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Neural Correlates of Effective Learning in Experienced Medical Decision-Makers

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dc.contributorVirginia Techen
dc.contributor.authorDownar, Jonathanen
dc.contributor.authorBhatt, Meghana A.en
dc.contributor.authorMontague, P. Readen
dc.date.accessioned2017-09-08T14:18:50Zen
dc.date.available2017-09-08T14:18:50Zen
dc.date.issued2011-11-23en
dc.description.abstractAccurate 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.en
dc.format.mimetypeapplication/pdfen
dc.identifier.doihttps://doi.org/10.1371/journal.pone.0027768en
dc.identifier.issue11en
dc.identifier.urihttp://hdl.handle.net/10919/78839en
dc.identifier.volume6en
dc.language.isoenen
dc.publisherPLOSen
dc.rightsIn Copyrighten
dc.rights.urihttp://rightsstatements.org/vocab/InC/1.0/en
dc.titleNeural Correlates of Effective Learning in Experienced Medical Decision-Makersen
dc.title.serialPLOS ONEen
dc.typeArticle - Refereeden
dc.type.dcmitypeTexten

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Destination Area: Adaptive Brain and Behavior (ABB)