BACKGROUND: Intentional Mind Wandering (IMW) is proposed to be a low arousal state resulting from boredom, to distinguish it from unintentional mind wandering (UMW), which may be a low executive control state resulting from exhaustion of resources. AIM: To demonstrate that there are objective differences between IMW and UMW reflecting the subjective difference that IMW is a low effort and high predictability strategy. METHODS: The metronome response task (MRT) requires participants to predict when the next tone in a regular series will occur. Inter-Trial Interval (ITI) variants of the MRT were presented in blocks of ∼ 90 seconds. RESULTS: The most predictable version of MRT resulted in the percentage of reported IMW doubling, whereas UMW remained similar in all three versions of the MRT. IMW necessitated subjective effort to be low (maximum 5 on a 1-9 scale). IMW in easy and predictable versions of the task resulted in normal performance, whereas IMW during difficult tasks that required sustained attention led to poor performance and occasional errors. IMW during the least predictable MRT led to a significantly higher rate of omission errors (compared to on-task or UMW), and also to a higher maximum-in-block reaction time, as predicted by the worst performance rule. Conscientiousness was linked to reduced IMW (but not reduced UMW), higher on-task probes, increased effort, and improved prediction accuracy. CONCLUSIONS: Subjective assessment of low task difficulty predisposes to IMW, evoking increases of both omission errors and slow lapses and decreases in willingness and in compliant allocation of cognitive resources.

Objectives: The aim of this study was to evaluate changes in corneal topography, wavefront aberrations, and densitometry after superficial keratectomy (SK) for Salzmann nodular degeneration (SND). Methods: This was an observational retrospective study. Pre- and post-operative data, including best spectacle-corrected visual acuity (BCVA), refraction, and Pentacam^® topography scans, were analysed. Changes in keratometry (K), wavefront aberrations, and corneal optical densitometry (COD) were evaluated. Results: A total of 21 eyes of 17 patients who underwent SK for SND were included. At an average follow-up of 6.3 ± 4.4 months, there was a significant reduction in RMS (root mean square) values for total wavefront aberrations after surgery (mean reduction: −3.89 ± 4.08 μm, p = 0.001), lower-order aberrations (mean reduction: −3.47 ± 3.52 μm, p = 0.001), and higher-order aberrations (mean: −0.42 ± 0.58 μm, p < 0.001). There was a significant improvement in BCVA (mean change: 0.27 ± 0.31 logMAR, p < 0.001) and spherical equivalent (mean change: −2.09 ± 2.73 D, p = 0.002), and a reduction in refractive cylinder (mean reduction: −0.85 ± 1.14 D, p = 0.008). There was a significant reduction in corneal astigmatism (mean reduction 1.04 ± 2.88 D; p = 0.041), and an increase in flat keratometry (mean change 1.46 ± 3.10 D; p = 0.029). Lastly, there was a significant decrease in total COD values in all zones except for the central 2 mm (p < 0.05) and in the overall total 12 mm cornea (p = 0.035). Conclusions: SK for SND resulted in better visual acuity and potentially improved quality as suggested by the reduction in corneal aberrations and improvement in corneal regularity and transparency.

Background: Traditional hands-on instruction of clinical skills in undergraduate medical education faced a paradigm shift with the emergence of COVID-19. Online teaching through virtual learning environments swiftly replaced traditional methods, necessitating an urgent reassessment of clinical skills education. Despite this, a knowledge gap persists regarding the effective delivery and integration of online clinical skills teaching within established medical curricula. This study investigated UK based medical educators and their experiences teaching clinical skills in an online environment enforced by social distancing. From these results we aimed to explore how aspects of online teaching can be strategically employed within the current landscape of medical education to optimize practical skills acquisition. Methods: A cross-sectional study design employing a survey with closed and open-ended questions was utilized. The survey was hosted through the online survey platform EU Qualtrics and approved by the Education Leads Advisory Group of the Medical Schools Council for further distribution to medical educators. The results were analysed by frequency of answers with accompanying thematic analysis. Results: This study gathered responses from 22 medical educators of various seniority across 11 UK universities. Pre-pandemic, educators reported low experience with online teaching (mean score 1.96/5) (SD = 0.81). During the March–Sept 2020 lockdown, 18% cancelled all clinical skills teaching, while 50% adopted blended learning; 67% viewed the shift positively. Challenges included technology issues and difficulty replicating hands-on practice, though some found improved engagement and flexibility for non-practical skill, communication skills teaching in particular was well-received. Post-pandemic, 65% disagreed that online teaching alone achieves competency however, 89% supported retaining some online innovations, citing flexibility and efficiency, but stressed the need for face-to-face (F2F) supervision and practice for full skills mastery. Despite uncertainties, educators acknowledged the benefits of online learning, emphasizing the need for proper resources and training for successful integration into clinical skills teaching. Conclusion: Despite a preference for online teaching in non-practical skills, educators continued to express reservations about fully replacing F2F clinical skills teaching due to technological challenges and limited digital fluency. The overall preference among educators leaned towards a blended approach utilising both modalities, harnessing benefits of online teaching while retaining the advantages of traditional methods.

BACKGROUND: In a go/no-go task, lengthening the time between stimuli (e.g. changes to the inter-trial interval (ITI) or to the press percentage (PP)) are known to have decelerating effects on rapid reaction times and possibly on thought probe response time. The cause for these delays may be mind wandering (MW). MW-induced delays theoretically arise from serial mental resources being decoupled, leading to poor stimulus detection and perception. AIMS: To see whether the delaying effects of ITI and PP are mediated by mind wandering (MW), and to explore the mental mechanisms of delay in a simple and a complex task. METHODS: An 18-minute online experiment with 60 participants who each performed 8 versions of a sustained attention task (Test of Variables of Attention, ToVA) with different ITIs and PPs. After each block there were MW thought probes. RESULTS: The slowing effects of long ITIs, low PPs, and MW seem to be synergistic, but the effects of individual factors are inconsistent. On ToVA reaction times (simple task), long ITIs caused delays, low PPs interacted with those delays, and MW seemed to have little consistent effect except when the certainty was maximized in the on-task condition. On thought probe response times (complex task), MW had strong effects, whereas there seemed to be no pattern to the lingering effects of longer ITIs or low PPs. CONCLUSION: The decoupled resources theoretically linked to MW may be parallel and related to task-reorienting, introspection, or decision-making events comprising thought probe responses, rather than to perceptual detection events.