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Does the think-aloud protocol reflect thinking? Exploring functional neuroimaging differences with thinking
Steven J Durning1, Anthony R Artino, Thomas J Beckman
1Uniformed Services University of the Health Sciences, USA. steven.durning@usuhs.edu
Medical Teacher
|June 29, 2013
Summary
Functional magnetic resonance imaging (fMRI) revealed distinct brain activity patterns between thinking and thinking aloud. These neuroimaging differences support the think-aloud protocol as a valid measure of cognitive processes.
Area of Science:
- Cognitive Neuroscience
- Neuroimaging
- Medical Education
Background:
- The validity of the think-aloud protocol as a measure of thinking is debated.
- Functional magnetic resonance imaging (fMRI) can investigate neuroanatomic differences in cognitive tasks.
Purpose of the Study:
- To investigate neuroanatomic differences between real-time thinking and thinking aloud using fMRI.
- To assess the validity of the think-aloud protocol by comparing brain activity during two distinct cognitive states.
Main Methods:
- Board-certified internal medicine physicians underwent think-aloud training.
- Participants answered multiple-choice questions in an fMRI scanner during two conditions: real-time answering (thinking) and thinking aloud (post-answering review).
- fMRI data were compared between the thinking and thinking aloud conditions.
Main Results:
- Statistically significant differences in brain activation were observed between thinking and thinking aloud (p < 0.01).
- Key regions exhibiting differences included the motor cortex, bilateral prefrontal cortex, bilateral cerebellum, and basal ganglia.
- Activation patterns were more focal during thinking aloud compared to real-time answering.
Conclusions:
- Significant neuroimaging differences exist between thinking and thinking aloud, particularly in motor cortex, prefrontal cortex, cerebellum, and basal ganglia.
- Prefrontal cortex and cerebellum activation relate to working memory, while basal ganglia activation is linked to the reward of answering questions.
- The observed neuroimaging findings align with existing theories and support the think-aloud protocol as a valid measure of thinking.
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