During Lipreading Training With Sentence Stimuli, Feedback Controls Learning and Generalization to Audiovisual Speech in Noise

Purpose: This study investigated the effects of external feedback on perceptual learning of visual speech during lipreading training with sentence stimuli. The goal was to improve visual-only (VO) speech recognition and increase accuracy of audiovisual (AV) speech recognition in noise. The rationale was that spoken word recognition depends on the accuracy of sublexical (phonemic/phonetic) speech perception; effective feedback during training must support sublexical perceptual learning. Method: Normal-hearing (NH) adults were assigned to one of three types of feedback: Sentence feedback was the entire sentence printed after responding to the stimulus. Word feedback was the correct response words and perceptually near but incorrect response words. Consonant feedback was correct response words and consonants in incorrect but perceptually near response words. Six training sessions were given. Pre- and posttraining testing included an untrained control group. Test stimuli were disyllable nonsense words for forced-choice consonant identification, and isolated words and sentences for open-set identification. Words and sentences were VO, AV, and audio-only (AO) with the audio in speech-shaped noise. Results: Lipreading accuracy increased during training. Pre- and posttraining tests of consonant identification showed no improvement beyond test–retest increases obtained by untrained controls. Isolated word recognition with a talker not seen during training showed that the control group improved more than the sentence group. Tests of untrained sentences showed that the consonant group significantly improved in all of the stimulus conditions (VO, AO, and AV). Its mean words correct scores increased by 9.2 percentage points for VO, 3.4 percentage points for AO, and 9.8 percentage points for AV stimuli. Conclusions: Consonant feedback during training with sentences stimuli significantly increased perceptual learning. The training generalized to untrained VO, AO, and AV sentence stimuli. Lipreading training has potential to significantly improve adults' face-to-face communication in noisy settings in which the talker can be seen.

The Influence of Feedback Content and Feedback Time on Multimedia Learning Achievement of College Students and Its Mechanism

This study investigated the content of feedback (adaptive, elaborated, and knowledge of correct response, KCR) and time (Immediate and Delayed) influences on multimedia learning of college students. Students from the Northeast Normal University (N = 157) were randomly assigned to one of the six experimental conditions. We tried to explain the influence mechanisms of different feedback effects through subjectively reported motivation, cognitive load, and eye movement trajectory during the feedback period. The results showed that (1) different feedback methods in terms of feedback time and feedback content have significantly different effects on scores. Among them, scores of the immediate feedback group were significantly higher than those of the delayed feedback group, and the scores of the adaptive feedback (AF) group were significantly higher than those of the elaborated feedback (EF) group and the knowledge of the correct response feedback group. (2) Different types of feedback contents have significantly different effects on motivation. The motivation scores reported by the AF group and EF group were significantly higher than those reported by the knowledge of the correct response feedback group. (3) Different feedback methods in terms of feedback time and feedback content had significantly different effects on subjective germane cognitive load reports. Among them, the germane cognitive load score of the immediate feedback group was significantly higher than that of the delayed feedback group. The germane cognitive load scores reported by the AF group were significantly higher than those reported by the EF group and knowledge of the correct response feedback group. (4) The germane cognitive load plays a partial mediating role between the AF and post-test scores. (5) Different feedback methods in feedback time have different effects on eye movement fixation trajectory, which shows that the subjects in the immediate feedback group were significantly less than those in the delayed feedback group in fixation count and fixation time in the interest area of the stem. (6) Consistent with our hypothesis, different feedback methods in feedback content have different effects on eye movement trajectory. In summary, the results show that the AF initiated in this study has a positive effect on multimedia learning of college students; it not only provides empirical evidence for cognitive load theory but also helps educators design adaptive learning feedback according to responses of students.

Improving Competence in Diagnosis, Referral and Initial Management of Acquired Hemophilia a through Online Interactive Case-Based Education

INTRODUCTION Diagnosing acquired haemophilia A (AHA) can be challenging due to a) it's rarity (~1.5 cases per million), and b) the range of nonspecific bleeding patterns that may present. Therefore, there is a substantial diagnostic delay and rate of misdiagnosis, leading to an increased risk of morbidity and mortality. This study was conducted to determine whether online interactive case-based independent medical education could improve clinicians' competence in identifying possible AHA, in appropriate referral to specialist centers and in initial management. METHODS Hematologists and emergency medicine (EM) physicians participated in a text, case-based activity and completed pre- and post-questions (Ma A. Active Bleeding in the ER and a Prolonged aPTT: What's Your Next Step? www.medscape.org/viewarticle/944112). Educational effect was assessed using a 3-question repeated-pair design with pre-/post-assessment. A paired samples t-test was conducted for significance testing on overall average number of correct responses and for confidence rating, and a McNemar's test was conducted at the learning objective level (5% significance level, P <.05). Cohen's d with correction for paired samples estimated the effect size of the education on number of correct responses (<.20 modest, .20-.49 small, .59-.79 moderate, ≥.80 large). Data were collected from 03/15/2021 to 06/14/2021. RESULTS Overall significant improvements at the aggregate level were seen after participation for hematologists (33% average correct response rate at pre-assessment vs 94% at post-assessment; P<.001, Cohen's d= 2.27, N=86), and EM physicians (24% average correct response rate at pre-assessment vs 80% at post-assessment; P<.001, Cohen's d= 1.30, N=102). Highly significant improvements were achieved with regards to recognizing symptoms of AHA, appropriate referral, and initial therapeutic management (figure). After participating, 37% of hematologists and 40% of pulmonologists had measurable improved confidence (both P<.001), resulting in 63% of hematologists and 46% of EM physicians who were mostly or very confident in identifying features consistent with a possible AHA diagnosis post-CME (vs 44% and 26% pre-CME respectively). CONCLUSIONS This study demonstrates the success of online, interactive case-based education in improving clinicians' competence in identifying patients with possible AHA, appropriate referral and initial treatment. Both improvement and reinforcement in the context of a linked learning assessment have been shown to positively correlate with increases in confidence as well as intention to make clinical practice changes (Lucero KS, Chen P. J Eur CME. 2020 Oct 12;9(1):1834759), suggesting that most clinicians who participated in this activity are likely to make improvements in their practice. This could lead to earlier appropriate treatment and improved overall outcomes for these patients. Figure 1 Figure 1. Disclosures Ma: Takeda: Honoraria, Research Funding; Accordant: Consultancy.

What is left after an error? Towards a comprehensive account of goal-based binding and retrieval

The cognitive system readily detects and corrects erroneous actions by establishing episodic bindings between representations of the acted upon stimuli and the intended correct response. If these stimuli are encountered again, they trigger the retrieval of the correct response. Thus, binding and retrieval efficiently pave the way for future success. The current study set out to define the role of the erroneous response itself and explicit feedback for the error during these processes of goal-based binding and retrieval. Two experiments showed robust and similar binding and retrieval effects with and without feedback and pointed towards sustained activation of the unbound, erroneous response. The third experiment confirmed that the erroneous response is more readily available than a neutral alternative. Together, the results demonstrate that episodic binding biases future actions toward success, guided primarily through internal feedback processes, while the erroneous response still leaves detectable traces in human action control.

The Evaluation of Responses and Abilities of 119 EMTs to Perform Pediatric Triage

This study aimed to evaluate the pediatric triage performance of 119 Emergency Medicine Technologists (EMTs) at a fire station, based on mass casualty incident scenarios of a pediatric disaster, and to evaluate effective measures of response. EMTs (N = 58) at a provincial fire station participated in this study and were asked to complete three questionnaires: one ‘general characteristics’ questionnaire, one problem solving questionnaire, consisting of questions based on mass casualty incident scenarios, and a post-questionnaire to explore the necessity of pediatric triage based on their responses. We used SPSS to analyze the data. The EMT-paramedics’ scores were high and statistically significant (p < .002). All 48 questions concerning the three scenarios were converted to a score ranging from 0 to 100 with an average score of 70.92 and an average correct response rate of 70%. We also found that the participants’ rate of recognition of the pediatric triage tool was significantly lower than that of the adult tool (p < .030). The usage rate was also low, at approximately 19.09%. After solving the questionnaire problems, the respondents reported a significantly higher score concerning the necessity of the pediatric triage tools than before (p < .006). Firefighting departments integrate pediatric triage tools into the E-triage system. However, EMTs should receive continuous training and practice to improve their pediatric triage tool classification capabilities.

The Theory and Measurement of Expertise-Based Problem Solving in Organizational Teams: Revisiting Demonstrability

The current paper revisits and builds upon task demonstrability, which defines the criteria necessary for groups to choose a correct response if any member prefers that response. We identify boundary conditions of the current conceptualization of task demonstrability with respect to its use in understanding modern organizational teams. Specifically, we argue that, in its current form, task demonstrability is not optimally suited to studying ongoing teams in which member expertise varies and teams work to complete complex multifaceted tasks. To address this issue, we provide a revisited perspective on demonstrability. We specify the nomological network of revisited demonstrability and recast each of its criteria in a form that preserves the original intent of the construct, but has broader applicability, particularly to organizational contexts. We then discuss theoretical implications and managerial applications of the construct. Finally, noting that there is no standard assessment tool for demonstrability (original or revisited), we develop and validate a measure to facilitate future research.

Benefits and costs of self-paced preparation of novel task instructions

Rapidly executing novel instructions is a critical ability. However, it remains unclear whether longer preparation of novel instructions improves performance, and if so, whether this link is modulated by performance benefits and costs of preparation. Regarding the first question, we reanalysed previous data on novel instruction implementation and ran Experiment 1. Experiment 1 consisted of multiple mini-blocks, in which participants prepared four novel stimulus–response (S-R) mappings in a self-paced instruction phase. After participants indicated they were ready, one of the four stimuli was presented and they responded. The reanalysis and Experiment 1 showed that longer preparation indeed led to better performance. To examine if preparation was modulated when the benefits of preparation were reduced, we presented the correct response with the stimulus on some trials in Experiments 2 and 3. Preparation was shorter when the probability that the correct response was presented with the stimulus increased. In Experiment 4, we manipulated the costs of preparation by changing the S-R mappings between the instruction and execution phases on some trials. This had only limited effects on preparation time. In conclusion, self-paced preparation of novel instructions comes with performance benefits and costs, and participants adjust their preparation strategy to the task context.

Awareness, Recognition, and Response to Stroke among the General Public—An Observational Study

Objective To evaluate awareness and response to stroke among the general public. Materials and Methods In this prospective, observational study, self-reported stroke awareness questionnaire was administered in 2000 consecutive participants who visited outpatient clinic of a tertiary care hospital. For data analysis, comparison included for awareness of stroke and response in case of stroke. Results The average age of the study participants was 39.64 ± 15.55 (17–85), with 651(32.6%) women. Among the respondents, 786(39.3%) participants mentioned stroke as blood clot in the brain; 268(13.4%) stated it as brain hemorrhage. Awareness of stroke was higher in people in cities (71.0 vs. 8.5%; p < 0.001) and graduates (75.3 vs. 60.9%; p < 0.001) or knew a family member or friend who had stroke (42.7 vs. 30.4%; p < 0.001). Most commonly recognized risk factors included stress (1,152; 57.6%) and hypertension (1,148; 57.4%). Most identified warning sign was weakness of one side of body (807; 40.4%) and speech impairment (658; 32.9%). Participants who were aware of stroke knew a greater number of risk factors (3.75 ± 2.88 vs. 2.45 ± 2.66; p < 0.001) and warning signs (2.85 ± 2.25 vs. 1.49 ± 1.41; p <0.001). Among 1,138 participants who were aware of stroke, 166 (14.6%) participants knew one correct response in case of a stroke, either call a doctor (49.3 vs. 35.0%; p <0.001) or call an ambulance (41.1 vs. 34.9%; p = 0.055). Participants who knew one correct response to stroke had at least a family member/friend who had stroke (44.1 vs. 34.3%; p < 0.022). Conclusion We report that among 56.9% of the participants who were aware of stroke most could not name more than four risk factors or three warning signs of stroke. Only 14.6% of those aware of stroke knew appropriate response to stroke.

‘Wang’s Paradox’

This chapter, specially written for the 2007 Schilp volume in his honour, revisits Sir Michael Dummett’s seminal contribution to the debates about vagueness in his ipsonymous 1975 paper. The chapter again rejects both the conception of vagueness as any kind of semantic incompleteness and Epistemicism, and critiques Dummett’s own suggestion of Incoherentism, returning again to the governing view and the question of the sense, if any, in which vague expressions should be thought of as governed by semantic rules. The Sorites for phenomenal predicates, ‘looks red’ and its ilk, receives special focus. It is argued that the correct response is that the competent use of these and other vague expressions is, in a certain sense, unprincipled: their vagueness is a phenomenon of reactive judgement unsupported by reasons. This conception enforces Agnosticism about Bivalence and a consequent repudiation of the validity of double negation elimination.