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High-Performing Docs Learn Equally From Success, Failure

Last Updated: November 28, 2011.

Among physicians making decisions in a medically-framed learning task, high and low performers show distinct behavioral and neural patterns of learning, according to a study published online Nov. 23 in PLoS One.

MONDAY, Nov. 28 (HealthDay News) -- Among physicians making decisions in a medically-framed learning task, high and low performers show distinct behavioral and neural patterns of learning, according to a study published online Nov. 23 in PLoS One.

Using functional magnetic resonance imaging, Jonathan Downar, M.D., Ph.D., from the University of Toronto, and colleagues examined neural activation in 35 experienced physicians while they learned to decide between two fictional treatments in a series of virtual patient encounters. Behavioral data on the physicians' choices were collected to produce a model which divided the physicians into high and low performers. The role of confirmation bias and success-chasing was investigated for high and low performers.

The investigators found that the learning rates for successes and failures were small but equal in the case of high performers. Very large and asymmetric learning rates were seen for low performers, who learned significantly more from successes than failures. Larger, more sustained blood oxygenation level-dependent responses to failed versus successful outcomes were seen in the dorsolateral prefrontal cortex and inferior parietal lobule of high performers, whereas the opposite response profile was seen in low performers. Learning asymmetry was associated with anticipatory activation in the nucleus accumbens. More success-chasing during learning was seen in physicians with anticipatory activation in the nucleus accumbens.

"High performers' brains achieve better outcomes by attending to informative failures during training, rather than chasing the reward value of successes," the authors write.

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