Use of neuroimaging to measure neurocognitive engagement in health professions education: a scoping review

Abstract

Purpose To map the current literature on functional neuroimaging use in medical education research as a novel measurement modality for neurocognitive engagement, learning, and expertise development. Method We searched PubMed, Embase, Cochrane, ERIC, and Web of Science, and hand-searched reference lists of relevant articles on April 4, 2019, and updated the search on July 7, 2020. Two authors screened the abstracts and then full-text articles for eligibility based on inclusion criteria. The data were then charted, synthesized, and analyzed descriptively. Results Sixty-seven articles published between 2007 and 2020 were included in this scoping review. These studies used three main neuroimaging modalities: functional magnetic resonance imaging, functional near-infrared spectroscopy, and electroencephalography. Most of the publications (90%, n = 60) were from the last 10 years (2011–2020). Although these studies were conducted in 16 countries, 68.7% (n = 46) were from three countries: the USA (n = 21), UK (n = 15), and Canada (n = 10). These studies were mainly non-experimental (74.6%, n = 50). Most used neuroimaging techniques to examine psychomotor skill development (57%, n = 38), but several investigated neurocognitive correlates of clinical reasoning skills (22%, n = 15). Conclusion This scoping review maps the available literature on functional neuroimaging use in medical education. Despite the heterogeneity in research questions, study designs, and outcome measures, we identified a few common themes. Included studies are encouraging of the potential for neuroimaging to complement commonly used measures in education research and may help validate/challenge established theoretical assumptions and provide insight into training methods. This review highlighted several areas for further research. The use of these emerging technologies appears ripe for developing precision education, establishing viable study protocols for realistic operational settings, examining team dynamics, and exploring applications for real-time monitoring/intervention during critical clinical tasks.

A Multimodal Evaluation of Podcast Learning, Retention, and Electroencephalographically Measured Attention in Medical Trainees

“…Our EEG findings are unique in the anesthesiology and podcast education literature. Our findings contribute to the growing body of literature supporting the use of EEG data to evaluate different aspects of learning [ 6 ]. It is feasible to measure EEG waveforms even while participants are moving, in this case on a treadmill, suggesting that this modality can likely be used to evaluate attention during activities that require movements, such as during simulated clinical scenarios or even actual clinical work.…”

“…Our EEG findings are unique in the anesthesiology and podcast education literature. Our findings contribute to the growing body of literature supporting the use of EEG data to evaluate different aspects of learning [6].…”

“…Despite advances in neuroimaging technology over the last two decades, use of neurocognitive assessment metrics, such as electroencephalography (EEG), in medical education research has been limited. To date, a small but growing body of research illustrates that neurocognitive evidence is effective in studying psychomotor skill development, clinical reasoning, visual expertise development, and neural correlates of resident well-being and burnout [ 6 ]. EEG offers a viable continuous measure of neurocognitive activities with high temporal resolution on the order of milliseconds when examining task-related online cognitive engagement [ 6 ].…”

“…To date, a small but growing body of research illustrates that neurocognitive evidence is effective in studying psychomotor skill development, clinical reasoning, visual expertise development, and neural correlates of resident well-being and burnout [ 6 ]. EEG offers a viable continuous measure of neurocognitive activities with high temporal resolution on the order of milliseconds when examining task-related online cognitive engagement [ 6 ]. Fan demonstrated that the three main attentional networks in the brain (alerting, orienting, and executive attention) are linked to separate, identifiable brain regions [ 7 , 8 ].…”

Neurocognitive Correlates of Clinical Decision Making: A Pilot Study Using Electroencephalography

“…A recent scoping review revealed an emerging area of research using neuroimaging evidence to investigate various clinical skills in health profession education research [18]. Most of these studies focused on psychomotor skill development, yet a few provided preliminary information on the neurocognitive aspects of clinical reasoning and decision making, supporting the theoretical assumptions.…”