Preparatory Module Research Articles

Pre-Post Quilombola – João Surá Class: an intercultural exercise?

This article intends to describe and analyze the trajectory of the constitution of the Pre-Academic Training Course: Affirmation in the Post UFPR - Quilombola Group João Surá that was held in 2017, at Colégio Estadual Quilombola Diogo Ramos, municipality of Adrianópolis - PR, under the auspices from the Nucleus of Afro-Brazilian Studies at the same University. The multiple strategies for composing the group that included 24 course participants will be presented, including: undergraduate students, quilombola teachers or teachers who teach quilombola students, with the objective of preparing to enter postgraduate studies. Among the preparatory modules, this work highlights the development of research projects that followed the interests of the students. Therefore, the possibility of decolonial critical intercultural production will be analyzed, that is, political projects that aim at authentic dialogues with epistemic-methodological perspectives based on the encounter of various subaltern knowledges in interaction. The qualitative methodology here involved participant observation, field diary and analysis of the students' research proposals.

Assistive Loading Promotes Goal-Directed Tuning of Stretch Reflex Gains.

Voluntary movements are prepared before they are executed. Preparatory activity has been observed across the CNS and recently documented in first-order neurons of the human PNS (i.e., in muscle spindles). Changes seen in sensory organs suggest that independent modulation of stretch reflex gains may represent an important component of movement preparation. The aim of the current study was to further investigate the preparatory modulation of short-latency stretch reflex responses (SLRs) and long-latency stretch reflex responses (LLRs) of the dominant upper limb of human subjects. Specifically, we investigated how different target parameters (target distance and direction) affect the preparatory tuning of stretch reflex gains in the context of goal-directed reaching, and whether any such tuning depends on preparation duration and the direction of background loads. We found that target distance produced only small variations in reflex gains. In contrast, both SLR and LLR gains were strongly modulated as a function of target direction, in a manner that facilitated the upcoming voluntary movement. This goal-directed tuning of SLR and LLR gains was present or enhanced when the preparatory delay was sufficiently long (>250 ms) and the homonymous muscle was unloaded [i.e., when a background load was first applied in the direction of homonymous muscle action (assistive loading)]. The results extend further support for a relatively slow-evolving process in reach preparation that functions to modulate reflexive muscle stiffness, likely via the independent control of fusimotor neurons. Such control can augment voluntary goal-directed movement and is triggered or enhanced when the homonymous muscle is unloaded.

Bridging the divide between medical school and clinical practice: identification of six key learning outcomes for an undergraduate preparatory course in radiology

BackgroundThere exists a significant divide between what is learnt in medical school and subsequently what is required to practice medicine effectively. Despite multiple strategies to remedy this discordance, the problem persists. Here, we describe the identification of a comprehensive set of learning outcomes for a preparation for practice course in radiology.MethodsAssessment of interns’ readiness to interact with the radiology department was conducted using a national survey of both interns and radiologists. In parallel, group concept mapping (GCM) which involves a combination of qualitative and quantitative techniques was used to identify the shared understanding of participants from a diverse range of medical specialties regarding what topics should be included in an intern preparatory course for interacting with the radiology department.ResultsThe survey demonstrated that most interns and radiologists felt that undergraduate medical training did not prepare interns to interact with the radiology department. GCM identified six learning outcomes that should be targeted when designing a preparatory module: requesting investigations; clinical decision support; radiology department IT and communication; adverse reactions and risks; interpretation of radiology results and urgent imaging. The thematic clusters from the group concept mapping corroborated the deficiencies identified in the national survey.ConclusionWe have identified six key learning outcomes that should be included in a preparation for practice module in radiology. Future courses targeting these thematic clusters may facilitate a smoother transition from theory to practice for newly graduated doctors.

Implementation and evaluation of an adaptive online summer preparatory course for general chemistry: Whom does it benefit?

General chemistry courses are key gateways for many Science, Technology, Engineering, and Mathematics (STEM) majors. Here, we report on the implementation and evaluation of an adaptive, ALEKS-based online preparatory module (PM) for general chemistry. The module was made available in Summer 2018 at no cost to all students entering any section of general chemistry that fall. Of the 827 students who registered into the PM, 44% fully completed the module, 48% completed part of the module, and 8% did not complete any of the module. Considering students enrolled in first-term general chemistry, we find a marked increase in ACS final exam percentile for students who completed more than 50% of the module. This is suggested to reflect the self-selection of users who were highly motivated and/or likely to succeed in the course, a hypothesis supported by an analysis using an internal diagnostic metric, the predicted first-year quality point average (PQPA). To examine longer term impacts of the PM, we examined performance in subsequent chemistry courses, through second-semester organic, and found that students completing more than 50% of the module outperformed their counterparts across all courses, with the gap largest in first semester general chemistry and narrowing across subsequent courses. Finally, we surveyed students in summer 2020, two years after the PM offering. The survey indicated overall satisfaction with the PM. For students who did not complete the module, primary reasons given were difficulty (29% of respondents) and insufficient time (46%). As the module did not proportionally benefit the target group of underprepared or at-risk students, we suggest tweaks for future implementations.

Flop to Flip: Integrating Technology and Team-Based Learning to Improve Student Engagement

Purpose: The first attempt to develop and instruct a new course in evidence-based practice in a physical therapy curriculum proved problematic. The purpose of this paper is to describe the method of revising this traditionally taught course using a combination of flipping the classroom, team-based learning, and technology. Methods: Working with an Instructional Design Specialist, a weekly online preparatory module was created for each content topic using a variety of multimedia learning provisions including micro learning videos (PowerPoint with voiceover), transcript of the PowerPoint, a list of vocabulary words, reading, Quizlet, Flipgrids and Concept Checks. Each week’s module was introduced with a listing of objectives, goals, time to complete tasks and a description of the in-class activities. Class began with a weekly 10-question vocabulary quiz to hold students accountable for their preparation. A short summary lecture followed. Students were then given an in-class assignment to complete either in pairs or small groups. Discussion of the assignment completed the session. Most of the assignments were submitted electronically prior to discussion for grading purposes. Several also utilized a team-based learning format. Pairs of students complete an assignment; students then convene with their group and discuss and complete the same assignment. This process facilitates a more active learning environment. Result: Students were consistently prepared for class as evidenced by their quiz performance. Informal assessment of the online preparatory modules was performed using a “One-Minute Paper” assessment. Students reported that the PowerPoint with voiceover, Quizlet, Concept Checks, and the weekly list of vocabulary terms were most helpful, whereas Flipgrids and reading were not helpful. In-class activities were interactive and facilitated deeper conversations about the content. Conclusion and Recommendations: The outcomes provided reflect student perception solely, which may have been biased by the instructor’s presence in the course. Formal assessment of changes was not possible using student performance as a measure because the course had dramatically changed from year one to year two. A more formal, scientific assessment is recommended to determine if and how course changes affected student performance.

SigPrep: Open Source Web-Based Prework for Signals and Systems [SP Education

An introductory course in signals requires a wide background of prerequisites covering complex numbers, series, calculus, and basic mathematical logic. Students often fail to engage with the material and find the course difficult because they do not recall the prerequisites. Time and curricular constraints usually limit in-class review. To address these issues, we present SigPrep, a set of open source, web-based preparatory modules for introductory courses in signals. SigPrep is designed as a preclass assignment that students can do independently at a self-set pace. SigPrep is designed in WeBWorK, a widely used platform for free, open source problems for science and math classes. Using WeBWorK features, SigPrep provides students instant feedback and linkages to relevant external e-learning resources as a refresher for concepts in which they fail to exhibit adequate proficiency. Instructors are also able to track students? progress and performance. We outline the pedagogical design of SigPrep, which provides problems of particular relevance and applicability covering prerequisites for signals classes. Finally, we share results and feedback from our own experience with using SigPrep as part of our teaching of an introductory class on signals.

Clickers in Class: Fostering Higher Cognitive Thinking Using ConcepTests in a Large Undergraduate Class

Unlike design studio, preparatory modules in the undergraduate Architecture course typically have a high student–teacher ratio and are conducted in a traditional lecture setting. By nature, lecture setting hinders engagement and reduces motivation, eventually lowering student learning outcomes. This study aimed to increase engagement with the content, lecturer, and among peers in a traditional lecture and consequently improve higher cognitive learning outcomes. Wi-Fi-enabled devices as clickers were used in all lectures to implement “pause and recall” with ConcepTests to increase participation and interaction. Lectures were paused every 15–20 min, and students were asked questions of higher cognitive order that required them to apply the concepts covered in an online platform that acted as clickers. For this quasi-non-experimental mixed-method study, 79 students’ approach to learning before and after the intervention, perception of using clickers, and learning outcomes were measured for a preparatory module, Environmental Systems in the undergraduate Architecture program. Learning outcomes were measured at various cognitive levels based on Bloom’s taxonomy. Students’ deep approach to learning increased at the end of the semester (Cohan’s d = 0.277 and 0.216 for deep motive and strategy, respectively). Students generally have a positive perception and those who showed a positive attitude towards using clickers achieved better scores at higher cognitive questions in the final test (rs = 0.359, p = 0.001). Students with a deep strategy approach to learning reflected increased self-evaluation (rs = 0.275, p = 0.022) and study behavior (rs = 0.263, p = 0.029) to use clickers. Clickers used to pose ‘ConcepTest’ questions to execute “pause and recall” in a large lecture class had a positive impact on student performance. Semi-structural interviews were performed to further explain the findings. Results were consistent with the generative theory of learning. The timing and design of clicker questions followed by a discussion were particularly beneficial in improving critical thinking among students.

Mechanisms that allow cortical preparatory activity without inappropriate movement.

We reveal a novel mechanism that explains how preparatory activity can evolve in motor-related cortical areas without prematurely inducing movement. The smooth eye movement region of the frontal eye fields (FEFSEM) is a critical node in the neural circuit controlling smooth pursuit eye movement. Preparatory activity evolves in the monkey FEFSEM during fixation in parallel with an objective measure of visual-motor gain. We propose that the use of FEFSEM output as a gain signal rather than a movement command allows for preparation to progress in pursuit without causing movement. We also show that preparatory modulation of firing rate in FEFSEM predicts movement, providing evidence against the 'movement-null' space hypothesis as an explanation of how preparatory activity can progress without movement. Finally, there is a partial reorganization of FEFSEM population activity between preparation and movement that would allow for a directionally non-specific component of preparatory visual-motor gain enhancement in pursuit.

Improving non-academic student outcomes using online and text-message coaching

We design and experimentally evaluate two low-cost, scalable interventions – an online preparatory module to help students reflect on and overcome barriers and a text-message coaching program – in a sample of over 3000 undergraduate students at a large Canadian university. Supplementing administrative data on academic outcomes with a unique follow-up survey on student well-being, we estimate positive program effects on non-academic outcomes such as feelings of satisfaction and belonging, despite estimating null effects on course grades and credit accumulation. Given the low costs associated with administering these programs, our results suggest that the positive impacts on student well-being may warrant program expansion even in the absence of impacts on academic outcomes.

Phasic alerting facilitates endogenous orienting of spatial attention: Evidence from event-related lateralizations of the EEG.

Alerting has been hypothesized to affect spatial orienting either by accelerating the speed of attentional shift toward the cued target location (the accelerating hypothesis) or by enhancing the orienting effect without changing its time course (the enhancing hypothesis). To investigate the neural underpinnings of the effect of phasic alerting on endogenous orienting, we recorded the electroencephalogram (EEG) in a variant of the spatial cueing task with a tone presented 100 ms before the cue as a phasic alerting signal, and calculated cue-evoked event-related lateralizations (ERLs) providing a precise assessment of preparatory visuospatial attention. Behavioral results showed that the spatial orienting effect was increased under the phasic alerting condition, as expected. The EEG results showed that an orienting-related ERL component called a late directing attention positivity (LDAP) had shorter onset latency and larger amplitude in the alerting condition than in the no-alerting (no-tone) condition. In conclusion, phasic alerting seems to both accelerate and enhance orienting-related preparatory modulations within the ventral visual stream.

A Pilot Project Exploring Medical Students' Barriers to Screening for Intimate Partner Violence and Reproductive Coercion.

Multiple studies have shown that the majority of health care practitioners do not routinely screen for intimate partner violence (IPV); lack of provider preparedness and education is an often-cited barrier to screening. Our third-year family medicine clerkship includes a pregnancy options counseling objective structured clinical examination (OSCE) that requires students to review a preencounter online educational module that highlights screening guidelines for IPV and reproductive coercion. The goal of this study was to explore students' internal barriers to screening patients for IPV and reproductive coercion, and whether our curricular interventions adequately addressed these barriers. We administered an immediate postencounter, anonymous, online survey with open-ended and Likert-type questions to 118 medical students during the 2016 academic year. We used an exploratory, iterative process to analyze qualitative responses and quantify recurrent and commonly identified themes. After the OSCE, students reported they were more likely to screen for IPV (94%) and reproductive coercion (82%) in future encounters. Qualitative analysis revealed two major types of barriers to screening: internal barriers concerning the screening inquiry itself and concerns regarding handling of patients' responses. The online preparatory module and subsequent OSCE provided a low-stakes environment in which to practice screening. However, student comments about their barriers to screening suggest that a first or early curricular intervention folding IPV and reproductive coercion into an educational module on pregnancy options counseling did not optimally promote this screening behavior.

Diminished pre-stimulus alpha-lateralization suggests compromised self-initiated attentional control of auditory processing in old age

Older adults experience difficulties in daily situations that require flexible information selection in the presence of multiple competing sensory inputs, like for instance multi-talker situations. Modulations of rhythmic neural activity in the alpha–beta (8–30 Hz) frequency range in posterior brain areas have been established as a cross-modal neural correlate of selective attention. However, research linking compromised auditory selective attention to changes in rhythmic neural activity in aging is sparse.We tested younger (n = 25; 22–35 years) and older adults (n = 26; 63–76 years) in an attention modulated dichotic listening task. In this, two streams of highly similar auditory input were simultaneously presented to participants’ both ears (i.e., dichotically) while attention had to be focused on the input to only one ear (i.e. target) and the other, distracting information had to be ignored.We here demonstrate a link between severely compromised auditory selective attention in aging and a partial reorganization of attention-related rhythmic neural responses. In particular, in old age we observed a shift from a self-initiated, preparatory modulation of lateralized alpha rhythmic activity to an externally driven response in the alpha–beta range. Critically, moment-to-moment fluctuations in the age-specific patterns of self-initiated and externally driven lateralized rhythmic activity were associated with behavioral performance. We conclude that adult age differences in spatial selective attention likely derive from a functional reorganization of rhythmic neural activity within the aging brain.

A Standardized Handoff Simulation Promotes Recovery From Auditory Distractions in Resident Physicians.

Despite the increasing use of training simulations to teach and assess resident handoffs, simulations that approximate realistic hospital conditions with distractions are lacking. This study explores the effects of a novel simulation-based training intervention on resident handoff performance in the face of prevalent hospital interruptions. After a preliminary educational module, entering postgraduate year 1 residents (interns) completed one of the following three handoff simulations: (1) no interruption, (2) hospital noise, or (3) noise and pager interruptions. Trained receivers rated interns using an evidence-based Handoff Behaviors Checklist and a previously validated Handoff Mini-Clinical Examination Exercise instrument. Of 127 eligible interns, 125 (98.4%) completed an online preparatory module and a handoff simulation. Interns receiving auditory interruptions were less likely to be heard adequately (48.8% noise and 71.8% noise + pager vs. 100.0% uninterrupted, P < 0.001) and scored lower on establishing appropriate handoff settings (5.7 ± 2.3 noise and 6.2 ± 1.8 noise + pager vs. 8.0 ± 0.8 uninterrupted, P < 0.001). Interns receiving noise only shared a written sign-out document more effectively (71.1% vs. 30.2% uninterrupted and 43.6% noise + pager, P < 0.001). There were no differences in averaged performance metrics on the Handoff Behaviors Checklist. While common hospital interruptions created nonideal circumstances for the handoff, interns receiving interruptions were rated similarly and recovered effectively. However, interns exposed to noise only used the written sign-out form more actively. Our findings suggest that this intervention was successful in promoting handoff proficiency despite exposure to common but significant hospital interruptions.

Popping the Erasmus Bubble: Perceptions of Intercultural Awareness and Competence of Incoming Erasmus+ Students and the Preparation Challenge

The Year Abroad is an important point of departure in many students’ lives, not only exposing them to new personal and academic contexts and challenges but also to providing them with the opportunity to grow and develop linguistically and interculturally. This article presents the findings of an empirical study comprising one-to-one semi-structured interviews with incoming Erasmus+ students at Maynooth University, and marries this with the dearth of research on outgoing students in multiple contexts, alongside the anecdotal shared experiences of previous outgoing domestic students at Maynooth University. The article examines the key issues of social media and social networks within the process of developing intercultural awareness and competence prior to and during the sojourn abroad, and the lack of sufficient and effective preparation of students before mobility which emerge as the two dominant issues in the empirical data obtained through anonymous module evaluations completed by students. The article culminates by discussing the development and piloting of a preparatory module at Maynooth University to address this preparation challenge. The empirical data generated from students matriculated in the piloted preparatory module indicates a strong desire for, and positivity towards, a well-developed, fully accredited, elective module integrated into students’ degree programmes prior to their sojourn abroad.

Psychosis subgroups differ in intrinsic neural activity but not task-specific processing

Individuals with psychosis often show high levels of intrinsic, or nonspecific, neural activity, but attenuated stimulus-specific activity. Clementz et al. (2016) proposed that one subgroup of psychosis cases has accentuated intrinsic activity (Biotype-2's) and a different subgroup (Biotype-1's) has diminished intrinsic activity, with both groups exhibiting varying degrees of cognitive deficits. This model was studied by assessing neural activity in psychosis probands (N=105) during baseline and a 5second period in preparation for a pro-/anti-saccade task. Steady-state stimuli allowed real-time assessment of modulation of visuocortical investment to different target locations.Psychosis probands as a whole showed poor antisaccade performance. As expected, Biotype-1 showed diminished intrinsic neural activity and the worst behavior, and Biotype-2 showed accentuated intrinsic activity and less deviant behavior. Both of these groups also exhibited less dynamic oscillatory phase synchrony. Biotype-3 showed no neurophysiological differences from healthy individuals, despite a history of psychosis. Interestingly, all psychosis subgroups showed normal (i.e., not different from healthy) preparatory modulation of visuocortical investment as a function of cognitive demands, despite varying levels of task performance. Similar analyses conducted subgrouping cases by psychotic symptomatology revealed fewer and less consistent differences, including no intrinsic activity differences between any clinical subgroup and healthy individuals. This study illustrates that (i) differences in intrinsic neural activity may be a fundamental characteristic of psychosis and need to be evaluated separately from stimulus-specific responses, and (ii) grouping patients based on multidimensional classification using neurobiological data may have advantages for resolving heterogeneity and clarifying illness mechanisms relative to traditional psychiatric diagnoses.

Non-Directive Pregnancy Options Counseling: Online Instructional Module, Objective Structured Clinical Exam, and Rater and Standardized Patient Training Materials.

Many patients receiving news of an unplanned pregnancy need not only a test result, but also the initiation of pregnancy options counseling. Thus, this online instructional module and objective structured clinical examination (OSCE) aim to provide foundational training for medical students in nondirective pregnancy options counseling. To further the validity of a previously published OSCE, we reconsidered content, revised the checklist, and produced videos for rater training. We also developed a 30-minute preparatory module outlining a stepwise approach and providing a structured opportunity for values clarification. The 10-minute OSCE scenario involves a 24-year-old woman presenting to an urgent care center with persistent nausea who receives the diagnosis of an early, unplanned pregnancy. She responds to the news with shock and emotional silence, asking for guidance. We conducted the OSCE with 46 third-year medical students on the family medicine clerkship. Immediately after the OSCE, students completed a survey and self-assessment, followed by an individualized feedback session with a faculty member. In the self-assessment phase, students reflected on how successfully they utilized methods in the online module for handling emotional silence and presenting options. Student self-identified areas for improvement highlighted use of terminology and their response to difficult emotional encounters in the future. This online module and validated OSCE provide a valued opportunity for learners to practice nondirective pregnancy options counseling skills, including screening for intimate partner violence and reproductive coercion, engagement in self-assessment and receiving feedback, and engaging in personal values clarification.

Preparatory α-band oscillations reflect spatial gating independently of predictions regarding target identity.

Preparatory modulations of cortical α-band oscillations are a reliable index of the voluntary allocation of covert spatial attention. It is currently unclear whether attentional cues containing information about a target's identity (such as its visual orientation), in addition to its location, might additionally shape preparatory α modulations. Here, we explore this question by directly comparing spatial and feature-based attention in the same visual detection task while recording brain activity using magnetoencephalography (MEG). At the behavioral level, preparatory feature-based and spatial attention cues both improved performance and did so independently of each other. Using MEG, we replicated robust α lateralization following spatial cues: in preparation for a visual target, α power decreased contralaterally and increased ipsilaterally to the attended location. Critically, however, preparatory α lateralization was not significantly modulated by predictions regarding target identity, as carried via the behaviorally effective feature-based attention cues. Furthermore, nonlateralized α power during the cue-target interval did not differentiate between uninformative cues and cues carrying feature-based predictions either. Based on these results we propose that preparatory α modulations play a role in the gating of information between spatially segregated cortical regions and are therefore particularly well suited for spatial gating of information.NEW & NOTEWORTHY The present work clarifies if and how human brain oscillations in the α-band support multiple types of anticipatory attention. Using magnetoencephalography, we show that posterior α-band oscillations are modulated by predictions regarding the spatial location of an upcoming visual target, but not by feature-based predictions regarding its identity, despite robust behavioral benefits. This provides novel insights into the functional role of preparatory α mechanisms and suggests a limited specificity with which they may operate.

TF11 The Practitioner's Guide to Global Health: Online Interactive Evaluative Preparatory Modules for Medical Students, Residents, and Attending Physicians

TF11 The Practitioner's Guide to Global Health: Online Interactive Evaluative Preparatory Modules for Medical Students, Residents, and Attending Physicians

Practitioners' Perceptions of the Soccer Extra-Time Period: Implications for Future Research.

Qualitative research investigating soccer practitioners’ perceptions can allow researchers to create practical research investigations. The extra-time period of soccer is understudied compared to other areas of soccer research. Using an open-ended online survey containing eleven main and nine sub questions, we gathered the perceptions of extra-time from 46 soccer practitioners, all working for different professional soccer clubs. Questions related to current practices, views on extra-time regulations, and ideas for future research. Using inductive content analysis, the following general dimensions were identified: ‘importance of extra-time’, ‘rule changes’, ‘efficacy of extra-time hydro-nutritional provision’, ‘nutritional timing’, ‘future research directions’, ‘preparatory modulations’ and ‘recovery’. The majority of practitioners (63%) either agreed or strongly agreed that extra-time is an important period for determining success in knockout football match-play. When asked if a fourth substitution should be permitted in extra-time, 67% agreed. The use of hydro-nutritional strategies prior to extra-time was predominately considered important or very important. However; only 41% of practitioners felt that it was the most important time point for the use of nutritional products. A similar number of practitioners account (50%) and do not (50%) account for the potential of extra-time when training and preparing players and 89% of practitioners stated that extra-time influences recovery practices following matches. In the five minute break prior to extra-time, the following practices (in order of priority) were advocated to players: hydration, energy provision, massage, and tactical preparations. Additionally, 87% of practitioners advocate a particular nutritional supplementation strategy prior to extra-time. In order of importance, practitioners see the following as future research areas: nutritional interventions, fatigue responses, acute injury risk, recovery modalities, training paradigms, injury epidemiology, and environmental considerations. This study presents novel insight into the practitioner perceptions of extra-time and provides information to readers about current applied practices and potential future research opportunities.

Task preparation and neural activation in stimulus-specific brain regions: An fMRI study with the cued task-switching paradigm

To investigate the role of posterior brain regions related to task-relevant stimulus processing in task preparation, we used a cued task-switching paradigm in which a pre-cue informed participants about the upcoming task on a trial: face discrimination or number comparison. Employing an event-related fMRI design, we examined for changes of activity in face- and number-related posterior brain regions (right fusiform face area (FFA) and right intraparietal sulcus (IPSnum), respectively), and explored the functional connectivity of these areas with other brain regions, during the (preparation) interval between cue onset and onset of the (to-be-responded) target stimulus. The results revealed task-relevant posterior brain regions to be modulated during this period: activation in task-relevant stimulus-specific regions was selectively enhanced and their functional connectivity to task-relevant anterior brain regions strengthened (right FFA – face task, right IPSnum – number task) while participants prepared for the cued task. Additionally, activity in task-relevant posterior brain regions was influenced by residual activation from the preceding trial in the right FFA and the right IPSnum, respectively. These findings indicate that, during task preparation, the activation pattern in currently task-relevant posterior brain regions is shaped by residual activation as well as preparatory modulation prior to the onset of the critical stimulus, even without participants being instructed to imagine the stimulus.