Received Performance Feedback Research Articles

Remote feedback in endovascular simulation training: a mixed-methods study

BackgroundThere is an increasing need to increase simulation-based learning opportunities for vascular surgery residents in endovascular skills training. This study aims to explore the effectiveness of remote expert instructional feedback of endovascular simulation-based education, as a means of increasing training opportunities in this area for vascular surgery residents.MethodsA mixed-methods study design was adopted. Twelve vascular surgery residents from Ireland were tasked with completing two endovascular renal artery procedures: one with in-person expert feedback and the other with remote instruction. Participants ranged in experience levels from second year to final year of residency. Following the training activities, interviews and a questionnaire were employed to gather information on the usefulness of remote feedback.ResultsThere was no significant difference reported by participants using a post-event validated questionnaire between remote and in-person feedback. During the interviews, participants expressed mixed feelings about the presence of the educator while practicing, but they eventually saw no limiting factors to their practice when the trainer provided remote feedback. When receiving performance feedback remotely, clear communication and a shared knowledge of the task development are critical to success.ConclusionsWe believe these findings can inform the design and development of remote learning and assessment of endovascular skills training and ultimately provide increased opportunities for more skills practice for vascular surgical residents.

Improving pediatric atopic dermatitis care in the emergency department and primary care setting: a collaborative quality improvement pilot project.

Emergency department visits and healthcare expenditures for pediatric atopic dermatitis have been increasing over the last two decades. There is a paucity of replicable quality improvement initiatives addressed at educating primary care and emergency medicine clinicians on this condition. The goal of this initiative was to improve clinician knowledge and comfort in the diagnosis and management of pediatric atopic dermatitis and superinfection. Clinicians were recruited via email from academic and community settings in Travis County, Texas, in 2020. They were sent a pre-intervention survey, a series of three quizzes, and a post-intervention survey. After each quiz, participants received performance feedback and various forms of multimodal education. Differences between the first and final quiz scores and clinician confidence levels were analyzed for statistical significance. Fifty-six clinicians completed the intervention. The average overall and treatment-specific scores increased significantly by 10% and 37%, respectively. Further, confidence levels improved significantly in the majority of clinicians. Clinician qualitative feedback revealed high satisfaction. Results from this educational quality improvement project have demonstrated that this is an effective and replicable resource for educating clinicians who manage pediatric atopic dermatitis in the emergency department and outpatient setting.

(HR) Manager in the Hot Seat: An Exercise to Practice Delivering (and Receiving) Performance Feedback

Performance conversations are a critical and necessary part of performance management. Feedback is most effective when it is constructive and when it involves a dialogue rather than a monologue, but people often struggle with this skill. This activity includes an experiential exercise that applies a five-part process for performance feedback, appropriate for human resources, conflict management, and/or organizational behavior classes. Students identify performance-based issues, create a plan to address the issues, craft an email to their employee requesting a meeting, meet with and engage in a performance feedback conversation, and develop an improvement plan collaboratively with the employee. “Managers” and “employees” reflect on the effectiveness of the performance conversation. This five-part exercise can be used in an undergraduate- or graduate-level course. Recommendations for adapting the exercise to the online environment are included.

Empathic forecasting of the big-fish-little-pond effect

ABSTRACT The big-fish-little-pond effect (BFLPE) is the tendency for students to evaluate themselves more favourably when they have high rank in a low rank school than low rank in a high rank school. Research has documented the BFLPE on experienced emotions. We conducted three studies that examined forecasts of how the BFLPE influences other people’s emotions (i.e. empathic forecasts). In Study 1, participants received performance feedback about themselves or another person and reported their own affect or anticipated the other person’s affect. Results extended the BFLPE to empathic forecasting. Moreover, forecasters anticipated that the BFLPE had a stronger influence on negative emotion than it actually did. Study 2 tested whether neglect of group rank underlies the BFLPE in empathic forecasting. Empathic forecasts were strongly influenced by another person’s rank in their group, but only weakly influenced by group rank. Study 3 tested whether extremity of group ranks exacerbates the BFLPE in empathic forecasting. Empathic forecasts were especially favourable (unfavourable) when a target had very high (low) rank in a very low (high) rank group. These data support the BFLPE in empathic forecasting, but also illustrate ways in which it is both similar to and different from actual experience of the effect.

Altered Putamen Activation for Social Comparison-Related Feedback in Social Anxiety Disorder: A Pilot Study

Introduction: Social anxiety disorder (SAD) is characterized by abnormal processing of performance-related social stimuli. Previous studies have shown altered emotional experiences and activations of different sub-regions of the striatum during processing of social stimuli in patients with SAD. However, whether and to what extent social comparisons affect behavioural and neural responses to feedback stimuli in patients with SAD is unknown. Materials and Methods: To address this issue, emotional ratings and functional magnetic resonance imaging (fMRI) responses were assessed while patients suffering from SAD and healthy controls (HC) were required to perform a choice task and received performance feedback (correct, incorrect, non-informative) that varied in relation to the performance of fictitious other participants (a few, half, or most of others had the same outcome). Results: Across all performance feedback conditions, fMRI analyses revealed reduced activations in bilateral putamen when feedback was assumed to be received by only a few compared to half of the other participants in patients with SAD. Nevertheless, analysis of rating data showed a similar modulation of valence and arousal ratings in patients with SAD and HC depending on social comparison-related feedback. Conclusions: This suggests altered neural processing of performance feedback depending on social comparisons in patients with SAD.

With or without Feedback?-How the Presence of Feedback Affects Processing in Children with Developmental Language Disorder.

Language acquisition depends on the ability to process and learn probabilistic information, often through the integration of performance feedback. Children with developmental language disorder (DLD) have demonstrated weaknesses in both probabilistic learning and feedback processing, but the individual effects of each skill are poorly understood in this population. This study examined school-aged children with DLD (n = 29) and age- and gender-matched children with typical development (TD; n = 44) on a visual probabilistic classification learning task presented with and without feedback. In the feedback-based version of the task, children received performance feedback on a trial-by-trial basis during the training phase of the task. In the feedback-free version, children responded after seeing the correct choice marked with a green border and were not presented with feedback. Children with TD achieved higher accuracy than children with DLD following feedback-based training, while the two groups achieved similar levels of accuracy following feedback-free training. Analyses of event-related potentials (ERPs) provided insight into stimulus encoding processes. The feedback-free task was dominated by a frontal slow wave (FSW) and a late parietal component (LPC) which were not different between the two groups. The feedback-based task was dominated by a parietal slow wave (PSW) and an LPC, both of which were found to be larger in the TD than in the DLD group. In combination, results suggest that engagement with feedback boosts learning in children with TD, but not in children with DLD. When the need to process feedback is eliminated, children with DLD demonstrate behavioral and neurophysiological responses similar to their peers with TD.

Neuroimaging of social motivation during winning and losing: Associations with social anhedonia across the psychosis spectrum

BackgroundIndividuals with psychosis spectrum disorders (PSD) have difficulty developing social relationships. This difficulty may reflect reduced response to social feedback involving functional alterations in brain regions that support the social motivation system: ventral striatum, orbital frontal cortex, insula, dorsal anterior cingulate cortex, and amygdala. Whether these alterations span PSD is unknown. Methods71 individuals with PSD, 27 unaffected siblings, and 37 control participants completed a team-based fMRI task. After each trial, participants received performance feedback paired with the expressive face of a teammate or opponent. A 2 × 2 (win versus loss outcome x teammate versus opponent) repeated measures ANOVA by group was performed on activation in the five key regions of interest during receipt of feedback. ResultsAcross groups, three social motivation regions, ventral striatum, orbital frontal cortex, and amygdala, showed sensitivity to feedback (significant main effect of outcome), with greater activation during win versus loss trials, regardless of whether the feedback was from a teammate or opponent. In PSD, ventral striatum and orbital frontal cortex activation to win feedback was negatively correlated with social anhedonia scores. ConclusionsPatterns of neural activation during social feedback were similar in PSD, their unaffected siblings, and healthy controls. Across the psychosis spectrum, activity in key social motivation regions during social feedback was associated with individual differences in social anhedonia.

Musculoskeletal risks of exergaming in adults: an observational cross-sectional study

Introduction: The past decade has seen a rapid increase in interest in using exergaming (exercise + gaming) for Physical Therapy (PT) management of adults. Exergaming utilizes an electronic device to allow participants to play a video game requiring physical movement while simultaneously receiving performance feedback on a monitor. Although potential sources of musculoskeletal risks may be present, evidence concerning musculoskeletal risks associated with exergaming is limited. The purpose of this study is to explore the body segments associated with musculoskeletal risk in exergaming among adults using the REBA tool and to assess the degree of musculoskeletal risk present using the participant’s demographic data in conjunction with REBA tool scores. Methods: An observational, analytic cross-sectional study design was utilized. Participants from the community who had exergaming as part of their PT management were recruited. Included participants were observed and assessed for 15 minutes using Rapid Entire Body Assessment (REBA) while performing exergaming with either Aerobic or Balance exercises. Demographic characteristics were analyzed descriptively while spearman’s correlation was utilized to explore the relationship between the REBA final score and subscales. Results: Twenty-four participants with mean age (±SD) of 27.13 (9.57) were recruited (14 (58%) female & 10 (42%) male). The Mean REBA score is 5.38. Significant correlations were found between the final REBA score and Upper arm (rs = 0.80, p < 0.001), Arm + Wrist (rs= 0.68, p = < 0.001), and Table C-partial REBA score (rs= 0.84, p = < 0.001). Demographic variables and the final REBA score were not significantly correlated. Discussion: Moderate risk is observed in balance and aerobic exercises during exergaming which warrants further investigations. Decreasing Upper arm and Arm + Wrist arm scores may decrease the final REBA score as these scores possess greater weight due to the correlation between the scores and the final REBA score. Exergaming remains a possible alternative for simulating activities and exercises as it allows for a consistent and controlled environment while presenting with great potential to reduce the level of musculoskeletal disease risk.

Reactions to Negative Feedback: The Role of Resiliency and Implications for Counterproductivity

We evaluated the effect of three self-regulatory processes on the relationship between affect and counterproductive workplace behaviour intentions (CWBi) in the context of employees receiving performance feedback using a moderated mediation approach. Using vignettes, participants were given job performance feedback and completed measures of affect, workplace resiliency, and CWBi. Using 292 employed participants, we found that two self-regulatory components of workplace resiliency moderated the relationship between feedback type and CWBi, as mediated by negative affect. This suggests that the more one engages in self-regulation, the less likely they are to engage in counterproductive workplace behaviours following an adverse workplace experience.

Special education teachers’ perspectives of effective pre-service training practices in systematic instruction for students with extensive support needs

This survey study examined 164 in-service special education teachers’ perceptions of training strategies in their cross categorical teacher preparation program in the United Sates for developing knowledge and skills in systematic instruction, an evidence-based practice for students with extensive support needs. Both classroom-based and field-based training strategies were evaluated along with teachers’ perceptions of the contribution and importance of the various training strategies. Results from Chi-square tests, Pearson correlations, multivariate analysis of covariance, and repeated measures of analysis of covariance indicated that teachers felt prepared to implement systematic instruction after exiting their program and after teaching students with disabilities, and the perceived effectiveness of training strategies was related to teacher experience. Teachers perceived modeling and receiving performance feedback in both university classrooms and field-based settings to contribute to their knowledge and skill development in systematic instruction. We present the results in terms of implications for practice and future research.

Different Patterns of Neural Activity Characterize Motor Skill Performance During Acquisition and Retention.

Motor performance and learning have distinct behavioral and neural signatures and can be uniquely modulated by various informational and motivational factors. Contemporary frameworks describe four different motor learning mechanisms mapped onto specific neural regions which are key for motor skill acquisition: error-based learning (cerebellum), reinforcement learning (basal ganglia), cognitive strategies (prefrontal cortex), and use-dependent learning (motor cortex). However, little is known about the neural circuits engaged during skill acquisition that are modulated specifically by practice-based performance improvement and those that predict recall performance. Based on previous work, we hypothesize that brain activity during practice in primary motor cortex and basal ganglia (1) is associated with trial-by-trial practice performance and (2) is predictive of immediate recall performance. Leveraging the contemporary framework, we use a well-known task paradigm that primarily relies upon cognitive strategy, reinforcement, and use-based learning mechanisms to test our hypotheses. Forty neurotypical young adults were asked to practice a pinch force tracking task. Participants received performance feedback after each trial during practice. We used whole brain analysis of functional magnetic resonance imaging (fMRI) and behavioral performance measures (i.e., time-on-target and self-efficacy) during the practice phase to determine which brain activation patterns are (1) associated with trial-by-trial tracking performance and (2) predictive of immediate no-feedback retention performance. We observed brain activations in the frontal orbital cortex, putamen, amygdala, and insula correlated with tracking performance improvement during practice. In contrast, a different set of performance-related activated regions were observed that were associated with immediate retention performance that included the primary motor cortex, superior frontal gyrus, somatosensory cortex, angular gyrus, and parietal gyrus. Our findings demonstrate that improved practice performance and recall of a sensorimotor skill are correlated with distinct neural activity patterns during acquisition, drawing on different motor learning mechanisms during encoding. While motor performance improvements depend on both cortical and subcortical regions, motor skill recall depends primarily on prefrontal and motor cortices. We discuss possible interpretations for why our hypothesis regarding basal ganglia activity and retention performance was not supported. Understanding the different neural mechanisms engaged in motor performance and learning may inform novel interventions to enhance motor skill learning.

The Associations Among Self-Compassion, Self-Esteem, Self-Criticism, and Concern Over Mistakes in Response to Biomechanical Feedback in Athletes.

Athletes regularly face the possibility of failing to meet expectations in training and competition, and it is essential that they are equipped with strategies to facilitate coping after receiving performance feedback. Self-compassion is a potential resource to help athletes manage the various setbacks that arise in sport over and above other psychological resources. The primary purpose of this research was to explore how athletes respond to objective biomechanical feedback given after a performance. Specifically, we investigated if levels of self-compassion, self-esteem, self-criticism, and concern over mistakes were related to one another before and after a series of sprint tests interspersed with biomechanical feedback, and whether self-compassionate athletes achieved a better sprint performance after receiving and implementing biomechanical feedback. Forty-eight athletes (20 female: Mage = 19.8 years, SD = 3.1; 28 male: Mage = 23.6 years, SD = 7.8) completed online measures of self-compassion, self-esteem, self-criticism and concern over mistakes before performing four sets of 40-m sprints. Participants received personalized biomechanical feedback after each sprint that compared their performance to gold standard results. Following all sprints, they then completed measures of self-criticism, and reported emotions, thoughts, and reactions. Self-compassion was positively correlated with self-esteem (r = 0.57, p < 0.01) and negatively related to both self-criticism (r = −0.52, p < 0.01) and concern over mistakes (r = −0.69, p < 0.01). We also found that athletes with higher levels of self-compassion prior to sprint performance experienced less self-critical thoughts following biomechanical feedback and subsequent sprint trials (r = −0.38, p < 0.01). Although the results of this study provide some support for the effectiveness of self-compassion in promoting healthy emotions, thoughts, and reactions in response to sprint performance-based biomechanical feedback, a moderated regression analysis between the first and fourth sprint time variables revealed that self-compassion was not a moderator for change in sprint performance (R2 = 0.64, ΔR2 = 0.10, p > 0.05). These findings suggest that there are likely longer-term benefits of athletes using self-compassion to cope with biomechanical feedback, but that any benefits might be limited in a short series of sprint trials.

COVID-19 and Kazakhstani Women Teachers: An Empirical Study of Factors Affecting Mental Health

The study investigates stress and organizational climate factors affecting mental health of women school and university teachers in pre‐COVID‐19 and COVID‐19 periods in the context of Central Asia considering the case of Kazakhstan. The results of quantitative empirical study show that the pandemic has caused an increase in perceived anxiety and depression among women teachers. Women teachers in urban areas experienced greater anxiety and depression than rural teachers. The moderation interaction predictor indicates that the effect of perceived stress becomes less negative with increased level of Material and Technical Security or Access to Technological Resources. In conditions of COVID-19 the effect of Material Technical Security/Access to Technological Resources on Mental Health becomes significant when women teachers have a better Social Climate at work. Its effect on Mental Health becomes significant when women teachers are more engaged in the decision making process with clearly defined organizational goals according to the Participatory Management policy and when women teachers more frequently receive Performance Feedback.

Training supervisors to provide performance feedback using video modeling with voiceover instructions: A replication.

Performance feedback is an effective strategy to improve and maintain therapist performance with implementing interventions. Shuler and Carroll (2019) successfully used video modeling with voiceover instructions (VMVO) to train supervisors to provide accurate performance feedback to a confederate therapist implementing guided compliance. In Study 1, we replicated Shuler and Carroll by using VMVO to train 5 supervisors to provide performance feedback to a confederate therapist on their guided-compliance integrity. Feedback accuracy increased following VMVO and maintained for 1 month. In Study 2, we extended Shuler and Carroll by demonstrating improvements in therapist guided-compliance integrity after they received performance feedback from supervisors from Study 1. The results of the current study support the use of VMVO to teach supervisory skills to behavior analysts.

Artificial intelligence application versus physical therapist for squat evaluation: a randomized controlled trial

Artificial intelligence technology is becoming more prevalent in health care as a tool to improve practice patterns and patient outcomes. This study assessed ability of a commercialized artificial intelligence (AI) mobile application to identify and improve bodyweight squat form in adult participants when compared to a physical therapist (PT). Participants randomized to AI group (n = 15) performed 3 squat sets: 10 unassisted control squats, 10 squats with performance feedback from AI, and 10 additional unassisted test squats. Participants randomized to PT group (n = 15) also performed 3 identical sets, but instead received performance feedback from PT. AI group intervention did not differ from PT group (log ratio of two odds ratios = − 0.462, 95% confidence interval (CI) (− 1.394, 0.471), p = 0.332). AI ability to identify a correct squat generated sensitivity 0.840 (95% CI (0.753, 0.901)), specificity 0.276 (95% CI (0.191, 0.382)), PPV 0.549 (95% CI (0.423, 0.669)), NPV 0.623 (95% CI (0.436, 0.780)), and accuracy 0.565 95% CI (0.477, 0.649)). There was no statistically significant association between group allocation and improved squat performance. Current AI had satisfactory ability to identify correct squat form and limited ability to identify incorrect squat form, which reduced diagnostic capabilities.Trial Registration NCT04624594, 12/11/2020, retrospectively registered.

I, robot: depression plays different roles in human\u2013human and human\u2013robot interactions

Socially engaging robots have been increasingly applied to alleviate depressive symptoms and to improve the quality of social life among different populations. Seeing that depression negatively influences social reward processing in everyday interaction, we investigate this influence during simulated interactions with humans or robots. In this study, 35 participants with mild depression and 35 controls (all from nonclinical populations) finished the social incentive delay task with event-related potential recording, in which they received performance feedback from other persons or from a robot. Compared to the controls, the mild depressive symptom (MDS) group represented abnormalities of social reward processing in the human feedback condition: first, the MDS group showed a lower hit rate and a smaller contingent-negative variation (correlated with each other) during reward anticipation; second, depression level modulated both the early phase (indexed by the feedback-related negativity (FRN)) and the late phase (indexed by the P3) of reward consumption. In contrast, the effect of depression was evident only on FRN amplitude in the robot feedback condition. We suggest that compared to human–human interaction, the rewarding properties of human–robot interaction are less likely to be affected by depression. These findings have implications for the utilization of robot-assisted intervention in clinical practice.

Speed versus damage: using selective feedback to modulate laparoscopic simulator performance

BackgroundAdaptive training is an approach in which training variables change with the needs and traits of individual trainees. It has potential to mitigate the effect of personality traits such as impulsiveness on surgical performance. Selective performance feedback is one way to implement adaptive training. This paper investigates whether selective feedback can direct performance of trainees of either high- or low impulsiveness.MethodsA total of 83 inexperienced medical students of known impulsiveness performed a four-session laparoscopic training course on a Virtual Reality Simulator. They performed two identical series of tasks every session. During one series of tasks they received performance feedback on duration and during the other series they received feedback on damage. Performance parameters (duration and damage) were compared between the two series of tasks to assess whether selective performance feedback can be used to steer emphasis in performance. To assess the effectiveness of selective feedback for people of high- or low impulsiveness, the difference in performance between the two series for both duration and damage was also assessed.ResultsParticipants were faster when given performance feedback for speed for all exercises in all sessions (average z-value = − 4.14, all p values < .05). Also, they performed better on damage control when given performance feedback for damage in all tasks and during all sessions except for one (average z-value = − 4.19, all but one p value < .05). Impulsiveness did not impact the effectiveness of selective feedback.ConclusionSelective feedback on either duration or damage can be used to improve performance for the variable that the trainee receives feedback on. Trainee impulsiveness did not modulate this effect. Selective feedback can be used to steer training focus in adaptive training systems and can mitigate the negative effects of impulsiveness on damage control.

Using a Meta-cognitive Wisconsin Card Sorting Test to measure introspective accuracy and biases in schizophrenia and bipolar disorder

People with schizophrenia (SCZ) and bipolar disorder (BD) have challenges in self-evaluation of their cognitive and functional performance (introspective accuracy). They also manifest response biases, with tendencies toward overestimation. This study aimed to examine objective test performance, momentary judgments of performance, momentary confidence, and subsequent global judgments of performance on a metacognitive version of the Wisconsin Card Sorting Test (WCST). This sample included 99 participants with SCZ and 67 with BD. After each of the 64 WCST trials, participants reported whether they believed their sort was correct and how confident they were in that judgment, they then received performance feedback. After completion of the entire task, participants generated a global performance judgment. On average, the SCZ group got 31 sorts correct, reporting being correct on 49 whereas the BD group got 37 trials correct but reported being correct on 53. For participants with BD, sorting performance correlated with trial x trial accuracy judgments, confidence, and predicted global judgments. For SCZ participants, performance minimally correlated with trial x trial accuracy judgments, confidence, and global judgments, while trial x trial confidence was strongly associated with trial x trial accuracy judgments (r = 0.58). Our findings suggest that confidence in participants with BD is correlated with task performance, whereas in SCZ confidence was entirely associated with self-generated performance judgments. SCZ participants manifested challenges with utilization of feedback. Global judgments of performance were predicted by task performance and confidence for BD participants, with performance and confidence judgments occurring prior to generation of the global performance judgments.

Outcomes of a health informatics technology-supported behavioral activation training for care managers in a collaborative care program.

Health informatics-supported strategies for training and ongoing support may aid the delivery of evidence-based psychotherapies. The objective of this study was to describe the development, implementation, and practice outcomes of a scalable health informatics-supported training program for behavioral activation for patients who screened positive for posttraumatic stress disorder and/or bipolar disorder. We trained 34 care managers in 12 rural health centers. They used a registry checklist to document the delivery of 10 behavioral activation skills for 4,632 sessions with 455 patients. Care managers received performance feedback based on registry data. Using encounter-level data reported by care managers, we described the implementation outcomes of patient reach and care manager skill adoption. We used cross-classified multilevel modeling to explore variation in skill delivery accounting for patient characteristics, provider characteristics, and change over time. Care managers engaged 88% of patients in behavioral activation and completed a minimum course for 57%. The average patient received 5.9 skills during treatment, with substantial variation driven more by providers (63%) than patients (29%). Care managers significantly increased the range of skills offered to patients over time. The registry-based checklist was a feasible training and support tool for community-based providers to deliver behavioral activation. Providers received data-driven performance feedback and demonstrated skill improvement over time, promoting sustainment. Future research will examine patient-level outcomes. Results underscore the potential public health impact of a simple registry-based skills checklist coupled with a scalable remote training program for evidence-based psychotherapy. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

Anchoring Effect of Performance Feedback on Accuracy of Metacognitive Monitoring in Preschool Children.

Preschool children are generally inaccurate at evaluating past and predicting future performance. The present study examines the effect of performance feedback on the accuracy of preschoolers’ predictive judgments and tests whether performance feedback acts as an anchor for postdictive judgments. In Experiment 1, preschool children (n = 40) solved number patterns, and in Experiment 2 they solved object patterns (n = 59). The results in both experiments revealed, firstly, that children receiving performance feedback made more accurate predictive judgments and lowered their certainty after their incorrect answer. Secondly, the children relied on performance feedback more than on actual task experience when making postdictive judgments, indicating that performance feedback was used as an anchor for subsequent postdictive judgments.