UNASSIGNED: The rapid transition to online delivery of medical curriculum has facilitated the continuation of medical education during the COVID-19 pandemic. Whilst active learning approaches, including Team-Based Learning (TBL), are generally more supportive of the learner\'s needs during such transition, it remains elusive how different learning environments affect a learner\'s motivation, engagement, and perceived learning over a prolonged period. We leveraged on Self-Determination Theory (SDT) and key learners\' characteristics to explore the levels of student\'s engagement and perceived learning in two TBL learning environments, online and in-person, over an extended period. We hypothesize that students\' self-reported perceptions of engagement and learning will be lower in online compared to in-person TBL classes.
UNASSIGNED: This is a mixed methods study with 49 preclinical graduate medical students completing the same questionnaire twice for each learning environment, online TBL and in-person TBL, over an eight-month period. Quantitative data were collected on learners\' characteristics, basic psychological needs satisfaction, motivation, student\'s engagement and perceived learning. The final questionnaire also explored participants\' perception on which learning environment better supported their learning.
UNASSIGNED: We found that autonomy support, perceived competence and needs satisfaction, and perceived learning were higher in-person than online. Additionally, most learners felt that in-person TBL was better for learning, as the concepts of learning space and the community of practice were mediated by being in-person.
UNASSIGNED: TBL, being an active instructional method, can maintain students\' engagement because it supports many aspects of SDT constructs and perceived learning. However, online TBL is unable to fully support the students\' needs and perceived learning. Hence, we strongly advocate for any in-person opportunities to be included in a course, as in-person classes best supports students\' engagement and perceived learning.

Child custody cases post-parental separation entail inherent complexities and uncertainties for legal experts and decision-makers, and are influenced by context factors. This study sheds light on how legal actors (i.e., judges, prosecutors, lawyers, psychologists, and social workers) navigate the uncertainties that arise in such context and, therefore, make their decisions. Based on a reflexive thematic analysis involving 73 participants from Brazil and England, this study reveals cognitive strategies employed by legal actors to comprehend uncertainty and operate in the decision-making context. These strategies encompass heuristics (i.e., selection, evaluation, degrees of freedom, and outsourcing decisions/ resolution) and metacognitive strategies (custodial arrangements, professional practices and \'best interests of the child\' speech). These results provide a window into the decision-making processes in child custody cases; they offer a comprehensive understanding of the multifaceted sensemaking strategies employed by legal professionals. The results carry substantial implications for informing and improving legal practice in handling complex child custody situations. Furthermore, this study charts new paths for future research by highlighting potential avenues for refining and advancing the strategies employed by legal experts in these cases, especially considering the child\'s best interests.

This study determined the extent to which working memory (WM) played a moderating and/or mediating role in word-problem-solving (WPS) instructional outcomes between children with and without math difficulties (MD). A randomized pretest-posttest control group study investigated the effects of 8-week strategy instruction in one of four treatment conditions on WPS accuracy of third graders with MD (N = 136) when compared to children with (N = 28) and without MD (N = 43). Comparisons were made of three strategy conditions that included overt cues (e.g. underlining key sentences, filling in diagrams), another treatment condition that removed the overt cues (material-only), and two control conditions (children with and without MD). Four important findings emerged. First, posttest WM significantly predicted posttest WPS, computation, and schema accuracy independent of pretest and treatment conditions. Second, posttest WM mediated posttest WPS treatment outcomes when the control conditions included children without MD. Third, strategy conditions that included overt cues (e.g. crossing out irrelevant sentences) decreased WM demands compared to the Materials-Only condition (without overt cues) for children with MD. Finally, incremental attention allocation training within treatment conditions improved posttest WM in children with MD but not posttest WPS. Results indicated that WPS differences between children with and without MD across treatment conditions were mediated by posttest WM performance.

This study was conducted in response to the increasing prevalence of Alzheimer\'s disease (AD) dementia and the significant risk faced by individuals with amnestic mild cognitive impairment with multiple-domain deficits (aMCI-md). Given the promising effects of MTPs, the primary aim of this study was to further explore their impact by assessing the maintenance of their benefits. Thus, 45 participants were randomly allocated in two groups: the Experimental group (n = 22), which received the metacognitive training program (MTP), and the Control group (n = 23) that received the cognitive exercises program (CEP). The training programs-the MTP and the CEP-included 10 individual sessions of a one-hour duration and took place once per week. To test the efficacy of the MTP, cognitive and metacognitive outcomes were compared between two groups-Experimental (EG) and Control (CG)-at four distinct time points: before-after-3 months-6 months after intervention. Based on this study\'s findings, the positive effects of the MTP were evident over a six-month period. Specifically, already three months post-training, the CG began to show a decline in training-related gains. In contrast, the EG\'s performance consistently improved, highlighting the superior efficacy of the MTP. Gains attributed to the MTP were detected in cognitive measures: cognitive flexibility and immediate visual recall, as well as in metacognitive measures: metacognitive control, improved metacognitive beliefs of attention, and an increased use of cognitive strategies. In conclusion, the results demonstrated the sustained effects of the MTP in cognitive and metacognitive measures over a period of six months, providing novel insight into the application and efficacy of the MTP in individuals with MCI.

Decision-making under uncertainty, a cornerstone of human cognition, is encapsulated by the \"secretary problem\" in optimal stopping theory. Our study examines this decision-making challenge, where participants are required to sequentially evaluate and make irreversible choices under conditions that simulate cognitive overload. We probed neurophysiological responses by engaging 27 students in a secretary problem simulation while undergoing EEG monitoring, focusing on Event-Related Potentials (ERPs) P200 and P400, and Theta to Beta Ratio (TBR) dynamics.Results revealed a nuanced pattern: the P200 component\'s amplitude declined from the initial to the middle offers, suggesting a diminishing attention span as participants grew accustomed to the task. This attenuation reversed at the final offer, indicating a heightened cognitive processing as the task concluded. In contrast, the P400 component\'s amplitude peaked at the middle offer, hinting at increased cognitive evaluation, and tapered off at the final decision. Additionally, TBR dynamics illustrated a fluctuation in attentional control and emotional regulation throughout the decision-making sequence, enhancing our understanding of the cognitive strategies employed.The research elucidates the dynamic interplay of cognitive processes in high-stakes environments, with neurophysiological markers fluctuating significantly as participants navigated sequential choices. By correlating these fluctuations with decision-making behavior, we provide insights into the evolving strategies from heightened alertness to strategic evaluation. Our findings offer insights that could inform the use of neurophysiological data in the development of decision-making frameworks, potentially contributing to the practical application of cognitive research in real-life contexts.

UNASSIGNED: Studies have shown age-related differences in numerical cognition, for example, in the level of numerosity comparison ability. Moreover, some studies point out individual differences in the cognitive strategies employed during the performance of numerosity comparison tasks and reveal that they are related to the aging process. One probable cause of these differences is the level of cognitive functioning. The aim of our study was to determine the relationships among numerosity comparison ability, the cognitive strategies utilized in the performance of numerosity comparison tasks and the general cognitive functioning in older people.
UNASSIGNED: Forty-seven elderly people participated in the study. The participants were examined using overall cognitive functioning scales and computerized numerosity comparison task.
UNASSIGNED: The results showed many correlations between the participants\' level of cognitive functioning and the percent of correct responses (PCR) and response time (RT) during numerosity comparison, as well as with the cognitive strategies applied by the participants. Task correctness was positively related to the level of performance in the attention and executive function tasks. In contrast, the long-term memory resources index and visuospatial skills level were negatively correlated with RT regarding numerosity comparison task performance. The level of long-term memory resources was also positively associated with the frequency of use of more complex cognitive strategies. Series of regression analyses showed that both the level of general cognitive functioning and the cognitive strategies employed by participants in numerosity comparison can explain 9-21 percent of the variance in the obtained results.
UNASSIGNED: In summary, these results showed significant relationships between the level of cognitive functioning and proficiency in numerosity comparison measured in older people. Moreover, it has been shown that cognitive resources level is related to the strategies utilized by older people, which indicates the potential application for cognitive strategy examinations in the development of new diagnostic tools.

Metacognition, the ability to monitor and regulate cognitive processes, is essential for individuals with Mild Cognitive Impairment (MCI) to accurately identify their deficits and effectively manage them. However, previous studies primarily focused on memory awareness in MCI, neglecting other domains affected in daily life. This study aimed to investigate how individuals with MCI perceive their abilities to handle various cognitively challenging situations representing real-life scenarios and their use of compensatory strategies. Thus 100 participants were recruited, including 50 with amnestic MCI with multiple deficits (aMCI) and 50 cognitively healthy controls (HC) matched in age and education. Participants completed three metacognitive scales assessing self-perceived efficacy in everyday life scenarios and one scale evaluating use of cognitive strategies. Results indicated that aMCI participants reported significantly lower self-efficacy in memory and divided-shifted attention scenarios compared to HC. Surprisingly, no significant group differences were found in the self-reports about the use of cognitive strategies. This suggests a potential gap in understanding or applying effective strategies for compensating cognitive deficits. These findings emphasize the importance of cognitive training programs targeting metacognitive knowledge enhancement and practical use of cognitive strategies that could enhance the quality of life for individuals with MCI.

The aim of the present study is to describe and measure the cognitive emotion regulation strategies of inpatient adolescents with clinical depression, aged 13-18, and to analyse these coping strategies in relation to different comorbidities of Major Depressive Disorder (MDD).
METHODS: There were 112 adolescents with MDD who were admitted to hospital and 78 healthy adolescents included in the study. The Cognitive Emotion Regulation Questionnaire (CERQ) was used to assess nine specific cognitive coping strategies. A cognitive coping style model for depression in adolescents was described by analysing the differences between the two groups. The CERQ scores in MDD participants, grouped by comorbidity, were also assessed.
RESULTS: Adolescents with MDD had significantly higher scores for Self-Blame and Catastrophising strategies, and significantly lower scores for Positive Refocusing, Refocusing on Planning, and Positive Reappraisal. Adolescents with MDD and Borderline Personality Disorder (BPD) traits had significantly higher scores for Rumination, Catastrophising, and Blaming Others than adolescents with MDD and anxiety or with no comorbidity.
CONCLUSIONS: Clinical depression in adolescents is associated with a cognitive profile that consists of an increased use of maladaptive coping styles and low employment of adaptive strategies. Early identification can contribute to the development of specific, individualised prevention and intervention programmes, while further longitudinal studies are necessary to adequately measure the outcome of these interventions.

Raven\'s advanced progressive matrices (APM) comprise two types of representational codes, namely visuo-spatial and verbal-analytical, that are used to solve APM puzzles. Studies using analytical, behavioral, and imaging methods have supported the multidimensional perspectives of APM puzzles. The visuo-spatial code is expected to recruit operations more responsive to the visual perception tasks. In contrast, the verbal-analytical code is expected to use operations more responsive to the logical reasoning task and may entail different cognitive strategies. Acknowledging different representational codes used in APM puzzle-solving is critical for a better understanding of APM\'s performance and their relationship with other tasks, especially creative reasoning. We used the eye-tracking method to investigate the role of two representational codes, visuo-spatial and verbal-analytical, in strategies involved in solving APM puzzles and in generating an APM-like puzzle by using a creative-reasoning task (CRT). Participants took longer time to complete the verbal-analytical than visuo-spatial puzzles. In addition, visuo-analytical than visual-spatial puzzles showed higher progressive and regressive saccade counts, suggesting the use of more response elimination than constructive matching strategies employed while solving verbal-analytical than visuo-spatial puzzles. We observed higher CRT scores when it followed verbal-analytical (Mdn = 84) than visuo-spatial (Mdn = 73) APM puzzles, suggesting puzzle-solving specific strategies affect puzzle-creating task performance. The advantage of verbal-analytical over visuo-spatial puzzle-solving has been discussed in light of shared cognitive processing between APM puzzle-solving and APM-like puzzle-creating task performance.

UNASSIGNED: Our objective was to understand the cognitive strategies used by surgeons to mentally visualize navigation of a surgical instrument through blind space.
UNASSIGNED: We conducted semi-structured interviews with 15 expert and novice surgeons following simulated retropubic trocar passage on 3D-printed models of pelvises segmented from preop MRIs. Midurethral sling surgery involves blind passage of a trocar among the urethra, bladder, iliac vessels, and bowel while relying primarily on haptic feedback from the suprapubic bone (SPB) for guidance. Our conceptual foundation was based on Lahav\'s study on blind people\'s mental mapping of spaces using haptic cues. Participants detailed how they mentally pictured the trocar\'s location relative to vital anatomy. We coded all responses and used constant comparative analysis to generate themes, confirmed with member checking.
UNASSIGNED: Expert and novice participants utilized multiple cognitive strategies combined with haptic feedback to accomplish safe trocar passage. Some used a step-by-step route strategy, visualizing sequential 2D axial images of anatomy adjacent to the SPB. Others used a map strategy, forming global 3D pictures. Although these mental pictures vanished when they were \"lost,\" a safe zone could be reestablished by touching the SPB. Experts were more likely to relate their body position to the trocar path and rely on minor variations in resistance. Novices were more inclined toward backtracking of the trocar.
UNASSIGNED: Our findings may be extended to any blind surgical procedure. Teaching visualization strategies and incorporating tactile feedback can be used intraoperatively to help learners navigate their instrument safely around vital organs.