Self-reported strategy generation and implementation in the multiple errands test: A qualitative description

The Multiple Errands Test (MET) is a naturalistic assessment of executive function. Strategy use during the MET can provide useful information for the development of a cognitive profile and intervention plan in patients with brain injury. However, while observed external strategy use in the MET is well-documented, information about internal strategy use and reference data with healthy controls is limited. Contextual influences on strategy selection in this real-world assessment are also not well understood. This qualitative descriptive study explored the internal and external strategies used during MET performance by cognitively intact adults. Strategies were categorized as planning, checking, and problem solving. When planning, participants simplified and familiarized themselves with MET requirements before developing an action plan. They checked their performance by asking for help and using cues in the physical environment. When problems arose, these were solved through self-talk, comparing alternatives, applying context and modifying their plan. Results highlighted that individuals employ both visible and hidden strategies during the MET. This suggests that reflective discussions with patients following cognitive task engagement may be important, to uncover and understand strategy use, both to inform analysis of performance and guide strategy training.