Low Performers Research Articles

The Short Physical Performance Battery (SPPB): A Quick and Useful Tool for Fall Risk Stratification Among Older Primary Care Patients

ObjectivesEvaluate fall risk with the Short Physical Performance Battery (SPPB) and examine its application within the Stopping Elderly Accidents, Deaths, and Injuries (STEADI) tool advocated by the Centers for Disease Control and Prevention. DesignProspective longitudinal cohort study. Setting and Participants417 community-dwelling adults aged ≥65 years at risk for mobility decline, recruited from 9 primary care practices. MethodsThe SPPB, a 3-part performance-based test (gait time, chair stand, and balance), was assessed at baseline. Previously established cutpoints were used to categorize participant scores into 3 groups: low, middle, and best performers. Self-reported falls were assessed in-person at baseline and via phone interviews quarterly for 4 years. Multivariable negative binomial regression models were used to evaluate the relationship of the SPPB and each of its 3 components with fall rates over 1 and 4 years of follow-up. Additional analysis were stratified by fall risk screen status (+/−) based on self-reported fall history and balance self-efficacy using an adapted STEADI model. ResultsParticipants had median age 76 years (interquartile range 70-82) and were 67.2% female with mean baseline SPPB 8.7 ± 2.3. Poor performance on the SPPB and on each of its 3 components independently predicted higher fall risk in the first year. After 4 years, the low total baseline SPPB [rate ratio (RR) 1.53, confidence interval (CI) 1.09-2.17] and gait time performances (RR 1.61, CI 1.07-2.41) predicted higher fall risk. After stratifying the sample according to the STEADI model, we observed the highest 1-year fall risk among those with a (+) fall risk screen who also scored lowest on the SPPB. Conclusions and ImplicationsThe SPPB is a performance measure with clinical utility for fall risk stratification over 1 and 4 years of follow-up among older adults. It shows promise as a complement to the STEADI guidelines, but its full benefits should be confirmed within a larger study.

Effects of tDCS on Tactile Perception Depend on Tactile Expertise in Both Musicians and Non-Musicians.

Brain plasticity in the somatosensory cortex and tactile performance can be facilitated by brain stimulation. Here, we investigated the effects of transcranial direct current stimulation (tDCS) on tactile perception in musicians and non-musicians to elucidate how tDCS-effects might depend on tactile expertise. On three separate days, 17 semi-professional musicians (e.g., piano or violin players) and 16 non-musicians aged 18–27 years received 15 min of 1 mA anodal (a-tDCS), cathodal (c-tDCS) or sham tDCS in a pseudorandomized design. Pre and post tDCS, tactile sensitivity (Touch Detection Task; TDT) and discrimination performance (Grating Orientation Task; GOT) were assessed. For further analysis, the weekly hours of instrument-playing and computer-typing were combined into a “tactile experience” variable. For GOT, but not TDT, a significant group effect at baseline was revealed with musicians performing better than non-musicians. TDT thresholds were significantly reduced after a-tDCS but not c-tDCS or sham stimulation. While both musicians’ and non-musicians’ performance improved after anodal stimulation, neither musical nor tactile expertise was directly associated with the magnitude of this improvement. Low performers in TDT with high tactile experience profited most from a-tDCS. We conclude that tactile expertise may facilitate somatosensory cortical plasticity and tactile learning in low performers.

The role of metacognition in the first-year design lab

Metacognition, or the ability to think about thinking, plays a significant role in the performance of first-year design students. Although the number of studies that focus on metacognition has increased in the past decade, additional studies are needed to more fully investigate metacognition and the use of metacognitive strategies in design education. Thus, this study focused on the influence of metacognitive knowledge, monitoring, and control on first-year design students’ performance. The conditions leading to changes in first-year design students’ metacognitive thinking and behaviors were also investigated. The processes of gathering data through concurrent verbalization and retrospective verbalization methods and a questionnaire are described. Thematic data analysis was used to extract the emerging themes from these data sources. Results indicated that metacognitive thinking was present in the generation and development of design ideas. Comparisons of higher- and lower-performing students demonstrated the importance of metacognitive thinking during design learning tasks; higher-performing (HP) students tended to focus more on metacognitive thinking, whereas lower-performing (LP) students focused more on cognitive activities. Other comparisons between HP and LP students, along with recommendations for improving students’ problem solving performance in design courses, are shared.

Increasing physical literacy in youth: A two-week Sport for Development program for children aged 6-10

Regular physical activity significantly improves health outcomes, yet rates of childhood physical activity remain alarmingly low. Physical literacy has been identified as the foundation for quality physical education, suggesting that sport, education, and public health interventions should seek to increase physical literacy to promote physical activity. A two-week day camp program for children aged 6–10 facing barriers to positive development, was developed and delivered by a Sport for Development facility in Toronto, Canada. Utilizing fundamental movement skills (FMS) as a teaching tool and a pre- and post-assessment, the camp aimed to increase physical literacy and promote engagement in physical activity. Results indicate a significant increase in FMS (t (44) = 4.37, p < .001) as well as improved self-perceptions of physical literacy (t (40) = 14.96, p < .001). The largest FMS increases were found in running and balance and the most significant impacts were among low baseline performers.

Positive deviants for medication therapy management: A mixed-methods comparative case study of community pharmacy practices.

To optimize medication use in older adults, the Centers for Medicare & Medicaid Services (CMS) launched Medication Therapy Management (MTM) services as part of Medicare Part D policy; however, strategies for achieving high quality MTM outcomes are not well understood. The objective of this study was to generate hypotheses for strategies contributing to community pharmacies' high performance on policy-relevant MTM quality measures. This mixed-methods comparative case study was guided by the Positive Deviance approach and Chronic Care Model. The study population consisted of pharmacy staff employed by a Midwestern division of a national supermarket-community pharmacy chain. Data consisted of demographics and qualitative data from semi-structured interviews. Qualitative and quantitative data were analyzed deductively and inductively or using descriptive statistics, respectively. MTM quality measures used to evaluate participant pharmacies' MTM performance mirrored select 2017 Medicare Part D Plans' Star Rating measures. Thirteen of 18 selected case pharmacies (72.2%) participated in this study, of which 5 were categorized as high performers, 4 moderate performers, and 4 low performers. Eleven pharmacists, 11 technicians, and 3 student interns participated in interviews. Eight strategies were hypothesized as contributing to MTM performance: Strong pharmacy staff-provider relationships and trust, Inability to address patients' social determinants of health (negatively contributing), Technician involvement in MTM, Providing comprehensive medication reviews in person vs. phone alone, Placing high priority on MTM, Using available clinical information systems to identify eligible patients, Technicians using clinical information systems to collect/document information for pharmacists, Faxing prescribers adherence medication therapy problems (MTPs) and calling on indication MTPs. Eight strategies were hypothesized as contributing to community pharmacies' performance on MTM quality measures. Findings from this work can inform MTM practice and Medicare Part D MTM policy changes to positively influence patient outcomes. Future research should test hypotheses in a larger representative sample of pharmacies.

ALTERNATIVE DELIVERY MODE (ADM) PROGRAM DELIVERY AND PERFORMANCE OF STUDENTS

Alternative Delivery Mode (ADM) of instruction had become an option of schools, parents, and learners to access education. Despite its implementation for several years, research on its delivery and students’ academic performance was not endeavored. Hence, this study was conducted to determine the relationship of Alternative Delivery Mode (ADM) program and performance of the students. The respondents of the study were 30 students from nine elementary schools in the Division of Digos, Davao del Sur. Results showed that most of the respondents enrolled in the Alternative Delivery Mode (ADM) were male, at age 11, and were laborers. Most of them were low performers. The respondents rated the Alternative Delivery Mode (ADM) implementation as moderate. It further revealed that there was no significant difference in the level of implementation of Alternative Delivery Mode in terms of gender and age but it showed significant relationship between the level of implementation of the program and the performance of the students. Intensification of Alternative Delivery Mode (ADM) was recommended.&#x0D; &#x0D; &lt;p&gt; &lt;/p&gt;&lt;p&gt;&lt;strong&gt; Article visualizations:&lt;/strong&gt;&lt;/p&gt;&lt;p&gt;&lt;img src="/-counters-/edu_01/0720/a.php" alt="Hit counter" /&gt;&lt;/p&gt;

Colonoscopist Performance and Colorectal Cancer Risk After Adenoma Removal to Stratify Surveillance: Two Nationwide Observational Studies

Colonoscopy surveillance after adenoma removal is an increasing burden in many countries. Surveillance recommendations consider characteristics of removed adenomas, but not colonoscopist performance. We investigated the impact of colonoscopist performance on colorectal cancer risk after adenoma removal. We compared colorectal cancer risk after removal of high-risk adenomas, low-risk adenomas, and after negative colonoscopy for all colonoscopies performed by colonoscopists with low vs high performance quality (adenoma detection rate <20% vs ≥20%) in the Polish screening program between 2000 and 2011, with follow-up until 2017. Findings were validated in the Austrian colonoscopy screening program. A total of 173,288 Polish colonoscopies were included in the study. Of 262 colonoscopists, 160 (61.1%) were low performers, and 102 (38.9%) were high performers; 11.1% of individuals had low-risk and 6.6% had high-risk adenomas removed at screening; 82.2% had no adenomas. During 10 years of follow-up, 443 colorectal cancers were diagnosed. For low-risk adenoma individuals, colorectal cancer incidence was 0.55% (95% confidence interval [CI] 0.40-0.75) with low-performing colonoscopists vs 0.22% (95% CI 0.14-0.34) with high-performing colonoscopists (hazard ratio [HR] 2.35; 95% CI 1.31-4.21; P= .004). For individuals with high-risk adenomas, colorectal cancer incidence was 1.14% (95% CI 0.87-1.48) with low-performing colonoscopists vs 0.43% (95% CI 0.27-0.69) with high-performing colonoscopists (HR 2.69; 95% CI 1.62-4.47; P < .001). After negative colonoscopy, colorectal cancer incidence was 0.30% (95% CI 0.27-0.34) for individuals examined by low-performing colonoscopists, vs 0.15% (95% CI 0.11-0.20) for high-performing (HR 2.10; 95% CI 1.52-2.91; P < .001). The observed trends were reproduced in the Austrian validation cohort. Our results suggest that endoscopist performance may be an important contributor in addition to polyp characteristics in determining colorectal cancer risk after colonoscopy screening.

Self-assessing a test with a possible bonus enhances low performers’ academic performance

Students tend not to review test feedback or process it cognitively. We examined whether and how self-assessment enhanced engineering students' engagement in test feedback and academic performance, and whether and how the impact differed for high and low performers. We also investigated whether peer assessment and bonus points added to the impact of self-assessment. Engineering students in the three experimental groups received different interventions: self-assessing their test (SA), self-assessing their test with a bonus (SAI), and assessing their own and peer's test with a bonus (PSAI). A video detailing the solutions and how to grade each test was provided to guide students in assessing tests. There were no statistically significant differences between the control and experimental groups in students' engagement and academic performance, but low-performing SAI's score change from Test 2 to the final exam was bigger than that of low performers in the control group. Reflections suggested that one possible reason for why high performers did not benefit as much as the low performers was the ceiling effect. That is, high performers already understood the concepts before the self-assessment.Students liked self-assessing tests, thought that it was of value, and thought about why they lost points. Our study contributes to the literature on how to improve the effectiveness of test feedback and the literature indicating that providing differentiated feedback based on students' prior knowledge can be beneficial. It also shows that video feedback can be helpful for students taking pen-and-paper tests.

The Development of a Knowledge Test on Transgender Patients' Care.

The objective of this study was to develop an assessment instrument to measure the effects of a continuing education intervention on 3 domains in pharmacists’ knowledge needed to provide pharmaceutical care for transgender patients: (1) foundations of gender-affirming care, (2) health disparities and the specific needs of transgender patients, and (3) hormone treatments for transgender patients. Multiple-choice questions were developed, and an initial item bank of 47 items was drafted. Item bank revision was conducted by content matter experts, while feedback from 8 practicing pharmacists was provided for face validity and further insights. A preliminary test, containing 42 items was administered to 64 pharmacists before and after a three-hour continuing education intervention. Cronbach’s alpha coefficient yielded a value of 0.65 as a pre-test and 0.77 as a post-test. Items were less difficult to answer by participants after taking the three-hour continuing education, showing better discrimination among high and low performers in the instrument administration as post-test, as well as better correlation when comparing participants’ performance in the overall score against item-level performance. Psychometric evidence supports further instrument examination, which can improve this tool to measure gains in pharmacists’ knowledge related to the care of transgender patients.

Perceptual-Cognitive Function and Unplanned Athletic Movement Task Performance: A Systematic Review.

The performance of choice-reaction tasks during athletic movement has been demonstrated to evoke unfavorable biomechanics in the lower limb. However, the mechanism of this observation is unknown. We conducted a systematic review examining the association between (1) the biomechanical and functional safety of unplanned sports-related movements (e.g., jumps/runs with a spontaneously indicated landing leg/cutting direction) and (2) markers of perceptual–cognitive function (PCF). A literature search in three databases (PubMed, ScienceDirect and Google Scholar) identified five relevant articles. The study quality, rated by means of a modified Downs and Black checklist, was moderate to high (average: 13/16 points). Four of five papers, in at least one parameter, found either an association of PCF with task safety or significantly reduced task safety in low vs. high PCF performers. However, as (a) the outcomes, populations and statistical methods of the included trials were highly heterogeneous and (b) only two out of five studies had an adequate control condition (pre-planned movement task), the evidence was classified as conflicting. In summary, PCF may represent a factor affecting injury risk and performance during unplanned sports-related movements, but future research strengthening the evidence for this association is warranted.

No Effect of Anodal tDCS on Verbal Episodic Memory Performance and Neurotransmitter Levels in Young and Elderly Participants.

Healthy ageing is accompanied by cognitive decline that affects episodic memory processes in particular. Studies showed that anodal transcranial direct current stimulation (tDCS) to the left dorsolateral prefrontal cortex (DLPFC) may counteract this cognitive deterioration by increasing excitability and inducing neuroplasticity in the targeted cortical region. While stimulation gains are more consistent in initial low performers, relying solely on behavioural measures to predict treatment benefits does not suffice for a reliable implementation of this method as a therapeutic option. Hence, an exploration of the underlying neurophysiological mechanisms regarding the differential stimulation effect is warranted. Glutamatergic metabolites (Glx) and γ-aminobutyric acid (GABA) are involved in learning and memory processes and can be influenced with tDCS; wherefore, they present themselves as potential biomarkers for tDCS-induced behavioural gains, which are affiliated with neuroplasticity processes. In the present randomized, double-blind, sham-controlled, crossover study, 33 healthy young and 22 elderly participants received anodal tDCS to their left DLPFC during the encoding phase of a verbal episodic memory task. Using MEGA-PRESS edited magnetic resonance spectroscopy (MRS), Glx and GABA levels were measured in the left DLPFC before and after the stimulation period. Further, we tested whether baseline performance and neurotransmitter levels predicted subsequent gains. No beneficial group effects of tDCS emerged in either verbal retrieval performances or neurotransmitter concentrations. Moreover, baseline performance levels did not predict stimulation-induced cognitive gains, nor did Glx or GABA levels. Nevertheless, exploratory analyses suggested a predictive value of the Glx : GABA ratio, with lower ratios at baseline indicating greater tDCS-related gains in delayed recall performance. This highlights the importance of further studies investigating neurophysiological mechanisms underlying previously observed stimulation-induced cognitive benefits and their respective interindividual heterogeneity.

Differences in transitional care processes among high-performing and low-performing hospital-SNF pairs: a rapid ethnographic approach

BackgroundDespite the increased focus on improving patient’s postacute care outcomes, best practices for reducing readmissions from skilled nursing facilities (SNFs) are unclear. The objective of this study was to observe...

Pulmonary complications in trauma: Another bellwether for failure to rescue?

BackgroundPulmonary complications are the most common adverse event after injury and second greatest cause of failure to rescue (death after pulmonary complications). It is not known whether readily accessible trauma center data can be used to stratify center-level performance for various complications. Performance variation between trauma centers would allow sharing of best practices among otherwise similar hospitals. We hypothesized that high-, average-, and low-performing centers for pulmonary complication and failure to rescue could be identified and that hospital factors associated with success and failure could be discovered. MethodsPennsylvania state trauma registry data (2007–2015) were abstracted for pulmonary complications. Burns and age <17 were excluded. Multivariable logistic regression models were developed for pulmonary complication and failure to rescue, using demographics, comorbidities, and injuries/physiology. Expected event rates were compared with observed rates to identify outliers. Center-level variables associated with outcomes of interest were taken from the American Hospital Association Annual Survey Database and assessed for inclusion. ResultsIncluded in the study were 283,121 patients (male [60%] blunt trauma [92%]). Of these patients, 3% (8,381 of 283,121) developed pulmonary complications (center-level range 0.18%–5.8%). The percentage of failure-to-rescue patients was 13.4% (1,120/8,381, center-level range 0.0%-22.6%). For pulmonary complications, 13 out of 27 centers were high performers (95% CI for O:E ratio <1) and 7 out of 27 were low (95% CI for an O:E ratio >1). For failure-to-rescue patients, 2 out of 27 centers were low performers and the remainder average. There was little concordance between performance for pulmonary complications and failure to rescue. Research programs, large non-teaching hospitals, those with advanced practice providers, and those with health maintenance organizations had reduced failure-to-rescue patients. ConclusionFactors associated with complications were distinct from those affecting failure to rescue and center-level success in reducing complications often did not translate into success in preventing death once they occurred. Our data demonstrate that high- and low-performing centers and the factors driving success or failure are identifiable. This work serves as a guide for comparing practices and improving outcomes with readily available data.

Delta Studies: Expanding the Concept of Deviance Studies to Design More Effective Improvement Interventions.

The effects of improvement (implementation and de-implementation) interventions are often modest. Although positive and negative deviance studies have been extensively used in improvement science and quality improvement efforts, conceptual and methodological innovations are needed to improve our ability to use information about variation in quality to design more effective interventions. We describe a novel mixed methods extension of the deviance study we term "delta studies." Delta studies seek to quantitatively identify sites that have recently changed from low performers to high performers, or vice versa, in order to qualitatively learn about active strategies that produced recent change, challenges change agents faced and how they overcame them, and where applicable, the causes of recent deterioration in performance-information intended to inform the design of improvement interventions for deployment in low performing sites. We provide examples of lessons learned from this method that may have been missed with traditional positive or negative deviance designs. Considerations for quantitatively identifying delta sites are described including which quality metrics to track, over what timeframe to observe change, how to account for reliability of observed change, consideration of patient volume and initial performance as implementation context factors, and how to define clinically meaningful change. Methods to adapt qualitative protocols by integrating quantitative information about change in performance are also presented. We provide sample data and R code that can be used to graphically display distributions of initial status, change, and volume that are essential to delta studies. Patients and facilities of the US Veterans Health Administration. As an example, we discuss what decisions we made regarding the delta study design considerations in a funded study of low-value preoperative testing. The method helped us find sites that had recently reduced the burden of low-value testing, and learn about the strategies they employed and challenges they faced. The delta study concept is a promising mixed methods innovation to efficiently and effectively identify improvement strategies and other factors that have actually produced change in real-world settings.

Willingness to Recommend: Does Workplace Incivility Actually Play a Role?

To prevent workplace incivility, scholars encourage organizations to use reference checks to help eliminate uncivil applicants. However, under certain conditions, reference providers may be willing to recommend their rude colleagues for employment. We test this possibility by studying willingness to recommend, which captures a willingness to serve as a professional reference for a colleague. Based on signaling theory, we hypothesized that colleague incivility is negatively related to willingness to recommend, but this relationship is moderated by colleague in-role performance and job-level factors. In study 1, multilevel modeling of multisource data revealed that colleague incivility negatively related to willingness to recommend, but troublingly, this relationship was weaker among colleagues who were high rather than low performers, regardless of job-level moderators. In study 2, we tested whether organizations can intervene and encourage potential reference providers to pay greater attention to incivility. Regression results showed that providers placed greater weight on their colleague’s incivility in relation to willingness to recommend when signals were sent that the hiring organization was unwilling to sacrifice civility for top performance. Our research helps illuminate when incivility instigators are likely to be recommended for employment and demonstrates a way to maximize the use of reference checks for incivility prevention.

Parameter-Specific Morphing Reveals Contributions of Timbre and Fundamental Frequency Cues to the Perception of Voice Gender and Age in Cochlear Implant Users.

Purpose Using naturalistic synthesized speech, we determined the relative importance of acoustic cues in voice gender and age perception in cochlear implant (CI) users. Method We investigated 28 CI users' abilities to utilize fundamental frequency (F0) and timbre in perceiving voice gender (Experiment 1) and vocal age (Experiment 2). Parameter-specific voice morphing was used to selectively control acoustic cues (F0; time; timbre, i.e., formant frequencies, spectral-level information, and aperiodicity, as defined in TANDEM-STRAIGHT) in voice stimuli. Individual differences in CI users' performance were quantified via deviations from the mean performance of 19 normal-hearing (NH) listeners. Results CI users' gender perception seemed exclusively based on F0, whereas NH listeners efficiently used timbre. For age perception, timbre was more informative than F0 for both groups, with minor contributions of temporal cues. While a few CI users performed comparable to NH listeners overall, others were at chance. Separate analyses confirmed that even high-performing CI users classified gender almost exclusively based on F0. While high performers could discriminate age in male and female voices, low performers were close to chance overall but used F0 as a misleading cue to age (classifying female voices as young and male voices as old). Satisfaction with CI generally correlated with performance in age perception. Conclusions We confirmed that CI users' gender classification is mainly based on F0. However, high performers could make reasonable usage of timbre cues in age perception. Overall, parameter-specific morphing can serve to objectively assess individual profiles of CI users' abilities to perceive nonverbal social-communicative vocal signals.

Errors in writing made by Malaysian rural primary school pupils

This study is to identify errors made by rural primary school pupils in writing and to get information about the causes or sources of errors that lead to pupils’ writing problems. The conceptual framework concerns four types of errors committed by rural primary school pupils in writing, namely tense, spelling, and vocabulary. The study is based on Corder’s (1971) Error Analysis (EA) and Richards’ (1974) Causes or Sources of Errors as its theoretical framework. It was conducted at two rural schools with 44 pupils of Primary 5, aged 11, as the research sample. A written task was taken as the study instrument in order to answer two research questions. This study has revealed that tense is the most frequent error committed by the pupils, followed by punctuation, vocabulary, and spelling. Moreover, the pupils’ errors are caused by both interlingual and intralingual transfer. It is concerned with rural primary school settings in Kerian where the majority of the pupils use the Malay language as their medium of instruction. In addition, this study has its implication for English Language Education in Malaysia, in which it affects rural pupils’ performance especially in Primary School Achievement Test also known as Ujian Pencapaian Sekolah Rendah (UPSR) in English Writing paper. Some adjustments in the education system and the total involvement from education departments are meant to better reduce the number of low performers, especially in English writing to enhance the level of English proficiency in rural schools.

Early assessment as a predictor of academic performance: An analysis of the interaction between early assessment and academic performance by first-year accounting students as a South African university

Current emphasis on students’ academic adaptation in higher education necessitates the evaluation of predictors of successful preparation of first-year students. This study evaluated the implementation of early assessment (EA) in two first-year financial accounting courses at a South African university, namely an introductory financial accounting course, aimed at students without prior exposure to accounting, and a professional body accredited accounting course, aimed at students with prior exposure to accounting. This module-specific benchmark assessment, early in the academic year is often used as a predictor of preparation, adaptation and potential future academic performance. Given the discontinuation of a university, wide EA protocol within a faculty the academic contribution of the EA has been questioned. The study’s focus comprised two research questions, namely whether the EA can be used as a predictor of future academic performance of two different academic performance groups and whether students in a lower academic performance group are able to achieve success despite a low result in the EA. The research methodology included an analysis of variances to determine the correlation between the early assessment and either mid-year or final marks, as well as significance evaluation of the measured variance analysis using the Bonferroni test. The findings suggest that whilst the EA could potentially be used as an early warning sign for at-risk academically low performing students, the EA could also result in a misleading representation to students in the high academic performance category. Principally, the EA was found not to be a reliable predictor of future academic performance. In addition, the mixed results obtained from the evaluation of the effect of the nature and format of the assessment suggested that it had a low and non-meaningful effect on the predictive value of the early assessment. The fact that students in the academically low performance group were largely able to pass the module, however, suggests the success of intervention utilising the EA as an early warning. Higher education module developers could therefore consider the implementation of an appropriate EA in various undergraduate modules, based on the findings.

Navigating Increasing Levels of Relational Complexity: Perceptual, Analogical, and System Mappings.

Relational thinking involves comparing abstract relationships between mental representations that vary in complexity; however, this complexity is rarely made explicit during everyday comparisons. This study explored how people naturally navigate relational complexity and interference using a novel relational match-to-sample (RMTS) task with both minimal and relationally directed instruction to observe changes in performance across three levels of relational complexity: perceptual, analogy, and system mappings. Individual working memory and relational abilities were examined to understand RMTS performance and susceptibility to interfering relational structures. Trials were presented without practice across four blocks, and participants received feedback after each attempt to guide learning. Experiment 1 instructed participants to select the target that best matched the sample, whereas Experiment 2 additionally directed participants' attention to same and different relations. Participants in Experiment 2 demonstrated improved performance when solving analogical mappings, suggesting that directing attention to relational characteristics affected behavior. Higher performing participants-those with above-chance performance on the final block of system mappings-solved more analogical RMTS problems and had greater visuospatial working memory, abstraction, verbal analogy, and scene analogy scores compared to lower performers. Lower performers were less dynamic in their performance across blocks and demonstrated negative relationships between analogy and system mapping accuracy, suggesting increased interference between these relational structures. Participant performance on RMTS problems did not change monotonically with relational complexity, suggesting that increases in relational complexity places nonlinear demands on working memory. We argue that competing relational information causes additional interference, especially in individuals with lower executive function abilities.

The Connection Between Mind Wandering, ADHD, and Level of Performance on an Attention Task

Background: ADHD is related to increased mind wandering (MW). However, it is not clear whether this is restricted by the methods used to measure MW in those studies. Moreover, it is not certain whether MW is an independent characteristic of people with ADHD or only due to their poor performance level in the primary task (the task from which attention wanders). Method: Participants with ADHD were compared to two control groups: high performers and low performers in the primary task who had a similar performance level to the ADHD group. Results: The ADHD group had greater MW than the two control groups, while no difference in MW was found between the two control groups. Conclusion: Increased MW is an independent characteristic of ADHD. This was further discussed within the context of different theories regarding ADHD and MW.