The authors have no acknowledgments.

All methods described here were exempt from review by the Summa Institutional Review Board.&#160;
1. Preparation
<ol>
	<li>Prepare the simulation lab prior to beginning the blindfolded code training exercise.&#160;
	<ol>
		<li>Prepare all supplies needed for code resuscitation, including an intravenous (IV) start kit, IV fluids, a code cart, a defibrillator with pads, a bag valve mask, a non-rebreather mask, a nasal cannula, a pulse oximeter, and intubating supplies (including a laryngoscope, an endotracheal tube, a stylet, a syringe, an end-tidal carbon dioxide monitor, and a cardiac monitor).</li>
		<li>Place the human-patient simulator on an emergency department bed. Turn on the simulator and connect it to the wireless network. Set the simulator vitals to match the case scenario.</li>
		<li>Provide a chair or stool and blindfold for the code team leader. Place the team leader 5 feet away from the foot of the bed, facing away from the team.&#160;</li>
	</ol>
	</li>
	<li>Print code resuscitation simulation scenarios for the faculty. Read the simulation scenarios prior to the start of the session.&#160;</li>
	<li>Upload any necessary radiographic images and electrocardiograms for each patient scenario.</li>
</ol>
2. Blindfolded Code Training Exercise
<ol>
	<li>Review the rules of the exercise with the learners. Provide a demonstration for the learners of the blindfolded code training exercise.</li>
	<li>Select a code team leader from the group of learners. Initially, start with more experienced learners as code team leaders.</li>
	<li>Sit the code team leader down on a chair or stool at the foot of the bed, facing away from the patient. Blindfold the code team leader.&#160; 
	NOTE: The best resuscitation team configuration is one embedded nurse, three resident physicians, and one resident as code team leader.</li>
	<li>Ensure that resuscitation team members verbally introduce themselves by role, name, and position in relation to the patient in the bed to the blindfolded code team leader prior to the start of the scenario.&#160; 
	NOTE: For example, &#8220;I am resident John at the head of the bed.&#8221;</li>
	<li>Start the scenario by reading the stem for the case scenario to the code team leader.</li>
	<li>Run the case scenario for approximately 8&#8211;10 min. Change the patient vitals and cardiac rhythms in alignment with the case scenario outline.&#160;</li>
</ol>
3. Blindfolded Code Team Debriefing
<ol>
	<li>Debrief the code team at the conclusion of the case scenario for approximately 10 min.&#160; 
	NOTE: Focus on the utilization of closed-loop communication, the leader&#8217;s effectiveness in leading the resuscitation, and the management decisions as they relate to the advanced cardiac life support (ACLS) or advanced trauma life support (ATLS) algorithms.&#160;</li>
	<li>Select another code team leader and repeat the process at the conclusion of the debriefing.</li>
</ol>

<ol>
	<li>Brindley, P. G., Hudson, D., Lord, J. A. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=The+blindfolded+learner+&#8211;+a+simple+intervention+to+improve+crisis+resource+management+skills.">The blindfolded learner &#8211; a simple intervention to improve crisis resource management skills.</a> Journal of Critical Care. 23 (2), 253-254 (2008).</li><li>Accreditation Council for Graduate Medical Education. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=.">.</a> ACGME Program Requirements for Graduate Medical Education in Pulmonary Disease and Critical Care Medicine (Internal Medicine). , (2017).</li><li>Accreditation Council for Graduate Medical Education and American Board of Emergency Medicine. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=.">.</a> The Emergency Medicine Milestone Project. , (2015).</li><li>Murphy, M., Curtis, K., McCloughen, A. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=What+is+the+impact+of+multidisciplinary+team+simulation+training+on+team+performance+and+efficiency+of+patient+care?+An+integrative+review.">What is the impact of multidisciplinary team simulation training on team performance and efficiency of patient care? An integrative review.</a> Australasian Emergency Nursing Journal. 19 (1), 44-53 (2016).</li><li>Ahmed, R., Hughes, K., Hughes, P. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=The+blindfolded+code+training+exercise.">The blindfolded code training exercise.</a> The Clinical Teacher. 15 (2), 120-125 (2018).</li><li>Ryoo, E. N., Ha, E. H. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=The+Importance+of+Debriefing+in+Simulation-Based+Learning:+Comparison+Between+Debriefing+and+No+Debriefing.">The Importance of Debriefing in Simulation-Based Learning: Comparison Between Debriefing and No Debriefing.</a> Computers, Informatics, Nursing. 33 (12), 538-545 (2015).</li><li>Shinnick, M. A., Woo, M., Horwich, T. B., Steadman, R. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Debriefing:+The+Most+Important+Component+in+Simulation?.">Debriefing: The Most Important Component in Simulation?.</a> Clinical Simulation in Nursing. 7 (3), e105-e111 (2011).</li><li>Bergs, E. A., Rutten, F. L., Tadros, T., Krijnen, P., Schipper, I. B. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Communication+during+trauma+resuscitation:+do+we+know+what+is+happening?.">Communication during trauma resuscitation: do we know what is happening?.</a> Injury. 36 (8), 905-911 (2005).</li><li>Carter, E. A., Waterhouse, L. J., Kovler, M. L., Fritzeen, J., Burd, R. S. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Adherence+to+ATLS+primary+and+secondary+surveys+during+pediatric+trauma+resuscitation.">Adherence to ATLS primary and secondary surveys during pediatric trauma resuscitation.</a> Resuscitation. 84 (1), 66-71 (2013).</li><li>Spanjersberg, W. R., Bergs, E. A., Mushkudiani, N., Klimek, M., Schipper, I. B. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Protocol+compliance+and+time+management+in+blunt+trauma+resuscitation.">Protocol compliance and time management in blunt trauma resuscitation.</a> Emergency Medicine Journal. 26 (1), 23-27 (2009).</li><li>Fitzgerald, M., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Using+video+audit+to+improve+trauma+resuscitation&#8212;time+for+a+new+approach.">Using video audit to improve trauma resuscitation&#8212;time for a new approach.</a> Canadian Journal of Surgery. 49 (3), 208-211 (2006).</li><li>Hughes, P. G., Ahmed, R. A. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=The+Blindfolded+Trauma+Team+Resuscitation:+a+strategy+for+improved+leadership+and+communication.">The Blindfolded Trauma Team Resuscitation: a strategy for improved leadership and communication.</a> BMJ Simulation &amp; Technology Enhanced Learning. , (2017).</li></ol>

The authors have nothing to disclose.

The blindfolded code exercise consists of several critical steps. First, the exercise requires an initial faculty demonstration to decrease the learners&#8217; intimidation and anxiety toward performing a resuscitation blindfolded. It also serves to give learners an example of a successful performance of the blindfolded resuscitation. Facing the code team leader away from the resuscitation team ensures that the leader is unable to visualize the scenario and forces them to give loud, clear orders (Fig...

The blindfolded code training exercise was developed to improve closed-loop communication, the utilization of a conceptual framework to organize the management of a resuscitation, and critical thinking skills. Previous scholars reported that communication, role clarity, and teamwork were enhanced by blindfolding physicians during simulated resuscitations1. Resident physicians, especially in critical care specialties, are frequently placed in high-acuity situations. In order to appropriately manage these high-risk cases, resident physicians require training in both leadership strategies and communication in high-risk environments2,3. Simulation is commonly used and is effective in teaching crisis resource management principles and communication skills4.&#160;
Currently, there is limited knowledge of innovative techniques to improve resident physician communication and leadership strategies in high-acuity situations. Ineffective communication may continue despite correct management and leadership observed in the simulation lab. A previous study highlights that the blindfolded code training exercise, when compared to typical code training, is more challenging and forces learners to use critical thinking skills and closed-loop communication. Learners felt the exercise solidified leadership skills and challenged them to maintain mental organization without visual cues5.&#160;
In preparation for the blindfolded code training exercise, the faculty provides a demonstration explaining how this advanced approach is performed, to decrease learner intimidation by the exercise. Once the demonstration is finished, the team leader is blindfolded. The team leader must use closed-loop communication and give explicit orders to the resuscitation team with a request to have all orders repeated back. The team cannot independently initiate any procedure or management without clear direction from the team leader. Team members can only execute orders from the team leader that are explicitly directed to them by name. If the team leader does not identify a specific person to perform the action, it is not performed. For example, if the team leader states, &#8220;Start compressions&#8221; without directing it to a specific team member, the order is not completed. All members of the team stand motionless. If a team member is given an order by the leader but is not requested to repeat the order as confirmation, the order can be executed but the team leader is not given verbal feedback at the completion of the order. This should prompt the team leader to ask that subsequent orders are to be repeated back, as the leader does not have visual stimuli to confirm order completion.&#160;
If the team leader asks team members to repeat the orders back, team members must reply to the team leader using closed-loop communication. This alerts the team leader when the order is received and completed. For example, if team leader Dr. Jones asks John to &#8220;Give 1 mg of epinephrine intravenously&#8221;, John will reply &#8220;I will get 1 mg of epinephrine. Dr. Jones, 1 mg of epinephrine has been administered intravenously&#8221;. The team leader can ask questions about the monitor. However, team members can only describe the appearance of the cardiac rhythm in layman&#8217;s terms (Table 1). For example, ventricular tachycardia would be described as a wide complex regular rhythm at the rate displayed on the monitor. Team members cannot use medical terms when describing the cardiac monitor, such as ventricular tachycardia or pulseless electrical activity. Lastly, faculty will verbally clarify all physical exam findings if the code team leader directs a team member to perform a physical exam.
By removing visual stimuli, the blindfolded code training exercise forces the team leader to maintain mental organization and use closed-loop communication to effectively manage a resuscitation. The purpose of the description of the blindfolded code training exercise is to provide guidance on how to perform this innovative teaching technique to force closed-loop communication.

<table><tbody><tr><td>Bag valve mask</td><td></td><td></td><td></td></tr><tr><td>Blindfold</td><td></td><td></td><td></td></tr><tr><td>Blood pressure cuff</td><td></td><td></td><td></td></tr><tr><td>Cardiac monitor</td><td></td><td></td><td></td></tr><tr><td>Chair</td><td></td><td></td><td></td></tr><tr><td>Code Cart</td><td></td><td></td><td>ACLS medications</td></tr><tr><td>Defibrillator with pads</td><td></td><td></td><td></td></tr><tr><td>Emergency department bed</td><td></td><td></td><td></td></tr><tr><td>End-tidal carbon dioxde monitor</td><td></td><td></td><td></td></tr><tr><td>Human-patient simulator</td><td></td><td></td><td></td></tr><tr><td>Intubation Kit&amp;nbsp;</td><td></td><td></td><td>endotracheal tube, laryngoscope, stylet, 10 mL syringe, endotracheal tube holder</td></tr><tr><td>IV fluids</td><td></td><td></td><td>1 L normal saline or lactated ringer&#039;s</td></tr><tr><td>IV start kit</td><td></td><td></td><td>tourniquet, tape, tegaderm, IV catheter</td></tr><tr><td>Nasal cannula</td><td></td><td></td><td></td></tr><tr><td>Non-rebreather mask</td><td></td><td></td><td></td></tr><tr><td>Pulse oximeter</td><td></td><td></td><td></td></tr><tr><td>Step stool</td><td></td><td></td><td></td></tr><tr><td>Stethoscope</td><td></td><td></td><td></td></tr></tbody></table>

setup and execution of the blindfolded code training exercise

Miscommunication is the most common cause of preventable patient harm in medicine. Currently, there is limited knowledge of innovative techniques to improve resident physician communication and leadership strategies in high-acuity situations. The blindfolded code training exercise removes visual stimuli from the team leader, forcing the team leader to effectively utilize closed-loop communication. The simple act of blindfolding the team leader creates a learning environment where the leader must utilize a conceptual framework and critical thinking strategies to organize the team and manage the resuscitation. An advantage to this teaching technique is that it does not require any special simulation equipment, making it a low-cost approach. The blindfolded code training exercise can be applied to the management of any critically ill patient where the primary objective is to focus on developing communication skills in acute resuscitations. The purpose of the description of the blindfolded code training exercise is to provide guidance on how to perform this innovative teaching technique to force effective closed-loop communication.

As noted in Ahmed et al., all residents (100%, 27/27) agreed/strongly agreed that knowledge obtained during the blindfolded code training exercise could be transferred to the clinical setting5. In addition, most residents strongly agreed that the blindfolded code training exercise was more challenging (81.5%, 22/27), allowed them to apply critical thinking skills (81.5%, 22/27), and improved use closed-loop communication (88.9%, 24/27) when compared to typical code training exercises (Tabl...

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Setup and Execution Of the Blindfolded Code Training Exercise

The blindfolded code training exercise, which blindfolds the team leader in a code resuscitation simulation, is an advanced teaching technique to improve closed-loop communication, organizational skills, and critical thinking.&#160;

Miscommunication is the most common cause of preventable patient harm in medicine. Currently, there is limited knowledge of innovative techniques to ...

setup-and-execution-of-the-blindfolded-code-training-exercise

Research

Education

JoVE Core

JoVE Journal

Nursing

Medicine

Unit 1

Communication

SCIENTISTS IN ACTION

9.3K Views.  Florida Atlantic University Schmidt College of Medicine. Communicatiefouten zijn de belangrijkste oorzaak van vermijdbare schade van patiënten in alle medicijnen. De geblinddoekte code training techniek is ontworpen om gesloten-loop communicatie te verbeteren en het verbeteren van kritisch denken in situaties met een hoge scherpte. Het belangrijkste voordeel van deze onderwijstechniek is dat het ingezeten artsen efficiënte communicatie en leidingsstrategieën in een hoge-scherptesituatie zonder het vereisen van enige speciale apparatuur leert.

Video: Setup and Execution Of the Blindfolded Code Training Exercise

Cortical Source Analysis of High-Density EEG Recordings in Children

EEG is traditionally described as a neuroimaging technique with high temporal and low spatial resolution. Recent advances in biophysical modelling and signal processing make it possible to exploit information from other imaging modalities like structural MRI that provide high spatial resolution to overcome this constraint1. This is especially useful for investigations that require high resolution in the temporal as well as spatial domain. In addition, due to the easy application and low cost of EEG recordings, EEG is often the method of choice when working with populations, such as young children, that do not tolerate functional MRI scans well. However, in order to investigate which neural substrates are involved, anatomical information from structural MRI is still needed. Most EEG analysis packages work with standard head models that are based on adult anatomy. The accuracy of these models when used for children is limited2, because the composition and spatial configuration of head tissues changes dramatically over development3.&#160;
In the present paper, we provide an overview of our recent work in utilizing head models based on individual structural MRI scans or age specific head models to reconstruct the cortical generators of high density EEG. This article describes how&#160;EEG recordings are acquired, processed, and analyzed with pediatric populations at the London Baby Lab, including laboratory setup, task design, EEG preprocessing, MRI processing, and EEG channel level and source analysis.&#160;

In recent years, there has been increasing interest in estimating the cortical sources of scalp measured electrical activity for cognitive neuroscience experiments. This article describes how high density EEG is acquired and how recordings are processed for cortical source estimation in children from the age of 2 years at the London Baby Lab.

EEG is traditionally described as a neuroimaging technique with high temporal and low spatial resolution. Recent advances in biophysical modelling and ...

Behavior

Combining Multiple Data Acquisition Systems to Study Corticospinal Output and Multi-segment Biomechanics

Transcranial magnetic stimulation techniques allow for an in-depth investigation into the neural mechanisms that underpin human behavior. To date, the use of TMS to study human movement, has been limited by the challenges related to precisely timing the delivery of TMS to features of the unfolding movement and, also, by accurately characterizing kinematics and kinetics. To overcome these technical challenges, TMS delivery and acquisition systems should be integrated with an online motion tracking system. The present manuscript details technical innovations that integrate multiple acquisition systems to facilitate and advance the use of TMS to study human movement. Using commercially available software and hardware systems, a step-by-step approach to both the hardware assembly and the software scripts necessary to perform TMS studies triggered by specific features of a movement is provided. The approach is focused on the study of upper limb, planar, multi-joint reaching movements. However, the same integrative system is amenable to a multitude of sophisticated studies of human motor control.

The use of transcranial magnetic stimulation (TMS) to study human motor control requires the integration of data acquisition systems to control TMS delivery and simultaneously record human behavior. The present manuscript provides a detailed methodology for integrating data acquisition systems for the purpose of investigating human movement via TMS.

Transcranial magnetic stimulation techniques allow for an in-depth investigation into the neural mechanisms that underpin human behavior. To date, the use ...

Frame-by-Frame Video Analysis of Idiosyncratic Reach-to-Grasp Movements in Humans

Prehension, the act of reaching to grasp an object, is central to the human experience. We use it to feed ourselves, groom ourselves, and manipulate objects and tools in our environment. Such behaviors are impaired by many sensorimotor disorders, yet our current understanding of their neural control is far from complete. Current technologies for investigating human reach-to-grasp movements often utilize motion tracking systems that can be expensive, require the attachment of markers or sensors to the hands, impede natural movement and sensory feedback, and provide kinematic output that can be difficult to interpret. While generally effective for studying the stereotypical reach-to-grasp movements of healthy sighted adults, many of these technologies face additional limitations when attempting to study the unpredictable and idiosyncratic reach-to-grasp movements of young infants, unsighted adults, and patients with neurological disorders. Thus, we present a novel, inexpensive, and highly reliable yet flexible protocol for quantifying the temporal and kinematic structure of idiosyncratic reach-to-grasp movements in humans. High speed video cameras capture multiple views of the reach-to-grasp movement. Frame-by-frame video analysis is then used to document the timing and magnitude of pre-defined behavioral events such as movement start, collection, maximum height, peak aperture, first contact, and final grasp. The temporal structure of the movement is reconstructed by documenting the relative frame number of each event while the kinematic structure of the hand is quantified using the ruler or measure function in photo editing software to calibrate 2 dimensional linear distances between two body parts or between a body part and the target. Frame-by-frame video analysis can provide a quantitative and comprehensive description of idiosyncratic reach-to-grasp movements and will enable researchers to expand their area of investigation to include a greater range of naturalistic prehensile behaviors, guided by a wider variety of sensory modalities, in both healthy and clinical populations.

This protocol describes how to use frame-by-frame video analysis to quantify idiosyncratic reach-to-grasp movements in humans. A comparative analysis of reaching in sighted versus unsighted healthy adults is used to demonstrate the technique, but the method can also be applied to the study of developmental and clinical populations.

Prehension, the act of reaching to grasp an object, is central to the human experience. We use it to feed ourselves, groom ourselves, and manipulate ...

Using Eye Movements Recorded in the Visual World Paradigm to Explore the Online Processing of Spoken Language

In a typical eye tracking study using the visual world paradigm, participants' eye movements to objects or pictures in the visual workspace are recorded via an eye tracker as the participant produces or comprehends a spoken language describing the concurrent visual world. This paradigm has high versatility, as it can be used in a wide range of populations, including those who cannot read and/or who cannot overtly give their behavioral responses, such as preliterate children, elderly adults, and patients. More importantly, the paradigm is extremely sensitive to fine grained manipulations of the speech signal, and it can be used to study the online processing of most topics in language comprehension at multiple levels, such as the fine grained acoustic phonetic features, the properties of words, and the linguistic structures. The protocol described in this article illustrates how a typical visual world eye tracking study is conducted, with an example showing how the online processing of some semantically complex statements can be explored with the visual world paradigm.

The visual world paradigm monitors participants' eye movements in the visual workspace as they are listening to or speaking a spoken language. This paradigm can be used to investigate the online processing of a wide range of psycholinguistic questions, including semantically complex statements, such as disjunctive statements.

In a typical eye tracking study using the visual world paradigm, participants' eye movements to objects or pictures in the visual workspace are recorded ...

Development of an Audio-based Virtual Gaming Environment to Assist with Navigation Skills in the Blind

Audio-based Environment Simulator (AbES) is virtual environment software designed to improve real world navigation skills in the blind. Using only audio based cues and set within the context of a video game metaphor, users gather relevant spatial information regarding a building's layout. This allows the user to develop an accurate spatial cognitive map of a large-scale three-dimensional space that can be manipulated for the purposes of a real indoor navigation task. After game play, participants are then assessed on their ability to navigate within the target physical building represented in the game. Preliminary results suggest that early blind users were able to acquire relevant information regarding the spatial layout of a previously unfamiliar building as indexed by their performance on a series of navigation tasks. These tasks included path finding through the virtual and physical building, as well as a series of drop off tasks. We find that the immersive and highly interactive nature of the AbES software appears to greatly engage the blind user to actively explore the virtual environment. Applications of this approach may extend to larger populations of visually impaired individuals.

Audio-based Environment Simulator (AbES) is virtual environment software designed to improve real world navigation skills in the blind.

Audio-based Environment Simulator (AbES) is virtual environment software designed to improve real world navigation skills in the blind. Using only audio ...

A Standardized Obstacle Course for Assessment of Visual Function in Ultra Low Vision and Artificial Vision

We describe an indoor, portable, standardized course that can be used to evaluate obstacle avoidance in persons who have ultralow vision. Six sighted controls and 36 completely blind but otherwise healthy adult male (n=29) and female (n=13) subjects (age range 19-85 years), were enrolled in one of three studies involving testing of the BrainPort sensory substitution device. Subjects were asked to navigate the course prior to, and after, BrainPort training. They completed a total of 837 course runs in two different locations. Means and standard deviations were calculated across control types, courses, lights, and visits. We used a linear mixed effects model to compare different categories in the PPWS (percent preferred walking speed) and error percent data to show that the course iterations were properly designed. The course is relatively inexpensive, simple to administer, and has been shown to be a feasible way to test mobility function. Data analysis demonstrates that for the outcome of percent error as well as for percentage preferred walking speed, that each of the three courses is different, and that within each level, each of the three iterations are equal. This allows for randomization of the courses during administration.
Abbreviations: 
preferred walking speed (PWS) 
course speed (CS) 
percentage preferred walking speed (PPWS)

We describe an indoor, portable, standardized course that can be used to evaluate obstacle avoidance in persons who have ultralow vision. The course is relatively inexpensive, simple to administer, and has been shown to be reliable and reproducible.

We describe an indoor, portable, standardized course that can be used to evaluate obstacle avoidance in persons who have ultralow vision. Six sighted ...

An Open-Source, Fully Customizable 5-Choice Serial Reaction Time Task Toolbox for Automated Behavioral Training of Rodents

The 5-choice serial reaction time task (5-CSRTT) is a behavioral test often used to study visuospatial attention and impulsiveness in rodents. The task requires animals to allocate attention to a horizontal array of five small apertures equipped with light sources and, within a limited time window, nose-poke one illuminated target aperture to get a food reward at the food magazine located in the opposite wall of the chamber. The task considers behavioral control measures such as response accuracy and reaction times and allows to infer selective attention and impulsivity. Task difficulty can be controlled by modifying the stimulus duration and task design in general. Commercially available apparatus usually consists of an experimental chamber and particular software to specify task parameters, but due to fixed hard- and software, they pose many limitations on changes in the general experimental design and specific task requirements and the related data output. This article explains a fully customizable alternative based on an easy-to-use single-board microcontroller and standard electrotechnical components, an open-access Arduino script, and a Matlab-toolbox for hardware control and behavioral task specifications, respectively. The toolbox includes an optional staircase procedure, enabling automated behavioral training. The complete hardware setup, which can be installed in customized chambers, and the freely adaptable software encourage non-standardized task and chamber design. The design of the system and the open-source code for hardware control and experimental setup are described.

The present protocol describes the development of an open-source 5-choice serial reaction time task toolbox for rodent animal models, using Arduino and related hardware and a versatile Matlab toolbox, including an optional script for automated behavioral training. The scripts are customizable and facilitate the implementation of different trial-and-test designs.

The 5-choice serial reaction time task (5-CSRTT) is a behavioral test often used to study visuospatial attention and impulsiveness in rodents. The task ...

Motor Imagery Using VR Digital Avatars in a Brain-Computer Interface System

Motor Imagery Performance Through Embodied Digital Twins in a Virtual Reality-Enabled Brain-Computer Interface Environment

This study introduces an innovative framework for neurological rehabilitation by integrating brain-computer interfaces (BCI) and virtual reality (VR) technologies with the customization of three-dimensional (3D) avatars. Traditional approaches to rehabilitation often fail to fully engage patients, primarily due to their inability to provide a deeply immersive and interactive experience. This research endeavors to fill this gap by utilizing motor imagery (MI) techniques, where participants visualize physical movements without actual execution. This method capitalizes on the brain's neural mechanisms, activating areas involved in movement execution when imagining movements, thereby facilitating the recovery process. The integration of VR's immersive capabilities with the precision of electroencephalography (EEG) to capture and interpret brain activity associated with imagined movements forms the core of this system. Digital Twins in the form of personalized 3D avatars are employed to significantly enhance the sense of immersion within the virtual environment. This heightened sense of embodiment is crucial for effective rehabilitation, aiming to bolster the connection between the patient and their virtual counterpart. By doing so, the system not only aims to improve motor imagery performance but also seeks to provide a more engaging and efficacious rehabilitation experience. Through the real-time application of BCI, the system allows for the direct translation of imagined movements into virtual actions performed by the 3D avatar, offering immediate feedback to the user. This feedback loop is essential for reinforcing the neural pathways involved in motor control and recovery. The ultimate goal of the developed system is to significantly enhance the effectiveness of motor imagery exercises by making them more interactive and responsive to the user's cognitive processes, thereby paving a new path in the field of neurological rehabilitation.

Author Spotlight: Enhancing Neurorehabilitation Through EEG, Motor Imagery, and Virtual Reality

Motor imagery in a virtual reality environment has wide applications in brain-computer interface systems. This manuscript outlines the use of personalized digital avatars that resemble the participants performing movements imagined by the participant in a virtual reality environment to enhance immersion and a sense of body ownership.

This study introduces an innovative framework for neurological rehabilitation by integrating brain-computer interfaces (BCI) and virtual reality (VR) ...

Bioengineering

A Visuospatial Planning Task Coupled with Eye-Tracker and Electroencephalogram Systems

The planning process, characterized by the capability to formulate an organized plan to reach a goal, is essential for human goal-directed behavior. Since planning is compromised in several neuropsychiatric disorders, the implementation of proper clinical and experimental tests to examine planning is critical. Due to the nature of the deployment of planning, in which several cognitive domains participate, the assessment of planning and the design of behavioral paradigms coupled with neuroimaging methods are current challenges in cognitive neuroscience. A planning task was evaluated in combination with an electroencephalogram (EEG) system and eye movement recordings in 27 healthy adult participants. Planning can be separated into two stages: a mental planning stage in which a sequence of steps is internally represented and an execution stage in which motor action is used to achieve a previously planned goal. Our protocol included a planning task and a control task. The planning task involved solving 36 maze trials, each representing a zoo map. The task had four periods: i) planning, where the subjects were instructed to plan a path to visit the locations of four animals according to a set of rules; ii) maintenance, where the subjects had to retain the planned path in their working memory; iii) execution, where the subjects used eye movements to trace the previously planned path as indicated by the eye-tracker system; and iv) response, where the subjects reported the order of the visited animals. The control task had a similar structure, but the cognitive planning component was removed by modifying the task goal. The spatial and temporal patterns of the EEG revealed that planning induces a gradual and lasting rise in frontal-midline theta activity (FM&#952;) over time. The source of this activity was identified within the prefrontal cortex by source analyses. Our results suggested that the experimental paradigm combining EEG and eye-tracker systems was optimal for evaluating cognitive planning.

The study of cognitive planning combining EEG and eye-tracking systems provides a multimodal approach to investigate the neural mechanisms that mediate cognitive control and goal-directed behavior in humans. Here, we describe a protocol for investigating the role of brain oscillations and eye movements in planning performance.

The planning process, characterized by the capability to formulate an organized plan to reach a goal, is essential for human goal-directed behavior. Since ...

Neuroscience

A Setup for Human Vision, Cognition, and Interaction in Real-Life Scenarios

A Naturalistic Setup for Presenting Real People and Live Actions in Experimental Psychology and Cognitive Neuroscience Studies

Perception of others&#39; actions is crucial for survival, interaction, and communication. Despite decades of cognitive neuroscience research dedicated to understanding the perception of actions, we are still far away from developing a neurally inspired computer vision system that approaches human action perception. A major challenge is that actions in the real world consist of temporally unfolding events in space that happen &#34;here and now&#34; and are actable. In contrast, visual perception and cognitive neuroscience research to date have largely studied action perception through 2D displays (e.g., images or videos) that lack the presence of actors in space and time, hence these displays are limited in affording actability. Despite the growing body of knowledge in the field, these challenges must be overcome for a better understanding of the fundamental mechanisms of the perception of others&#39; actions in the real world. The aim of this study is to introduce a novel setup to conduct naturalistic laboratory experiments with live actors in scenarios that approximate real-world settings. The core element of the setup used in this study is a transparent organic light-emitting diode (OLED) screen through which participants can watch the live actions of a physically present actor while the timing of their presentation is precisely controlled. In this work, this setup was tested in a behavioral experiment. We believe that the setup will help researchers reveal fundamental and previously inaccessible cognitive and neural mechanisms of action perception and will be a foundation for future studies investigating social perception and cognition in naturalistic settings.

Author Spotlight: A Novel Setup to Conduct Naturalistic Laboratory Experiments with Real Human Actors in Scenarios 

This study presents a naturalistic experimental setup that allows researchers to present real-time action stimuli, obtain response time and mouse tracking data while participants respond after each stimulus display, and change actors between experimental conditions with a unique system including a special transparent organic light-emitting diode (OLED) screen and light manipulation.

Perception of others&#39; actions is crucial for survival, interaction, and communication. Despite decades of cognitive neuroscience research dedicated to ...

Setup and Execution Of the Blindfolded Code Training Exercise

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