Neural correlates of effective learning in experienced medical decision-makers.

Accurate associative learning is often hindered by confirmation bias and success-chasing, which together can conspire to produce or solidify false beliefs in the decision-maker. We performed functional magnetic resonance imaging in 35 experienced physicians, while they learned to choose between two...

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Autores principales:	Jonathan Downar, Meghana Bhatt, P Read Montague
Formato:	article
Lenguaje:	EN
Publicado:	Public Library of Science (PLoS) 2011
Materias:	Medicine R Science Q
Acceso en línea:	https://doaj.org/article/5516322cceb64ae396351c8b86105415
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spelling	oai:doaj.org-article:5516322cceb64ae396351c8b861054152021-11-18T07:33:38ZNeural correlates of effective learning in experienced medical decision-makers.1932-620310.1371/journal.pone.0027768https://doaj.org/article/5516322cceb64ae396351c8b861054152011-01-01T00:00:00Zhttps://www.ncbi.nlm.nih.gov/pmc/articles/pmid/22132137/pdf/?tool=EBIhttps://doaj.org/toc/1932-6203Accurate associative learning is often hindered by confirmation bias and success-chasing, which together can conspire to produce or solidify false beliefs in the decision-maker. We performed functional magnetic resonance imaging in 35 experienced physicians, while they learned to choose between two treatments in a series of virtual patient encounters. We estimated a learning model for each subject based on their observed behavior and this model divided clearly into high performers and low performers. The high performers showed small, but equal learning rates for both successes (positive outcomes) and failures (no response to the drug). In contrast, low performers showed very large and asymmetric learning rates, learning significantly more from successes than failures; a tendency that led to sub-optimal treatment choices. Consistently with these behavioral findings, high performers showed larger, more sustained BOLD responses to failed vs. successful outcomes in the dorsolateral prefrontal cortex and inferior parietal lobule while low performers displayed the opposite response profile. Furthermore, participants' learning asymmetry correlated with anticipatory activation in the nucleus accumbens at trial onset, well before outcome presentation. Subjects with anticipatory activation in the nucleus accumbens showed more success-chasing during learning. These results suggest that high performers' brains achieve better outcomes by attending to informative failures during training, rather than chasing the reward value of successes. The differential brain activations between high and low performers could potentially be developed into biomarkers to identify efficient learners on novel decision tasks, in medical or other contexts.Jonathan DownarMeghana BhattP Read MontaguePublic Library of Science (PLoS)articleMedicineRScienceQENPLoS ONE, Vol 6, Iss 11, p e27768 (2011)
institution	DOAJ
collection	DOAJ
language	EN
topic	Medicine R Science Q
spellingShingle	Medicine R Science Q Jonathan Downar Meghana Bhatt P Read Montague Neural correlates of effective learning in experienced medical decision-makers.
description	Accurate associative learning is often hindered by confirmation bias and success-chasing, which together can conspire to produce or solidify false beliefs in the decision-maker. We performed functional magnetic resonance imaging in 35 experienced physicians, while they learned to choose between two treatments in a series of virtual patient encounters. We estimated a learning model for each subject based on their observed behavior and this model divided clearly into high performers and low performers. The high performers showed small, but equal learning rates for both successes (positive outcomes) and failures (no response to the drug). In contrast, low performers showed very large and asymmetric learning rates, learning significantly more from successes than failures; a tendency that led to sub-optimal treatment choices. Consistently with these behavioral findings, high performers showed larger, more sustained BOLD responses to failed vs. successful outcomes in the dorsolateral prefrontal cortex and inferior parietal lobule while low performers displayed the opposite response profile. Furthermore, participants' learning asymmetry correlated with anticipatory activation in the nucleus accumbens at trial onset, well before outcome presentation. Subjects with anticipatory activation in the nucleus accumbens showed more success-chasing during learning. These results suggest that high performers' brains achieve better outcomes by attending to informative failures during training, rather than chasing the reward value of successes. The differential brain activations between high and low performers could potentially be developed into biomarkers to identify efficient learners on novel decision tasks, in medical or other contexts.
format	article
author	Jonathan Downar Meghana Bhatt P Read Montague
author_facet	Jonathan Downar Meghana Bhatt P Read Montague
author_sort	Jonathan Downar
title	Neural correlates of effective learning in experienced medical decision-makers.
title_short	Neural correlates of effective learning in experienced medical decision-makers.
title_full	Neural correlates of effective learning in experienced medical decision-makers.
title_fullStr	Neural correlates of effective learning in experienced medical decision-makers.
title_full_unstemmed	Neural correlates of effective learning in experienced medical decision-makers.
title_sort	neural correlates of effective learning in experienced medical decision-makers.
publisher	Public Library of Science (PLoS)
publishDate	2011
url	https://doaj.org/article/5516322cceb64ae396351c8b86105415
work_keys_str_mv	AT jonathandownar neuralcorrelatesofeffectivelearninginexperiencedmedicaldecisionmakers AT meghanabhatt neuralcorrelatesofeffectivelearninginexperiencedmedicaldecisionmakers AT preadmontague neuralcorrelatesofeffectivelearninginexperiencedmedicaldecisionmakers
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Neural correlates of effective learning in experienced medical decision-makers.

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