantly decreased (F=16.69, p<0.001). Learning to diagnose chest X-rays was associated with a significant decrease in PFC activity (F=33.21, p<0.001) in the left dorsolateral prefrontal cortex, the orbitofrontal area, the frontopolar area and the frontal eye field. Further, the results of the test phase indicated that participants’ diagnostic accuracy was significantly higher for the four trained cases, second highest for the near-transfer, third highest for the far-transfer cases and lowest for the untrained cases (F=167.20, p<0.001) and response time was lowest for the trained cases, second lowest for the near-transfer, third lowest for the far-transfer cases and highest for the untrained cases (F=9.72, p<0.001). In addition, PFC activity was lowest for the trained and near-transfer cases, followed by the far-transfer cases and highest for the untrained cases (F=282.38, p<0.001). Conclusions The results suggest that learning to diagnose X-rays is associated with a significant decrease in PFC activity. In terms of dual-process theory, these findings support the notion that students initially rely more on slow analytical system-2 reasoning. As expertise develops, system-2 reasoning transitions into faster and automatic system-1 reasoning.

scholarly journals Promotion of knowledge transfer and retention in year 2 medical students using an online training exercise

2021 ◽  
Author(s):  
Lucy V. Rosby ◽  
Henk G. Schmidt ◽  
Gerald J. S. Tan ◽  
Naomi Low-Beer ◽  
Silvia Mamede ◽  
...  
Keyword(s):  
Medical Students ◽  
Knowledge Transfer ◽  
Online Training ◽  
Far Transfer ◽  
Near Transfer ◽  
Training Exercise ◽  
X Ray ◽  
Transfer And Retention ◽  
Chest X Ray ◽  
Mean Time

AbstractIt was recently shown that novice medical students could be trained to demonstrate the speed-to-diagnosis and diagnostic accuracy typical of System-1-type reasoning. However, the effectiveness of this training can only be fully evaluated when considering the extent to which knowledge transfer and long-term retention occur as a result, the former of which is known to be notoriously difficult to achieve. This study aimed to investigate whether knowledge learned during an online training exercise for chest X-ray diagnosis promoted either knowledge transfer or retention, or both. Second year medical students were presented with, and trained to recognise the features of four chest X-ray conditions. Subsequently, they were shown the four trained-for cases again as well as different representations of the same conditions varying in the number of common elements and asked to provide a diagnosis, to test for near-transfer (four cases) and far-transfer (four cases) of knowledge. They were also shown four completely new conditions to diagnose. Two weeks later they were asked to diagnose the 16 aforementioned cases again to assess for knowledge retention. Dependent variables were diagnostic accuracy and time-to-diagnosis. Thirty-six students volunteered. Trained-for cases were diagnosed most accurately and with most speed (mean score = 3.75/4, mean time = 4.95 s). When assessing knowledge transfer, participants were able to diagnose near-transfer cases more accurately (mean score = 2.08/4, mean time = 15.77 s) than far-transfer cases (mean score = 1.31/4, mean time = 18.80 s), which showed similar results to those conditions previously unseen (mean score = 0.72/4, mean time = 19.46 s). Retention tests showed a similar pattern but accuracy scores were lower overall. This study demonstrates that it is possible to successfully promote knowledge transfer and retention in Year 2 medical students, using an online training exercise involving diagnosis of chest X-rays, and is one of the few studies to provide evidence of actual knowledge transfer.

Task-Switching Training and Transfer

2018 ◽  
Vol 32 (3) ◽  
pp. 106-130 ◽  
Author(s):  
Zsófia Anna Gaál ◽  
István Czigler
Keyword(s):  
Older Adults ◽  
Young Adults ◽  
Cognitive Training ◽  
Task Switching ◽  
Difficulty Level ◽  
Training Procedure ◽  
Far Transfer ◽  
Near Transfer ◽  
Related Potentials ◽  
Transfer Tasks

Abstract. We used task-switching (TS) paradigms to study how cognitive training can compensate age-related cognitive decline. Thirty-nine young (age span: 18–25 years) and 40 older (age span: 60–75 years) women were assigned to training and control groups. The training group received 8 one-hour long cognitive training sessions in which the difficulty level of TS was individually adjusted. The other half of the sample did not receive any intervention. The reference task was an informatively cued TS paradigm with nogo stimuli. Performance was measured on reference, near-transfer, and far-transfer tasks by behavioral indicators and event-related potentials (ERPs) before training, 1 month after pretraining, and in case of older adults, 1 year later. The results showed that young adults had better pretraining performance. The reference task was too difficult for older adults to form appropriate representations as indicated by the behavioral data and the lack of P3b components. But after training older adults reached the level of performance of young participants, and accordingly, P3b emerged after both the cue and the target. Training gain was observed also in near-transfer tasks, and partly in far-transfer tasks; working memory and executive functions did not improve, but we found improvement in alerting and orienting networks, and in the execution of variants of TS paradigms. Behavioral and ERP changes remained preserved even after 1 year. These findings suggest that with an appropriate training procedure older adults can reach the level of performance seen in young adults and these changes persist for a long period. The training also affects the unpracticed tasks, but the transfer depends on the extent of task similarities.

scholarly journals EXPRESS: Standing out from the crowd: Both cue numerosity and social information affect attention in multi-agent contexts

2021 ◽  
pp. 174702182110130
Author(s):  
Francesca Capozzi ◽  
Andrew Paul Bayliss ◽  
Jelena Ristic
Keyword(s):  
Social Interactions ◽  
Social Information ◽  
Test Phase ◽  
Learning Phase ◽  
Complex Interplay ◽  
Two Phase ◽  
Attentional Allocation ◽  
Social Cue ◽  
Gaze Cuing ◽  
Multi Agent

Groups of people offer abundant opportunities for social interactions. We used a two-phase task to investigate how social cue numerosity and social information about an individual affected attentional allocation in such multi-agent settings. The learning phase was a standard gaze-cuing procedure in which a stimulus face could be either uninformative or informative about the upcoming target. The test phase was a group-cuing procedure in which the stimulus faces from the learning phase were presented in groups of three. The target could either be cued by the group minority (i.e., one face) or majority (i.e., two faces) or by uninformative or informative stimulus faces. Results showed an effect of cue numerosity, whereby responses were faster to targets cued by the group majority than the group minority. However, responses to targets cued by informative identities included in the group minority were as fast as responses to targets cued by the group majority. Thus, previously learned social information about an individual was able to offset the general enhancement of cue numerosity, revealing a complex interplay between cue numerosity and social information in guiding attention in multi-agent settings.

Recognition Memory for Emotional and Neutral Faces: An Event-Related Potential Study

2004 ◽  
Vol 16 (10) ◽  
pp. 1840-1853 ◽  
Author(s):  
Mikael Johansson ◽  
Axel Mecklinger ◽  
Anne-Cécile Treese
Keyword(s):  
Prefrontal Cortex ◽  
Recognition Memory ◽  
Recognition Performance ◽  
Facial Affect ◽  
Test Phase ◽  
Event Related Potential ◽  
Affect Recognition ◽  
Negative Events ◽  
Familiarity And Recollection ◽  
Criterion Setting

This study examined emotional influences on the hypothesized event-related potential (ERP) correlates of familiarity and recollection (Experiment 1) and the states of awareness (Experiment 2) accompanying recognition memory for faces differing in facial affect. Participants made gender judgments to positive, negative, and neutral faces at study and were in the test phase instructed to discriminate between studied and nonstudied faces. Whereas old–new discrimination was unaffected by facial expression, negative faces were recollected to a greater extent than both positive and neutral faces as reflected in the parietal ERP old–new effect and in the proportion of remember judgments. Moreover, emotion-specific modulations were observed in frontally recorded ERPs elicited by correctly rejected new faces that concurred with a more liberal response criterion for emotional as compared to neutral faces. Taken together, the results are consistent with the view that processes promoting recollection are facilitated for negative events and that emotion may affect recognition performance by influencing criterion setting mediated by the prefrontal cortex.

scholarly journals Evaluating the diagnostic accuracy of gene xpert analysis in pediatric pulmonary tuberculosis: a prospective clinical study in North-Western India

2021 ◽  
Vol 8 (4) ◽  
pp. 716
Author(s):  
Venkatesh Karthik S. ◽  
Jigisha Patadiya
Keyword(s):  
Diagnostic Accuracy ◽  
Predictive Value ◽  
Roc Analysis ◽  
Gastric Lavage ◽  
Control Program ◽  
Tuberculin Test ◽  
Receiver Operating Curve ◽  
Prospective Clinical Study ◽  
Western India ◽  
X Rays

Background: The diagnosis of tuberculosis (TB) by microbiological tests is a major challenge particularly in children. The use of Xpert analysis, a rapid genetic testing modality is not widely reported in our locality. The aim of the study to evaluate the diagnostic accuracy of Gene xpert analysis in diagnosis of pediatric Pulmonary TB.Methods: A prospective hospital-based study was conducted among 140 participants with symptomatology pertaining to pulmonary TB as per Revised national tuberculosis control program (RNTCP, India) criteria. The Xpert testing (GXT) was performed as per standards and was compared with erythrocyte sedimentation rate (ESR), tuberculin test (TT) and chest X-rays (CXR). The obtained results were reported in terms of Sensitivity %, Specificity %, Positive Predictive Value % (PPV) and Negative Predictive Value % (NPV) for comparisons. The receiver operating curve (ROC) analysis was employed to evaluate the accuracy of diagnosis.Results: The GXT was positive (10.71 %) in suspected TB patients. TT has significantly (10 %) with a73.33% sensitivity, 93.60% specificity and a PPV of 57.89 % when compared with xpert. The ESR showed a sensitivity of 53.33% and a specificity of 56%. The CXR showed sensitivity of 93.33%. The ROC analysis showed that TT had a higher confidence interval (0.699-0.970) t5`han other methods. The Rifampicin resistance was found 7.5% (n=2) of 15 GXT positive cases.Conclusions: The xpert based diagnosis of gastric lavage samples after a tuberculin test (TT) had high sensitivity and specificity, followed by chest X ray while the ESR had lower clinical accuracy. The ‘gene xpert analysis’ is highly useful rapid tool for diagnosis of children with TB. 

Online Behavior Modeling

2008 ◽  
pp. 1922-1937
Author(s):  
Charlie C. Chen ◽  
Terry Ryan
Keyword(s):  
Ease Of Use ◽  
Perceived Usefulness ◽  
Behavior Modeling ◽  
Perceived Ease Of Use ◽  
Online Behavior ◽  
Far Transfer ◽  
Software Training ◽  
Near Transfer ◽  
Face To Face ◽  
Sufficient Power

Organizations need effective and affordable software training. In face-to-face settings, behavior modeling (BM) is an effective, but expensive, training method. Can BM be employed effectively, and more affordably, for software training in the online environment? An experiment was conducted to compare the effectiveness of online BM with that of face-to-face (F2F) BM for software training. Results indicate that online BM and F2F BM provide essentially the same outcomes in terms of knowledge near transfer, immediate knowledge far transfer, delayed knowledge far transfer, perceived ease of use, perceived usefulness and satisfaction. Observed differences were not significant, nor were their patterns consistent, despite sufficient power in the experimental design to detect meaningful differences. These results suggest that organizations should consider online BM as a primary method of software training.

Learning Transfer of Computer Skills: Examining the Impact of Multilevel Computer Self-Efficacy Beliefs

2005 ◽  
Vol 04 (02) ◽  
pp. 125-132
Author(s):  
Bassam Hasan
Keyword(s):  
Transfer Learning ◽  
Self Efficacy ◽  
Positive Relationship ◽  
Computer Training ◽  
Far Transfer ◽  
Near Transfer ◽  
Computing Skills ◽  
The Impact ◽  
Training Practice ◽  
Computer Self Efficacy

The information systems literature has demonstrated a positive relationship between an individual's computer self-efficacy (CSE) and his/her ability to learn new computing skills. However, most past studies have overlooked the multilevel nature of the CSE construct and have not differentiated between near-transfer and far-transfer learning of computing skills. Accordingly, this study focuses on these two issues by investigating the impact of two levels of CSE (general and software specific) on two types of learning (near- and far-transfer) in computer training. The results of an experiment conducted to empirically test the relationships hypothesised among the study variables showed that software-specific CSE had significant effects on near-transfer and far-transfer learning and software-specific self-efficacy. In contrast, general CSE was found to have a significant effect on far-transfer learning only. The results provide valuable implications of computer training practice and research.

scholarly journals Transfer of metacognitive skills in self-regulated learning: an experimental training study

2020 ◽  
Vol 15 (3) ◽  
pp. 455-477
Author(s):  
Corinna Schuster ◽  
Ferdinand Stebner ◽  
Detlev Leutner ◽  
Joachim Wirth
Keyword(s):  
Cognitive Strategies ◽  
Cognitive Strategy ◽  
Training Transfer ◽  
Metacognitive Skills ◽  
Far Transfer ◽  
Near Transfer ◽  
Training Conditions ◽  
Self Regulated Learning ◽  
Learning Tasks ◽  
Regulated Learning

Abstract Training interventions for self-regulated learning foster the use of strategies and skills as well as their transfer to new learning tasks. Because cognitive strategies or motivation regulation strategies are task-specific, their transfer is limited. In contrast, metacognitive skills are task-general and transferable to a wide variety of learning tasks. Questions arise, therefore, as to whether students transfer metacognitive skills spontaneously and how to support metacognitive skill transfer. Previous research shows that hybrid training, which addresses both metacognitive skills and cognitive strategies, supports near transfer. However, it is not clear whether hybrid training also fosters far transfer of metacognitive skills. In investigating this research question, 233 fifth-grade students were randomly assigned to six different conditions: two hybrid-training conditions (metacognitive skills and one out of two cognitive strategies), two non-hybrid training conditions (“only” one out of two cognitive strategies), and two control training conditions (neither metacognitive skills nor cognitive strategies). After 15 weeks of training, transfer of metacognitive skills to learning tasks similar to training tasks (near transfer) was tested. In the following 15 weeks, all students received a second, non-hybrid training involving a new cognitive strategy. Far transfer of metacognitive skills to the new cognitive strategy was tested afterward. The results show that hybrid training, compared to non-hybrid and control training, improved both students’ near and far transfer of metacognitive skills. Moreover, cognitive strategy use increased in at least one of the hybrid-training conditions. However, since the level of metacognitive skills use remained low, further means to support transfer are discussed.

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