Improving smartphone use after brain injury

Systematic Instruction Under this approach, participants will be taught to use an app (Cozi Family Organiser) using a training method that aims to prevent and minimise error commission during learning. Procedure: All participants will have an initial session where baseline measures (smartphone ability, neuropsychological measures and self-report questionnaires) will be administered. Following this, participants will be randomly allocated to one of the groups. Training will take place in the second session. The functionalities of the app and their real-life applications will be explained at the beginning of each of four scenarios. Then the trainer will model step by step the correct performance of the task in his/her own smartphone, while the participant follows and repeats the steps in his/her own smartphone. Trainers then provide direct instructions with different levels of prompting (which include full verbal explanation + modelling, verbal explanation + pointing, confirmation of a correct query, and no environmental support), according to the participant's progress. Under this method, errors are prevented as much as possible and if they occur the participant is stopped, and immediate corrective feedback is given. Each task is repeated until 95% of the steps are completed without cuing. Only then, the next scenario will be introduced. A total of four scenarios will be presented and the skills that will be taught include: creating, modifying and sharing a shopping list, creating and modifying an event in the calendar and making use of the smartphone while on a phone call. At the end of the training session there will be a post-training test in which the participant will be asked to independently complete tasks, similar to the ones practiced before. There will also be one- and six-week follow-up sessions in which a similar test will be conducted and where other follow-up measures will be taken. Error-based Learning Under this approach, participants will be taught to use an app (Cozi Family Organiser) using a training method that teaches self-regulatory skills, allowing participants to stop, check and modify their actions. Procedure: All participants will have an initial session where baseline measures (smartphone ability, neuropsychological measures and self-report questionnaires) will be administered. Following this, participants will be randomly allocated to one of the groups. Training will take place in the second session. Participants will be encouraged to provide real-life examples where the functionalities of the app would be useful. Then the participant will read the instructions for each task step-by-step, while the trainer provides a correct demonstration. Following this, the trainer allows participants to independently attempt the tasks, to commit errors and to notice and self-correct them. They will only intervene if errors are not immediately self-corrected, in which case participants are stopped and provided with non-specific or/and specific prompts (See next paragraph). Trainer will prompt participants to make self-predictions of performance, to generate strategies for potential difficulties and will encourage a high level of reflection and self-regulation following a Stop, Check and Correct approach. Each task is repeated until 95% of the steps are completed without errors. Only then, the next scenario will be introduced. A total of four scenarios will be presented and the skills that will be taught include: creating, modifying and sharing a shopping list, creating and modifying an event in the calendar and making use of the smartphone while on a phone call. At the end of the training session there will be a post-training test in which the participant will be asked to independently complete tasks, similar to the ones practiced before. There will also be one- and six-weeks follow-up sessions in which a similar test will be conducted and where other follow-up measures will be taken. The prompts that the trainer provides in the Error-based learning condition are guided by the following: 1. If an error is self-corrected the trainer reinforces the participant by emphasising the correct action (Well spotted, you noticed that you had to click “save” before trying to enter the time of the event) 2. If there is no self-correction, trainer immediately provides a non-specific prompt (i.e. can I get you to stop for a moment and check where you are up to in the instructions? [tap sheet]). 2.1 If error is self-corrected, give specific praise (Well done, you need to save that information first before doing that next step) and continue. 2.2 If error is still not self-corrected, a specific prompt is provided (You need to click on “save” on the top right of your screen before trying to enter the time of the event, otherwise the date of the event will disappear) 3. If the person asks a question or seeks reassurance, the trainer smiles encouragingly and gets them to check the instructions (e.g. "check the steps and see what you think - does it seem right to you?") - then provide praise or correction as needed. Materials: All participants will use their own smartphone and will be provided with written scenarios and tasks where they can apply different functionalities of the app. Step-by-step written instructions indicating how to complete each of the trained tasks will also be provided. All three groups will be trained with the same four scenarios. The following is an example of one of the training scenarios: . . You have a doctor’s appointment on the _(Date)__ This is the relevant information of that appointment: 1. The appointment is at the Medical Centre 2. You are going alone to the appointment 3. The appointment is from 10:30 to 11:00 am 4. You have follow-up appointments every Friday and this ends on the _(date)_ 5. You want to set a reminder, 3 hours earlier so you can get ready 6. Every time you go, you need to remember to bring your Medicare card, so you want to make a note about this You close the app after you have finished . . . Trainers: The training sessions will be provided by provisionally registered psychologists who are completing their doctoral programme and who will be trained on how to deliver each training technique. The post-training test and follow-up sessions will be conducted by blinded assessors who could either be provisionally registered psychologists or research assistants (bachelor’s in psychology honours students). Both trainers and blinded assessors will be constantly supervised by one of the following endorsed neuropsychologists: Dr Rene Stolwyk (Senior lecturer and research supervisor within the School of Psychological Sciences at Monash University, since 2009. He has published over 45 journal articles in the field of neuropsychological rehabilitation), Dr Dana Wong (Senior lecturer of the School of Psychology & Public Health at La Trobe University, who has extensive experience in a variety of clinical settings since 2002) or Dr Adam McKay (Senior Clinical Neuropsychologist at Epworth Healthcare and Senior lecturer and research supervisor within the School of Psychological Sciences at Monash University). Mode of delivery: Both training techniques will be delivered face to face and individually. Time commitment: Four sessions of approximately two hours each. First session is to take baseline measures and to verify technical requirements of the participant’s smartphone. Second session (approximately one or two weeks after the first one) is when the training is provided. The last two sessions are one- and six- weeks follow-ups. Location: Sessions can be completed at the Monash Psychology Centre in Notting Hill, at the La Trobe Psychology Clinic in Bundoora, or at the participant’s home.