Why Does Dual-Tasking Hamper Implicit Sequence Learning?

Research on the limitations of dual-tasking might profit from using setups with a predictable sequence of stimuli and responses and assessing the acquisition of this sequence. Detrimental effects of dual-tasking on implicit sequence learning in the serial reaction time task (SRTT; Nissen & Bullemer, 1987) - when paired with an uncorrelated task - have been attributed to participants' lack of separating the streams of events in either task. Assuming that co-occurring events are automatically integrated, we reasoned that participants could need to first learn which events co-occur, before they can acquire sequence knowledge. In the training phase, we paired an 8-element visual-manual SRTT with an auditory-vocal task. Afterwards, we tested under single-tasking conditions whether SRTT sequence knowledge had been acquired. By applying different variants of probabilistic SRTT-tone pairings across three experiments, we tested what type of predictive relationship was needed to preserve sequence learning. In Experiment 1, where half of the SRTT-elements were paired to 100% with one specific tone and the other half randomly, only the fixedly paired elements were learned. Yet, no sequence learning was found when each of the eight SRTT-elements was paired with tone identity in a 75%-25% ratio (Experiment 2). Sequence learning was, however, intact when the 75%-25% ratio was applied to the four SRTT target locations instead (Experiment 3). The results suggest that participants (when lacking a separation of the task representations while dual-tasking) can learn a sequence inherent in one of two tasks to the extent that across-task contingencies can be learned first.

The impact of predictability on dual-task performance and implications for resource-sharing accounts

The aim of this study was to examine the impact of predictability on dual-task performance by systematically manipulating predictability in either one of two tasks, as well as between tasks. According to capacity-sharing accounts of multitasking, assuming a general pool of resources two tasks can draw upon, predictability should reduce the need for resources and allow more resources to be used by the other task. However, it is currently not well understood what drives resource-allocation policy in dual tasks and which resource allocation policies participants pursue. We used a continuous tracking task together with an audiomotor task and manipulated advance visual information about the tracking path in the first experiment and a sound sequence in the second experiments (2a/b). Results show that performance predominantly improved in the predictable task but not in the unpredictable task, suggesting that participants did not invest more resources into the unpredictable task. One possible explanation was that the re-investment of resources into another task requires some relationship between the tasks. Therefore, in the third experiment, we covaried the two tasks by having sounds 250 ms before turning points in the tracking curve. This enabled participants to improve performance in both tasks, suggesting that resources were shared better between tasks.

Daily life activities in patients with Alzheimer's disease or semantic dementia: Multitasking assessment

The aim of the present study was to compare patients with mild to moderate Alzheimer's disease (AD) or semantic dementia (SD) on their cognitive processes and the severity of their daily life activity impairments. Three types of tasks were administered to patients (SD = 15; AD = 31) and 30 healthy controls (HC): 1) informant-based scales and questionnaires, 2) a neuropsychological assessment exploring executive functions, episodic and semantic memory, and 3) a new original test featuring multi-step naturalistic actions and multitasking: the Sequential Daily Life Multitasking (SDLM). We predicted that patients with AD would mainly exhibit task perplexity, associated with episodic and executive deficits on the SDLM, while the behavior of patients with SD would mostly be characterized by object perplexity, associated with semantic memory deficits. Results showed that patients with AD or SD were impaired across all neuropsychological tests, particularly episodic memory in AD and semantic memory in SD. General performance on the SDLM also appeared dramatically impaired in both patient groups, and correlated with results of questionnaires about instrumental activities and memory impairments. However, specific qualitative measurements on the SDLM did not allow us to pinpoint different patterns of errors and behavior in patients with AD versus SD. We suggest that the inability of patients in both groups to perform the SDLM may derive from a constellation of disorders or else from more subtle impairment of cognitive and conative processes that requires further exploration.

Effects of task probability on prioritized processing: Modulating the efficiency of parallel response selection

Four experiments investigated the extent to which a limited pool of resources can be shared between different tasks performed simultaneously when it is efficient to do so. The experiments used a prioritized processing paradigm, in which stimuli for both a primary task and a background task were presented in each trial. If the primary-task stimulus required a response in a trial, participants made only that response. If the primary-task stimulus did not require a response, participants responded to the background task. The main manipulation was the relative probability that a response would be required to the primary versus background task. In some blocks, the majority of trials required responses to the primary task (Experiments 1 and 2: 80%; Experiments 3 and 4: 60%), whereas in other blocks the majority required responses to the background task. Background-task responses were substantially faster in blocks where they were more likely to be required, consistent with the idea that more capacity was allocated to them in these blocks. Backward compatibility effects on primary-task responses and stimulus-onset asynchrony effects on background-task responses provided further evidence of greater capacity allocation to the background task when there was a higher probability of responding to it. The results support the view that two tasks can be processed in parallel, with resources divided between them, when it is efficient to do so.

SPRINT Through Tasks: A Novel Curriculum for Improving Resident Task Management in the Emergency Department

INTRODUCTION

The emergency department (ED) presents a challenging task-management environment to emergency medicine (EM) trainees. However, equipping residents with a tool to improve task switching (generically known as multitasking) could have positive impacts on patient care and physician emotional state. We designed a task-management tool and educational curriculum with the goal of improving emergency medicine resident task-switching ability.

METHODS

The task-management tool uses the acronym SPRINT: (1) stabilize critical patients, (2) perform procedures, (3) rack (see new patients in the chart rack), (4) in or out (reassess and disposition), (5) type it up (chart completion). These tasks and their order were decided on by two seasoned clinicians based on their years of experience in the ED. The SPRINT tool was taught to EM residents through a 1-hour curriculum consisting of an introductory video, a classroom-based workshop with multimedia didactics, and team learning with a card game simulating the use of the SPRINT tool on a shift. Residents were surveyed to evaluate their task-management confidence and perceived effectiveness of the curriculum.

RESULTS

A total of 34 EM residents participated in this training on the SPRINT tool. There was an improvement in resident confidence in task management, and residents reporting having a strategy for task prioritization 8 weeks after the workshop.

DISCUSSION

The SPRINT curriculum provides EM residents with a tool to manage the complex task-management environment of the ED. Further research in task-management education should focus on patient-oriented outcomes among physicians who have received this training.

Team-based primary care practice and physician's services: Evidence from Family Health Teams in Ontario, Canada

Team-based primary care offers a wide range of health services to patients by using interdisciplinary health care providers committed to delivering comprehensive, coordinated and high-quality care through team collaboration. Ontario's Family Health Team (FHT), the largest team-based practice model in Canada, was introduced to improve access to and effectiveness of primary health care services, and was available primarily for physicians paid under blended capitation models (Family Health Organizations and Family Health Networks). Using health administrative data on physicians practicing under blended capitation models in Ontario between 2006 and 2015, we study the impact of switching from non-FHT to FHTs on the production of capitated comprehensive care services, after-hours services, non-incentivized services, and services provided to non-enrolled patients by family physicians. We find that when in FHTs, physicians increase the production of total services and non-incentivized services by 26% and 5% per annum and reduce capitated comprehensive care services by 3.2% per annum. When in FHTs, physicians also see and enroll more patients relative to those practicing in non-FHTs. We find evidence of improved access to physician's services under team-based primary care, but switching to FHTs has no effect on the production of after-hours services and services provided to non-enrolled patients.

Spatial ability contributes to memory for delayed intentions

Most everyday activities involve delayed intentions referring to different event structures and timelines. Yet, past research has mostly considered prospective memory (PM) as a dual-task phenomenon in which the primary task to fulfill PM intentions is realized within an ongoing secondary task. We hypothesized that these simplified simulations of PM may have obscured the role of spatial relational processing that is functional to represent and meet the increased temporal demands in more complex PM scenarios involving multiple timelines. To test this spatiotemporal hypothesis, participants monitored four digital clocks, with PM deadlines referring either to the same clock (single-context condition) or different clocks (multiple-context condition), along with separate tests of spatial ability (mental rotation task) and executive functioning (working memory updating). We found that performance in the mental rotation task incrementally explained PM performance in the multiple-context, but not in the single-context, condition, even after controlling for individual differences in working memory updating and ongoing task performance. These findings suggest that delayed intentions occurring in multiple ongoing task contexts reflect independent contributions of working memory updating and mental rotation and that spatial relational processing may specifically be involved in higher cognitive functions, such as complex PM in multiple contexts or multitasking.

Using a smartphone while walking: The cost of smartphone-addiction proneness

Distracted walking is an ever-increasing problem. Studies have already shown that using a smartphone while walking impairs attention and increases the risk of accidents. This study seeks to determine if smartphone-addiction proneness magnifies the risks of using a smartphone while walking. In an experimental design, participants, while walking on a treadmill and engaged in a smartphone task, were required to switch tasks by responding to an external stimulus, i.e., determining the direction of movement of a point-light walker. Participants were chosen to cover a range of smartphone-addiction proneness. Four smartphone-use conditions were simulated: a control condition with no smartphone-use, an individual conversation condition, a gaming condition, and a group conversation condition. Our results show that using a smartphone while walking decreases accuracy and increases the number of missed stimuli. Moreover, participants with higher smartphone-addiction proneness scores were also prone to missing more stimuli, and this effect was found regardless of experimental condition. The effect of the smartphone task on accuracy and the number of missed stimuli was mediated by the emotional arousal caused by the smartphone task. Smartphone-addiction proneness was positively correlated with a declared frequency of smartphone use while walking. Furthermore, of all the smartphone tasks, the gaming condition was found to be the most distracting.

Multitasking additional-to-driving: Prevalence, structure, and associated risk in SHRP2 naturalistic driving data

OBJECTIVE

This paper 1) analyzes the extent to which drivers engage in multitasking additional-to-driving (MAD) under various conditions, 2) specifies odds ratios (ORs) of crashing associated with MAD, and 3) explores the structure of MAD.

METHODS

Data from the Second Strategic Highway Research Program Naturalistic Driving Study (SHRP2 NDS) was analyzed to quantify the prevalence of MAD in normal driving as well as in safety-critical events of various severity level and compute point estimates and confidence intervals for the corresponding odds ratios estimating the risk associated with MAD compared to no task engagement. Sensitivity analysis in which secondary tasks were re-defined by grouping similar tasks was performed to investigate the extent to which ORs are affected by the specific task definitions in SHRP2. A novel visual representation of multitasking was developed to show which secondary tasks co-occur frequently and which ones do not.

RESULTS

MAD occurs in 11 % of control driving segments, 22 % of crashes and near-crashes (CNC), 26 % of Level 1-3 crashes and 39 % of rear-end striking crashes, and 9 %, 16 %, 17 % and 28 % respectively for the same event types if MAD is defined in terms of general task groups. The most common co-occurrences of secondary tasks vary substantially among event types; for example, "Passenger in adjacent seat - interaction" and "Other non-specific internal eye glance" tend to co-occur in CNC but tend not to co-occur in control driving segments. The odds ratios of MAD using SHRP2 task definitions compared to driving without any secondary task and the corresponding 95 % confidence intervals are 2.38 (2.17-2.61) for CNC, 3.72 (3.11-4.45) for Level 1-3 crashes and 8.48 (5.11-14.07) for rear-end striking crashes. The corresponding ORs using general task groups to define MAD are slightly lower at 2.00 (1.80-2.21) for CNC, 3.03 (2.48-3.69) for Level 1-3 crashes and 6.94 (4.04-11.94) for rear-end striking crashes.

CONCLUSIONS

The number of secondary tasks that the drivers were engaged in differs substantially for different event types. A graphical representation was presented that allows mapping task prevalence and co-occurrence within an event type as well as a comparison between different event types. The ORs of MAD indicate an elevated risk for all safety-critical events, with the greatest increase in the risk of rear-end striking crashes. The results are similar independently of whether secondary tasks are defined according to SHRP2 or general task groups. The results confirm that the reduction of driving performance from MAD observed in simulator studies is manifested in real-world crashes as well.

White matter correlates of gait perturbations resulting from spontaneous and lateralized attention in healthy older adults: A dual-task study

To date the neural mechanisms behind gait perturbations caused by dual-task paradigms are still unknown. Therefore, the present study examined white matter correlates of gait perturbations caused by a dichotic listening task where spontaneous (free focus of attention) and lateralized attentional control (voluntary attention directed to right or left-ear) were tested. Fifty-nine right-handed, healthy older adults (59-88 years) were evaluated during single-task walking and three dual-task conditions. Dual-task costs were calculated for mean (DTCM) and coefficients of variation (DTCCoV) in gait speed, step length, stride length and step width. Volume, fractional anisotropy and mean diffusivity were estimated using global probabilistic tractography for the 18 major brain tracts and correlated with the DTCs. Data demonstrated that DTCs on gait speed and step length significantly correlated with white matter integrity and volume in various tracts. Perturbations on gait speed caused by spontaneous attention were related to frontal circuitry integrity including corpus callosum, while perturbations on gait speed and step length produced by voluntary lateralized attention were associated to tracts subserving visuomotor integration and frontal function.

Visualising clinical work in the emergency department: Understanding interleaved patient management

We present a unique data visualisation approach, called workflow time charts, to illustrate the sequential and multi-dimensional nature of work in emergency departments. Using 40 h of data from direct observations of emergency physicians, we applied the charts to visualise patient-stratified physicians' work as a continuous temporal process, including distinguishing tasks of different types and representing external prompts (similar to interruptions) and multitasking performance. The charts showed frequent changes in the nature of observed activities, with interleaved multitasking a constant feature and external prompts often clustered in time. Evidence of seniority-related differences in work were apparent with consultants switching between more concurrent patients and receiving more frequent clinical prompts than junior physicians, illustrating their overseeing and advice-giving role. The ubiquity of interleaved multitasking suggests a need to focus on developing individual strategies to support frequent cognitive switching. Work that appears fragmented at physician level may form part of a flexible and robust system, rather than an error-prone set of isolated individual behaviours.

Electrophysiological correlates of spatial processing during multitasking

Multitasking is ubiquitous in everyday life. It can have a detrimental effect on several cognitive abilities including spatial processing in both brain-damaged and healthy participants. The present study investigated, in healthy adults, the electrophysiological mechanisms associated with correct detection vs. misdetection of peripheral visual target(s) while processing concurrent visual or auditory stimuli. Correct responses were coupled with increased N1 amplitude under visual (i.e., intra-modal) load but not under auditory (i.e., cross-modal) load. Under visual load, error responses were associated to opposite patterns on N1/N2 components for unilateral and bilateral stimuli. In particular, errors were marked by significantly reduced N1 and N2 amplitude for the left and right visual field, respectively, whereas higher N1 amplitude was found for errors to bilateral targets. This suggests that early negative components represent the biological marker of target awareness under visual load, whereby correct target detection is grounded on a threshold criterion. These results provide an electrophysiological correlate for the allocation of capacity-limited cognitive resources during the concurrent processing of multiple and heterogeneous visual stimuli.

Building the multitasking brain: An integrated perspective on functional brain activation during task-switching and dual-tasking

Multitasking behavior is associated with well-known performance costs, but the question of why individuals falter when attempting to manage multiple streams of information remains difficult to answer. One reason for this difficulty may be that multitasking costs are often characterized by isolating component processes that are studied largely independently. In this study, we instead integrate two commonly studied substrates of multitasking, task-switching and dual-tasking, within the same procedural context. This method allows not only a direct comparison of performance costs associated with different demand types but also examination of their interaction. We measured functional brain activation in thirty healthy young adults as they completed a block-design version of the task, observing consistent and separable patterns of frontoparietal activation as a function of demand type. Broadly, task-switching was associated with activation of left premotor and inferior parietal regions, and dual-tasking was associated with activation in regions of right prefrontal and inferior parietal cortex. In the interaction condition, we observed a distributed bilateral pattern of activation across the areas associated with each demand in isolation. These results provide both behavioral and neuroimaging evidence that task-switching and dual-tasking demands can be dissociated and contribute to multitasking costs in unique and separable ways.

The effects of mobile phone use on walking: a dual task study

OBJECTIVES

The aim of this study was to examine the effects of walking at different speeds while using a mobile phone on spatiotemporal stride parameters among young adults. Ten participants (7 male, 3 female; age = 24.7 ± 4.4 years, mean ± 1SD) completed 12 walking trials. Trials consisted of tasks performed at both normal and fast walking speeds-walking only, walking while texting, and walking while talking on a mobile phone. Gait velocity, stride length, cadence, and double support time were computed using data from accelerometers on either shoe.

RESULTS

The effects of distracted walking were not significantly larger when performed at a self-selected fast walking speed compared with a normal walking speed. However, walking while texting produced significant decreases in gait velocity, stride length, and cadence, with a significant increase in double support time at both walking speeds. Moreover texting increased the size of the relative variability of walking, observed through a significant increase in the coefficient of variation of cadence, stride length, and double support time. The observed changes may be suggestive of compromised balance when walking while texting regardless of walking speed. This may place the individual at a greater risk of, slips, trips and falls.

Effects of multitasking and intention-behaviour consistency when facing yellow traffic light uncertainty

We examined the effects of multitasking on resolving response bistability to yellow traffic lights, using the performance metrics of reaction time and stopping frequency. We also examined whether people's actual behaviours, measured by implicit foot pedal responses, differed from their intentions related to these factors, as measured by explicit verbal commands. In a dual-task paradigm, participants responded to random traffic light changes, presented over a static background photograph of an intersection, using either foot pedals or verbal commands, while simultaneously identifying spoken words as either "animals" or "artefacts" via button pressing. The dual-task condition was found to prolong reaction times relative to a single-task condition. In addition, verbal commands were faster than the foot pedal responses, and conservativeness was the same for both types of responses. A second experiment, which provided a more dynamic simulation of the first experiment, confirmed that conservativeness did not differ between verbal commands and foot pedal responses. We conclude that multitasking affects a person's ability to resolve response bistability to yellow traffic lights. If one considers that prolonged reaction times reduce the amount of distance available to safely stop at intersections, this study underscores how multitasking poses a considerable safety risk for drivers approaching a yellow traffic light.

Common and distinct neural correlates of dual-tasking and task-switching: a meta-analytic review and a neuro-cognitive processing model of human multitasking

Although there are well-known limitations of the human cognitive system in performing two tasks simultaneously (dual-tasking) or alternatingly (task-switching), the question for a common vs. distinct neural basis of these multitasking limitations is still open. We performed two Activation Likelihood Estimation meta-analyses of neuroimaging studies on dual-tasking or task-switching and tested for commonalities and differences in the brain regions associated with either domain. We found a common core network related to multitasking comprising bilateral intraparietal sulcus (IPS), left dorsal premotor cortex (dPMC), and right anterior insula. Meta-analytic contrasts revealed eight fronto-parietal clusters more consistently activated in dual-tasking (bilateral frontal operculum, dPMC, and anterior IPS, left inferior frontal sulcus and left inferior frontal gyrus) and, conversely, four clusters (left inferior frontal junction, posterior IPS, and precuneus as well as frontomedial cortex) more consistently activated in task-switching. Together with sub-analyses of preparation effects in task-switching, our results argue against purely passive structural processing limitations in multitasking. Based on these findings and drawing on current theorizing, we present a neuro-cognitive processing model of multitasking.

Predicting attention shifting abilities from self-reported media multitasking

Media multitasking is an increasingly prominent behavior in affluent societies. However, it still needs to be established if simultaneous use of several modes of media content has an influence on higher cognitive functions, such as divided attention. In this study, attention shifting was the primary focus, since switching between tasks is assumed to be necessary for media multitasking. Two tasks, the number-letter and local-global task, were used as measures of switching ability. The cognitive reflections task was included to control for possible effects of intelligence. Results from linear regression analyses showed that higher levels of media multitasking was related to lower switching costs in the two attention-shifting tasks. These findings replicate previous findings suggesting that heavy media multitaskers perform better on select measures of task switching. We suggest two possible explanations for our results: media multitasking may practice skills needed for switching between tasks, or high media multitaskers are choosing this style of technology use due to a dominating personality trait in this group.

A Pilot Study Examining the Effects of Educational Setting and Stress on Multitasking Among Medical Students

This study examines multitasking with media and technology among medical students across four learning contexts (lecture, lab, team-based learning, and homework) and whether stress moderates the relationship between multitasking and academic performance. The proliferation of technology simultaneously used for learning, entertainment, and socialization facilitates multitasking in learning environments. There is comparatively little research on multitasking behavior among medical students. Data were collected using a survey distributed online to four cohorts of an allopathic medical school to examine the relationship of multitasking and academic performance using both descriptive and correlational analyses of multitasking behavior in each of the four learning contexts. A moderation analysis was used to investigate the role of stress in this relationship. Lower multitasking was reported as learning contexts became more active (e.g., lecture versus lab). Some respondents, however, appeared resilient to the changing environment, maintaining high levels of multitasking. In the low multitasking environment of lab, respondents with high levels of stress, who multitasked heavily, reported better academic performance. Approaches to multitasking must account for learning environments and the individual propensities of students. Additionally, some forms of multitasking may not be counterproductive to learning, but the boundaries between productive and counterproductive multitasking are difficult to distinguish.

Aging of the frontal lobe

Healthy aging is associated with numerous deficits in cognitive function, which have been attributed to changes within the prefrontal cortex (PFC). This chapter summarizes some of the most prominent cognitive changes associated with age-related alterations in the anatomy and physiology of the PFC. Specifically, aging of the PFC results in deficient aspects of cognitive control, including sustained attention, selective attention, inhibitory control, working memory, and multitasking abilities. Yet, not all cognitive functions associated with the PFC exhibit age-related declines, such as arithmetic, comprehension, emotion perception, and emotional control. Moreover, not all older adults exhibit declines in cognition. Multiple life-course and lifestyle factors, as well as genetics, play a role in the trajectory of cognitive performance across the life span. Thus many adults retain cognitive function well into advanced age. Moreover, the brain remains plastic throughout life and there is increasing evidence that most age-related declines in cognition can be remediated by various methods such as physical exercise, cognitive training, or noninvasive brain stimulation. Overall, because cognitive aging is associated with numerous life-course and lifestyle factors, successful aging likely begins in early life, while maintaining cognition or remediating declines is a life-long process.

Differential effects of cue-based and sequence knowledge-based predictability on multitasking performance

Everyday multitasking often is characterized by predictable sequences. While such sequential regularities are present in setups using the Serial Reaction Time Task (SRTT), many laboratory studies on dual-tasking performance use random sequences of stimuli in either of the two tasks. In the current study, following single-task training on the SRTT, participants completed trials where they were confronted with an additional visual-manual task with either a random (Experiment 1) or a partially predictable (Experiment 2) stimulus sequence. In the SRTT, we cued participants with respect to which of the four stimulus options were yet to occur (before a new round with all four options would start). We randomly mixed a sequence to be practiced with random sequences of the same length and with the same constraint. Thus, we were able to vary predictability of upcoming stimuli (from chance to 100%) as well as sequence knowledge (practiced vs. random sequence) in order to assess how cueing and sequence knowledge, as two potential bases of prediction, would affect performance in single- and dual-tasking. Results suggest that both cueing and sequence knowledge-based prediction can lead to shorter RTs in dual-tasking. In previous studies, the disruption of sequence learning by adding a task with a random stimulus sequence has been linked to the effects of automatic prediction between events in the two tasks. In line with these studies, dual-task performance did not impede usage of sequence knowledge when a task with a predictable (rather than random) sequence of stimuli was added to the SRTT.

Shielding and relaxation in multitasking: Prospect of reward counteracts relaxation of task shielding in multitasking

Performing two similar tasks at the same time requires the shielding of the prioritized Task 1 from interference of additional Task 2 processing (between-task interference). In the present study we tested how motivational factors such as prospect of reward might drive shifts between increased proactive control, enabling task shielding, and reduced proactive control resulting in relaxed task shielding. In Experiment 1 an instruction-induced prioritization of Task 1 over Task 2 resulted in initially reduced between-task interference. With increasing time on task, however, between-task interference continuously increased, presumably because participants engaged less in proactive control resulting in reduced task shielding. In Experiment 2 the prospect of reward activated proactive control as indicated by reduced between-task interference in the Reward than in the No reward condition. In Experiment 3, we directly compared the performance of a Reward and a No reward group in a between-subject design. Whereas between-task interference again continuously increased over time in the No reward group, indicating a relaxed mode of task shielding, the Reward group displayed constant small between-task interference over time, suggesting maintained high levels of task shielding. Together these findings speak in favor of an impressive flexibility in regulating cognitive control engagement in multitasking situations. This not only shows the capacity for optimization of multitasking performance by motivational incentives but also further supports assumptions of the strategic nature of assumed processing limitations (bottlenecks) in dual-task performance.

The visual guidance of action is not insulated from cognitive interference: A multitasking study on obstacle-avoidance and bisection

The Perception-Action Model (PAM) considers the visual system to be divided into two streams defined by their specific functions, a ventral stream for vision and a dorsal stream for action. In this study we investigated two behavioral paradigms which according to PAM represent the two contrasting functions of the ventral and dorsal stream, namely bisection and obstacle-avoidance, respectively. It is an assumption of PAM that while ventral stream processing is ultimately linked with processing in other cognitive systems, dorsal stream processing is insulated from cognition. Accordingly it can be expected that a secondary task will interfere with bisection but not with obstacle-avoidance. We tested this prediction using a rapid serial visual presentation task as our secondary task (RSVP). Contrary to expectations we found significant interference for both bisection and obstacle-avoidance. Our findings suggest that dorsal-stream processing is not insulated from cognitive processes.

Structured box training improves stability of retraction while multitasking in colorectal surgery simulation

BACKGROUND

Laparoscopic colorectal surgery has an established role. The ability to multitask (use a retraction tool with one hand and navigate a laparoscopic camera with the other) is desired for efficient laparoscopic surgery. Surgical trainees must learn this skill to perform advanced laparoscopic tasks. The aim was to determine whether a box-training protocol improves the stability of retraction while multitasking in colorectal surgery simulation.

MATERIALS AND METHODS

Fifty-eight medical students were recruited to attend a basic laparoscopic box-training course. Ability to perform steady retraction with and without multitasking was measured initially and at the conclusion of the course.

RESULTS

Before training, students demonstrated a decrease in performance while multitasking with a greater maximal exerted force, a greater range of force, and a greater standard deviation for traction and minimal exerted force, range of force and a greater standard deviation for countertraction. Statistically significant improvement (lower maximal exerted force and lower range of force) was observed for traction while multitasking after training. After the training, no statistically significant differences were found when the student performed a single task versus multitasking, both for traction and countertraction.

CONCLUSIONS

A structured box-training curriculum improved the stability of retraction while multitasking in this colorectal surgery simulation. Although it did not improve stability of retraction as a single task, it did improve stability of retraction while multitasking. After training, this enables the trainee to retract as efficiently while operating the camera as they retract when only focusing on retraction as a single task.

Connectivity patterns in cognitive control networks predict naturalistic multitasking ability

Multitasking is a fundamental aspect of everyday life activities. To achieve a complex, multi-component goal, the tasks must be subdivided into sub-tasks and component steps, a critical function of prefrontal networks. The prefrontal cortex is considered to be organized in a cascade of executive processes from the sensorimotor to anterior prefrontal cortex, which includes execution of specific goal-directed action, to encoding and maintaining task rules, and finally monitoring distal goals. In the current study, we used a virtual multitasking paradigm to tap into real-world performance and relate it to each individual's resting-state functional connectivity in fMRI. While did not find any correlation between global connectivity of any of the major networks with multitasking ability, global connectivity of the lateral prefrontal cortex (LPFC) was predictive of multitasking ability. Further analysis showed that multivariate connectivity patterns within the sensorimotor network (SMN), and between-network connectivity of the frontoparietal network (FPN) and dorsal attention network (DAN), predicted individual multitasking ability and could be generalized to novel individuals. Together, these results support previous research that prefrontal networks underlie multitasking abilities and show that connectivity patterns in the cascade of prefrontal networks may explain individual differences in performance.

Development of a Contextualized Version of the Multiple Errands Test for People with Substance Dependence

BACKGROUND

Substance dependence is associated with deficits in several areas of executive functioning, such as planning and multitasking. Traditional tests of executive functioning have been criticized for their low ecological validity. Shallice and Burgess (1991) developed the Multiple Errands Test (MET), where participants are required to perform multiple tasks in a real-world setting. In this study, we aimed to adapt the MET for use in populations with substance dependence.

OBJECTIVES

This study aimed to: (1) examine the applicability of a contextualized version of the Multiple Errands Test, namely, the Multiple Errands Test - Contextualized Version (MET-CV); (2) study the testing context reliability and convergent validity of MET-CV scores; (3) compare the performance of people with substance dependence to a control group.

METHODS

Data were collected from 60 participants with substance dependence and 30 healthy controls. Both groups performed a neuropsychological assessment, which consisted of the MET-CV and traditional neuropsychological tests (Letter Number Sequencing, Zoo Map Test, Revised Strategy Application Test, Information Sampling Test, Stockings of Cambridge).

RESULTS

The MET-CV has adequate testing context reliability and moderate convergent validity relative to traditional planning measures. People with substance dependence (PWSD) showed significant deficits in executive function tests compared to healthy controls, most notably on the MET-CV rather than on traditional neuropsychological tests.

CONCLUSIONS

The MET-CV can be feasibly applied in the context of therapeutic communities treatment in PWSD. The MET-CV showed adequate reliability and validity, and detected planning deficits in PWSD. (JINS, 2018, 24, 347-359).