Aidan Moran and John Toner
We are constantly bombarded by information. Therefore, during every waking moment of our lives, we face decisions about which stimuli to prioritize and which ones to ignore. To complicate matters, the information that clamors for our attention includes not only events that occur in the world around us but also experiences that originate in the subjective domain of our own thoughts and feelings. The end result is that our minds can consciously attend to only a fraction of the rich kaleidoscope of information and experiences available to us from our senses, thoughts, memories, and imagination. Attentional processes such as “concentration,” or the ability to focus on the task at hand while ignoring distractions, are crucial for success in sport and other domains of skilled performance. To illustrate, Venus Williams, one of the greatest tennis players of all time, proclaimed that “for the players it is complete and pure focus. You don’t see anything or hear anything except the ball and what’s going on in your head.” For psychological scientists, concentration resembles a mental spotlight (like the head-mounted torch that miners and divers wear in dark environments) that illuminates targets located either in the external world around us or in the internal world of our subjective experiences. A major advantage of this spotlight metaphor is that it shows us that concentration is never “lost”—although it can be diverted to targets (whether in the external world or inside our heads) that are irrelevant to the task at hand. Research on attentional processes in sport and performance has been conducted in cognitive psychology (the study of how the mind works), cognitive sport psychology (the study of mental processes in athletes), and cognitive neuroscience (the study of how brain systems give rise to mental processes). From this research, advances have been made both in measuring attentional processes and in understanding their significance in sport and performance settings. For example, pupillometry, or the study of changes in pupil diameter as a function of cognitive processing, has been used as an objective index of attentional effort among skilled performers such as musicians and equestrian athletes. Next, research suggests that a heightened state of concentration (i.e., total absorption in the task at hand) is crucial to the genesis of “flow” states (i.e., rare and elusive moments when everything seems to come together for the performer) and optimal performance in athletes. More recently, studies have shown that brief mindfulness intervention programs, where people are trained to attend non-judgmentally to their own thoughts, feelings, and sensations, offer promise in the quest to enhance attentional skills in elite athletes. By contrast, anxiety has been shown to divert skilled performers’ attention to task-irrelevant information—sometimes triggering “choking” behavior or the sudden and significant deterioration of skilled performance. Finally, concentration strategies such as “trigger words” (i.e., the use of short, vivid, and positively phrased verbal reminders such as “this ball now”) are known to improve athletes’ ability to focus on a specific target or to execute skilled actions successfully.
Jennifer L. Etnier
There is substantial interest in identifying the behavioral means by which to improve cognitive performance. Recent research and commercial ventures have focused on cognitive training interventions, but evidence suggests that the effects of these programs are small and task-specific. Researchers have also shown interest in exploring the potential benefits of physical activity for cognitive performance. Because the effects of physical activity have been found to be small to moderate and to be more global in nature, interest in physical activity has been growing over the past several decades. Evidence regarding the efficacy of physical activity is provided through cross-sectional studies, longitudinal prospective studies, and randomized controlled trials. When reviewed meta-analytically, small-to-moderate beneficial effects are reported for children, adults, older adults, and cognitively impaired older adults, and these effects are evident for a wide range of cognitive domains, including executive function, memory, and information processing. Researchers are currently focused on identifying the mechanisms of these effects. Most of this research has been conducted using animal models, but there is a growing body of literature with humans. From this evidence, there is support for the role of changes in cerebral structure, hippocampal perfusion, and growth factors in explaining the observed benefits. Thus far, however, the literature is quite sparse, and future research is needed to clarify our understanding of the mechanisms that provide the causal link between physical activity and cognitive performance. Research is also focused on understanding how to increase the benefits by potentially combining cognitive training with physical activity and by identifying the genetic moderators of the effects. These lines of work are designed to elucidate ways of increasing the magnitude of the benefits that can be obtained. At this point in time, the evidence with respect to the potential of physical activity for benefiting cognitive performance is quite promising, but it is critical that funding agencies commit their support to the continued exploration necessary to allow us to ultimately be able to prescribe physical activity to specific individuals with the express purpose of improving cognition.
Joan N. Vickers and A. Mark Williams
Considerable debate has arisen about whether brain activity in elite athletes is characterized by an overall quieting, or neural efficiency in brain processes, or whether elite performance is characterized by activation of two simultaneous networks. One network exercises cognitive control using increased theta activation of premotor and cingulate gyrus, whereas the second reduces alpha activation in an inhibitory network that prevents the intrusion of debilitating thoughts emanating from the temporal lobe and other areas. Also, there is controversy about how a long-duration “quiet eye” (QE) can fit within a single efficient neural system, or whether a dual system where both increased cognitive control and reduced inhibitory processes has advantages. The literature on neural efficiency, the QE, and theta cognitive control, suggest that a long-duration QE promotes both an increase in theta band activation of the medial prefrontal cortex and anterior cingulate and reduced activation and inhibition of the temporal regions during high-pressure situations when a high level of focused, cognitive control is essential.
Aidan Moran, Nick Sevdalis, and Lauren Wallace
At first glance, there are certain similarities between performance in surgery and that in competitive sports. Clearly, both require exceptional gross and fine motor ability and effective concentration skills, and both are routinely performed in dynamic environments, often under time constraints. On closer inspection, however, crucial differences emerge between these skilled domains. For example, surgery does not involve directly antagonistic opponents competing for victory. Nevertheless, analogies between surgery and sport have contributed to an upsurge of research interest in the psychological processes that underlie expertise in surgical performance. Of these processes, perhaps the most frequently investigated in recent years is that of motor imagery (MI) or the cognitive simulation skill that enables us to rehearse actions in our imagination without engaging in the physical movements involved. Research on motor imagery training (MIT; also called motor imagery practice, MIP) has important theoretical and practical implications. Specifically, at a theoretical level, hundreds of experimental studies in psychology have demonstrated the efficacy of MIT/MIP in improving skill learning and skilled performance in a variety of fields such as sport and music. The most widely accepted explanation of these effects comes from “simulation theory,” which postulates that executed and imagined actions share some common neural circuits and cognitive mechanisms. Put simply, imagining a skill activates some of the brain areas and neural circuits that are involved in its actual execution. Accordingly, systematic engagement in MI appears to “prime” the brain for optimal skilled performance. At the practical level, as surgical instruction has moved largely from an apprenticeship model (the so-called see one, do one, teach one approach) to one based on simulation technology and practice (e.g., the use of virtual reality equipment), there has been a corresponding growth of interest in the potential of cognitive training techniques (e.g., MIT/MIP) to improve and augment surgical skills and performance. Although these cognitive training techniques suffer both from certain conceptual confusion (e.g., with regard to the clarity of key terms) and inadequate empirical validation, they offer considerable promise in the quest for a cost-effective supplementary training tool in surgical education. Against this background, it is important for researchers and practitioners alike to explore the cognitive psychological factors (such as motor imagery) that underlie surgical skill learning and performance.