Specialist\nexplainer only. No maximal self-testing.
" }, "next_gate": "External confirmation is required before higher-authority use because: SUPERVISION_OR_NON_ATTEMPT_BOUNDARY.", "evidence_count": 7 }, "full_training_programme": false, "independently_validated": false, "publication_state": "PUBLISHED_PUBLIC_RESEARCH_EDITION__EDITORIAL_REVIEW_PENDING", "related_power_ids": [ "PWR-002", "PWR-003", "PWR-004", "PWR-005" ] }, { "power_id": "PWR-002", "learning_unit_id": "TLU-PWR-002", "title": "Relative strength", "main_description": "Relative strength is not a new strength test. It is a way to place an already-known absolute result beside a declared size adjustment. This pack uses fictional values, keeps the original force visible, and shows why a ratio can change even when force does not.", "main_description_source": "GOVERNED_TUTORIAL_PLAIN_ENGLISH_INTRO", "family_id": "FAM-01", "family": "Strength & Force Production", "superdomain": "Body & Performance", "canonical_route": "/powers/pwr-002/", "treatment": "RESEARCH_EXPLORATION_ROUTE", "treatment_label": "Full research tutorial", "treatment_boundary": "Titan teaches a complete Power-specific research method because operational capability practice is not currently justified.", "tutorial_route": "/tutorials/pwr-002/", "governed_lesson_route": "/tutorials/pwr-002/", "self_attempt_status": "NO_TRAINING_AUTHORITY", "gold_pathway_ids": [ "G-CUR-001" ], "route_membership": { "kind": "GOLD_PATHWAY", "id": "G-CUR-001", "coverage_status": "EXACT_ONCE" }, "source_authority_tier": "G2", "source_build_state": "RESEARCH_ONLY", "source_instructional_route": "EXPLAINER_ONLY_RESEARCH", "source_count": 3, "research_depth": "FOCUSED", "risk_level": "LOW_TO_MODERATE", "prerequisite_status": "NONE_FOR_READING__NO_PRACTICE_AUTHORITY", "learning_route": { "mode": "RESEARCH_EXPLORATION", "label": "Explore the research frontier", "summary": "Relative strength is not a new strength test. It is a way to place an already-known absolute result beside a declared size adjustment. This pack uses fictional values, keeps the original force visible, and shows why a ratio can change even when force does not.", "steps": [ [ "Frame the question", "State the capability claim narrowly enough that evidence could support or limit it." ], [ "Map the evidence", "Distinguish existence, measurement, trainability, retention, transfer, safety and functional value." ], [ "Find uncertainty", "Identify small samples, proxy measures, missing controls, null findings and unresolved authority questions." ], [ "Compare alternatives", "Consider competing explanations and what evidence would change the current treatment." ], [ "Stay non-operational", "Use the record for research literacy only until a separate gate authorises instruction." ] ], "practical_authority": false, "provider_required": false, "next_action_route": "/tutorials/pwr-002/" }, "path_builder": { "selectable": true, "completion_allowed": true, "warning": "Titan teaches a complete Power-specific research method because operational capability practice is not currently justified." }, "full_tutorial": { "version": "1.0", "authorship": "AUTHORED_GOVERNED_SOURCE", "practice_pack": { "power_id": "PWR-002", "title": "Relative strength", "heading": "Calculate and interpret one declared relative-strength ratio", "plain_english_intro": "Relative strength is not a new strength test. It is a way to place an already-known absolute result beside a declared size adjustment. This pack uses fictional values, keeps the original force visible, and shows why a ratio can change even when force does not.", "authority_and_safety": [ "Governance ceiling: explanation and static fictional record analysis only. Capability self-practice, live administration, protocol delivery and efficacy claims are not authorised until the recorded next_gate adjudication changes.", "Use only the supplied fictional force and body-mass values. Do not lift, squeeze, diet, alter body mass or generate a new personal result.", "The ratio is a teaching calculation for one declared setup; it is not a strength, health, readiness, worth or treatment score." ], "materials": [ "The four-case fixture in this record", "Paper or a blank calculation area", "A calculator, optional", "The answer key, kept hidden until each calculation is complete" ], "setup_steps": [ "Write the formula: simple ratio = force in newtons divided by body mass in kilograms.", "For each case, write the original force first. Do not replace it with the ratio.", "Copy the task, equipment, posture and support before comparing two cases.", "Divide force by body mass and write the answer to two decimal places with the unit N/kg.", "Ask what changed: force, body mass, support, or more than one field.", "Finish with one conclusion limited to this task. Then write two things the ratio does not tell you." ], "fixture": { "caption": "Calculate the simple ratio for each fictional case, then decide which cases can be compared fairly.", "headers": [ "Case", "Task", "Equipment and posture", "Support", "Absolute force (N)", "Body mass (kg)" ], "rows": [ [ "A", "Isometric handle pull", "Rig R1, seated", "Back support only", "600", "75" ], [ "B", "Isometric handle pull", "Rig R1, seated", "Back support only", "600", "60" ], [ "C", "Isometric handle pull", "Rig R1, seated", "Back support only", "660", "75" ], [ "D", "Isometric handle pull", "Rig R2, semi-reclined", "Back and arm support", "600", "75" ] ] }, "scoring_rule": "For each case, award 1 point for showing the original force, 1 for the correct two-decimal ratio, 1 for the N/kg unit and 1 for a conclusion that respects the setup: 16 points total. Correct arithmetic without the original force or setup is incomplete. The score checks the worksheet, not the person.", "worked_example": { "steps": [ "Write the unchanged absolute result: A = 600 N and B = 600 N.", "Write the declared formula: force divided by body mass.", "Calculate A: 600 / 75 = 8.00 N/kg.", "Calculate B: 600 / 60 = 10.00 N/kg.", "Calculate the relative ratio change: (10.00 - 8.00) / 8.00 = 0.25, or 25%.", "Run the denominator check: force stayed at 600 N; only body mass changed from 75 kg to 60 kg." ], "result": "Bounded conclusion: In this fictional seated handle-pull and simple-ratio model, B has the larger N/kg ratio, but A and B have identical absolute force. The ratio does not establish greater universal strength, health, character, safety, or transfer." }, "right_vs_wrong": [ { "situation": "Reporting Case B", "right": "600 N and 10.00 N/kg under the declared simple-ratio model.", "wrong": "B's strength is 10.", "why": "The wrong version drops the absolute result, unit, task, and model." }, { "situation": "Comparing A and B", "right": "Same absolute force; different ratios because the denominators differ.", "wrong": "B produced more force.", "why": "Both cases produced 600 N." }, { "situation": "Comparing A and C", "right": "C is 60 N and 0.80 N/kg higher in the same fictional configuration.", "wrong": "C is universally 10% stronger.", "why": "The result belongs only to the declared task and model." }, { "situation": "Comparing A and D", "right": "Do not make a performance ranking because rig, posture, and support differ.", "wrong": "They are identical performers because both ratios equal 8.00.", "why": "Equal numbers from different configurations are not interchangeable evidence." } ], "common_mistakes": [ { "mistake": "Dividing before writing the original force.", "fix": "Put the force and unit in the first column, then calculate in a separate column." }, { "mistake": "Writing a bare decimal with no formula or unit.", "fix": "Show numerator, denominator, division, rounded value, and N/kg." }, { "mistake": "Treating a lower denominator as increased force.", "fix": "Hold force constant and rerun the denominator check, as in A versus B." }, { "mistake": "Ranking cases with different apparatus or support.", "fix": "Mark them as different configurations and report each result separately." } ], "answer_key_route": "/tutorials/pwr-002/answer-key/", "answer_key_delivery": "SEPARATE_NOINDEX_NOARCHIVE_CHECKING_PAGE" }, "tutorial_mode": "RESEARCH_EXPLORATION", "orientation": { "bounded_definition": "Capability to develop or express relative strength in a declared context without inheriting broader claims.", "evidence_summary": "Relative strength is a calculation that relates declared force performance to a declared body-size measure. Titan reports the absolute result and formula rather than treating the ratio as a universal human ranking.", "measurement_boundary": "Report absolute force and the exact ratio or allometric model together; do not turn a sample-specific normalisation into a universal ranking or health score.", "myth_to_metric": { "myth": "Pound-for-pound supremacy", "metric": "Absolute task force plus a predeclared, population-appropriate size-adjusted index", "boundary": "The metric is valid only for its declared task and cannot establish universal ability, character, diagnosis, safety or far transfer." }, "limiting_findings": [ "Simple force divided by body mass is not universally size-independent.", "A ratio can improve without increased absolute force and can obscure assistance or body-composition context." ], "prohibited_claims": [ "Titan proves anyone can develop unlimited or superhuman relative strength.", "One test score reveals whole-person capability, health, discipline, potential or worth.", "Improvement guarantees injury prevention, clinical benefit, occupational readiness or transfer to every real-world task." ] }, "outcomes": [ "Define relative strength without inheriting mythology or broader claims.", "Explain what the current evidence supports and what it does not establish.", "Use the declared measurement boundary and recognise misleading proxies.", "Complete the current learning route without converting it into unauthorised capability practice.", "Make a retention, transfer, maintenance, provider or stop decision without overclaiming." ], "prerequisites": "NONE_FOR_READING__NO_PRACTICE_AUTHORITY", "baseline": { "instruction": "Before reading the sequence, record your current definition, confidence, assumed measure, expected value, known risks and intended next action. Do not attempt the capability.", "record": [ "date and context", "current definition", "confidence from 0 to 100", "assumed measure", "expected benefit", "known limitation", "intended next action" ] }, "modules": [ { "order": 1, "title": "Frame the question", "instruction": "State the capability claim narrowly enough that evidence could support or limit it.", "completion_evidence": "Record the decision or output from frame the question in one or two sentences." }, { "order": 2, "title": "Map the evidence", "instruction": "Distinguish existence, measurement, trainability, retention, transfer, safety and functional value.", "completion_evidence": "Record the decision or output from map the evidence in one or two sentences." }, { "order": 3, "title": "Find uncertainty", "instruction": "Identify small samples, proxy measures, missing controls, null findings and unresolved authority questions.", "completion_evidence": "Record the decision or output from find uncertainty in one or two sentences." }, { "order": 4, "title": "Compare alternatives", "instruction": "Consider competing explanations and what evidence would change the current treatment.", "completion_evidence": "Record the decision or output from compare alternatives in one or two sentences." }, { "order": 5, "title": "Stay non-operational", "instruction": "Use the record for research literacy only until a separate gate authorises instruction.", "completion_evidence": "Record the decision or output from stay non-operational in one or two sentences." } ], "lab": { "title": "Claim-audit lab", "instruction": "Choose one public claim about this Power. Compare it with the bounded definition, measurement limit, supporting evidence, limiting findings and prohibited wording.", "deliverable": "A one-page claim verdict: supported, partly supported, unresolved or contradicted, with the reason stated." }, "assessment": { "immediate": "Restate the bounded definition, evidence ceiling, measurement boundary and current authority route without looking.", "delayed_retention": "Repeat the explanation and route decision after at least 48 hours; record what changed or was forgotten.", "transfer": "Evaluate a new claim, provider option or research result using the same evidence and authority checklist; do not perform the capability.", "interpretation": "Completion demonstrates learning of this tutorial only. It does not prove capability, qualification, independent validation, safety clearance or far transfer." }, "maintenance": { "cadence": "Review after 48 hours, again after 2-4 weeks, and whenever the evidence or authority treatment changes.", "decisions": [ "retain", "refresh", "seek qualified support", "return to research", "retire" ] }, "accessibility": "Use text-to-speech, enlarged text, keyboard navigation, shorter sessions, a support person or an equivalent non-practical record format as needed. Accessibility changes must not enlarge practical authority.", "stopping_and_escalation": "Titan teaches a complete Power-specific research method because operational capability practice is not currently justified. Stop if the declared configuration cannot be maintained, uncertainty becomes material, adverse effects appear, or qualified authority is required.", "next_gate": "No external confirmation is required for the current bounded explainer permission. Guide permission remains NOT_READY; any guide, stronger efficacy, generalisation, protocol, promotion or independent-validation claim requires a new adjudication.", "evidence_count": 3 }, "full_training_programme": false, "independently_validated": false, "publication_state": "PUBLISHED_PUBLIC_RESEARCH_EDITION__EDITORIAL_REVIEW_PENDING", "related_power_ids": [ "PWR-001", "PWR-003", "PWR-004", "PWR-005" ] }, { "power_id": "PWR-003", "learning_unit_id": "TLU-PWR-003", "title": "Isometric strength", "main_description": "Across three supervised submaximal plateaus, the learner enters a provider-set force ribbon without an overshoot, keeps at least the declared dwell time with the knee visibly still, and distinguishes force level from steadiness.", "main_description_source": "FULL_TUTORIAL_OUTCOME", "family_id": "FAM-01", "family": "Strength & Force Production", "superdomain": "Body & Performance", "canonical_route": "/powers/pwr-003/", "treatment": "SPECIALIST_PROVIDER_ROUTE", "treatment_label": "Full supervised tutorial", "treatment_boundary": "Titan teaches the complete method; a qualified person controls the parts that require supervision, clearance, specialist equipment, load, dose or progression.", "tutorial_route": "/tutorials/pwr-003/", "governed_lesson_route": null, "self_attempt_status": "PROHIBITED_WITHOUT_QUALIFIED_SUPERVISION", "gold_pathway_ids": [ "G-CUR-001" ], "route_membership": { "kind": "GOLD_PATHWAY", "id": "G-CUR-001", "coverage_status": "EXACT_ONCE" }, "source_authority_tier": "G4", "source_build_state": "EXTERNAL_PROVIDER_ROUTE", "source_instructional_route": "LEARN_ELSEWHERE_TRACK_WITH_TITAN", "source_count": 2, "research_depth": "FOCUSED", "risk_level": "MODERATE", "prerequisite_status": "QUALIFIED_PROVIDER_DETERMINES", "learning_route": { "mode": "FULL_SUPERVISED_TUTORIAL", "label": "Learn isometric strength step by step", "summary": "Across three supervised submaximal plateaus, the learner enters a provider-set force ribbon without an overshoot, keeps at least the declared dwell time with the knee visibly still, and distinguishes force level from steadiness.", "steps": [ [ "Get ready", "Confirm the movement, side, exact joint angle and whether the goal is peak force or steadiness." ], [ "Learn the method", "11 concrete steps teach the permitted method from start to finish." ], [ "See right and wrong", "8 comparisons show correct or safer execution beside common wrong or riskier choices." ], [ "Practise", "On a later provider-scheduled visit, reproduce the seat code, lever length, 60-degree geometry, ribbon width, screen smoothing and eight-second window. Practise cleaner acquisition before any target increase. The provider may alter one variable—ribbon location, ribbon width or duration—but never all three at once, so the source of change remains interpretable." ], [ "Check progress", "Preserve the same seat code, lever arm, angle, sampling and display-smoothing settings. Score only the fixed window after ribbon entry; retain the unsmoothed trace, geometry decision and any excluded attempt. Retain the trace-shape label because acquisition, drift and pulsing can differ despite similar dwell percentages. Preserve a ribbon-dose matrix that separates width, plateau duration and feedback mode." ] ], "practical_authority": false, "provider_required": true, "next_action_route": "/tutorials/pwr-003/" }, "path_builder": { "selectable": true, "completion_allowed": true, "warning": "Titan teaches the complete method; a qualified person controls the parts that require supervision, clearance, specialist equipment, load, dose or progression." }, "full_tutorial": { "version": "3.0", "authorship": "POWER_SPECIFIC_FULL_TUTORIAL", "tutorial_mode": "SUPERVISED", "promise": "Learn to hold a steady, submaximal knee-extension force inside a target band for eight seconds. A qualified provider sets posture, joint angle, target, rest and eligibility. You learn to enter the band smoothly, keep the knee still, breathe, make small corrections, leave on the tone, and recognise overshoot, drift and pulsing. This is force-control practice, not a maximum-strength test.", "power_id": "PWR-003", "title": "Isometric strength", "lesson_type": "SUPERVISED", "headline": "Make a stable, angle-specific isometric hold under provider control", "plain_english_summary": "Learn to hold a steady, submaximal knee-extension force inside a target band for eight seconds. A qualified provider sets posture, joint angle, target, rest and eligibility. You learn to enter the band smoothly, keep the knee still, breathe, make small corrections, leave on the tone, and recognise overshoot, drift and pulsing. This is force-control practice, not a maximum-strength test.", "outcome": "Across three supervised submaximal plateaus, the learner enters a provider-set force ribbon without an overshoot, keeps at least the declared dwell time with the knee visibly still, and distinguishes force level from steadiness.", "authority": { "learner_may": [ "Isometric strength: Let the provider align the joint and lever, then place the trunk, hands and other limb in the recorded position. Relax completely until the display returns to its baseline. Do not lean into the pad while waiting.", "During an authorised attempt, Keep the joint and body still, look at the target display if authorised and breathe normally while making very small pressure corrections. Relax the tested limb, report symptoms and wait for the entire provider-timed rest before the next hold.", "Before each hold, match the device, joint angle and target band to the setup sheet; record force magnitude and force steadiness in separate fields." ], "qualified_person_required_for": [ "Assess whether the selected joint can be held safely at the declared angle and whether pain, breath-holding or compensatory movement makes the isometric task inappropriate.", "Set the joint angle, lever arm, target force, duration, rest and validity tolerance.", "Watch the learner's contact with the pad from zero force onward. Remove pre-cue leaning, keep the target unchanged across trials and accept a hold only when the joint and body remain still." ], "never_do": [ "Self-prescribe prolonged or maximal holds from this page.", "Do not raise the target, lengthen the hold or add repetitions outside the provider-written isometric plan.", "End the hold if the target is reached only with overshoot, breath-holding, visible joint movement or whole-body bracing." ] }, "materials": [ "Calibrated force or torque device with a live target display", "Stable supports and provider-approved restraints", "Metronome or spoken ramp-hold-release cues", "An isometric record showing device, side, joint angle, lever setting, force target, hold time, release time, validity flags and separate steadiness values." ], "before_you_start": [ "Confirm the movement, side, exact joint angle and whether the goal is peak force or steadiness.", "Tell the provider about pain, cardiovascular concerns, recent surgery and reactions to straining.", "Set the dynamometer and limb to the written angle, then let the learner find the pad without pushing. Begin only when the device, joint angle and zero-force start match the setup sheet.", "Rehearse finding zero force and ramping smoothly into the visible band at submaximal effort before any recorded hold." ], "steps": [ { "title": "Lock the geometry and clear the trace", "instruction": "Settle into the recorded seat and lever settings while the provider confirms the knee angle. Let every muscle soften until the live line rests on the stored zero; do not preload the pad.", "reason": "A hidden preload shifts every later ribbon calculation and makes the acquisition time false.", "success_check": "The baseline stays within the device's zero tolerance for three quiet seconds." }, { "title": "Read the whole target ribbon", "instruction": "Before pressing, point to the lower boundary, centre line and upper boundary. Repeat the hold duration and the provider's rule for when scoring begins.", "reason": "Knowing only the centre encourages large corrections; the ribbon defines an acceptable plateau.", "success_check": "The learner names both boundaries, the centre value and the scoring window without looking away from the setup." }, { "title": "Use a three-beat entry", "instruction": "At the start tone, raise pressure in three smooth beats: leave zero, approach the lower boundary, then settle near centre. Never punch through the upper edge and drop back.", "reason": "A staged ascent separates controlled recruitment from a ballistic spike.", "success_check": "The line crosses the lower boundary once and reaches the ribbon without an upper-edge overshoot." }, { "title": "Settle before correcting", "instruction": "Once inside, wait for one display update before changing pressure. If the line sits low, add a tiny squeeze; if it sits high, ease a tiny amount.", "reason": "Reacting to every pixel creates a saw-tooth trace because visual feedback has delay.", "success_check": "Corrections become small and infrequent instead of alternating above and below the ribbon." }, { "title": "Keep a quiet breathing rhythm", "instruction": "Use easy breaths while holding the submaximal plateau. Maintain jaw, shoulders and hands relaxed; pressure should come from the declared knee action, not a whole-body brace.", "reason": "Breath-holding and accessory tension can alter the trace and add unnecessary strain.", "success_check": "Speech remains possible after release and observation shows no gripping, shoulder lift or facial strain." }, { "title": "Guard the angle as a separate channel", "instruction": "Keep the kneecap, ankle pad and trunk landmarks aligned while watching the force ribbon. If the number looks good but a landmark moves, tell the provider rather than rescuing the score.", "reason": "A stable force value cannot validate a hold performed through changing geometry.", "success_check": "The provider's angle check stays inside tolerance for the complete scored window." }, { "title": "Leave the ribbon on the end tone", "instruction": "When the end tone sounds, taper pressure directly back to zero over the agreed release interval. Do not add a final squeeze or extend the plateau.", "reason": "An extra pulse changes duration and can hide loss of control near the end.", "success_check": "The line returns once to baseline with no rebound peak and no delayed pressure." }, { "title": "Label the trace before resting", "instruction": "Call the attempt clean, overshot, drifted, pulsed or moved, then compare that label with the provider's trace review. Fully relax for the prescribed recovery.", "reason": "Immediate trace classification teaches error recognition without turning recovery into another contraction.", "success_check": "Learner and provider identify the same main feature before the next plateau begins." }, { "title": "Score control, not just magnitude", "instruction": "Report acquisition time, dwell percentage, centre-line bias and coefficient of variation alongside average force. Keep invalid movement trials visible but out of the summary calculation.", "reason": "These values reveal slow settling, one-sided drift and oscillation that an average alone conceals.", "success_check": "The session ledger contains separate columns for force level, dwell, bias, variability and validity." }, { "title": "Match trace shape to one correction", "instruction": "Classify the plateau as overshoot, slow acquisition, centre drift or rhythmic pulsing. Choose only the matching response for the next familiarisation: soften entry, clarify three beats, make one micro-adjustment or wait longer between corrections.", "reason": "Different control errors have different causes; a generic instruction to squeeze harder can worsen all four.", "success_check": "The next trace shows less of the named shape without changing ribbon, duration or knee geometry." }, { "title": "Use the ribbon dose matrix", "instruction": "Record ribbon width, plateau seconds and visual, auditory or haptic feedback mode. When authorised, change only one cell and compare dwell, centre bias and pulsing with the previous plateau.", "reason": "Simultaneous ribbon, duration and feedback changes make loss of control impossible to diagnose.", "success_check": "The ledger names one changed ribbon variable and retains matched dwell, bias, pulsing and geometry results." } ], "worked_example": { "scenario": "A rehabilitation specialist sets seated knee extension at 60 degrees, an eight-second scoring window and a 180–200 N ribbon centred on 190 N.", "walkthrough": [ "The learner relaxes until the display holds the stored zero for three seconds, then correctly identifies 180 N, 190 N and 200 N on screen.", "Plateau one jumps to 207 N before returning; its average is high enough, but it is labelled overshot rather than clean.", "After recovery, plateau two enters at 1.4 seconds, spends 7.2 seconds in the ribbon and shows a small downward bias with no knee motion.", "Plateau three spends 7.4 seconds inside, averages 191 N and has a 4 N standard deviation, giving roughly 2.1% coefficient of variation.", "The ledger retains every trace, excludes the overshot attempt from the clean-trial summary and records normal breathing and no symptoms.", "The learner explains that 191 N describes force level while 7.4 seconds in range and 2.1% variation describe control.", "Plateau two is classified as mild downward drift rather than weakness; one delayed micro-adjustment corrects it without creating rhythmic pulsing.", "The matrix records a 20 N ribbon, eight-second plateau and visual feedback; no second variable changes during comparison.", "Because dwell and bias meet criteria without pulsing, the provider may later narrow the ribbon while preserving plateau duration and feedback mode." ], "result": "Two clean plateaus satisfy the declared dwell and geometry rules. The session demonstrates repeatable submaximal control at one knee angle; it neither supplies a maximal-force score nor predicts walking, lifting or endurance." }, "right_vs_wrong": [ { "situation": "Approaching the ribbon", "right": "Climb in three smooth beats and settle near centre.", "wrong": "Hit 207 N, fall to 176 N and call the average acceptable.", "why": "Crossing both boundaries shows overshoot, not controlled acquisition." }, { "situation": "Responding to a low display", "right": "Wait one update, then add a very small squeeze.", "wrong": "Alternate large squeezes and releases on every screen movement.", "why": "Delayed visual feedback turns aggressive chasing into oscillation." }, { "situation": "Protecting task geometry", "right": "Invalidate a trace when the knee angle drifts even if force remains centred.", "wrong": "Keep the attractive force graph because movement was small.", "why": "Changing leverage means the plateau is no longer the declared isometric task." }, { "situation": "Judging steadiness", "right": "Use dwell, bias and variability together.", "wrong": "Use average newtons alone to award a steady score.", "why": "A mean can sit at centre while repeated excursions leave the acceptable ribbon." }, { "situation": "Ending the plateau", "right": "Taper to zero on the tone and remain relaxed.", "wrong": "Add a last pulse to improve the average or continue for bonus seconds.", "why": "A finishing surge alters dose and corrupts the fixed scoring window." }, { "situation": "Choosing progression", "right": "Narrow or raise the ribbon only when the provider sees repeatable quiet plateaus.", "wrong": "Raise the target because one attempt briefly touched a larger number.", "why": "Momentary magnitude is not evidence of repeatable force control." }, { "situation": "Choosing a trace correction", "right": "Match overshoot, acquisition, drift or pulsing to one specific adjustment.", "wrong": "Respond to every graph shape by increasing average pressure.", "why": "More pressure cannot correct timing delay, visual chasing or geometry drift." }, { "situation": "Progressing target-band control", "right": "Change ribbon width, plateau duration or feedback mode one at a time.", "wrong": "Narrow the ribbon, lengthen the plateau and remove feedback together.", "why": "A three-variable change cannot reveal why dwell, bias or pulsing changed." } ], "common_mistakes": [ { "mistake": "Preloading the pad while waiting for the tone.", "fix": "Remove pressure and require a three-second zero baseline before restarting." }, { "mistake": "Treating the centre line as a point that must be chased continuously.", "fix": "Teach the learner to accept any value inside the ribbon and correct only sustained drift." }, { "mistake": "Overshooting the upper boundary during the entry ramp.", "fix": "Rehearse the three-beat ascent at a lower ribbon before another scored plateau." }, { "mistake": "Keeping a smooth graph while the knee slowly opens.", "fix": "Use visible joint landmarks and mark any geometry breach invalid regardless of the graph." }, { "mistake": "Reporting average force as the steadiness result.", "fix": "Add dwell percentage, centre bias and coefficient of variation as separate columns." }, { "mistake": "Extending the hold past the end tone.", "fix": "Practise a timed taper to zero and reject any attempt with extra unprescribed seconds." }, { "mistake": "All out-of-ribbon traces are labelled weak.", "fix": "Name overshoot, slow acquisition, centre drift or pulsing before selecting a correction." }, { "mistake": "Ribbon width and plateau duration change in the same comparison.", "fix": "Restore the prior matrix and alter only one provider-selected control variable." } ], "practice": { "first_session": [ "Learn the screen by naming the lower edge, centre and upper edge while fully relaxed.", "Perform three no-score pressure ramps that stop at the lower boundary and return to zero.", "Complete two short familiarisation plateaus at an easier ribbon, focusing on delayed micro-corrections.", "After prescribed recovery, complete three eight-second working plateaus with joint landmarks observed.", "Classify each graph as clean, overshot, drifted, pulsed or moved before seeing the numeric summary.", "Calculate dwell, bias and variation only from attempts that met the geometry and timing rules.", "Sort four sample plateau graphs by overshoot, slow acquisition, centre drift and pulsing before the working ribbon appears.", "Complete a sample ribbon-dose matrix with width, plateau seconds, feedback mode, dwell, bias and pulsing columns." ], "repeat_plan": "On a later provider-scheduled visit, reproduce the seat code, lever length, 60-degree geometry, ribbon width, screen smoothing and eight-second window. Practise cleaner acquisition before any target increase. The provider may alter one variable—ribbon location, ribbon width or duration—but never all three at once, so the source of change remains interpretable.", "progress_when": [ "Three plateaus cross the lower edge once, without an upper-edge spike or final pulse.", "At least 90% of each scoring window lies inside the prescribed ribbon while landmarks remain fixed.", "Centre bias stays small and coefficient of variation remains within the provider's predeclared tolerance across visits.", "Normal breathing and symptom-free recovery continue at the current submaximal demand.", "The learner correctly identifies each trace shape and applies its matching single correction without target escalation.", "One provider-selected matrix change preserves ribbon dwell, centre bias, low pulsing and fixed geometry." ], "do_not_progress_when": [ "The graph improves only because the learner braces, holds breath or changes knee geometry.", "Oscillation grows after each correction or dwell falls across consecutive plateaus.", "Pain, dizziness, numbness, cramp, unusual fatigue or a shifted baseline appears.", "Display smoothing, target definition or seat configuration differs from the comparison visit.", "Repeated pulsing persists when visual feedback is present; the provider must review display delay or an alternative cue channel." ] }, "self_check": [ "Can you point to both ribbon boundaries and state when the scoring window starts?", "Can you enter with one controlled crossing rather than an overshoot-and-return?", "Do your corrections wait for sustained drift instead of chasing every display update?", "Did the knee landmarks and trunk remain unchanged while the trace looked steady?", "Can you calculate dwell percentage and explain what centre-line bias means?", "Can you explain why a 191 N average is not a maximal-strength result?", "Can you give a different correction for overshoot, slow acquisition, centre drift and rhythmic pulsing?", "Can you explain how ribbon width, plateau duration and feedback mode change different parts of the control task?" ], "measurement": { "primary": "Submaximal isometric plateau quality: acquisition time, time in target ribbon, centre bias and force variability at one declared knee angle", "how": "Preserve the same seat code, lever arm, angle, sampling and display-smoothing settings. Score only the fixed window after ribbon entry; retain the unsmoothed trace, geometry decision and any excluded attempt. Retain the trace-shape label because acquisition, drift and pulsing can differ despite similar dwell percentages. Preserve a ribbon-dose matrix that separates width, plateau duration and feedback mode.", "good_result": "At least three plateaus meet the entry, dwell and geometry rules, with low repeat variability and no symptom or breathing penalty. Across visits, the same ribbon produces quicker clean acquisition, less centre drift and fewer rhythmic excursions.", "does_not_prove": "A quiet target-band plateau does not establish maximal torque, dynamic lifting strength, pain resolution, balance or transfer to another joint position." }, "stop_and_get_help": [ "Release the plateau at once for chest pain, faintness, severe headache, unusual breathlessness or a new neurological symptom.", "Abort that graph when sharp pain, cramp, numbness, visible joint drift, restraint shift or an unexplained zero offset appears.", "Suspend further ribbon work when control worsens despite the full recovery interval; the provider must review target demand and setup before another attempt." ], "accessibility": [ "Offer a large high-contrast ribbon, an auditory pitch band or haptic boundary cue; record which feedback channel was used because it changes the control task.", "Use the learner's established yes/no and stop signals, including switch access or eye gaze, before any pressure is requested.", "Adapt seating, limb support and display position to reduce unrelated effort while preserving the recorded knee geometry and zero baseline." ], "evidence_notes": [ { "claim": "Isometric strength can improve in a trained configuration, while gait speed may remain unchanged.", "source_title": "Effects of maximal isometric and isokinetic resistance training on strength and functional mobility in older adults", "source_url": "https://pubmed.ncbi.nlm.nih.gov/15983182/", "source_kind": "PRIMARY_RESEARCH" }, { "claim": "Contraction mode affects adaptation, so isometric results should not be treated as interchangeable with dynamic strength.", "source_title": "Effects of concentric and eccentric training on muscle strength, cross-sectional area, and neural activation", "source_url": "https://doi.org/10.1152/jappl.1996.81.5.2173", "source_kind": "PRIMARY_RESEARCH" } ], "limits": [ "There is no universal safe force, angle or hold duration.", "A stable hold at one angle does not prove control through a range of motion.", "This lesson does not diagnose weakness, pain or cardiovascular risk." ], "orientation": { "bounded_definition": "Capability to develop or express isometric strength in a declared context without inheriting broader claims.", "evidence_summary": "Isometric strength is real as a bounded, measurable capability, but the evidence is task- and population-specific. Titan separates improvement in the test from retention, transfer and meaningful function.", "supportable_public_claim": "In selected people and declared configurations, isometric strength can be measured and may improve with task-relevant practice; retention, transfer and meaningful value require separate testing.", "measurement_boundary": "Declare joint angle, posture, lever arm, ramp instructions and dynamometer reliability; peak isometric torque says nothing by itself about dynamic speed, balance or pain.", "myth_to_metric": { "myth": "Unshakeable static power", "metric": "Peak isometric force/torque and force-time characteristics at a specified joint angle", "boundary": "The metric is valid only for its declared task and cannot establish universal ability, character, diagnosis, safety or far transfer." }, "limiting_findings": [ "Strength training in older adults did not change gait speed in the Symons trial.", "Force steadiness during submaximal isometric contraction did not improve in the Tracy trial although anisometric steadiness did." ], "prohibited_claims": [ "Titan proves anyone can develop unlimited or superhuman isometric strength.", "One test score reveals whole-person capability, health, discipline, potential or worth.", "Improvement guarantees injury prevention, clinical benefit, occupational readiness or transfer to every real-world task." ] }, "gold_source_lesson": { "curriculum_id": "G-CUR-001", "source_heading": "PWR-003 - Isometric strength", "source_html_sha256": "0320e8f58e8b320dc121a043a52110bbe42bfcc2d5526054b29e5b3a591170b2", "html": "Specialist\nexplainer only. No self-prescribed prolonged/maximal holds.
" }, "next_gate": "External confirmation is required before higher-authority use because: SUPERVISION_OR_NON_ATTEMPT_BOUNDARY.", "evidence_count": 2 }, "full_training_programme": false, "independently_validated": false, "publication_state": "PUBLISHED_PUBLIC_RESEARCH_EDITION__EDITORIAL_REVIEW_PENDING", "related_power_ids": [ "PWR-001", "PWR-002", "PWR-004", "PWR-005" ] }, { "power_id": "PWR-004", "learning_unit_id": "TLU-PWR-004", "title": "Eccentric strength", "main_description": "In one authorised appointment, a participant performs a continuously resisted knee-extension descent, completes passive return without lifting, logs later response and distinguishes full-arc control from an impressive but invalid torque spike.", "main_description_source": "FULL_TUTORIAL_OUTCOME", "family_id": "FAM-01", "family": "Strength & Force Production", "superdomain": "Body & Performance", "canonical_route": "/powers/pwr-004/", "treatment": "SPECIALIST_PROVIDER_ROUTE", "treatment_label": "Full supervised tutorial", "treatment_boundary": "Titan teaches the complete method; a qualified person controls the parts that require supervision, clearance, specialist equipment, load, dose or progression.", "tutorial_route": "/tutorials/pwr-004/", "governed_lesson_route": null, "self_attempt_status": "PROHIBITED_WITHOUT_QUALIFIED_SUPERVISION", "gold_pathway_ids": [ "G-CUR-001" ], "route_membership": { "kind": "GOLD_PATHWAY", "id": "G-CUR-001", "coverage_status": "EXACT_ONCE" }, "source_authority_tier": "G4", "source_build_state": "EXTERNAL_PROVIDER_ROUTE", "source_instructional_route": "LEARN_ELSEWHERE_TRACK_WITH_TITAN", "source_count": 3, "research_depth": "FOCUSED", "risk_level": "MODERATE_TO_HIGH", "prerequisite_status": "QUALIFIED_PROVIDER_DETERMINES", "learning_route": { "mode": "FULL_SUPERVISED_TUTORIAL", "label": "Learn eccentric strength step by step", "summary": "In one authorised appointment, a participant performs a continuously resisted knee-extension descent, completes passive return without lifting, logs later response and distinguishes full-arc control from an impressive but invalid torque spike.", "steps": [ [ "Get ready", "Report recent injury, operation, swelling, instability, unexplained weakness, severe soreness or any previous unusual response to lengthening exercise." ], [ "Learn the method", "8 concrete steps teach the permitted method from start to finish." ], [ "See right and wrong", "6 comparisons show correct or safer execution beside common wrong or riskier choices." ], [ "Practise", "For retention, classify an anonymised curve and recall receive-lower-unload at least 48 hours later without performing loaded movement. A delayed physical retest requires clinician authorisation after review of evening and next-morning entries. Reproduce apparatus, limb, seating, supports, angles, angular velocity, commands and validity rules. Do not deepen range, raise resistance or add volume to manufacture progression." ], [ "Check progress", "Store programmed angles, velocity, resistance setting, supports, bin-by-bin torque, speed departures, unload boundary, return mode, symptoms and pattern label. Decide smooth arc versus catch-and-drop, stall, mid-arc hole, end-range dump or active-reset contamination before summarising peak and mean N·m. Preserve evening and next-morning response plus separate step-down observation." ] ], "practical_authority": false, "provider_required": true, "next_action_route": "/tutorials/pwr-004/" }, "path_builder": { "selectable": true, "completion_allowed": true, "warning": "Titan teaches the complete method; a qualified person controls the parts that require supervision, clearance, specialist equipment, load, dose or progression." }, "full_tutorial": { "version": "3.0", "authorship": "POWER_SPECIFIC_FULL_TUTORIAL", "tutorial_mode": "SUPERVISED", "promise": "Eccentric work happens when muscle produces force while lengthening. Here, quadriceps activity brakes a machine arm as a seated knee bends. This is neither a slow lift nor a static hold. Learn receive-lower-unload: accept supported tension, allow continuous descent, resist from first marker through final marker, unload, then relax for passive return. Curve-reading exercises expose four failures—catch-and-drop, stall, mid-arc hole and end-range dump. A rehabilitation clinician selects apparatus, range, velocity, resistance, repetition count and recovery.", "power_id": "PWR-004", "title": "Eccentric strength", "lesson_type": "SUPERVISED", "headline": "Brake a moving load through one marked lowering arc", "plain_english_summary": "Eccentric work happens when muscle produces force while lengthening. Here, quadriceps activity brakes a machine arm as a seated knee bends. This is neither a slow lift nor a static hold. Learn receive-lower-unload: accept supported tension, allow continuous descent, resist from first marker through final marker, unload, then relax for passive return. Curve-reading exercises expose four failures—catch-and-drop, stall, mid-arc hole and end-range dump. A rehabilitation clinician selects apparatus, range, velocity, resistance, repetition count and recovery.", "outcome": "In one authorised appointment, a participant performs a continuously resisted knee-extension descent, completes passive return without lifting, logs later response and distinguishes full-arc control from an impressive but invalid torque spike.", "authority": { "learner_may": [ "Name working limb, travel direction and arc markers; rehearse receive-lower-unload without working resistance.", "Accept clinician-positioned tension, brake a moving apparatus arm and use an agreed abort signal whenever comfort or control changes.", "Review angle-binned descent evidence after unloading and complete later-that-day and next-morning symptom entries." ], "qualified_person_required_for": [ "Screen joint, muscle-tendon and delayed-soreness history before authorising loaded lengthening work.", "Choose seating, alignment, supports, angles, angular velocity, resistance, repetitions, recovery and symptom limits.", "Support each hand-off, guard movement, operate emergency release, provide passive return and classify curve validity." ], "never_do": [ "Do not improvise overload with free weights, household objects, partner-held resistance or equipment lacking safe escape.", "Do not hoist an eccentric-only load into position, kick it upward during reset or alter depth, speed, resistance or volume independently.", "Do not continue after sharp pain, a pop, instability, sudden weakness, uncontrolled acceleration or an unreviewed delayed reaction." ] }, "materials": [ "Clinician-controlled isokinetic or resistance apparatus with emergency release and assisted reset", "Stable seating plus fitted pelvic, thigh and lower-leg supports", "Start, middle and finish markers", "Velocity display or tempo cue", "Descent worksheet for angle bins, torque continuity, speed, unload point, reset mode and symptoms", "Delayed-response log plus a separate supported step-down sheet" ], "before_you_start": [ "Report recent injury, operation, swelling, instability, unexplained weakness, severe soreness or any previous unusual response to lengthening exercise.", "Describe today's action: apparatus starts with lower leg raised, then travels downward while quadriceps acts as a brake.", "Sweep through planned angles without working resistance. Identify beginning, midpoint and finish; mention pinching or guarding immediately.", "Practise three commands. Receive means meet supported tension. Lower means allow movement while resisting. Unload means stop resisting for mechanical removal.", "Rehearse once lightly. The lever must keep moving during lower; a frozen arm signals a different contraction.", "Agree how same-day and next-morning effects will reach the responsible clinician." ], "steps": [ { "title": "Map travel direction", "instruction": "Point from start angle to finish angle. Say, 'My knee bends while I brake this arm.' Name midpoint as a separate landmark.", "reason": "Direction determines whether quadriceps fibres shorten, hold length or lengthen.", "success_check": "Participant identifies correct limb, direction and three landmarks without looking at torque." }, { "title": "Fit supports and rehearse", "instruction": "Sit against backrest while clinician aligns knee axis, secures pelvis and positions shin pad. Perform an unloaded sweep, then a light receive-lower-unload rehearsal.", "reason": "Stable geometry keeps measured work inside a repeatable arc and exposes uncomfortable contact before loading.", "success_check": "No pelvic slide, thigh lift, knee twist, pinching or numbness appears." }, { "title": "Receive supported tension", "instruction": "Remain relaxed while apparatus places its arm at start. On receive, meet already-supported resistance smoothly—no upward pull, kick or sudden catch.", "reason": "Snatching produces an early torque spike without showing braking capacity.", "success_check": "Curve begins without impact and arm waits at start until lower command." }, { "title": "Allow movement while braking", "instruction": "On lower, permit knee flexion while maintaining pressure against moving arm, like controlling a heavy door. Avoid freezing or letting descent run away.", "reason": "Lengthening control requires force during movement; stalling becomes an isometric hold, whereas runaway motion becomes a drop.", "success_check": "Angular velocity remains inside its declared corridor and braking torque persists through first half." }, { "title": "Brake through the final third", "instruction": "Continue resisting beyond midpoint to finish. Keep pelvis level and torso supported. If control disappears, signal abort instead of catching a falling arm.", "reason": "Strong early output can hide release near terminal angles.", "success_check": "Final bins retain torque without acceleration, twisting or shortened travel." }, { "title": "Unload, then accept passive return", "instruction": "At finish, follow unload command. Relax quadriceps while apparatus removes resistance and restores start position. Never lift during reset.", "reason": "An active upward reset adds concentric work, changing dose and meaning.", "success_check": "Trace shows a distinct unload boundary followed by assisted return with no participant-generated positive work." }, { "title": "Classify descent shape", "instruction": "Before reading peak N·m, label each curve smooth arc, catch-and-drop, mid-arc hole or end-range dump. Check angular speed beside torque in every bin.", "reason": "Peak magnitude cannot reveal missing braking elsewhere.", "success_check": "Validity decision cites exact bin and velocity departure rather than overall impression." }, { "title": "Log delayed response", "instruction": "After recovery, document immediate symptoms and separate step-down observation. Add later-that-day and next-morning soreness, swelling and ordinary-activity change before another loaded decision.", "reason": "Lengthening work may produce effects after departure.", "success_check": "Both delayed entries exist and clinician reviews them before changing any parameter." } ], "worked_example": { "scenario": "Clinician programs right-knee travel from 30 to 80 degrees of flexion at 60 degrees per second. Apparatus performs every reset. A supported step-down remains a separate observation.", "walkthrough": [ "Ana identifies 30-degree start, midpoint and 80-degree finish, then describes braking while her knee bends.", "After support fitting, an unloaded sweep and light rehearsal show comfortable travel.", "Descent A begins smoothly, holds velocity near 60 degrees per second and retains torque through all bins; peak equals 146 N·m.", "Descent B spikes at 155 N·m, stalls, then loses torque from 58 to 70 degrees. It receives catch-and-drop plus mid-arc-hole labels and is rejected.", "Descent C remains continuous through 80 degrees, peaks at 149 N·m and ends in passive return.", "Ana keeps 146 and 149 N·m as full-arc results. She does not average invalid 155 N·m into them.", "Later log records soreness and stair response that evening and next morning. Clinician reviews those entries before scheduling any comparable descent." ], "result": "Two continuous descents demonstrate angle- and velocity-specific braking. A larger interrupted spike does not count. Nothing here establishes concentric strength, tendon safety or independent stair ability." }, "right_vs_wrong": [ { "situation": "Receiving resistance", "right": "Meet an already-supported machine arm smoothly.", "wrong": "Snatch resistance or lift it into place.", "why": "Impact and lifting precede intended lengthening phase." }, { "situation": "Descending", "right": "Brake while apparatus continues travelling.", "wrong": "Freeze midway or suddenly let go.", "why": "A freeze becomes holding; release becomes dropping." }, { "situation": "Terminal angles", "right": "Maintain braking through final marker.", "wrong": "Relax after midpoint because finish is close.", "why": "Premature release creates an end-range dump." }, { "situation": "Reset", "right": "Relax for mechanical passive return.", "wrong": "Kick upward to save time.", "why": "Active reset adds positive concentric work." }, { "situation": "Curve selection", "right": "Check torque continuity and velocity bin by bin.", "wrong": "Choose tallest N·m spike.", "why": "A spike can precede a torque hole or runaway segment." }, { "situation": "Next decision", "right": "Review immediate and delayed response together.", "wrong": "Increase resistance because soreness or one number seems impressive.", "why": "Neither soreness nor isolated magnitude proves useful progression." } ], "common_mistakes": [ { "mistake": "Participant describes a slow lift instead of braking.", "fix": "Trace direction from raised start toward bent-knee finish and repeat receive-lower-unload." }, { "mistake": "Arm stops at midpoint.", "fix": "Mark a stall; use velocity cue during any further clinician-authorised rehearsal." }, { "mistake": "Torque vanishes near finish.", "fix": "Label exact missing bins as an end-range dump; never hide them with peak averaging." }, { "mistake": "Participant drives reset upward.", "fix": "Segment descent, unload and passive return; exclude contaminated repetition." }, { "mistake": "Only immediate discomfort is noted.", "fix": "Complete evening and next-morning entries before another loaded choice." }, { "mistake": "Device torque becomes a stair-safety claim.", "fix": "Keep supported step-down data separate and limit interpretation to programmed arc and speed." } ], "practice": { "first_session": [ "Screen readiness and agree abort signal plus delayed-contact plan.", "Name limb, direction, angles, velocity and three landmarks.", "Rehearse receive-lower-unload without working resistance.", "Complete authorised descents with supported start and passive reset.", "Classify every curve before inspecting peak N·m.", "Log separate step-down, evening response and next-morning response." ], "repeat_plan": "For retention, classify an anonymised curve and recall receive-lower-unload at least 48 hours later without performing loaded movement. A delayed physical retest requires clinician authorisation after review of evening and next-morning entries. Reproduce apparatus, limb, seating, supports, angles, angular velocity, commands and validity rules. Do not deepen range, raise resistance or add volume to manufacture progression.", "progress_when": [ "Supported hand-off occurs without catch; every descent stays moving.", "Torque persists across all bins while angular speed remains inside corridor.", "Every reset is passive and delayed response stays inside individually agreed limits.", "A later authorised session reproduces geometry and again shows continuous braking." ], "do_not_progress_when": [ "A catch, stall, torque hole, dump, posture shift or active reset remains.", "Pain, swelling, instability, weakness, altered sensation or delayed reaction increases.", "Apparatus cannot provide safe support, emergency release or assisted reset.", "Evening and next-morning entries remain unavailable or unreviewed." ] }, "self_check": [ "Can you explain muscle lengthening while braking?", "Can you identify start, midpoint, finish and travel direction?", "Can you demonstrate receive-lower-unload without lifting?", "Can you distinguish moving control from a stall?", "Can you locate a mid-arc hole or end-range dump on a curve?", "Can you explain why passive return and delayed logging matter?" ], "measurement": { "primary": "Continuous negative-work knee-extension descent across specified angles and angular velocity", "how": "Store programmed angles, velocity, resistance setting, supports, bin-by-bin torque, speed departures, unload boundary, return mode, symptoms and pattern label. Decide smooth arc versus catch-and-drop, stall, mid-arc hole, end-range dump or active-reset contamination before summarising peak and mean N·m. Preserve evening and next-morning response plus separate step-down observation.", "good_result": "At least two authorised descents retain torque and commanded velocity from start through finish, followed by assisted reset. A delayed comparison reproduces geometry, commands and symptom safeguards.", "does_not_prove": "This profile does not prove shortening strength, tendon integrity, injury immunity, safe independent loading or transfer to stairs, running, landing, work or sport." }, "stop_and_get_help": [ "Abort for sharp pain, pop, sudden weakness, swelling, instability, numbness or uncontrolled apparatus motion.", "Stop if support loosens, velocity escapes, travel leaves marked arc or emergency release becomes unavailable.", "Seek clinician review for unusual or worsening delayed effects; seek prompt medical advice for marked swelling, profound weakness, systemic illness or dark urine." ], "accessibility": [ "Offer high-contrast or tactile angle landmarks plus spoken or visual commands.", "Use transfer help, pressure relief and fitted supports; preserve each adaptation in session configuration.", "Provide an annotated plot naming catch, continuous braking, torque hole, finish, unload and assisted reset." ], "evidence_notes": [ { "claim": "Strength gains in one contraction mode do not automatically generalise to another mode or to functional mobility.", "source_title": "Effects of maximal isometric and isokinetic resistance training on strength and functional mobility in older adults", "source_url": "https://pubmed.ncbi.nlm.nih.gov/15983182/", "source_kind": "PRIMARY_RESEARCH" }, { "claim": "Eccentric and concentric programmes can yield different task and pain outcomes, so lowering performance must be measured directly.", "source_title": "Concentric and Eccentric Resistance Training Comparison on Physical Function and Functional Pain Outcomes in Knee Osteoarthritis: A Randomized Controlled Trial", "source_url": "https://pubmed.ncbi.nlm.nih.gov/32324615/", "source_kind": "PRIMARY_RESEARCH" } ], "limits": [ "This supervised method does not prescribe independent lengthening exercise.", "No universal resistance, arc, velocity, repetition count, soreness threshold or progression schedule exists.", "Peak torque cannot substitute for full-arc braking.", "Improved apparatus performance does not establish tissue health, pain resolution or real-world capability." ], "orientation": { "bounded_definition": "Capability to develop or express eccentric strength in a declared context without inheriting broader claims.", "evidence_summary": "Eccentric strength is real as a bounded, measurable capability, but the evidence is task- and population-specific. Titan separates improvement in the test from retention, transfer and meaningful function.", "supportable_public_claim": "In selected people and declared configurations, eccentric strength can be measured and may improve with task-relevant practice; retention, transfer and meaningful value require separate testing.", "measurement_boundary": "Measure eccentric peak/mean torque at specified velocity and range, with a separate lowering or braking transfer task; do not infer tendon safety or injury prevention from torque alone.", "myth_to_metric": { "myth": "Indestructible negative strength", "metric": "Controlled eccentric torque and task-specific energy absorption under declared conditions", "boundary": "The metric is valid only for its declared task and cannot establish universal ability, character, diagnosis, safety or far transfer." }, "limiting_findings": [ "Eccentric gains may not generalise to concentric performance.", "Strength or pain change does not guarantee chair-rise, stair, walking or community-ambulation improvement." ], "prohibited_claims": [ "Titan proves anyone can develop unlimited or superhuman eccentric strength.", "One test score reveals whole-person capability, health, discipline, potential or worth.", "Improvement guarantees injury prevention, clinical benefit, occupational readiness or transfer to every real-world task." ] }, "gold_source_lesson": { "curriculum_id": "G-CUR-001", "source_heading": "PWR-004 - Eccentric strength", "source_html_sha256": "fea92bb3b5adc584650c25fb1af6d413e979d6095701f34cafd9a096fd4125d5", "html": "Specialist\nexplainer only. No unsupervised eccentric-loading sequence.
" }, "next_gate": "External confirmation is required before higher-authority use because: CLINICAL_HIGH_RISK_OR_REGULATED_CONFIGURATION; SUPERVISION_OR_NON_ATTEMPT_BOUNDARY.", "evidence_count": 3 }, "full_training_programme": false, "independently_validated": false, "publication_state": "PUBLISHED_PUBLIC_RESEARCH_EDITION__EDITORIAL_REVIEW_PENDING", "related_power_ids": [ "PWR-001", "PWR-002", "PWR-003", "PWR-005" ] }, { "power_id": "PWR-005", "learning_unit_id": "TLU-PWR-005", "title": "Strength endurance", "main_description": "The learner completes a supervised sit-to-stand repetition set at a fixed cadence and stops on the first missed range or cadence, with valid repetitions and technique decrement recorded.", "main_description_source": "FULL_TUTORIAL_OUTCOME", "family_id": "FAM-01", "family": "Strength & Force Production", "superdomain": "Body & Performance", "canonical_route": "/powers/pwr-005/", "treatment": "SPECIALIST_PROVIDER_ROUTE", "treatment_label": "Full supervised tutorial", "treatment_boundary": "Titan teaches the complete method; a qualified person controls the parts that require supervision, clearance, specialist equipment, load, dose or progression.", "tutorial_route": "/tutorials/pwr-005/", "governed_lesson_route": null, "self_attempt_status": "PROHIBITED_WITHOUT_QUALIFIED_SUPERVISION", "gold_pathway_ids": [ "G-CUR-001" ], "route_membership": { "kind": "GOLD_PATHWAY", "id": "G-CUR-001", "coverage_status": "EXACT_ONCE" }, "source_authority_tier": "G4", "source_build_state": "EXTERNAL_PROVIDER_ROUTE", "source_instructional_route": "LEARN_ELSEWHERE_TRACK_WITH_TITAN", "source_count": 3, "research_depth": "FOCUSED", "risk_level": "MODERATE", "prerequisite_status": "QUALIFIED_PROVIDER_DETERMINES", "learning_route": { "mode": "FULL_SUPERVISED_TUTORIAL", "label": "Learn strength endurance step by step", "summary": "The learner completes a supervised sit-to-stand repetition set at a fixed cadence and stops on the first missed range or cadence, with valid repetitions and technique decrement recorded.", "steps": [ [ "Get ready", "Agree on the exact start and finish positions and whether hands or aids are allowed." ], [ "Learn the method", "7 concrete steps teach the permitted method from start to finish." ], [ "See right and wrong", "5 comparisons show correct or safer execution beside common wrong or riskier choices." ], [ "Practise", "The provider sets frequency, load, repetition cap, sets and recovery. Repeated-failure training is not supplied. Retest only after recovery and only in the identical configuration." ], [ "Check progress", "Declare load, chair or device, range, cadence, support, repetition cap and stop rule; record valid reps, first error, local effort and recovery." ] ], "practical_authority": false, "provider_required": true, "next_action_route": "/tutorials/pwr-005/" }, "path_builder": { "selectable": true, "completion_allowed": true, "warning": "Titan teaches the complete method; a qualified person controls the parts that require supervision, clearance, specialist equipment, load, dose or progression." }, "full_tutorial": { "version": "3.0", "authorship": "POWER_SPECIFIC_FULL_TUTORIAL", "tutorial_mode": "SUPERVISED", "promise": "Strength endurance is the ability to preserve force and execution across repeated or sustained muscular work. This lesson teaches a provider-set repetition test with one load, range, cadence and termination rule. The learner completes each repetition to the same standard and stops at the first technical failure; the provider chooses the load, number of attempts, rest and progression.", "power_id": "PWR-005", "title": "Strength endurance", "lesson_type": "SUPERVISED", "headline": "Repeat a fixed submaximal strength task without hiding form loss", "plain_english_summary": "Strength endurance is the ability to preserve force and execution across repeated or sustained muscular work. This lesson teaches a provider-set repetition test with one load, range, cadence and termination rule. The learner completes each repetition to the same standard and stops at the first technical failure; the provider chooses the load, number of attempts, rest and progression.", "outcome": "The learner completes a supervised sit-to-stand repetition set at a fixed cadence and stops on the first missed range or cadence, with valid repetitions and technique decrement recorded.", "authority": { "learner_may": [ "Practise the repetition standard and cadence without added load.", "Perform a provider-set submaximal set while counting only repetitions that meet the rule.", "Stop voluntarily before failure and report local fatigue separately from breathlessness or pain." ], "qualified_person_required_for": [ "Select the task, relative load, cadence, range, cap and recovery after assessment.", "Decide whether repeated-fatigue testing is appropriate and observe the termination rule.", "Set progression and distinguish local muscular endurance from cardiorespiratory limitation." ], "never_do": [ "Run an exhaustion, repeated-failure or maximum-repetition test alone.", "Speed up, shorten the range or bounce to inflate the count.", "Continue after the first provider-defined technical failure, pain, dizziness or unsafe breathlessness." ] }, "materials": [ "Stable armless chair fixed against a wall or provider-selected resistance station", "Metronome or recorded cadence", "Repetition-validity checklist", "Session log for valid reps, error type, fatigue and recovery" ], "before_you_start": [ "Agree on the exact start and finish positions and whether hands or aids are allowed.", "Set the cadence, load, maximum set length and first-failure stop rule in writing.", "Complete the provider's warm-up and verify that the chair or device cannot move.", "Distinguish expected local effort from pain, dizziness, chest symptoms or unusual breathlessness." ], "steps": [ { "title": "Define one valid repetition", "instruction": "From the same seated start, stand to the declared hip and knee extension, then sit under control until the chair supports you. Use only the agreed hand support.", "reason": "A repetition count is meaningless if the movement standard drifts.", "success_check": "Learner and provider score the same two demonstrations as valid or invalid." }, { "title": "Lock the cadence", "instruction": "Start on the metronome and match one stand and one sit to the agreed beats. Do not begin ahead of the first cue.", "reason": "Cadence changes time under tension and fatigue.", "success_check": "The first three repetitions land on the intended beats." }, { "title": "Keep the range constant", "instruction": "Reach the same standing marker and controlled seat contact each time; do not hover above the chair or drop onto it.", "reason": "Shortening the range can disguise fatigue.", "success_check": "Each repetition meets both range markers." }, { "title": "Breathe and keep the task local", "instruction": "Breathe throughout and keep feet in the marked position. Tell the provider if breathlessness, pain or balance rather than local leg fatigue is limiting the set.", "reason": "Different limiting systems require different interpretation.", "success_check": "The learner can name what caused the stop." }, { "title": "Stop at first technical failure", "instruction": "End the set when one repetition misses cadence, range, control or permitted support, even if another repetition might be forced.", "reason": "The endpoint is loss of declared performance, not collapse.", "success_check": "No unscored extra repetitions occur after the first failure." }, { "title": "Record the valid count and decrement", "instruction": "Write the number of valid repetitions, elapsed time, first error, perceived local effort and time until ordinary breathing returns.", "reason": "The first error explains how endurance failed.", "success_check": "The log shows the count and the exact stop reason." }, { "title": "Retest only in the same configuration", "instruction": "Use the same chair height, foot marks, cadence, hand rule and provider-set load. Treat any change as a new test.", "reason": "Otherwise a higher count may come from an easier fixture.", "success_check": "Both session records match on every declared configuration field." } ], "worked_example": { "scenario": "A provider uses a 45-cm chair, arms folded, feet on tape marks and a 3-second stand-sit cycle with a 12-repetition cap.", "walkthrough": [ "The learner and provider score two practice repetitions against the range and cadence rule.", "The learner begins on the metronome and completes eight valid repetitions.", "Repetition nine reaches standing late but still within the provider's tolerance and is valid.", "Repetition ten ends with an uncontrolled drop to the chair, so the set stops immediately.", "The log records nine valid repetitions, first failure 'uncontrolled descent', local leg effort 7/10 and normal breathing after 70 seconds." ], "result": "The score is nine valid repetitions in this chair-and-cadence configuration. It is not ten, and it does not prove occupational endurance or aerobic fitness." }, "right_vs_wrong": [ { "situation": "Counting: Strength endurance checkpoint", "right": "Count only repetitions meeting range, cadence and support rules.", "wrong": "Count every attempt that ends upright.", "why": "Invalid repetitions inflate endurance. That changes valid repetitions or sustained time at a fixed submaximal task before the first technical failure. It is no longer the same test." }, { "situation": "Responding to fatigue", "right": "Stop at the first missed execution rule.", "wrong": "Use momentum and shortened range to keep going.", "why": "Compensation changes the task. That changes valid repetitions or sustained time at a fixed submaximal task before the first technical failure. It is no longer the same test." }, { "situation": "Pacing: Strength endurance checkpoint", "right": "Follow the fixed cadence from the first repetition.", "wrong": "Rush early and slow down later.", "why": "Variable cadence changes the dose. That changes valid repetitions or sustained time at a fixed submaximal task before the first technical failure. It is no longer the same test." }, { "situation": "Naming the limiter", "right": "Separate local fatigue, breathlessness, pain and balance.", "wrong": "Call every stop 'muscle fatigue'; it breaks the 'Breathe and keep the task local' execution rule.", "why": "The cause changes what the score means." }, { "situation": "Retesting: Strength endurance checkpoint", "right": "Match chair, foot marks, cadence and hand use.", "wrong": "Use a higher chair and claim improvement.", "why": "An easier configuration is not a clean retest." } ], "common_mistakes": [ { "mistake": "The endpoint is vague 'until tired'.", "fix": "Predeclare the first missed range, cadence, control or support rule as the endpoint." }, { "mistake": "The learner speeds up to build a larger count.", "fix": "Use an audible metronome and invalidate out-of-tolerance repetitions." }, { "mistake": "Later repetitions use less range.", "fix": "Use visible standing and seat-contact markers and stop on the first miss." }, { "mistake": "An invalid final repetition is counted.", "fix": "Record only completed valid repetitions and name the first failure separately." }, { "mistake": "The count is called aerobic endurance.", "fix": "Record local muscular performance and any cardiorespiratory symptoms as separate outcomes." } ], "practice": { "first_session": [ "Provider defines and demonstrates one valid repetition.", "Practise cadence for four unloaded or assisted repetitions.", "Rest fully and complete one submaximal familiarisation set below the cap.", "After recovery, complete one scored set using the first-failure rule.", "Review the first error and rehearse one corrected repetition only if authorised." ], "repeat_plan": "The provider sets frequency, load, repetition cap, sets and recovery. Repeated-failure training is not supplied. Retest only after recovery and only in the identical configuration.", "progress_when": [ "Every counted repetition meets range, cadence and support rules.", "The first-failure point improves without a new compensation.", "Local fatigue and recovery remain within the provider's agreed range." ], "do_not_progress_when": [ "The count rises only because cadence, chair height, range or hand support changed.", "Pain, balance loss or cardiorespiratory symptoms end the set.", "Technique deteriorates earlier across sessions or recovery is incomplete." ] }, "self_check": [ "Can you demonstrate and score one valid repetition?", "What exact event ends the set?", "Did you count the failed repetition? The correct answer is no.", "Can you state whether local fatigue, breathlessness, pain or balance caused the stop?" ], "measurement": { "primary": "Valid repetitions or sustained time at a fixed submaximal task before the first technical failure", "how": "Declare load, chair or device, range, cadence, support, repetition cap and stop rule; record valid reps, first error, local effort and recovery.", "good_result": "The valid count or time improves in the same configuration without earlier form loss, worse symptoms or longer problematic recovery.", "does_not_prove": "It does not prove maximal strength, aerobic fitness, occupational endurance or safety under prolonged work." }, "stop_and_get_help": [ "Stop immediately for chest pain, faintness, severe dizziness, unusual breathlessness or a new neurological symptom.", "Stop the set for sharp or increasing pain, balance loss, uncontrolled descent or failure of the chair/device.", "Seek provider review when recovery is unexpectedly prolonged or symptoms worsen after the session." ], "accessibility": [ "Keep authorised hand support, mobility aids or a higher stable chair and record them as part of the configuration.", "Use visual or haptic cadence cues when sound is inaccessible.", "Use a provider-selected single-limb or upper-limb task if sit-to-stand does not match the learner's function; do not compare unlike tasks." ], "evidence_notes": [ { "claim": "High-repetition training produces task-specific endurance adaptations that differ from maximal-strength adaptations.", "source_title": "Muscular adaptations in response to three different resistance-training regimens: specificity of repetition maximum training zones", "source_url": "https://pubmed.ncbi.nlm.nih.gov/12436270/", "source_kind": "PRIMARY_RESEARCH" }, { "claim": "A specialised handgrip programme can improve declared grip endurance, but that result remains task- and population-specific.", "source_title": "Can maximal handgrip strength and endurance be improved by an 8-week specialized strength training program in older women? A randomized controlled study", "source_url": "https://pubmed.ncbi.nlm.nih.gov/33340721/", "source_kind": "PRIMARY_RESEARCH" } ], "limits": [ "There is no universal repetition target or fatigue threshold.", "More repetitions are not better when range or control is lost.", "A laboratory or chair score does not certify sustained work, caregiving or sport performance." ], "orientation": { "bounded_definition": "Capability to develop or express strength endurance in a declared context without inheriting broader claims.", "evidence_summary": "Strength endurance is real as a bounded, measurable capability, but the evidence is task- and population-specific. Titan separates improvement in the test from retention, transfer and meaningful function.", "supportable_public_claim": "In selected people and declared configurations, strength endurance can be measured and may improve with task-relevant practice; retention, transfer and meaningful value require separate testing.", "measurement_boundary": "Declare load relative to a valid maximum, cadence, range, termination rule and force decrement; separate local muscular endurance from cardiorespiratory endurance.", "myth_to_metric": { "myth": "Muscles that never tire", "metric": "Repetitions or sustained time at a declared load with force/technique decrement tracked", "boundary": "The metric is valid only for its declared task and cannot establish universal ability, character, diagnosis, safety or far transfer." }, "limiting_findings": [ "High-repetition adaptation differs from maximal-strength adaptation.", "A laboratory repetition count does not prove safe occupational endurance or sustained quality." ], "prohibited_claims": [ "Titan proves anyone can develop unlimited or superhuman strength endurance.", "One test score reveals whole-person capability, health, discipline, potential or worth.", "Improvement guarantees injury prevention, clinical benefit, occupational readiness or transfer to every real-world task." ] }, "gold_source_lesson": { "curriculum_id": "G-CUR-001", "source_heading": "PWR-005 - Strength endurance", "source_html_sha256": "5a4557f01db7647c168aa3c33eb32067d6e82838b4133e5c3b5e54ab59bbe1ab", "html": "Specialist\nexplainer only. No repeated-fatigue protocol.
" }, "next_gate": "No external confirmation is required for the current bounded explainer permission. Guide permission remains NOT_READY; any guide, stronger efficacy, generalisation, protocol, promotion or independent-validation claim requires a new adjudication.", "evidence_count": 3 }, "full_training_programme": false, "independently_validated": false, "publication_state": "PUBLISHED_PUBLIC_RESEARCH_EDITION__EDITORIAL_REVIEW_PENDING", "related_power_ids": [ "PWR-001", "PWR-002", "PWR-003", "PWR-004" ] }, { "power_id": "PWR-006", "learning_unit_id": "TLU-PWR-006", "title": "Functional lifting and carrying", "main_description": "The learner can plan, lift, carry and set down one light, stable object while keeping it close, moving smoothly and changing direction with the feet.", "main_description_source": "FULL_TUTORIAL_OUTCOME", "family_id": "FAM-01", "family": "Strength & Force Production", "superdomain": "Body & Performance", "canonical_route": "/powers/pwr-006/", "treatment": "SPECIALIST_PROVIDER_ROUTE", "treatment_label": "Full supervised tutorial", "treatment_boundary": "Titan teaches the complete method; a qualified person controls the parts that require supervision, clearance, specialist equipment, load, dose or progression.", "tutorial_route": "/tutorials/pwr-006/", "governed_lesson_route": null, "self_attempt_status": "PROHIBITED_WITHOUT_QUALIFIED_SUPERVISION", "gold_pathway_ids": [ "G-CUR-001" ], "route_membership": { "kind": "GOLD_PATHWAY", "id": "G-CUR-001", "coverage_status": "EXACT_ONCE" }, "source_authority_tier": "G4", "source_build_state": "EXTERNAL_PROVIDER_ROUTE", "source_instructional_route": "LEARN_ELSEWHERE_TRACK_WITH_TITAN", "source_count": 6, "research_depth": "DEEP", "risk_level": "MODERATE_TO_HIGH", "prerequisite_status": "QUALIFIED_PROVIDER_DETERMINES", "learning_route": { "mode": "FULL_SUPERVISED_TUTORIAL", "label": "Learn functional lifting and carrying step by step", "summary": "The learner can plan, lift, carry and set down one light, stable object while keeping it close, moving smoothly and changing direction with the feet.", "steps": [ [ "Get ready", "Look at the object. If it is leaking, damaged, unstable, sharp, hot or difficult to grip, do not lift it by hand." ], [ "Learn the method", "9 concrete steps teach the permitted method from start to finish." ], [ "See right and wrong", "6 comparisons show correct or safer execution beside common wrong or riskier choices." ], [ "Practise", "For ordinary low-risk rehearsal, use two to five controlled attempts in one session and stop before fatigue changes the movement. Delayed retention: wait at least 48 hours, do not reread the steps, then make three attempts with the same empty box and route; record every control feature separately. Near transfer: on a later day, use a different clearly light, stable object with secure handholds on a different short, dry, level route of similar difficulty; do not increase weight, distance or repetition. Stop for any surprise, symptom, grip problem, blocked view or loss of control. Workplace, heavy, repeated, rehabilitation or fitness progression remains under the responsible qualified person's plan." ], [ "Check progress", "Record the object, start and finish heights, distance, assistance and whether the lift included a secure hold, close load, smooth rise, foot turn, visible route and controlled set-down." ] ], "practical_authority": false, "provider_required": true, "next_action_route": "/tutorials/pwr-006/" }, "path_builder": { "selectable": true, "completion_allowed": true, "warning": "Titan teaches the complete method; a qualified person controls the parts that require supervision, clearance, specialist equipment, load, dose or progression." }, "full_tutorial": { "version": "3.0", "authorship": "POWER_SPECIFIC_FULL_TUTORIAL", "tutorial_mode": "SUPERVISED", "promise": "This lesson teaches a basic two-handed lift: decide whether to lift, prepare the route, take a stable hold, move the load smoothly, carry it without twisting and put it down under control. There is no single perfect posture and no technique can guarantee that an injury will not happen. The aim is to make an ordinary lift easier to control and to recognise when an aid, another person or professional instruction is the better choice.", "power_id": "PWR-006", "title": "Functional lifting and carrying", "lesson_type": "SUPERVISED", "headline": "Lift and carry an ordinary object with control", "plain_english_summary": "This lesson teaches a basic two-handed lift: decide whether to lift, prepare the route, take a stable hold, move the load smoothly, carry it without twisting and put it down under control. There is no single perfect posture and no technique can guarantee that an injury will not happen. The aim is to make an ordinary lift easier to control and to recognise when an aid, another person or professional instruction is the better choice.", "outcome": "The learner can plan, lift, carry and set down one light, stable object while keeping it close, moving smoothly and changing direction with the feet.", "authority": { "learner_may": [ "Read and rehearse the sequence without a load.", "Practise with an empty or clearly light, stable box on a clear, level route if ordinary movement is comfortable.", "Choose not to lift and use a trolley, smaller loads or another person instead." ], "qualified_person_required_for": [ "Workplace manual-handling assessment or certification.", "Heavy, repeated, awkward, unstable, hot, sharp, hazardous or overhead loads.", "Lifting when pain, weakness, dizziness, recent injury, pregnancy, disability or a health condition may change what is appropriate.", "Moving another person or animal." ], "never_do": [ "Use this page as permission to exceed workplace rules or an agreed load limit.", "Test a maximum lift or continue through pain, dizziness, loss of grip or blocked vision.", "Manually lift a fallen person from the floor unless trained and authorised for the exact situation." ] }, "materials": [ "An empty box with two secure handholds, or another clearly light and stable object.", "A waist-height table or firm surface for the destination.", "A short, dry, level route with no cables, packaging, pets or other obstructions.", "Flat, secure footwear and clothing that allows you to move.", "A helper or qualified trainer for the first loaded attempt when supervision is required." ], "before_you_start": [ "Look at the object. If it is leaking, damaged, unstable, sharp, hot or difficult to grip, do not lift it by hand.", "Plan where it will go and clear the full route before touching it.", "Push one corner gently or tilt it only if that is safe. If the weight surprises you, split the load or get help.", "Make space to get close to the object and close to the destination.", "Stop before starting if you have new pain, dizziness, numbness, weakness, breathlessness or a condition for which lifting advice has not been agreed." ], "steps": [ { "title": "Decide whether lifting is the right method", "instruction": "Check the weight, shape, handholds, starting height, destination and distance. Use a trolley, slide the object, divide the contents or ask for help when that removes the difficult part of the task.", "reason": "Good handling starts by avoiding an unnecessary or badly designed lift.", "success_check": "You can explain why this object, route and destination are manageable before you begin." }, { "title": "Prepare the route and landing place", "instruction": "Open doors, remove trip hazards and make an empty space at the destination. If the lift is long, prepare a stable halfway surface before you start.", "reason": "Stopping while holding a load or discovering a blocked destination makes control harder.", "success_check": "You can walk the route empty and place both hands on the destination without moving anything out of the way." }, { "title": "Get close and make a stable base", "instruction": "Stand close enough that you do not have to reach. Put your feet apart, with one foot slightly forward if that feels stable. Leave room to move your feet during the lift.", "reason": "Reaching increases the distance between the load and your body; a stable base makes balance easier to recover.", "success_check": "Your whole feet feel planted and the load is between or just in front of them, not at arm's length." }, { "title": "Take a secure hold", "instruction": "Use both hands on firm handles or solid parts of the object. Bring the object towards you before lifting if it can be slid safely. Hold it close against the body rather than pinching it at the fingertips.", "reason": "A secure hold reduces the chance of a sudden slip and keeping the load close makes it easier to control.", "success_check": "Your hands cannot slide off easily, the contents do not shift and you can still see where you will move." }, { "title": "Start from a comfortable bend", "instruction": "Bend your hips and knees enough to reach the load without forcing a deep squat or hanging from a fully rounded back. Use the position that feels controlled for your body and the object.", "reason": "There is no single perfect posture, but an extreme or strained position makes a basic lift harder to control.", "success_check": "You can pause at the start without wobbling, holding your breath or feeling a sharp strain." }, { "title": "Raise the load smoothly", "instruction": "Look ahead once the hold is secure. Stand up in one smooth movement while the load stays close. Breathe normally; do not jerk, snatch or race the first part of the lift.", "reason": "A sudden pull can make the load shift and gives you less time to correct your balance or grip.", "success_check": "The box follows a steady path, does not swing and your feet remain controlled." }, { "title": "Turn with your feet", "instruction": "If the destination is to one side, take small steps until your hips and shoulders face it. Do not keep your feet fixed and twist your trunk while holding the load.", "reason": "Moving the feet keeps the whole body and load travelling in the same direction.", "success_check": "Your belt line and shoulders face the direction in which the load is moving." }, { "title": "Carry without losing the route", "instruction": "Keep the load close at a comfortable height, walk at a pace that lets you stop and keep enough space to see the floor ahead. Put it down if you need to change your grip or rest.", "reason": "Blocked vision, a drifting grip or rushing turns a manageable carry into a fall or drop risk.", "success_check": "You can see the route, stop on request and keep the load from bouncing or sliding." }, { "title": "Put it down before adjusting it", "instruction": "Step close to the destination, bend only as far as needed and lower the object smoothly until its full weight is supported. Release your fingers, stand up, then slide or rotate it into its final position.", "reason": "Trying to make tiny adjustments while still carrying the full weight prolongs the difficult part of the task.", "success_check": "The object lands fully on the surface without a drop, trapped fingers or a final twist." } ], "worked_example": { "scenario": "Move an empty archive box from the floor beside a desk to the centre of a waist-height table two metres away.", "walkthrough": [ "Clear the two-metre route and make an empty space in the centre of the table.", "Check that the box base and handholds are intact, then nudge it to confirm that it is light.", "Stand close with feet apart, take both handholds and bring the box against the front of the body.", "Rise smoothly, take small steps to face the table and walk while looking over the top edge of the box.", "Step close to the table, lower the box until the table supports it, release the grip and then slide it to the centre." ], "result": "The box moves without a jerk, swing, fixed-foot twist, blocked route, grip change in mid-air or drop. That demonstrates control of this light box on this route; it does not prove readiness for heavier, repeated or workplace lifting." }, "right_vs_wrong": [ { "situation": "Choosing the task", "right": "Check the object and use an aid, smaller load or helper when that makes the task straightforward.", "wrong": "Treat asking for help as failure and lift an unknown load to discover whether you can manage it.", "why": "The safest improvement may be removing the difficult lift rather than perfecting it." }, { "situation": "Distance from the body", "right": "Move close and keep the load near the waist or trunk.", "wrong": "Reach forward and hold the load at arm's length.", "why": "A distant load is harder to balance and control." }, { "situation": "Starting movement", "right": "Build tension gradually and raise the load smoothly.", "wrong": "Jerk the object from the floor or snatch it before checking the grip.", "why": "A sudden start can shift the contents, break the grip or upset balance." }, { "situation": "Changing direction", "right": "Take small steps so feet, hips and shoulders turn together.", "wrong": "Plant the feet and twist the trunk while the load stays in the hands.", "why": "Moving the feet preserves a more controlled relationship between the body and load." }, { "situation": "Carrying", "right": "Carry only when you can see the route and stop under control.", "wrong": "Stack the load above eye level or hurry because the grip is failing.", "why": "Blocked vision and rushing increase the chance of a collision, trip or drop." }, { "situation": "Final placement", "right": "Put the load down fully, release it and then slide it into exact position.", "wrong": "Hold the weight while reaching, twisting or rearranging nearby objects.", "why": "Putting down first shortens the loaded part of the task and protects the fingers." } ], "common_mistakes": [ { "mistake": "The route is checked only after the object is already in the hands.", "fix": "Walk the route empty and prepare the destination before the first lift." }, { "mistake": "The learner starts too far from the load.", "fix": "Move the feet closer or slide the object closer before lifting." }, { "mistake": "The grip uses fingertips on weak cardboard.", "fix": "Use intact handles, support the base if appropriate, or transfer the contents to a sound container." }, { "mistake": "The load moves before the learner knows its weight or balance.", "fix": "Test gently, stop if the weight surprises you and change the plan." }, { "mistake": "The learner holds the breath and becomes rigid.", "fix": "Reduce the load, pause, choose a more comfortable start position and breathe normally during the easy rehearsal." }, { "mistake": "A grip correction is attempted while walking.", "fix": "Stop and put the object on a stable surface before changing the grip." }, { "mistake": "The final turn is made by twisting at the waist.", "fix": "Take one or two extra steps until the whole body faces the destination." } ], "practice": { "first_session": [ "Walk the route empty and point to every possible obstruction.", "Rehearse the approach, foot turn and set-down with empty hands twice.", "Use one empty box for three slow lifts from a raised surface to another raised surface.", "Rest, then complete two floor-to-table lifts only if the empty-hand and raised-surface versions were comfortable and controlled.", "After each attempt, name one thing that was controlled and one thing to correct on the next attempt." ], "repeat_plan": "For ordinary low-risk rehearsal, use two to five controlled attempts in one session and stop before fatigue changes the movement. Delayed retention: wait at least 48 hours, do not reread the steps, then make three attempts with the same empty box and route; record every control feature separately. Near transfer: on a later day, use a different clearly light, stable object with secure handholds on a different short, dry, level route of similar difficulty; do not increase weight, distance or repetition. Stop for any surprise, symptom, grip problem, blocked view or loss of control. Workplace, heavy, repeated, rehabilitation or fitness progression remains under the responsible qualified person's plan.", "progress_when": [ "The route remains clear and visible on every attempt.", "The load stays close without a jerk, swing or mid-carry grip change.", "Direction changes are made with the feet and the set-down is controlled.", "There is no pain, dizziness, numbness, unexpected breathlessness or loss of balance during or after the session." ], "do_not_progress_when": [ "The object must be held away from the body or blocks the route from view.", "Technique changes as the learner tires or hurries.", "The task is repeated, occupational, overhead, from an awkward space or involves another person.", "The learner is unsure whether health, medication, injury or disability changes the safe plan." ] }, "self_check": [ "Before touching the object, can you state where it is going, how you will get there and what will make you stop?", "Can you show the difference between turning with your feet and twisting with fixed feet?", "Can you complete the lift without the object moving away from your body, blocking your view or changing grip in mid-air?", "Can you name an easier alternative to lifting this object by hand?", "Can an observer identify the same right and wrong features from the comparison table?" ], "measurement": { "primary": "Controlled completion of one declared lift-and-carry task.", "how": "Record the object, start and finish heights, distance, assistance and whether the lift included a secure hold, close load, smooth rise, foot turn, visible route and controlled set-down.", "good_result": "Immediate practice: all required control features are present on three attempts with the same light object and route. Delayed retention: the same features remain present after at least 48 hours without rereading the method. Near transfer: the features remain present with one different clearly light, stable object and one different short, clear, level route. Record the three results separately; none may include a stop symptom, surprise or increasing error.", "does_not_prove": "It does not establish a safe maximum weight, absence of injury risk, workplace competence, clinical readiness or transfer to another object or environment." }, "stop_and_get_help": [ "Stop immediately for new or increasing pain, dizziness, weakness, numbness, breathlessness, loss of balance or loss of grip.", "Put the object down and change the plan if the weight, contents, route or destination is different from what you expected.", "Use trained assistance for moving another person; do not improvise a person-lift from this object-handling lesson.", "Ask the employer or responsible person for a task assessment when lifting is part of work, repeated frequently or involves awkward conditions.", "Seek appropriate clinical or rehabilitation advice when a health condition, recent injury, pregnancy or persistent pain affects lifting." ], "accessibility": [ "Raise the starting or finishing surface to reduce reaching when that is permitted and stable.", "Use a trolley, wheeled container, transfer surface, smaller containers or a helper instead of removing an ordinary aid.", "Choose a container with larger handles or add an authorised grip aid.", "Use a seated or supported alternative only after the exact object, reach and stability have been assessed for that person.", "Use spoken, pictured or tactile step cues and practise the empty route before adding the object." ], "evidence_notes": [ { "claim": "A basic lift should begin with planning, a clear route and consideration of aids or help; the load should be held close, moved smoothly and set down before fine adjustment.", "source_title": "Manual handling at work: Good handling technique", "source_url": "https://www.hse.gov.uk/msd/manual-handling/good-handling-technique.htm", "source_kind": "OFFICIAL_GUIDANCE" }, { "claim": "Manual-handling instruction should be specific to the real task and include practical correction; training alone does not make a poorly designed task safe.", "source_title": "Manual handling at work: Training", "source_url": "https://www.hse.gov.uk/msd/manual-handling/training.htm", "source_kind": "OFFICIAL_GUIDANCE" }, { "claim": "There is no single perfect posture and claims that one correct lifting posture prevents back pain or injury should be avoided.", "source_title": "Myth busting about posture, core stability and lifting", "source_url": "https://www.cuh.nhs.uk/patient-information/myth-busting-about-posture-core-stability-and-lifting/", "source_kind": "OFFICIAL_GUIDANCE" }, { "claim": "Repeated occupational two-handed lifting requires formal risk assessment that considers task conditions rather than a universal weight limit.", "source_title": "Revised NIOSH Lifting Equation", "source_url": "https://www.cdc.gov/niosh/ergonomics/about/RNLE.html", "source_kind": "OFFICIAL_GUIDANCE" } ], "limits": [ "No handling technique guarantees that pain or injury will not occur.", "A successful light-box rehearsal does not establish a safe maximum load.", "Object handling does not authorise moving a person, animal, hazardous material or unstable load.", "Workplace duties, equipment rules and task-specific risk assessments remain controlling.", "The most useful change may be redesigning or avoiding the lift rather than training the person to tolerate it." ], "orientation": { "bounded_definition": "Capability to develop or express functional lifting and carrying in a declared context without inheriting broader claims.", "evidence_summary": "Functional lifting and carrying is real as a bounded, measurable capability, but the evidence is task- and population-specific. Titan separates improvement in the test from retention, transfer and meaningful function.", "supportable_public_claim": "In selected people and declared configurations, functional lifting and carrying can be measured and may improve with task-relevant practice; retention, transfer and meaningful value require separate testing.", "measurement_boundary": "Use a bounded object-handling task with load, origin/destination, distance, time, technique and assistance declared; do not infer spinal safety or occupational readiness from gym strength alone.", "myth_to_metric": { "myth": "Effortless lifting of anything", "metric": "Successful, repeatable lift/carry of a declared object over a declared route with safe technique and assistance recorded", "boundary": "The metric is valid only for its declared task and cannot establish universal ability, character, diagnosis, safety or far transfer." }, "limiting_findings": [ "Passive finger exercise did not improve grip strength despite changes in selected ADL scores.", "Knee-strength gains in osteoarthritis did not improve the trial's functional performance scores." ], "prohibited_claims": [ "Titan proves anyone can develop unlimited or superhuman functional lifting and carrying.", "One test score reveals whole-person capability, health, discipline, potential or worth.", "Improvement guarantees injury prevention, clinical benefit, occupational readiness or transfer to every real-world task." ] }, "gold_source_lesson": { "curriculum_id": "G-CUR-001", "source_heading": "PWR-006 - Functional lifting and carrying", "source_html_sha256": "46ac0190eac78b4e534c526698e823107eaac15126e1190499696fc1b9a2d81a", "html": "Specialist\nexplainer only. No lifting programme or occupational clearance.
" }, "next_gate": "External confirmation is required before higher-authority use because: CLINICAL_HIGH_RISK_OR_REGULATED_CONFIGURATION; SUPERVISION_OR_NON_ATTEMPT_BOUNDARY.", "evidence_count": 6 }, "full_training_programme": false, "independently_validated": false, "publication_state": "PUBLISHED_PUBLIC_RESEARCH_EDITION__EDITORIAL_REVIEW_PENDING", "related_power_ids": [ "PWR-001", "PWR-002", "PWR-003", "PWR-004" ] }, { "power_id": "PWR-007", "learning_unit_id": "TLU-PWR-007", "title": "Grip and pinch force", "main_description": "This supplement uses supplied fictional records, so it is runnable with no physical attempt. Do not perform a maximal squeeze, repeated fatigue work, painful pinch, hanging, carrying challenge or comparison between hands. A force value and a useful object-handling result answer different questions; neither diagnoses injury, dexterity or whole-person capability. Braces, adapted handles, two-hand use, forearm support and another person are part of the configuration, not defects to erase. New pain, swelling, numbness, recent injury, postoperative restrictions, rehabilitation questions or persistent weakness belong with an appropriately qualified clinician or therapist.", "main_description_source": "GOVERNED_TUTORIAL_PLAIN_ENGLISH_INTRO", "family_id": "FAM-01", "family": "Strength & Force Production", "superdomain": "Body & Performance", "canonical_route": "/powers/pwr-007/", "treatment": "RESEARCH_EXPLORATION_ROUTE", "treatment_label": "Full research tutorial", "treatment_boundary": "Titan teaches a complete Power-specific research method because operational capability practice is not currently justified.", "tutorial_route": "/tutorials/pwr-007/", "governed_lesson_route": "/tutorials/pwr-007/", "self_attempt_status": "NO_TRAINING_AUTHORITY", "gold_pathway_ids": [ "G-CUR-001" ], "route_membership": { "kind": "GOLD_PATHWAY", "id": "G-CUR-001", "coverage_status": "EXACT_ONCE" }, "source_authority_tier": "G2", "source_build_state": "RESEARCH_ONLY", "source_instructional_route": "EXPLAINER_ONLY_RESEARCH", "source_count": 4, "research_depth": "DETAILED", "risk_level": "LOW_TO_MODERATE", "prerequisite_status": "NONE_FOR_READING__NO_PRACTICE_AUTHORITY", "learning_route": { "mode": "RESEARCH_EXPLORATION", "label": "Explore the research frontier", "summary": "This supplement uses supplied fictional records, so it is runnable with no physical attempt. Do not perform a maximal squeeze, repeated fatigue work, painful pinch, hanging, carrying challenge or comparison between hands. A force value and a useful object-handling result answer different questions; neither diagnoses injury, dexterity or whole-person capability. Braces, adapted handles, two-hand use, forearm support and another person are part of the configuration, not defects to erase. New pain, swelling, numbness, recent injury, postoperative restrictions, rehabilitation questions or persistent weakness belong with an appropriately qualified clinician or therapist.", "steps": [ [ "Frame the question", "State the capability claim narrowly enough that evidence could support or limit it." ], [ "Map the evidence", "Distinguish existence, measurement, trainability, retention, transfer, safety and functional value." ], [ "Find uncertainty", "Identify small samples, proxy measures, missing controls, null findings and unresolved authority questions." ], [ "Compare alternatives", "Consider competing explanations and what evidence would change the current treatment." ], [ "Stay non-operational", "Use the record for research literacy only until a separate gate authorises instruction." ] ], "practical_authority": false, "provider_required": false, "next_action_route": "/tutorials/pwr-007/" }, "path_builder": { "selectable": true, "completion_allowed": true, "warning": "Titan teaches a complete Power-specific research method because operational capability practice is not currently justified." }, "full_tutorial": { "version": "1.0", "authorship": "AUTHORED_GOVERNED_SOURCE", "practice_pack": { "power_id": "PWR-007", "title": "Grip and pinch force", "heading": "Interpret fictional hand-force and object-task records without squeezing", "plain_english_intro": "This supplement uses supplied fictional records, so it is runnable with no physical attempt. Do not perform a maximal squeeze, repeated fatigue work, painful pinch, hanging, carrying challenge or comparison between hands. A force value and a useful object-handling result answer different questions; neither diagnoses injury, dexterity or whole-person capability. Braces, adapted handles, two-hand use, forearm support and another person are part of the configuration, not defects to erase. New pain, swelling, numbness, recent injury, postoperative restrictions, rehabilitation questions or persistent weakness belong with an appropriately qualified clinician or therapist.", "authority_and_safety": [ "Governance ceiling: explanation and static fictional record analysis only. Capability self-practice, live administration, protocol delivery and efficacy claims are not authorised until the recorded next_gate adjudication changes.", "Use only the four supplied fictional hand records. Do not squeeze, pinch, carry, handle an object or reproduce any task in the table.", "Do not diagnose injury, weakness or work readiness; preserve support, symptoms, apparatus and unknowns exactly as recorded." ], "materials": [ "The four fictional hand records in the fixture table; no dynamometer, pinch gauge or object is needed.", "Classification sheet with columns: force result; object-task function; support configuration; symptoms; what remains unknown; keep, redesign, seek review or stop.", "Boundary card: no maximal testing, no repetitions, no fatigue set, no painful movement, no hazardous object and no diagnosis.", "Optional diagram showing a seated forearm-supported posture and an adapted handle. It is for configuration description only, not an instruction to reproduce the posture." ], "setup_steps": [ "Choose the no-attempt route and state that every row is fictional. Do not imitate a squeeze, pinch or object task while analysing it.", "Read each row once and underline apparatus, handle, posture, object, support and symptom details. A changed handle or aid creates a different configuration.", "Write a force statement only when a standardised force result is supplied. Include apparatus and setting; do not convert units or compare with a norm.", "Write a separate function statement for the ordinary object task. Include accuracy, release, support and any symptom; do not infer force when none was measured.", "Name at least two unknowns per row, then choose keep, redesign, seek qualified review or stop.", "Finish by explaining why a higher force number cannot automatically replace a lower-force but successful supported task result." ], "fixture": { "caption": "Fictional grip/pinch records for no-attempt interpretation", "headers": [ "Case", "Supplied force record", "Supplied object-task record", "Support and symptom information" ], "rows": [ [ "G1", "Existing fictional grip record: 18 kg on Device K, handle setting 2, right hand, seated, forearm supported; one historical trial", "Moved an empty plastic cup 20 cm and released it on a mat without a drop", "Used a wide foam handle sleeve; no symptom was recorded on the old sheet" ], [ "G2", "No force measurement", "Held a postcard between thumb and side of index finger for five seconds, then placed it in a tray; task completed accurately", "Used forearm support; fictional note says mild new thumb pain began earlier that day" ], [ "G3", "Existing fictional pinch record: 3.1 kg on Gauge P, lateral pinch, left hand, one trial; posture not recorded", "Could not open a fictional spring clip; then opened it using two hands and a clip aid", "Two-hand use and aid were effective; no pain reported; apparatus posture and clip resistance are unknown" ], [ "G4", "Existing fictional grip record: 22 kg on Device Q, handle setting unknown", "Dropped a glass jar during an unrelated household event", "Object was breakable and hazardous; support, surface and symptoms are unknown" ] ] }, "scoring_rule": "Score each case out of 6: 1 point for a configuration-bound force statement or ‘no force data’; 1 for a separate function statement; 1 for preserving all support; 1 for symptoms; 1 for at least two unknowns; and 1 for the responsible decision. Total 24. Passing requires 21 and correct automatic stops for G2 and hazardous practice based on G4. Any invented diagnosis, maximal-test suggestion, hidden aid or conclusion that more kilograms means better whole-hand function receives STOP.", "worked_example": { "steps": [ "A learner reads G3 and writes, ‘Left pinch strength is 3.1 kg and the person has weak hands because they could not open the clip.’", "They repair the force statement to ‘A single fictional 3.1 kg lateral-pinch result was recorded on Gauge P; posture is unknown.’", "They separate function: one-hand spring-clip opening was not completed, while two-hand opening with a clip aid was completed.", "They preserve the aid and list unknown clip resistance, posture, repeatability and performance on any other task.", "They choose KEEP AS A FICTIONAL CONFIGURATION EXAMPLE; no physical retest or stronger squeeze is proposed." ], "result": "The repaired G3 answer earns 6/6. It describes one force record and two object-task configurations without diagnosing weakness, subtracting assistance or generalising to other hand functions." }, "right_vs_wrong": [ { "situation": "Reading a force value", "right": "Report the value with device, handle, hand, posture and trial details that are actually supplied.", "wrong": "Call the number strong, weak or normal from memory.", "why": "A standardised result belongs to its apparatus and setup; normative and clinical interpretation is not supplied." }, { "situation": "Reading an object task", "right": "State whether this object was handled and released accurately with the recorded support.", "wrong": "Use cup or card success as proof of maximal grip strength.", "why": "Function and force are related questions, not interchangeable measures." }, { "situation": "Handling assistance", "right": "Include the foam sleeve, forearm support, two hands and clip aid in the capability configuration.", "wrong": "Remove aids from the conclusion so the result sounds independent.", "why": "Hidden support makes the statement false and can create unsafe pressure." }, { "situation": "Responding to symptoms", "right": "Stop G2 and route new thumb pain for appropriate review if it persists or concerns the person.", "wrong": "Repeat the pinch to see whether pain improves after warming up.", "why": "The governed lesson authorises no pain test, repetitions or rehabilitation experiment." }, { "situation": "Choosing a record", "right": "Use only the supplied fictional row and preserve every stated object hazard as data.", "wrong": "Recreate G4 with a jar or another object to make the analysis realistic.", "why": "This route authorises static record analysis only and no object-handling attempt." } ], "common_mistakes": [ { "mistake": "Force and function are merged into one ‘hand score.’", "fix": "Write two sentences and two fields: one for standardised force, one for the declared object task." }, { "mistake": "Unknown apparatus settings are silently filled in.", "fix": "Write UNKNOWN and refuse cross-record comparison until the configuration is complete." }, { "mistake": "A successful aided task is relabelled as failure.", "fix": "Record the aid, the task result and its effect; support is part of the observed system." }, { "mistake": "The learner wants to generate a fresh maximal value.", "fix": "Use the fictional table or an existing qualified record. No maximal or fatigue self-test is authorised." }, { "mistake": "A number is used to infer injury, diagnosis or work readiness.", "fix": "Restore the measurement boundary and refer clinical, rehabilitation or occupational questions to the relevant professional." } ], "answer_key_route": "/tutorials/pwr-007/answer-key/", "answer_key_delivery": "SEPARATE_NOINDEX_NOARCHIVE_CHECKING_PAGE" }, "tutorial_mode": "RESEARCH_EXPLORATION", "orientation": { "bounded_definition": "Capability to develop or express grip and pinch force in a declared context without inheriting broader claims.", "evidence_summary": "Grip and pinch force is real as a bounded, measurable capability, but the evidence is task- and population-specific. Titan separates improvement in the test from retention, transfer and meaningful function.", "measurement_boundary": "Standardise dynamometer/pinch gauge, handle setting, arm posture and trials; pair force with a relevant object-manipulation task and declare adaptive devices.", "myth_to_metric": { "myth": "A crushing, universal grip", "metric": "Maximum and repeated grip/pinch force in a standardised posture plus a task-specific hand-function measure", "boundary": "The metric is valid only for its declared task and cannot establish universal ability, character, diagnosis, safety or far transfer." }, "limiting_findings": [ "Passive finger exercise produced no grip-strength gain in older adults with dementia.", "A stronger dynamometer score does not establish dexterity or every activity of daily living." ], "prohibited_claims": [ "Titan proves anyone can develop unlimited or superhuman grip and pinch force.", "One test score reveals whole-person capability, health, discipline, potential or worth.", "Improvement guarantees injury prevention, clinical benefit, occupational readiness or transfer to every real-world task." ] }, "outcomes": [ "Define grip and pinch force without inheriting mythology or broader claims.", "Explain what the current evidence supports and what it does not establish.", "Use the declared measurement boundary and recognise misleading proxies.", "Complete the current learning route without converting it into unauthorised capability practice.", "Make a retention, transfer, maintenance, provider or stop decision without overclaiming." ], "prerequisites": "NONE_FOR_READING__NO_PRACTICE_AUTHORITY", "baseline": { "instruction": "Before reading the sequence, record your current definition, confidence, assumed measure, expected value, known risks and intended next action. Do not attempt the capability.", "record": [ "date and context", "current definition", "confidence from 0 to 100", "assumed measure", "expected benefit", "known limitation", "intended next action" ] }, "modules": [ { "order": 1, "title": "Frame the question", "instruction": "State the capability claim narrowly enough that evidence could support or limit it.", "completion_evidence": "Record the decision or output from frame the question in one or two sentences." }, { "order": 2, "title": "Map the evidence", "instruction": "Distinguish existence, measurement, trainability, retention, transfer, safety and functional value.", "completion_evidence": "Record the decision or output from map the evidence in one or two sentences." }, { "order": 3, "title": "Find uncertainty", "instruction": "Identify small samples, proxy measures, missing controls, null findings and unresolved authority questions.", "completion_evidence": "Record the decision or output from find uncertainty in one or two sentences." }, { "order": 4, "title": "Compare alternatives", "instruction": "Consider competing explanations and what evidence would change the current treatment.", "completion_evidence": "Record the decision or output from compare alternatives in one or two sentences." }, { "order": 5, "title": "Stay non-operational", "instruction": "Use the record for research literacy only until a separate gate authorises instruction.", "completion_evidence": "Record the decision or output from stay non-operational in one or two sentences." } ], "lab": { "title": "Claim-audit lab", "instruction": "Choose one public claim about this Power. Compare it with the bounded definition, measurement limit, supporting evidence, limiting findings and prohibited wording.", "deliverable": "A one-page claim verdict: supported, partly supported, unresolved or contradicted, with the reason stated." }, "assessment": { "immediate": "Restate the bounded definition, evidence ceiling, measurement boundary and current authority route without looking.", "delayed_retention": "Repeat the explanation and route decision after at least 48 hours; record what changed or was forgotten.", "transfer": "Evaluate a new claim, provider option or research result using the same evidence and authority checklist; do not perform the capability.", "interpretation": "Completion demonstrates learning of this tutorial only. It does not prove capability, qualification, independent validation, safety clearance or far transfer." }, "maintenance": { "cadence": "Review after 48 hours, again after 2-4 weeks, and whenever the evidence or authority treatment changes.", "decisions": [ "retain", "refresh", "seek qualified support", "return to research", "retire" ] }, "accessibility": "Use text-to-speech, enlarged text, keyboard navigation, shorter sessions, a support person or an equivalent non-practical record format as needed. Accessibility changes must not enlarge practical authority.", "stopping_and_escalation": "Titan teaches a complete Power-specific research method because operational capability practice is not currently justified. Stop if the declared configuration cannot be maintained, uncertainty becomes material, adverse effects appear, or qualified authority is required.", "next_gate": "No external confirmation is required for the current bounded explainer permission. Guide permission remains NOT_READY; any guide, stronger efficacy, generalisation, protocol, promotion or independent-validation claim requires a new adjudication.", "evidence_count": 4 }, "full_training_programme": false, "independently_validated": false, "publication_state": "PUBLISHED_PUBLIC_RESEARCH_EDITION__EDITORIAL_REVIEW_PENDING", "related_power_ids": [ "PWR-001", "PWR-002", "PWR-003", "PWR-004" ] }, { "power_id": "PWR-008", "learning_unit_id": "TLU-PWR-008", "title": "Force steadiness", "main_description": "A force trace is not better merely because it looks flat. This pack supplies three like-for-like fictional traces so the learner can calculate simple spread, distinguish an isolated event from drift, and write a non-diagnostic conclusion.", "main_description_source": "GOVERNED_TUTORIAL_PLAIN_ENGLISH_INTRO", "family_id": "FAM-01", "family": "Strength & Force Production", "superdomain": "Body & Performance", "canonical_route": "/powers/pwr-008/", "treatment": "RESEARCH_EXPLORATION_ROUTE", "treatment_label": "Full research tutorial", "treatment_boundary": "Titan teaches a complete Power-specific research method because operational capability practice is not currently justified.", "tutorial_route": "/tutorials/pwr-008/", "governed_lesson_route": "/tutorials/pwr-008/", "self_attempt_status": "NO_TRAINING_AUTHORITY", "gold_pathway_ids": [ "G-CUR-001" ], "route_membership": { "kind": "GOLD_PATHWAY", "id": "G-CUR-001", "coverage_status": "EXACT_ONCE" }, "source_authority_tier": "G2", "source_build_state": "RESEARCH_ONLY", "source_instructional_route": "EXPLAINER_ONLY_RESEARCH", "source_count": 2, "research_depth": "FOCUSED", "risk_level": "LOW_TO_MODERATE", "prerequisite_status": "NONE_FOR_READING__NO_PRACTICE_AUTHORITY", "learning_route": { "mode": "RESEARCH_EXPLORATION", "label": "Explore the research frontier", "summary": "A force trace is not better merely because it looks flat. This pack supplies three like-for-like fictional traces so the learner can calculate simple spread, distinguish an isolated event from drift, and write a non-diagnostic conclusion.", "steps": [ [ "Frame the question", "State the capability claim narrowly enough that evidence could support or limit it." ], [ "Map the evidence", "Distinguish existence, measurement, trainability, retention, transfer, safety and functional value." ], [ "Find uncertainty", "Identify small samples, proxy measures, missing controls, null findings and unresolved authority questions." ], [ "Compare alternatives", "Consider competing explanations and what evidence would change the current treatment." ], [ "Stay non-operational", "Use the record for research literacy only until a separate gate authorises instruction." ] ], "practical_authority": false, "provider_required": false, "next_action_route": "/tutorials/pwr-008/" }, "path_builder": { "selectable": true, "completion_allowed": true, "warning": "Titan teaches a complete Power-specific research method because operational capability practice is not currently justified." }, "full_tutorial": { "version": "1.0", "authorship": "AUTHORED_GOVERNED_SOURCE", "practice_pack": { "power_id": "PWR-008", "title": "Force steadiness", "heading": "Read spread, outliers, and drift in three fictional force traces", "plain_english_intro": "A force trace is not better merely because it looks flat. This pack supplies three like-for-like fictional traces so the learner can calculate simple spread, distinguish an isolated event from drift, and write a non-diagnostic conclusion.", "authority_and_safety": [ "Governance ceiling: explanation and static fictional record analysis only. Capability self-practice, live administration, protocol delivery and efficacy claims are not authorised until the recorded next_gate adjudication changes.", "Use only the supplied fictional traces. Do not create a contraction, fatigue task, repeated movement or personal measurement.", "The trace comparison cannot diagnose tremor, weakness, neurological disease or broad motor control." ], "materials": [ "The three-trace table in this record", "Paper or spreadsheet", "A calculator, optional", "The answer key, hidden until calculations and pattern labels are complete" ], "setup_steps": [ "Confirm the common configuration: target 50 N, eight seconds, one sample per second, same fictional sensor and filter.", "For each trace, calculate the sum and mean.", "Calculate range as maximum minus minimum.", "Calculate mean absolute deviation, or MAD, as the mean of the absolute distances from that trace's mean.", "Inspect the time order and label the dominant pattern: low spread, isolated event, or gradual drift.", "Write one result sentence and one non-diagnostic boundary sentence." ], "fixture": { "caption": "All values are fictional newtons measured at one-second intervals against the same 50 N target.", "headers": [ "Second", "Trace a n", "Trace b n", "Trace c n" ], "rows": [ [ "1", "49", "50", "47" ], [ "2", "51", "50", "48" ], [ "3", "50", "50", "49" ], [ "4", "50", "50", "50" ], [ "5", "49", "50", "51" ], [ "6", "51", "50", "52" ], [ "7", "50", "50", "53" ], [ "8", "50", "58", "54" ] ] }, "scoring_rule": "Award 1 point per trace for the correct mean, range, MAD, and pattern: 12 points.; Award 1 point for confirming the configurations are comparable and 1 point for a non-diagnostic conclusion: 14 points total.; Do not award the pattern point when B is called drift or C is called one outlier.", "worked_example": { "steps": [ "Add the values: 47 + 48 + 49 + 50 + 51 + 52 + 53 + 54 = 404 N.", "Divide by eight: 404 / 8 = 50.5 N.", "Find the range: 54 - 47 = 7 N.", "Find absolute distances from 50.5: 3.5, 2.5, 1.5, 0.5, 0.5, 1.5, 2.5, and 3.5 N. Their sum is 16 N.", "Calculate MAD: 16 / 8 = 2.0 N.", "Read time order: every value rises by 1 N, so the defining pattern is gradual upward drift." ], "result": "Trace C has mean 50.5 N, range 7 N, MAD 2.0 N, and an upward drift under this fictional configuration. Those numbers do not identify a cause or diagnose a person." }, "right_vs_wrong": [ { "situation": "Reading Trace B", "right": "One isolated high sample raises the mean and range.", "wrong": "The force steadily drifted upward.", "why": "The first seven samples are constant; only the final sample differs." }, { "situation": "Reading Trace C", "right": "The ordered values show gradual drift.", "wrong": "The range alone proves random variability.", "why": "Range discards time order." }, { "situation": "Comparing traces", "right": "Compare because target, duration, mode, and sampling are declared equal.", "wrong": "Any two traces can be ranked by whichever line looks flatter.", "why": "Different configurations would make the comparison indeterminate." }, { "situation": "Writing the conclusion", "right": "Describe the trace under these fictional conditions.", "wrong": "Trace C proves a neurological problem.", "why": "A trace pattern is not a diagnosis." } ], "common_mistakes": [ { "mistake": "Judging steadiness by appearance without calculating spread.", "fix": "Calculate mean, range, and MAD before assigning a pattern label." }, { "mistake": "Ignoring sample order.", "fix": "Read from second 1 through second 8 and mark trend versus isolated event." }, { "mistake": "Using the target value instead of the trace mean in MAD.", "fix": "Calculate each trace's mean first, then take distances from that mean." }, { "mistake": "Explaining the cause from these values alone.", "fix": "State the observed pattern and mark cause and diagnosis as unknown." } ], "answer_key_route": "/tutorials/pwr-008/answer-key/", "answer_key_delivery": "SEPARATE_NOINDEX_NOARCHIVE_CHECKING_PAGE" }, "tutorial_mode": "RESEARCH_EXPLORATION", "orientation": { "bounded_definition": "Capability to develop or express force steadiness in a declared context without inheriting broader claims.", "evidence_summary": "Force steadiness is real as a bounded, measurable capability, but the evidence is task- and population-specific. Titan separates improvement in the test from retention, transfer and meaningful function.", "measurement_boundary": "Report target level, absolute and normalised variability, contraction mode, duration and filtering; lower variability is not always better and cannot diagnose neurological disease.", "myth_to_metric": { "myth": "Perfectly unwavering force", "metric": "Force/position coefficient of variation around a declared target, with a separate precision task", "boundary": "The metric is valid only for its declared task and cannot establish universal ability, character, diagnosis, safety or far transfer." }, "limiting_findings": [ "The Tracy trial found no change in submaximal isometric force variability despite anisometric improvement.", "The evidence base here is small and concentrated in older adults and laboratory tasks." ], "prohibited_claims": [ "Titan proves anyone can develop unlimited or superhuman force steadiness.", "One test score reveals whole-person capability, health, discipline, potential or worth.", "Improvement guarantees injury prevention, clinical benefit, occupational readiness or transfer to every real-world task." ] }, "outcomes": [ "Define force steadiness without inheriting mythology or broader claims.", "Explain what the current evidence supports and what it does not establish.", "Use the declared measurement boundary and recognise misleading proxies.", "Complete the current learning route without converting it into unauthorised capability practice.", "Make a retention, transfer, maintenance, provider or stop decision without overclaiming." ], "prerequisites": "NONE_FOR_READING__NO_PRACTICE_AUTHORITY", "baseline": { "instruction": "Before reading the sequence, record your current definition, confidence, assumed measure, expected value, known risks and intended next action. Do not attempt the capability.", "record": [ "date and context", "current definition", "confidence from 0 to 100", "assumed measure", "expected benefit", "known limitation", "intended next action" ] }, "modules": [ { "order": 1, "title": "Frame the question", "instruction": "State the capability claim narrowly enough that evidence could support or limit it.", "completion_evidence": "Record the decision or output from frame the question in one or two sentences." }, { "order": 2, "title": "Map the evidence", "instruction": "Distinguish existence, measurement, trainability, retention, transfer, safety and functional value.", "completion_evidence": "Record the decision or output from map the evidence in one or two sentences." }, { "order": 3, "title": "Find uncertainty", "instruction": "Identify small samples, proxy measures, missing controls, null findings and unresolved authority questions.", "completion_evidence": "Record the decision or output from find uncertainty in one or two sentences." }, { "order": 4, "title": "Compare alternatives", "instruction": "Consider competing explanations and what evidence would change the current treatment.", "completion_evidence": "Record the decision or output from compare alternatives in one or two sentences." }, { "order": 5, "title": "Stay non-operational", "instruction": "Use the record for research literacy only until a separate gate authorises instruction.", "completion_evidence": "Record the decision or output from stay non-operational in one or two sentences." } ], "lab": { "title": "Claim-audit lab", "instruction": "Choose one public claim about this Power. Compare it with the bounded definition, measurement limit, supporting evidence, limiting findings and prohibited wording.", "deliverable": "A one-page claim verdict: supported, partly supported, unresolved or contradicted, with the reason stated." }, "assessment": { "immediate": "Restate the bounded definition, evidence ceiling, measurement boundary and current authority route without looking.", "delayed_retention": "Repeat the explanation and route decision after at least 48 hours; record what changed or was forgotten.", "transfer": "Evaluate a new claim, provider option or research result using the same evidence and authority checklist; do not perform the capability.", "interpretation": "Completion demonstrates learning of this tutorial only. It does not prove capability, qualification, independent validation, safety clearance or far transfer." }, "maintenance": { "cadence": "Review after 48 hours, again after 2-4 weeks, and whenever the evidence or authority treatment changes.", "decisions": [ "retain", "refresh", "seek qualified support", "return to research", "retire" ] }, "accessibility": "Use text-to-speech, enlarged text, keyboard navigation, shorter sessions, a support person or an equivalent non-practical record format as needed. Accessibility changes must not enlarge practical authority.", "stopping_and_escalation": "Titan teaches a complete Power-specific research method because operational capability practice is not currently justified. Stop if the declared configuration cannot be maintained, uncertainty becomes material, adverse effects appear, or qualified authority is required.", "next_gate": "No external confirmation is required for the current bounded explainer permission. Guide permission remains NOT_READY; any guide, stronger efficacy, generalisation, protocol, promotion or independent-validation claim requires a new adjudication.", "evidence_count": 2 }, "full_training_programme": false, "independently_validated": false, "publication_state": "PUBLISHED_PUBLIC_RESEARCH_EDITION__EDITORIAL_REVIEW_PENDING", "related_power_ids": [ "PWR-001", "PWR-002", "PWR-003", "PWR-004" ] }, { "power_id": "PWR-009", "learning_unit_id": "TLU-PWR-009", "title": "Acceleration", "main_description": "Using the same photographed launch geometry, the learner completes two coach-authorised ten-metre departures with valid beam trigger, forward projection, split continuity and post-gate slowdown, then locates any time change in 0–5 m or 5–10 m.", "main_description_source": "FULL_TUTORIAL_OUTCOME", "family_id": "FAM-02", "family": "Power, Speed & Agility", "superdomain": "Body & Performance", "canonical_route": "/powers/pwr-009/", "treatment": "SPECIALIST_PROVIDER_ROUTE", "treatment_label": "Full supervised tutorial", "treatment_boundary": "Titan teaches the complete method; a qualified person controls the parts that require supervision, clearance, specialist equipment, load, dose or progression.", "tutorial_route": "/tutorials/pwr-009/", "governed_lesson_route": null, "self_attempt_status": "PROHIBITED_WITHOUT_QUALIFIED_SUPERVISION", "gold_pathway_ids": [], "route_membership": { "kind": "RETAINED_EXTERNAL_ROUTE", "id": "SP-HUB-001", "coverage_status": "RETAINED" }, "source_authority_tier": "G4", "source_build_state": "EXTERNAL_PROVIDER_ROUTE", "source_instructional_route": "LEARN_ELSEWHERE_TRACK_WITH_TITAN", "source_count": 7, "research_depth": "DEEP", "risk_level": "HIGH", "prerequisite_status": "QUALIFIED_PROVIDER_DETERMINES", "learning_route": { "mode": "FULL_SUPERVISED_TUTORIAL", "label": "Learn acceleration step by step", "summary": "Using the same photographed launch geometry, the learner completes two coach-authorised ten-metre departures with valid beam trigger, forward projection, split continuity and post-gate slowdown, then locates any time change in 0–5 m or 5–10 m.", "steps": [ [ "Get ready", "Walk the entire lane and remove people, objects, wet patches and loose material." ], [ "Learn the method", "10 concrete steps teach the permitted method from start to finish." ], [ "See right and wrong", "7 comparisons show correct or safer execution beside common wrong or riskier choices." ], [ "Practise", "At the next coach-approved exposure, reproduce stance marks and start logic before arming sector gates. Work first on whichever segment was inconsistent: quiet departures and contact one for 0–5 m, or gradual posture change for 5–10 m. Resistance, hills, extra starts and weekly frequency remain provider decisions because they change load and the task." ], [ "Check progress", "Reuse photographed toe marks, the same self-start trigger, gate geometry, surface, footwear and camera view. Decide trigger and technical validity before comparing either sector. Preserve distinct departure-sector and transition-sector tag profiles beside their split times." ] ], "practical_authority": false, "provider_required": true, "next_action_route": "/tutorials/pwr-009/" }, "path_builder": { "selectable": true, "completion_allowed": true, "warning": "Titan teaches the complete method; a qualified person controls the parts that require supervision, clearance, specialist equipment, load, dose or progression." }, "full_tutorial": { "version": "3.0", "authorship": "POWER_SPECIFIC_FULL_TUTORIAL", "tutorial_mode": "SUPERVISED", "promise": "Acceleration here means gaining sprint velocity across a measured ten metres. Gate zero, gate five and gate ten create a departure split and a transition split. A side camera verifies the launch: shoes remain on their tape marks, no preload crosses the beam, pelvis and trunk project together, and touchdown one does not reach ahead of the moving hip. Frames after gate five show whether posture rises over several contacts rather than popping upright. Each departure receives separate tags for trigger, first motion, touchdown, projection, transition rhythm and post-gate deceleration. Only a run whose tags pass may contribute split times. A tempting clock reading is discarded when a shoe creeps, the timer fires falsely, an opening stride brakes forward motion, or sprinting ends at gate ten. The timed fixture finishes at ten metres, but the athlete continues into a dedicated slowdown corridor before turning. A qualified sprint coach sets readiness, warm-up, intensity, recovery, departure count, surface and hardware. Review begins with validity tags, continues with 0–5 m and 5–10 m clocks, and ends with the total. That order shows whether change arose during launch or transition and prevents one fast number from hiding a different start geometry.", "power_id": "PWR-009", "title": "Acceleration", "lesson_type": "SUPERVISED", "headline": "Accelerate through a fixed 10-metre split with a repeatable start", "plain_english_summary": "Acceleration here means gaining sprint velocity across a measured ten metres. Gate zero, gate five and gate ten create a departure split and a transition split. A side camera verifies the launch: shoes remain on their tape marks, no preload crosses the beam, pelvis and trunk project together, and touchdown one does not reach ahead of the moving hip. Frames after gate five show whether posture rises over several contacts rather than popping upright. Each departure receives separate tags for trigger, first motion, touchdown, projection, transition rhythm and post-gate deceleration. Only a run whose tags pass may contribute split times. A tempting clock reading is discarded when a shoe creeps, the timer fires falsely, an opening stride brakes forward motion, or sprinting ends at gate ten. The timed fixture finishes at ten metres, but the athlete continues into a dedicated slowdown corridor before turning. A qualified sprint coach sets readiness, warm-up, intensity, recovery, departure count, surface and hardware. Review begins with validity tags, continues with 0–5 m and 5–10 m clocks, and ends with the total. That order shows whether change arose during launch or transition and prevents one fast number from hiding a different start geometry.", "outcome": "Using the same photographed launch geometry, the learner completes two coach-authorised ten-metre departures with valid beam trigger, forward projection, split continuity and post-gate slowdown, then locates any time change in 0–5 m or 5–10 m.", "authority": { "learner_may": [ "Acceleration: Place the front foot behind the line and the other foot about one comfortable step back. Lean forward from the ankles and hips with weight shared so neither foot has to shuffle. Hold still until the declared cue or self-start rule. Do not rock, lift a foot or cross the beam early.", "During an authorised attempt, For the next two to four steps, push the ground back and down, swing the arms front to back and allow the torso to rise gradually. Keep sprinting past the second gate; do not lunge, jump or slow before it.", "Photograph or mark the two-point start, record every 0–10 m split and validity decision, and confirm that the full deceleration lane remained clear." ], "qualified_person_required_for": [ "Check sprint readiness, current lower-limb symptoms, footwear, surface traction and available runoff before authorising a measured acceleration.", "Set surface, footwear, start method, sprint intensity, trial count, rest, timing gates and the deceleration zone.", "Reposition the rear foot on its mark before every start, reject a trial containing a pre-push balance step and review first-step video, symptoms and recovery before calling the next sprint." ], "never_do": [ "Sprint on an unchecked surface, start before the course is clear or use sled resistance that the provider has not selected.", "Do not add a harder start, another sprint or a shorter runoff simply to improve the 10-metre time.", "End acceleration work for pain, tightness, loss of coordination, unsafe braking or a pattern of worsening times with increasing technical error." ] }, "materials": [ "A level sprint lane with a separate marked deceleration zone", "Timing gates or validated split-timing equipment", "Start-line and 10 m markers", "Secure task-appropriate footwear", "A start-and-split log containing foot marks, surface, footwear, timing-gate positions, first movement, 0–10 m time, video validity and rejected-trial reasons." ], "before_you_start": [ "Walk the entire lane and remove people, objects, wet patches and loose material.", "Confirm that the timing starts from the same body movement or external signal on every trial.", "Tell the provider about lower-limb pain, recent sprinting absence, hamstring or tendon injury and illness or heat concerns.", "Walk through the start, sprint lane and full runoff before timing anything. Put both feet on their marks and confirm the learner can hold the photographed start without a balance step.", "Use progressive run-throughs to practise waiting without creeping, pushing from the marked stance and continuing into the full runoff before timing begins." ], "steps": [ { "title": "Rebuild launch geometry", "instruction": "Align lead and rear toes with their taped coordinates, copy the photographed hip height, and set the same arm forward. Let the coach confirm camera and gate-zero alignment.", "reason": "Changed toe spacing or hip height creates a different launch rather than a clean retest.", "success_check": "Reference photo and live side view show matching shoes, pelvis height and arm arrangement." }, { "title": "Prove a zero-momentum trigger", "instruction": "Settle pressure toward the lead side while both shoes stay quiet behind gate zero. Maintain one visible still frame before the agreed self-start movement fires timing.", "reason": "Pre-trigger rocking supplies unmeasured momentum and shortens the recorded departure artificially.", "success_check": "A freeze-frame precedes first motion, and gate zero remains clear until that motion." }, { "title": "Project pelvis through gate zero", "instruction": "At release, push from the rear side so shin, pelvis and trunk translate forward together. Keep the chest from rising ahead of pelvic travel and omit any balance shuffle.", "reason": "Coordinated forward projection converts push into displacement instead of spending time rearranging posture vertically.", "success_check": "First-motion video shows pelvic travel toward lane centre before any obvious upright lift." }, { "title": "Audit touchdown one", "instruction": "Recover the swing thigh promptly, place touchdown one near or just behind projected hip position, and coordinate the opposite arm through the launch rhythm.", "reason": "An outstretched opening foot applies braking exactly where early velocity should be increasing.", "success_check": "Side footage places the first shoe near hip projection, with no heel reaching forward." }, { "title": "Complete the departure split", "instruction": "During contacts two and three, direct force backward into the lane, preserve broad shin-to-trunk alignment, and allow step travel to expand progressively toward gate five.", "reason": "Useful 0–5 m acceleration comes from successive projections, not a single exaggerated bound.", "success_check": "Gate-five footage contains no stutter, crossover, sudden rise or conspicuous forward reach." }, { "title": "Transition after gate five", "instruction": "Across 5–10 m, raise posture over several footfalls while cadence develops naturally. Direct vision beyond gate ten and avoid forcing longer strides from the knee.", "reason": "Gradual transition preserves acceleration mechanics; an instant upright switch belongs to neither launch nor mature maximum-speed running.", "success_check": "Frame sequence shows progressive trunk rise and uninterrupted rhythm across the middle gate." }, { "title": "Clear gate ten in stride", "instruction": "Maintain sprint rhythm through the second timing beam and for several metres afterward. Do not lean, leap, reach with the head or prepare a plant at gate ten.", "reason": "Finish gestures contaminate the 5–10 m clock and add an unnecessary braking impulse.", "success_check": "Gate ten is crossed on a normal footfall cycle with velocity continuing beyond timing." }, { "title": "Use post-gate slowdown space", "instruction": "Inside the marked corridor, reduce velocity through successive footfalls until walking pace is reached. Turn back only after the coach confirms timing traffic is clear.", "reason": "Separating sprint measurement from deceleration avoids a forced stop or high-speed pivot near equipment.", "success_check": "Slowdown stays inside its corridor, with no skid, cut, gate collision or rapid turn." }, { "title": "Validate tags before clocks", "instruction": "Score gate-zero stillness, first-motion projection and touchdown one before opening split results. Next score posture transition, rhythm, gate-ten continuity and corridor use.", "reason": "Technical validity determines whether either clock value belongs in the acceleration record.", "success_check": "Each retained departure has a completed launch row and transition row beside its clocks." }, { "title": "Locate the changed sector", "instruction": "Compare 0–5 m and 5–10 m separately, then add them to verify the displayed total. Match any meaningful difference with the corresponding tagged frame sequence.", "reason": "Split diagnosis distinguishes altered departure mechanics from altered transition rhythm and prevents vague feedback.", "success_check": "The review names a valid sector difference, its arithmetic, and one relevant video observation." } ], "worked_example": { "scenario": "An indoor sprint coach records three self-start departures using gates at 0, 5 and 10 m, side video at the first three contacts and a 15 m braking corridor.", "walkthrough": [ "The stance photo records both toe marks, hip height and left arm forward; a rehearsal confirms that the first movement starts the clock.", "Attempt A is 1.18 s to 5 m and 0.76 s from 5–10 m, totalling 1.94 s; video shows the chest lifting before the pelvis moves.", "Attempt B is 1.14 s plus 0.75 s, totalling 1.89 s, with a unified break and three progressive drive contacts.", "Attempt C displays 1.10 s plus 0.74 s, but a shoe crept across the beam during the quiet count, so the attractive 1.84 s total is rejected.", "The coach selects Attempt B, links the 0.04 s first-sector gain to the cleaner departure and ends at the planned count.", "The learner uses the full braking corridor each time and reports no calf, hamstring or Achilles symptom.", "Attempt B's departure row passes still frame, toe marks, unified first motion and contact one; its transition row passes gradual unfold, rhythm and no-reach tags." ], "result": "The report keeps the valid 1.14 s and 0.75 s sector splits, giving a 1.89 s 0–10 m total from the declared stance. It does not substitute the invalid 1.84 s trace or claim top-speed ability." }, "right_vs_wrong": [ { "situation": "Pre-trigger pressure", "right": "Hold the loaded stance for a quiet count with both toe marks visible.", "wrong": "Rock forward so momentum exists before the clock begins.", "why": "A rolling departure is not the declared fixed-start acceleration." }, { "situation": "First visible movement", "right": "Send pelvis and torso forward together from the rear-side drive.", "wrong": "Lift the chest, shuffle, then begin pushing.", "why": "Vertical rearrangement spends time without useful forward displacement." }, { "situation": "Contact one", "right": "Strike close to the projected hip and push the surface behind.", "wrong": "Reach the lower leg forward to manufacture a long opening step.", "why": "The outstretched contact can brake the body during the first sector." }, { "situation": "Sector transition", "right": "Unfold gradually after 5 m while rhythm develops.", "wrong": "Stand tall on contact two because upright running looks faster.", "why": "Premature rise changes early push orientation and often slows 0–5 m." }, { "situation": "Reading the clock", "right": "Validate the trigger, then inspect both sector times and video.", "wrong": "Keep the smallest total even though the beam was crossed before departure.", "why": "An invalid trigger cannot reveal acceleration performance." }, { "situation": "Crossing 10 m", "right": "Continue an ordinary stride beyond the beam and brake later.", "wrong": "Dive, jump or plant to stop on the finish line.", "why": "A finish manoeuvre corrupts the second sector and raises braking demand." }, { "situation": "Interpreting sector profile", "right": "Validate departure tags and transition tags before ranking total time.", "wrong": "Use one fast total to excuse a crept departure or reaching transition.", "why": "Different sector errors require different start coaching." } ], "common_mistakes": [ { "mistake": "Rear-toe placement drifts a shoe length backward between attempts.", "fix": "Reset both toes to tape marks and compare the hip-height photo before arming the timer." }, { "mistake": "A tiny heel lift breaks the beam during the quiet count.", "fix": "Reduce the forward load until one full still count is repeatable, then recheck trigger logic." }, { "mistake": "The chest rises before the pelvis leaves the line.", "fix": "Rehearse a submaximal unified break over one step, using side video for immediate confirmation." }, { "mistake": "The first foot reaches beyond the hip projection.", "fix": "Use a short contact-one rehearsal and the cue 'strike back under you' rather than asking for a longer step." }, { "mistake": "Only the 10 m total is saved.", "fix": "Export 0–5 m and 5–10 m sectors so departure and transition remain distinguishable." }, { "mistake": "An extra departure is added after the planned set to chase a personal best.", "fix": "End at the authorised trial count; a faster unplanned attempt does not justify added high-intensity exposure." }, { "mistake": "Departure and transition notes are merged into one generic technique score.", "fix": "Keep separate 0–5 m and 5–10 m tag rows linked to their split times." } ], "practice": { "first_session": [ "Photograph one two-point stance and reproduce toe marks, hip height and arm arrangement three times without running.", "Practise the quiet count and unified line break at walking intensity until no heel lift or balance step appears.", "Complete two coached three-contact departures, stopping well before the timing gates and reviewing contact one on side video.", "After the coach's progressive warm-up and full recovery, run two or three authorised 0–10 m trials with both sector clocks active.", "Classify trigger validity before viewing the total, then connect one video landmark to either 0–5 m or 5–10 m.", "Finish with a controlled walk from the end of the braking corridor; do not add a personal-best attempt.", "Complete one sample departure-transition profile with both sector times and all eight technical tags." ], "repeat_plan": "At the next coach-approved exposure, reproduce stance marks and start logic before arming sector gates. Work first on whichever segment was inconsistent: quiet departures and contact one for 0–5 m, or gradual posture change for 5–10 m. Resistance, hills, extra starts and weekly frequency remain provider decisions because they change load and the task.", "progress_when": [ "Two valid starts show the same still frame, first movement and first-contact placement.", "The 0–5 m sector becomes repeatable without a creep, reach or abrupt chest lift.", "The 5–10 m sector improves or holds while posture unfolds across several contacts.", "Every run-through ends with symptom-free, controlled braking inside the marked corridor." ], "do_not_progress_when": [ "A quicker number depends on altered toe marks, a rolling start or a different trigger.", "Contact-one reach, lateral crossover or early upright posture worsens as intensity rises.", "Either sector slows beyond the coach's decrement rule across consecutive departures.", "Hamstring, calf, Achilles, knee or hip pain, a pop, unusual tightness or impaired braking appears." ] }, "self_check": [ "Can you reproduce both toe marks, hip height and lead-arm arrangement from the stance photo?", "Does a full still frame appear immediately before the trigger?", "Does contact one land near the moving hip projection rather than reaching ahead?", "Can you identify whether a time loss occurred in 0–5 m or 5–10 m?", "Did you cross 10 m during an ordinary stride and use the complete braking corridor?", "Can you explain why the crept 1.84 s attempt must be discarded?", "Can you name four departure tags and three transition tags without using total time?" ], "measurement": { "primary": "Fixed-start acceleration described by 0–5 m, 5–10 m and total 0–10 m sector times", "how": "Reuse photographed toe marks, the same self-start trigger, gate geometry, surface, footwear and camera view. Decide trigger and technical validity before comparing either sector. Preserve distinct departure-sector and transition-sector tag profiles beside their split times.", "good_result": "At least two departures have valid still starts and similar sector profiles; improvement exceeds timing noise without a reach, abrupt rise, symptom or braking failure.", "does_not_prove": "Short-sector gains do not establish reaction time, flying maximum velocity, change-of-direction skill or safe acceleration on another surface." }, "stop_and_get_help": [ "End the departure immediately for a pop, sudden hamstring or calf grab, Achilles pain, loss of stride or inability to enter the braking corridor normally.", "Close the start set when either sector deteriorates beyond the coach's predeclared decrement or contact-one mechanics become less controlled.", "Do not resume timed departures after dizziness, illness, neurological symptoms or an equipment/beam fault until the appropriate person has reviewed the cause." ], "accessibility": [ "For wheeled or assisted acceleration, define a mode-specific start posture, propulsion landmarks and sector timing; never compare its splits with running norms.", "Use tactile toe references, high-contrast 5 m and 10 m marks, and a visual or vibratory trigger selected with the learner while recording trigger latency limitations.", "Provide an accessible braking corridor and guide support positioned beyond the timing path, preserving the fixed-start and sector definitions." ], "evidence_notes": [ { "claim": "Repeated-sprint performance changes across bouts, showing why recovery and trial order must be declared.", "source_title": "Performance and physiological responses to repeated-sprint exercise: a novel multiple-set approach", "source_url": "https://pubmed.ncbi.nlm.nih.gov/20957389/", "source_kind": "PRIMARY_RESEARCH" }, { "claim": "Resisted-sprint training may improve a specific acceleration test, but the configuration and comparison group control the claim.", "source_title": "Efficacy of Resisted Sled Sprint Training Compared With Unresisted Sprint Training on Acceleration and Sprint Performance in Rugby Players: An 8-Week Randomized Controlled Trial", "source_url": "https://pubmed.ncbi.nlm.nih.gov/37536676/", "source_kind": "PRIMARY_RESEARCH" } ], "limits": [ "A faster 10 m split does not prove maximum-speed or reactive-agility improvement.", "Sled, hill, track and field acceleration are different tasks.", "No sprint method eliminates hamstring, tendon or fall risk." ], "orientation": { "bounded_definition": "Capability to develop or express acceleration in a declared context without inheriting broader claims.", "evidence_summary": "Acceleration is real as a bounded, measurable capability, but the evidence is task- and population-specific. Titan separates improvement in the test from retention, transfer and meaningful function.", "supportable_public_claim": "In selected people and declared configurations, acceleration can be measured and may improve with task-relevant practice; retention, transfer and meaningful value require separate testing.", "measurement_boundary": "Use instrumented split times or velocity-time data with surface, footwear, start and aid declared; do not infer reaction ability, agility or safety from a 10-m time.", "myth_to_metric": { "myth": "Instant zero-to-maximum speed", "metric": "Velocity change and split time over a predeclared distance with start method and environment fixed", "boundary": "The metric is valid only for its declared task and cannot establish universal ability, character, diagnosis, safety or far transfer." }, "limiting_findings": [ "Moderate resisted conditioning sprints gave no acute potentiation advantage in varsity sprinters.", "Resisted training that improved acceleration did not necessarily improve maximum-speed phase or jump more than comparison training." ], "prohibited_claims": [ "Titan proves anyone can develop unlimited or superhuman acceleration.", "One test score reveals whole-person capability, health, discipline, potential or worth.", "Improvement guarantees injury prevention, clinical benefit, occupational readiness or transfer to every real-world task." ] }, "gold_source_lesson": null, "next_gate": "External confirmation is required before higher-authority use because: CLINICAL_HIGH_RISK_OR_REGULATED_CONFIGURATION; SUPERVISION_OR_NON_ATTEMPT_BOUNDARY.", "evidence_count": 7 }, "full_training_programme": false, "independently_validated": false, "publication_state": "PUBLISHED_PUBLIC_RESEARCH_EDITION__EDITORIAL_REVIEW_PENDING", "related_power_ids": [ "PWR-010", "PWR-011", "PWR-012", "PWR-013" ] }, { "power_id": "PWR-010", "learning_unit_id": "TLU-PWR-010", "title": "Maximum locomotor speed", "main_description": "The learner completes two supervised 30 m build plus 20 m fly passes whose entry and exit halves are valid, closely matched and followed by controlled long-runoff deceleration.", "main_description_source": "FULL_TUTORIAL_OUTCOME", "family_id": "FAM-02", "family": "Power, Speed & Agility", "superdomain": "Body & Performance", "canonical_route": "/powers/pwr-010/", "treatment": "SPECIALIST_PROVIDER_ROUTE", "treatment_label": "Full supervised tutorial", "treatment_boundary": "Titan teaches the complete method; a qualified person controls the parts that require supervision, clearance, specialist equipment, load, dose or progression.", "tutorial_route": "/tutorials/pwr-010/", "governed_lesson_route": null, "self_attempt_status": "PROHIBITED_WITHOUT_QUALIFIED_SUPERVISION", "gold_pathway_ids": [], "route_membership": { "kind": "RETAINED_EXTERNAL_ROUTE", "id": "SP-HUB-001", "coverage_status": "RETAINED" }, "source_authority_tier": "G4", "source_build_state": "EXTERNAL_PROVIDER_ROUTE", "source_instructional_route": "LEARN_ELSEWHERE_TRACK_WITH_TITAN", "source_count": 6, "research_depth": "DEEP", "risk_level": "HIGH", "prerequisite_status": "QUALIFIED_PROVIDER_DETERMINES", "learning_route": { "mode": "FULL_SUPERVISED_TUTORIAL", "label": "Learn maximum locomotor speed step by step", "summary": "The learner completes two supervised 30 m build plus 20 m fly passes whose entry and exit halves are valid, closely matched and followed by controlled long-runoff deceleration.", "steps": [ [ "Get ready", "Inspect the full lane, including the space beyond the finish gate." ], [ "Learn the method", "9 concrete steps teach the permitted method from start to finish." ], [ "See right and wrong", "6 comparisons show correct or safer execution beside common wrong or riskier choices." ], [ "Practise", "A later high-speed session repeats approach check marks, sensor geometry, footwear, surface and environmental record. The coach may progress approach rhythm or target velocity only after both fly halves remain technically organised and the runoff stays effortless. Assisted towing, overspeed devices, additional passes and weekly loading are separate provider decisions, never learner-selected extensions." ], [ "Check progress", "Fix rolling entry, build checkpoints, consecutive 10 m sectors, sensor model, surface, footwear and indoor or wind record. Convert each valid sector time to velocity and retain technical video notes." ] ], "practical_authority": false, "provider_required": true, "next_action_route": "/tutorials/pwr-010/" }, "path_builder": { "selectable": true, "completion_allowed": true, "warning": "Titan teaches the complete method; a qualified person controls the parts that require supervision, clearance, specialist equipment, load, dose or progression." }, "full_tutorial": { "version": "3.0", "authorship": "POWER_SPECIFIC_FULL_TUTORIAL", "tutorial_mode": "SUPERVISED", "promise": "Maximum locomotor speed is assessed after the departure phase, when the athlete is already upright. This lesson uses a measured 30 m build-up followed by a 20 m fly zone divided into entry and exit halves. The goal is not simply to attack the first fly gate: the learner arrives tall, cycles the limbs without reaching, preserves cadence across both halves, continues beyond the last sensor and then eases down across a long runoff. Comparing entry-half and exit-half velocities reveals whether speed was maintained or merely peaked and faded. A coach decides eligibility, environmental limits, build-up length, target intensity, repetition count and recovery; the learner executes the pass, recognises tension or asymmetry and never chases an extra high-speed exposure.", "power_id": "PWR-010", "title": "Maximum locomotor speed", "lesson_type": "SUPERVISED", "headline": "Reach and hold a measured flying speed, then decelerate safely", "plain_english_summary": "Maximum locomotor speed is assessed after the departure phase, when the athlete is already upright. This lesson uses a measured 30 m build-up followed by a 20 m fly zone divided into entry and exit halves. The goal is not simply to attack the first fly gate: the learner arrives tall, cycles the limbs without reaching, preserves cadence across both halves, continues beyond the last sensor and then eases down across a long runoff. Comparing entry-half and exit-half velocities reveals whether speed was maintained or merely peaked and faded. A coach decides eligibility, environmental limits, build-up length, target intensity, repetition count and recovery; the learner executes the pass, recognises tension or asymmetry and never chases an extra high-speed exposure.", "outcome": "The learner completes two supervised 30 m build plus 20 m fly passes whose entry and exit halves are valid, closely matched and followed by controlled long-runoff deceleration.", "authority": { "learner_may": [ "Maximum locomotor speed: Point out the run-in, 10 m flying split and deceleration finish. Walk the whole route before running. Start below sprint pace and increase speed smoothly through the run-in; do not blast the first three steps as a separate acceleration test.", "During an authorised attempt, Through the flying zone, place each foot down and back close under the hips; keep the ankle firm without reaching forward. Keep the same action for several steps beyond the finish. Do not dip, lunge or look sideways at the timer.", "Mark the build-up, fly and runoff zones, save both flying splits and record whether the learner completed the full braking zone under control." ], "qualified_person_required_for": [ "Review high-speed running history, present pain or asymmetry, environmental conditions and runoff space before approving a flying-speed exposure.", "Choose the locomotor mode, run-in length, target intensity, timing zone, trial number, rest, surface and environmental limits.", "Measure the same run-in for every pass, keep the timing display outside the runner's sightline, verify gate alignment and withhold another exposure until breathing, gait and readiness recover." ], "never_do": [ "Attempt all-out speed after an inadequate run-in, on a crowded or slippery lane, or when the braking distance is shortened.", "Do not lengthen the build-up, chase an extra fast pass or reduce the braking zone after seeing a favourable split.", "Stop for pain, tightness, new asymmetry, loss of upright mechanics or inability to use the complete runoff without abrupt braking." ] }, "materials": [ "A straight level lane with marked run-in, flying zone and long deceleration zone", "Electronic timing gates or validated continuous-speed equipment", "Cones or high-contrast ground marks", "Secure footwear appropriate to the surface", "A flying-speed record with locomotor mode, run-in length, gate spacing, surface, wind, footwear, entry and exit split, validity, symptoms and runoff outcome." ], "before_you_start": [ "Inspect the full lane, including the space beyond the finish gate.", "Confirm run-in and flying-zone distances, wind or indoor conditions and the exact timing method.", "Report recent hamstring, calf, Achilles or back symptoms and any long break from high-speed running.", "Show the learner where to build speed, where the timed fly begins and where braking is allowed. Ask them to point to all three zones correctly before the first run-through.", "Build speed in stages and rehearse arriving tall through the fly zone while continuing past the last gate; none of these preparatory runs is a maximum trial." ], "steps": [ { "title": "Survey the build, fly and runoff", "instruction": "Walk from the rolling approach mark through the 30 m build, both 10 m fly sectors and the final runoff cone. Identify where upright fast running begins and where easing down is permitted.", "reason": "A maximum-velocity pass needs enough approach to organise speed and much more space after measurement to reduce it safely.", "success_check": "The learner can point to approach, fly entry, fly midpoint, fly exit and full-stop boundary." }, { "title": "Choose a rolling approach rhythm", "instruction": "Enter the build from relaxed movement, then increase cadence and amplitude in planned stages. Do not imitate a crouched race start or attack the first steps.", "reason": "A repeatable rolling approach reduces variation unrelated to upright velocity.", "success_check": "The 30 m build uses the same check marks and no abrupt early burst." }, { "title": "Finish rising before fly entry", "instruction": "By the last build marker, bring the torso upright with the pelvis tall and head quiet. Direct attention down the corridor rather than toward a sensor.", "reason": "The fly zone is intended to sample upright locomotion, not the transition out of projection.", "success_check": "Side view shows stable torso height before the first timing beam." }, { "title": "Cycle down beneath the pelvis", "instruction": "Through the entry half, lift and recover the leg, then drive the foot down near the body's vertical line. Let stride length emerge from speed; never cast the shin forward.", "reason": "A forward cast creates braking and often a visible backside recovery pattern.", "success_check": "Contacts occur close beneath the pelvis with no conspicuous heel-first reach." }, { "title": "Preserve rhythm through the midpoint", "instruction": "Cross the middle sensor without changing expression, arm sweep or contact timing. Keep hands loose, jaw soft and shoulders quiet while cadence remains brisk.", "reason": "Many athletes strain at a landmark and lose velocity in the exit half.", "success_check": "Video and sector clocks show no midpoint lunge, lateral drift or sudden cadence disruption." }, { "title": "Hold the exit half, not your breath", "instruction": "Continue the same upright pattern across the second 10 m. If tightness or asymmetry appears, abandon the speed target and move into a gradual safe runoff.", "reason": "Exit-half maintenance is useful only while movement remains organised and symptom-free.", "success_check": "Exit velocity stays within the coach's maintenance band and breathing remains unforced." }, { "title": "Ignore the final clock", "instruction": "Look beyond the last beam and continue fast for the provider-marked buffer steps. Do not dip, glance sideways or prepare a stopping plant.", "reason": "Anticipating the sensor causes premature deceleration and contaminates the exit split.", "success_check": "The last beam is crossed in normal upright rhythm without a finish gesture." }, { "title": "Bleed speed across the runoff", "instruction": "After the buffer, reduce cadence gradually, allow shorter steps and remain on the straight corridor until walking. Turn only beyond the full-stop boundary.", "reason": "A sharp plant or high-speed turn adds an unnecessary eccentric braking event.", "success_check": "The learner reaches a walk within the runoff without skid, cut, stumble or lane exit." }, { "title": "Calculate maintenance before ranking", "instruction": "Convert each 10 m sector to metres per second and divide exit velocity by entry velocity. Validate upright mechanics and environment before choosing the best pass.", "reason": "The fastest entry half may produce a poor complete fly exposure if velocity collapses afterward.", "success_check": "The report shows entry velocity, exit velocity, maintenance percentage, wind or indoor status and technical validity." } ], "worked_example": { "scenario": "A trained runner uses an indoor straight with a rolling 30 m build, two consecutive 10 m fly sectors, a short buffer and a 35 m runoff.", "walkthrough": [ "The coach verifies sensor spacing, marks three approach checkpoints and records still indoor conditions before the high-speed warm-up.", "Pass A covers the entry half in 1.09 s and the exit half in 1.16 s: about 9.17 then 8.62 m/s, or roughly 94% maintenance; video shows straining at midpoint.", "After full recovery, Pass B records 1.12 s and 1.13 s: about 8.93 then 8.85 m/s, or roughly 99% maintenance, with quiet shoulders and contacts beneath the pelvis.", "Pass C is not requested because the planned exposure is complete; the learner does not chase Pass A's faster entry value.", "Both authorised passes continue beyond the last beam and end as a walk inside the 35 m runoff.", "The report selects Pass B as the cleaner maximum-velocity sample and retains Pass A as evidence of entry-speed fade." ], "result": "Pass B provides a valid 8.93 m/s entry and 8.85 m/s exit with approximately 99% maintenance in this indoor fly configuration. It does not measure departure acceleration or justify more all-out running." }, "right_vs_wrong": [ { "situation": "Using the build-up", "right": "Increase rhythm through the same 30 m checkpoints and arrive upright before fly entry.", "wrong": "Explode from a crouch and reach full effort in the opening metres.", "why": "That substitutes a start test for a repeatable rolling approach." }, { "situation": "Foot recovery at upright speed", "right": "Recover compactly and strike down near the pelvis line.", "wrong": "Throw the shin forward to manufacture stride length.", "why": "Casting ahead creates a braking contact and disrupts fast cyclic action." }, { "situation": "Crossing the midpoint", "right": "Keep face, hands and shoulders quiet while preserving cadence.", "wrong": "Clench, lunge or surge because a sensor is visible.", "why": "Landmark tension can create a fast entry followed by an exit-half fade." }, { "situation": "Selecting the best pass", "right": "Prefer a valid, technically organised pass with strong velocity maintenance.", "wrong": "Rank only the quickest entry 10 m despite a large second-half loss.", "why": "Maximum-velocity execution includes sustaining the fly zone, not touching one early peak." }, { "situation": "Leaving the fly zone", "right": "Maintain rhythm beyond the last beam before gradually easing down.", "wrong": "Plant, dip or look at the clock as soon as the exit sensor arrives.", "why": "Finish anticipation corrupts the exit value and increases sudden braking demand." }, { "situation": "Deciding on another exposure", "right": "Stop at the pre-authorised count after a clean pass.", "wrong": "Add repetitions until the display shows a personal record.", "why": "Extra maximum-velocity contacts increase load while fatigue can hide emerging asymmetry." } ], "common_mistakes": [ { "mistake": "The athlete begins each build-up at a different approach pace.", "fix": "Use the same rolling entry and three approach checkpoints before comparing fly sectors." }, { "mistake": "Upright posture is still changing at the first sensor.", "fix": "Lengthen or reorganise the provider-controlled build rather than forcing more effort inside the fly zone." }, { "mistake": "The lower leg casts ahead in pursuit of a longer stride.", "fix": "Return to a submaximal upright rehearsal and cue compact recovery followed by a downward strike." }, { "mistake": "A fast first half hides a clear second-half fade.", "fix": "Convert and display both velocities plus the exit-to-entry maintenance percentage." }, { "mistake": "The runner tightens at the midpoint marker.", "fix": "Move attention beyond fly exit and rehearse crossing all sensors without a gesture." }, { "mistake": "The runoff is shortened to fit another repetition.", "fix": "Keep the full marked stopping distance; remove the repetition, never the deceleration space." } ], "practice": { "first_session": [ "Walk the entire rolling approach, 30 m build, entry half, exit half, buffer and 35 m runoff while naming each boundary.", "Rehearse two progressive builds below high speed, using approach checkpoints and finishing upright before fly entry.", "Perform one submaximal fly pass to practise compact leg recovery, quiet midpoint crossing and a complete runoff.", "After coach-timed recovery, complete no more than two authorised high-speed passes with both sector clocks active.", "Calculate entry velocity, exit velocity and maintenance percentage before discussing the fastest display.", "End the exposure after the planned clean pass and review one upright video landmark rather than adding another run." ], "repeat_plan": "A later high-speed session repeats approach check marks, sensor geometry, footwear, surface and environmental record. The coach may progress approach rhythm or target velocity only after both fly halves remain technically organised and the runoff stays effortless. Assisted towing, overspeed devices, additional passes and weekly loading are separate provider decisions, never learner-selected extensions.", "progress_when": [ "The rolling approach reaches upright posture at the same pre-entry location on consecutive passes.", "Entry and exit velocities are repeatable and maintenance remains inside the provider's band.", "Compact recovery, down-under contact and quiet midpoint rhythm persist as velocity rises.", "The learner completes the buffer and long runoff without symptom, stumble or abrupt braking." ], "do_not_progress_when": [ "A faster entry sector produces growing exit fade, reach or upper-body strain.", "Wind, sensor spacing, approach marks, surface or footwear no longer match the comparison setup.", "Cadence becomes irregular or one side visibly shortens during upright running.", "Hamstring, calf, Achilles, hip or back tightness, pain, a pop or reduced runoff control appears." ] }, "self_check": [ "Can you name the rolling approach, three build checkpoints, two fly halves, buffer and full-stop boundary?", "Are you already upright before fly entry rather than still rising inside measurement?", "Do contacts strike down near the pelvis without a forward lower-leg cast?", "Can you convert 1.12 s over 10 m to about 8.93 m/s?", "Can you explain why 99% maintenance can be more useful than a faster entry followed by 94%?", "Did you continue beyond the final sensor and walk before turning?" ], "measurement": { "primary": "Maximum-velocity fly profile: entry-half velocity, exit-half velocity and exit-to-entry maintenance percentage after a fixed rolling build", "how": "Fix rolling entry, build checkpoints, consecutive 10 m sectors, sensor model, surface, footwear and indoor or wind record. Convert each valid sector time to velocity and retain technical video notes.", "good_result": "Two passes reproduce upright entry and sector velocities within tolerance, with strong second-half maintenance, organised contacts and safe runoff.", "does_not_prove": "A fly profile does not establish fixed-start acceleration, reaction ability, curved or change-of-direction speed, competition readiness or safety elsewhere." }, "stop_and_get_help": [ "Abandon the fly pass for a sudden hamstring, calf, Achilles, hip or back sensation, a pop, asymmetrical stride or loss of upright rhythm.", "Close maximum-velocity exposure when exit velocity falls beyond the coach's maintenance rule or the full runoff cannot be completed smoothly.", "Suspend testing after dizziness, illness, neurological symptoms, a sensor fault or unsafe surface change until the appropriate review occurs." ], "accessibility": [ "For racing-chair or assisted locomotion, construct mode-specific rolling checkpoints, fly sectors and runoff controls; use that mode's own velocity interpretation.", "Provide tactile or high-contrast boundary cues outside the travel line and an accessible pre-pass signal, without asking the learner to look sideways at speed.", "Position guides and support staff beyond sensor beams, preserving an unobstructed wide corridor and enough stopping distance for the learner's mobility mode." ], "evidence_notes": [ { "claim": "Resisted sprint training can improve early acceleration without necessarily improving the maximum-speed phase.", "source_title": "Efficacy of Resisted Sled Sprint Training Compared With Unresisted Sprint Training on Acceleration and Sprint Performance in Rugby Players: An 8-Week Randomized Controlled Trial", "source_url": "https://pubmed.ncbi.nlm.nih.gov/37536676/", "source_kind": "PRIMARY_RESEARCH" }, { "claim": "Straight sprint practice shows limited transfer to complex agility tasks, so flying speed must remain a separate result.", "source_title": "Specificity of sprint and agility training methods", "source_url": "https://pubmed.ncbi.nlm.nih.gov/11710657/", "source_kind": "PRIMARY_RESEARCH" } ], "limits": [ "Top speed is specific to mode, surface, run-in, wind and timing method.", "A fast flying split is not permission to run at maximum speed in public spaces.", "No technique guarantees freedom from muscle or tendon injury." ], "orientation": { "bounded_definition": "Capability to develop or express maximum locomotor speed in a declared context without inheriting broader claims.", "evidence_summary": "Maximum locomotor speed is real as a bounded, measurable capability, but the evidence is task- and population-specific. Titan separates improvement in the test from retention, transfer and meaningful function.", "supportable_public_claim": "In selected people and declared configurations, maximum locomotor speed can be measured and may improve with task-relevant practice; retention, transfer and meaningful value require separate testing.", "measurement_boundary": "Use flying-split or continuous velocity measurement with run-in, distance, surface and assistance declared; distinguish peak speed from acceleration and average sprint time.", "myth_to_metric": { "myth": "Superhuman running speed", "metric": "Peak or flying-split velocity in a declared locomotor and environmental configuration", "boundary": "The metric is valid only for its declared task and cannot establish universal ability, character, diagnosis, safety or far transfer." }, "limiting_findings": [ "Sled training improved early acceleration but not maximum-speed phase in one controlled study.", "Straight sprint training showed limited transfer to increasingly complex agility tests." ], "prohibited_claims": [ "Titan proves anyone can develop unlimited or superhuman maximum locomotor speed.", "One test score reveals whole-person capability, health, discipline, potential or worth.", "Improvement guarantees injury prevention, clinical benefit, occupational readiness or transfer to every real-world task." ] }, "gold_source_lesson": null, "next_gate": "External confirmation is required before higher-authority use because: CLINICAL_HIGH_RISK_OR_REGULATED_CONFIGURATION; SUPERVISION_OR_NON_ATTEMPT_BOUNDARY.", "evidence_count": 6 }, "full_training_programme": false, "independently_validated": false, "publication_state": "PUBLISHED_PUBLIC_RESEARCH_EDITION__EDITORIAL_REVIEW_PENDING", "related_power_ids": [ "PWR-009", "PWR-011", "PWR-012", "PWR-013" ] }, { "power_id": "PWR-011", "learning_unit_id": "TLU-PWR-011", "title": "Jumping power", "main_description": "The learner completes three valid countermovement jumps with identical arm rule and start, while jump height/impulse and landing control are scored separately.", "main_description_source": "FULL_TUTORIAL_OUTCOME", "family_id": "FAM-02", "family": "Power, Speed & Agility", "superdomain": "Body & Performance", "canonical_route": "/powers/pwr-011/", "treatment": "SPECIALIST_PROVIDER_ROUTE", "treatment_label": "Full supervised tutorial", "treatment_boundary": "Titan teaches the complete method; a qualified person controls the parts that require supervision, clearance, specialist equipment, load, dose or progression.", "tutorial_route": "/tutorials/pwr-011/", "governed_lesson_route": null, "self_attempt_status": "PROHIBITED_WITHOUT_QUALIFIED_SUPERVISION", "gold_pathway_ids": [], "route_membership": { "kind": "RETAINED_EXTERNAL_ROUTE", "id": "SP-HUB-001", "coverage_status": "RETAINED" }, "source_authority_tier": "G4", "source_build_state": "EXTERNAL_PROVIDER_ROUTE", "source_instructional_route": "LEARN_ELSEWHERE_TRACK_WITH_TITAN", "source_count": 5, "research_depth": "DETAILED", "risk_level": "HIGH", "prerequisite_status": "QUALIFIED_PROVIDER_DETERMINES", "learning_route": { "mode": "FULL_SUPERVISED_TUTORIAL", "label": "Learn jumping power step by step", "summary": "The learner completes three valid countermovement jumps with identical arm rule and start, while jump height/impulse and landing control are scored separately.", "steps": [ [ "Get ready", "Tell the provider about joint pain, instability, recent lower-limb injury, dizziness or pregnancy." ], [ "Learn the method", "7 concrete steps teach the permitted method from start to finish." ], [ "See right and wrong", "5 comparisons show correct or safer execution beside common wrong or riskier choices." ], [ "Practise", "The provider controls jump height demand, intensity, repetitions, surfaces, external load and weekly plyometric dose. Progress from a stable countermovement jump to another jump type only as a separately taught and measured task." ], [ "Check progress", "Use the same platform, foot marks, arm rule and countermovement instruction; reject technique violations and record height, impulse and landing status." ] ], "practical_authority": false, "provider_required": true, "next_action_route": "/tutorials/pwr-011/" }, "path_builder": { "selectable": true, "completion_allowed": true, "warning": "Titan teaches the complete method; a qualified person controls the parts that require supervision, clearance, specialist equipment, load, dose or progression." }, "full_tutorial": { "version": "3.0", "authorship": "POWER_SPECIFIC_FULL_TUTORIAL", "tutorial_mode": "SUPERVISED", "promise": "Jumping power combines rapid force and impulse with a specific jump technique. This lesson teaches a hands-on-hips countermovement jump on a force platform: stand still, dip to a provider-set comfortable depth, reverse without a pause, extend through the floor, keep the legs consistent in flight and land softly in the marked area. The provider controls clearance, jump type, effort, repetitions, rest and measurement.", "power_id": "PWR-011", "title": "Jumping power", "lesson_type": "SUPERVISED", "headline": "Produce one standardised jump and land before chasing height", "plain_english_summary": "Jumping power combines rapid force and impulse with a specific jump technique. This lesson teaches a hands-on-hips countermovement jump on a force platform: stand still, dip to a provider-set comfortable depth, reverse without a pause, extend through the floor, keep the legs consistent in flight and land softly in the marked area. The provider controls clearance, jump type, effort, repetitions, rest and measurement.", "outcome": "The learner completes three valid countermovement jumps with identical arm rule and start, while jump height/impulse and landing control are scored separately.", "authority": { "learner_may": [ "Jumping power: Place both feet on the recorded marks, hands on hips and eyes forward; wait until the force trace is stable. Bend hips, knees and ankles to the agreed depth while the torso stays controlled; do not take extra bounces.", "During an authorised attempt, Finish the push through ankles, knees and hips while keeping hands on hips and take off from both feet. Meet the floor on both feet, bend hips and knees to absorb the landing and hold the finish for two seconds.", "Confirm a quiet body-weight baseline before take-off and preserve jump output, flight validity and landing control as separate results." ], "qualified_person_required_for": [ "Assess lower-limb readiness, balance, landing tolerance and platform safety before authorising a maximal or near-maximal jump.", "Set the jump type, arm rule, countermovement range, target effort, repetitions, rest, platform and landing criteria.", "Require a still start and the same arm rule and dip range on every attempt. Reject a jump that uses extra sway, a deeper countermovement or altered flight posture, then reassess landing quality before another trial." ], "never_do": [ "Use an unapproved box, depth jump, weighted jump or maximum jump when landing space, readiness or supervision is uncertain.", "Do not add arm swing, external load, greater depth or extra jumps to chase height outside the declared protocol.", "Finish the session for pain, dizziness, an uncontrolled landing, repeated baseline movement or any need to change the jump definition mid-test." ] }, "materials": [ "Force platform or validated jump-measurement device", "Flat non-slip landing area with foot marks", "Video from a provider-selected view", "Stable support available outside the landing area", "A jump sheet for platform zeroing, stance, arm rule, countermovement range, impulse or height, flight validity, landing zone, balance recovery and rejected attempts." ], "before_you_start": [ "Tell the provider about joint pain, instability, recent lower-limb injury, dizziness or pregnancy.", "Agree whether hands stay on hips and whether the countermovement depth is self-selected or marked.", "Practise a quiet two-foot landing and hold it for two seconds before any measured jump.", "Zero the platform with nobody touching it, then have the learner stand quietly on the marks. Do not start a jump until the body-weight trace is steady and the landing area is clear.", "Rehearse a single smooth dip-and-reverse and a quiet landing at low effort before any jump is entered in the scored set." ], "steps": [ { "title": "Stand still on the marks", "instruction": "Place both feet on the recorded marks, hands on hips and eyes forward; wait until the force trace is stable.", "reason": "Pre-jump movement changes the baseline; this preserves the jumping power rule for 'Stand still on the marks'.", "success_check": "The platform shows a stable body-weight line." }, { "title": "Dip as one movement", "instruction": "Bend hips, knees and ankles to the agreed depth while the torso stays controlled; do not take extra bounces.", "reason": "A single countermovement makes trials comparable.", "success_check": "Video shows one continuous descent without foot movement." }, { "title": "Reverse without a pause", "instruction": "At the bottom, change direction promptly and push the platform away.", "reason": "A long pause turns the task into a squat jump.", "success_check": "The force trace shows one clear braking-to-propulsive transition." }, { "title": "Extend through take-off", "instruction": "Finish the push through ankles, knees and hips while keeping hands on hips and take off from both feet.", "reason": "Arm swing or uneven take-off changes measured impulse.", "success_check": "Both feet leave together and hands stay in the declared position." }, { "title": "Keep the flight shape consistent", "instruction": "Do not tuck the knees or reach the feet downward to alter flight time; keep the body long until preparing to land.", "reason": "Flight-time methods assume a consistent take-off and landing position.", "success_check": "Video shows no knee tuck or exaggerated toe reach." }, { "title": "Land in the marked area", "instruction": "Meet the floor on both feet, bend hips and knees to absorb the landing and hold the finish for two seconds.", "reason": "A high jump with an uncontrolled landing is not a complete successful trial.", "success_check": "Feet stay on the platform and balance is held without a step." }, { "title": "Score output and landing separately", "instruction": "Record jump height and force-time impulse, then mark landing as held, stepped or failed. Reject trials that break the arm, start or flight rule.", "reason": "One height number can hide technique or landing failure.", "success_check": "The record contains both output and landing outcome." } ], "worked_example": { "scenario": "A provider measures hands-on-hips countermovement jumps on a force platform with a self-selected comfortable dip and two-second landing hold.", "walkthrough": [ "The learner practises two non-jumping dips and two low jumps with quiet landings.", "Trial one reaches 24.1 cm but includes a knee tuck and is rejected.", "Trial two reaches 22.8 cm with 173 N·s net impulse and a held landing.", "Trial three reaches 23.0 cm with 175 N·s and a held landing.", "The provider records 23.0 cm as the best valid height and keeps landing status separate." ], "result": "Two valid trials agree closely and show controlled landings. The rejected 24.1 cm is not used; the result does not prove sport jumping skill or injury prevention." }, "right_vs_wrong": [ { "situation": "Countermovement: Jumping power checkpoint", "right": "Use one smooth dip and reversal.", "wrong": "Bounce twice or pause at the bottom.", "why": "The jump type changes. That changes jump height and take-off impulse in a standardised jump, plus landing control. It is no longer the same test." }, { "situation": "Arms: Jumping power checkpoint", "right": "Keep hands in the declared position.", "wrong": "Swing arms only on later trials.", "why": "Arm use changes output. That changes jump height and take-off impulse in a standardised jump, plus landing control. It is no longer the same test." }, { "situation": "Flight: Jumping power checkpoint", "right": "Keep a consistent body shape. It is correct when the force trace shows one clear braking-to-propulsive transition.", "wrong": "Tuck knees to lengthen flight time.", "why": "Height estimation becomes inflated. That changes jump height and take-off impulse in a standardised jump, plus landing control. It is no longer the same test." }, { "situation": "Landing: Jumping power checkpoint", "right": "Bend and hold balance on the platform.", "wrong": "Stiffen, step off or ignore the landing after a high jump.", "why": "Landing control is a separate required outcome." }, { "situation": "Scoring: Jumping power checkpoint", "right": "Reject rule-breaking jumps before comparing height.", "wrong": "Use the largest number regardless of technique.", "why": "An invalid high value is misleading." } ], "common_mistakes": [ { "mistake": "The learner starts while still swaying.", "fix": "Wait for a stable force trace and still posture." }, { "mistake": "The dip gets deeper on every attempt.", "fix": "Mark a comfortable range or record depth and reject large changes." }, { "mistake": "Hands leave the hips near take-off.", "fix": "Return to low-effort rehearsal until the arm rule is automatic." }, { "mistake": "Knees tuck in flight during 'Extend through take-off' in jumping power.", "fix": "Use video feedback and reduce effort; keep the flight shape long." }, { "mistake": "Landing steps are not recorded.", "fix": "Add a separate held/step/fail landing field to every trial." } ], "practice": { "first_session": [ "Provider reviews readiness and demonstrates valid and invalid jumps.", "Practise two dips and two low landings without measurement pressure.", "Complete two submaximal familiarisation jumps.", "Complete two or three measured jumps with full rest.", "Review one force-time trace and one landing video, then stop at the planned count." ], "repeat_plan": "The provider controls jump height demand, intensity, repetitions, surfaces, external load and weekly plyometric dose. Progress from a stable countermovement jump to another jump type only as a separately taught and measured task.", "progress_when": [ "Start, arm rule and countermovement are repeatable.", "Valid jump height/impulse is stable or improves while landing remains held.", "No pain, instability or technique degradation appears across the planned trials." ], "do_not_progress_when": [ "A higher number depends on a knee tuck, arm swing, deeper dip or changed device.", "Landing requires a step, leaves the platform or becomes stiff and uncontrolled.", "Pain, swelling, dizziness, fear or unexpected fatigue occurs." ] }, "self_check": [ "Can you name the jump type and arm rule?", "Was there one dip and no pause?", "Did both feet take off and land within the marked area?", "Can you explain why height and landing require separate scores?" ], "measurement": { "primary": "Jump height and take-off impulse in a standardised jump, plus landing control", "how": "Use the same platform, foot marks, arm rule and countermovement instruction; reject technique violations and record height, impulse and landing status.", "good_result": "At least two valid jumps are repeatable and output improves without a failed landing or symptoms.", "does_not_prove": "It does not prove reactive strength, sport transfer, bone benefit or injury prevention." }, "stop_and_get_help": [ "Stop for a pop, sharp pain, joint giving way, swelling, loss of landing control or inability to bear weight normally.", "End jumping when landings, force trace or technique deteriorate even if the planned count is not complete.", "End jump testing if landing produces sharp pain, new swelling, buckling or inability to walk normally; seek clinical review before exposing that leg to another take-off." ], "accessibility": [ "Use a provider-selected supported rise, seated push or non-flight power task when jumping is not appropriate; report it as a different task.", "Use high-contrast foot marks, visual demonstration and accessible start cues while preserving the landing area.", "Use floor outlines, a demonstration or concise audio cues for stance and dip, while retaining the identical take-off and landing validity rules." ], "evidence_notes": [ { "claim": "Different sprint training programmes can change jump outcomes differently, so jump results remain programme- and task-specific.", "source_title": "Efficacy of Resisted Sled Sprint Training Compared With Unresisted Sprint Training on Acceleration and Sprint Performance in Rugby Players: An 8-Week Randomized Controlled Trial", "source_url": "https://pubmed.ncbi.nlm.nih.gov/37536676/", "source_kind": "PRIMARY_RESEARCH" }, { "claim": "Resistance training can change rate of force development, but that physiological change does not replace direct jump and landing measurement.", "source_title": "Increased rate of force development and neural drive of human skeletal muscle following resistance training", "source_url": "https://pubmed.ncbi.nlm.nih.gov/12235031/", "source_kind": "PRIMARY_RESEARCH" } ], "limits": [ "Jump height alone cannot identify technique, impulse, body mass effects or landing quality.", "One jump test does not certify sport performance or safe landing from other heights.", "This lesson supplies no unsupervised plyometric dose." ], "orientation": { "bounded_definition": "Capability to develop or express jumping power in a declared context without inheriting broader claims.", "evidence_summary": "Jumping power is real as a bounded, measurable capability, but the evidence is task- and population-specific. Titan separates improvement in the test from retention, transfer and meaningful function.", "supportable_public_claim": "In selected people and declared configurations, jumping power can be measured and may improve with task-relevant practice; retention, transfer and meaningful value require separate testing.", "measurement_boundary": "Report jump type, arm use, take-off constraints, height/flight-time method, force-time impulse and landing outcome; do not equate flight time with universal explosive power.", "myth_to_metric": { "myth": "Gravity-defying leaps", "metric": "Jump height and mass-specific take-off power/impulse in a standardised jump, plus landing control", "boundary": "The metric is valid only for its declared task and cannot establish universal ability, character, diagnosis, safety or far transfer." }, "limiting_findings": [ "Different active programmes can yield similar jump changes despite different sprint adaptations.", "Jump height alone cannot distinguish impulse, technique, body mass or landing control." ], "prohibited_claims": [ "Titan proves anyone can develop unlimited or superhuman jumping power.", "One test score reveals whole-person capability, health, discipline, potential or worth.", "Improvement guarantees injury prevention, clinical benefit, occupational readiness or transfer to every real-world task." ] }, "gold_source_lesson": null, "next_gate": "External confirmation is required before higher-authority use because: CLINICAL_HIGH_RISK_OR_REGULATED_CONFIGURATION; SUPERVISION_OR_NON_ATTEMPT_BOUNDARY.", "evidence_count": 5 }, "full_training_programme": false, "independently_validated": false, "publication_state": "PUBLISHED_PUBLIC_RESEARCH_EDITION__EDITORIAL_REVIEW_PENDING", "related_power_ids": [ "PWR-009", "PWR-010", "PWR-012", "PWR-013" ] }, { "power_id": "PWR-012", "learning_unit_id": "TLU-PWR-012", "title": "Throwing and striking power", "main_description": "The learner completes four valid chest passes with the same ball and stance while release velocity/distance and target accuracy are both recorded.", "main_description_source": "FULL_TUTORIAL_OUTCOME", "family_id": "FAM-02", "family": "Power, Speed & Agility", "superdomain": "Body & Performance", "canonical_route": "/powers/pwr-012/", "treatment": "SPECIALIST_PROVIDER_ROUTE", "treatment_label": "Full supervised tutorial", "treatment_boundary": "Titan teaches the complete method; a qualified person controls the parts that require supervision, clearance, specialist equipment, load, dose or progression.", "tutorial_route": "/tutorials/pwr-012/", "governed_lesson_route": null, "self_attempt_status": "PROHIBITED_WITHOUT_QUALIFIED_SUPERVISION", "gold_pathway_ids": [], "route_membership": { "kind": "RETAINED_EXTERNAL_ROUTE", "id": "SP-HUB-001", "coverage_status": "RETAINED" }, "source_authority_tier": "G4", "source_build_state": "EXTERNAL_PROVIDER_ROUTE", "source_instructional_route": "LEARN_ELSEWHERE_TRACK_WITH_TITAN", "source_count": 3, "research_depth": "FOCUSED", "risk_level": "HIGH", "prerequisite_status": "QUALIFIED_PROVIDER_DETERMINES", "learning_route": { "mode": "FULL_SUPERVISED_TUTORIAL", "label": "Learn throwing and striking power step by step", "summary": "The learner completes four valid chest passes with the same ball and stance while release velocity/distance and target accuracy are both recorded.", "steps": [ [ "Get ready", "Create an exclusion zone behind and beside the target and appoint one person to declare it clear." ], [ "Learn the method", "9 concrete steps teach the permitted method from start to finish." ], [ "See right and wrong", "7 comparisons show correct or safer execution beside common wrong or riskier choices." ], [ "Practise", "The qualified coach sets ball mass, throwing volume, intensity, rest and any transition to one-handed throws or strikes. Change only one variable at a time and treat every new implement or technique as a new task." ], [ "Check progress", "Hold implement mass, stance, distance, target, radar/video method and line rule constant; record output, target zone, faults and pain for every throw. Verify radar alignment and record medicine-ball mass, release line, target-grid zone, foot legality and capture outcome for every projectile." ] ], "practical_authority": false, "provider_required": true, "next_action_route": "/tutorials/pwr-012/" }, "path_builder": { "selectable": true, "completion_allowed": true, "warning": "Titan teaches the complete method; a qualified person controls the parts that require supervision, clearance, specialist equipment, load, dose or progression." }, "full_tutorial": { "version": "3.0", "authorship": "POWER_SPECIFIC_FULL_TUTORIAL", "tutorial_mode": "SUPERVISED", "promise": "Throwing and striking power is rapid force delivered to an implement or target under a declared technique. This lesson teaches one bounded version: a standing two-handed medicine-ball chest pass into a capture net. The learner establishes a stable stance, loads without twisting, drives from the floor through the trunk and arms, releases toward a marked target and finishes without crossing the line. The provider controls ball mass, distance, intensity, repetitions, rest and the exclusion zone. Usable projectile power is a velocity-accuracy envelope, not the fastest radar flash. Radar alignment, medicine-ball mass, release line, capture-net lane and target grid belong to the method. Each pass receives three independent labels: legal foot position, valid velocity beam and impact zone. A central hit at repeatable speed can be progressed; a faster pass with a foot fault, side-net impact or uncontrolled rebound remains invalid. Retrieval is a locked phase: nobody crosses the line until the ball is motionless and the provider gives an all-clear.", "power_id": "PWR-012", "title": "Throwing and striking power", "lesson_type": "SUPERVISED", "headline": "Sequence a medicine-ball chest pass for velocity and accuracy", "plain_english_summary": "Throwing and striking power is rapid force delivered to an implement or target under a declared technique. This lesson teaches one bounded version: a standing two-handed medicine-ball chest pass into a capture net. The learner establishes a stable stance, loads without twisting, drives from the floor through the trunk and arms, releases toward a marked target and finishes without crossing the line. The provider controls ball mass, distance, intensity, repetitions, rest and the exclusion zone. Usable projectile power is a velocity-accuracy envelope, not the fastest radar flash. Radar alignment, medicine-ball mass, release line, capture-net lane and target grid belong to the method. Each pass receives three independent labels: legal foot position, valid velocity beam and impact zone. A central hit at repeatable speed can be progressed; a faster pass with a foot fault, side-net impact or uncontrolled rebound remains invalid. Retrieval is a locked phase: nobody crosses the line until the ball is motionless and the provider gives an all-clear.", "outcome": "The learner completes four valid chest passes with the same ball and stance while release velocity/distance and target accuracy are both recorded.", "authority": { "learner_may": [ "Throwing and striking power: Stand behind the line with feet at the recorded width and the target centred. Keep the ball close to the chest with fingers spread. Look at the target and wait for the provider's 'clear' signal. No one retrieves a ball until all throws have stopped.", "During an authorised attempt, Push through the feet, extend hips and knees, then let the chest and arms finish the pass. Avoid throwing only with the elbows. Let the arms follow through, absorb forward momentum with the stance and hold balance without stepping into the exclusion zone.", "Match feet, release line and ball start to the reference marks, then record velocity or distance, target zone and validity separately for every pass." ], "qualified_person_required_for": [ "Check shoulder, elbow, trunk and balance readiness and confirm that the capture net, exclusion zone and retrieval rule are safe before throwing begins.", "Choose ball mass, technique, target distance, effort, repetitions, rest, radar/video setup and a protected throwing area.", "Choose a ball mass that can be accelerated from a true chest-pass start, prevent a behind-the-head wind-up, verify radar alignment and target impact, and keep retrieval locked until the lane is cleared." ], "never_do": [ "Throw or strike toward a person, animal, breakable object or occupied area, or use an implement whose weight or rebound has not been assessed.", "Do not substitute a heavier ball, overhead throw, rotational wind-up or unprotected striking task for the declared chest pass.", "Stop when foot faults, target misses, uncontrolled rebound, pain or deteriorating sequencing make the next throw unsafe or incomparable." ] }, "materials": [ "Provider-selected medicine ball with secure dry surface", "Capture net or solid non-rebounding receiving setup", "Marked throwing line and target", "Validated radar, video or distance measure", "A throwing record for ball identity and mass, stance marks, release line, radar or distance method, target zone, foot validity, rebound control and every excluded pass." ], "before_you_start": [ "Create an exclusion zone behind and beside the target and appoint one person to declare it clear.", "Check the ball for damage and the floor for slipping or uncontrolled rebound.", "Report shoulder, elbow, wrist, back or pelvic pain and any recent throwing absence.", "Clear the throwing lane and place feet, release line and ball on their reference marks. Ask for a motionless chest-level start before permitting the first light familiarisation pass.", "Practise the empty-lane check, stable chest-level start and straight release with a light familiarisation ball before measured passes." ], "steps": [ { "title": "Set the stance and line", "instruction": "Stand behind the line with feet at the recorded width and the target centred. Keep the ball close to the chest with fingers spread.", "reason": "A stable, repeatable base makes velocity and accuracy comparable.", "success_check": "Feet and ball start match the photo and neither foot touches the line." }, { "title": "Confirm the range is clear", "instruction": "Look at the target and wait for the provider's 'clear' signal. No one retrieves a ball until all throws have stopped.", "reason": "Projectile safety depends on a controlled exclusion zone.", "success_check": "The learner can see an empty net area and names the retrieval rule." }, { "title": "Load without a wind-up", "instruction": "Make the provider-taught shallow hip and knee bend while keeping the chest facing the target; do not swing the ball behind the head.", "reason": "An extra wind-up changes joint load and technique.", "success_check": "The ball remains in front and the stance stays planted." }, { "title": "Drive in sequence", "instruction": "Push through the feet, extend hips and knees, then let the chest and arms finish the pass. Avoid throwing only with the elbows.", "reason": "A coordinated proximal-to-distal sequence transfers force to the ball.", "success_check": "Video shows lower-body movement beginning before final arm extension." }, { "title": "Release toward the mark", "instruction": "Extend both arms and release at chest height toward the target centre; do not chase velocity by launching high or sideways.", "reason": "Accuracy is a separate part of usable throwing power.", "success_check": "The ball enters the capture area and the release stays within the declared lane." }, { "title": "Finish behind the line", "instruction": "Let the arms follow through, absorb forward momentum with the stance and hold balance without stepping into the exclusion zone.", "reason": "Crossing the line changes distance and can enter the ball path.", "success_check": "Both feet remain legal and balance is held." }, { "title": "Measure before retrieving", "instruction": "Record velocity or distance, target hit, foot fault and symptoms. Retrieve only on the provider's all-clear.", "reason": "A fast miss or foot fault is not a valid trial.", "success_check": "Each throw has separate output, accuracy and validity fields." }, { "title": "Align radar and target grid", "instruction": "Confirm the radar points along the chest-pass lane and the capture net displays central, inner and outer impact zones. Perform the provider's calibration check before a measured projectile is released.", "reason": "Off-axis radar and an unmarked net make velocity and accuracy labels unreliable.", "success_check": "A calibration movement registers in lane and every visible target zone has an unambiguous score." }, { "title": "Build the velocity accuracy envelope", "instruction": "Plot each legal pass by release velocity and impact zone. Keep foot faults, radar dropouts and side-net catches on the sheet with invalid labels instead of averaging them.", "reason": "The plot shows whether faster delivery preserves placement and capture safety.", "success_check": "At least three legal throws form a repeatable speed cluster with separately recorded target zones." } ], "worked_example": { "scenario": "A coach uses a 2 kg medicine ball, a target centred 4 m away and a capture net; radar and target zones score each pass.", "walkthrough": [ "The learner rehearses the sequence without the ball and repeats the exclusion-zone rule.", "Throw one is 7.8 m/s but the learner steps over the line, so it is invalid.", "Throws two to four are 7.4, 7.6 and 7.5 m/s; all hit the central target and finish behind the line.", "Throw five is not added because the planned valid set is complete.", "The coach records the best valid 7.6 m/s and 3/3 central hits, with no pain.", "Radar alignment is verified along the four-metre lane, and the learner identifies central, inner, outer and side-net impact zones before touching the 2 kg ball.", "The three legal throws form a 7.4–7.6 m/s cluster with central impacts; the 7.8 m/s foot-fault pass remains visible but outside the valid envelope.", "The ball becomes motionless behind the capture net before the provider announces retrieval, so no learner enters an active projectile lane." ], "result": "The valid result is 7.6 m/s with central accuracy in this two-handed 2 kg chest-pass fixture. It does not establish striking power, one-handed throwing skill or self-defence ability." }, "right_vs_wrong": [ { "situation": "Range control", "right": "Throw only after the exclusion zone is declared clear.", "wrong": "Throw while someone retrieves the prior ball.", "why": "A projectile can strike the retriever." }, { "situation": "Sequence: Throwing and striking power checkpoint", "right": "Drive feet and lower body before the arms finish.", "wrong": "Snap only the elbows from a rigid base.", "why": "The declared whole-body technique is not used." }, { "situation": "Release: Throwing and striking power checkpoint", "right": "Aim through the marked capture area.", "wrong": "Chase velocity with a wild release.", "why": "Power without accuracy is unusable in this task." }, { "situation": "Foot rule", "right": "Finish balanced behind the line. It is correct when video shows lower-body movement beginning before final arm extension.", "wrong": "Step over the line to gain distance.", "why": "The attempt becomes invalid and less safe." }, { "situation": "Interpretation: Throwing and striking power checkpoint", "right": "Report ball, technique, velocity and hits.", "wrong": "Call the result general throwing or fighting power.", "why": "Implement and technique specificity is large." }, { "situation": "Choosing the strongest pass", "right": "Use a legal radar value paired with its target-grid impact.", "wrong": "Select the fastest flash although the foot crossed the release line.", "why": "Velocity cannot rescue an illegal stance or shortened throwing distance." }, { "situation": "Retrieving the medicine ball", "right": "Wait until capture is complete and the all-clear is spoken.", "wrong": "Walk into the net lane while another projectile may be released.", "why": "Retrieval lockout prevents exposure inside the active ball path." } ], "common_mistakes": [ { "mistake": "The ball is too heavy to accelerate cleanly.", "fix": "Have the provider reduce mass until sequence and target control are stable." }, { "mistake": "The learner winds the ball behind the head.", "fix": "Reset to the chest start and practise the shallow load without a ball." }, { "mistake": "Arms move before the lower body.", "fix": "Use slow segmented rehearsal: feet, hips, chest, arms." }, { "mistake": "A fast target miss is celebrated as the best throw.", "fix": "Require both the validity and target rule before ranking velocity." }, { "mistake": "Balls are retrieved before the range closes.", "fix": "Use one provider-controlled all-clear after the full set." }, { "mistake": "Radar is angled across rather than along the chest-pass lane.", "fix": "Realign and repeat the calibration check before accepting another velocity value." }, { "mistake": "A side-net catch is recorded simply as a target hit.", "fix": "Use central, inner, outer and side-net labels so accuracy loss remains visible." } ], "practice": { "first_session": [ "Inspect the ball, net, floor and exclusion zone.", "Rehearse the sequence and retrieval rule without a ball.", "Complete three easy passes to find target line and finish balance.", "Complete three or four measured provider-set passes with full rest.", "Review velocity, accuracy, line faults and symptoms separately.", "Practise scoring central, inner, outer, side-net, foot-fault and radar-dropout examples before the measured chest passes.", "Rehearse capture, motionless-ball confirmation and provider all-clear as a separate retrieval sequence." ], "repeat_plan": "The qualified coach sets ball mass, throwing volume, intensity, rest and any transition to one-handed throws or strikes. Change only one variable at a time and treat every new implement or technique as a new task.", "progress_when": [ "All throws begin from the same stance and keep the exclusion zone controlled.", "Velocity is repeatable or improves while accuracy and line legality remain stable.", "No pain, uncontrolled rebound or sequence breakdown occurs.", "The legal velocity cluster rises while central or inner target placement and capture-net control remain stable." ], "do_not_progress_when": [ "Higher velocity comes with target misses, foot faults or altered ball mass.", "Shoulder, elbow, wrist, back or pelvic symptoms appear.", "The capture setup, lighting or supervision cannot keep the projectile zone clear.", "Radar calibration, target grid, capture integrity or retrieval lockout cannot be confirmed." ] }, "self_check": [ "Can you state ball mass, technique, line and target distance?", "Does the lower body begin before the arms finish?", "Was every ranked throw both legal and accurate?", "Can you explain why this result does not establish striking skill?", "Can you plot release velocity beside central, inner, outer or side-net impact for every legal pass?", "Can you explain why the 7.8 m/s foot-fault throw remains invalid despite being fastest?" ], "measurement": { "primary": "Projectile velocity or distance and target accuracy under one declared technique", "how": "Hold implement mass, stance, distance, target, radar/video method and line rule constant; record output, target zone, faults and pain for every throw. Verify radar alignment and record medicine-ball mass, release line, target-grid zone, foot legality and capture outcome for every projectile.", "good_result": "At least three valid throws are repeatable and output improves without loss of target accuracy or symptoms. A tight cluster of legal velocities remains paired with central or inner impacts and an intact retrieval lockout.", "does_not_prove": "It does not prove other throwing techniques, striking, joint safety, combat ability or transfer to a heavier implement." }, "stop_and_get_help": [ "Stop for sharp shoulder, elbow, wrist, back or pelvic pain, a pop, numbness or loss of grip.", "Stop immediately if a person enters the exclusion zone, the ball or net is damaged, or rebound becomes uncontrolled.", "Remove the implement if a throw causes new shoulder weakness, numbness, spinal pain or loss of grip, and obtain an appropriate sports-medicine or clinical assessment before repeating it." ], "accessibility": [ "Use a seated, supported or lighter-ball provider-selected pass with its own start and validity rules.", "Use a larger high-contrast target or audible target cue while recording the changed accuracy fixture.", "Show the stance, release line and clear-sector check through high-contrast marks, demonstration or audio description, documenting any altered implement or assistant cue." ], "evidence_notes": [ { "claim": "Medicine-ball training can change throwing velocity and precision, which should be measured as separate outcomes.", "source_title": "Effects of Six Weeks of Medicine Ball Training on Throwing Velocity, Throwing Precision, and Isokinetic Strength of Shoulder Rotators in Female Handball Players", "source_url": "https://pubmed.ncbi.nlm.nih.gov/26102258/", "source_kind": "PRIMARY_RESEARCH" }, { "claim": "Sport-specific proximal-segment training has been studied in trained throwers, so results should not be generalised to public striking or self-defence.", "source_title": "Sport-specific training targeting the proximal segments and throwing velocity in collegiate throwing athletes", "source_url": "https://pubmed.ncbi.nlm.nih.gov/25844854/", "source_kind": "PRIMARY_RESEARCH" } ], "limits": [ "A chest-pass result is specific to ball, stance, target and technique.", "Impact damage is never an acceptable performance endpoint.", "The lesson does not teach striking a person or authorise weapon, combat or self-defence practice." ], "orientation": { "bounded_definition": "Capability to develop or express throwing and striking power in a declared context without inheriting broader claims.", "evidence_summary": "Throwing and striking power is real as a bounded, measurable capability, but the evidence is task- and population-specific. Titan separates improvement in the test from retention, transfer and meaningful function.", "supportable_public_claim": "In selected people and declared configurations, throwing and striking power can be measured and may improve with task-relevant practice; retention, transfer and meaningful value require separate testing.", "measurement_boundary": "Declare implement, technique, distance, radar/video method, accuracy target and joint-load monitoring; never treat impact damage as a capability endpoint.", "myth_to_metric": { "myth": "A devastating one-hit strike", "metric": "Projectile/implement velocity and target accuracy under a declared technique, with joint-load and pain monitoring", "boundary": "The metric is valid only for its declared task and cannot establish universal ability, character, diagnosis, safety or far transfer." }, "limiting_findings": [ "Throwing velocity and precision are separable outcomes.", "Evidence from trained throwing athletes cannot be generalised to untrained public striking or self-defence claims." ], "prohibited_claims": [ "Titan proves anyone can develop unlimited or superhuman throwing and striking power.", "One test score reveals whole-person capability, health, discipline, potential or worth.", "Improvement guarantees injury prevention, clinical benefit, occupational readiness or transfer to every real-world task." ] }, "gold_source_lesson": null, "next_gate": "External confirmation is required before higher-authority use because: CLINICAL_HIGH_RISK_OR_REGULATED_CONFIGURATION; SUPERVISION_OR_NON_ATTEMPT_BOUNDARY.", "evidence_count": 3 }, "full_training_programme": false, "independently_validated": false, "publication_state": "PUBLISHED_PUBLIC_RESEARCH_EDITION__EDITORIAL_REVIEW_PENDING", "related_power_ids": [ "PWR-009", "PWR-010", "PWR-011", "PWR-013" ] }, { "power_id": "PWR-013", "learning_unit_id": "TLU-PWR-013", "title": "Reactive strength", "main_description": "The learner completes one short provider-set series of bilateral rebounds with consistent contact time, jump height and alignment, then stops on the first control failure.", "main_description_source": "FULL_TUTORIAL_OUTCOME", "family_id": "FAM-02", "family": "Power, Speed & Agility", "superdomain": "Body & Performance", "canonical_route": "/powers/pwr-013/", "treatment": "SPECIALIST_PROVIDER_ROUTE", "treatment_label": "Full supervised tutorial", "treatment_boundary": "Titan teaches the complete method; a qualified person controls the parts that require supervision, clearance, specialist equipment, load, dose or progression.", "tutorial_route": "/tutorials/pwr-013/", "governed_lesson_route": null, "self_attempt_status": "PROHIBITED_WITHOUT_QUALIFIED_SUPERVISION", "gold_pathway_ids": [], "route_membership": { "kind": "RETAINED_EXTERNAL_ROUTE", "id": "SP-HUB-001", "coverage_status": "RETAINED" }, "source_authority_tier": "G4", "source_build_state": "EXTERNAL_PROVIDER_ROUTE", "source_instructional_route": "LEARN_ELSEWHERE_TRACK_WITH_TITAN", "source_count": 3, "research_depth": "FOCUSED", "risk_level": "HIGH", "prerequisite_status": "QUALIFIED_PROVIDER_DETERMINES", "learning_route": { "mode": "FULL_SUPERVISED_TUTORIAL", "label": "Learn reactive strength step by step", "summary": "The learner completes one short provider-set series of bilateral rebounds with consistent contact time, jump height and alignment, then stops on the first control failure.", "steps": [ [ "Get ready", "Demonstrate a quiet two-foot landing and hold balance for two seconds before repeated rebound work." ], [ "Learn the method", "7 concrete steps teach the permitted method from start to finish." ], [ "See right and wrong", "5 comparisons show correct or safer execution beside common wrong or riskier choices." ], [ "Practise", "The qualified provider controls contact count, height, surfaces, rest and weekly plyometric exposure. Drop height, unilateral work or external load are new higher-risk tasks and require separate teaching and clearance." ], [ "Check progress", "Use the same force plate, arm rule, hop or drop condition, foot marks and validity bands; calculate RSI only after excluding failed contacts." ] ], "practical_authority": false, "provider_required": true, "next_action_route": "/tutorials/pwr-013/" }, "path_builder": { "selectable": true, "completion_allowed": true, "warning": "Titan teaches the complete method; a qualified person controls the parts that require supervision, clearance, specialist equipment, load, dose or progression." }, "full_tutorial": { "version": "3.0", "authorship": "POWER_SPECIFIC_FULL_TUTORIAL", "tutorial_mode": "SUPERVISED", "promise": "Reactive strength is the ability to switch rapidly from landing force to take-off force in a declared rebound. This lesson teaches a provider-controlled low-amplitude bilateral pogo hop on a force plate: establish a stable landing first, keep the trunk tall, contact through the forefoot and whole foot, rebound without a deep squat and stop when contact time, height or alignment deteriorates. The provider controls clearance, hop height, repetitions, rest and whether drop jumps are ever appropriate.", "power_id": "PWR-013", "title": "Reactive strength", "lesson_type": "SUPERVISED", "headline": "Rebound quickly from a small supervised hop while keeping landing control", "plain_english_summary": "Reactive strength is the ability to switch rapidly from landing force to take-off force in a declared rebound. This lesson teaches a provider-controlled low-amplitude bilateral pogo hop on a force plate: establish a stable landing first, keep the trunk tall, contact through the forefoot and whole foot, rebound without a deep squat and stop when contact time, height or alignment deteriorates. The provider controls clearance, hop height, repetitions, rest and whether drop jumps are ever appropriate.", "outcome": "The learner completes one short provider-set series of bilateral rebounds with consistent contact time, jump height and alignment, then stops on the first control failure.", "authority": { "learner_may": [ "Reactive strength: Complete a provider-set low jump, land on both marked feet and hold for two seconds with hips and knees flexed. Stand tall with feet on the marks, ankles ready and arms in the declared position. Keep the gaze forward.", "During an authorised attempt, On landing, allow the whole foot to load while ankles, knees and hips flex slightly, then push away promptly without a deep squat. End the set when contact becomes clearly longer, height falls outside the band, alignment breaks or symptoms appear; step out and settle rather than forcing one more hop.", "Keep each rebound linked to its contact time, height and alignment result, and record the exact surface, footwear and stopping contact." ], "qualified_person_required_for": [ "Review ankle, knee and landing readiness and confirm that the force plate or marked surface can support a short, low-amplitude rebound series.", "Select the rebound task, surface, hop height, footwear, contacts, rest, force-plate method and any progression toward drop jumps.", "Use live observation or force data to keep the hop small and fast, correct a deep knee-dominant rebound and end the series as soon as contact time, height or alignment leaves its corridor." ], "never_do": [ "Step or jump from a box, add external load or continue repeated contacts without explicit provider instruction and a protected landing area.", "Do not progress to higher hops, unilateral contacts or drop jumps from this page or after one good rebound series.", "Terminate the set for lengthening contact, falling height, knee or foot misalignment, pain, loss of balance or a heavy uncontrolled landing." ] }, "materials": [ "Force plate or validated contact-time and jump-height system", "Flat resilient non-slip surface with foot marks", "Video view of trunk, knees and feet", "Stable support outside the landing zone", "A rebound sheet showing task, surface, footwear, contact number, ground-contact time, jump height, alignment flag, stopping reason and invalid contacts." ], "before_you_start": [ "Demonstrate a quiet two-foot landing and hold balance for two seconds before repeated rebound work.", "Report recent tendon, bone, knee, ankle or back symptoms and any long break from jumping.", "Agree on contact count and the exact stop rule for height loss, longer contact or alignment error.", "Mark the take-off and landing area and rehearse one quiet, low landing. Start the rebound series only when the learner can stay on the marks without stepping, collapsing or reaching for support.", "Rehearse the tall ready posture, a quiet landing and one small rebound before starting the provider-limited contact series." ], "steps": [ { "title": "Earn the landing first", "instruction": "Complete a provider-set low jump, land on both marked feet and hold for two seconds with hips and knees flexed.", "reason": "Repeated rebound is inappropriate when one landing is not controlled.", "success_check": "The learner stays on the marks without a step or collapse." }, { "title": "Set the rebound posture", "instruction": "Stand tall with feet on the marks, ankles ready and arms in the declared position. Keep the gaze forward.", "reason": "A repeatable start controls arm and trunk contributions.", "success_check": "Feet, arms and trunk match the setup image." }, { "title": "Use a small first hop", "instruction": "Rise only to the provider-set low height and return to the same marks; do not chase maximum height.", "reason": "The first contact should establish rhythm, not create an overload.", "success_check": "The first landing is quiet, centred and within the target height range." }, { "title": "Rebound from the ankle-led contact", "instruction": "On landing, allow the whole foot to load while ankles, knees and hips flex slightly, then push away promptly without a deep squat.", "reason": "A deep, slow countermovement changes the task from short-contact reactive work.", "success_check": "Contact remains brief and the trunk does not fold." }, { "title": "Keep contacts aligned", "instruction": "Track knees in line with feet and keep each contact on the marks. Do not let one leg take over or the feet drift.", "reason": "Drift and collapse show loss of a repeatable rebound pattern.", "success_check": "Video shows centred contacts and similar left-right timing." }, { "title": "Stop at the first failed rebound", "instruction": "End the set when contact becomes clearly longer, height falls outside the band, alignment breaks or symptoms appear; step out and settle rather than forcing one more hop.", "reason": "Technique failure is the endpoint, not exhaustion.", "success_check": "No extra contacts occur after the first stop criterion." }, { "title": "Calculate and interpret RSI", "instruction": "For valid contacts, divide jump height by ground-contact time using consistent units and report height and contact time alongside the ratio.", "reason": "The same ratio can hide different height-contact strategies.", "success_check": "The record retains all three values and the exact hop condition." } ], "worked_example": { "scenario": "A strength coach prescribes five low bilateral rebounds on a force plate, hands on hips, with a 12–16 cm height band and a stop if contact exceeds 0.25 s.", "walkthrough": [ "The learner first demonstrates two stable single landings.", "Contacts one to three show 0.21, 0.20 and 0.21 s with heights of 14, 15 and 14 cm.", "Contact four lasts 0.27 s and the knees collapse inward, so the learner stops and does not perform contact five.", "The coach calculates RSI only for the first three valid contacts and keeps height and time visible.", "After rest, the coach ends the session rather than adding a replacement set because the predeclared failure occurred." ], "result": "The valid series is three controlled contacts, not five. The mean valid RSI describes this low hands-on-hips rebound; it does not establish repeated-sprint endurance, sprint speed or safe drop-jump capacity." }, "right_vs_wrong": [ { "situation": "Entry level", "right": "Show a stable landing before repeated rebound.", "wrong": "Begin with a box drop to discover whether landing is adequate.", "why": "Box height adds unearned impact demand." }, { "situation": "Contact: Reactive strength checkpoint", "right": "Use a small prompt rebound with slight joint flexion.", "wrong": "Sink into a deep squat and pause.", "why": "The task becomes a slower countermovement jump." }, { "situation": "Set endpoint", "right": "Stop at first height, contact-time or alignment failure.", "wrong": "Continue until exhaustion to improve the score.", "why": "Extra poor contacts add risk and corrupt the measure." }, { "situation": "RSI: Reactive strength checkpoint", "right": "Report height and contact time beside the ratio.", "wrong": "Report only the ratio and hide how it was achieved.", "why": "Identical ratios can represent different strategies." }, { "situation": "Transfer: Reactive strength checkpoint", "right": "Call it performance in this rebound fixture.", "wrong": "Use it as proof of sprint or repeated-sprint ability.", "why": "Reactive rebound and sprint endurance are different constructs." } ], "common_mistakes": [ { "mistake": "The learner chases height and lengthens contact.", "fix": "Reinstate the provider's height band and prioritise the declared contact task." }, { "mistake": "A deep knee bend replaces the ankle-led rebound.", "fix": "Lower the hop height and rehearse two low contacts before another set." }, { "mistake": "Invalid contacts remain in the mean RSI.", "fix": "Apply the contact-time, height and alignment rules before calculation." }, { "mistake": "The series continues after inward knee collapse.", "fix": "End at the first failed contact and review the cause." }, { "mistake": "Repeated-sprint evidence is presented as rebound evidence.", "fix": "Keep the dossier mismatch explicit and use direct RSI sources for this method." } ], "practice": { "first_session": [ "Provider checks readiness and teaches a stable single landing.", "Practise two low hops separated by a full reset.", "Complete one three-contact familiarisation series.", "After full rest, complete one short measured series with a declared failure rule.", "Review contact time, jump height, RSI and alignment for each valid contact." ], "repeat_plan": "The qualified provider controls contact count, height, surfaces, rest and weekly plyometric exposure. Drop height, unilateral work or external load are new higher-risk tasks and require separate teaching and clearance.", "progress_when": [ "Every rebound returns to the same foot marks with stable alignment.", "Height and contact time remain inside the declared bands for the full short series.", "Symptoms and next-day response remain acceptable under the provider's rule." ], "do_not_progress_when": [ "Contact time lengthens, jump height falls or alignment fails before the planned endpoint.", "Pain, swelling, stiffness, fear or asymmetry appears during or after the session.", "The learner needs a higher drop or more contacts to make the ratio look better." ] }, "self_check": [ "Can you demonstrate a stable landing before rebounding?", "Did you stop at the first failed contact?", "Can you calculate RSI and still show height and contact time?", "Can you explain why this is not repeated-sprint endurance?" ], "measurement": { "primary": "Jump height divided by ground-contact time for valid short-contact rebounds, with height, time and alignment reported", "how": "Use the same force plate, arm rule, hop or drop condition, foot marks and validity bands; calculate RSI only after excluding failed contacts.", "good_result": "All contacts in the declared short series meet height, contact-time and alignment rules with stable symptoms and a consistent ratio.", "does_not_prove": "It does not prove sprint performance, repeated-sprint endurance, injury prevention or readiness for higher drop heights." }, "stop_and_get_help": [ "Stop for sharp tendon, bone, knee, ankle or back pain, a pop, swelling, giving way or inability to land normally.", "End the series on the first contact-time, height or alignment failure; do not finish the count for completeness.", "Abandon rebound contacts after focal tendon or bone pain, swelling, instability or a visibly protective landing, and let the qualified provider decide whether impact testing remains suitable." ], "accessibility": [ "Use a provider-selected supported heel raise, rapid seated push or non-flight stretch-shortening task when hopping is not appropriate and label it separately.", "Use high-contrast foot marks and visual or tactile start-stop cues without reducing the landing area.", "Teach the landing and rebound shape with a side-view demonstration, tactile position targets or short sound cues, without relaxing the contact-time and landing-quality criteria." ], "evidence_notes": [ { "claim": "The cited study evaluates a modified reactive strength index based on jump height and time to take-off; that value should not be substituted silently for contact-time RSI.", "source_title": "Using the reactive strength index modified to evaluate plyometric performance", "source_url": "https://pubmed.ncbi.nlm.nih.gov/20634740/", "source_kind": "PRIMARY_RESEARCH" }, { "claim": "Drop-jump and hopping RSI did not show a consistent relationship with sprint measures in one primary study, limiting transfer claims.", "source_title": "Influence of Reactive and Maximum Strength Indicators on Sprint Performance", "source_url": "https://pubmed.ncbi.nlm.nih.gov/29939904/", "source_kind": "PRIMARY_RESEARCH" } ], "limits": [ "The current canonical evidence register for PWR-013 is bound to repeated-sprint studies; those sources do not substantiate this rebound method.", "RSI depends on the hop/drop condition, technique and device.", "A higher RSI is not permission to add box height, contacts or load." ], "orientation": { "bounded_definition": "Capability to develop or express reactive strength in a declared context without inheriting broader claims.", "evidence_summary": "Reactive strength is real as a bounded, measurable capability, but the evidence is task- and population-specific. Titan separates improvement in the test from retention, transfer and meaningful function.", "supportable_public_claim": "In selected people and declared configurations, reactive strength can be measured and may improve with task-relevant practice; retention, transfer and meaningful value require separate testing.", "measurement_boundary": "Predeclare sprint mode, distance/duration, repetitions, recovery, best/mean/total performance and decrement formula; do not collapse these into one stamina score.", "myth_to_metric": { "myth": "Endless explosive bursts", "metric": "Best, mean and total repeated-sprint performance plus a predeclared decrement under fixed recovery", "boundary": "The metric is valid only for its declared task and cannot establish universal ability, character, diagnosis, safety or far transfer." }, "limiting_findings": [ "Two distinct training groups improved similarly in a youth soccer trial with no passive control.", "A fatigue index can remain unchanged while mean or total work improves." ], "prohibited_claims": [ "Titan proves anyone can develop unlimited or superhuman reactive strength.", "One test score reveals whole-person capability, health, discipline, potential or worth.", "Improvement guarantees injury prevention, clinical benefit, occupational readiness or transfer to every real-world task." ] }, "gold_source_lesson": null, "next_gate": "External confirmation is required before higher-authority use because: CLINICAL_HIGH_RISK_OR_REGULATED_CONFIGURATION; SUPERVISION_OR_NON_ATTEMPT_BOUNDARY.", "evidence_count": 3 }, "full_training_programme": false, "independently_validated": false, "publication_state": "PUBLISHED_PUBLIC_RESEARCH_EDITION__EDITORIAL_REVIEW_PENDING", "related_power_ids": [ "PWR-009", "PWR-010", "PWR-011", "PWR-012" ] }, { "power_id": "PWR-014", "learning_unit_id": "TLU-PWR-014", "title": "Deceleration and braking", "main_description": "The learner completes three valid supervised stops from the same entry-speed band, with stopping distance, time and technique recorded.", "main_description_source": "FULL_TUTORIAL_OUTCOME", "family_id": "FAM-02", "family": "Power, Speed & Agility", "superdomain": "Body & Performance", "canonical_route": "/powers/pwr-014/", "treatment": "SPECIALIST_PROVIDER_ROUTE", "treatment_label": "Full supervised tutorial", "treatment_boundary": "Titan teaches the complete method; a qualified person controls the parts that require supervision, clearance, specialist equipment, load, dose or progression.", "tutorial_route": "/tutorials/pwr-014/", "governed_lesson_route": null, "self_attempt_status": "PROHIBITED_WITHOUT_QUALIFIED_SUPERVISION", "gold_pathway_ids": [], "route_membership": { "kind": "RETAINED_EXTERNAL_ROUTE", "id": "SP-HUB-001", "coverage_status": "RETAINED" }, "source_authority_tier": "G4", "source_build_state": "EXTERNAL_PROVIDER_ROUTE", "source_instructional_route": "LEARN_ELSEWHERE_TRACK_WITH_TITAN", "source_count": 2, "research_depth": "FOCUSED", "risk_level": "HIGH", "prerequisite_status": "QUALIFIED_PROVIDER_DETERMINES", "learning_route": { "mode": "FULL_SUPERVISED_TUTORIAL", "label": "Learn deceleration and braking step by step", "summary": "The learner completes three valid supervised stops from the same entry-speed band, with stopping distance, time and technique recorded.", "steps": [ [ "Get ready", "Walk the lane and verify there is clear space beyond the intended stop." ], [ "Learn the method", "12 concrete steps teach the permitted method from start to finish." ], [ "See right and wrong", "11 comparisons show correct or safer execution beside common wrong or riskier choices." ], [ "Practise", "The provider sets speed, volume, rest, surface and any later angle or reactive cue. Increase entry speed only after repeated in-band stops meet distance and balance rules; add carried load or direction change as separate tasks." ], [ "Check progress", "Measure entry speed, braking line, stop point, contacts and final balance under the same surface and footwear; invalidate out-of-band or unstable trials. Define the stop endpoint as the first stationary footprint followed by the declared balance hold. Pair distance with contact count, skid, overstride, alignment and lane codes. Retain contact-frame labels and false-short pattern codes—heel anchor, sideways escape and rebound step—beside the tape distance. Use an unadjusted braking-line-to-stationary-footprint tape reading verified by a second reviewer. Bind tape endpoint to a verified stationary-footprint timestamp and uninterrupted balance timer." ] ], "practical_authority": false, "provider_required": true, "next_action_route": "/tutorials/pwr-014/" }, "path_builder": { "selectable": true, "completion_allowed": true, "warning": "Titan teaches the complete method; a qualified person controls the parts that require supervision, clearance, specialist equipment, load, dose or progression." }, "full_tutorial": { "version": "3.0", "authorship": "POWER_SPECIFIC_FULL_TUTORIAL", "tutorial_mode": "SUPERVISED", "promise": "Learn a straight-line stop from a provider-set approach speed. You will lower before the braking line, use several shorter contacts under the body, keep the trunk and knees aligned, and finish balanced inside the stop zone. The lesson shows which short stops are invalid—heel planting, skidding, sideways escape or a rebound step—and when to use the runoff instead of forcing the stop.", "power_id": "PWR-014", "title": "Deceleration and braking", "lesson_type": "SUPERVISED", "headline": "Enter at a measured speed and stop inside a marked zone", "plain_english_summary": "Learn a straight-line stop from a provider-set approach speed. You will lower before the braking line, use several shorter contacts under the body, keep the trunk and knees aligned, and finish balanced inside the stop zone. The lesson shows which short stops are invalid—heel planting, skidding, sideways escape or a rebound step—and when to use the runoff instead of forcing the stop.", "outcome": "The learner completes three valid supervised stops from the same entry-speed band, with stopping distance, time and technique recorded.", "authority": { "learner_may": [ "Deceleration and braking: Approach smoothly and pass the entry gate inside the provider's speed band; use the run-off route if you arrive too fast. Just before braking, lower the hips slightly, keep the chest controlled and bring the feet ready beneath the body.", "During an authorised attempt, Keep knees tracking with feet and the trunk facing forward; use the arms for balance without twisting. If the approach is too fast or the stop feels unsafe, keep moving straight through the escape lane and tell the provider; do not force the target zone.", "Pair every stopping result with its measured entry speed and retain footprint, contact, skid, balance and recovery-step observations." ], "qualified_person_required_for": [ "Assess readiness for fast braking, lower-limb symptoms, surface grip and escape-runoff space before setting the approach-speed band.", "Set the entry-speed band, approach distance, stop zone, footwear, trial count, recovery, timing and any load or change-of-direction demand.", "Confirm an in-band entry at the gate, reject any run that begins braking early and use the first genuinely stationary footprint—not the shortest-looking mark—as the endpoint." ], "never_do": [ "Use an uncontrolled downhill approach, surprise cue, obstacle, heavy carried load or maximum entry speed without separate provider assessment.", "Do not raise approach speed, shorten the stop zone or force a measured stop when the safe choice is to continue into the runoff.", "Stop testing after an overstride, skid, trunk or knee collapse, lateral escape, rebound step, pain or inability to hold the final balance." ] }, "materials": [ "Level high-grip lane with approach, braking line and stop-zone marks", "Timing gates or validated entry-speed measurement", "Video view of contacts and trunk", "Cones that do not create a trip hazard", "A braking record for approach-gate speed, braking-line crossing, contact count, stationary footprint, stopping distance, skid, alignment, balance hold and rejected trials." ], "before_you_start": [ "Walk the lane and verify there is clear space beyond the intended stop.", "Agree on the entry-speed band and a trial-abort route if the speed is too high.", "Report knee, ankle, hip, back or tendon pain and any recent giving-way episode.", "Identify the braking line and the escape runoff, then rehearse continuing through the course when a stop is not safe. Score a trial only after the gate confirms an entry inside the assigned speed band.", "Rehearse preparing before the line, using several shortening contacts and escaping into the runoff without asking for a shortest stop." ], "steps": [ { "title": "Build only the assigned speed", "instruction": "Approach smoothly and pass the entry gate inside the provider's speed band; use the run-off route if you arrive too fast.", "reason": "Stopping distance cannot be compared across unknown entry speeds.", "success_check": "The gate confirms an in-band entry before the trial is scored." }, { "title": "Prepare before the line", "instruction": "Just before braking, lower the hips slightly, keep the chest controlled and bring the feet ready beneath the body.", "reason": "Early preparation reduces the need for one abrupt final plant.", "success_check": "Video shows the body lowering before, not after, the braking line." }, { "title": "Use several braking contacts", "instruction": "Take progressively shorter, firmer steps, placing the foot close to the body rather than reaching far ahead.", "reason": "Braking distributed across contacts is easier to control.", "success_check": "No single overstriding contact carries the whole stop." }, { "title": "Keep the body aligned", "instruction": "Keep knees tracking with feet and the trunk facing forward; use the arms for balance without twisting.", "reason": "Collapse or rotation changes load and direction.", "success_check": "Front and side video show stable knee and trunk alignment." }, { "title": "Finish with a stable base", "instruction": "Bring the last steps to a complete stop with feet apart and hold balance for two seconds.", "reason": "Crossing feet or hopping after the stop shows incomplete braking control.", "success_check": "No extra recovery step leaves the stop zone." }, { "title": "Use the run-off when needed", "instruction": "If the approach is too fast or the stop feels unsafe, keep moving straight through the escape lane and tell the provider; do not force the target zone.", "reason": "Aborting safely is better than manufacturing a score.", "success_check": "The learner can choose the run-off before losing control." }, { "title": "Score entry and stop together", "instruction": "Record entry speed, stopping time/distance, contact count, balance hold, pain and validity.", "reason": "A shorter stop from a slower entry is not necessarily improvement.", "success_check": "Every stop result is paired with its measured entry speed." }, { "title": "Locate the true stop footprint", "instruction": "After an in-band trial, identify the first footprint at which forward travel has ended and the required balance hold begins. Measure from the braking line to that footprint, not to a leaning torso or trailing shoe.", "reason": "A consistent endpoint prevents body lean and later recovery steps from shortening the reported distance.", "success_check": "Video, footprint and tape measure identify the same stationary endpoint." }, { "title": "Classify every braking contact", "instruction": "Count contacts after the line and label any overstride, skid, knee drift, trunk collapse or lateral escape. Keep the entry speed and distance beside these labels.", "reason": "Distance without contact quality can reward a mechanically failed stop.", "success_check": "Each valid trial has entry band, contact count, stop distance and held-balance code." }, { "title": "Name false short stop patterns", "instruction": "Compare video with the tape result and label heel-anchor, sideways-escape or rebound-step patterns. Keep the short distance visible but invalidate it when stationary balance, lane or alignment fails.", "reason": "False-short patterns reward abrupt contact strategies rather than controlled deceleration.", "success_check": "The learner can identify all three patterns and locate the stationary-footprint rule each one breaks." }, { "title": "Reproduce the tape calculation", "instruction": "Set tape zero at the braking line and read metres at the stationary footprint selected by the hold rule. Record entry speed and contact count beside that unadjusted distance.", "reason": "Post-hoc shoe-length or torso corrections create non-reproducible stopping values.", "success_check": "A second reviewer obtains the same footprint, tape distance, entry velocity and braking-contact count." }, { "title": "Confirm the stationary timestamp", "instruction": "Freeze video at the chosen footprint and inspect following frames for slide, pivot or renewed travel. Start the balance timer only when the same footprint remains stationary.", "reason": "A momentary slowdown is not the endpoint of a controlled stop.", "success_check": "Tape endpoint, stationary-footprint timestamp and uninterrupted balance timer refer to the same contact." } ], "worked_example": { "scenario": "A coach sets a 4.0–4.3 m/s entry band and a 3 m stopping zone on an indoor court.", "walkthrough": [ "The learner rehearses the short-step stop at jogging speed.", "Trial one enters at 3.7 m/s and is excluded because it is below the band.", "Trial two enters at 4.1 m/s and stops in 2.4 m with five contacts and a held finish.", "Trial three enters at 4.2 m/s but needs a step outside the zone, so it is invalid for balance.", "After rest, a final authorised trial enters at 4.1 m/s and stops in 2.3 m with a held finish.", "For the 2.3 m trial, frame-by-frame review locates four braking contacts and a fifth stationary footprint held for two seconds.", "The 4.2 m/s trial is retained as invalid because its lateral recovery step leaves the marked stopping lane despite a short tape distance.", "The learner demonstrates the escape option by continuing through the runoff when an approach rehearsal arrives off balance.", "A heel-anchor sample stops the tape at 2.1 m but skids after an extended first braking contact, so it fails contact quality.", "A sideways-escape sample reaches 2.0 m yet leaves the corridor before balance, while a rebound-step sample travels forward again after the apparent endpoint.", "The valid 2.3 m stop uses progressive contacts, a clearly stationary footprint and an uninterrupted two-second hold.", "Tape zero remains fixed at the braking line; the valid stationary footprint reads 2.30 m without a shoe-length correction.", "A second reviewer reproduces 2.30 m, four moving braking contacts and the fifth stationary balance footprint.", "The 2.30 m footprint remains fixed through the balance timer; a 2.18 m candidate slides in the next frame and is rejected." ], "result": "The best valid stop is 2.3 m from a 4.1 m/s entry, with control held. It does not prove reactive braking, injury prevention or stopping from a higher speed." }, "right_vs_wrong": [ { "situation": "Entry speed", "right": "Measure and stay inside the declared band.", "wrong": "Compare stops from whatever speed occurred.", "why": "Entry speed drives braking demand. That changes stopping distance and time from a controlled measured entry speed, plus technique and balance. It is no longer the same test." }, { "situation": "Braking contacts", "right": "Use several shorter contacts under the body.", "wrong": "Reach for one long heel plant.", "why": "Overreaching can create abrupt braking and loss of control." }, { "situation": "Posture: Deceleration and braking checkpoint", "right": "Lower before braking and keep trunk aligned.", "wrong": "Stay tall until the final step, then fold or twist.", "why": "Late collapse concentrates the stop. That changes stopping distance and time from a controlled measured entry speed, plus technique and balance. It is no longer the same test." }, { "situation": "Unsafe entry", "right": "Run through the escape lane and void the trial.", "wrong": "Force the stop zone to preserve the attempt.", "why": "A safe abort prevents an uncontrolled stop." }, { "situation": "Result: Deceleration and braking checkpoint", "right": "Report distance alongside entry speed and validity.", "wrong": "Rank shortest distance without normalising entry.", "why": "A slower approach can look falsely better." }, { "situation": "Defining the endpoint", "right": "Measure to the first stationary footprint followed by the required hold.", "wrong": "Measure to the front of the torso while the feet are still recovering.", "why": "A moving body has not completed the declared stop." }, { "situation": "Handling a poor approach", "right": "Use the runoff when entry posture or lane control is lost.", "wrong": "Force a sharp plant merely because timing has begun.", "why": "Aborting protects control and prevents an invalid approach from dictating braking load." }, { "situation": "Heel-anchor stop", "right": "Use progressive contacts beneath a controllable centre of mass.", "wrong": "Reach a stiff heel far ahead to create the shortest tape number.", "why": "The skid and overstride fail controlled braking quality." }, { "situation": "Rebound-step stop", "right": "Hold the stationary footprint for the declared duration.", "wrong": "Call the first pause finished before another forward recovery step.", "why": "Renewed travel means the earlier footprint was not the endpoint." }, { "situation": "Reading stopping distance", "right": "Use braking-line zero and the held stationary footprint.", "wrong": "Subtract shoe length or estimate where the torso first slowed.", "why": "Those corrections change the declared tape endpoint." }, { "situation": "Starting the balance timer", "right": "Begin when the selected footprint stops sliding and remains fixed.", "wrong": "Begin at the slowest video frame before a pivot or rebound.", "why": "Timer and tape must describe the same stationary endpoint." } ], "common_mistakes": [ { "mistake": "Approach speed is not measured.", "fix": "Use timing gates or a validated speed method and predeclare the band." }, { "mistake": "The learner brakes before the entry gate.", "fix": "Move the cue beyond the gate and void early-braking trials." }, { "mistake": "One overlong step does all the stopping.", "fix": "Reduce speed and rehearse progressively shorter contacts." }, { "mistake": "A recovery step is ignored.", "fix": "Require a two-second balance hold inside the zone." }, { "mistake": "The learner turns immediately after stopping.", "fix": "Hold, then walk out; do not add a high-load turn." }, { "mistake": "A skid mark is mistaken for the stationary stop footprint.", "fix": "Use video and the held-balance rule to locate the first truly stationary contact." }, { "mistake": "The shortest tape distance is chosen despite a lateral recovery step.", "fix": "Apply the lane and hold codes before ranking any braking distance." }, { "mistake": "A brief pause before a rebound step is treated as stationary balance.", "fix": "Use the full hold window and select the later true endpoint or invalidate the trial." }, { "mistake": "A sideways escape is ignored because forward distance is short.", "fix": "Apply corridor validity before comparing tape measurements." }, { "mistake": "Shoe length is subtracted to improve the stopping score.", "fix": "Report the direct braking-line-to-stationary-footprint tape reading." }, { "mistake": "The balance timer starts while the selected footprint still pivots.", "fix": "Advance frame by frame and use the later truly stationary timestamp." } ], "practice": { "first_session": [ "Inspect the lane, stop zone and run-off.", "Practise posture and short contacts at walking speed.", "Complete provider-set progressive approaches below test speed.", "Complete two or three in-band measured stops with full recovery.", "Review entry speed, distance, contacts and balance before deciding next session.", "At walking speed, practise identifying braking line, successive contact numbers, stationary footprint and two-second balance hold.", "Rehearse the runoff escape twice so abandoning an off-balance approach is an accepted response.", "Label braking-contact frames and three false-short patterns on sample videos before measured approaches.", "Practise placing tape zero and independently selecting the stationary footprint from held-balance video." ], "repeat_plan": "The provider sets speed, volume, rest, surface and any later angle or reactive cue. Increase entry speed only after repeated in-band stops meet distance and balance rules; add carried load or direction change as separate tasks.", "progress_when": [ "Entry speed stays within the same band across valid trials.", "Stopping distance/time improves with stable contact and alignment quality.", "The learner consistently chooses the run-off if a stop will not be controlled.", "In-band stops shorten only while contact count, stationary-footprint hold and lane alignment remain valid.", "Valid distance improves while heel-anchor, sideways-escape and rebound-step labels remain absent.", "Two reviewers reproduce the same braking-line zero, stationary footprint, tape value and contact count." ], "do_not_progress_when": [ "A shorter stop requires an overstride, trunk collapse or recovery step.", "Pain, swelling, giving way, fear or asymmetry appears.", "The surface, footwear, speed measure or run-off area changes.", "The learner feels compelled to force the stop rather than selecting the runoff after a poor approach.", "A short distance repeatedly depends on skid, lane escape or renewed forward travel.", "Reviewers disagree about the true stationary footprint or tape zero moves between trials." ] }, "self_check": [ "Can you state the entry-speed band and run-off route?", "Did the body lower before the braking line?", "Were several contacts used without a recovery step?", "Can you explain why stopping distance alone is insufficient?", "Can you point to the stationary footprint that defines distance rather than a skid or trailing step?", "Can you name the contact-count and balance reasons the 4.2 m/s trial was invalid?", "Can you distinguish a stationary footprint from the brief pause before a rebound step?", "Why does a 2.0 m sideways-escape trial lose to a controlled 2.3 m stop?", "Where is tape zero placed, and which held footprint supplies the 2.30 m reading?", "Do tape endpoint, stationary timestamp and balance timer identify one unchanged footprint?" ], "measurement": { "primary": "Stopping distance and time from a controlled measured entry speed, plus technique and balance", "how": "Measure entry speed, braking line, stop point, contacts and final balance under the same surface and footwear; invalidate out-of-band or unstable trials. Define the stop endpoint as the first stationary footprint followed by the declared balance hold. Pair distance with contact count, skid, overstride, alignment and lane codes. Retain contact-frame labels and false-short pattern codes—heel anchor, sideways escape and rebound step—beside the tape distance. Use an unadjusted braking-line-to-stationary-footprint tape reading verified by a second reviewer. Bind tape endpoint to a verified stationary-footprint timestamp and uninterrupted balance timer.", "good_result": "At least two in-band stops meet the balance and alignment criteria and improve beyond measurement noise without symptoms. A shorter in-band distance is accepted only when the stationary endpoint, contact sequence and held balance all pass.", "does_not_prove": "It does not prove reactive stopping, safe braking at higher speed, injury prevention or sport transfer." }, "stop_and_get_help": [ "Stop for sharp lower-limb pain, a pop, giving way, fall, collision or inability to use the run-off safely.", "End the set when approach speed or stop technique becomes inconsistent or fatigue delays braking.", "Do not restart the approach lane after a collision, fall, new limb symptom or loss of normal walking; secure the area and obtain the level of assessment the event requires." ], "accessibility": [ "Use a provider-selected wheeled or supported braking task with its own speed and stopping measures when running is not appropriate.", "Use high-contrast/tactile braking lines and accessible cues while keeping a full escape route.", "Make the approach speed, preparation zone and stop boundary available through colored cones, raised markers or caller cues, noting the chosen route aid on the trial sheet." ], "evidence_notes": [ { "claim": "Technique-modification training can change a pre-planned 180-degree braking task, but the evidence does not establish delayed retention or reactive stopping.", "source_title": "Change of Direction Speed and Technique Modification Training Improves 180° Turning Performance, Kinetics, and Kinematics", "source_url": "https://pubmed.ncbi.nlm.nih.gov/34073842/", "source_kind": "PRIMARY_RESEARCH" }, { "claim": "Official physical-activity guidance supports individual progression and risk-aware activity, not a universal high-speed braking dose.", "source_title": "WHO guidelines on physical activity and sedentary behaviour", "source_url": "https://www.who.int/publications/b/55518", "source_kind": "OFFICIAL_GUIDANCE" } ], "limits": [ "Stopping distance depends on entry speed, surface, footwear and instruction.", "A pre-planned stop does not establish response to an unexpected hazard.", "No braking technique guarantees injury prevention." ], "orientation": { "bounded_definition": "Capability to develop or express deceleration and braking in a declared context without inheriting broader claims.", "evidence_summary": "Deceleration and braking is real as a bounded, measurable capability, but the evidence is task- and population-specific. Titan separates improvement in the test from retention, transfer and meaningful function.", "supportable_public_claim": "In selected people and declared configurations, deceleration and braking can be measured and may improve with task-relevant practice; retention, transfer and meaningful value require separate testing.", "measurement_boundary": "Measure approach speed, stopping distance/time, horizontal braking impulse, contacts and technique; normalise for entry speed and report pain or loss of control.", "myth_to_metric": { "myth": "Instant stopping with no consequence", "metric": "Stopping time/distance and braking impulse from a controlled entry speed with technique and load recorded", "boundary": "The metric is valid only for its declared task and cannot establish universal ability, character, diagnosis, safety or far transfer." }, "limiting_findings": [ "No delayed retention test was performed.", "Pre-planned 180-degree turn improvement does not establish reactive braking or injury prevention." ], "prohibited_claims": [ "Titan proves anyone can develop unlimited or superhuman deceleration and braking.", "One test score reveals whole-person capability, health, discipline, potential or worth.", "Improvement guarantees injury prevention, clinical benefit, occupational readiness or transfer to every real-world task." ] }, "gold_source_lesson": null, "next_gate": "External confirmation is required before higher-authority use because: CLINICAL_HIGH_RISK_OR_REGULATED_CONFIGURATION; SUPERVISION_OR_NON_ATTEMPT_BOUNDARY.", "evidence_count": 2 }, "full_training_programme": false, "independently_validated": false, "publication_state": "PUBLISHED_PUBLIC_RESEARCH_EDITION__EDITORIAL_REVIEW_PENDING", "related_power_ids": [ "PWR-009", "PWR-010", "PWR-011", "PWR-012" ] }, { "power_id": "PWR-015", "learning_unit_id": "TLU-PWR-015", "title": "Change of direction", "main_description": "The learner completes three valid pre-planned 45-degree cuts from the same approach side and speed band, with course time, straight-sprint comparison and technique recorded.", "main_description_source": "FULL_TUTORIAL_OUTCOME", "family_id": "FAM-02", "family": "Power, Speed & Agility", "superdomain": "Body & Performance", "canonical_route": "/powers/pwr-015/", "treatment": "SPECIALIST_PROVIDER_ROUTE", "treatment_label": "Full supervised tutorial", "treatment_boundary": "Titan teaches the complete method; a qualified person controls the parts that require supervision, clearance, specialist equipment, load, dose or progression.", "tutorial_route": "/tutorials/pwr-015/", "governed_lesson_route": null, "self_attempt_status": "PROHIBITED_WITHOUT_QUALIFIED_SUPERVISION", "gold_pathway_ids": [], "route_membership": { "kind": "RETAINED_EXTERNAL_ROUTE", "id": "SP-HUB-001", "coverage_status": "RETAINED" }, "source_authority_tier": "G4", "source_build_state": "EXTERNAL_PROVIDER_ROUTE", "source_instructional_route": "LEARN_ELSEWHERE_TRACK_WITH_TITAN", "source_count": 4, "research_depth": "DETAILED", "risk_level": "HIGH", "prerequisite_status": "QUALIFIED_PROVIDER_DETERMINES", "learning_route": { "mode": "FULL_SUPERVISED_TUTORIAL", "label": "Learn change of direction step by step", "summary": "The learner completes three valid pre-planned 45-degree cuts from the same approach side and speed band, with course time, straight-sprint comparison and technique recorded.", "steps": [ [ "Get ready", "Walk the course in both travel directions and check that no cone creates a trip point." ], [ "Learn the method", "7 concrete steps teach the permitted method from start to finish." ], [ "See right and wrong", "5 comparisons show correct or safer execution beside common wrong or riskier choices." ], [ "Practise", "The provider controls angles, sides, approach speed, trials, rest and later reactive cues. Progress angle or speed one at a time; unplanned agility remains a separate advanced assessment." ], [ "Check progress", "Use the same course, entry-speed band, surface, footwear and timing; record route faults, plant alignment and a matched straight sprint." ] ], "practical_authority": false, "provider_required": true, "next_action_route": "/tutorials/pwr-015/" }, "path_builder": { "selectable": true, "completion_allowed": true, "warning": "Titan teaches the complete method; a qualified person controls the parts that require supervision, clearance, specialist equipment, load, dose or progression." }, "full_tutorial": { "version": "3.0", "authorship": "POWER_SPECIFIC_FULL_TUTORIAL", "tutorial_mode": "SUPERVISED", "promise": "Change of direction combines approach speed, braking, foot placement and re-acceleration around a known course. This lesson teaches a pre-planned 45-degree cut: enter inside a fixed speed band, lower before the marker, place the outside foot close enough to the body for control, align knee and foot toward the new path, push away and accelerate through the exit gate. The provider controls angle, speed, repetitions, rest and progression; reactive agility is tested separately.", "power_id": "PWR-015", "title": "Change of direction", "lesson_type": "SUPERVISED", "headline": "Brake, plant and leave a pre-planned 45-degree cut under control", "plain_english_summary": "Change of direction combines approach speed, braking, foot placement and re-acceleration around a known course. This lesson teaches a pre-planned 45-degree cut: enter inside a fixed speed band, lower before the marker, place the outside foot close enough to the body for control, align knee and foot toward the new path, push away and accelerate through the exit gate. The provider controls angle, speed, repetitions, rest and progression; reactive agility is tested separately.", "outcome": "The learner completes three valid pre-planned 45-degree cuts from the same approach side and speed band, with course time, straight-sprint comparison and technique recorded.", "authority": { "learner_may": [ "Change of direction: Walk through the exact approach, 45-degree marker and exit gate until the new travel line is unambiguous. Build smoothly and cross the entry gate inside the provider's speed band; do not brake early to make the cut easier.", "During an authorised attempt, Plant the outside foot close enough to the body to support the turn, with the foot and knee directed toward the intended exit path. Run past the exit gate before slowing; do not cut the corner or lunge at the timer.", "Record measured entry speed, approach side, plant validity, exit line, course time and straight-sprint comparison for each planned cut." ], "qualified_person_required_for": [ "Review knee, ankle and hip readiness, surface traction and space around the course before authorising a timed change-of-direction trial.", "Set course geometry, approach side and speed, footwear, surface, trial count, rest, timing and any later reactive cue.", "Use the entry gate to hold approach speed constant, cue the eyes to the exit line rather than the feet and reject cuts that clip the marker or leave knee and foot aimed away from the new path." ], "never_do": [ "Use an unannounced direction cue, opponent, unstable surface or maximum-speed cut before the pre-planned task is controlled.", "Do not add a reactive cue, sharper angle, faster entry or extra repetitions merely because the pre-planned 45-degree cut was completed.", "End the task for pain, slipping, uncontrolled trunk or knee position, missed course geometry or any cut that cannot be followed by balanced acceleration." ] }, "materials": [ "Level court or field with approach, cut and exit gates", "45-degree floor or cone guide", "Electronic timing and entry-speed measurement", "Video view of plant foot, knee and trunk", "A change-of-direction sheet for course dimensions, side, surface, footwear, entry-speed band, plant frame, exit gate, total time, COD deficit and invalid-trial reason." ], "before_you_start": [ "Walk the course in both travel directions and check that no cone creates a trip point.", "Declare the approach side, plant foot, turn angle, entry-speed band and exit line.", "Report knee, ankle, hip or back symptoms and any history of giving way during cutting.", "Walk the exact approach, plant and exit line from both sides. The learner must be able to trace the route and point their eyes to the exit without turning back before speed is added.", "Walk the exact course, then rehearse lowering before the marker and looking through the exit line at submaximal speed before timing starts." ], "steps": [ { "title": "Learn the course", "instruction": "Walk through the exact approach, 45-degree marker and exit gate until the new travel line is unambiguous.", "reason": "A course error is not a movement-capacity result.", "success_check": "The learner traces the correct line without looking back." }, { "title": "Enter at the assigned speed", "instruction": "Build smoothly and cross the entry gate inside the provider's speed band; do not brake early to make the cut easier.", "reason": "Approach speed changes cutting demand; this preserves the change of direction rule for 'Enter at the assigned speed'.", "success_check": "The timing record confirms an in-band approach." }, { "title": "Lower before the marker", "instruction": "Use one or more shorter braking steps and lower the hips before the final plant.", "reason": "Late braking forces the plant to absorb too much demand.", "success_check": "Video shows centre of mass lowering before foot placement." }, { "title": "Place the outside foot for control", "instruction": "Plant the outside foot close enough to the body to support the turn, with the foot and knee directed toward the intended exit path.", "reason": "A far reaching or misaligned plant can cause braking and collapse.", "success_check": "Knee tracks over the foot and the trunk stays controlled." }, { "title": "Push into the new line", "instruction": "Drive away from the planted leg and direct hips, chest and first exit step along the 45-degree path.", "reason": "Rotation without translation wastes the redirection.", "success_check": "The first two exit contacts follow the marked lane." }, { "title": "Accelerate through the exit", "instruction": "Run past the exit gate before slowing; do not cut the corner or lunge at the timer.", "reason": "A full exit is part of the timed task.", "success_check": "The learner stays inside the exit lane and runs through." }, { "title": "Separate COD from sprint speed", "instruction": "Record course time and subtract or compare the matched straight-sprint time using the predeclared COD-deficit method. Keep technical validity separate.", "reason": "Total course time includes straight-speed ability.", "success_check": "The record includes both total time and COD deficit." } ], "worked_example": { "scenario": "A coach uses a 5 m approach, one pre-planned right-side 45-degree cut and a 5 m exit, with a 3.5–3.8 m/s entry band.", "walkthrough": [ "The learner walks the course and rehearses the outside-foot plant at half speed.", "Trial one is invalid because entry speed is 3.2 m/s.", "Trial two enters at 3.6 m/s, takes 2.42 s and shows a stable plant and full exit.", "Trial three takes 2.39 s but the learner cuts inside the cone, so it is invalid.", "A matched straight 10 m time is recorded separately and the provider calculates the declared COD deficit." ], "result": "The valid cut time is 2.42 s at an in-band approach, with the COD deficit reported beside it. This is pre-planned 45-degree COD, not reactive agility." }, "right_vs_wrong": [ { "situation": "Approach: Change of direction checkpoint", "right": "Maintain the measured speed until the braking phase.", "wrong": "Slow early outside the measured zone.", "why": "The cut becomes easier and incomparable." }, { "situation": "Plant: Change of direction checkpoint", "right": "Place the foot near enough for knee-foot alignment.", "wrong": "Reach far outside and let the knee collapse inward.", "why": "The plant becomes an uncontrolled brake." }, { "situation": "Exit: Change of direction checkpoint", "right": "Direct hips and first steps down the new lane.", "wrong": "Spin in place and then restart.", "why": "Rotation alone is not efficient redirection." }, { "situation": "Course: Change of direction checkpoint", "right": "Run around the declared marker and through the gate.", "wrong": "Cut inside the cone to save distance.", "why": "The timed course is shortened. That changes pre-planned COD completion time and COD deficit at a fixed approach speed, with technique validity. It is no longer the same test." }, { "situation": "Claim: Change of direction checkpoint", "right": "Call the result pre-planned COD. It is correct when the first two exit contacts follow the marked lane.", "wrong": "Call it reactive agility against an opponent.", "why": "Decision time was not tested. That changes pre-planned COD completion time and COD deficit at a fixed approach speed, with technique validity. It is no longer the same test." } ], "common_mistakes": [ { "mistake": "Entry speed is missing during 'Learn the course' in change of direction.", "fix": "Measure it or use a provider-controlled approach that stays inside a declared band." }, { "mistake": "The learner watches the feet and loses the exit line.", "fix": "Use a visible exit target and rehearse at slower speed." }, { "mistake": "The plant is too far from the body.", "fix": "Reduce approach speed and practise a closer controlled plant." }, { "mistake": "A cone cut is still timed as valid.", "fix": "Mark route violations before reviewing times." }, { "mistake": "Total time is treated as pure COD ability.", "fix": "Report a matched straight-sprint time and the predeclared COD deficit." } ], "practice": { "first_session": [ "Walk and memorise the exact course.", "Rehearse braking, plant and exit at low speed on each provider-approved side.", "Complete progressive in-band approaches without timing pressure.", "Complete two or three timed cuts with full rest.", "Review one plant video, total time, entry speed and COD deficit." ], "repeat_plan": "The provider controls angles, sides, approach speed, trials, rest and later reactive cues. Progress angle or speed one at a time; unplanned agility remains a separate advanced assessment.", "progress_when": [ "Entry speed, course and plant side are repeatable.", "The plant stays aligned and the exit follows the marked lane.", "Total time and COD deficit improve without route or technique violations." ], "do_not_progress_when": [ "Faster time comes from slower entry, cutting the cone or a new surface.", "Knee collapse, slipping, pain, giving way or poor braking appears.", "The learner cannot keep the pre-planned course before adding a decision cue." ] }, "self_check": [ "Can you state the angle, approach side and speed band?", "Did braking start before the final plant?", "Did the plant and knee point toward the exit path?", "Can you explain the difference between total time, COD deficit and reactive agility?" ], "measurement": { "primary": "Pre-planned COD completion time and COD deficit at a fixed approach speed, with technique validity", "how": "Use the same course, entry-speed band, surface, footwear and timing; record route faults, plant alignment and a matched straight sprint.", "good_result": "At least two in-band valid cuts are repeatable and time/deficit improves without route error, alignment loss or symptoms.", "does_not_prove": "It does not prove reactive decision ability, opponent response, injury prevention or transfer to another angle." }, "stop_and_get_help": [ "Stop for sharp pain, a pop, joint giving way, slip, fall or inability to brake before the plant.", "End the session when route errors, entry-speed drift or knee/trunk control worsens.", "Close the course after a new twist, stumble with injury, joint giving-way or inability to decelerate under control; reassess health and entry-speed suitability before another cut." ], "accessibility": [ "Use a provider-selected wheeled, walking or supported redirection task with its own course and timing when running is not appropriate.", "Use high-contrast/tactile course markers and an accessible start signal without narrowing the safe lane.", "Provide the COD course as a walk-through, overhead diagram or sequential cone call, and write down any navigation aid so repeat timing uses the same support." ], "evidence_notes": [ { "claim": "Straight sprint and agility training show task-specific transfer, so pre-planned COD and linear speed should be measured separately.", "source_title": "Specificity of sprint and agility training methods", "source_url": "https://pubmed.ncbi.nlm.nih.gov/11710657/", "source_kind": "PRIMARY_RESEARCH" }, { "claim": "Resisted sprint training effects on sprint, jump and balance do not establish pre-planned or reactive COD across tasks.", "source_title": "Effects of Resisted Sprint Training and Traditional Power Training on Sprint, Jump, and Balance Performance in Healthy Young Adults: A Randomized Controlled Trial", "source_url": "https://pubmed.ncbi.nlm.nih.gov/29551981/", "source_kind": "PRIMARY_RESEARCH" } ], "limits": [ "A 45-degree cut does not establish 90- or 180-degree turning ability.", "Pre-planned COD is not reactive agility.", "No cutting technique guarantees protection from knee or ankle injury." ], "orientation": { "bounded_definition": "Capability to develop or express change of direction in a declared context without inheriting broader claims.", "evidence_summary": "Change of direction is real as a bounded, measurable capability, but the evidence is task- and population-specific. Titan separates improvement in the test from retention, transfer and meaningful function.", "supportable_public_claim": "In selected people and declared configurations, change of direction can be measured and may improve with task-relevant practice; retention, transfer and meaningful value require separate testing.", "measurement_boundary": "Declare course, angle, entry speed and timing method; separate total time, COD deficit and reactive decision latency.", "myth_to_metric": { "myth": "Impossible agility", "metric": "Pre-planned COD completion and COD deficit at a fixed approach speed, with reactive agility tested separately", "boundary": "The metric is valid only for its declared task and cannot establish universal ability, character, diagnosis, safety or far transfer." }, "limiting_findings": [ "Agility training did not improve straight sprint performance in the Young study.", "Pre-planned COD gains do not establish decision-making or opponent-responsive agility." ], "prohibited_claims": [ "Titan proves anyone can develop unlimited or superhuman change of direction.", "One test score reveals whole-person capability, health, discipline, potential or worth.", "Improvement guarantees injury prevention, clinical benefit, occupational readiness or transfer to every real-world task." ] }, "gold_source_lesson": null, "next_gate": "External confirmation is required before higher-authority use because: CLINICAL_HIGH_RISK_OR_REGULATED_CONFIGURATION; SUPERVISION_OR_NON_ATTEMPT_BOUNDARY.", "evidence_count": 4 }, "full_training_programme": false, "independently_validated": false, "publication_state": "PUBLISHED_PUBLIC_RESEARCH_EDITION__EDITORIAL_REVIEW_PENDING", "related_power_ids": [ "PWR-009", "PWR-010", "PWR-011", "PWR-012" ] }, { "power_id": "PWR-016", "learning_unit_id": "TLU-PWR-016", "title": "Rapid force sequencing", "main_description": "The learner completes four provider-set throws in which leg drive begins before trunk and arm finish, with phase timing, impulse and ball outcome recorded.", "main_description_source": "FULL_TUTORIAL_OUTCOME", "family_id": "FAM-02", "family": "Power, Speed & Agility", "superdomain": "Body & Performance", "canonical_route": "/powers/pwr-016/", "treatment": "SPECIALIST_PROVIDER_ROUTE", "treatment_label": "Full supervised tutorial", "treatment_boundary": "Titan teaches the complete method; a qualified person controls the parts that require supervision, clearance, specialist equipment, load, dose or progression.", "tutorial_route": "/tutorials/pwr-016/", "governed_lesson_route": null, "self_attempt_status": "PROHIBITED_WITHOUT_QUALIFIED_SUPERVISION", "gold_pathway_ids": [], "route_membership": { "kind": "RETAINED_EXTERNAL_ROUTE", "id": "SP-HUB-001", "coverage_status": "RETAINED" }, "source_authority_tier": "G4", "source_build_state": "EXTERNAL_PROVIDER_ROUTE", "source_instructional_route": "LEARN_ELSEWHERE_TRACK_WITH_TITAN", "source_count": 4, "research_depth": "DETAILED", "risk_level": "HIGH", "prerequisite_status": "QUALIFIED_PROVIDER_DETERMINES", "learning_route": { "mode": "FULL_SUPERVISED_TUTORIAL", "label": "Learn rapid force sequencing step by step", "summary": "The learner completes four provider-set throws in which leg drive begins before trunk and arm finish, with phase timing, impulse and ball outcome recorded.", "steps": [ [ "Get ready", "Agree on the named action and its intended phase order; do not mix a chest pass with an overhead or rotational throw." ], [ "Learn the method", "7 concrete steps teach the permitted method from start to finish." ], [ "See right and wrong", "5 comparisons show correct or safer execution beside common wrong or riskier choices." ], [ "Practise", "The provider controls ball mass, intensity, feedback frequency, repetitions and recovery. Progress by stabilising sequence first, then changing one speed or load variable; each new sport action requires its own phase model." ], [ "Check progress", "Synchronise video and force data, use fixed stance/implement/instruction, mark phase events with a predeclared rule and retain velocity/accuracy separately." ] ], "practical_authority": false, "provider_required": true, "next_action_route": "/tutorials/pwr-016/" }, "path_builder": { "selectable": true, "completion_allowed": true, "warning": "Titan teaches the complete method; a qualified person controls the parts that require supervision, clearance, specialist equipment, load, dose or progression." }, "full_tutorial": { "version": "3.0", "authorship": "POWER_SPECIFIC_FULL_TUTORIAL", "tutorial_mode": "SUPERVISED", "promise": "Rapid force sequencing is the timed order in which body segments contribute to a named action. This lesson teaches a provider-led forward medicine-ball throw for timing: hold a fixed stance, begin with leg drive, let hip and trunk extension follow, finish with the arms and release into a net. Synchronous video or force data is used to check onset order and impulse; ball velocity is recorded separately from sequence quality.", "power_id": "PWR-016", "title": "Rapid force sequencing", "lesson_type": "SUPERVISED", "headline": "Sequence legs, trunk and arms in one measured medicine-ball throw", "plain_english_summary": "Rapid force sequencing is the timed order in which body segments contribute to a named action. This lesson teaches a provider-led forward medicine-ball throw for timing: hold a fixed stance, begin with leg drive, let hip and trunk extension follow, finish with the arms and release into a net. Synchronous video or force data is used to check onset order and impulse; ball velocity is recorded separately from sequence quality.", "outcome": "The learner completes four provider-set throws in which leg drive begins before trunk and arm finish, with phase timing, impulse and ball outcome recorded.", "authority": { "learner_may": [ "Rapid force sequencing: Stand on the recorded foot marks with the ball at the declared start point and the target centred. Move slowly through 'legs, trunk, arms, release' without the ball, then with a very light provider-selected ball.", "During an authorised attempt, As the legs extend, let hips and trunk transfer forward while keeping the ball on the target line. Absorb forward momentum without crossing the line or twisting; wait until the ball is captured before relaxing.", "Match the stance and ball start to the reference image and keep leg, trunk and arm onset, impulse and ball outcome in separate columns." ], "qualified_person_required_for": [ "Check lower-limb, trunk and upper-limb readiness and secure the ball, net, exclusion zone and recording equipment before measuring a force sequence.", "Select the action, ball mass, stance, intensity, trials, rest, capture area, camera or force instrumentation and sequence criteria.", "Name the exact throw, synchronise video or force channels, cue leg drive before trunk and arms and reject an arms-first action even when the ball travels farther." ], "never_do": [ "Use a heavy implement, ballistic lift or striking target to chase segment speed outside a protected provider-led setup.", "Do not increase ball mass, effort or complexity to manufacture a more dramatic sequence or faster release.", "Stop when onset order deteriorates, the learner loses stance control, the ball leaves the capture lane or pain appears during any phase." ] }, "materials": [ "Provider-selected medicine ball and secure capture net", "Synchronized high-frame-rate video or force platform", "Visible phase markers and fixed stance line", "Protected throwing exclusion zone", "A sequencing record with named action, stance, ball mass, camera or force synchronisation, phase onsets, impulse, release result, accuracy and validity flags." ], "before_you_start": [ "Agree on the named action and its intended phase order; do not mix a chest pass with an overhead or rotational throw.", "Synchronise the camera/force clock and place phase markers before warming up.", "Report shoulder, back, hip, knee or pelvic symptoms and any loss of grip.", "Place feet and ball exactly as shown in the reference image, then name the sequence aloud: legs, trunk, arms. Capture a still reference frame before any measured throw.", "Practise the words legs–trunk–arms and perform slow captured throws from the marked stance before collecting onset timing." ], "steps": [ { "title": "Lock the action and stance", "instruction": "Stand on the recorded foot marks with the ball at the declared start point and the target centred.", "reason": "Segment timing is interpretable only in one repeated action.", "success_check": "The stance and ball start match the reference image." }, { "title": "Rehearse the phase words", "instruction": "Move slowly through 'legs, trunk, arms, release' without the ball, then with a very light provider-selected ball.", "reason": "Slow rehearsal makes the order explicit before speed is added.", "success_check": "The learner can pause and name each phase correctly." }, { "title": "Start from the floor", "instruction": "On the cue, begin pressure through the feet and leg extension before the arms push the ball.", "reason": "Early arm action removes the intended proximal-to-distal sequence.", "success_check": "Video/force data shows lower-body onset first." }, { "title": "Carry force through the trunk", "instruction": "As the legs extend, let hips and trunk transfer forward while keeping the ball on the target line.", "reason": "A disconnected pause loses continuity between phases.", "success_check": "Trunk motion follows leg onset without a visible stop." }, { "title": "Finish with the arms", "instruction": "Extend the arms only after the lower body and trunk have begun; release toward the target and keep both hands symmetrical.", "reason": "The arms should complete rather than initiate the sequence.", "success_check": "Arm extension onset follows the declared earlier phases." }, { "title": "Hold the finish", "instruction": "Absorb forward momentum without crossing the line or twisting; wait until the ball is captured before relaxing.", "reason": "A stable finish shows the sequence did not end in loss of control.", "success_check": "Balance is held and the exclusion zone remains clear." }, { "title": "Score sequence and outcome separately", "instruction": "Mark phase onsets, phase-specific impulse and ball velocity/target result. A fast throw with reversed order remains a sequence error.", "reason": "Outcome alone cannot reveal how force was organised.", "success_check": "The record has timing, impulse and ball-result columns." } ], "worked_example": { "scenario": "A coach uses a 2 kg forward medicine-ball throw, fixed stance, force platform and synchronized side video.", "walkthrough": [ "The learner rehearses 'legs, trunk, arms' slowly twice.", "Throw one reaches 7.9 m/s but video shows arms starting before leg drive, so sequence is invalid.", "Throw two shows leg onset at 0 ms, trunk at 70 ms and arms at 135 ms, with 7.5 m/s ball speed and target hit.", "Throws three and four keep the same order with similar phase impulse and hit the target.", "The coach ranks sequence consistency separately from fastest ball velocity." ], "result": "Three throws meet the declared onset order and target rule. The faster invalid throw is not evidence of better rapid force sequencing, and the task does not establish sequencing in sprinting or lifting." }, "right_vs_wrong": [ { "situation": "First phase", "right": "Begin force through the feet and legs.", "wrong": "Punch the ball with the arms before the body moves.", "why": "The intended sequence is reversed. That changes phase-specific onset timing and impulse in one named action, alongside task outcome. It is no longer the same test." }, { "situation": "Phase continuity", "right": "Let trunk motion follow leg onset smoothly.", "wrong": "Pause between leg drive and trunk action.", "why": "The force sequence becomes disconnected. That changes phase-specific onset timing and impulse in one named action, alongside task outcome. It is no longer the same test." }, { "situation": "Outcome: Rapid force sequencing checkpoint", "right": "Score velocity and timing separately. It is correct when video/force data shows lower-body onset first.", "wrong": "Call the fastest ball the best sequence.", "why": "A fast result can use the wrong order." }, { "situation": "Fixture: Rapid force sequencing checkpoint", "right": "Use the same stance, mass and throw type.", "wrong": "Compare a rotational throw with a forward pass.", "why": "Different actions have different valid sequences." }, { "situation": "Feedback: Rapid force sequencing checkpoint", "right": "Use synchronized video/force timing. It is correct when arm extension onset follows the declared earlier phases.", "wrong": "Judge onset order from memory after the throw.", "why": "Rapid events are difficult to rank reliably by unaided recall." } ], "common_mistakes": [ { "mistake": "The action is named only as 'explosive movement'.", "fix": "Declare implement, stance, direction and phase order." }, { "mistake": "Arms initiate before the legs.", "fix": "Return to slow segmented rehearsal and reduce ball mass." }, { "mistake": "A pause appears between phases.", "fix": "Practise a continuous low-speed sequence before adding intensity." }, { "mistake": "Only ball velocity is kept.", "fix": "Add phase-onset and phase-impulse fields and score both." }, { "mistake": "Camera and force data are not synchronized.", "fix": "Use one visible/audible synchronization event before trials." } ], "practice": { "first_session": [ "Set the exact throw and synchronise measurement tools.", "Rehearse phase order twice without the ball.", "Complete three light slow throws with immediate video feedback.", "Complete three or four measured provider-set throws with full rest.", "Review onset order, phase impulse, velocity and target separately." ], "repeat_plan": "The provider controls ball mass, intensity, feedback frequency, repetitions and recovery. Progress by stabilising sequence first, then changing one speed or load variable; each new sport action requires its own phase model.", "progress_when": [ "Onset order is repeatable across valid throws.", "Phase impulse and outcome improve without a reversed or paused sequence.", "The learner remains balanced and symptom-free at the planned dose." ], "do_not_progress_when": [ "Ball speed rises while onset order deteriorates.", "Timing cannot be synchronised or phase events cannot be identified reliably.", "Pain, loss of grip, line faults or uncontrolled follow-through occurs." ] }, "self_check": [ "Can you name the exact action and its phase order?", "Does leg drive begin before arm extension?", "Are phase timing and ball outcome recorded separately?", "Can you explain why this throw does not prove whole-body coordination?" ], "measurement": { "primary": "Phase-specific onset timing and impulse in one named action, alongside task outcome", "how": "Synchronise video and force data, use fixed stance/implement/instruction, mark phase events with a predeclared rule and retain velocity/accuracy separately.", "good_result": "At least three valid attempts show the same intended phase order and improving or stable phase impulse without worse outcome or symptoms.", "does_not_prove": "It does not prove coordination in another movement, sport transfer, injury prevention or a general rate-of-force-development trait." }, "stop_and_get_help": [ "Stop for sharp shoulder, back, hip, knee or pelvic pain, loss of grip or an uncontrolled projectile.", "End the set when phase order, balance or target control worsens despite rest.", "Terminate the sequence when the implement escapes control or a new shoulder, back or hip symptom changes a phase; refer the symptom before restoring speed or load." ], "accessibility": [ "Use a seated, supported or lighter-implement sequence with a newly declared phase model rather than forcing a standing throw.", "Provide colour, number, spoken or tactile phase cues matched to the learner's communication.", "Represent the action phases with numbered images, rhythm sounds or tactile stance guides, and annotate which prompts were present when phase timing was scored." ], "evidence_notes": [ { "claim": "Rate-of-force-development adaptations measured in one muscle action do not establish sequence or performance in an unrelated real-world skill.", "source_title": "Increased rate of force development and neural drive of human skeletal muscle following resistance training", "source_url": "https://pubmed.ncbi.nlm.nih.gov/12235031/", "source_kind": "PRIMARY_RESEARCH" }, { "claim": "Technique training can change movement kinetics and timing, but short interventions do not establish durable transfer to other actions.", "source_title": "Change of Direction Speed and Technique Modification Training Improves 180° Turning Performance, Kinetics, and Kinematics", "source_url": "https://pubmed.ncbi.nlm.nih.gov/34073842/", "source_kind": "PRIMARY_RESEARCH" } ], "limits": [ "There is no single ideal sequence for every action.", "A proximal-to-distal order in this throw does not prove the same order is optimal elsewhere.", "Fast ball output cannot substitute for direct phase measurement." ], "orientation": { "bounded_definition": "Capability to develop or express rapid force sequencing in a declared context without inheriting broader claims.", "evidence_summary": "Rapid force sequencing is real as a bounded, measurable capability, but the evidence is task- and population-specific. Titan separates improvement in the test from retention, transfer and meaningful function.", "supportable_public_claim": "In selected people and declared configurations, rapid force sequencing can be measured and may improve with task-relevant practice; retention, transfer and meaningful value require separate testing.", "measurement_boundary": "Use synchronised kinematics, kinetics and event timing for the target action; do not infer whole-body coordination from one muscle's RFD.", "myth_to_metric": { "myth": "Perfect explosive coordination on demand", "metric": "Phase-specific impulse, onset timing and segment sequence in a named action, alongside task outcome", "boundary": "The metric is valid only for its declared task and cannot establish universal ability, character, diagnosis, safety or far transfer." }, "limiting_findings": [ "Laboratory quadriceps RFD was not tested in an unrelated real-world skill.", "Short interventions did not establish retention of revised movement timing." ], "prohibited_claims": [ "Titan proves anyone can develop unlimited or superhuman rapid force sequencing.", "One test score reveals whole-person capability, health, discipline, potential or worth.", "Improvement guarantees injury prevention, clinical benefit, occupational readiness or transfer to every real-world task." ] }, "gold_source_lesson": null, "next_gate": "External confirmation is required before higher-authority use because: CLINICAL_HIGH_RISK_OR_REGULATED_CONFIGURATION; SUPERVISION_OR_NON_ATTEMPT_BOUNDARY.", "evidence_count": 4 }, "full_training_programme": false, "independently_validated": false, "publication_state": "PUBLISHED_PUBLIC_RESEARCH_EDITION__EDITORIAL_REVIEW_PENDING", "related_power_ids": [ "PWR-009", "PWR-010", "PWR-011", "PWR-012" ] }, { "power_id": "PWR-017", "learning_unit_id": "TLU-PWR-017", "title": "Aerobic endurance", "main_description": "The learner completes one supervised constant-power cycle bout inside the prescribed power/cadence band, with time, symptoms, effort and any oxygen-uptake data interpreted separately.", "main_description_source": "FULL_TUTORIAL_OUTCOME", "family_id": "FAM-03", "family": "Endurance & Metabolic Work Capacity", "superdomain": "Body & Performance", "canonical_route": "/powers/pwr-017/", "treatment": "SPECIALIST_PROVIDER_ROUTE", "treatment_label": "Full supervised tutorial", "treatment_boundary": "Titan teaches the complete method; a qualified person controls the parts that require supervision, clearance, specialist equipment, load, dose or progression.", "tutorial_route": "/tutorials/pwr-017/", "governed_lesson_route": null, "self_attempt_status": "PROHIBITED_WITHOUT_QUALIFIED_SUPERVISION", "gold_pathway_ids": [ "G-CUR-002" ], "route_membership": { "kind": "GOLD_PATHWAY", "id": "G-CUR-002", "coverage_status": "EXACT_ONCE" }, "source_authority_tier": "G4", "source_build_state": "EXTERNAL_PROVIDER_ROUTE", "source_instructional_route": "LEARN_ELSEWHERE_TRACK_WITH_TITAN", "source_count": 5, "research_depth": "DETAILED", "risk_level": "MODERATE_TO_HIGH", "prerequisite_status": "QUALIFIED_PROVIDER_DETERMINES", "learning_route": { "mode": "FULL_SUPERVISED_TUTORIAL", "label": "Learn aerobic endurance step by step", "summary": "The learner completes one supervised constant-power cycle bout inside the prescribed power/cadence band, with time, symptoms, effort and any oxygen-uptake data interpreted separately.", "steps": [ [ "Get ready", "Tell the provider about chest symptoms, fainting, unusual breathlessness, infection, medication changes and current joint pain." ], [ "Learn the method", "7 concrete steps teach the permitted method from start to finish." ], [ "See right and wrong", "5 comparisons show correct or safer execution beside common wrong or riskier choices." ], [ "Practise", "The qualified exercise provider sets frequency, duration, intensity, interval structure and recovery. Change only one dose variable at a time and retest in the same mode; no universal endurance programme is supplied." ], [ "Check progress", "Reproduce equipment fit, calibration, power/cadence target, duration and environment; record output, effort, symptoms, assistance and physiological measures separately." ] ], "practical_authority": false, "provider_required": true, "next_action_route": "/tutorials/pwr-017/" }, "path_builder": { "selectable": true, "completion_allowed": true, "warning": "Titan teaches the complete method; a qualified person controls the parts that require supervision, clearance, specialist equipment, load, dose or progression." }, "full_tutorial": { "version": "3.0", "authorship": "POWER_SPECIFIC_FULL_TUTORIAL", "tutorial_mode": "SUPERVISED", "promise": "Aerobic endurance is sustained performance in a declared movement mode, not a single universal fitness trait. This lesson teaches a provider-set cycle-ergometer bout: set the bike consistently, warm up gradually, settle into a target power and cadence, check breathing, symptoms and perceived effort at fixed times, finish without a sprint and cool down. The provider controls clearance, mode, duration, intensity, recovery and whether oxygen-uptake testing is justified.", "power_id": "PWR-017", "title": "Aerobic endurance", "lesson_type": "SUPERVISED", "headline": "Pace a declared cycle bout and finish with output still controlled", "plain_english_summary": "Aerobic endurance is sustained performance in a declared movement mode, not a single universal fitness trait. This lesson teaches a provider-set cycle-ergometer bout: set the bike consistently, warm up gradually, settle into a target power and cadence, check breathing, symptoms and perceived effort at fixed times, finish without a sprint and cool down. The provider controls clearance, mode, duration, intensity, recovery and whether oxygen-uptake testing is justified.", "outcome": "The learner completes one supervised constant-power cycle bout inside the prescribed power/cadence band, with time, symptoms, effort and any oxygen-uptake data interpreted separately.", "authority": { "learner_may": [ "Aerobic endurance: Set seat and handlebars to the recorded positions, secure feet as authorised and pedal easily to confirm no reaching or joint pain. Begin at the provider's easy power and raise workload only at the stated times while keeping cadence inside the band.", "During an authorised attempt, Keep cadence in its band, shoulders relaxed and hands light. Make small resistance or cadence corrections rather than repeated large changes. At the work endpoint, reduce resistance; do not accelerate for a final number unless the protocol specifically requires it.", "Reproduce saddle, handlebar and pedal settings and log power, cadence, duration, effort, symptoms and recovery without merging them into one endurance score." ], "qualified_person_required_for": [ "Review cardiovascular and respiratory status, medication effects, current illness and bike fit before choosing bout intensity or any oxygen-uptake test.", "Set mode, ergometer fit, power or heart-rate target, cadence band, duration, warm-up, cool-down, monitoring and any VO2 test criteria.", "Set the ergometer to the recorded fit, hold the prescribed power and cadence from the opening minutes, monitor symptoms and physiological signals and control both termination and cool-down." ], "never_do": [ "Use this lesson for an independent exhaustion, VO2-max, heat, altitude or medical exercise test.", "Do not lengthen the bout, raise power or turn a constant-power session into a maximal oxygen-uptake test without new clearance.", "Stop for chest pain, faintness, unusual breathlessness, abnormal monitored response, inability to hold cadence or movement that becomes unsafe on the bike." ] }, "materials": [ "Calibrated cycle ergometer with recorded seat and handlebar settings", "Cadence and power display", "Provider-approved heart-rate or gas-analysis equipment when relevant", "Perceived-exertion and symptom scale", "A cycle-endurance log for ergometer model and fit, power, cadence, duration, heart rate when authorised, effort, symptoms, interruptions, cool-down and recovery." ], "before_you_start": [ "Tell the provider about chest symptoms, fainting, unusual breathlessness, infection, medication changes and current joint pain.", "Record the cycle model, seat/handle position, target power, cadence band and planned duration.", "Check that emergency stop, foot retention and communication signals can be used without delay.", "Rebuild saddle, handlebar and pedal settings from the fit sheet and pedal easily for a brief check. Continue only if cadence is smooth, the learner is not rocking and no concerning symptom appears.", "Increase cycle work in planned stages until the target cadence and fit are stable; familiarisation minutes are not added to the measured bout." ], "steps": [ { "title": "Rebuild the same bike fit", "instruction": "Set seat and handlebars to the recorded positions, secure feet as authorised and pedal easily to confirm no reaching or joint pain.", "reason": "Fit changes efficiency and which tissues limit the bout.", "success_check": "Settings match the sheet and the learner pedals without rocking." }, { "title": "Warm up in stages", "instruction": "Begin at the provider's easy power and raise workload only at the stated times while keeping cadence inside the band.", "reason": "A staged warm-up reveals problems before the work interval.", "success_check": "Power and cadence rise without symptoms or abrupt breathing change." }, { "title": "Settle into target power", "instruction": "At the work cue, adjust resistance and cadence until power stays within the target band; do not surge above it to build a buffer.", "reason": "Early surges distort sustainable-performance measurement; this preserves the aerobic endurance rule for 'Settle into target power'.", "success_check": "Power remains in band for the first two minutes." }, { "title": "Hold a repeatable rhythm", "instruction": "Keep cadence in its band, shoulders relaxed and hands light. Make small resistance or cadence corrections rather than repeated large changes.", "reason": "Large oscillations waste effort and change the task.", "success_check": "Minute averages stay within the declared tolerance." }, { "title": "Report at fixed checkpoints", "instruction": "At the scheduled minutes, state perceived effort, breathing comfort and any pain while continuing the same workload.", "reason": "Symptoms and effort show how the same output is being tolerated.", "success_check": "Every checkpoint has a complete response without missed warning signs." }, { "title": "Finish without a sprint", "instruction": "At the work endpoint, reduce resistance; do not accelerate for a final number unless the protocol specifically requires it.", "reason": "A finishing sprint changes a constant-power test.", "success_check": "The final work minute remains inside the same target band." }, { "title": "Cool down and interpret", "instruction": "Pedal easily for the provider-set time, then dismount only when stable. Record completed time/distance or power and keep VO2, heart rate and symptoms as separate measures.", "reason": "Physiological and performance outcomes are related but not interchangeable.", "success_check": "The log shows mode-specific output, effort, symptoms and recovery." } ], "worked_example": { "scenario": "An exercise physiologist prescribes 20 minutes at 80 W and 60–70 rpm after a graded warm-up on a calibrated cycle.", "walkthrough": [ "The learner reproduces the seat setting and completes six minutes of staged warm-up.", "Power settles at 80 W and cadence averages 65 rpm without an early surge.", "At minutes 5, 10, 15 and 20, effort is 3, 4, 5 and 5 out of 10, with no pain or unusual breathlessness.", "The learner completes the full 20 minutes, reduces to 30 W and cools down for five minutes.", "The provider records work, cadence, heart rate trend and symptoms; no VO2 value is inferred because gas analysis was not used." ], "result": "The learner sustained the declared cycle task with controlled pacing. This does not establish VO2max, running endurance or a safe independent training dose." }, "right_vs_wrong": [ { "situation": "Opening pace", "right": "Enter the target band and hold it.", "wrong": "Start well above target to gain time or distance.", "why": "An early surge changes later fatigue." }, { "situation": "Cadence: Aerobic endurance checkpoint", "right": "Make small corrections inside the band.", "wrong": "Alternate very fast and very slow pedalling.", "why": "Oscillation changes efficiency and load. That changes time, distance or sustainable power in one declared exercise mode, with validated oxygen uptake only when directly measured. It is no longer the same test." }, { "situation": "Symptoms: Aerobic endurance checkpoint", "right": "Report them at each checkpoint and immediately if new.", "wrong": "Hide symptoms to finish the protocol.", "why": "Completion cannot outrank safety. That changes time, distance or sustainable power in one declared exercise mode, with validated oxygen uptake only when directly measured. It is no longer the same test." }, { "situation": "Finish: Aerobic endurance checkpoint", "right": "End at the same target and cool down.", "wrong": "Sprint the last minute in a constant-power test.", "why": "The task and interpretation change. That changes time, distance or sustainable power in one declared exercise mode, with validated oxygen uptake only when directly measured. It is no longer the same test." }, { "situation": "Claim: Aerobic endurance checkpoint", "right": "Report cycling output and measured physiology separately.", "wrong": "Call completion a VO2max or running result.", "why": "Mode and test criteria matter. That changes time, distance or sustainable power in one declared exercise mode, with validated oxygen uptake only when directly measured. It is no longer the same test." } ], "common_mistakes": [ { "mistake": "Bike fit is not reproduced.", "fix": "Record device model and exact seat/handle settings." }, { "mistake": "The first minutes are too hard.", "fix": "Use a visible target band and invalidate uncontrolled surges." }, { "mistake": "Heart rate is treated as the performance result.", "fix": "Keep completed work/time and heart rate as separate fields." }, { "mistake": "A final sprint is added.", "fix": "End the work interval at the prescribed output and begin cool-down." }, { "mistake": "VO2max is inferred from effort alone.", "fix": "Use validated gas-analysis criteria when VO2 testing is actually indicated." } ], "practice": { "first_session": [ "Provider screens readiness and fits the cycle.", "Complete a staged easy warm-up while learning the target displays.", "Practise two short target-power intervals below the full duration.", "Complete one provider-selected steady bout if readiness remains good.", "Cool down and review output, cadence, effort, symptoms and recovery." ], "repeat_plan": "The qualified exercise provider sets frequency, duration, intensity, interval structure and recovery. Change only one dose variable at a time and retest in the same mode; no universal endurance programme is supplied.", "progress_when": [ "The target power and cadence are held without early surges.", "The same output is completed with stable or lower effort and no worse symptoms.", "Recovery meets the provider's rule and any change exceeds test variability." ], "do_not_progress_when": [ "The learner cannot maintain output without cadence swings or altered fit.", "Effort or recovery worsens unexpectedly across comparable bouts.", "Chest symptoms, dizziness, unusual breathlessness, pain, illness or heat stress appears." ] }, "self_check": [ "Can you state the cycle settings, power, cadence and duration?", "Was the first work minute inside the target rather than above it?", "Were output, heart rate/VO2 and symptoms recorded separately?", "Can you explain why this result is not running endurance?" ], "measurement": { "primary": "Time, distance or sustainable power in one declared exercise mode, with validated oxygen uptake only when directly measured", "how": "Reproduce equipment fit, calibration, power/cadence target, duration and environment; record output, effort, symptoms, assistance and physiological measures separately.", "good_result": "The declared task is completed within its output band on repeat sessions with acceptable symptoms and a change beyond test error.", "does_not_prove": "It does not prove universal endurance, VO2max without valid testing, disease status or transfer to another mode." }, "stop_and_get_help": [ "Stop for chest pain, faintness, severe or unusual breathlessness, palpitations with illness, confusion or a new neurological symptom.", "Stop when power cannot be held without unsafe cadence, posture loss, sharp pain or equipment instability.", "Treat chest pressure, faintness, marked breathlessness out of proportion, new palpitations or a concerning blood-pressure response as reasons to stop the cycle test and follow the site's medical escalation procedure." ], "accessibility": [ "Use a recumbent, arm-crank or other provider-selected mode when cycling posture is inaccessible, with its own baseline.", "Keep usual supports and use an accessible exertion/symptom scale rather than removing assistance.", "Supply bike-fit positions and warm-up stages in large print, audio or one-step cards, then preserve the resulting fit dimensions and communication support with the test file." ], "evidence_notes": [ { "claim": "High-intensity interval and moderate endurance protocols can change aerobic and anaerobic outcomes differently in a declared population.", "source_title": "Effects of moderate-intensity endurance and high-intensity intermittent training on anaerobic capacity and VO2max", "source_url": "https://pubmed.ncbi.nlm.nih.gov/8897392/", "source_kind": "PRIMARY_RESEARCH" }, { "claim": "Short-term sprint-interval and endurance programmes can show similar selected adaptations without proving long-term equivalence or universal safety.", "source_title": "Short-term sprint interval versus traditional endurance training: similar initial adaptations in human skeletal muscle and exercise performance", "source_url": "https://pubmed.ncbi.nlm.nih.gov/16825308/", "source_kind": "PRIMARY_RESEARCH" } ], "limits": [ "Mode-specific endurance does not automatically transfer to walking, running or swimming.", "Heart rate, perceived effort and VO2 answer different questions.", "One completed bout is not a medical clearance or training prescription." ], "orientation": { "bounded_definition": "Capability to develop or express aerobic endurance in a declared context without inheriting broader claims.", "evidence_summary": "Aerobic endurance is real as a bounded, measurable capability, but the evidence is task- and population-specific. Titan separates improvement in the test from retention, transfer and meaningful function.", "supportable_public_claim": "In selected people and declared configurations, aerobic endurance can be measured and may improve with task-relevant practice; retention, transfer and meaningful value require separate testing.", "measurement_boundary": "Use a reliable mode-specific performance test and, where justified, VO2peak/max with criteria; separate physiological capacity from task endurance and symptoms.", "myth_to_metric": { "myth": "A bottomless aerobic engine", "metric": "Time/distance or sustainable power in a declared mode plus validated oxygen-uptake measures where appropriate", "boundary": "The metric is valid only for its declared task and cannot establish universal ability, character, diagnosis, safety or far transfer." }, "limiting_findings": [ "HERITAGE showed large response heterogeneity under a standardised programme.", "Short-term interval equivalence in young men does not establish long-term equivalence, adherence or safety across populations." ], "prohibited_claims": [ "Titan proves anyone can develop unlimited or superhuman aerobic endurance.", "One test score reveals whole-person capability, health, discipline, potential or worth.", "Improvement guarantees injury prevention, clinical benefit, occupational readiness or transfer to every real-world task." ] }, "gold_source_lesson": { "curriculum_id": "G-CUR-002", "source_heading": "PWR-017 - Aerobic endurance", "source_html_sha256": "04dba2f73e36c7c724be24084324ed30fb77e3ed8ffe160d9cfdb57cc54023a7", "html": "Specialist pathway. No self-directed endurance programme or medical clearance.
" }, "next_gate": "External confirmation is required before higher-authority use because: CLINICAL_HIGH_RISK_OR_REGULATED_CONFIGURATION; SUPERVISION_OR_NON_ATTEMPT_BOUNDARY.", "evidence_count": 5 }, "full_training_programme": false, "independently_validated": false, "publication_state": "PUBLISHED_PUBLIC_RESEARCH_EDITION__EDITORIAL_REVIEW_PENDING", "related_power_ids": [ "PWR-018", "PWR-019", "PWR-020", "PWR-021" ] }, { "power_id": "PWR-018", "learning_unit_id": "TLU-PWR-018", "title": "Anaerobic work capacity", "main_description": "The learner completes the authorised repeated-cycle test with identical bout and recovery timing, while best, mean and total work plus validity and symptoms are recorded.", "main_description_source": "FULL_TUTORIAL_OUTCOME", "family_id": "FAM-03", "family": "Endurance & Metabolic Work Capacity", "superdomain": "Body & Performance", "canonical_route": "/powers/pwr-018/", "treatment": "SPECIALIST_PROVIDER_ROUTE", "treatment_label": "Full supervised tutorial", "treatment_boundary": "Titan teaches the complete method; a qualified person controls the parts that require supervision, clearance, specialist equipment, load, dose or progression.", "tutorial_route": "/tutorials/pwr-018/", "governed_lesson_route": null, "self_attempt_status": "PROHIBITED_WITHOUT_QUALIFIED_SUPERVISION", "gold_pathway_ids": [ "G-CUR-002" ], "route_membership": { "kind": "GOLD_PATHWAY", "id": "G-CUR-002", "coverage_status": "EXACT_ONCE" }, "source_authority_tier": "G4", "source_build_state": "EXTERNAL_PROVIDER_ROUTE", "source_instructional_route": "LEARN_ELSEWHERE_TRACK_WITH_TITAN", "source_count": 6, "research_depth": "DEEP", "risk_level": "HIGH", "prerequisite_status": "QUALIFIED_PROVIDER_DETERMINES", "learning_route": { "mode": "FULL_SUPERVISED_TUTORIAL", "label": "Learn anaerobic work capacity step by step", "summary": "The learner completes the authorised repeated-cycle test with identical bout and recovery timing, while best, mean and total work plus validity and symptoms are recorded.", "steps": [ [ "Get ready", "Confirm bike fit, resistance model, work duration, number of bouts and exact recovery interval." ], [ "Learn the method", "9 concrete steps teach the permitted method from start to finish." ], [ "See right and wrong", "7 comparisons show correct or safer execution beside common wrong or riskier choices." ], [ "Practise", "A qualified exercise professional controls intensity, resistance, bouts, recovery and retest timing. Maximal or exhaustion protocols are never progressed from this page; compare only identical tests after full recovery." ], [ "Check progress", "Lock ergometer, resistance, start, bout duration/count and recovery; retain power traces and compute best, mean, total and predeclared decrement. Segment cue, launch, peak timestamp, mean window, end power and stop for each bout; save resistance and posture flags. Report total work and decrement separately." ] ], "practical_authority": false, "provider_required": true, "next_action_route": "/tutorials/pwr-018/" }, "path_builder": { "selectable": true, "completion_allowed": true, "warning": "Titan teaches the complete method; a qualified person controls the parts that require supervision, clearance, specialist equipment, load, dose or progression." }, "full_tutorial": { "version": "3.0", "authorship": "POWER_SPECIFIC_FULL_TUTORIAL", "tutorial_mode": "SUPERVISED", "promise": "Anaerobic work capacity concerns high-intensity work above a declared aerobic reference in a specific test. This lesson teaches a provider-controlled repeated-cycle fixture: use the same bike setup, accelerate on the cue, complete each fixed 10-second bout, stop pedalling hard exactly on time, recover for the fixed interval and repeat only the authorised bouts. Peak, mean and total work are recorded; lactate is never treated as a direct capacity meter. This repeated-cycle method treats each ten-second power trace as a time series. The provider inspects launch latency, peak timestamp, mean power, ten-second work and end-power decay for every bout. Total work is the sum of valid traces, whereas decrement describes how output changes across the set; the two cannot be exchanged. An early start, missed stop, saddle lift or resistance fault invalidates that bout. Recovery mode stays passive for the full 80 seconds, and a fifth effort never appears simply to replace an unfavourable trace.", "power_id": "PWR-018", "title": "Anaerobic work capacity", "lesson_type": "SUPERVISED", "headline": "Complete fixed short cycle bouts without confusing work, lactate and capacity", "plain_english_summary": "Anaerobic work capacity concerns high-intensity work above a declared aerobic reference in a specific test. This lesson teaches a provider-controlled repeated-cycle fixture: use the same bike setup, accelerate on the cue, complete each fixed 10-second bout, stop pedalling hard exactly on time, recover for the fixed interval and repeat only the authorised bouts. Peak, mean and total work are recorded; lactate is never treated as a direct capacity meter. This repeated-cycle method treats each ten-second power trace as a time series. The provider inspects launch latency, peak timestamp, mean power, ten-second work and end-power decay for every bout. Total work is the sum of valid traces, whereas decrement describes how output changes across the set; the two cannot be exchanged. An early start, missed stop, saddle lift or resistance fault invalidates that bout. Recovery mode stays passive for the full 80 seconds, and a fifth effort never appears simply to replace an unfavourable trace.", "outcome": "The learner completes the authorised repeated-cycle test with identical bout and recovery timing, while best, mean and total work plus validity and symptoms are recorded.", "authority": { "learner_may": [ "Anaerobic work capacity: Record the bike, fit, resistance rule, 10-second bout, bout count and recovery. Do not change resistance after seeing an early score. Complete the provider's progressive warm-up, including only the authorised short accelerations, then use the full pre-test rest.", "During an authorised attempt, Pedal as the provider instructs for 10 seconds while keeping feet secured and posture controlled; do not stop early because power falls. Use the prescribed passive or easy-pedalling recovery and wait for the full timed interval. Report symptoms without changing the next start.", "Complete all configuration fields before warm-up and keep each bout's raw work, peak, mean, total and calculation steps visible." ], "qualified_person_required_for": [ "Determine whether repeated high-intensity cycling is appropriate after reviewing cardiac, respiratory and musculoskeletal risk and the learner's recent training state.", "Set ergometer resistance, bout duration, repetitions, recovery, warm-up, monitoring, termination and whether any maximal effort is appropriate.", "Lock the ergometer resistance before bout one, start the recovery clock at the exact work endpoint, keep every recovery identical and invalidate comparisons when either setting or timing drifts." ], "never_do": [ "Run a repeated-sprint, Wingate, exhaustion or blood-sampling protocol without qualified control and emergency procedures.", "Do not add a bonus bout, change resistance or shorten recovery after seeing an unfavourable work result.", "Terminate the test for concerning symptoms, unsafe cadence, inability to control the ergometer or technical failure that prevents a valid repeated-bout comparison." ] }, "materials": [ "Calibrated cycle ergometer capable of recording power and work", "Visible or audible 10-second work and recovery timer", "Provider-selected resistance setting", "Symptom and recovery monitoring tools", "A repeated-bout worksheet containing ergometer setup, resistance, bout and recovery timestamps, work from every bout, validity, symptoms and the declared summary calculation." ], "before_you_start": [ "Confirm bike fit, resistance model, work duration, number of bouts and exact recovery interval.", "Report cardiovascular, metabolic, neurological or musculoskeletal conditions, illness and prior adverse response to high-intensity effort.", "Practise immediate reduction from hard pedalling to the declared recovery mode.", "Complete the ergometer, resistance, bout and recovery fields before warm-up. Do not begin until the provider can reproduce the whole test from the protocol card without filling in a missing setting by guesswork.", "Rehearse starting on the cue and stopping the pedals safely at the exact endpoint before the fixed repeated-bout protocol begins." ], "steps": [ { "title": "Lock the test model", "instruction": "Record the bike, fit, resistance rule, 10-second bout, bout count and recovery. Do not change resistance after seeing an early score.", "reason": "Anaerobic estimates are protocol-specific; this preserves the anaerobic work capacity rule for 'Lock the test model'.", "success_check": "All configuration fields are complete before warm-up." }, { "title": "Warm up and rehearse", "instruction": "Complete the provider's progressive warm-up, including only the authorised short accelerations, then use the full pre-test rest.", "reason": "The first scored bout should not also teach the start.", "success_check": "The learner follows start and stop cues without delay." }, { "title": "Start on the cue", "instruction": "From the prescribed cadence or stationary start, accelerate only when cued and keep the body in the recorded position.", "reason": "A rolling start or early effort changes peak power.", "success_check": "Timing and power recording begin at the declared event." }, { "title": "Work for the exact duration", "instruction": "Pedal as the provider instructs for 10 seconds while keeping feet secured and posture controlled; do not stop early because power falls.", "reason": "The fixed duration defines the work sample.", "success_check": "A complete power trace exists for all 10 seconds." }, { "title": "Stop hard work exactly", "instruction": "At the stop cue, reduce resistance or effort into the declared recovery; do not add a final stroke or coast unpredictably.", "reason": "Recovery timing begins at a defined endpoint.", "success_check": "Power falls into the recovery range promptly." }, { "title": "Recover in the fixed mode", "instruction": "Use the prescribed passive or easy-pedalling recovery and wait for the full timed interval. Report symptoms without changing the next start.", "reason": "Recovery mode and duration alter repeated performance.", "success_check": "Every bout begins after the same recovery." }, { "title": "Report work and decrement", "instruction": "Record peak, mean and total work for each valid bout and the predeclared decrement. Keep lactate, heart rate and effort separate.", "reason": "No single marker is a universal anaerobic-capacity score.", "success_check": "The log shows raw bout data and the exact calculation." }, { "title": "Segment each power trace", "instruction": "For every ten-second bout, mark cue, first power rise, peak timestamp, mean-power window and exact stop. Flag cadence dropout, saddle lift, resistance fault or data gap before calculating work.", "reason": "Trace segmentation distinguishes physiological decline from timing and equipment errors.", "success_check": "Every retained bout contains a complete cue-to-stop trace with no unresolved validity flag." }, { "title": "Separate total work from decrement", "instruction": "Sum kilojoules from all valid bouts for total work, then apply the predeclared decrement formula to the bout sequence. Report both numbers and the individual trace values.", "reason": "Identical totals can arise from very different peak and fade patterns.", "success_check": "Another reader can reproduce total kilojoules and decrement from the four stored bouts." } ], "worked_example": { "scenario": "An exercise physiologist prescribes four 10-second cycle bouts with 80 seconds of passive recovery at a provider-selected resistance.", "walkthrough": [ "The learner reproduces bike fit and completes the progressive warm-up.", "Bouts record 6.2, 5.9, 5.6 and 5.5 kJ; each lasts exactly 10 seconds.", "The learner uses the full 80-second passive recovery and reports leg effort after each bout.", "A fifth bout is not added even though the learner asks to improve the total.", "The provider calculates best, mean, total and the predeclared decrement from the four valid traces.", "Trace segmentation confirms prompt launches and exact ten-second endpoints; bout three shows lower mean power but no cadence dropout or resistance fault.", "The four valid work values sum to 23.2 kJ, while the provider calculates decrement separately from the declared formula rather than substituting the total.", "Peak timestamps, end-power values and 80-second passive-recovery logs remain attached to each bout for later interpretation." ], "result": "The result describes repeated 10-second cycle work under fixed recovery. It is not a direct measure of a universal anaerobic store, and a lactate value would not replace the work data." }, "right_vs_wrong": [ { "situation": "Start: Anaerobic work capacity checkpoint", "right": "Use the same stationary or rolling start each time.", "wrong": "Begin pedalling hard before the cue.", "why": "Peak and total work become incomparable." }, { "situation": "Duration: Anaerobic work capacity checkpoint", "right": "Complete exactly 10 seconds. It is correct when the learner follows start and stop cues without delay.", "wrong": "Stop when the legs feel finished or extend a good bout.", "why": "The work interval changes. That changes work above a declared reference or repeated high-intensity work in a fixed validated test. It is no longer the same test." }, { "situation": "Recovery: Anaerobic work capacity checkpoint", "right": "Use the full fixed mode and time.", "wrong": "Walk, pedal or shorten rest differently between bouts.", "why": "Recovery changes the next performance. That changes work above a declared reference or repeated high-intensity work in a fixed validated test. It is no longer the same test." }, { "situation": "Data: Anaerobic work capacity checkpoint", "right": "Keep raw work for every bout.", "wrong": "Report only the best peak; it breaks the 'Work for the exact duration' execution rule.", "why": "Mean, total and decrement can tell different stories." }, { "situation": "Biomarker: Anaerobic work capacity checkpoint", "right": "Treat lactate as a separate context-sensitive marker.", "wrong": "Call lactate the anaerobic-capacity meter; it breaks the 'Stop hard work exactly' execution rule.", "why": "It is not a direct capacity measurement." }, { "situation": "Reading repeated-cycle output", "right": "Keep peak timing, mean power, work and end-power decay as distinct trace features.", "wrong": "Call the highest instantaneous wattage the entire anaerobic result.", "why": "A brief peak cannot describe ten-second work or repetition-to-repetition decay." }, { "situation": "Responding to an invalid bout", "right": "Flag the trace and let the provider decide whether the protocol ends.", "wrong": "Automatically add a fifth maximal effort to replace it.", "why": "An extra bout changes total exposure, sequence and decrement mathematics." } ], "common_mistakes": [ { "mistake": "Resistance is changed after bout one.", "fix": "Lock the resistance rule before warm-up and treat a change as a new test." }, { "mistake": "The recovery clock starts late.", "fix": "Start it at the exact hard-work stop cue." }, { "mistake": "A fifth bout is added to rescue a score.", "fix": "Use only the predeclared bout count." }, { "mistake": "Only peak power is retained.", "fix": "Keep full traces and compute best, mean, total and decrement." }, { "mistake": "Lactate change is called performance improvement.", "fix": "Require actual task work and report biomarkers separately." }, { "mistake": "Kilojoules and decrement percentage are used as interchangeable scores.", "fix": "Display every bout, summed work and the exact decrement equation in separate fields." }, { "mistake": "A saddle lift during the peak is ignored because the wattage is large.", "fix": "Apply posture validity before retaining peak, mean or work from that trace." } ], "practice": { "first_session": [ "Provider confirms readiness and locks the cycle protocol.", "Complete progressive warm-up and two brief submaximal starts.", "Rest fully, then complete the authorised repeated-bout test.", "Use the exact recovery mode and interval after every bout.", "Cool down and review raw work, decrement, symptoms and recovery.", "Annotate a sample ten-second trace with launch, peak timestamp, mean window, end power and stop cue before riding.", "Rehearse entering exactly 80 seconds of passive recovery without pedalling, stretching or changing the cycle setup." ], "repeat_plan": "A qualified exercise professional controls intensity, resistance, bouts, recovery and retest timing. Maximal or exhaustion protocols are never progressed from this page; compare only identical tests after full recovery.", "progress_when": [ "All bouts and recoveries meet timing and posture rules.", "Mean or total work improves beyond test noise without a worse decrement or symptom response.", "The learner recovers within the provider's predeclared criteria.", "Summed valid work improves while launch latency, posture, end-power trace and decrement remain within declared limits." ], "do_not_progress_when": [ "The score improves only because resistance, start, bout number or recovery changed.", "Power traces become technically invalid or recovery is incomplete.", "Chest symptoms, dizziness, severe nausea, unusual breathlessness, pain or confusion appears.", "A resistance fault, timing gap, cadence dropout or unresolved trace invalidity prevents reproducible calculation." ] }, "self_check": [ "Can you state resistance, work time, bout count and recovery exactly?", "Did every recovery begin at the same stop event?", "Are peak, mean, total and decrement all visible?", "Can you explain why lactate is not a direct capacity meter?", "Can you mark launch, peak timestamp, mean window, end power and stop on a ten-second trace?", "Can you sum 6.2, 5.9, 5.6 and 5.5 kJ to 23.2 kJ without calling that sum the decrement?" ], "measurement": { "primary": "Work above a declared reference or repeated high-intensity work in a fixed validated test", "how": "Lock ergometer, resistance, start, bout duration/count and recovery; retain power traces and compute best, mean, total and predeclared decrement. Segment cue, launch, peak timestamp, mean window, end power and stop for each bout; save resistance and posture flags. Report total work and decrement separately.", "good_result": "All bouts are valid and repeatable, and work improves beyond measurement error without worse symptoms or altered protocol. All four traces remain valid and complete, with reproducible total work and decrement calculations under identical passive recovery.", "does_not_prove": "It does not prove a universal anaerobic capacity, sport transfer, lactate tolerance or safe independent high-intensity training." }, "stop_and_get_help": [ "Stop for chest pain, faintness, severe breathing difficulty, confusion, uncontrolled vomiting or a new neurological symptom.", "Stop for sharp musculoskeletal pain, equipment/foot-strap failure, loss of posture or inability to enter the recovery mode safely.", "End the maximal work bout for presyncope, chest symptoms, abnormal breathing, loss of safe pedalling or an adverse response outside the protocol, and activate the laboratory's emergency plan." ], "accessibility": [ "Use a provider-selected arm-crank or other accessible high-intensity mode with its own validation and baseline.", "Provide visual, spoken and tactile timing cues and keep needed positioning supports.", "Give resistance-setting and sprint-start instructions through a demonstration, countdown lights or audible count, recording any altered signal beside peak and mean power." ], "evidence_notes": [ { "claim": "Repeated-sprint studies show that best, mean, total and decrement can change differently and must remain separate.", "source_title": "Performance and physiological responses to repeated-sprint exercise: a novel multiple-set approach", "source_url": "https://pubmed.ncbi.nlm.nih.gov/20957389/", "source_kind": "PRIMARY_RESEARCH" }, { "claim": "A high-intensity interval protocol can change anaerobic and aerobic outcomes differently from moderate endurance work in a specific sample.", "source_title": "Effects of moderate-intensity endurance and high-intensity intermittent training on anaerobic capacity and VO2max", "source_url": "https://pubmed.ncbi.nlm.nih.gov/8897392/", "source_kind": "PRIMARY_RESEARCH" } ], "limits": [ "This lesson supplies no self-directed high-intensity dose.", "Cycle work does not automatically transfer to running or sport.", "Biomarkers such as lactate do not replace direct performance measurement." ], "orientation": { "bounded_definition": "Capability to develop or express anaerobic work capacity in a declared context without inheriting broader claims.", "evidence_summary": "Anaerobic work capacity is real as a bounded, measurable capability, but the evidence is task- and population-specific. Titan separates improvement in the test from retention, transfer and meaningful function.", "supportable_public_claim": "In selected people and declared configurations, anaerobic work capacity can be measured and may improve with task-relevant practice; retention, transfer and meaningful value require separate testing.", "measurement_boundary": "Declare the work test and estimation model (for example accumulated oxygen deficit or repeated work); report reliability and avoid treating lactate as a direct capacity meter.", "myth_to_metric": { "myth": "Unlimited anaerobic reserves", "metric": "Work above a declared aerobic reference or repeated high-intensity work in a validated task-specific test", "boundary": "The metric is valid only for its declared task and cannot establish universal ability, character, diagnosis, safety or far transfer." }, "limiting_findings": [ "Moderate endurance training in the Tabata experiment improved VO2max but not anaerobic capacity.", "Metabolic-marker change is not itself a real-world performance gain." ], "prohibited_claims": [ "Titan proves anyone can develop unlimited or superhuman anaerobic work capacity.", "One test score reveals whole-person capability, health, discipline, potential or worth.", "Improvement guarantees injury prevention, clinical benefit, occupational readiness or transfer to every real-world task." ] }, "gold_source_lesson": { "curriculum_id": "G-CUR-002", "source_heading": "PWR-018 - Anaerobic work capacity", "source_html_sha256": "9126ae2d69c396e0ad342d2ee7f9f056a21292258b36549fb7f817d01753777d", "html": "Specialist pathway. No repeated-sprint, high-intensity or exhaustion protocol.
" }, "next_gate": "External confirmation is required before higher-authority use because: CLINICAL_HIGH_RISK_OR_REGULATED_CONFIGURATION; SUPERVISION_OR_NON_ATTEMPT_BOUNDARY.", "evidence_count": 6 }, "full_training_programme": false, "independently_validated": false, "publication_state": "PUBLISHED_PUBLIC_RESEARCH_EDITION__EDITORIAL_REVIEW_PENDING", "related_power_ids": [ "PWR-017", "PWR-019", "PWR-020", "PWR-021" ] }, { "power_id": "PWR-019", "learning_unit_id": "TLU-PWR-019", "title": "Respiratory-muscle endurance", "main_description": "The learner completes one supervised set at the provider-prescribed inspiratory threshold with a sealed mouthpiece, full valve-opening breaths and no breath-holding, dizziness or technique loss.", "main_description_source": "FULL_TUTORIAL_OUTCOME", "family_id": "FAM-03", "family": "Endurance & Metabolic Work Capacity", "superdomain": "Body & Performance", "canonical_route": "/powers/pwr-019/", "treatment": "SPECIALIST_PROVIDER_ROUTE", "treatment_label": "Full supervised tutorial", "treatment_boundary": "Titan teaches the complete method; a qualified person controls the parts that require supervision, clearance, specialist equipment, load, dose or progression.", "tutorial_route": "/tutorials/pwr-019/", "governed_lesson_route": null, "self_attempt_status": "PROHIBITED_WITHOUT_QUALIFIED_SUPERVISION", "gold_pathway_ids": [ "G-CUR-002" ], "route_membership": { "kind": "GOLD_PATHWAY", "id": "G-CUR-002", "coverage_status": "EXACT_ONCE" }, "source_authority_tier": "G4", "source_build_state": "EXTERNAL_PROVIDER_ROUTE", "source_instructional_route": "LEARN_ELSEWHERE_TRACK_WITH_TITAN", "source_count": 3, "research_depth": "FOCUSED", "risk_level": "MODERATE_TO_HIGH", "prerequisite_status": "QUALIFIED_PROVIDER_DETERMINES", "learning_route": { "mode": "FULL_SUPERVISED_TUTORIAL", "label": "Learn respiratory-muscle endurance step by step", "summary": "The learner completes one supervised set at the provider-prescribed inspiratory threshold with a sealed mouthpiece, full valve-opening breaths and no breath-holding, dizziness or technique loss.", "steps": [ [ "Get ready", "Tell the provider about acute respiratory illness, chest pain, fainting, uncontrolled asthma symptoms, pneumothorax history or recent surgery." ], [ "Learn the method", "7 concrete steps teach the permitted method from start to finish." ], [ "See right and wrong", "5 comparisons show correct or safer execution beside common wrong or riskier choices." ], [ "Practise", "The respiratory or exercise professional sets pressure relative to a valid assessment, breaths, sets, rest and frequency. Change only pressure or volume at one review, and never progress during acute respiratory symptoms." ], [ "Check progress", "Use the same device, pressure, posture, seal, pace and breath count; record valid breaths, first error, symptoms and provider-selected functional result, with lung function separate." ] ], "practical_authority": false, "provider_required": true, "next_action_route": "/tutorials/pwr-019/" }, "path_builder": { "selectable": true, "completion_allowed": true, "warning": "Titan teaches the complete method; a qualified person controls the parts that require supervision, clearance, specialist equipment, load, dose or progression." }, "full_tutorial": { "version": "3.0", "authorship": "POWER_SPECIFIC_FULL_TUTORIAL", "tutorial_mode": "SUPERVISED", "promise": "Respiratory-muscle endurance is sustained work by the breathing muscles under a declared test or training load. This lesson teaches a supervised threshold-inspiratory sequence: sit supported, seal the lips around the mouthpiece, exhale normally, inhale briskly enough to open the valve, complete the breath without gulping, remove or relax from the device for a normal exhale and keep the provider-set rhythm. The provider controls clearance, pressure, breaths, sets, rest, monitoring and hygiene.", "power_id": "PWR-019", "title": "Respiratory-muscle endurance", "lesson_type": "SUPERVISED", "headline": "Breathe through a threshold device with a clean seal and fixed rhythm", "plain_english_summary": "Respiratory-muscle endurance is sustained work by the breathing muscles under a declared test or training load. This lesson teaches a supervised threshold-inspiratory sequence: sit supported, seal the lips around the mouthpiece, exhale normally, inhale briskly enough to open the valve, complete the breath without gulping, remove or relax from the device for a normal exhale and keep the provider-set rhythm. The provider controls clearance, pressure, breaths, sets, rest, monitoring and hygiene.", "outcome": "The learner completes one supervised set at the provider-prescribed inspiratory threshold with a sealed mouthpiece, full valve-opening breaths and no breath-holding, dizziness or technique loss.", "authority": { "learner_may": [ "Respiratory-muscle endurance: Sit supported with head and neck comfortable, device upright as instructed and the nose clip only if prescribed. Place lips around the mouthpiece so air does not leak at the corners; keep teeth and jaw relaxed.", "During an authorised attempt, Inhale briskly through the device until the valve opens, then continue a smooth full comfortable breath. Count a breath only when the seal holds and the valve opens fully. Stop the set on the first repeated leak, incomplete breath or symptom threshold.", "Confirm comfortable ordinary breathing before the set and record threshold, valid breaths, seal errors, symptoms, recovery and device cleaning." ], "qualified_person_required_for": [ "Assess respiratory status and contraindications and confirm that the threshold device and prescribed inspiratory load are suitable for this learner.", "Assess respiratory status, measure inspiratory pressure when indicated, set device threshold, breath count, pace, sets, rest, monitoring and cleaning procedure.", "Verify the device setting before the first breath, fit the mouthpiece to eliminate corner leaks, maintain the provider-set rhythm and monitor for hyperventilation or respiratory distress throughout the set." ], "never_do": [ "Self-prescribe forceful breathing, prolonged breath-holds, maximal inspiratory testing or a threshold dose for respiratory disease.", "Do not raise pressure, add breaths or sets, shorten rest or use the device during an acute respiratory episode without clinical direction.", "Stop for dizziness, tingling, headache, chest discomfort, wheeze, inability to open the valve cleanly or unusual breathlessness." ] }, "materials": [ "Calibrated provider-approved threshold inspiratory device", "Clean personal mouthpiece and manufacturer cleaning materials", "Supported chair and optional nose clip if prescribed", "Breath counter, pace cue and symptom scale", "A respiratory-device log for device and threshold, mouthpiece fit, breath count, rhythm, seal validity, rest, symptoms, cleaning and separate functional outcome." ], "before_you_start": [ "Tell the provider about acute respiratory illness, chest pain, fainting, uncontrolled asthma symptoms, pneumothorax history or recent surgery.", "Confirm device model, pressure setting, breath count, pace, rest and cleaning procedure.", "Practise removing the mouthpiece and returning to ordinary breathing immediately.", "Seat the learner upright, check the threshold-device setting and fit the mouthpiece. Start only when ordinary breathing is comfortable and the learner can make a full seal without strain.", "Practise a complete lip seal, brisk valve-opening inhale and ordinary unforced exhale at the provider's easiest familiarisation setting." ], "steps": [ { "title": "Sit and set the airway", "instruction": "Sit supported with head and neck comfortable, device upright as instructed and the nose clip only if prescribed.", "reason": "Posture and device angle affect the seal and valve action.", "success_check": "The learner can breathe normally without strain before starting." }, { "title": "Make a complete lip seal", "instruction": "Place lips around the mouthpiece so air does not leak at the corners; keep teeth and jaw relaxed.", "reason": "A leak lowers the actual threshold work.", "success_check": "No air hiss or cheek leak is heard during an easy test breath." }, { "title": "Exhale normally", "instruction": "Breathe out to a comfortable level; do not force to empty the lungs or pause in a breath-hold.", "reason": "Forced exhalation and holds change the task and can cause symptoms.", "success_check": "The next inhale begins without gasping." }, { "title": "Open the threshold with the inhale", "instruction": "Inhale briskly through the device until the valve opens, then continue a smooth full comfortable breath.", "reason": "The threshold must be crossed for the breath to count.", "success_check": "The device indicator and sound confirm a complete valve-opening breath." }, { "title": "Use a relaxed exhale", "instruction": "Exhale normally through the prescribed route and return promptly to the next paced breath; do not hyperventilate.", "reason": "A consistent cycle controls duty and recovery time.", "success_check": "Breathing follows the pace without rushed extra breaths." }, { "title": "Count only valid breaths", "instruction": "Count a breath only when the seal holds and the valve opens fully. Stop the set on the first repeated leak, incomplete breath or symptom threshold.", "reason": "Invalid breaths should not inflate endurance.", "success_check": "The valid count and first error are recorded separately." }, { "title": "Recover and clean", "instruction": "Remove the mouthpiece, breathe normally while supported and report symptoms. Clean and dry the personal device exactly as the manufacturer and provider direct.", "reason": "Recovery and hygiene are part of safe repeated use.", "success_check": "Ordinary breathing returns and the device is stored clean and dry." } ], "worked_example": { "scenario": "A respiratory physiotherapist sets a familiarisation threshold of 15 cmH2O, 10 paced breaths and two minutes of seated recovery.", "walkthrough": [ "The learner confirms the setting and practises two minimal-load breaths.", "Breaths one to six open the valve with a good seal.", "Breath seven leaks at the lip and is not counted; the learner resets rather than increasing effort.", "Four further valid breaths complete the set of ten, with no dizziness or chest discomfort.", "The learner recovers, records one leak and cleans the personal mouthpiece." ], "result": "Ten valid threshold breaths were completed in this device configuration. The result does not show increased lung volume, oxygenation, VO2max or treatment of respiratory disease." }, "right_vs_wrong": [ { "situation": "Exhale: Respiratory-muscle endurance checkpoint", "right": "Use a normal comfortable exhale. It is correct when the learner can breathe normally without strain before starting.", "wrong": "Force all air out and hold before inhaling.", "why": "Forced manoeuvres change the task and symptom risk." }, { "situation": "Seal: Respiratory-muscle endurance checkpoint", "right": "Keep lips sealed and jaw relaxed.", "wrong": "Let air leak and compensate by inhaling harder.", "why": "Actual load becomes unknown. That changes valid sustained inspiratory pressure/work and a separate task outcome. It is no longer the same test." }, { "situation": "Threshold breath", "right": "Count only a full valve-opening inhale.", "wrong": "Count a shallow breath that never opens the valve.", "why": "The prescribed work was not completed." }, { "situation": "Pace: Respiratory-muscle endurance checkpoint", "right": "Follow the fixed rhythm with relaxed exhale.", "wrong": "Rush extra breaths to finish sooner.", "why": "Hyperventilation and duty cycle change. That changes valid sustained inspiratory pressure/work and a separate task outcome. It is no longer the same test." }, { "situation": "Progression: Respiratory-muscle endurance checkpoint", "right": "Let the provider change pressure or count.", "wrong": "Turn the dial up after an easy set.", "why": "Pressure and dose require assessment. That changes valid sustained inspiratory pressure/work and a separate task outcome. It is no longer the same test." } ], "common_mistakes": [ { "mistake": "The device setting is not checked.", "fix": "Read and record the pressure before every set." }, { "mistake": "Air leaks at the corners of the mouth.", "fix": "Pause, reposition the mouthpiece and reduce pressure if the provider directs." }, { "mistake": "Shallow valve-failing breaths are counted.", "fix": "Use the device indicator and count only complete threshold breaths." }, { "mistake": "The learner holds the breath between phases.", "fix": "Return to normal exhale-inhale rhythm at a lower provider-set pace." }, { "mistake": "A shared mouthpiece is reused without protocol cleaning.", "fix": "Use personal equipment or the approved infection-control process." } ], "practice": { "first_session": [ "Provider reviews respiratory history and device use.", "Practise seal and normal exhale at minimal load.", "Complete three low-load threshold breaths with feedback.", "After rest, complete one short prescribed set.", "Recover seated, review valid breaths and clean the device." ], "repeat_plan": "The respiratory or exercise professional sets pressure relative to a valid assessment, breaths, sets, rest and frequency. Change only pressure or volume at one review, and never progress during acute respiratory symptoms.", "progress_when": [ "Every counted inhale opens the valve with no leak.", "The prescribed set is completed at the fixed rhythm with ordinary recovery.", "Provider-measured inspiratory performance or task outcome improves without symptom cost." ], "do_not_progress_when": [ "Dizziness, tingling, headache, chest discomfort, wheeze or unusual breathlessness appears.", "The learner must leak, gasp, force exhalation or hold breath to open the valve.", "The device cannot be cleaned, calibrated or assigned to one user safely." ] }, "self_check": [ "Can you state the device pressure, breath count and pace?", "Did every counted breath open the valve with a sealed mouthpiece?", "Was exhalation normal rather than forced?", "Can you explain why this does not measure lung volume or oxygenation?" ], "measurement": { "primary": "Valid sustained inspiratory pressure/work and a separate task outcome", "how": "Use the same device, pressure, posture, seal, pace and breath count; record valid breaths, first error, symptoms and provider-selected functional result, with lung function separate.", "good_result": "The full provider-prescribed set is completed with valid valve-opening breaths and acceptable recovery, and change exceeds device/test error.", "does_not_prove": "It does not prove larger lungs, higher oxygenation, VO2max, disease treatment or athletic transfer." }, "stop_and_get_help": [ "Stop for chest pain, faintness, severe breathlessness, new wheeze not relieved under the care plan, blue/grey lips or confusion.", "Stop for dizziness, tingling, headache, repeated seal failure, inability to open the valve or panic/distress.", "Stop mouth-pressure trials for new wheeze, chest pain, faintness, coughing blood or a breathing change that does not settle promptly, and use the respiratory service's clinical escalation route." ], "accessibility": [ "Use a fitted mouthpiece, mask interface or supported device only when assessed and documented by the provider.", "Use visual, vibration or spoken pace cues and allow longer provider-set rest without hiding the adaptation.", "Demonstrate the seated airway position and seal with a mirror, model or tactile placement cue, documenting mouthpiece adaptations and leak assistance for interpretation." ], "evidence_notes": [ { "claim": "Inspiratory-muscle training changed inspiratory performance and a cycling time trial in a small trained sample, not lung volume or universal fitness.", "source_title": "Effects of inspiratory muscle training on time-trial performance in trained cyclists", "source_url": "https://pubmed.ncbi.nlm.nih.gov/12166881/", "source_kind": "PRIMARY_RESEARCH" }, { "claim": "Inspiratory-muscle fatigue and training effects have been measured in trained cyclists, limiting generalisation to patients or the public.", "source_title": "Inspiratory muscle fatigue in trained cyclists: effects of inspiratory muscle training", "source_url": "https://pubmed.ncbi.nlm.nih.gov/11984296/", "source_kind": "PRIMARY_RESEARCH" } ], "limits": [ "Threshold breathing is not respiratory diagnosis or treatment advice.", "A device result is specific to pressure, seal, posture and pace.", "Improved inspiratory work does not establish improved lung function or oxygenation." ], "orientation": { "bounded_definition": "Capability to develop or express respiratory-muscle endurance in a declared context without inheriting broader claims.", "evidence_summary": "Respiratory-muscle endurance is real as a bounded, measurable capability, but the evidence is task- and population-specific. Titan separates improvement in the test from retention, transfer and meaningful function.", "supportable_public_claim": "In selected people and declared configurations, respiratory-muscle endurance can be measured and may improve with task-relevant practice; retention, transfer and meaningful value require separate testing.", "measurement_boundary": "Use validated inspiratory pressure/endurance measures with spirometry or medical assessment where indicated; do not infer disease treatment or oxygenation control.", "myth_to_metric": { "myth": "Superhuman lungs", "metric": "Sustained inspiratory pressure/work and a separate task performance outcome; lung function reported separately", "boundary": "The metric is valid only for its declared task and cannot establish universal ability, character, diagnosis, safety or far transfer." }, "limiting_findings": [ "Improved inspiratory performance did not mean increased lung volume or VO2max.", "Small trained-male cyclist studies cannot justify forceful breathing or breath-hold claims for the public." ], "prohibited_claims": [ "Titan proves anyone can develop unlimited or superhuman respiratory-muscle endurance.", "One test score reveals whole-person capability, health, discipline, potential or worth.", "Improvement guarantees injury prevention, clinical benefit, occupational readiness or transfer to every real-world task." ] }, "gold_source_lesson": { "curriculum_id": "G-CUR-002", "source_heading": "PWR-019 - Respiratory-muscle endurance", "source_html_sha256": "402c08b2004846c6159dc2f37f12846f0eb95972e06b864242d3456f80754f04", "html": "Specialist pathway. No unsupervised inspiratory-muscle prescription or respiratory diagnosis.
" }, "next_gate": "External confirmation is required before higher-authority use because: CLINICAL_HIGH_RISK_OR_REGULATED_CONFIGURATION; SUPERVISION_OR_NON_ATTEMPT_BOUNDARY.", "evidence_count": 3 }, "full_training_programme": false, "independently_validated": false, "publication_state": "PUBLISHED_PUBLIC_RESEARCH_EDITION__EDITORIAL_REVIEW_PENDING", "related_power_ids": [ "PWR-017", "PWR-018", "PWR-020", "PWR-021" ] }, { "power_id": "PWR-020", "learning_unit_id": "TLU-PWR-020", "title": "Fatigue resistance", "main_description": "The learner completes a provider-set series of handgrip pulses while valid force, time-in-band, errors and decrement are tracked separately.", "main_description_source": "FULL_TUTORIAL_OUTCOME", "family_id": "FAM-03", "family": "Endurance & Metabolic Work Capacity", "superdomain": "Body & Performance", "canonical_route": "/powers/pwr-020/", "treatment": "SPECIALIST_PROVIDER_ROUTE", "treatment_label": "Full supervised tutorial", "treatment_boundary": "Titan teaches the complete method; a qualified person controls the parts that require supervision, clearance, specialist equipment, load, dose or progression.", "tutorial_route": "/tutorials/pwr-020/", "governed_lesson_route": null, "self_attempt_status": "PROHIBITED_WITHOUT_QUALIFIED_SUPERVISION", "gold_pathway_ids": [ "G-CUR-002" ], "route_membership": { "kind": "GOLD_PATHWAY", "id": "G-CUR-002", "coverage_status": "EXACT_ONCE" }, "source_authority_tier": "G4", "source_build_state": "EXTERNAL_PROVIDER_ROUTE", "source_instructional_route": "LEARN_ELSEWHERE_TRACK_WITH_TITAN", "source_count": 8, "research_depth": "DEEP", "risk_level": "MODERATE_TO_HIGH", "prerequisite_status": "QUALIFIED_PROVIDER_DETERMINES", "learning_route": { "mode": "FULL_SUPERVISED_TUTORIAL", "label": "Learn fatigue resistance step by step", "summary": "The learner completes a provider-set series of handgrip pulses while valid force, time-in-band, errors and decrement are tracked separately.", "steps": [ [ "Get ready", "Confirm hand, handle setting, arm position, target band, pulse count, work time and rest time." ], [ "Learn the method", "7 concrete steps teach the permitted method from start to finish." ], [ "See right and wrong", "5 comparisons show correct or safer execution beside common wrong or riskier choices." ], [ "Practise", "The provider controls target, duty cycle, pulses, series, rest and frequency. Progress only after the full current series meets output and quality criteria; deliberate exhaustion is not required." ], [ "Check progress", "Reproduce handle, posture, target, pulse time, recovery and count; retain every force trace, validity, first error and predeclared decrement." ] ], "practical_authority": false, "provider_required": true, "next_action_route": "/tutorials/pwr-020/" }, "path_builder": { "selectable": true, "completion_allowed": true, "warning": "Titan teaches the complete method; a qualified person controls the parts that require supervision, clearance, specialist equipment, load, dose or progression." }, "full_tutorial": { "version": "3.0", "authorship": "POWER_SPECIFIC_FULL_TUTORIAL", "tutorial_mode": "SUPERVISED", "promise": "Fatigue resistance is preservation of a declared task's output and quality across a fixed workload and recovery schedule. This lesson teaches a supervised handgrip-pulse task: establish one submaximal target, squeeze into a visible band for a fixed time, release fully for a fixed interval, repeat the predeclared count and stop when force, timing or grip position fails. The provider controls target, repetitions, work-rest timing and whether fatigue induction is appropriate.", "power_id": "PWR-020", "title": "Fatigue resistance", "lesson_type": "SUPERVISED", "headline": "Preserve force accuracy across fixed repeated handgrip pulses", "plain_english_summary": "Fatigue resistance is preservation of a declared task's output and quality across a fixed workload and recovery schedule. This lesson teaches a supervised handgrip-pulse task: establish one submaximal target, squeeze into a visible band for a fixed time, release fully for a fixed interval, repeat the predeclared count and stop when force, timing or grip position fails. The provider controls target, repetitions, work-rest timing and whether fatigue induction is appropriate.", "outcome": "The learner completes a provider-set series of handgrip pulses while valid force, time-in-band, errors and decrement are tracked separately.", "authority": { "learner_may": [ "Fatigue resistance: Use the recorded handle position, wrist angle and supported elbow posture; keep the other hand off the device. Complete one low familiarisation squeeze, raising force smoothly into the band without overshoot.", "During an authorised attempt, Relax until the trace returns to baseline, then leave the hand open for the full recovery interval. End the series when force leaves the band, release is incomplete, timing fails or symptoms reach the stop rule.", "Match handle, hand, posture and target to the reference setup and keep every force pulse visible beside time-in-band, errors and decrement summaries." ], "qualified_person_required_for": [ "Review hand, wrist and upper-limb symptoms and establish a current valid baseline before prescribing a repeated handgrip target.", "Set dynamometer handle, target force, pulse duration, repetitions, recovery, validity, decrement and termination rules.", "Calculate the target from the current baseline, require a complete release between pulses and stop counting as soon as force, timing, hand position or relaxation misses the declared rule." ], "never_do": [ "Use pain, shaking, numbness or inability to release as a signal to push through and finish the repetition count.", "Do not turn the pulse task into a maximal squeeze, fatigue-to-failure challenge or comparison between painful or injured hands.", "End the task for pain, cramp, numbness, swelling, loss of full release, altered grip position or repeated failure to enter the target band." ] }, "materials": [ "Calibrated handgrip dynamometer with visible target band", "Recorded handle position and supported arm posture", "Work-rest timer", "Force-trace export or session sheet", "A handgrip-pulse record for device and handle, side, posture, current baseline, target band, work-rest timing, each pulse, errors, decrement and symptoms." ], "before_you_start": [ "Confirm hand, handle setting, arm position, target band, pulse count, work time and rest time.", "Report hand, wrist, elbow, neck or neurological symptoms and recent injury.", "Demonstrate full relaxation to baseline before the next pulse.", "Set the handle, hand, arm and posture from the reference record and watch one complete squeeze-and-release at low force. Begin only when the setup stays still and the hand fully relaxes.", "Use low-force pulses to find the target band and practise full relaxation during the fixed recovery interval before recorded work begins." ], "steps": [ { "title": "Set hand and arm", "instruction": "Use the recorded handle position, wrist angle and supported elbow posture; keep the other hand off the device.", "reason": "Grip leverage changes force and fatigue.", "success_check": "The setup matches the reference and remains still." }, { "title": "Find the target band", "instruction": "Complete one low familiarisation squeeze, raising force smoothly into the band without overshoot.", "reason": "The task measures controlled repeat output, not an explosive peak.", "success_check": "The trace enters the band once and stays there." }, { "title": "Hold for the fixed time", "instruction": "Keep force inside the band until the hold cue ends while breathing and keeping the wrist still.", "reason": "Time and force quality must both be preserved.", "success_check": "The trace stays in band for the required interval." }, { "title": "Release completely", "instruction": "Relax until the trace returns to baseline, then leave the hand open for the full recovery interval.", "reason": "Partial release adds unmeasured duty and fatigue.", "success_check": "Every recovery begins at baseline; the visible 'Release completely' check is satisfied." }, { "title": "Repeat without compensation", "instruction": "Begin the next pulse only on the cue; do not change handle position, brace with the trunk or use the other hand.", "reason": "Compensation can hide local performance loss.", "success_check": "Posture and handle remain unchanged; the visible 'Repeat without compensation' check is satisfied." }, { "title": "Stop at the declared failure", "instruction": "End the series when force leaves the band, release is incomplete, timing fails or symptoms reach the stop rule.", "reason": "The endpoint is preserved task quality, not exhaustion.", "success_check": "No extra pulse follows the first failure." }, { "title": "Separate output, errors and decrement", "instruction": "Record force for each pulse, time-in-band, first error and the predeclared decrement. Report symptoms and recovery separately.", "reason": "Mean output and decrement can move independently.", "success_check": "Raw pulses remain visible beside the summary." } ], "worked_example": { "scenario": "A provider sets right-hand pulses at 30–35% of a valid maximum: five seconds in band, ten seconds fully relaxed, eight-pulse cap.", "walkthrough": [ "The learner reproduces the handle and arm setup and practises one low squeeze.", "Pulses one to five remain in band with full release.", "Pulse six drops below band during the last second and is the first technical failure.", "The learner stops; pulses seven and eight are not attempted.", "The provider records five fully valid pulses, the force trace, first error and recovery without calling the result whole-body stamina." ], "result": "The endpoint is five valid repeated handgrip pulses in this target and duty cycle. It does not establish occupational endurance, aerobic fitness or tolerance for pain." }, "right_vs_wrong": [ { "situation": "Recovery: Fatigue resistance checkpoint", "right": "Return fully to baseline for the fixed interval.", "wrong": "Keep squeezing lightly between pulses; it breaks the 'Set hand and arm' execution rule.", "why": "Duty cycle and fatigue change. That changes preserved handgrip output and accuracy across a fixed work-recovery schedule. It is no longer the same test." }, { "situation": "Compensation: Fatigue resistance checkpoint", "right": "Keep wrist and trunk in the recorded position.", "wrong": "Brace, bend the wrist or use the other hand.", "why": "Other leverage hides task failure. That changes preserved handgrip output and accuracy across a fixed work-recovery schedule. It is no longer the same test." }, { "situation": "Endpoint: Fatigue resistance checkpoint", "right": "Stop at the first force/timing error.", "wrong": "Continue to the full count after repeated failures.", "why": "The measure is preservation, not exhaustion." }, { "situation": "Data: Fatigue resistance checkpoint", "right": "Keep every pulse and error. It is correct when every recovery begins at baseline.", "wrong": "Report only the best squeeze; it breaks the 'Release completely' execution rule.", "why": "Fatigue pattern disappears. That changes preserved handgrip output and accuracy across a fixed work-recovery schedule. It is no longer the same test." }, { "situation": "Claim: Fatigue resistance checkpoint", "right": "Call it handgrip fatigue resistance in this fixture.", "wrong": "Call it general stamina or resilience.", "why": "Transfer is not established. That changes preserved handgrip output and accuracy across a fixed work-recovery schedule. It is no longer the same test." } ], "common_mistakes": [ { "mistake": "The target is based on an old maximum.", "fix": "Use a provider-approved current reference or declare the alternative target method." }, { "mistake": "The hand never fully relaxes.", "fix": "Require a visible baseline before starting the recovery clock." }, { "mistake": "The wrist flexes as force falls.", "fix": "Mark the pulse invalid and adjust support before any repeat." }, { "mistake": "The planned count is completed after failure.", "fix": "End on the first predeclared error." }, { "mistake": "A single fatigue index hides higher mean work.", "fix": "Retain raw output, mean, errors and decrement separately." } ], "practice": { "first_session": [ "Provider fixes the handgrip setup and target.", "Rehearse two low-force pulse-release cycles.", "Complete one short familiarisation series below the cap.", "After full rest, complete one scored series using the first-failure rule.", "Review raw pulses, time-in-band, errors and symptoms." ], "repeat_plan": "The provider controls target, duty cycle, pulses, series, rest and frequency. Progress only after the full current series meets output and quality criteria; deliberate exhaustion is not required.", "progress_when": [ "All recoveries return to baseline and all valid pulses stay in band.", "The first-failure point moves later without compensation.", "Mean output and error rate improve with acceptable symptoms and recovery." ], "do_not_progress_when": [ "Higher output uses a different handle, posture, target or recovery.", "Numbness, pain, cramp, tremor or inability to release develops.", "Raw traces show worsening error even if a summary index looks better." ] }, "self_check": [ "Can you state target band, work time, rest time and cap?", "Does force return to baseline between every pulse?", "Did the set stop at the first technical failure?", "Can you explain why mean output and decrement both need reporting?" ], "measurement": { "primary": "Preserved handgrip output and accuracy across a fixed work-recovery schedule", "how": "Reproduce handle, posture, target, pulse time, recovery and count; retain every force trace, validity, first error and predeclared decrement.", "good_result": "More valid pulses or less error occurs in the identical fixture without compensation or worse symptoms.", "does_not_prove": "It does not prove whole-body stamina, occupational endurance, pain tolerance or aerobic capacity." }, "stop_and_get_help": [ "Stop for pain, numbness, tingling, cramp, marked tremor, colour change or inability to relax the hand.", "End the series at the first force, timing, posture or release failure.", "Release the grip device immediately for hand discoloration, new numbness, cramping that does not release or sudden weakness, and investigate the hand or circulation concern before another hold." ], "accessibility": [ "Use the person's usual grip aid or a provider-selected larger handle and record it as the fixture.", "Use visual, auditory or vibration work-rest cues and supported positioning.", "Indicate arm position and the force band with a molded handle guide, enlarged gauge or sound threshold, and retain those adaptations with the hold-duration data." ], "evidence_notes": [ { "claim": "Repeated-sprint data show that mean, peak and decrement need not change together, supporting separate output and error tracking.", "source_title": "Performance and physiological responses to repeated-sprint exercise: a novel multiple-set approach", "source_url": "https://pubmed.ncbi.nlm.nih.gov/20957389/", "source_kind": "PRIMARY_RESEARCH" }, { "claim": "Inspiratory training studies illustrate that fatigue resistance can be task-specific and should be paired with a direct task outcome.", "source_title": "Effects of inspiratory muscle training on time-trial performance in trained cyclists", "source_url": "https://pubmed.ncbi.nlm.nih.gov/12166881/", "source_kind": "PRIMARY_RESEARCH" } ], "limits": [ "Fatigue resistance is task-, target- and duty-cycle specific.", "Stopping later is not better if errors or symptoms rise.", "A handgrip series is not a diagnosis or a general fatigue score." ], "orientation": { "bounded_definition": "Capability to develop or express fatigue resistance in a declared context without inheriting broader claims.", "evidence_summary": "Fatigue resistance is real as a bounded, measurable capability, but the evidence is task- and population-specific. Titan separates improvement in the test from retention, transfer and meaningful function.", "supportable_public_claim": "In selected people and declared configurations, fatigue resistance can be measured and may improve with task-relevant practice; retention, transfer and meaningful value require separate testing.", "measurement_boundary": "Track absolute output, quality/error and predeclared decrement over a realistic task; pair with symptoms and stop rules rather than using lactate alone.", "myth_to_metric": { "myth": "Never feeling tired", "metric": "Preserved task output and quality across a fixed workload/recovery schedule, with symptoms and errors recorded", "boundary": "The metric is valid only for its declared task and cannot establish universal ability, character, diagnosis, safety or far transfer." }, "limiting_findings": [ "Mean performance, peak performance and decrement need not change together.", "Active recovery can help, harm or make no performance difference depending on placement, duration and task." ], "prohibited_claims": [ "Titan proves anyone can develop unlimited or superhuman fatigue resistance.", "One test score reveals whole-person capability, health, discipline, potential or worth.", "Improvement guarantees injury prevention, clinical benefit, occupational readiness or transfer to every real-world task." ] }, "gold_source_lesson": { "curriculum_id": "G-CUR-002", "source_heading": "PWR-020 - Fatigue resistance", "source_html_sha256": "61946be35c4a10796dbcd22576875380d3db63e5fada5e2cd281b2fee13981b5", "html": "Specialist pathway. No deliberate fatigue-induction or push-through protocol.
" }, "next_gate": "External confirmation is required before higher-authority use because: CLINICAL_HIGH_RISK_OR_REGULATED_CONFIGURATION.", "evidence_count": 8 }, "full_training_programme": false, "independently_validated": false, "publication_state": "PUBLISHED_PUBLIC_RESEARCH_EDITION__EDITORIAL_REVIEW_PENDING", "related_power_ids": [ "PWR-017", "PWR-018", "PWR-019", "PWR-021" ] }, { "power_id": "PWR-021", "learning_unit_id": "TLU-PWR-021", "title": "Load-carriage endurance", "main_description": "The learner completes one provider-selected pack-and-route configuration while time, pace, assistance, gait changes, pain and recovery are recorded.", "main_description_source": "FULL_TUTORIAL_OUTCOME", "family_id": "FAM-03", "family": "Endurance & Metabolic Work Capacity", "superdomain": "Body & Performance", "canonical_route": "/powers/pwr-021/", "treatment": "SPECIALIST_PROVIDER_ROUTE", "treatment_label": "Full supervised tutorial", "treatment_boundary": "Titan teaches the complete method; a qualified person controls the parts that require supervision, clearance, specialist equipment, load, dose or progression.", "tutorial_route": "/tutorials/pwr-021/", "governed_lesson_route": null, "self_attempt_status": "PROHIBITED_WITHOUT_QUALIFIED_SUPERVISION", "gold_pathway_ids": [ "G-CUR-002" ], "route_membership": { "kind": "GOLD_PATHWAY", "id": "G-CUR-002", "coverage_status": "EXACT_ONCE" }, "source_authority_tier": "G4", "source_build_state": "EXTERNAL_PROVIDER_ROUTE", "source_instructional_route": "LEARN_ELSEWHERE_TRACK_WITH_TITAN", "source_count": 3, "research_depth": "FOCUSED", "risk_level": "HIGH", "prerequisite_status": "QUALIFIED_PROVIDER_DETERMINES", "learning_route": { "mode": "FULL_SUPERVISED_TUTORIAL", "label": "Learn load-carriage endurance step by step", "summary": "The learner completes one provider-selected pack-and-route configuration while time, pace, assistance, gait changes, pain and recovery are recorded.", "steps": [ [ "Get ready", "Inspect the pack and secure contents so nothing shifts, leaks or protrudes." ], [ "Learn the method", "7 concrete steps teach the permitted method from start to finish." ], [ "See right and wrong", "5 comparisons show correct or safer execution beside common wrong or riskier choices." ], [ "Practise", "The provider changes only load, distance, pace, terrain or distribution at one time and sets rest and frequency. Occupational, heat, hill and stair carriage require separate assessment; there is no universal percentage-body-mass progression." ], [ "Check progress", "Record complete pack mass, distribution, route, terrain, pace, footwear, aid, assistance, symptoms, gait and post-task recovery; split data at any change." ] ], "practical_authority": false, "provider_required": true, "next_action_route": "/tutorials/pwr-021/" }, "path_builder": { "selectable": true, "completion_allowed": true, "warning": "Titan teaches the complete method; a qualified person controls the parts that require supervision, clearance, specialist equipment, load, dose or progression." }, "full_tutorial": { "version": "3.0", "authorship": "POWER_SPECIFIC_FULL_TUTORIAL", "tutorial_mode": "SUPERVISED", "promise": "Load-carriage endurance is sustained travel with a specific external load, distribution, route and aid. This lesson teaches a supervised level-route walk: inspect the pack, centre and secure the load, fit hip/shoulder straps, walk at the agreed pace with the usual aid, keep the route visible, report symptoms at checkpoints and remove the pack before making adjustments. The provider controls load, distance, terrain, speed, rest and progression.", "power_id": "PWR-021", "title": "Load-carriage endurance", "lesson_type": "SUPERVISED", "headline": "Carry one provider-set pack over one declared level route", "plain_english_summary": "Load-carriage endurance is sustained travel with a specific external load, distribution, route and aid. This lesson teaches a supervised level-route walk: inspect the pack, centre and secure the load, fit hip/shoulder straps, walk at the agreed pace with the usual aid, keep the route visible, report symptoms at checkpoints and remove the pack before making adjustments. The provider controls load, distance, terrain, speed, rest and progression.", "outcome": "The learner completes one provider-selected pack-and-route configuration while time, pace, assistance, gait changes, pain and recovery are recorded.", "authority": { "learner_may": [ "Load-carriage endurance: Place the provider-selected load close to the back, prevent movement and weigh the complete pack; do not estimate by item labels. Loosen straps enough to put the pack on with authorised help, then set hip belt, shoulder straps and chest strap as taught without compressing breathing.", "During an authorised attempt, Walk the marked level route at the agreed pace with the usual aid and natural step pattern; do not rush to shorten exposure. If fit or grip needs changing, stop at the designated surface, remove the pack with help and adjust it unloaded.", "Verify the scale value and pack layout against the plan and record pace, assistance, gait change, discomfort, recovery and the exact route used." ], "qualified_person_required_for": [ "Assess load-carriage readiness, aid use, pack fit, skin and foot risk, route conditions and occupational constraints before selecting a carried load.", "Assess readiness and select absolute/relative load, distribution, pack, route, footwear, pace, distance, assistance, monitoring and recovery.", "Weigh the complete loaded pack, secure its contents, fit all straps and aids, observe gait and symptoms at checkpoints and remove the pack before making any adjustment." ], "never_do": [ "Add weight, distance, hills, stairs, heat, occupational simulation or unstable terrain outside the provider's plan.", "Do not increase pack mass, distance, pace or terrain difficulty from this lesson or because one level-route walk was completed.", "Stop for gait change, hot spots, numbness, pain, unusual breathlessness, dizziness, shifting contents, failed straps or inability to see and control the route." ] }, "materials": [ "Provider-selected pack with intact straps and closures", "Individually selected stable contents and internal load securing", "Level inspected route with rest/pack-removal points", "Usual footwear, mobility aid and optional physiological monitor", "A load-carriage sheet for total pack mass, contents and distribution, fit, aid, route, surface, pace, distance, assistance, gait, symptoms and recovery." ], "before_you_start": [ "Inspect the pack and secure contents so nothing shifts, leaks or protrudes.", "Record absolute load, body mass if appropriate, distribution, route, surface, footwear, aid and pace.", "Report back, hip, knee, foot, skin, balance, cardiovascular or neurological concerns and any recent load-carriage exposure.", "Weigh the finished pack, photograph or note its layout and fit every strap and usual aid. Take the first supervised steps only when the scale value and load arrangement match the written plan.", "Rehearse fitting and removing the pack, standing with the planned support and walking the route without load before the supervised carry." ], "steps": [ { "title": "Build and weigh the pack", "instruction": "Place the provider-selected load close to the back, prevent movement and weigh the complete pack; do not estimate by item labels.", "reason": "Mass and distribution both change carriage demand.", "success_check": "The scale value and layout match the plan." }, { "title": "Fit before standing", "instruction": "Loosen straps enough to put the pack on with authorised help, then set hip belt, shoulder straps and chest strap as taught without compressing breathing.", "reason": "Poor fit can create shifting, pressure and posture changes.", "success_check": "The pack stays close and straps do not pinch or restrict a full breath." }, { "title": "Stand using the planned support", "instruction": "Use the bench, helper or stable support specified by the provider; establish balance before walking.", "reason": "The transition with the pack is part of the task.", "success_check": "The learner stands without a lurch or uncontrolled step." }, { "title": "Start at the target pace", "instruction": "Walk the marked level route at the agreed pace with the usual aid and natural step pattern; do not rush to shorten exposure.", "reason": "Pace changes physiological cost and gait.", "success_check": "Checkpoint pace remains inside the declared band." }, { "title": "Check fit and symptoms at markers", "instruction": "At each marker, report breathing, pain, numbness, hot spots and balance; observe strap position and load shift.", "reason": "Early signs can precede skin, nerve, gait or fatigue problems.", "success_check": "Each checkpoint has a complete report and the pack remains centred." }, { "title": "Put the pack down before adjusting", "instruction": "If fit or grip needs changing, stop at the designated surface, remove the pack with help and adjust it unloaded.", "reason": "Reaching and twisting under load adds uncontrolled demand.", "success_check": "No strap adjustment occurs while walking or balancing under full load." }, { "title": "Finish, remove and recheck", "instruction": "Stop at the planned endpoint, remove the pack using the taught method, inspect skin/feet and record post-task gait and recovery.", "reason": "After-effects are part of the carriage response.", "success_check": "The learner returns to baseline walking or the provider acts on the recorded change." } ], "worked_example": { "scenario": "A physiotherapist prescribes a 5 kg pack for one learner, centred high in the pack, over a 400 m level indoor route at a comfortable fixed pace with checks every 100 m.", "walkthrough": [ "The complete pack weighs 5.0 kg and contents are secured against the back panel.", "The learner fits the pack seated, stands with the rail and begins with the usual walking stick.", "At 100 and 200 m, pace and gait remain stable; at 300 m a right shoulder hot spot is reported.", "The learner stops at a bench, removes the pack and the provider adjusts the strap; the configuration change is recorded.", "The final 100 m is treated as an adapted segment, not merged with the original configuration." ], "result": "The learner completed 300 m in the original setup and 100 m after an attributed fit change. The result does not set a universal safe pack mass or occupational readiness." }, "right_vs_wrong": [ { "situation": "Load record", "right": "Weigh the complete pack and map distribution.", "wrong": "Say 'light pack' without a mass or layout.", "why": "Dose cannot be reproduced. That changes time and physiological/task cost for one declared load-route configuration. It is no longer the same test." }, { "situation": "Fit: Load-carriage endurance checkpoint", "right": "Keep load secured close and straps comfortable.", "wrong": "Allow contents to swing or a strap to compress breathing.", "why": "Shifting and pressure change gait and symptoms." }, { "situation": "Pace: Load-carriage endurance checkpoint", "right": "Walk at the declared pace with usual aid.", "wrong": "Rush or remove the aid to improve time.", "why": "The task and risk change. That changes time and physiological/task cost for one declared load-route configuration. It is no longer the same test." }, { "situation": "Adjustment: Load-carriage endurance checkpoint", "right": "Remove the pack at a stable point first.", "wrong": "Twist and pull straps while walking loaded.", "why": "Balance and tissue load become uncontrolled." }, { "situation": "Interpretation: Load-carriage endurance checkpoint", "right": "Report route, load, aid, symptoms and changes.", "wrong": "Use completion as work or military clearance.", "why": "Those roles require task-specific assessment. That changes time and physiological/task cost for one declared load-route configuration. It is no longer the same test." } ], "common_mistakes": [ { "mistake": "Pack weight excludes the pack itself.", "fix": "Weigh the complete packed system; then confirm: The scale value and layout match the plan." }, { "mistake": "Contents shift during walking during 'Fit before standing' in load-carriage endurance.", "fix": "Secure compartments and retest fit before starting." }, { "mistake": "The usual walking aid is removed for the score.", "fix": "Keep the aid and record it as part of the configuration." }, { "mistake": "A strap change is hidden in one average.", "fix": "Split the result before and after the change." }, { "mistake": "Only completion time is recorded.", "fix": "Add pain, gait, balance, skin/foot check and recovery." } ], "practice": { "first_session": [ "Provider assesses fit and route without load.", "Pack and weigh the selected load and rehearse on/off transitions.", "Walk a short low-load segment with a checkpoint.", "After review, complete the provider-selected route or stop earlier under the rule.", "Remove the pack and record gait, symptoms, skin/feet and recovery." ], "repeat_plan": "The provider changes only load, distance, pace, terrain or distribution at one time and sets rest and frequency. Occupational, heat, hill and stair carriage require separate assessment; there is no universal percentage-body-mass progression.", "progress_when": [ "Pack fit and distribution remain stable at every checkpoint.", "Route and pace are completed without worsening gait, balance, pain or skin signs.", "Recovery and next-day response meet the provider's rule." ], "do_not_progress_when": [ "A higher load or distance causes gait change, hot spots, numbness, pain or unusual breathlessness.", "The learner must remove an aid, change route or hide an adjustment to meet the target.", "The pack, surface, footwear, weather or assistance cannot be reproduced." ] }, "self_check": [ "Can you state complete pack mass, distribution, route, pace and aid?", "Can you put on and remove the pack using the planned support?", "Were every fit change and symptom checkpoint recorded?", "Can you explain why completion does not establish job readiness?" ], "measurement": { "primary": "Time and physiological/task cost for one declared load-route configuration", "how": "Record complete pack mass, distribution, route, terrain, pace, footwear, aid, assistance, symptoms, gait and post-task recovery; split data at any change.", "good_result": "The same configuration is completed with stable or improved time/cost and no worse gait, pain, skin, balance or recovery.", "does_not_prove": "It does not prove a safe maximum load, occupational or military readiness, fracture safety or transfer to hills/heat." }, "stop_and_get_help": [ "Stop for chest pain, faintness, severe breathlessness, confusion, heat illness signs or a new neurological symptom.", "Stop and unload for sharp pain, numbness, skin injury, foot hot spot, pack failure, gait deterioration or loss of balance.", "Remove the pack safely after new radiating pain, foot numbness, balance loss or an inability to maintain gait, then obtain the relevant clinical or occupational review before reloading." ], "accessibility": [ "Keep the usual mobility aid and use a provider-selected pack, wheeled carrier or distributed-load alternative with separate measurement.", "Use seated fitting, a helper, large strap pulls and planned rest/transfer surfaces.", "Label pack components by color or touch and provide fit instructions as photos or narrated checks, while recording helper input and the final strap configuration." ], "evidence_notes": [ { "claim": "Backpack design variants did not produce an objective advantage in one tested load configuration, so fit claims must be measured directly.", "source_title": "Soldier load carriage: Does the type of pack matter?", "source_url": "https://pubmed.ncbi.nlm.nih.gov/41548350/", "source_kind": "PRIMARY_RESEARCH" }, { "claim": "Simple anthropometric and performance tests had large prediction error for load carriage, supporting direct testing of the actual load-route task.", "source_title": "Can simple anthropometric and physical performance tests track training-induced changes in load-carriage ability?", "source_url": "https://pubmed.ncbi.nlm.nih.gov/16933815/", "source_kind": "PRIMARY_RESEARCH" } ], "limits": [ "There is no universal safe pack mass or body-mass percentage.", "Level indoor carriage does not establish hills, stairs, heat or occupational performance.", "Training cannot make a poorly designed pack or route safe." ], "orientation": { "bounded_definition": "Capability to develop or express load-carriage endurance in a declared context without inheriting broader claims.", "evidence_summary": "Load-carriage endurance is real as a bounded, measurable capability, but the evidence is task- and population-specific. Titan separates improvement in the test from retention, transfer and meaningful function.", "supportable_public_claim": "In selected people and declared configurations, load-carriage endurance can be measured and may improve with task-relevant practice; retention, transfer and meaningful value require separate testing.", "measurement_boundary": "Declare absolute and relative load, distribution, distance, terrain, speed, footwear and symptoms; test the actual bounded task and record assistive equipment.", "myth_to_metric": { "myth": "March forever under any load", "metric": "Completion time/physiological cost for a declared load-route configuration, with pain, gait and post-task performance monitored", "boundary": "The metric is valid only for its declared task and cannot establish universal ability, character, diagnosis, safety or far transfer." }, "limiting_findings": [ "Prediction error from simple tests was as large as average training gains in one recruit cohort.", "Three backpack variants produced no objective advantage at the tested load." ], "prohibited_claims": [ "Titan proves anyone can develop unlimited or superhuman load-carriage endurance.", "One test score reveals whole-person capability, health, discipline, potential or worth.", "Improvement guarantees injury prevention, clinical benefit, occupational readiness or transfer to every real-world task." ] }, "gold_source_lesson": { "curriculum_id": "G-CUR-002", "source_heading": "PWR-021 - Load-carriage endurance", "source_html_sha256": "29466b3917422381d7d828ada08b6e8f1c0e09f2d46c1352eef3bddeb5445b20", "html": "Specialist pathway. No load progression, occupational simulation or clearance.
" }, "next_gate": "External confirmation is required before higher-authority use because: CLINICAL_HIGH_RISK_OR_REGULATED_CONFIGURATION; SUPERVISION_OR_NON_ATTEMPT_BOUNDARY.", "evidence_count": 3 }, "full_training_programme": false, "independently_validated": false, "publication_state": "PUBLISHED_PUBLIC_RESEARCH_EDITION__EDITORIAL_REVIEW_PENDING", "related_power_ids": [ "PWR-017", "PWR-018", "PWR-019", "PWR-020" ] }, { "power_id": "PWR-022", "learning_unit_id": "TLU-PWR-022", "title": "Pacing", "main_description": "This pack supplies a complete fictional card-sorting dataset, so nobody needs to walk, wheel, cycle, race, hold their breath or provoke fatigue. The task is to describe how output, errors, pauses and burden are distributed across equal segments, then compare one predeclared pacing change. A flatter curve is not automatically better, and the pattern cannot diagnose motivation, general endurance, post-exertional illness or work capacity. People with energy-limiting illness, exertional symptoms, rehabilitation needs or an existing pacing plan should use their qualified route; this fictional analysis does not override care.", "main_description_source": "GOVERNED_TUTORIAL_PLAIN_ENGLISH_INTRO", "family_id": "FAM-03", "family": "Endurance & Metabolic Work Capacity", "superdomain": "Body & Performance", "canonical_route": "/powers/pwr-022/", "treatment": "RESEARCH_EXPLORATION_ROUTE", "treatment_label": "Full research tutorial", "treatment_boundary": "Titan teaches a complete Power-specific research method because operational capability practice is not currently justified.", "tutorial_route": "/tutorials/pwr-022/", "governed_lesson_route": "/tutorials/pwr-022/", "self_attempt_status": "NO_TRAINING_AUTHORITY", "gold_pathway_ids": [ "G-CUR-002" ], "route_membership": { "kind": "GOLD_PATHWAY", "id": "G-CUR-002", "coverage_status": "EXACT_ONCE" }, "source_authority_tier": "G2", "source_build_state": "RESEARCH_ONLY", "source_instructional_route": "EXPLAINER_ONLY_RESEARCH", "source_count": 3, "research_depth": "FOCUSED", "risk_level": "LOW_TO_MODERATE", "prerequisite_status": "NONE_FOR_READING__NO_PRACTICE_AUTHORITY", "learning_route": { "mode": "RESEARCH_EXPLORATION", "label": "Explore the research frontier", "summary": "This pack supplies a complete fictional card-sorting dataset, so nobody needs to walk, wheel, cycle, race, hold their breath or provoke fatigue. The task is to describe how output, errors, pauses and burden are distributed across equal segments, then compare one predeclared pacing change. A flatter curve is not automatically better, and the pattern cannot diagnose motivation, general endurance, post-exertional illness or work capacity. People with energy-limiting illness, exertional symptoms, rehabilitation needs or an existing pacing plan should use their qualified route; this fictional analysis does not override care.", "steps": [ [ "Frame the question", "State the capability claim narrowly enough that evidence could support or limit it." ], [ "Map the evidence", "Distinguish existence, measurement, trainability, retention, transfer, safety and functional value." ], [ "Find uncertainty", "Identify small samples, proxy measures, missing controls, null findings and unresolved authority questions." ], [ "Compare alternatives", "Consider competing explanations and what evidence would change the current treatment." ], [ "Stay non-operational", "Use the record for research literacy only until a separate gate authorises instruction." ] ], "practical_authority": false, "provider_required": false, "next_action_route": "/tutorials/pwr-022/" }, "path_builder": { "selectable": true, "completion_allowed": true, "warning": "Titan teaches a complete Power-specific research method because operational capability practice is not currently justified." }, "full_tutorial": { "version": "1.0", "authorship": "AUTHORED_GOVERNED_SOURCE", "practice_pack": { "power_id": "PWR-022", "title": "Pacing", "heading": "Read a fictional segmented pacing curve without racing or symptom provocation", "plain_english_intro": "This pack supplies a complete fictional card-sorting dataset, so nobody needs to walk, wheel, cycle, race, hold their breath or provoke fatigue. The task is to describe how output, errors, pauses and burden are distributed across equal segments, then compare one predeclared pacing change. A flatter curve is not automatically better, and the pattern cannot diagnose motivation, general endurance, post-exertional illness or work capacity. People with energy-limiting illness, exertional symptoms, rehabilitation needs or an existing pacing plan should use their qualified route; this fictional analysis does not override care.", "authority_and_safety": [ "Governance ceiling: explanation and static fictional record analysis only. Capability self-practice, live administration, protocol delivery and efficacy claims are not authorised until the recorded next_gate adjudication changes.", "Use only the eight supplied fictional pacing rows. Do not sort cards, time a task, change activity pacing, provoke symptoms or test exertion.", "The fictional segment durations and pause are data, not a real-world pacing dose or permission to override an existing care plan." ], "materials": [ "The eight fictional segmented rows in the fixture table; no timer or physical task is required.", "Two blank curve grids labelled segment 1 through 4 on the horizontal axis and completed cards on the vertical axis.", "Comparison sheet with fields for total units, total errors, pauses, burden change, configuration differences, delayed worsening and keep/adapt/stop decision.", "Boundary card: fictional data only; accuracy and burden matter; no speed target, exertion test, quota, character judgement or universal pacing formula." ], "setup_steps": [ "Confirm that both rows describe the same fictional four-minute neutral card task divided into four one-minute segments. The timing is dataset metadata, not a recommended pacing dose.", "For every segment calculate attempted cards = correct cards + errors. Then calculate error rate = errors divided by attempted cards.", "Record active opportunity separately. Trial A has no supplied pause; Trial B includes a 15-second pause inside the same total clock, so active task time differs.", "Add the complete records: A has 23 correct, 6 errors and 29 attempts; B has 22 correct, 2 errors and 24 attempts.", "Calculate error rates: A is 6/29 = 20.7%; B is 2/24 = 8.3%, rounded to one decimal.", "Compare correct output, error rate, burden, pause and active opportunity as separate outcomes. Do not call raw error counts ‘accuracy’ without the denominator.", "Choose KEEP FOR FICTIONAL REVIEW, ADAPT or STOP and state that the table cannot prescribe a real pacing pattern or establish a causal effect." ], "fixture": { "caption": "Fictional four-segment card-sorting baseline and comparison", "headers": [ "Trial", "Segment", "Correct units", "Errors", "Planned pause", "Burden 0–10" ], "rows": [ [ "A — natural baseline", "1", "8", "1", "0 seconds", "3" ], [ "A — natural baseline", "2", "7", "1", "0 seconds", "4" ], [ "A — natural baseline", "3", "5", "2", "0 seconds", "6" ], [ "A — natural baseline", "4", "3", "2", "0 seconds", "8" ], [ "B — gentler start + micro-pause", "1", "5", "0", "0 seconds", "2" ], [ "B — gentler start + micro-pause", "2", "6", "0", "15 seconds", "3" ], [ "B — gentler start + micro-pause", "3", "6", "1", "0 seconds", "4" ], [ "B — gentler start + micro-pause", "4", "5", "1", "0 seconds", "5" ] ] }, "scoring_rule": "Award 2 points each for correct A totals, correct B totals, both attempt denominators, both error rates, accurate curve description, explicit burden treatment, active-opportunity caveat and a bounded non-causal conclusion: 16 total. Passing requires A=23/6/29/20.7%, B=22/2/24/8.3% and no claim that B proves a universally better pacing strategy.", "worked_example": { "steps": [ "Add Trial A: 23 correct and 6 errors means 29 attempted cards; error rate is 6/29 = 20.7%.", "Add Trial B: 22 correct and 2 errors means 24 attempted cards; error rate is 2/24 = 8.3%.", "B has one fewer correct card, four fewer errors and a 12.4-percentage-point lower error rate in the supplied record.", "B also includes a 15-second pause inside the same four-minute clock, so active opportunity differs and output per active minute cannot be inferred without more timing data.", "Report the trade-off and lower burden descriptively without prescribing Trial B's pattern." ], "result": "The static record supports a descriptive trade-off: B has 22 correct at 8.3% errors versus A's 23 correct at 20.7% errors, with lower burden and different active opportunity. It does not establish a causal or universal pacing rule." }, "right_vs_wrong": [ { "situation": "Looking at the curve", "right": "Describe segment values, starts, finishes, pauses, errors and total outcome before judging the hypothesis.", "wrong": "Call the flattest line the best pacing pattern immediately.", "why": "A curve shape alone can hide lower output, errors, burden or a changed configuration." }, { "situation": "Comparing totals", "right": "Report that B has one fewer correct unit and four fewer errors.", "wrong": "Say B produces more because its middle segments are higher than A’s finish.", "why": "Segment impressions do not replace the complete sum." }, { "situation": "Interpreting burden", "right": "Keep the 0–10 burden values visible as a separate outcome.", "wrong": "Ignore burden because the task is fictional and benign.", "why": "The lesson requires total outcome, perception and configuration to remain separate." }, { "situation": "Explaining the person", "right": "Describe Trial A’s late output decline without assigning motive.", "wrong": "Call the fictional worker unmotivated in segment 4.", "why": "A pacing curve cannot establish motivation, character or diagnosis." }, { "situation": "Transferring", "right": "Use a new benign dataset and new baseline for another task.", "wrong": "Prescribe a gentler first segment and fifteen-second pause for every activity.", "why": "This pattern is fixture-specific and the supplied timings are not a universal formula." } ], "common_mistakes": [ { "mistake": "Errors are added to completed units as if all activity were productive output.", "fix": "Sum only correctly sorted cards and report errors in their own total." }, { "mistake": "The planned pause disappears from the comparison.", "fix": "Annotate segment 2 and include the pause in the configuration statement." }, { "mistake": "The learner compares segment 1 of A with segment 4 of B selectively.", "fix": "Use matched segments plus whole-trial totals and state every trade-off." }, { "mistake": "A fictional pattern becomes advice for post-exertional symptoms.", "fix": "Stop. Existing qualified pacing and care plans take priority; this pack contains no symptom-provocation authority." }, { "mistake": "The one-minute segments are treated as recommended dose.", "fix": "State that one minute is merely the fictional table’s equal segment and supplies no real-world duration rule." } ], "answer_key_route": "/tutorials/pwr-022/answer-key/", "answer_key_delivery": "SEPARATE_NOINDEX_NOARCHIVE_CHECKING_PAGE" }, "tutorial_mode": "RESEARCH_EXPLORATION", "orientation": { "bounded_definition": "Capability to develop or express pacing in a declared context without inheriting broader claims.", "evidence_summary": "Pacing patterns can be measured and may be reproducible in a familiar task. The bound evidence does not yet establish a general trainable pacing skill, durable retention or transfer across activities.", "measurement_boundary": "Analyse power/speed/work-rate over predeclared task segments with total outcome, perception and environment; do not diagnose motivation from a pacing curve.", "myth_to_metric": { "myth": "Perfect energy management in every challenge", "metric": "Segment-by-segment work-rate distribution and total outcome in a declared task", "boundary": "The metric is valid only for its declared task and cannot establish universal ability, character, diagnosis, safety or far transfer." }, "limiting_findings": [ "Start and finish pacing showed greater variability even when whole-trial performance was reproducible.", "Incorrect distance feedback did not alter time or pacing in the cited trial, contradicting a simple feedback-control claim." ], "prohibited_claims": [ "Titan proves anyone can develop unlimited or superhuman pacing.", "One test score reveals whole-person capability, health, discipline, potential or worth.", "Improvement guarantees injury prevention, clinical benefit, occupational readiness or transfer to every real-world task." ] }, "outcomes": [ "Define pacing without inheriting mythology or broader claims.", "Explain what the current evidence supports and what it does not establish.", "Use the declared measurement boundary and recognise misleading proxies.", "Complete the current learning route without converting it into unauthorised capability practice.", "Make a retention, transfer, maintenance, provider or stop decision without overclaiming." ], "prerequisites": "NONE_FOR_READING__NO_PRACTICE_AUTHORITY", "baseline": { "instruction": "Before reading the sequence, record your current definition, confidence, assumed measure, expected value, known risks and intended next action. Do not attempt the capability.", "record": [ "date and context", "current definition", "confidence from 0 to 100", "assumed measure", "expected benefit", "known limitation", "intended next action" ] }, "modules": [ { "order": 1, "title": "Frame the question", "instruction": "State the capability claim narrowly enough that evidence could support or limit it.", "completion_evidence": "Record the decision or output from frame the question in one or two sentences." }, { "order": 2, "title": "Map the evidence", "instruction": "Distinguish existence, measurement, trainability, retention, transfer, safety and functional value.", "completion_evidence": "Record the decision or output from map the evidence in one or two sentences." }, { "order": 3, "title": "Find uncertainty", "instruction": "Identify small samples, proxy measures, missing controls, null findings and unresolved authority questions.", "completion_evidence": "Record the decision or output from find uncertainty in one or two sentences." }, { "order": 4, "title": "Compare alternatives", "instruction": "Consider competing explanations and what evidence would change the current treatment.", "completion_evidence": "Record the decision or output from compare alternatives in one or two sentences." }, { "order": 5, "title": "Stay non-operational", "instruction": "Use the record for research literacy only until a separate gate authorises instruction.", "completion_evidence": "Record the decision or output from stay non-operational in one or two sentences." } ], "lab": { "title": "Claim-audit lab", "instruction": "Choose one public claim about this Power. Compare it with the bounded definition, measurement limit, supporting evidence, limiting findings and prohibited wording.", "deliverable": "A one-page claim verdict: supported, partly supported, unresolved or contradicted, with the reason stated." }, "assessment": { "immediate": "Restate the bounded definition, evidence ceiling, measurement boundary and current authority route without looking.", "delayed_retention": "Repeat the explanation and route decision after at least 48 hours; record what changed or was forgotten.", "transfer": "Evaluate a new claim, provider option or research result using the same evidence and authority checklist; do not perform the capability.", "interpretation": "Completion demonstrates learning of this tutorial only. It does not prove capability, qualification, independent validation, safety clearance or far transfer." }, "maintenance": { "cadence": "Review after 48 hours, again after 2-4 weeks, and whenever the evidence or authority treatment changes.", "decisions": [ "retain", "refresh", "seek qualified support", "return to research", "retire" ] }, "accessibility": "Use text-to-speech, enlarged text, keyboard navigation, shorter sessions, a support person or an equivalent non-practical record format as needed. Accessibility changes must not enlarge practical authority.", "stopping_and_escalation": "Titan teaches a complete Power-specific research method because operational capability practice is not currently justified. Stop if the declared configuration cannot be maintained, uncertainty becomes material, adverse effects appear, or qualified authority is required.", "next_gate": "No external confirmation is required for the current bounded explainer permission. Guide permission remains NOT_READY; any guide, stronger efficacy, generalisation, protocol, promotion or independent-validation claim requires a new adjudication.", "evidence_count": 3 }, "full_training_programme": false, "independently_validated": false, "publication_state": "PUBLISHED_PUBLIC_RESEARCH_EDITION__EDITORIAL_REVIEW_PENDING", "related_power_ids": [ "PWR-017", "PWR-018", "PWR-019", "PWR-020" ] }, { "power_id": "PWR-023", "learning_unit_id": "TLU-PWR-023", "title": "Metabolic flexibility", "main_description": "The learner produces a one-page audit of a metabolic-flexibility study that states the stimulus, population, calorimetry conditions, RER/substrate outcome, comparator, missing controls and claim ceiling.", "main_description_source": "FULL_TUTORIAL_OUTCOME", "family_id": "FAM-03", "family": "Endurance & Metabolic Work Capacity", "superdomain": "Body & Performance", "canonical_route": "/powers/pwr-023/", "treatment": "RESEARCH_EXPLORATION_ROUTE", "treatment_label": "Full research tutorial", "treatment_boundary": "Titan teaches a complete Power-specific research method because operational capability practice is not currently justified.", "tutorial_route": "/tutorials/pwr-023/", "governed_lesson_route": null, "self_attempt_status": "NO_OPERATIONAL_SELF_EXPERIMENT", "gold_pathway_ids": [ "G-CUR-002" ], "route_membership": { "kind": "GOLD_PATHWAY", "id": "G-CUR-002", "coverage_status": "EXACT_ONCE" }, "source_authority_tier": "G5", "source_build_state": "RESEARCH_ONLY", "source_instructional_route": "EXPLAINER_ONLY_RESEARCH", "source_count": 3, "research_depth": "FOCUSED", "risk_level": "MODERATE", "prerequisite_status": "NONE_FOR_READING__NO_PRACTICE_AUTHORITY", "learning_route": { "mode": "FULL_RESEARCH_TUTORIAL", "label": "Learn metabolic flexibility step by step", "summary": "The learner produces a one-page audit of a metabolic-flexibility study that states the stimulus, population, calorimetry conditions, RER/substrate outcome, comparator, missing controls and claim ceiling.", "steps": [ [ "Get ready", "Choose one paper with a clearly described indirect-calorimetry or substrate-oxidation method." ], [ "Learn the method", "8 concrete steps teach the permitted method from start to finish." ], [ "See right and wrong", "5 comparisons show correct or safer execution beside common wrong or riskier choices." ], [ "Practise", "Audit one additional paper per session. After three papers, build a comparison table only when operational definitions and stimuli are genuinely comparable. Recheck the same audit one week later without notes and have another reader verify one calculation and one claim ceiling." ], [ "Check progress", "Score whether the audit correctly identifies construct, stimulus, population, standardisation, calorimetry quality, raw change, comparator, uncertainty, null finding and claim ceiling." ] ], "practical_authority": false, "provider_required": false, "next_action_route": "/tutorials/pwr-023/" }, "path_builder": { "selectable": true, "completion_allowed": true, "warning": "Titan teaches a complete Power-specific research method because operational capability practice is not currently justified." }, "full_tutorial": { "version": "3.0", "authorship": "POWER_SPECIFIC_FULL_TUTORIAL", "tutorial_mode": "RESEARCH", "promise": "Metabolic flexibility is not a feeling or a voluntary switch that a person can train from a consumer score. In research it can mean change in fuel oxidation or respiratory exchange ratio (RER) when metabolic demand changes. RER is carbon dioxide produced divided by oxygen consumed during indirect calorimetry. This tutorial teaches how to define the construct, extract the laboratory conditions, check gas-quality data, calculate the declared change and keep insulin sensitivity, resting oxidation and exercise performance separate. It does not instruct fasting, diet, glucose, supplement or exercise self-experimentation.", "power_id": "PWR-023", "title": "Metabolic flexibility", "lesson_type": "RESEARCH", "headline": "Audit a metabolic-flexibility claim without running a fasting or exercise experiment", "plain_english_summary": "Metabolic flexibility is not a feeling or a voluntary switch that a person can train from a consumer score. In research it can mean change in fuel oxidation or respiratory exchange ratio (RER) when metabolic demand changes. RER is carbon dioxide produced divided by oxygen consumed during indirect calorimetry. This tutorial teaches how to define the construct, extract the laboratory conditions, check gas-quality data, calculate the declared change and keep insulin sensitivity, resting oxidation and exercise performance separate. It does not instruct fasting, diet, glucose, supplement or exercise self-experimentation.", "outcome": "The learner produces a one-page audit of a metabolic-flexibility study that states the stimulus, population, calorimetry conditions, RER/substrate outcome, comparator, missing controls and claim ceiling.", "authority": { "learner_may": [ "Read a primary study and extract its declared metabolic-flexibility definition.", "Recalculate a published or fictional RER change from supplied non-identifiable data.", "Compare study conditions and identify whether the claim is association, intervention effect or null result." ], "qualified_person_required_for": [ "Any indirect-calorimetry collection, fasting, meal challenge, glucose/insulin procedure, exercise test or biological sampling.", "Clinical interpretation of insulin sensitivity, diabetes risk, respiratory disease or abnormal metabolic results.", "Design and ethics approval of a human metabolic study." ], "never_do": [ "Change fasting, diet, medication, glucose intake, supplements or exercise to create personal metabolic data from this lesson.", "Use a wearable or consumer fuel-use score as a clinical diagnosis or validated laboratory substitute.", "Call one RER change proof of metabolic health, fat-burning ability or voluntary control." ] }, "materials": [ "The full primary paper, protocol and supplementary methods", "A data-extraction sheet with stimulus, timing, diet/fasting, prior exercise, gas system and population", "A calculator or spreadsheet for supplied RER differences", "A quality checklist for gas calibration, steady state, missing data and protocol deviations" ], "before_you_start": [ "Choose one paper with a clearly described indirect-calorimetry or substrate-oxidation method.", "Use only published, de-identified or fictional data; do not collect personal physiological measurements.", "Write the research question before reading the results so the outcome is not redefined after the fact.", "Mark clinical, fasting, exercise and sampling procedures as provider/laboratory controlled." ], "steps": [ { "title": "Name the construct", "instruction": "Copy the paper's exact definition of metabolic flexibility. State whether it means RER change, substrate oxidation, response to insulin/meal/exercise or another construct.", "reason": "Different studies use the same label for different measurements.", "success_check": "The audit contains one quoted or accurately paraphrased operational definition, not only the title term." }, { "title": "Draw the stimulus and time points", "instruction": "List the baseline state, the metabolic challenge and every measurement time. Examples are fasted-to-fed, rest-to-exercise or low-to-higher workload.", "reason": "A change score has meaning only across declared conditions.", "success_check": "A reader can reproduce the sequence from the audit." }, { "title": "Extract the population", "instruction": "Record sample size, age range, sex reporting, training status, obesity/diabetes criteria, medication exclusions and attrition.", "reason": "Response and safety can differ across populations.", "success_check": "The audit names who was studied and who was not." }, { "title": "Check standardisation", "instruction": "Find diet control, fasting duration, time of day, prior exercise, caffeine/nicotine rules, workload and rest before gas collection. Mark each as reported, absent or unclear.", "reason": "These conditions alter substrate oxidation and RER.", "success_check": "No unreported control is assumed; the visible 'Check standardisation' check is satisfied." }, { "title": "Audit indirect calorimetry", "instruction": "Record gas analyser, calibration, mask/hood, averaging window and steady-state or plausibility rule. Flag RER values outside the study's physiological/technical range rather than silently deleting them.", "reason": "Calibration and non-steady-state data can make fuel estimates unreliable.", "success_check": "The quality table shows how each time point passed or failed." }, { "title": "Calculate the declared response", "instruction": "For supplied data, subtract baseline RER from challenge RER, or use the paper's prespecified oxidation formula. Keep the sign and units visible and do not invent a universal good direction.", "reason": "The same absolute change can have different meaning under different stimuli.", "success_check": "Another reader obtains the same calculation from the shown numbers." }, { "title": "Compare groups and outcomes", "instruction": "Report within-person change and the between-group contrast with uncertainty. Keep resting oxidation, exercise oxidation, insulin sensitivity and performance in separate rows.", "reason": "Correlation or change in one outcome does not establish change in another.", "success_check": "The result table contains effect estimates and uncertainty, not just significant/not significant labels." }, { "title": "Write the claim ceiling", "instruction": "State what the design supports, the key null/contrary finding and what it cannot establish. End with the next research need, not a lifestyle prescription.", "reason": "A bounded conclusion prevents biomarker results becoming personal treatment advice.", "success_check": "The final paragraph names at least one supported claim, one limitation and one prohibited inference." } ], "worked_example": { "scenario": "A fictional randomised study reports fasting and standard-workload indirect calorimetry before and after six weeks. Group A has mean RER 0.80 at rest and 0.91 at the workload before training, then 0.79 and 0.87 after training. Group B changes from 0.80/0.90 to 0.80/0.90.", "walkthrough": [ "Define the study's flexibility metric as workload RER minus resting RER, not 'fat-burning'.", "Calculate Group A as 0.11 before and 0.08 after; calculate Group B as 0.10 before and 0.10 after.", "Record that a smaller rest-to-work RER rise occurred in Group A, but retain the separate resting and workload values.", "Check whether workload, diet, fasting, prior exercise, calibration and steady state were identical; mark any missing item as unclear.", "Report the between-group difference in change only with the study's confidence interval, and check insulin sensitivity and performance as separate outcomes." ], "result": "The fictional data show a changed RER response under one standard workload. They do not prove better health, voluntary fuel switching, clinical benefit or the effect of a different meal, workload or population. If the confidence interval includes no group difference, the correct conclusion is uncertainty, not improvement." }, "right_vs_wrong": [ { "situation": "Definition: Metabolic flexibility checkpoint", "right": "State the exact stimulus and RER/oxidation response.", "wrong": "Treat metabolic flexibility as a single universal personal trait.", "why": "Different operational definitions are not interchangeable." }, { "situation": "Standardisation: Metabolic flexibility checkpoint", "right": "Extract fasting, diet, prior exercise, time and workload.", "wrong": "Compare RER values collected under unknown conditions.", "why": "Context can drive the apparent change." }, { "situation": "Calculation: Metabolic flexibility checkpoint", "right": "Show baseline, challenge, difference and units.", "wrong": "Call any lower RER automatically healthier.", "why": "Direction depends on the declared demand and outcome." }, { "situation": "Inference: Metabolic flexibility checkpoint", "right": "Keep RER, insulin sensitivity and performance separate.", "wrong": "Assume one biomarker change caused all other outcomes.", "why": "Association does not establish mechanism or benefit." }, { "situation": "Action: Metabolic flexibility checkpoint", "right": "End with a research limitation and next study.", "wrong": "Prescribe fasting or interval training from the audit.", "why": "Operational practice is outside this research lesson." } ], "common_mistakes": [ { "mistake": "The label is copied but the operational definition is missing.", "fix": "Write the exact before-and-after conditions and measured variable." }, { "mistake": "RER values from rest and exercise are compared without matching workload.", "fix": "Match absolute or relative workload as the protocol specifies and flag differences." }, { "mistake": "Diet and prior exercise controls are assumed.", "fix": "Mark each control reported, absent or unclear; never fill blanks by intuition." }, { "mistake": "Statistical significance replaces effect size and uncertainty.", "fix": "Extract the effect estimate and confidence interval for the prespecified contrast." }, { "mistake": "A biomarker finding becomes a personal diet plan.", "fix": "Restore the claim ceiling and route any clinical or behavioural question to qualified care/research." } ], "practice": { "first_session": [ "Select one primary paper and write the research question.", "Complete the construct, stimulus/time-point and population fields.", "Audit standardisation and calorimetry quality before opening the results table.", "Recalculate one published or supplied change score.", "Write a three-sentence supported claim, contrary/null finding and non-claim." ], "repeat_plan": "Audit one additional paper per session. After three papers, build a comparison table only when operational definitions and stimuli are genuinely comparable. Recheck the same audit one week later without notes and have another reader verify one calculation and one claim ceiling.", "progress_when": [ "Operational definitions, stimuli and time points are extracted without conflation.", "Every calculation is reproducible and uncertainty is retained.", "The learner rejects a lifestyle or clinical inference that the design cannot support." ], "do_not_progress_when": [ "The full methods or calibration/standardisation details are unavailable.", "Different metabolic-flexibility constructs are being pooled as one outcome.", "The learner feels pushed to collect personal data or change diet, medication, fasting or exercise." ] }, "self_check": [ "What exact change did this study call metabolic flexibility?", "Were diet, fasting, prior exercise, time of day and workload standardised?", "Can another reader reproduce the change score from the shown values?", "What null or contrary result limits the claim?", "Does the conclusion avoid a personal prescription?" ], "measurement": { "primary": "Accuracy and completeness of a metabolic-flexibility evidence audit", "how": "Score whether the audit correctly identifies construct, stimulus, population, standardisation, calorimetry quality, raw change, comparator, uncertainty, null finding and claim ceiling.", "good_result": "All ten fields are correct for two independent papers and a second reader reproduces the calculation and agrees with the claim ceiling.", "does_not_prove": "It does not prove the learner can run indirect calorimetry, diagnose metabolic health or recommend diet/exercise treatment." }, "stop_and_get_help": [ "Stop the research exercise if it is becoming a personal fasting, glucose, supplement, medication or high-intensity exercise experiment.", "Route abnormal personal symptoms or laboratory results to a qualified clinician; do not interpret them from this tutorial.", "Seek methods expertise when gas calibration, non-steady-state handling, oxidation equations or statistical contrasts cannot be verified.", "Do not pool studies when their operational definitions, workloads or populations are materially different." ], "accessibility": [ "Use structured extraction tables, screen-reader-friendly papers or text-to-speech and plain-language definitions of RER and substrate oxidation.", "Provide a calculator template with labelled cells and retain the formula so arithmetic is not a gate to interpretation.", "Allow a partner to read inaccessible figures while the learner independently states the method and claim ceiling." ], "evidence_notes": [ { "claim": "Exercise-training studies can show metabolic adaptations under controlled laboratory conditions, but the result is tied to the protocol and population.", "source_title": "Similar metabolic adaptations during exercise after low volume sprint interval and traditional endurance training in humans", "source_url": "https://pubmed.ncbi.nlm.nih.gov/17991697/", "source_kind": "PRIMARY_RESEARCH" }, { "claim": "The i-FLEX study found no resting substrate-oxidation change and no correlation between oxidation and insulin-sensitivity changes, limiting simple consumer claims.", "source_title": "Effects of sprint interval training on substrate oxidation in adults living with and without obesity: The i-FLEX study", "source_url": "https://pubmed.ncbi.nlm.nih.gov/34110721/", "source_kind": "PRIMARY_RESEARCH" } ], "limits": [ "Metabolic flexibility has multiple operational definitions.", "Indirect-calorimetry RER is a context-sensitive biomarker, not a voluntary skill score.", "This lesson authorises evidence evaluation only, not fasting, diet, glucose, supplement, medication or exercise experimentation.", "A changed RER response does not by itself establish insulin sensitivity, performance or clinical benefit." ], "orientation": { "bounded_definition": "Capability to develop or express metabolic flexibility in a declared context without inheriting broader claims.", "evidence_summary": "Metabolic flexibility is best treated here as a context-sensitive research biomarker, not a proven voluntary human power. A laboratory oxidation shift does not establish weight control, health or real-world function.", "supportable_public_claim": "Standardised indirect calorimetry can describe context-sensitive substrate-use responses; Titan does not currently classify this biomarker as a demonstrated voluntary functional capability.", "measurement_boundary": "Treat indirect-calorimetry substrate switching as a context-sensitive biomarker; standardise diet, fasting, prior exercise and workload and do not turn it into a consumer score.", "myth_to_metric": { "myth": "Switching fat burning on at will", "metric": "Change in respiratory exchange/substrate oxidation across standardised metabolic demands, reported as a biomarker not a voluntary ability", "boundary": "The metric is valid only for its declared task and cannot establish universal ability, character, diagnosis, safety or far transfer." }, "limiting_findings": [ "The i-FLEX study found no resting substrate-oxidation change and no correlation between oxidation and insulin-sensitivity changes.", "Insulin sensitivity decreased in participants without obesity after the short intervention." ], "prohibited_claims": [ "Titan proves anyone can develop unlimited or superhuman metabolic flexibility.", "One test score reveals whole-person capability, health, discipline, potential or worth.", "Improvement guarantees injury prevention, clinical benefit, occupational readiness or transfer to every real-world task." ] }, "gold_source_lesson": { "curriculum_id": "G-CUR-002", "source_heading": "12. Metabolic flexibility: research, not a tutorial", "source_html_sha256": "384b5e5c32f7b7f32c7c3a067cc61ba6a47bb4610550225c6bbed1619788f8d9", "html": "PWR-023 remains a G5 research route. “Metabolic flexibility” can refer to different physiological constructs measured with different laboratory methods. Titan does not turn the concept into a fasting, diet, glucose, supplement or exercise self-experiment.\nThe public-facing role is to explain:
\nSpecialist pathway. No return-to-play or high-intensity recovery prescription.
" }, "next_gate": "External confirmation is required before higher-authority use because: CLINICAL_HIGH_RISK_OR_REGULATED_CONFIGURATION.", "evidence_count": 4 }, "full_training_programme": false, "independently_validated": false, "publication_state": "PUBLISHED_PUBLIC_RESEARCH_EDITION__EDITORIAL_REVIEW_PENDING", "related_power_ids": [ "PWR-017", "PWR-018", "PWR-019", "PWR-020" ] }, { "power_id": "PWR-025", "learning_unit_id": "TLU-PWR-025", "title": "Active range of motion", "main_description": "This supplement is a no-movement route. It provides fictional diagrams in table form and already-recorded observations, so the learner does not need to stretch, load, bounce, hold, push or test pain. The task is to distinguish movement produced by the person from range created by outside assistance, then keep angle, support, comfort and meaningful function separate. No normative target is supplied, and more range is not assumed to be better. New pain, injury concern, unexplained limitation or rehabilitation decisions require an appropriately qualified clinician who knows the person’s context.", "main_description_source": "GOVERNED_TUTORIAL_PLAIN_ENGLISH_INTRO", "family_id": "FAM-04", "family": "Mobility, Balance & Locomotion", "superdomain": "Body & Performance", "canonical_route": "/powers/pwr-025/", "treatment": "BOUNDED_GUIDED_LESSON", "treatment_label": "Bounded guided lesson", "treatment_boundary": "A governed exercise is available only in the declared configuration, dose and stopping rules.", "tutorial_route": "/tutorials/pwr-025/", "governed_lesson_route": "/tutorials/pwr-025/", "self_attempt_status": "PERMITTED_ONLY_INSIDE_DECLARED_BOUNDARY", "gold_pathway_ids": [ "G-CUR-003" ], "route_membership": { "kind": "GOLD_PATHWAY", "id": "G-CUR-003", "coverage_status": "EXACT_ONCE" }, "source_authority_tier": "G2", "source_build_state": "COMPREHENSIVE_OWNER_CANDIDATE", "source_instructional_route": "BOUNDED_GUIDED_EXERCISE", "source_count": 2, "research_depth": "FOCUSED", "risk_level": "LOW_TO_MODERATE", "prerequisite_status": "DECLARED_IN_GOVERNED_LESSON", "learning_route": { "mode": "BOUNDED_PRACTICAL_LESSON", "label": "Learn inside the bounded governed lesson", "summary": "This supplement is a no-movement route. It provides fictional diagrams in table form and already-recorded observations, so the learner does not need to stretch, load, bounce, hold, push or test pain. The task is to distinguish movement produced by the person from range created by outside assistance, then keep angle, support, comfort and meaningful function separate. No normative target is supplied, and more range is not assumed to be better. New pain, injury concern, unexplained limitation or rehabilitation decisions require an appropriately qualified clinician who knows the person’s context.", "steps": [ [ "Check the boundary", "Read the evidence, risk framing, prerequisites and stopping rules before attempting anything." ], [ "Declare the baseline", "Use only the task and measurement contract specified by the governed lesson." ], [ "Complete the bounded practice", "Follow the ordered steps without hidden progression or improvised intensity." ], [ "Retest separately", "Keep direct performance, delayed retention and transfer as different questions." ], [ "Review", "Continue, adapt, seek support or stop according to the lesson's declared decision rules." ] ], "practical_authority": true, "provider_required": false, "next_action_route": "/tutorials/pwr-025/" }, "path_builder": { "selectable": true, "completion_allowed": true, "warning": "A governed exercise is available only in the declared configuration, dose and stopping rules." }, "full_tutorial": { "version": "1.0", "authorship": "AUTHORED_GOVERNED_SOURCE", "practice_pack": { "power_id": "PWR-025", "title": "Active range of motion", "heading": "Classify fictional active, active-assisted, passive and unknown range records", "plain_english_intro": "This supplement is a no-movement route. It provides fictional diagrams in table form and already-recorded observations, so the learner does not need to stretch, load, bounce, hold, push or test pain. The task is to distinguish movement produced by the person from range created by outside assistance, then keep angle, support, comfort and meaningful function separate. No normative target is supplied, and more range is not assumed to be better. New pain, injury concern, unexplained limitation or rehabilitation decisions require an appropriately qualified clinician who knows the person’s context.", "authority_and_safety": [ "Use only the bounded configuration. Use a diagram, imagined example, or an ordinary movement already known to be comfortable and permitted. Do not add force, load, stretching or a new range challenge.", "Stop if the frame is being converted into stretching, loading, pain-testing or a self-assessment of injury.", "Stop if comparison with a normative body ideal creates pain, distress or pressure to attempt movement." ], "materials": [ "The four fictional configuration cards in the fixture table; no goniometer, exercise band or physical demonstration is required.", "Classification sheet with fields: joint and direction; ACTIVE, ACTIVE_ASSISTED, PASSIVE or UNKNOWN; posture; support; recorded observation; task outcome; comfort; unknowns; responsible next action.", "Boundary card: diagram/no-attempt route; no stretching time, repetitions, weekly frequency, target angle, loading or progression.", "Optional blank stick-figure outline for drawing arrows. Drawing an arrow does not instruct or request movement." ], "setup_steps": [ "Select the no-movement route and write FICTIONAL/EXISTING RECORD ONLY at the top of the sheet.", "For each row, name one joint and one direction. Reject vague labels such as whole-body flexibility.", "Classify ACTIVE when the person produces the movement without movement assistance; ACTIVE_ASSISTED when the person contributes while a support helps produce motion; PASSIVE when an external person or device produces the motion while the person remains relaxed; and UNKNOWN when the producer is not recorded.", "Copy posture, aid and support exactly. A seated supported observation is a different configuration from standing or unsupported movement.", "Write one thing the observation could show and one meaningful function it cannot establish.", "Choose keep as description, leave unanswered, seek qualified review or stop. Do not recommend another movement observation." ], "fixture": { "caption": "Fictional active, active-assisted, passive and unknown range records for no-movement classification", "headers": [ "Case", "Already-recorded configuration", "Already-recorded task outcome", "Comfort and unknowns" ], "rows": [ [ "R1", "Seated shoulder flexion; person raised the right arm themselves while the forearm rested lightly on a sliding table support; no angle recorded", "Reached a fictional switch at shoulder height once", "Recorded comfortable; performance without the sliding support is unknown" ], [ "R2", "Supine knee flexion; a clinician moved the lower leg while the fictional person remained relaxed; existing record says 105°", "No standing, walking or stair task was recorded", "Comfort recorded; active knee motion and function are unknown" ], [ "R3", "Seated active ankle dorsiflexion; fictional person moved the foot themselves; clinician-approved existing goniometer record says 8°", "Could place the foot on a low fictional footrest with the usual shoe and brace", "No pain recorded; tissue health, gait and performance without brace are unknown" ], [ "R4", "Standing trunk reach described only as ‘good flexibility’; observer, direction, support and whether movement was active are absent", "No task outcome supplied", "Configuration is too incomplete to interpret" ] ] }, "scoring_rule": "Score each case out of 6: joint/direction, exact ACTIVE/ACTIVE_ASSISTED/PASSIVE/UNKNOWN class, support, bounded observation, separate function and responsible next action. Total 24; passing requires R1 ACTIVE_ASSISTED, R2 PASSIVE, R3 ACTIVE and R4 UNKNOWN. Any movement instruction or universal target receives STOP.", "worked_example": { "steps": [ "A learner first writes, ‘R3 has only eight degrees, so ankle flexibility is poor and should be stretched.’", "They repair the classification: R3 is an existing active dorsiflexion observation in a seated setup with the usual brace.", "They separate task function: the fictional person placed the foot on a low footrest with the shoe and brace.", "They list unknown gait, tissue health, unbraced performance, repeatability and whether another setup would produce the same value.", "They choose KEEP AS A BOUNDED EXISTING RECORD; no movement, stretching target or progression is proposed." ], "result": "The repaired R3 answer earns 6/6. It preserves active movement, setup, support, task and uncertainty without turning eight degrees into a body judgement or programme." }, "right_vs_wrong": [ { "situation": "Classifying R2", "right": "Call it PASSIVE because the clinician produced the movement while the fictional person remained relaxed.", "wrong": "Call it ACTIVE_ASSISTED because the knee moved through 105 degrees.", "why": "The class depends on who produced the motion, not its size." }, { "situation": "Preserving support", "right": "Describe R1 as a supported sliding-table reach.", "wrong": "Drop the support from the sentence to claim independent shoulder range.", "why": "Support is part of the observed configuration." }, { "situation": "Interpreting an angle", "right": "State R3’s existing 8° only in its exact seated, braced setup.", "wrong": "Compare 8° with a remembered norm and prescribe stretching.", "why": "The lesson supplies neither a normative target nor exercise authority." }, { "situation": "Handling incomplete data", "right": "Leave R4 unanswered and list the missing configuration fields.", "wrong": "Ask the learner to demonstrate a trunk reach so the table can be completed.", "why": "The no-movement route is complete; missing data do not justify a new physical test." }, { "situation": "Connecting range and function", "right": "Record angle or reach and meaningful task as separate observations.", "wrong": "Assume a larger angle guarantees better function or comfort.", "why": "Range alone cannot establish control, pain relief, tissue health or everyday performance." } ], "common_mistakes": [ { "mistake": "Active and assisted range are merged into one flexibility value.", "fix": "Create separate configuration sentences naming who produced each movement." }, { "mistake": "The learner tries the movement once because the supplied record feels incomplete.", "fix": "Stay with the fictional/no-attempt route; write UNKNOWN or seek appropriate qualified clarification." }, { "mistake": "A brace or table support is treated as cheating.", "fix": "Include the aid in setup and function; do not manufacture an unsupported independence score." }, { "mistake": "An angle is interpreted as tissue health or injury status.", "fix": "Restore the measurement boundary and route clinical questions to a qualified clinician." }, { "mistake": "More range becomes the default next action.", "fix": "Choose keep, pause, leave unanswered or seek review according to task relevance and safety; no progression is implied." } ], "answer_key_route": "/tutorials/pwr-025/answer-key/", "answer_key_delivery": "SEPARATE_NOINDEX_NOARCHIVE_CHECKING_PAGE" }, "tutorial_mode": "BOUNDED_PRACTICAL_LESSON", "orientation": { "bounded_definition": "Capability to develop or express active range of motion in a declared context without inheriting broader claims.", "evidence_summary": "Active range is the motion a person can produce and control themselves. It can change, but gains are joint-specific and not guaranteed to improve real-life function.", "measurement_boundary": "Degrees of active motion establish range in the tested setup; they do not establish tissue health, pain relief, movement quality or whole-body mobility.", "myth_to_metric": { "myth": "Become infinitely flexible", "metric": "Joint-specific active degrees plus a declared task", "boundary": "Range alone cannot show control, comfort, safety or function." }, "limiting_findings": [ "Six weeks of daily calf stretching did not improve active ankle dorsiflexion in the cited trial." ], "prohibited_claims": [ "Unlock every joint", "Permanent flexibility", "Pain means the tissue is opening", "More range is always superior" ] }, "outcomes": [ "Define active range of motion without inheriting mythology or broader claims.", "Explain what the current evidence supports and what it does not establish.", "Use the declared measurement boundary and recognise misleading proxies.", "Complete only the separately governed capability practice inside its declared limits.", "Make a retention, transfer, maintenance, provider or stop decision without overclaiming." ], "prerequisites": "DECLARED_IN_GOVERNED_LESSON", "baseline": { "instruction": "Complete the baseline declared by the governed lesson before practice; keep it separate from the knowledge baseline.", "record": [ "date and context", "current definition", "confidence from 0 to 100", "assumed measure", "expected benefit", "known limitation", "intended next action" ] }, "modules": [ { "order": 1, "title": "Check the boundary", "instruction": "Read the evidence, risk framing, prerequisites and stopping rules before attempting anything.", "completion_evidence": "Record the decision or output from check the boundary in one or two sentences." }, { "order": 2, "title": "Declare the baseline", "instruction": "Use only the task and measurement contract specified by the governed lesson.", "completion_evidence": "Record the decision or output from declare the baseline in one or two sentences." }, { "order": 3, "title": "Complete the bounded practice", "instruction": "Follow the ordered steps without hidden progression or improvised intensity.", "completion_evidence": "Record the decision or output from complete the bounded practice in one or two sentences." }, { "order": 4, "title": "Retest separately", "instruction": "Keep direct performance, delayed retention and transfer as different questions.", "completion_evidence": "Record the decision or output from retest separately in one or two sentences." }, { "order": 5, "title": "Review", "instruction": "Continue, adapt, seek support or stop according to the lesson's declared decision rules.", "completion_evidence": "Record the decision or output from review in one or two sentences." } ], "lab": { "title": "Governed capability lab", "instruction": "Open the separately governed practical lesson and complete only its declared configuration, dose, measurement, accessibility and stopping rules.", "deliverable": "The lesson's declared baseline, practice and retest record; no additional exercise is implied here." }, "assessment": { "immediate": "Restate the bounded definition, evidence ceiling, measurement boundary and current authority route without looking.", "delayed_retention": "Repeat the explanation and route decision after at least 48 hours; record what changed or was forgotten.", "transfer": "Use only the lesson's predeclared transfer task; do not infer far transfer from the trained task.", "interpretation": "Completion demonstrates learning of this tutorial only. It does not prove capability, qualification, independent validation, safety clearance or far transfer." }, "maintenance": { "cadence": "Review after 48 hours, again after 2-4 weeks, and whenever the evidence or authority treatment changes.", "decisions": [ "retain", "refresh", "seek qualified support", "return to research", "retire" ] }, "accessibility": "Use text-to-speech, enlarged text, keyboard navigation, shorter sessions, a support person or an equivalent non-practical record format as needed. Accessibility changes must not enlarge practical authority.", "stopping_and_escalation": "A governed exercise is available only in the declared configuration, dose and stopping rules. Stop if the declared configuration cannot be maintained, uncertainty becomes material, adverse effects appear, or qualified authority is required.", "next_gate": "No external confirmation is required for the current bounded explainer and non-prescriptive guide-frame permissions; any stronger efficacy, generalisation, protocol, promotion or independent-validation claim requires a new adjudication.", "evidence_count": 2 }, "full_training_programme": false, "independently_validated": false, "publication_state": "PUBLISHED_PUBLIC_RESEARCH_EDITION__EDITORIAL_REVIEW_PENDING", "related_power_ids": [ "PWR-026", "PWR-027", "PWR-028", "PWR-029" ] }, { "power_id": "PWR-026", "learning_unit_id": "TLU-PWR-026", "title": "End-range control", "main_description": "This is a static, no-movement worksheet. It teaches the difference between arriving at a declared angle and controlling an already-recorded task there. All angles, cursor samples and support configurations are fictional. Do not copy a position, test a joint, hold an end range, remove support, add load or use pain as data. This supplement deliberately uses the governed lesson’s no-attempt record route; it neither replaces nor expands the separately declared bounded configuration. The worksheet score checks calculations and boundary reasoning; it does not score a body. Angle-specific improvement can be described only inside the same device and support configuration. It cannot establish tissue integrity, joint safety, whole-range control or injury prevention.", "main_description_source": "GOVERNED_TUTORIAL_PLAIN_ENGLISH_INTRO", "family_id": "FAM-04", "family": "Mobility, Balance & Locomotion", "superdomain": "Body & Performance", "canonical_route": "/powers/pwr-026/", "treatment": "BOUNDED_GUIDED_LESSON", "treatment_label": "Bounded guided lesson", "treatment_boundary": "A governed exercise is available only in the declared configuration, dose and stopping rules.", "tutorial_route": "/tutorials/pwr-026/", "governed_lesson_route": "/tutorials/pwr-026/", "self_attempt_status": "PERMITTED_ONLY_INSIDE_DECLARED_BOUNDARY", "gold_pathway_ids": [ "G-CUR-003" ], "route_membership": { "kind": "GOLD_PATHWAY", "id": "G-CUR-003", "coverage_status": "EXACT_ONCE" }, "source_authority_tier": "G2", "source_build_state": "COMPREHENSIVE_OWNER_CANDIDATE", "source_instructional_route": "BOUNDED_GUIDED_EXERCISE", "source_count": 2, "research_depth": "FOCUSED", "risk_level": "MODERATE", "prerequisite_status": "DECLARED_IN_GOVERNED_LESSON", "learning_route": { "mode": "BOUNDED_PRACTICAL_LESSON", "label": "Learn inside the bounded governed lesson", "summary": "This is a static, no-movement worksheet. It teaches the difference between arriving at a declared angle and controlling an already-recorded task there. All angles, cursor samples and support configurations are fictional. Do not copy a position, test a joint, hold an end range, remove support, add load or use pain as data. This supplement deliberately uses the governed lesson’s no-attempt record route; it neither replaces nor expands the separately declared bounded configuration. The worksheet score checks calculations and boundary reasoning; it does not score a body. Angle-specific improvement can be described only inside the same device and support configuration. It cannot establish tissue integrity, joint safety, whole-range control or injury prevention.", "steps": [ [ "Check the boundary", "Read the evidence, risk framing, prerequisites and stopping rules before attempting anything." ], [ "Declare the baseline", "Use only the task and measurement contract specified by the governed lesson." ], [ "Complete the bounded practice", "Follow the ordered steps without hidden progression or improvised intensity." ], [ "Retest separately", "Keep direct performance, delayed retention and transfer as different questions." ], [ "Review", "Continue, adapt, seek support or stop according to the lesson's declared decision rules." ] ], "practical_authority": true, "provider_required": false, "next_action_route": "/tutorials/pwr-026/" }, "path_builder": { "selectable": true, "completion_allowed": true, "warning": "A governed exercise is available only in the declared configuration, dose and stopping rules." }, "full_tutorial": { "version": "1.0", "authorship": "AUTHORED_GOVERNED_SOURCE", "practice_pack": { "power_id": "PWR-026", "title": "End-range control", "heading": "Read angle-specific control from fictional device records without moving", "plain_english_intro": "This is a static, no-movement worksheet. It teaches the difference between arriving at a declared angle and controlling an already-recorded task there. All angles, cursor samples and support configurations are fictional. Do not copy a position, test a joint, hold an end range, remove support, add load or use pain as data. This supplement deliberately uses the governed lesson’s no-attempt record route; it neither replaces nor expands the separately declared bounded configuration. The worksheet score checks calculations and boundary reasoning; it does not score a body. Angle-specific improvement can be described only inside the same device and support configuration. It cannot establish tissue integrity, joint safety, whole-range control or injury prevention.", "authority_and_safety": [ "Use only the bounded configuration. Use words, a diagram, or a movement already approved and comfortable. Do not add a hold, resistance, load or new end-range attempt.", "Stop if the frame is being turned into an end-range hold, loaded position, pain test or joint challenge.", "Stop if the reader feels pressure to remove support or exceed a comfortable, clinician-approved boundary." ], "materials": [ "The four fictional device records in the fixture table; no person, joint movement, goniometer or physical demonstration is required.", "Formula card: arrival error = absolute value of observed angle minus target angle; mean absolute error from target = sum of the absolute cursor deviations divided by five; an in-band sample is any cursor deviation from -1 degree through +1 degree, inclusive.", "Calculation sheet with four labelled rows E1–E4 and columns for arrival error, five absolute deviations, deviation sum, mean absolute error from target, in-band count, valid comparison and bounded conclusion.", "Boundary card: STATIC RECORDS ONLY; supports stay in the configuration; no target angle, stretch, hold, repetition, duration, load, progression, pain test or safety claim.", "Calculator, optional, and the answer key kept hidden until all four rows are classified." ], "setup_steps": [ "Write STATIC/NO MOVEMENT at the top of the calculation sheet and copy the in-band rule exactly: deviations from -1 degree through +1 degree count; -2 and +2 do not.", "Copy each target angle, observed arrival angle, support code and five cursor deviations without changing signs or dropping zeroes.", "Calculate arrival error first, then convert every cursor sample to its absolute value before calculating the mean absolute error from target.", "Count in-band samples separately from the mean. Do not call a zero arrival error stable until the five-sample record is checked.", "Permit a direct performance comparison only when target angle, device and support code match. Otherwise describe each record separately.", "Finish each row with one supported statement and one explicit non-claim about untested angles, supports or tissue safety." ], "fixture": { "caption": "Fictional angle-control device records; cursor deviations are already recorded and request no movement", "headers": [ "Case", "Target angle", "Observed arrival", "Device and support", "Five cursor deviations from target", "Context note" ], "rows": [ [ "E1", "120 degrees", "118 degrees", "Device Q7; forearm cradle C1", "-2, -1, +1, +2, +1 degrees", "Baseline at the declared 120-degree configuration" ], [ "E2", "120 degrees", "120 degrees", "Device Q7; forearm cradle C1", "0, +1, 0, -1, 0 degrees", "Later record in the same declared configuration" ], [ "E3", "90 degrees", "90 degrees", "Device Q7; forearm cradle C1", "0, +3, -2, +3, -2 degrees", "Different angle; no whole-range inference is permitted" ], [ "E4", "120 degrees", "120 degrees", "Device Q7; no forearm cradle", "0, +2, -3, +4, -2 degrees", "Support changed; not like-for-like with E1 or E2" ] ] }, "scoring_rule": "Score the worksheet, never the person. For each case award 1 point for correct arrival error, 1 for the correct mean absolute error from target, 1 for the correct in-band count and 1 for a configuration-bounded interpretation: 16 points total. Passing requires at least 14 points, the E1–E2 comparison identified as the only direct comparison, and E3/E4 not treated as transfer evidence. Any instruction to copy a position, stretch, hold, load, remove support, test pain or progress receives STOP rather than a score.", "worked_example": { "steps": [ "For E1, compute arrival error: |118 - 120| = 2 degrees.", "Remove signs from the five deviations: 2, 1, 1, 2 and 1 degrees.", "Add them: 2 + 1 + 1 + 2 + 1 = 7 degrees; divide by five to obtain 1.4 degrees mean absolute error from target.", "Apply the inclusive -1-to-+1 band: -1, +1 and +1 count, while -2 and +2 do not, giving three of five.", "Write the bounded result: E1 shows imperfect arrival and variable five-sample control at 120 degrees on Device Q7 with cradle C1." ], "result": "E1 earns 4/4 when reported as 2-degree arrival error, 1.4-degree mean absolute error from target, 3/5 in-band samples and a configuration-specific conclusion. It says nothing about another angle, unsupported control, tissue safety or a movement prescription." }, "right_vs_wrong": [ { "situation": "Reading E3", "right": "Report zero arrival error and 2.0-degree mean absolute error from target at the separate 90-degree record.", "wrong": "Call E3 stable because the observed arrival equals the target.", "why": "Arrival and sustained accuracy answer different questions." }, { "situation": "Comparing E1 and E2", "right": "Compare them because angle, device and cradle match, then name all three improved metrics.", "wrong": "Say E2 proves whole-range joint control.", "why": "The records cover one angle and one support configuration only." }, { "situation": "Reading E4", "right": "Preserve the no-cradle configuration and report it separately.", "wrong": "Treat support as cheating and rank E4 directly against E2.", "why": "Support is part of what was measured, not a moral attribute." }, { "situation": "Using the worksheet", "right": "Calculate from supplied records while remaining still or using text-to-speech.", "wrong": "Try the pictured angle to make the numbers feel meaningful.", "why": "This supplied exercise deliberately uses the lesson’s no-attempt route and authorises no movement or joint challenge." }, { "situation": "Making a safety claim", "right": "State that device accuracy does not establish tissue integrity or injury prevention.", "wrong": "Call five in-band samples proof of a bulletproof joint.", "why": "Performance at one recorded angle cannot certify tissue safety." } ], "common_mistakes": [ { "mistake": "Signed deviations are averaged and cancel to a deceptively small value.", "fix": "Take the absolute value of every sample before adding and dividing by five." }, { "mistake": "Zero arrival error is used as the entire control score.", "fix": "Calculate mean absolute error from target and in-band count from all five samples." }, { "mistake": "E2 and E4 are ranked without recording support.", "fix": "Mark support mismatch and keep the no-cradle record separate." }, { "mistake": "A strong 120-degree result is generalized to the 90-degree row.", "fix": "Apply the angle-specific boundary and report E3 on its own terms." }, { "mistake": "The learner attempts an end-range position to fill an imagined missing input.", "fix": "Use only the complete fictional table; choose no attempt and stop if the worksheet is becoming physical." } ], "answer_key_route": "/tutorials/pwr-026/answer-key/", "answer_key_delivery": "SEPARATE_NOINDEX_NOARCHIVE_CHECKING_PAGE" }, "tutorial_mode": "BOUNDED_PRACTICAL_LESSON", "orientation": { "bounded_definition": "Capability to develop or express end-range control in a declared context without inheriting broader claims.", "evidence_summary": "End-range control is not just reaching a position; it is producing stable, accurate action there. Training effects are real but highly specific.", "measurement_boundary": "Angle-specific torque or task accuracy measures tested capacity in that position, not tissue integrity or safety in every movement.", "myth_to_metric": { "myth": "Own impossible joint angles", "metric": "Accuracy and force at a declared angle", "boundary": "One-angle strength cannot prove whole-range control or tissue safety." }, "limiting_findings": [ "Isometric strength gains were limited to the trained and adjacent angles." ], "prohibited_claims": [ "Bulletproof joints", "Own every range", "Loaded stretching repairs injuries", "End range prevents all injury" ] }, "outcomes": [ "Define end-range control without inheriting mythology or broader claims.", "Explain what the current evidence supports and what it does not establish.", "Use the declared measurement boundary and recognise misleading proxies.", "Complete only the separately governed capability practice inside its declared limits.", "Make a retention, transfer, maintenance, provider or stop decision without overclaiming." ], "prerequisites": "DECLARED_IN_GOVERNED_LESSON", "baseline": { "instruction": "Complete the baseline declared by the governed lesson before practice; keep it separate from the knowledge baseline.", "record": [ "date and context", "current definition", "confidence from 0 to 100", "assumed measure", "expected benefit", "known limitation", "intended next action" ] }, "modules": [ { "order": 1, "title": "Check the boundary", "instruction": "Read the evidence, risk framing, prerequisites and stopping rules before attempting anything.", "completion_evidence": "Record the decision or output from check the boundary in one or two sentences." }, { "order": 2, "title": "Declare the baseline", "instruction": "Use only the task and measurement contract specified by the governed lesson.", "completion_evidence": "Record the decision or output from declare the baseline in one or two sentences." }, { "order": 3, "title": "Complete the bounded practice", "instruction": "Follow the ordered steps without hidden progression or improvised intensity.", "completion_evidence": "Record the decision or output from complete the bounded practice in one or two sentences." }, { "order": 4, "title": "Retest separately", "instruction": "Keep direct performance, delayed retention and transfer as different questions.", "completion_evidence": "Record the decision or output from retest separately in one or two sentences." }, { "order": 5, "title": "Review", "instruction": "Continue, adapt, seek support or stop according to the lesson's declared decision rules.", "completion_evidence": "Record the decision or output from review in one or two sentences." } ], "lab": { "title": "Governed capability lab", "instruction": "Open the separately governed practical lesson and complete only its declared configuration, dose, measurement, accessibility and stopping rules.", "deliverable": "The lesson's declared baseline, practice and retest record; no additional exercise is implied here." }, "assessment": { "immediate": "Restate the bounded definition, evidence ceiling, measurement boundary and current authority route without looking.", "delayed_retention": "Repeat the explanation and route decision after at least 48 hours; record what changed or was forgotten.", "transfer": "Use only the lesson's predeclared transfer task; do not infer far transfer from the trained task.", "interpretation": "Completion demonstrates learning of this tutorial only. It does not prove capability, qualification, independent validation, safety clearance or far transfer." }, "maintenance": { "cadence": "Review after 48 hours, again after 2-4 weeks, and whenever the evidence or authority treatment changes.", "decisions": [ "retain", "refresh", "seek qualified support", "return to research", "retire" ] }, "accessibility": "Use text-to-speech, enlarged text, keyboard navigation, shorter sessions, a support person or an equivalent non-practical record format as needed. Accessibility changes must not enlarge practical authority.", "stopping_and_escalation": "A governed exercise is available only in the declared configuration, dose and stopping rules. Stop if the declared configuration cannot be maintained, uncertainty becomes material, adverse effects appear, or qualified authority is required.", "next_gate": "No external confirmation is required for the current bounded explainer and non-prescriptive guide-frame permissions; any stronger efficacy, generalisation, protocol, promotion or independent-validation claim requires a new adjudication.", "evidence_count": 2 }, "full_training_programme": false, "independently_validated": false, "publication_state": "PUBLISHED_PUBLIC_RESEARCH_EDITION__EDITORIAL_REVIEW_PENDING", "related_power_ids": [ "PWR-025", "PWR-027", "PWR-028", "PWR-029" ] }, { "power_id": "PWR-027", "learning_unit_id": "TLU-PWR-027", "title": "Static balance", "main_description": "This tutorial teaches one supported static-balance practice. The learner follows the movement and recovery cues. A qualified clinician decides whether practice happens, then chooses the stance, hand support, guarding, maximum hold time, number of attempts and stopping rules. Do not copy the practice alone or remove support to make it harder.", "main_description_source": "GOVERNED_TUTORIAL_PLAIN_ENGLISH_INTRO", "family_id": "FAM-04", "family": "Mobility, Balance & Locomotion", "superdomain": "Body & Performance", "canonical_route": "/powers/pwr-027/", "treatment": "QUALIFIED_SUPERVISION_LESSON", "treatment_label": "Qualified-supervision lesson", "treatment_boundary": "The lesson is actionable only with the declared qualified supervision.", "tutorial_route": "/tutorials/pwr-027/", "governed_lesson_route": "/tutorials/pwr-027/", "self_attempt_status": "PROHIBITED_WITHOUT_QUALIFIED_SUPERVISION", "gold_pathway_ids": [ "G-CUR-003" ], "route_membership": { "kind": "GOLD_PATHWAY", "id": "G-CUR-003", "coverage_status": "EXACT_ONCE" }, "source_authority_tier": "G3", "source_build_state": "COMPREHENSIVE_OWNER_CANDIDATE", "source_instructional_route": "QUALIFIED_SUPERVISION_TUTORIAL", "source_count": 3, "research_depth": "FOCUSED", "risk_level": "MODERATE", "prerequisite_status": "QUALIFIED_PROVIDER_DETERMINES", "learning_route": { "mode": "SUPERVISED_PRACTICAL_LESSON", "label": "Prepare for qualified-supervision learning", "summary": "This tutorial teaches one supported static-balance practice. The learner follows the movement and recovery cues. A qualified clinician decides whether practice happens, then chooses the stance, hand support, guarding, maximum hold time, number of attempts and stopping rules. Do not copy the practice alone or remove support to make it harder.", "steps": [ [ "Read the evidence boundary", "Understand what the capability and its measures can and cannot establish." ], [ "Identify the required qualification", "Use the lesson's supervision requirement to select an appropriate provider." ], [ "Prepare the handoff", "Bring goals, relevant context, accessibility needs and the Titan measurement boundary." ], [ "Practise only under supervision", "Do not convert the published lesson into independent self-training." ], [ "Record the declared outcome", "Track only the provider-controlled task, retention, transfer and stopping decisions." ] ], "practical_authority": true, "provider_required": true, "next_action_route": "/tutorials/pwr-027/" }, "path_builder": { "selectable": true, "completion_allowed": true, "warning": "The lesson is actionable only with the declared qualified supervision." }, "full_tutorial": { "version": "1.0", "authorship": "AUTHORED_GOVERNED_SOURCE", "practice_pack": { "power_id": "PWR-027", "title": "Static balance", "heading": "Learn the provider-supervised static-balance method: set, hold and recover", "plain_english_intro": "This tutorial teaches one supported static-balance practice. The learner follows the movement and recovery cues. A qualified clinician decides whether practice happens, then chooses the stance, hand support, guarding, maximum hold time, number of attempts and stopping rules. Do not copy the practice alone or remove support to make it harder.", "authority_and_safety": [ "A qualified clinician must review falls, near-falls, dizziness, pain, fatigue, medicines, usual aids and the real-world goal before any standing practice.", "Use the learner's usual footwear and aid unless the clinician changes them. Keep a fixed rail or clinician-approved support within reach and use close guarding.", "Stop for dizziness, pain, new weakness or numbness, blurred vision, nausea, unusual breathlessness, a step, an unplanned hand movement, loss of position, the learner's request or the clinician's stop cue.", "No independent practice, eyes-closed stance, narrowed or one-leg stance, unstable surface, support removal or self-chosen progression is authorised." ], "materials": [ "A qualified clinician who can assess balance and provide close guarding", "A dry, level floor, fixed support and stable chair for immediate recovery", "The learner's usual footwear, mobility aid, orthosis or prosthesis", "A large visual target and a record for setup, stop event, symptoms and next decision" ], "setup_steps": [ "Get permission first. The clinician writes PRACTISE or NO ATTEMPT. A no-attempt decision ends the physical lesson.", "Before standing, write the exact foot position, footwear, aid, hand support, target, guarding, maximum hold time, maximum attempts and stop events.", "Place the support where the declared hand can reach it without leaning. Place the chair so the learner can sit without turning or walking.", "Stand only on the clinician's cue. Use the written foot and hand positions, look at the target and do not remove support.", "Feel both feet, keep the knees comfortable rather than locked, stay tall without stiffening and breathe normally. Hold until the clinician says stop or a stop event occurs.", "At the first loss of position, grip the support, step if needed and sit when directed. Safe recovery is correct, not failure.", "Sit, report symptoms and record what ended the attempt. Repeat or change the task only after a fresh clinician decision." ], "fixture": { "caption": "Complete during one clinician-controlled practice. The clinician fills every control field before standing.", "headers": [ "Phase", "Learner action", "Pass check" ], "rows": [ [ "Permission", "Wait for PRACTISE or NO ATTEMPT", "Named clinician and decision recorded" ], [ "Set", "Copy the written stance, aid, support and target", "Support reachable; chair ready" ], [ "Hold", "Feel both feet, look ahead, breathe and keep support unchanged", "First stop event recognised" ], [ "Recover", "Grip, step or sit as soon as needed", "No attempt to hide loss of balance" ], [ "Review", "Sit and report symptoms and the ending event", "Support, event and next decision recorded" ] ] }, "scoring_rule": "Award 1 point for each fixture phase: 5 points total. All phases and the stop rule must pass. A clinician-declared NO ATTEMPT also counts as correct completion. This is a tutorial check, not a balance or fall-risk score.", "worked_example": { "steps": [ "After reviewing two recent near-falls, the physiotherapist authorises one supported practice.", "The physiotherapist writes: usual shoes, comfortable parallel stance, left hand on a fixed rail, large wall target, close guarding, chair behind, a provider-selected maximum time and stop on any step, second-hand contact, symptom, request or cue.", "The learner copies the setup, feels both feet, looks at the target and breathes normally without lifting the hand.", "When the right foot starts to move, the learner grips the rail, takes the needed step and sits on cue.", "The learner reports no symptom and records the step. The clinician keeps the current support rather than progressing it." ], "result": "The set-hold-recover method was completed correctly because the setup stayed unchanged and recovery began at the first stop event. This does not prove independent standing safety or authorise home progression." }, "right_vs_wrong": [ { "situation": "Starting", "right": "Wait for the clinician and copy the written setup.", "wrong": "Stand early or copy a stance from the example.", "why": "The safe setup is person- and context-specific." }, { "situation": "Holding", "right": "Feel both feet, look ahead and breathe normally.", "wrong": "Lock the knees, hold the breath and freeze.", "why": "Small sway is normal; stiffening is not better balance." }, { "situation": "Support", "right": "Keep the selected hand support and aid.", "wrong": "Remove support to improve the time.", "why": "That changes the task and may increase risk." }, { "situation": "Recovery", "right": "Grip, step or sit at the first stop event.", "wrong": "Fight to stay up for a longer score.", "why": "Early recovery protects the learner." } ], "common_mistakes": [ { "mistake": "Standing before support, chair and stop rules are ready.", "fix": "Sit and complete every setup field first." }, { "mistake": "A foot or hand moves without being recorded.", "fix": "End the attempt and record the first unplanned change." }, { "mistake": "Using the rail is treated as cheating.", "fix": "Keep and record support as part of the task." }, { "mistake": "A good attempt triggers a harder stance.", "fix": "Keep the setup and wait for the clinician's next decision." } ], "answer_key_route": "/tutorials/pwr-027/answer-key/", "answer_key_delivery": "SEPARATE_NOINDEX_NOARCHIVE_CHECKING_PAGE" }, "tutorial_mode": "SUPERVISED_PRACTICAL_LESSON", "orientation": { "bounded_definition": "Capability to develop or express static balance in a declared context without inheriting broader claims.", "evidence_summary": "Balance is many tasks, not one trait. You can improve a practiced stance, while a different surface or movement may remain unchanged.", "measurement_boundary": "Time, sway or errors in a specified stance establish task performance only, not universal balance or fall immunity.", "myth_to_metric": { "myth": "Become unshakeable", "metric": "Errors or sway in one declared stance", "boundary": "One stance cannot establish stability everywhere." }, "limiting_findings": [ "Six weeks of varied balance or power training did not improve two untrained balance tasks." ], "prohibited_claims": [ "Perfect balance", "Never fall again", "One-leg stance predicts all mobility", "Balance boards make anyone stable" ] }, "outcomes": [ "Define static balance without inheriting mythology or broader claims.", "Explain what the current evidence supports and what it does not establish.", "Use the declared measurement boundary and recognise misleading proxies.", "Complete only the separately governed capability practice inside its declared limits.", "Make a retention, transfer, maintenance, provider or stop decision without overclaiming." ], "prerequisites": "QUALIFIED_PROVIDER_DETERMINES", "baseline": { "instruction": "Complete the baseline declared by the governed lesson before practice; keep it separate from the knowledge baseline.", "record": [ "date and context", "current definition", "confidence from 0 to 100", "assumed measure", "expected benefit", "known limitation", "intended next action" ] }, "modules": [ { "order": 1, "title": "Read the evidence boundary", "instruction": "Understand what the capability and its measures can and cannot establish.", "completion_evidence": "Record the decision or output from read the evidence boundary in one or two sentences." }, { "order": 2, "title": "Identify the required qualification", "instruction": "Use the lesson's supervision requirement to select an appropriate provider.", "completion_evidence": "Record the decision or output from identify the required qualification in one or two sentences." }, { "order": 3, "title": "Prepare the handoff", "instruction": "Bring goals, relevant context, accessibility needs and the Titan measurement boundary.", "completion_evidence": "Record the decision or output from prepare the handoff in one or two sentences." }, { "order": 4, "title": "Practise only under supervision", "instruction": "Do not convert the published lesson into independent self-training.", "completion_evidence": "Record the decision or output from practise only under supervision in one or two sentences." }, { "order": 5, "title": "Record the declared outcome", "instruction": "Track only the provider-controlled task, retention, transfer and stopping decisions.", "completion_evidence": "Record the decision or output from record the declared outcome in one or two sentences." } ], "lab": { "title": "Governed capability lab", "instruction": "Open the separately governed practical lesson and complete only its declared configuration, dose, measurement, accessibility and stopping rules.", "deliverable": "The lesson's declared baseline, practice and retest record; no additional exercise is implied here." }, "assessment": { "immediate": "Restate the bounded definition, evidence ceiling, measurement boundary and current authority route without looking.", "delayed_retention": "Repeat the explanation and route decision after at least 48 hours; record what changed or was forgotten.", "transfer": "Use only the lesson's predeclared transfer task; do not infer far transfer from the trained task.", "interpretation": "Completion demonstrates learning of this tutorial only. It does not prove capability, qualification, independent validation, safety clearance or far transfer." }, "maintenance": { "cadence": "Review after 48 hours, again after 2-4 weeks, and whenever the evidence or authority treatment changes.", "decisions": [ "retain", "refresh", "seek qualified support", "return to research", "retire" ] }, "accessibility": "Use text-to-speech, enlarged text, keyboard navigation, shorter sessions, a support person or an equivalent non-practical record format as needed. Accessibility changes must not enlarge practical authority.", "stopping_and_escalation": "The lesson is actionable only with the declared qualified supervision. Stop if the declared configuration cannot be maintained, uncertainty becomes material, adverse effects appear, or qualified authority is required.", "next_gate": "No external confirmation is required for the current bounded explainer and non-prescriptive guide-frame permissions; any stronger efficacy, generalisation, protocol, promotion or independent-validation claim requires a new adjudication.", "evidence_count": 3 }, "full_training_programme": false, "independently_validated": false, "publication_state": "PUBLISHED_PUBLIC_RESEARCH_EDITION__EDITORIAL_REVIEW_PENDING", "related_power_ids": [ "PWR-025", "PWR-026", "PWR-028", "PWR-029" ] }, { "power_id": "PWR-028", "learning_unit_id": "TLU-PWR-028", "title": "Reactive balance", "main_description": "The learner completes a provider-set series of protected perturbations and records recovery steps, harness catches, rail use and symptoms for each trial.", "main_description_source": "FULL_TUTORIAL_OUTCOME", "family_id": "FAM-04", "family": "Mobility, Balance & Locomotion", "superdomain": "Body & Performance", "canonical_route": "/powers/pwr-028/", "treatment": "SPECIALIST_PROVIDER_ROUTE", "treatment_label": "Full supervised tutorial", "treatment_boundary": "Titan teaches the complete method; a qualified person controls the parts that require supervision, clearance, specialist equipment, load, dose or progression.", "tutorial_route": "/tutorials/pwr-028/", "governed_lesson_route": null, "self_attempt_status": "PROHIBITED_WITHOUT_QUALIFIED_SUPERVISION", "gold_pathway_ids": [ "G-CUR-003" ], "route_membership": { "kind": "GOLD_PATHWAY", "id": "G-CUR-003", "coverage_status": "EXACT_ONCE" }, "source_authority_tier": "G4", "source_build_state": "EXTERNAL_PROVIDER_ROUTE", "source_instructional_route": "LEARN_ELSEWHERE_TRACK_WITH_TITAN", "source_count": 2, "research_depth": "FOCUSED", "risk_level": "HIGH", "prerequisite_status": "QUALIFIED_PROVIDER_DETERMINES", "learning_route": { "mode": "FULL_SUPERVISED_TUTORIAL", "label": "Learn reactive balance step by step", "summary": "The learner completes a provider-set series of protected perturbations and records recovery steps, harness catches, rail use and symptoms for each trial.", "steps": [ [ "Get ready", "Confirm the harness supports body weight without contacting the learner during ordinary standing." ], [ "Learn the method", "7 concrete steps teach the permitted method from start to finish." ], [ "See right and wrong", "5 comparisons show correct or safer execution beside common wrong or riskier choices." ], [ "Practise", "Only the qualified balance team selects perturbation direction, magnitude, unpredictability, trials and sessions. Progress one dimension at a time; home trips, shoves and slips are never assigned." ], [ "Check progress", "Record device, stance, aid, direction, magnitude, timing, steps, rail use, harness loading, provider contact, symptoms and follow-up falls." ] ], "practical_authority": false, "provider_required": true, "next_action_route": "/tutorials/pwr-028/" }, "path_builder": { "selectable": true, "completion_allowed": true, "warning": "Titan teaches the complete method; a qualified person controls the parts that require supervision, clearance, specialist equipment, load, dose or progression." }, "full_tutorial": { "version": "3.0", "authorship": "POWER_SPECIFIC_FULL_TUTORIAL", "tutorial_mode": "SUPERVISED", "promise": "Reactive balance is the response after support or body position changes unexpectedly. This lesson teaches a protected laboratory method: stand in a provider-fitted harness, keep a natural ready stance, allow a small platform or treadmill perturbation, take one or more recovery steps toward the direction of the loss, regain a stable base and report whether the harness, rails or provider had to catch body weight. The provider controls eligibility, harness, perturbation size/direction, trial count and progression.", "power_id": "PWR-028", "title": "Reactive balance", "lesson_type": "SUPERVISED", "headline": "Recover from a protected perturbation with a step, not a fall drill", "plain_english_summary": "Reactive balance is the response after support or body position changes unexpectedly. This lesson teaches a protected laboratory method: stand in a provider-fitted harness, keep a natural ready stance, allow a small platform or treadmill perturbation, take one or more recovery steps toward the direction of the loss, regain a stable base and report whether the harness, rails or provider had to catch body weight. The provider controls eligibility, harness, perturbation size/direction, trial count and progression.", "outcome": "The learner completes a provider-set series of protected perturbations and records recovery steps, harness catches, rail use and symptoms for each trial.", "authority": { "learner_may": [ "Reactive balance: Let the provider fit the harness, clear straps from the neck and test the support over the platform before any disturbance. Stand on the marked feet with the usual footwear and authorised aid configuration, arms relaxed and gaze at the fixed target.", "During an authorised attempt, If balance moves beyond the feet, take a quick step in that direction and use additional steps as needed; do not cross the legs unless that is the taught response. State whether you used a rail, the harness took weight or the provider touched you. Do not hide assistance to make the trial look successful.", "Confirm that the fitted harness catches a controlled weight shift without pain or obstruction, and record perturbation setting, recovery steps, rail use and reset for every trial." ], "qualified_person_required_for": [ "Evaluate fall risk, vestibular and neurological status, weight-bearing tolerance and harness suitability before permitting a reactive-balance perturbation.", "Fit and test the harness, select perturbation device/direction/magnitude/timing, guard the learner, set trials/rest and decide progression or referral.", "Load-test the harness and attachment, vary perturbation timing enough to prevent rehearsal of a fixed sequence, guard the recovery space and review every catch or rail contact before continuing." ], "never_do": [ "Create a trip, shove, slip or surprise disturbance at home, or practise fall recovery without a qualified team and protected system.", "Do not practise unprotected falls, increase perturbation size or remove the harness because early protected trials appeared easy.", "End testing after a harness catch, fall-like event, rail dependence, unsafe crossing step, pain, dizziness or failure to regain a stable base." ] }, "materials": [ "Certified overhead safety harness and provider-checked attachment", "Calibrated perturbation treadmill or platform with emergency stop", "Guard rails positioned as declared", "Video or trial sheet for step, catch, rail and symptom scoring", "A protected-balance log for harness fit and test, perturbation direction and magnitude, timing, recovery steps, rail contact, catches, assistance, symptoms and reset." ], "before_you_start": [ "Confirm the harness supports body weight without contacting the learner during ordinary standing.", "Practise the stop signal, emergency stop and safe return to the platform.", "Report falls, faintness, vestibular symptoms, pain, fear, neurological change and any condition affecting safe stepping.", "Fit and load-test the harness according to its instructions, then practise one guarded weight shift. Proceed only if the system catches the shift without strap pain, breathing obstruction or unsafe slack.", "Practise the natural ready stance, one supported weight shift and the instruction to respond rather than guess before unpredictable trials begin." ], "steps": [ { "title": "Fit and test protection", "instruction": "Let the provider fit the harness, clear straps from the neck and test the support over the platform before any disturbance.", "reason": "A harness is protection only when fitted and attached correctly.", "success_check": "The attachment catches a controlled weight shift without strap pain or obstruction." }, { "title": "Set a natural ready stance", "instruction": "Stand on the marked feet with the usual footwear and authorised aid configuration, arms relaxed and gaze at the fixed target.", "reason": "A repeatable stance changes the available recovery step.", "success_check": "Feet, aid, gaze and rail rule match the trial card." }, { "title": "Respond rather than predict", "instruction": "Wait for the provider's signal that a trial may occur, but do not count down or pre-step. Let the small perturbation start before moving.", "reason": "Pre-planning removes the reactive element; this preserves the reactive balance rule for 'Respond rather than predict'.", "success_check": "Video shows no step before platform movement." }, { "title": "Step toward the loss", "instruction": "If balance moves beyond the feet, take a quick step in that direction and use additional steps as needed; do not cross the legs unless that is the taught response.", "reason": "A recovery step enlarges the base under the moving body.", "success_check": "The new foot lands where it supports the displaced body." }, { "title": "Regain a stable base", "instruction": "Bring the other foot to a comfortable stance, steady the trunk and hold for two seconds before the next trial.", "reason": "The response is incomplete until balance is restored.", "success_check": "No continued hopping, rail grab or harness loading occurs during the hold." }, { "title": "Name any assistance", "instruction": "State whether you used a rail, the harness took weight or the provider touched you. Do not hide assistance to make the trial look successful.", "reason": "Assistance changes the outcome and safety interpretation.", "success_check": "Learner and provider agree on the assistance code." }, { "title": "Reset and vary only by plan", "instruction": "Return to the exact foot marks and rest. The provider changes only the predeclared magnitude or direction and stops at the first failed safety rule.", "reason": "Unplanned escalation can exceed stepping capacity.", "success_check": "Every trial has a known setting and full reset." } ], "worked_example": { "scenario": "A balance specialist uses an overhead harness and six low-magnitude treadmill-belt slips: two backward, two forward and two lateral, in a predeclared pseudorandom order.", "walkthrough": [ "The harness is fitted and tested; the learner practises a forward, back and side recovery step without belt movement.", "Trials one to three end with one or two steps and no rail or harness loading.", "Trial four requires a rail touch; it is recorded as assisted, not a failure hidden from the result.", "Trial five produces harness loading, so the provider stops the series and does not deliver trial six.", "The log records direction, magnitude, steps, rail, harness catch, fear and symptoms for every delivered trial." ], "result": "Three unassisted recoveries, one rail-assisted recovery and one harness catch were observed under protected laboratory perturbations. This does not prove fewer community falls or permit home perturbation practice." }, "right_vs_wrong": [ { "situation": "Protection: Reactive balance checkpoint", "right": "Use a tested overhead harness and qualified operator.", "wrong": "Ask someone to trip or shove the learner.", "why": "Improvised disturbance can cause a real fall." }, { "situation": "Timing: Reactive balance checkpoint", "right": "Move after the perturbation begins. It is correct when feet, aid, gaze and rail rule match the trial card.", "wrong": "Pre-step on a countdown; it breaks the 'Set a natural ready stance' execution rule.", "why": "Prediction removes the reactive response. That changes falls or harness catches and recovery-step quality during standardised protected perturbations, with community falls separate. It is no longer the same test." }, { "situation": "Recovery: Reactive balance checkpoint", "right": "Step toward the displacement and rebuild the base.", "wrong": "Freeze with feet fixed while the body leaves the base.", "why": "A step may be needed to catch the centre of mass." }, { "situation": "Assistance: Reactive balance checkpoint", "right": "Record rail, harness and provider contact.", "wrong": "Call the trial independent because the learner did not fall to the floor.", "why": "The safety system may have prevented the fall." }, { "situation": "Progression: Reactive balance checkpoint", "right": "Provider increases one setting only after stable recoveries.", "wrong": "Add larger surprises after a harness catch.", "why": "Failure should trigger review, not escalation." } ], "common_mistakes": [ { "mistake": "Harness slack or attachment is not tested.", "fix": "Test support and clearance before the learner steps onto the active device." }, { "mistake": "The learner anticipates a fixed sequence.", "fix": "Use a provider-controlled unpredictable order within a declared safe set." }, { "mistake": "Feet cross or tangle during lateral recovery.", "fix": "Lower magnitude and rehearse a provider-taught side step before repeating." }, { "mistake": "Rail touches are omitted during 'Step toward the loss' in reactive balance.", "fix": "Use a visible assistance code for every trial." }, { "mistake": "Laboratory recovery is claimed to prevent daily falls.", "fix": "Track community falls separately and retain the trial evidence ceiling." } ], "practice": { "first_session": [ "Provider assesses readiness and fits/tests the harness.", "Practise stepping and stable reset without perturbation.", "Complete one or two fully announced very small familiarisation perturbations.", "Complete a short provider-selected protected series with rest.", "Review step direction, assistance, fear, symptoms and stopping decision." ], "repeat_plan": "Only the qualified balance team selects perturbation direction, magnitude, unpredictability, trials and sessions. Progress one dimension at a time; home trips, shoves and slips are never assigned.", "progress_when": [ "Recovery begins only after the perturbation and steps move toward the displacement.", "Stable base returns without rail, harness or provider support across the declared set.", "Fear and symptoms remain acceptable and any community outcome is tracked separately." ], "do_not_progress_when": [ "A harness catch, fall-like event, rail dependence or unsafe crossing step occurs.", "Dizziness, pain, panic, neurological change or worsening gait appears.", "Harness, device, staffing or emergency procedures cannot be verified." ] }, "self_check": [ "Can you show the stop signal and explain the harness role?", "Did the recovery step begin after the perturbation?", "Were rail, harness and provider contacts recorded?", "Can you explain why protected trial success does not prove fewer community falls?" ], "measurement": { "primary": "Falls or harness catches and recovery-step quality during standardised protected perturbations, with community falls separate", "how": "Record device, stance, aid, direction, magnitude, timing, steps, rail use, harness loading, provider contact, symptoms and follow-up falls.", "good_result": "Across the declared protected set, recoveries become stable with fewer catches/assists and no worse symptoms; community transfer is claimed only if prospectively measured.", "does_not_prove": "It does not prove independent balance everywhere, freedom from falls or permission for unprotected perturbation practice." }, "stop_and_get_help": [ "Stop immediately after a harness catch, fall-like event, head impact, severe fear or inability to regain stable stance.", "Stop for new dizziness, vision change, weakness, numbness, severe pain, chest symptoms or abnormal breathlessness.", "Call off perturbations after a head impact, fall, new vertigo, neurological change or repeated harness catch, and seek the indicated clinical assessment before balance challenge resumes." ], "accessibility": [ "Keep the learner's usual aid when the provider can safely integrate it and treat aid use as part of the configuration.", "Use accessible consent and stop signals; adjust visual target, cue modality and rest without reducing harness protection.", "Use a tactile harness check, stance footprint and agreed verbal or light signal for setup, but keep perturbation direction genuinely unrehearsed and log all assistance." ], "evidence_notes": [ { "claim": "A randomized trial of treadmill perturbation training found no statistically significant reduction in daily-life fall rate, so laboratory improvement must not be treated as community prevention.", "source_title": "Effect of Treadmill Perturbation-Based Balance Training on Fall Rates in Community-Dwelling Older Adults: A Randomized Clinical Trial", "source_url": "https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2803960", "source_kind": "PRIMARY_RESEARCH" }, { "claim": "An earlier trial reported reduced annual fall risk in a specific older-adult programme, showing that transfer claims depend on the exact population and follow-up.", "source_title": "Perturbation training can reduce community-dwelling older adults' annual fall risk: a randomized controlled trial", "source_url": "https://pubmed.ncbi.nlm.nih.gov/24966227/", "source_kind": "PRIMARY_RESEARCH" } ], "limits": [ "Protected perturbation performance is device-, direction- and magnitude-specific.", "A harness catch is an assisted outcome, not an independent recovery.", "No laboratory series guarantees fall prevention in daily life." ], "orientation": { "bounded_definition": "Capability to develop or express reactive balance in a declared context without inheriting broader claims.", "evidence_summary": "People can learn to recover better from controlled slips and trips. That does not make unsupervised perturbation practice safe or prove fewer real-life falls.", "supportable_public_claim": "Protected perturbation training can improve recovery from similar laboratory slips and trips, while real-world fall reduction is uncertain.", "measurement_boundary": "Harness-defined laboratory falls and stability metrics establish response to that perturbation; only prospective community falls can establish real-world transfer.", "myth_to_metric": { "myth": "Train until you cannot be knocked over", "metric": "Falls during standardized protected perturbations plus community follow-up", "boundary": "Laboratory recovery cannot prove real-world fall immunity." }, "limiting_findings": [ "A 2023 randomized trial found no statistically significant reduction in daily-life fall rate or other daily-life fall metrics." ], "prohibited_claims": [ "Fall-proof yourself", "Practice slipping at home", "A harness drill prevents all falls", "One session inoculates anyone" ] }, "gold_source_lesson": { "curriculum_id": "G-CUR-003", "source_heading": "PWR-028 — Reactive balance", "source_html_sha256": "4c35a054e53a0cbb10a3427de0c0bfc8f698d5222f0070c09da78139d2ee7c68", "html": "Specialist route. No perturbation or fall-recovery drill in the bounded non-public self-guided layer.
" }, "next_gate": "External confirmation is required before higher-authority use because: CLINICAL_HIGH_RISK_OR_REGULATED_CONFIGURATION; SUPERVISION_OR_NON_ATTEMPT_BOUNDARY; SAFETY_LEGITIMACY_RESTRICTED.", "evidence_count": 2 }, "full_training_programme": false, "independently_validated": false, "publication_state": "PUBLISHED_PUBLIC_RESEARCH_EDITION__EDITORIAL_REVIEW_PENDING", "related_power_ids": [ "PWR-025", "PWR-026", "PWR-027", "PWR-029" ] }, { "power_id": "PWR-029", "learning_unit_id": "TLU-PWR-029", "title": "Gait efficiency", "main_description": "The learner completes three natural walks on the same familiar route and one matched test of a single benign external change, with time, steps, effort, comfort, stability and aid use recorded.", "main_description_source": "FULL_TUTORIAL_OUTCOME", "family_id": "FAM-04", "family": "Mobility, Balance & Locomotion", "superdomain": "Body & Performance", "canonical_route": "/powers/pwr-029/", "treatment": "EVIDENCE_REVIEW_ROUTE", "treatment_label": "Full low-stakes tutorial", "treatment_boundary": "Titan teaches a concrete low-stakes method step by step while keeping evidence and transfer claims bounded.", "tutorial_route": "/tutorials/pwr-029/", "governed_lesson_route": null, "self_attempt_status": "PERMITTED_INSIDE_FULL_TUTORIAL_LIMITS", "gold_pathway_ids": [ "G-CUR-003" ], "route_membership": { "kind": "GOLD_PATHWAY", "id": "G-CUR-003", "coverage_status": "EXACT_ONCE" }, "source_authority_tier": "G2", "source_build_state": "TARGETED_REVIEW_REQUIRED", "source_instructional_route": "BOUNDED_GUIDED_EXERCISE", "source_count": 2, "research_depth": "FOCUSED", "risk_level": "MODERATE", "prerequisite_status": "NONE_FOR_READING__NO_PRACTICE_AUTHORITY", "learning_route": { "mode": "FULL_SELF_GUIDED_TUTORIAL", "label": "Learn gait efficiency step by step", "summary": "The learner completes three natural walks on the same familiar route and one matched test of a single benign external change, with time, steps, effort, comfort, stability and aid use recorded.", "steps": [ [ "Get ready", "Choose a route already walked safely and clear pets, cables, rugs and movable obstacles." ], [ "Learn the method", "7 concrete steps teach the permitted method from start to finish." ], [ "See right and wrong", "5 comparisons show correct or safer execution beside common wrong or riskier choices." ], [ "Practise", "Repeat the same observation on no more than two comparable days in one week, with two or three natural trials and one single-feature test per session. Stop before fatigue. Retain a change only if the pattern is consistent; seek assessment rather than stacking gait cues." ], [ "Check progress", "Record three natural trials, their range and one single-feature comparison using the same route, supports and comfortable pace." ] ], "practical_authority": true, "provider_required": false, "next_action_route": "/tutorials/pwr-029/" }, "path_builder": { "selectable": true, "completion_allowed": true, "warning": "Titan teaches a concrete low-stakes method step by step while keeping evidence and transfer claims bounded." }, "full_tutorial": { "version": "3.0", "authorship": "POWER_SPECIFIC_FULL_TUTORIAL", "tutorial_mode": "SELF_GUIDED", "promise": "Gait efficiency can refer to energy cost, step pattern, variability, smoothness or usefulness; these are not one score. This lesson teaches a low-risk home observation on a route the learner already walks safely. Record the natural walk first, change only one benign external feature such as where an object is carried or whether the route is cleared, repeat at the same comfortable pace, and keep the change only if the whole task is easier, stable and comfortable. It does not teach a forced foot strike, cadence, symmetry or clinical gait correction.", "power_id": "PWR-029", "title": "Gait efficiency", "lesson_type": "SELF_GUIDED", "headline": "Make one ordinary safe walk easier without forcing a new gait", "plain_english_summary": "Gait efficiency can refer to energy cost, step pattern, variability, smoothness or usefulness; these are not one score. This lesson teaches a low-risk home observation on a route the learner already walks safely. Record the natural walk first, change only one benign external feature such as where an object is carried or whether the route is cleared, repeat at the same comfortable pace, and keep the change only if the whole task is easier, stable and comfortable. It does not teach a forced foot strike, cadence, symmetry or clinical gait correction.", "outcome": "The learner completes three natural walks on the same familiar route and one matched test of a single benign external change, with time, steps, effort, comfort, stability and aid use recorded.", "authority": { "learner_may": [ "Observe a short level route already walked safely with usual footwear and aids.", "Test one reversible external change such as clearing clutter, moving a carried item closer or using an existing authorised aid.", "Stop and keep the natural pattern when a change is less comfortable, stable or useful." ], "qualified_person_required_for": [ "New gait retraining, prescribed cadence, foot-strike change, orthosis adjustment or removal of an aid.", "Walking assessment after falls, injury, neurological symptoms, dizziness, chest symptoms or unexplained decline.", "Treadmill, obstacle, uneven-terrain or endurance testing when safety is uncertain." ], "never_do": [ "Force a different foot strike, stride length, posture or symmetry from this page.", "Remove a cane, walker, brace or other support to make the result look independent.", "Use a road crossing, stairs, treadmill, fatigue task or crowded public route as the experiment." ] }, "materials": [ "A familiar dry level indoor route of 6–10 metres with a stable turn or straight finish", "Usual footwear, mobility aid and glasses/hearing support", "Two route markers, timer and optional hand counter", "Simple sheet for time, steps, effort, comfort, stability and the exact tested change" ], "before_you_start": [ "Choose a route already walked safely and clear pets, cables, rugs and movable obstacles.", "Keep usual aid, footwear and carrying support; ask a helper to observe if that is normally needed.", "Do not start with new pain, dizziness, unusual breathlessness, illness, recent fall or a noticeable gait change.", "Plan three natural walks with rest; stop before fatigue alters the pattern." ], "steps": [ { "title": "Declare the ordinary route", "instruction": "Mark the same start and finish and describe surface, turn, footwear, aid and carried item.", "reason": "Efficiency comparisons require the same task.", "success_check": "Another person could reset the route from the note." }, { "title": "Walk naturally once", "instruction": "At a comfortable everyday pace, walk the route without trying to look efficient. Use the usual aid and look where you normally look.", "reason": "The first aim is a truthful baseline, not a performance pose.", "success_check": "The walk finishes safely without a cue-induced gait change." }, { "title": "Record the whole task", "instruction": "Write time, approximate steps, effort 0–10, comfort 0–10, any stumble/hesitation and aid used.", "reason": "A lower time or step count can hide more effort or less stability.", "success_check": "All fields are completed before the next walk." }, { "title": "Repeat the natural pattern", "instruction": "After rest, repeat twice under the same conditions and note ordinary variation.", "reason": "One trial may reflect timing or attention noise.", "success_check": "Three natural trials use the same route and supports." }, { "title": "Choose one benign external change", "instruction": "Select only one reversible feature: clear the route, move a carried object closer, improve lighting or use an already authorised support. Do not instruct the feet or cadence.", "reason": "External organisation can reduce task burden without imposing gait dogma.", "success_check": "The change is named in one sentence and affects only one feature." }, { "title": "Test and compare", "instruction": "Repeat once at natural comfortable pace, then compare time, steps, effort, comfort and stability with the baseline range.", "reason": "A useful change should improve the whole task, not one number at a cost.", "success_check": "The comparison shows every outcome, including any worsening." }, { "title": "Keep, revert or refer", "instruction": "Keep the change only if it is easier or more useful with equal or better comfort and stability. Revert if mixed; seek assessment for persistent difficulty.", "reason": "A reversible decision respects individual self-organisation and safety.", "success_check": "The final decision and reason are written." } ], "worked_example": { "scenario": "A learner safely walks an 8 m hallway with a cane while carrying mail in the free hand. The test change is placing the mail in a close-fitting cross-body pouch so the free hand is not occupied.", "walkthrough": [ "The hallway is cleared and the cane, footwear and start/finish marks are fixed.", "Three natural walks take 10.8, 10.5 and 10.7 s with 16–17 steps, effort 4/10 and one hesitation while adjusting the mail.", "After rest, the mail goes into the pouch; no gait cue is given.", "The test walk takes 10.6 s and 16 steps, effort 3/10, with no hesitation and unchanged comfort/stability.", "The learner keeps the carrying arrangement because the whole task is easier, not because time is dramatically faster." ], "result": "The external carrying change reduced effort and hesitation on this familiar route without removing the cane or forcing gait. It does not prove lower oxygen cost, clinical gait improvement or transfer outdoors." }, "right_vs_wrong": [ { "situation": "Setting the baseline", "right": "Mark the route, keep the usual footwear and aid, and walk at a normal comfortable pace.", "wrong": "Try to produce an unusually fast, long-striding or impressive first walk.", "why": "The baseline must represent the ordinary task that the learner actually performs." }, { "situation": "Choosing a change", "right": "Change one external feature, such as clearing the route or carrying an item closer to the body.", "wrong": "Force a longer stride, a different foot strike or a prescribed cadence.", "why": "An external change is reversible; an unassessed gait prescription may increase effort or instability." }, { "situation": "Judging the result", "right": "Compare time, steps, effort, comfort, hesitation and stability together.", "wrong": "Call the test successful only because it took fewer steps.", "why": "A lower step count can hide greater effort, discomfort or loss of control." }, { "situation": "Using a mobility aid", "right": "Keep the usual authorised aid and record it as part of the walking task.", "wrong": "Remove the aid to make the walk appear more independent.", "why": "Removing normal support changes the task and can create an unsafe comparison." }, { "situation": "Making the decision", "right": "Keep the external change only when it repeatedly makes the task easier without reducing comfort or stability.", "wrong": "Keep a mixed or uncomfortable change because one number improved.", "why": "The decision is based on the whole walking task, not a single attractive number." } ], "common_mistakes": [ { "mistake": "The route changes between trials.", "fix": "Mark start/finish and keep surface, turn and obstacles unchanged." }, { "mistake": "The learner consciously lengthens steps for a lower count.", "fix": "Return to natural comfortable walking and use step count only descriptively." }, { "mistake": "Two external features are changed in the same comparison.", "fix": "Restore the baseline and test only one change at a time." }, { "mistake": "Usual aid or footwear is changed.", "fix": "Restore them and treat the altered-support walk as a different task." }, { "mistake": "A treadmill or outdoor result is assumed.", "fix": "Claim only the familiar level route unless each context is tested safely." } ], "practice": { "first_session": [ "Prepare and describe the safe route.", "Complete one natural walk and record all outcomes.", "Rest and complete two matched natural repeats.", "Choose one benign external change and test it once.", "Write keep, revert or refer with the whole-task reason." ], "repeat_plan": "Repeat the same observation on no more than two comparable days in one week, with two or three natural trials and one single-feature test per session. Stop before fatigue. Retain a change only if the pattern is consistent; seek assessment rather than stacking gait cues.", "progress_when": [ "The route is completed safely with the usual aid and no new symptoms.", "A single external change repeatedly lowers effort or burden without worse comfort/stability.", "The learner can explain which metric changed and which did not." ], "do_not_progress_when": [ "Walking becomes more hesitant, painful, unstable or breathless.", "Improvement requires forced cadence, step length, foot strike or aid removal.", "The route or health status is no longer comparable." ] }, "self_check": [ "Did you use the same safe route, footwear and aid?", "Did you walk naturally rather than pose or force a new pattern?", "Was only one external feature changed?", "Did you check comfort, effort and stability as well as time/steps?", "Can you state why the result is route-specific?" ], "measurement": { "primary": "Whole-task result on one familiar route: time, steps, effort, comfort, stability and aid", "how": "Record three natural trials, their range and one single-feature comparison using the same route, supports and comfortable pace.", "good_result": "The tested external change gives equal or better stability/comfort and a repeatable reduction in effort, hesitation or task burden without a new symptom.", "does_not_prove": "It does not prove lower metabolic cost, normal gait, clinical improvement or transfer to treadmill, outdoors, stairs or crowds." }, "stop_and_get_help": [ "Stop for chest pain, faintness, new severe breathlessness, sudden weakness/numbness, new vision change or confusion.", "Stop for new/increasing pain, dizziness, near-fall, foot drag, repeated stumble or need for unexpected support.", "Seek qualified gait or medical assessment after a fall, unexplained gait decline or persistent change; do not self-correct it with cues." ], "accessibility": [ "Keep the person's usual mobility, sensory and communication aids throughout.", "Use a helper for timing/recording so the learner can look at the route, without adding gait coaching.", "Shorten the already-safe route or use seated rests while preserving the same start/finish task for comparisons." ], "evidence_notes": [ { "claim": "A motor-control walking trial measured a specific intervention in older adults with walking difficulty, so effects remain population- and task-specific.", "source_title": "Improving motor control in walking: a randomized clinical trial in older adults with subclinical walking difficulty", "source_url": "https://pubmed.ncbi.nlm.nih.gov/25448244/", "source_kind": "PRIMARY_RESEARCH" }, { "claim": "People can adapt walking to energetic cost in a controlled laboratory landscape, but device-on adaptation does not establish durable overground benefit.", "source_title": "Humans Can Continuously Optimize Energetic Cost during Walking", "source_url": "https://pubmed.ncbi.nlm.nih.gov/26365256/", "source_kind": "PRIMARY_RESEARCH" } ], "limits": [ "Time, steps, variability, smoothness and oxygen cost are different outcomes.", "A different-looking or more symmetrical gait is not automatically more efficient.", "Natural self-organisation and usual aids should not be removed to manufacture a score.", "Persistent or new gait problems require qualified assessment." ], "orientation": { "bounded_definition": "Capability to develop or express gait efficiency in a declared context without inheriting broader claims.", "evidence_summary": "Gait efficiency can mean using less energy, moving more smoothly or completing a task safely. Titan keeps those outcomes separate.", "supportable_public_claim": "People can adapt aspects of gait control and energetic cost, but “efficiency” must name the metric, task and assistance.", "measurement_boundary": "Oxygen cost, step pattern, variability and smoothness answer different questions and cannot be collapsed into one gait score.", "myth_to_metric": { "myth": "Find the one perfect way to walk", "metric": "Declared energy cost, variability, smoothness and task result", "boundary": "One gait metric cannot define safety, comfort or participation." }, "limiting_findings": [ "Adaptation to a robotic energy landscape does not establish durable device-off benefit." ], "prohibited_claims": [ "Perfect walking form", "Fix your gait from one metric", "Symmetry is always optimal", "AI can optimize anyone’s walk" ] }, "gold_source_lesson": { "curriculum_id": "G-CUR-003", "source_heading": "7. Ordinary walking efficiency without gait dogma", "source_html_sha256": "d584f002ca87546bbd1fd003792dad21875e5e49f36bb594bf98c60d9a9c7ea7", "html": "PWR-029 is not a licence to redesign everybody's gait. Humans often self-organise walking in energetically economical ways, and forced patterns can add cost.
\nFor an ordinary route you already walk safely:
\nA treadmill result is not automatically an overground result. A lower step count is not necessarily greater efficiency. A different-looking gait is not automatically better.
" }, "next_gate": "No external confirmation is required for the current bounded explainer permission. Guide permission remains NOT_READY; any guide, stronger efficacy, generalisation, protocol, promotion or independent-validation claim requires a new adjudication.", "evidence_count": 2 }, "full_training_programme": false, "independently_validated": false, "publication_state": "PUBLISHED_PUBLIC_RESEARCH_EDITION__EDITORIAL_REVIEW_PENDING", "related_power_ids": [ "PWR-025", "PWR-026", "PWR-027", "PWR-028" ] }, { "power_id": "PWR-030", "learning_unit_id": "TLU-PWR-030", "title": "Quiet locomotion", "main_description": "This pack supplies fictional measurements from recordings that already exist. The learner reports peak sound in each recording setup, checks which configurations can be compared, and keeps sound separate from force, tissue safety, stealth, and gait quality.", "main_description_source": "GOVERNED_TUTORIAL_PLAIN_ENGLISH_INTRO", "family_id": "FAM-04", "family": "Mobility, Balance & Locomotion", "superdomain": "Body & Performance", "canonical_route": "/powers/pwr-030/", "treatment": "BOUNDED_GUIDED_LESSON", "treatment_label": "Bounded guided lesson", "treatment_boundary": "A governed exercise is available only in the declared configuration, dose and stopping rules.", "tutorial_route": "/tutorials/pwr-030/", "governed_lesson_route": "/tutorials/pwr-030/", "self_attempt_status": "PERMITTED_ONLY_INSIDE_DECLARED_BOUNDARY", "gold_pathway_ids": [ "G-CUR-003" ], "route_membership": { "kind": "GOLD_PATHWAY", "id": "G-CUR-003", "coverage_status": "EXACT_ONCE" }, "source_authority_tier": "G2", "source_build_state": "COMPREHENSIVE_OWNER_CANDIDATE", "source_instructional_route": "BOUNDED_GUIDED_EXERCISE", "source_count": 2, "research_depth": "FOCUSED", "risk_level": "LOW_TO_MODERATE", "prerequisite_status": "DECLARED_IN_GOVERNED_LESSON", "learning_route": { "mode": "BOUNDED_PRACTICAL_LESSON", "label": "Learn inside the bounded governed lesson", "summary": "This pack supplies fictional measurements from recordings that already exist. The learner reports peak sound in each recording setup, checks which configurations can be compared, and keeps sound separate from force, tissue safety, stealth, and gait quality.", "steps": [ [ "Check the boundary", "Read the evidence, risk framing, prerequisites and stopping rules before attempting anything." ], [ "Declare the baseline", "Use only the task and measurement contract specified by the governed lesson." ], [ "Complete the bounded practice", "Follow the ordered steps without hidden progression or improvised intensity." ], [ "Retest separately", "Keep direct performance, delayed retention and transfer as different questions." ], [ "Review", "Continue, adapt, seek support or stop according to the lesson's declared decision rules." ] ], "practical_authority": true, "provider_required": false, "next_action_route": "/tutorials/pwr-030/" }, "path_builder": { "selectable": true, "completion_allowed": true, "warning": "A governed exercise is available only in the declared configuration, dose and stopping rules." }, "full_tutorial": { "version": "1.0", "authorship": "AUTHORED_GOVERNED_SOURCE", "practice_pack": { "power_id": "PWR-030", "title": "Quiet locomotion", "heading": "Describe footstep sound in a declared recording without changing gait", "plain_english_intro": "This pack supplies fictional measurements from recordings that already exist. The learner reports peak sound in each recording setup, checks which configurations can be compared, and keeps sound separate from force, tissue safety, stealth, and gait quality.", "authority_and_safety": [ "Do not make a new walking take, change speed, change foot strike, remove an aid, or try to walk quietly for this exercise.", "Use the fictional data below or an ordinary recording that already exists and was made safely.", "Peak dBA is a sound measurement in a declared setup; it is not ground-reaction force, loading rate, tissue safety, or a judgement about an aid or prosthesis." ], "materials": [ "The three fictional recording rows below", "Paper or spreadsheet", "A calculator, optional", "No walking task and no new recording" ], "setup_steps": [ "For every clip, copy surface, footwear, aid, speed, microphone distance, meter mode, and the five peak readings.", "Sort the five readings and select the middle value as the median peak dBA.", "Calculate the range as maximum minus minimum.", "Compare clips only after checking which configuration fields match.", "Describe the observed sound difference without inferring force or safety.", "Finish with a bounded conclusion and a list of non-claims." ], "fixture": { "caption": "These are fictional A-weighted peak readings from three already-recorded clips. The descriptive statistic is the median, not an arithmetic energy average of decibels.", "headers": [ "Clip", "Surface", "Footwear and aid", "Speed m per s", "Microphone distance m", "Meter mode", "Five peak readings dba" ], "rows": [ [ "A", "Vinyl", "Walking shoes; no aid", "1.2", "1", "Same fictional peak-dBA meter", "62; 64; 63; 61; 65" ], [ "B", "Carpet", "Walking shoes; no aid", "1.2", "1", "Same fictional peak-dBA meter", "55; 56; 54; 55; 55" ], [ "C", "Vinyl", "Boots; cane present", "1.4", "0.5", "Same fictional peak-dBA meter", "68; 69; 67; 70; 68" ] ] }, "scoring_rule": "Award 1 point per correct median and range, 2 points for the A/B configuration comparison, 2 points for rejecting A/C as like-for-like, and 2 points for the sound-not-force boundary: 12 points total.", "worked_example": { "steps": [ "Sort A: 61, 62, 63, 64, 65; the middle value is 63 dBA.", "Calculate A's range: 65 - 61 = 4 dB.", "Sort B: 54, 55, 55, 55, 56; the middle value is 55 dBA.", "Calculate B's range: 56 - 54 = 2 dB.", "Check configuration: footwear, aid, speed, microphone distance, and meter match; surface differs.", "Calculate the descriptive median difference: 63 - 55 = 8 dB." ], "result": "In these fictional recordings, Clip B on carpet has a median peak 8 dB below Clip A on vinyl. This observation is about recorded sound only and does not establish lower force, safer loading, better gait, or stealth." }, "right_vs_wrong": [ { "situation": "Describing A versus B", "right": "B's median recorded peak is 8 dB lower in the declared setup.", "wrong": "Carpet makes this person land with less force.", "why": "There is no force measurement or causal replication." }, { "situation": "Using Clip C", "right": "Report C separately because footwear, aid, speed, and microphone distance differ.", "wrong": "C proves the person's gait became louder.", "why": "Several recording and task fields changed." }, { "situation": "Handling an aid sound", "right": "Record the cane as part of the sound configuration without ranking it.", "wrong": "Remove the cane so the recording is cleaner.", "why": "Removing support changes the task and may be unsafe." }, { "situation": "Summarising decibels", "right": "Use the declared median peak statistic for this exercise.", "wrong": "Average decibels as if they were ordinary linear energy values and omit the meter mode.", "why": "Decibels are logarithmic and the measurement rule must remain explicit." } ], "common_mistakes": [ { "mistake": "Changing walking technique to produce a quieter comparison.", "fix": "Use only the supplied fictional data or an existing clip; do not create another take." }, { "mistake": "Comparing readings taken at different microphone distances as if only gait changed.", "fix": "Mark the configurations different and report them separately." }, { "mistake": "Calling sound a proxy for force or injury risk.", "fix": "Write force, loading, and tissue safety in the non-claims field." }, { "mistake": "Treating an aid or prosthesis sound as an error.", "fix": "Record it neutrally as part of the capability configuration and preserve the aid." } ], "answer_key_route": "/tutorials/pwr-030/answer-key/", "answer_key_delivery": "SEPARATE_NOINDEX_NOARCHIVE_CHECKING_PAGE" }, "tutorial_mode": "BOUNDED_PRACTICAL_LESSON", "orientation": { "bounded_definition": "Capability to develop or express quiet locomotion in a declared context without inheriting broader claims.", "evidence_summary": "Quiet movement is measurable—not mystical. People can change footstep sound, but quieter does not automatically mean safer or more efficient.", "measurement_boundary": "Decibels establish sound in the measurement setup; force plates establish loading. Neither alone establishes tissue safety or stealth.", "myth_to_metric": { "myth": "Walk in supernatural silence", "metric": "Footstep decibels, loading rate and speed on a declared surface", "boundary": "Quiet sound cannot prove invisibility, safety or universal technique." }, "limiting_findings": [ "Peak sound was not directly associated with peak ground-reaction force or loading rate in the running experiment." ], "prohibited_claims": [ "Move like a ghost", "Silent walking prevents injury", "Sound reveals force exactly", "Forefoot striking is universally safer" ] }, "outcomes": [ "Define quiet locomotion without inheriting mythology or broader claims.", "Explain what the current evidence supports and what it does not establish.", "Use the declared measurement boundary and recognise misleading proxies.", "Complete only the separately governed capability practice inside its declared limits.", "Make a retention, transfer, maintenance, provider or stop decision without overclaiming." ], "prerequisites": "DECLARED_IN_GOVERNED_LESSON", "baseline": { "instruction": "Complete the baseline declared by the governed lesson before practice; keep it separate from the knowledge baseline.", "record": [ "date and context", "current definition", "confidence from 0 to 100", "assumed measure", "expected benefit", "known limitation", "intended next action" ] }, "modules": [ { "order": 1, "title": "Check the boundary", "instruction": "Read the evidence, risk framing, prerequisites and stopping rules before attempting anything.", "completion_evidence": "Record the decision or output from check the boundary in one or two sentences." }, { "order": 2, "title": "Declare the baseline", "instruction": "Use only the task and measurement contract specified by the governed lesson.", "completion_evidence": "Record the decision or output from declare the baseline in one or two sentences." }, { "order": 3, "title": "Complete the bounded practice", "instruction": "Follow the ordered steps without hidden progression or improvised intensity.", "completion_evidence": "Record the decision or output from complete the bounded practice in one or two sentences." }, { "order": 4, "title": "Retest separately", "instruction": "Keep direct performance, delayed retention and transfer as different questions.", "completion_evidence": "Record the decision or output from retest separately in one or two sentences." }, { "order": 5, "title": "Review", "instruction": "Continue, adapt, seek support or stop according to the lesson's declared decision rules.", "completion_evidence": "Record the decision or output from review in one or two sentences." } ], "lab": { "title": "Governed capability lab", "instruction": "Open the separately governed practical lesson and complete only its declared configuration, dose, measurement, accessibility and stopping rules.", "deliverable": "The lesson's declared baseline, practice and retest record; no additional exercise is implied here." }, "assessment": { "immediate": "Restate the bounded definition, evidence ceiling, measurement boundary and current authority route without looking.", "delayed_retention": "Repeat the explanation and route decision after at least 48 hours; record what changed or was forgotten.", "transfer": "Use only the lesson's predeclared transfer task; do not infer far transfer from the trained task.", "interpretation": "Completion demonstrates learning of this tutorial only. It does not prove capability, qualification, independent validation, safety clearance or far transfer." }, "maintenance": { "cadence": "Review after 48 hours, again after 2-4 weeks, and whenever the evidence or authority treatment changes.", "decisions": [ "retain", "refresh", "seek qualified support", "return to research", "retire" ] }, "accessibility": "Use text-to-speech, enlarged text, keyboard navigation, shorter sessions, a support person or an equivalent non-practical record format as needed. Accessibility changes must not enlarge practical authority.", "stopping_and_escalation": "A governed exercise is available only in the declared configuration, dose and stopping rules. Stop if the declared configuration cannot be maintained, uncertainty becomes material, adverse effects appear, or qualified authority is required.", "next_gate": "No external confirmation is required for the current bounded explainer and non-prescriptive guide-frame permissions; any stronger efficacy, generalisation, protocol, promotion or independent-validation claim requires a new adjudication.", "evidence_count": 2 }, "full_training_programme": false, "independently_validated": false, "publication_state": "PUBLISHED_PUBLIC_RESEARCH_EDITION__EDITORIAL_REVIEW_PENDING", "related_power_ids": [ "PWR-025", "PWR-026", "PWR-027", "PWR-028" ] }, { "power_id": "PWR-031", "learning_unit_id": "TLU-PWR-031", "title": "Terrain adaptation", "main_description": "The learner completes a supervised declared route with the same aid while obstacle contacts, stumbles, pauses, assistance, time and symptoms are recorded.", "main_description_source": "FULL_TUTORIAL_OUTCOME", "family_id": "FAM-04", "family": "Mobility, Balance & Locomotion", "superdomain": "Body & Performance", "canonical_route": "/powers/pwr-031/", "treatment": "SPECIALIST_PROVIDER_ROUTE", "treatment_label": "Full supervised tutorial", "treatment_boundary": "Titan teaches the complete method; a qualified person controls the parts that require supervision, clearance, specialist equipment, load, dose or progression.", "tutorial_route": "/tutorials/pwr-031/", "governed_lesson_route": null, "self_attempt_status": "PROHIBITED_WITHOUT_QUALIFIED_SUPERVISION", "gold_pathway_ids": [ "G-CUR-003" ], "route_membership": { "kind": "GOLD_PATHWAY", "id": "G-CUR-003", "coverage_status": "EXACT_ONCE" }, "source_authority_tier": "G4", "source_build_state": "EXTERNAL_PROVIDER_ROUTE", "source_instructional_route": "LEARN_ELSEWHERE_TRACK_WITH_TITAN", "source_count": 2, "research_depth": "FOCUSED", "risk_level": "MODERATE_TO_HIGH", "prerequisite_status": "QUALIFIED_PROVIDER_DETERMINES", "learning_route": { "mode": "FULL_SUPERVISED_TUTORIAL", "label": "Learn terrain adaptation step by step", "summary": "The learner completes a supervised declared route with the same aid while obstacle contacts, stumbles, pauses, assistance, time and symptoms are recorded.", "steps": [ [ "Get ready", "Walk or visually inspect the route with the provider and identify every surface change and rest point." ], [ "Learn the method", "7 concrete steps teach the permitted method from start to finish." ], [ "See right and wrong", "5 comparisons show correct or safer execution beside common wrong or riskier choices." ], [ "Practise", "The provider changes only one feature—surface compliance, obstacle height, route length, pace or aid demand—after repeated control. Outdoor, stair, slope and low-light routes require separate assessment." ], [ "Check progress", "Declare surface, obstacle, route, light, footwear, aid, guarding and pace; count contacts, placement errors, pauses, stumbles, assistance and symptoms." ] ], "practical_authority": false, "provider_required": true, "next_action_route": "/tutorials/pwr-031/" }, "path_builder": { "selectable": true, "completion_allowed": true, "warning": "Titan teaches the complete method; a qualified person controls the parts that require supervision, clearance, specialist equipment, load, dose or progression." }, "full_tutorial": { "version": "3.0", "authorship": "POWER_SPECIFIC_FULL_TUTORIAL", "tutorial_mode": "SUPERVISED", "promise": "Terrain adaptation is safe adjustment of gaze, step placement, aid use and speed to a specified surface. This lesson teaches a provider-built route with one firm uneven mat and one low obstacle: preview the route, choose the aid and lead strategy, approach at controlled speed, shorten steps, place the whole foot on known surfaces, clear the obstacle without rushing and pause after each transition. The provider controls surface, obstacle, guarding, repetitions and progression.", "power_id": "PWR-031", "title": "Terrain adaptation", "lesson_type": "SUPERVISED", "headline": "Scan, step and stabilise across one declared uneven route", "plain_english_summary": "Terrain adaptation is safe adjustment of gaze, step placement, aid use and speed to a specified surface. This lesson teaches a provider-built route with one firm uneven mat and one low obstacle: preview the route, choose the aid and lead strategy, approach at controlled speed, shorten steps, place the whole foot on known surfaces, clear the obstacle without rushing and pause after each transition. The provider controls surface, obstacle, guarding, repetitions and progression.", "outcome": "The learner completes a supervised declared route with the same aid while obstacle contacts, stumbles, pauses, assistance, time and symptoms are recorded.", "authority": { "learner_may": [ "Terrain adaptation: Stop on level ground and scan from near to far, naming the mat, obstacle, exit and any support point. Use the provider-agreed aid placement and lead foot for this route; keep the aid inside the support area.", "During an authorised attempt, On the known uneven mat, place enough of the foot to support weight and keep knee/trunk aligned; use the aid before transferring weight as taught. Take one or two settling steps and pause if needed before the next feature; do not link features faster than control allows.", "Point out each surface transition and exit before moving, then record obstacle contact, pause, stumble, assistance, time and symptoms for the declared route." ], "qualified_person_required_for": [ "Review mobility, vision, sensation, aid use and fall history and decide whether the secured indoor terrain route and guarding level are appropriate.", "Select and secure terrain/obstacles, assess aid and lead strategy, guard the learner, set speed/trials/rest and decide any outdoor transfer.", "Secure the mat and obstacle, set the usual aid and lead strategy, guard each transition and cue alternating preview gaze with foot placement instead of continuous downward staring." ], "never_do": [ "Practise on loose rock, wet ground, traffic, height, steep slope or an unknown outdoor route from this lesson.", "Do not transfer this drill to loose rock, wet ground, traffic, steep slopes or an unfamiliar outdoor route without a separate assessment.", "Stop after a fall, near-fall, repeated obstacle contact, foot drag, unexpected assistance, new pain or inability to scan ahead while controlling the next step." ] }, "materials": [ "Provider-secured route with level lead-in/out, one uneven mat and one low obstacle", "Usual mobility aid and footwear", "Gait belt or guarding equipment when indicated", "High-contrast edge marks and route video/score sheet", "A terrain-route record with surface and obstacle dimensions, aid, lead strategy, guarding, contacts, pauses, stumbles, assistance, time, symptoms and invalid trials." ], "before_you_start": [ "Walk or visually inspect the route with the provider and identify every surface change and rest point.", "Check that mats and obstacles cannot slide and that an escape route remains clear.", "Report falls, dizziness, pain, sensory loss, vision change, fatigue and any new aid or footwear.", "Walk beside the secured route and identify every surface change, obstacle and exit. Ask the learner to point out the next transition while standing still before attempting it with the planned aid and guard.", "Walk the route beside the obstacles, rehearse the aid and lead plan and practise looking ahead before attempting the secured transitions." ], "steps": [ { "title": "Preview the route", "instruction": "Stop on level ground and scan from near to far, naming the mat, obstacle, exit and any support point.", "reason": "Planning reduces late surprise without removing the adaptation task.", "success_check": "The learner points to each transition and exit." }, { "title": "Set aid and lead plan", "instruction": "Use the provider-agreed aid placement and lead foot for this route; keep the aid inside the support area.", "reason": "Aid and lead strategy affect stability.", "success_check": "The learner demonstrates the first transition on level ground." }, { "title": "Approach under control", "instruction": "Walk at a pace that allows a stop before the transition and shorten the final steps rather than lunging.", "reason": "A controllable approach preserves time to place the foot.", "success_check": "The learner can pause before the mat without a recovery step." }, { "title": "Place the whole foot", "instruction": "On the known uneven mat, place enough of the foot to support weight and keep knee/trunk aligned; use the aid before transferring weight as taught.", "reason": "Edge or partial contacts can slip or roll.", "success_check": "Foot and aid land inside the marked safe area." }, { "title": "Clear the low obstacle", "instruction": "Look ahead to the landing spot, lift the lead foot over without circling, then bring the trailing foot through before accelerating.", "reason": "A rushed trailing foot commonly contacts the obstacle.", "success_check": "Neither foot touches and landing remains inside the lane." }, { "title": "Stabilise after each change", "instruction": "Take one or two settling steps and pause if needed before the next feature; do not link features faster than control allows.", "reason": "Terrain adaptation includes recovery after transition.", "success_check": "Balance is stable before the next feature." }, { "title": "Score errors and assistance", "instruction": "Record obstacle contacts, foot-placement errors, pauses, rail/helper contact, time and symptoms. Keep the aid visible in the result.", "reason": "Completion alone hides how the route was achieved.", "success_check": "Every trial has error and assistance fields." } ], "worked_example": { "scenario": "A physiotherapist builds an 8 m indoor route: 2 m level, 2 m firm uneven mat, a 5 cm foam obstacle and 3 m level exit. The learner uses a cane.", "walkthrough": [ "The learner previews all features and rehearses cane placement before the mat.", "Trial one contacts the obstacle with the trailing foot and requires a pause; no fall occurs.", "After feedback and rest, trial two uses shorter approach steps, clears both feet and pauses safely after the mat.", "Trial three repeats the route with no contact and the same cane, taking 14.2 s.", "The provider records errors, pauses and cane use; no outdoor transfer is claimed." ], "result": "The learner completed this secured indoor route with the cane and fewer obstacle errors. It does not establish independent travel on unknown, wet, steep or crowded terrain." }, "right_vs_wrong": [ { "situation": "Preview: Terrain adaptation checkpoint", "right": "Scan features and exit before moving.", "wrong": "Look only at the feet after stepping onto the surface.", "why": "Late information reduces planning time. That changes errors, stability, time and assistance on one specified terrain route. It is no longer the same test." }, { "situation": "Approach: Terrain adaptation checkpoint", "right": "Slow enough to stop before the transition.", "wrong": "Rush and use one long reaching step.", "why": "A long step is harder to control." }, { "situation": "Aid: Terrain adaptation checkpoint", "right": "Place the aid before transferring weight as taught.", "wrong": "Swing it beyond the support area.", "why": "The base becomes less useful. That changes errors, stability, time and assistance on one specified terrain route. It is no longer the same test." }, { "situation": "Obstacle: Terrain adaptation checkpoint", "right": "Clear lead and trailing feet before speeding up.", "wrong": "Accelerate after the lead foot only.", "why": "The trailing foot may catch. That changes errors, stability, time and assistance on one specified terrain route. It is no longer the same test." }, { "situation": "Score: Terrain adaptation checkpoint", "right": "Record obstacle contacts, route pauses and any cane or helper assistance. It is correct when neither foot touches and landing remains inside the lane.", "wrong": "Record only route time; it breaks the 'Clear the low obstacle' execution rule.", "why": "Fast completion can hide instability. That changes errors, stability, time and assistance on one specified terrain route. It is no longer the same test." } ], "common_mistakes": [ { "mistake": "The mat or obstacle moves.", "fix": "Secure and recheck every surface before trials." }, { "mistake": "The learner looks down continuously.", "fix": "Use near-far scanning: check the feature, then the landing and exit." }, { "mistake": "The approach step becomes a lunge.", "fix": "Reduce speed and use two shorter setup steps." }, { "mistake": "The trailing foot clips the obstacle.", "fix": "Pause after the lead landing and consciously clear the trailing foot at low speed." }, { "mistake": "Cane use is omitted from the result.", "fix": "Record aid type, side and placement rule for every trial." } ], "practice": { "first_session": [ "Provider inspects and demonstrates the route.", "Rehearse scan, aid placement and obstacle clearance on level ground.", "Complete one guarded familiarisation at slow speed.", "Complete two or three declared-route trials with rest and error feedback.", "Review errors, assistance, time and symptoms; no surprise terrain is added." ], "repeat_plan": "The provider changes only one feature—surface compliance, obstacle height, route length, pace or aid demand—after repeated control. Outdoor, stair, slope and low-light routes require separate assessment.", "progress_when": [ "Foot and aid placement remain inside the safe zones.", "Obstacle contacts and recovery steps reduce without aid removal or rushing.", "The learner can stop before any feature and reports no new symptoms." ], "do_not_progress_when": [ "A fall, near-fall, repeated contact, foot drag or unexpected assistance occurs.", "Pain, dizziness, fear, fatigue or sensory/vision change appears.", "The surface, obstacle, lighting, guard or aid cannot be kept constant." ] }, "self_check": [ "Can you name every route feature and exit before walking?", "Can you stop before the surface change?", "Did both feet clear the obstacle and did aid use remain the same?", "Were errors and assistance recorded as well as time?" ], "measurement": { "primary": "Errors, stability, time and assistance on one specified terrain route", "how": "Declare surface, obstacle, route, light, footwear, aid, guarding and pace; count contacts, placement errors, pauses, stumbles, assistance and symptoms.", "good_result": "At least two trials complete with fewer or no errors and stable aid use, without faster pace causing worse control.", "does_not_prove": "It does not prove safe independent travel on every surface, outdoor community mobility or fall prevention." }, "stop_and_get_help": [ "Stop after a fall, harness/guard catch, repeated obstacle contact, foot drag or inability to stop before a feature.", "Stop for new dizziness, vision change, weakness, numbness, severe pain or unusual breathlessness.", "Leave the route after a fall, new dizziness, unexpected foot or limb pain, or an aid failure; move to a safe surface and arrange the needed mobility or medical review." ], "accessibility": [ "Keep the usual cane, walker, prosthesis or orthosis and record it as part of the route.", "Use high-contrast, tactile or audible edge cues and accessible preview while preserving the physical route.", "Preview terrain hazards with a tactile map, high-contrast route card or spoken sequence, recording guide, aid and cue choices without removing the tested surface changes." ], "evidence_notes": [ { "claim": "A multicentre trial found specialised walking-adaptability training was not superior to dose-matched conventional training in motor-incomplete spinal cord injury.", "source_title": "Efficacy of Walking Adaptability Training on Walking Capacity in Ambulatory People With Motor Incomplete Spinal Cord Injury: A Multicenter Pragmatic Randomized Controlled Trial", "source_url": "https://pubmed.ncbi.nlm.nih.gov/38661122/", "source_kind": "PRIMARY_RESEARCH" }, { "claim": "Uneven-terrain treadmill research shows age- and condition-specific walking responses, not universal independent travel competence.", "source_title": "Uneven terrain treadmill walking in younger and older adults", "source_url": "https://pubmed.ncbi.nlm.nih.gov/36534645/", "source_kind": "PRIMARY_RESEARCH" } ], "limits": [ "Performance is specific to the secured route, light, surface, obstacle and aid.", "A fast time cannot erase obstacle contacts or assistance.", "Indoor practice does not authorise unknown outdoor terrain." ], "orientation": { "bounded_definition": "Capability to develop or express terrain adaptation in a declared context without inheriting broader claims.", "evidence_summary": "Terrain adaptation is a configured skill: person, surface, vision, footwear and assistance all matter. Specialized technology is not automatically better.", "supportable_public_claim": "People adjust walking to terrain, and configured practice may help; superiority over conventional rehabilitation and broad outdoor transfer are not established.", "measurement_boundary": "Variability, obstacle errors and speed quantify specified conditions; they do not establish safe independent travel in every environment.", "myth_to_metric": { "myth": "Become at home on any terrain", "metric": "Errors, stability and completion on a specified route with declared aid", "boundary": "One surface cannot prove universal outdoor mobility." }, "limiting_findings": [ "Specialized VR walking-adaptability training was not superior to dose-matched conventional training in motor-incomplete spinal cord injury." ], "prohibited_claims": [ "Conquer any terrain", "Terrain instincts", "Train without looking", "A treadmill makes outdoor mobility safe" ] }, "gold_source_lesson": { "curriculum_id": "G-CUR-003", "source_heading": "PWR-031 / PWR-032 — Terrain adaptation and transitions/crawling/climbing", "source_html_sha256": "da25104310494805caae2d773bf533b796d6a4872e9712c1deba4a9884de4931", "html": "Specialist route where loss of balance, height, strength demand or surface hazard creates consequence.
" }, "next_gate": "External confirmation is required before higher-authority use because: CLINICAL_HIGH_RISK_OR_REGULATED_CONFIGURATION; SUPERVISION_OR_NON_ATTEMPT_BOUNDARY.", "evidence_count": 2 }, "full_training_programme": false, "independently_validated": false, "publication_state": "PUBLISHED_PUBLIC_RESEARCH_EDITION__EDITORIAL_REVIEW_PENDING", "related_power_ids": [ "PWR-025", "PWR-026", "PWR-027", "PWR-028" ] }, { "power_id": "PWR-032", "learning_unit_id": "TLU-PWR-032", "title": "Transitions, crawling and climbing", "main_description": "The learner completes the declared floor-to-stand chain with the recorded chair and assistance level, and can stop safely at each intermediate position.", "main_description_source": "FULL_TUTORIAL_OUTCOME", "family_id": "FAM-04", "family": "Mobility, Balance & Locomotion", "superdomain": "Body & Performance", "canonical_route": "/powers/pwr-032/", "treatment": "SPECIALIST_PROVIDER_ROUTE", "treatment_label": "Full supervised tutorial", "treatment_boundary": "Titan teaches the complete method; a qualified person controls the parts that require supervision, clearance, specialist equipment, load, dose or progression.", "tutorial_route": "/tutorials/pwr-032/", "governed_lesson_route": null, "self_attempt_status": "PROHIBITED_WITHOUT_QUALIFIED_SUPERVISION", "gold_pathway_ids": [ "G-CUR-003" ], "route_membership": { "kind": "GOLD_PATHWAY", "id": "G-CUR-003", "coverage_status": "EXACT_ONCE" }, "source_authority_tier": "G4", "source_build_state": "EXTERNAL_PROVIDER_ROUTE", "source_instructional_route": "LEARN_ELSEWHERE_TRACK_WITH_TITAN", "source_count": 2, "research_depth": "FOCUSED", "risk_level": "MODERATE_TO_HIGH", "prerequisite_status": "QUALIFIED_PROVIDER_DETERMINES", "learning_route": { "mode": "FULL_SUPERVISED_TUTORIAL", "label": "Learn transitions, crawling and climbing step by step", "summary": "The learner completes the declared floor-to-stand chain with the recorded chair and assistance level, and can stop safely at each intermediate position.", "steps": [ [ "Get ready", "Confirm with the provider that kneeling, weight-bearing through hands and floor transfers are appropriate." ], [ "Learn the method", "7 concrete steps teach the permitted method from start to finish." ], [ "See right and wrong", "5 comparisons show correct or safer execution beside common wrong or riskier choices." ], [ "Practise", "The qualified provider decides repetitions, rest, side choice and when to reduce help or change support height. Add crawling distance, stairs, ladders or outdoor surfaces only as separate assessed tasks." ], [ "Check progress", "Record chair/support, surface, lead side, step order, time, errors, symptoms and assistance at each link rather than only at the finish." ] ], "practical_authority": false, "provider_required": true, "next_action_route": "/tutorials/pwr-032/" }, "path_builder": { "selectable": true, "completion_allowed": true, "warning": "Titan teaches the complete method; a qualified person controls the parts that require supervision, clearance, specialist equipment, load, dose or progression." }, "full_tutorial": { "version": "3.0", "authorship": "POWER_SPECIFIC_FULL_TUTORIAL", "tutorial_mode": "SUPERVISED", "promise": "Transitions, crawling and climbing are distinct tasks that require their own assessment. This lesson teaches one bounded transition: getting from a supported side-sit on the floor to standing at a stable chair. The method uses backward chaining: first learn the last step from half-kneel to stand, then add hands-and-knees, side-sit and floor entry. The learner moves only on the provider's cue; the provider controls medical readiness, chair, guarding, assistance, step order and dose.", "power_id": "PWR-032", "title": "Transitions, crawling and climbing", "lesson_type": "SUPERVISED", "headline": "Rebuild a floor-to-stand transition one safe link at a time", "plain_english_summary": "Transitions, crawling and climbing are distinct tasks that require their own assessment. This lesson teaches one bounded transition: getting from a supported side-sit on the floor to standing at a stable chair. The method uses backward chaining: first learn the last step from half-kneel to stand, then add hands-and-knees, side-sit and floor entry. The learner moves only on the provider's cue; the provider controls medical readiness, chair, guarding, assistance, step order and dose.", "outcome": "The learner completes the declared floor-to-stand chain with the recorded chair and assistance level, and can stop safely at each intermediate position.", "authority": { "learner_may": [ "Transitions, crawling and climbing: Start in a provider-assisted half-kneel facing the chair, both hands on the seat; bring the rear foot under the body and stand using legs and the approved hand support. With provider guidance, step one foot back, lower the knee to the pad and pause with both hands on the chair.", "During an authorised attempt, Turn toward the chair, place hands on the floor or approved support and bring knees under the hips without twisting through pain. Once upright, keep hands on the chair until balance and symptoms are checked; step away only on the provider's cue.", "Record the exact floor-to-stand link, chair and assistance used, and confirm that standing occurred without the chair moving or a helper lifting the learner." ], "qualified_person_required_for": [ "Determine whether floor practice is medically and emotionally appropriate, especially after a recent fall, injury, illness or change in strength or balance.", "Determine whether floor practice is medically appropriate, select chair/support and sequence, guard every link, set assistance/repetitions and teach any fall-response plan.", "Load-test the chair, guard every link, adjust assistance before movement and establish a flat, stable half-kneel foot rather than accepting a toe-only base." ], "never_do": [ "Use this sequence immediately after a real fall, head impact, suspected fracture or acute illness, or practise stairs/climbing from this lesson.", "Do not attempt an unassisted floor rise, crawling course, stairs or climbing task merely because one supported transition link was successful.", "Pause or end the sequence for pain, dizziness, breathlessness, fear, weakness, chair movement or inability to return safely to the previous position." ] }, "materials": [ "Heavy stable chair against a wall with no wheels", "Firm padded floor area clear on all sides", "Gait belt/transfer equipment and trained helper when indicated", "Step picture card and assistance-level record", "A transition sheet for surface, chair, sequence link, limb position, assistance and guarding, completion, time, symptoms, stopping point and unsuccessful attempts." ], "before_you_start": [ "Confirm with the provider that kneeling, weight-bearing through hands and floor transfers are appropriate.", "Test that the chair cannot slide or tip when pushed from the front edge.", "Agree on hands-on assistance, no-lift boundary and a safe rest position at each link.", "Load-test the chair and position the mat, helper and usual aid before the learner goes to the floor. Rehearse the final supported half-kneel-to-stand link first and confirm the chair does not move.", "Rehearse the final half-kneel-to-stand link and the hands-and-knees-to-half-kneel link with the prescribed support before joining them into a chain." ], "steps": [ { "title": "Learn the last link first", "instruction": "Start in a provider-assisted half-kneel facing the chair, both hands on the seat; bring the rear foot under the body and stand using legs and the approved hand support.", "reason": "Backward chaining makes the successful finish familiar first.", "success_check": "The learner stands without the chair moving or the helper lifting." }, { "title": "Return to half-kneel", "instruction": "With provider guidance, step one foot back, lower the knee to the pad and pause with both hands on the chair.", "reason": "Controlled reversal teaches a safe checkpoint.", "success_check": "The knee reaches the pad without a drop." }, { "title": "Move between all-fours and half-kneel", "instruction": "From hands-and-knees, bring the stronger or provider-selected foot forward between the hands, then place both hands on the chair.", "reason": "Foot placement creates a base for standing.", "success_check": "The whole foot is planted and the learner can pause." }, { "title": "Move from side-sit to all-fours", "instruction": "Turn toward the chair, place hands on the floor or approved support and bring knees under the hips without twisting through pain.", "reason": "This link organises the body for the kneeling phase.", "success_check": "The learner reaches a stable hands-and-knees position." }, { "title": "Assemble the full chain", "instruction": "From supported side-sit: turn to all-fours, bring one foot to half-kneel, place hands on the chair, bring the rear foot under and rise.", "reason": "Linking occurs only after each part is controlled.", "success_check": "The learner pauses at every checkpoint and uses the recorded help." }, { "title": "Stand and orient before walking", "instruction": "Once upright, keep hands on the chair until balance and symptoms are checked; step away only on the provider's cue.", "reason": "Standing up is not the same as being ready to walk.", "success_check": "The learner remains stable for the agreed time." }, { "title": "Record assistance at each link", "instruction": "Use the declared scale—independent, cue, steadying contact, partial lift or full help—for every step. Stop if the provider would need to improvise a lift.", "reason": "A single completion label hides where support was needed.", "success_check": "The record identifies the exact link and assistance." } ], "worked_example": { "scenario": "A physiotherapist teaches floor-to-stand at a heavy dining chair fixed against a wall. The learner may use hands and needs steadying contact at half-kneel.", "walkthrough": [ "The learner first practises half-kneel to stand twice with the provider steadying the pelvis.", "Next, hands-and-knees to half-kneel is added; the whole right foot plants between the hands.", "After rest, side-sit to all-fours is practised and the learner pauses without pain.", "The full chain is completed with verbal cues at side-sit and steadying contact at half-kneel.", "The learner stands holding the chair for five seconds before stepping away; assistance is recorded per link." ], "result": "The learner completes this chair-supported chain with specific cues and steadying contact. It does not prove safe response after a fall, stair climbing, crawling endurance or independent floor transfer elsewhere." }, "right_vs_wrong": [ { "situation": "Context: Transitions, crawling and climbing checkpoint", "right": "Practise after provider clearance on a planned mat.", "wrong": "Use the sequence immediately after an actual fall.", "why": "Injury or illness may make movement unsafe." }, { "situation": "Chair: Transitions, crawling and climbing checkpoint", "right": "Use a heavy chair fixed against a wall.", "wrong": "Pull on a wheeled or light chair.", "why": "The support can slide or tip." }, { "situation": "Chaining: Transitions, crawling and climbing checkpoint", "right": "Master each link and add one at a time.", "wrong": "Rush the whole transfer before checkpoints are stable.", "why": "The provider cannot identify the failing link." }, { "situation": "Assistance: Transitions, crawling and climbing checkpoint", "right": "Record help at each step. It is correct when the learner reaches a stable hands-and-knees position.", "wrong": "Call the transfer independent because the learner ended standing.", "why": "Support level matters. That changes completion, time and assistance for one declared floor-to-stand transition. It is no longer the same test." }, { "situation": "Finish: Transitions, crawling and climbing checkpoint", "right": "Stabilise before walking away. It is correct when the learner pauses at every checkpoint and uses the recorded help.", "wrong": "Turn and walk immediately after standing.", "why": "Postural symptoms or balance may not have settled." } ], "common_mistakes": [ { "mistake": "The chair is not load-tested.", "fix": "Fix it against a wall and have the provider test it before floor entry." }, { "mistake": "The foot lands only on the toes in half-kneel.", "fix": "Reposition the whole foot before shifting weight." }, { "mistake": "The learner skips a stable pause.", "fix": "Use a spoken checkpoint at side-sit, all-fours, half-kneel and stand." }, { "mistake": "The helper lifts under the arms.", "fix": "Stop and use the provider's assessed transfer equipment or assistance plan." }, { "mistake": "Completion hides where help occurred.", "fix": "Score assistance separately at every link." } ], "practice": { "first_session": [ "Provider screens medical and joint readiness and tests the chair.", "Teach the final half-kneel-to-stand link with guarding.", "Add hands-and-knees to half-kneel, then side-sit to all-fours.", "After rest, assemble one full chain if each link is controlled.", "Record time, errors, symptoms and assistance at every link." ], "repeat_plan": "The qualified provider decides repetitions, rest, side choice and when to reduce help or change support height. Add crawling distance, stairs, ladders or outdoor surfaces only as separate assessed tasks.", "progress_when": [ "Each checkpoint can be held without collapse or increased symptoms.", "Assistance falls at one identified link without losing control elsewhere.", "The full chain is repeatable with the same chair and no unsafe fatigue." ], "do_not_progress_when": [ "Pain, dizziness, breathlessness, fear or weakness worsens at any link.", "The chair moves or the helper must improvise a lift.", "A real fall, head strike, suspected fracture or acute medical event has occurred." ] }, "self_check": [ "Can you name and pause at all four intermediate positions?", "Is the chair fixed and tested?", "Where exactly was cueing or physical help used?", "Can you explain why this is not a post-fall self-rescue instruction?" ], "measurement": { "primary": "Completion, time and assistance for one declared floor-to-stand transition", "how": "Record chair/support, surface, lead side, step order, time, errors, symptoms and assistance at each link rather than only at the finish.", "good_result": "The chain is completed twice with the same or less assistance, stable checkpoints and no new symptoms.", "does_not_prove": "It does not prove medical safety after a fall, stair/ladder ability, crawling endurance or transfer to another support." }, "stop_and_get_help": [ "Do not move after a real fall with severe pain, head impact, deformity, inability to bear weight, new confusion or neurological symptoms; seek emergency help.", "Stop practice for chest pain, faintness, severe breathlessness, new weakness/numbness or acute joint pain.", "Stop when the chair moves, the helper would need to lift unexpectedly or a checkpoint cannot be held.", "End the chain when weight bearing changes suddenly, a knee or arm gives way, or the learner cannot reach the agreed safe position; use the fall-response or clinical plan before retrying." ], "accessibility": [ "Use a higher stable support, additional pads, transfer equipment or two trained helpers when assessed and record the adaptation.", "Provide pictured, spoken or tactile link cues and allow rest at every checkpoint.", "Teach each floor-to-stand link with picture cards, touch targets or one spoken command at a time, noting rails, furniture and physical help used at every link." ], "evidence_notes": [ { "claim": "A pilot trial studied backward chaining for standing from the floor in long-term-care residents and did not show significant between-group improvement in broader mobility or strength outcomes.", "source_title": "Backward Chaining Method for Teaching Long-Term Care Residents to Stand Up from the Floor: A Pilot Randomized Controlled Trial", "source_url": "https://pubmed.ncbi.nlm.nih.gov/40806915/", "source_kind": "PRIMARY_RESEARCH" }, { "claim": "Official physical-activity guidance supports individualised, ability-appropriate activity and does not make floor recovery after a fall universally safe.", "source_title": "WHO guidelines on physical activity and sedentary behaviour", "source_url": "https://www.who.int/publications/i/item/9789240015128", "source_kind": "OFFICIAL_GUIDANCE" } ], "limits": [ "The method teaches one planned chair-supported transition only.", "A successful practice transfer does not make it safe to move after an actual fall.", "Crawling, climbing and stair/ladder tasks require separate teaching and measurement." ], "orientation": { "bounded_definition": "Capability to develop or express transitions, crawling and climbing in a declared context without inheriting broader claims.", "evidence_summary": "Transitions are practical superpowers when they matter—but floor rise, crawling and climbing are different tasks and safety comes first.", "supportable_public_claim": "Specific transitions such as rising from the floor can be practiced in supported settings, but crawling and climbing require separate evidence and safety routes.", "measurement_boundary": "Task completion, time and assistance level establish that transition only; they do not establish that moving after a fall is medically safe.", "myth_to_metric": { "myth": "Always spring back to your feet", "metric": "Completion, time and assistance for one declared transition", "boundary": "A task score cannot rule out injury or prove climbing ability." }, "limiting_findings": [ "The pilot found no significant between-group improvement in Timed Up and Go or strength." ], "prohibited_claims": [ "Escape any fall", "Move like an animal", "Climb anything", "Everyone should get up without help" ] }, "gold_source_lesson": { "curriculum_id": "G-CUR-003", "source_heading": "PWR-031 / PWR-032 — Terrain adaptation and transitions/crawling/climbing", "source_html_sha256": "da25104310494805caae2d773bf533b796d6a4872e9712c1deba4a9884de4931", "html": "Specialist route where loss of balance, height, strength demand or surface hazard creates consequence.
" }, "next_gate": "External confirmation is required before higher-authority use because: CLINICAL_HIGH_RISK_OR_REGULATED_CONFIGURATION; SUPERVISION_OR_NON_ATTEMPT_BOUNDARY; SAFETY_LEGITIMACY_RESTRICTED.", "evidence_count": 2 }, "full_training_programme": false, "independently_validated": false, "publication_state": "PUBLISHED_PUBLIC_RESEARCH_EDITION__EDITORIAL_REVIEW_PENDING", "related_power_ids": [ "PWR-025", "PWR-026", "PWR-027", "PWR-028" ] }, { "power_id": "PWR-033", "learning_unit_id": "TLU-PWR-033", "title": "Tendon adaptation", "main_description": "The learner completes one supervised set of provider-prescribed heel raises with the same range and tempo, without bouncing, foot collapse or an unacceptable delayed response.", "main_description_source": "FULL_TUTORIAL_OUTCOME", "family_id": "FAM-05", "family": "Tissue Adaptation, Repair & Reacquisition", "superdomain": "Regulation & Recovery", "canonical_route": "/powers/pwr-033/", "treatment": "SPECIALIST_PROVIDER_ROUTE", "treatment_label": "Full supervised tutorial", "treatment_boundary": "Titan teaches the complete method; a qualified person controls the parts that require supervision, clearance, specialist equipment, load, dose or progression.", "tutorial_route": "/tutorials/pwr-033/", "governed_lesson_route": null, "self_attempt_status": "PROHIBITED_WITHOUT_QUALIFIED_SUPERVISION", "gold_pathway_ids": [], "route_membership": { "kind": "RETAINED_EXTERNAL_ROUTE", "id": "SP-HUB-002", "coverage_status": "RETAINED" }, "source_authority_tier": "G4", "source_build_state": "EXTERNAL_PROVIDER_ROUTE", "source_instructional_route": "LEARN_ELSEWHERE_TRACK_WITH_TITAN", "source_count": 2, "research_depth": "FOCUSED", "risk_level": "MODERATE_TO_HIGH", "prerequisite_status": "QUALIFIED_PROVIDER_DETERMINES", "learning_route": { "mode": "FULL_SUPERVISED_TUTORIAL", "label": "Learn tendon adaptation step by step", "summary": "The learner completes one supervised set of provider-prescribed heel raises with the same range and tempo, without bouncing, foot collapse or an unacceptable delayed response.", "steps": [ [ "Get ready", "Name the exact tendon and side; report sudden pain, swelling, warmth, a recent pop, morning stiffness change or inability to push off." ], [ "Learn the method", "10 concrete steps teach the permitted method from start to finish." ], [ "See right and wrong", "10 comparisons show correct or safer execution beside common wrong or riskier choices." ], [ "Practise", "The provider controls load, repetitions, sets, frequency, range and progression. Increase only one of load, range or volume after the delayed response is acceptable; step-edge, single-leg and plyometric loading are separate progressions." ], [ "Check progress", "Use provider-calibrated imaging/mechanics when indicated and separately record heel-raise range, load, tempo, valid repetitions, symptoms and function. Keep an Achilles execution ledger for heel height, cadence, calcaneal alignment and support, plus a dated response ledger for push-off and stiffness minutes. Structural mechanics require calibrated imaging-force synchronisation. For Achilles mechanics, synchronise ultrasound landmarks, calcaneal reference and force timestamps across a declared interval; store rejected frames and calculation choices." ] ], "practical_authority": false, "provider_required": true, "next_action_route": "/tutorials/pwr-033/" }, "path_builder": { "selectable": true, "completion_allowed": true, "warning": "Titan teaches the complete method; a qualified person controls the parts that require supervision, clearance, specialist equipment, load, dose or progression." }, "full_tutorial": { "version": "3.0", "authorship": "POWER_SPECIFIC_FULL_TUTORIAL", "tutorial_mode": "SUPERVISED", "promise": "Tendon adaptation is a site-specific change in tendon mechanics or structure after repeated loading. This lesson teaches one provider-led Achilles loading method: a supported bilateral heel raise through a marked range, brief top pause and slow controlled lowering. The learner keeps foot and ankle alignment, follows the prescribed tempo and logs immediate and next-day response. The provider selects whether loading is appropriate, the load, range, tempo, repetitions, rest and progression. Achilles adaptation requires two ledgers. The execution ledger records foot marks, heel-rise height, 2-1-3 cadence, rail pressure, valid repetition count and the exact failure mode. The response ledger records walking push-off, next-morning stiffness duration, swelling and provider-selected function. Neither ledger proves tendon structural change. Ultrasound elongation and stiffness-slope estimates require calibrated imaging and force synchronisation; the learner never infers them from soreness or the number of heel raises. When Achilles mechanics are measured, the provider synchronises ultrasound with force. Ultrasound follows an Achilles fascicle or landmark between calcaneal insertion and muscle-tendon junction while the force device supplies the matching load. Achilles elongation is the change in landmark distance; a stiffness slope is estimated only across a declared force interval. Probe slip, calcaneal movement, unsynchronised frames and force misalignment invalidate the estimate. The learner stays still, follows the ramp cue and reports symptoms; the imaging specialist controls probe position, force conversion, frame selection and calculation.", "power_id": "PWR-033", "title": "Tendon adaptation", "lesson_type": "SUPERVISED", "headline": "Load one Achilles tendon with a measured slow heel-raise repetition", "plain_english_summary": "Tendon adaptation is a site-specific change in tendon mechanics or structure after repeated loading. This lesson teaches one provider-led Achilles loading method: a supported bilateral heel raise through a marked range, brief top pause and slow controlled lowering. The learner keeps foot and ankle alignment, follows the prescribed tempo and logs immediate and next-day response. The provider selects whether loading is appropriate, the load, range, tempo, repetitions, rest and progression. Achilles adaptation requires two ledgers. The execution ledger records foot marks, heel-rise height, 2-1-3 cadence, rail pressure, valid repetition count and the exact failure mode. The response ledger records walking push-off, next-morning stiffness duration, swelling and provider-selected function. Neither ledger proves tendon structural change. Ultrasound elongation and stiffness-slope estimates require calibrated imaging and force synchronisation; the learner never infers them from soreness or the number of heel raises. When Achilles mechanics are measured, the provider synchronises ultrasound with force. Ultrasound follows an Achilles fascicle or landmark between calcaneal insertion and muscle-tendon junction while the force device supplies the matching load. Achilles elongation is the change in landmark distance; a stiffness slope is estimated only across a declared force interval. Probe slip, calcaneal movement, unsynchronised frames and force misalignment invalidate the estimate. The learner stays still, follows the ramp cue and reports symptoms; the imaging specialist controls probe position, force conversion, frame selection and calculation.", "outcome": "The learner completes one supervised set of provider-prescribed heel raises with the same range and tempo, without bouncing, foot collapse or an unacceptable delayed response.", "authority": { "learner_may": [ "Tendon adaptation: Stand with feet on recorded marks and light hands on a fixed rail; keep weight shared as prescribed and toes pointing forward or in the recorded angle. Press through the forefoot and lift both heels over the provider-set count; do not dip quickly first or spring from the bottom.", "During an authorised attempt, Reach the recorded height and hold briefly while breathing; stop below the marker if the provider's range is limited. Pause only as prescribed, confirm foot position and repeat. End at the first range, tempo or alignment failure.", "Match foot marks, rail contact and weight distribution to the plan and record heel height, tempo, valid repetitions, immediate symptoms and next-morning response." ], "qualified_person_required_for": [ "Assess the named Achilles tendon, rupture or postoperative risk, swelling, walking function and delayed load response before prescribing heel raises.", "Assess the named Achilles tendon, choose support, external load, range, tempo, repetitions, sets, rest, frequency and response threshold.", "Standardise rail assistance and heel-rise markers, enforce the prescribed cadence and stop the set when height, alignment or tempo fails; review later-day and next-morning findings before progression." ], "never_do": [ "Add a step-edge drop, external weight, single-leg version or painful stretching without the provider's explicit plan.", "Do not add external load, repetitions, range or impact work in response to a comfortable set without the clinician's progression decision.", "Stop immediately for sudden pain, a pop, swelling, warmth, loss of push-off, marked limp or an abrupt change in the tendon response." ] }, "materials": [ "Stable rail or fixed support", "Flat non-slip floor or provider-approved step", "Range marker and audible tempo", "Provider-selected load plus immediate/24-hour symptom log", "An Achilles record for side and site, foot marks, support, load, heel-rise height, cadence, valid and failed repetitions, immediate response, walking function and next-morning stiffness." ], "before_you_start": [ "Name the exact tendon and side; report sudden pain, swelling, warmth, a recent pop, morning stiffness change or inability to push off.", "Check footwear, surface, support and the provider-set range and tempo.", "Agree on the allowed symptom response during the set and the next-morning review rule.", "Mark the foot position, set the rail contact and show the top heel-height marker. Practise one easy rise and start the set only when the foot, support and weight distribution match the clinician's plan.", "Practise one supported rise without bouncing and check foot and ankle alignment at an easy provider-selected load before the prescribed set." ], "steps": [ { "title": "Set the foot and support", "instruction": "Stand with feet on recorded marks and light hands on a fixed rail; keep weight shared as prescribed and toes pointing forward or in the recorded angle.", "reason": "Foot position changes which tissues and range are loaded.", "success_check": "Marks, support and weight distribution match the plan." }, { "title": "Rise without a bounce", "instruction": "Press through the forefoot and lift both heels over the provider-set count; do not dip quickly first or spring from the bottom.", "reason": "A slow rise keeps the repetition attributable to the declared load.", "success_check": "Heels rise smoothly and the support does not carry body weight." }, { "title": "Keep ankle alignment", "instruction": "Track each heel above the second toe and keep the arch from collapsing or rolling outward.", "reason": "Alignment drift can shift load away from the intended tendon task.", "success_check": "Rear-view observation stays inside the provider's alignment tolerance." }, { "title": "Pause at the marked top", "instruction": "Reach the recorded height and hold briefly while breathing; stop below the marker if the provider's range is limited.", "reason": "A repeatable top defines the working range.", "success_check": "Both heels reach the marker without cramp or pain escalation." }, { "title": "Lower on the slow count", "instruction": "Lower the heels evenly for the full prescribed count until the floor or marked bottom; do not drop the final part.", "reason": "The lowering phase supplies controlled tendon loading and reveals fatigue.", "success_check": "The full descent follows the tempo without a sudden fall." }, { "title": "Reset before the next repetition", "instruction": "Pause only as prescribed, confirm foot position and repeat. End at the first range, tempo or alignment failure.", "reason": "Invalid repetitions should not be completed for volume.", "success_check": "Every counted repetition meets all three rules." }, { "title": "Log delayed response", "instruction": "Record set response, walking/push-off afterwards and the next morning's pain, stiffness, swelling and function before any progression.", "reason": "Tendon response may appear after the session.", "success_check": "The provider receives both immediate and delayed data." }, { "title": "Calibrate heel rise height", "instruction": "Before the set, place a visible marker at the provider-approved heel height and rehearse touching it without rolling the calcaneus inward or outward. Record whether the task uses shoes, bare feet or an insert.", "reason": "Heel height and footwear alter ankle excursion and make repetition comparisons ambiguous.", "success_check": "Both calcanei reach the same marked height while arches and toe pressure remain organised." }, { "title": "Complete the Achilles response ledger", "instruction": "At the agreed later-day and next-morning times, enter push-off quality, stiffness minutes, swelling and the same walking or stair item. Do not replace a missed check with memory several days later.", "reason": "A time-anchored response can reveal irritability after an apparently comfortable heel-raise set.", "success_check": "Execution data and delayed Achilles response appear as separate dated entries before progression is discussed." }, { "title": "Synchronise Achilles imaging and force", "instruction": "During a provider-authorised submaximal mechanics trial, keep foot and calcaneus fixed while the specialist records ultrasound frames and matching force timestamps. Relax immediately if the probe slips or the Achilles landmark disappears.", "reason": "Unsynchronised force and elongation cannot produce a defensible Achilles stiffness slope.", "success_check": "Every retained Achilles frame has a matching force value, visible landmark, stable calcaneus and provider validity code." } ], "worked_example": { "scenario": "A physiotherapist prescribes six bilateral heel raises on flat ground: two seconds up, one-second pause, three seconds down, light fingertip support and no external load.", "walkthrough": [ "The learner marks foot position and practises one unloaded-tempo repetition.", "Repetitions one to four meet range, alignment and 2-1-3 timing.", "Repetition five drops through the last lowering second and is the first technical failure.", "The set stops; repetition six is not attempted.", "The learner records four valid repetitions and next-morning walking/stiffness before the provider decides whether to repeat.", "The top marker is 62 mm above resting heel level; repetitions one through four reach it without calcaneal roll or heavy rail pressure.", "At the later-day check, walking push-off is unchanged; next morning, stiffness lasts eight minutes versus the recorded six-minute baseline.", "The physiotherapist keeps the same flat-ground bilateral task because height failed on repetition five; no step-edge or single-leg progression is introduced.", "At the imaging visit, the specialist marks calcaneal insertion and an Achilles proximal landmark, then checks ultrasound visibility during a gentle ramp.", "Matched frames show 2.0 mm Achilles elongation across the provider's declared force interval; a separate unsynchronised frame is rejected.", "The learner records no symptom during imaging and does not convert the calculated Achilles stiffness slope into a self-selected heel-raise load.", "Heel-rise height, morning stiffness and walking push-off stay in the execution-response ledger, separate from ultrasound elongation." ], "result": "Four valid slow heel raises were completed in this flat-ground bilateral setup. This does not establish tendon stiffness change, safe maximum strain, pain cure or injury immunity." }, "right_vs_wrong": [ { "situation": "Rise: Tendon adaptation checkpoint", "right": "Lift smoothly without a countermovement. It is correct when marks, support and weight distribution match the plan.", "wrong": "Bounce from the bottom; it breaks the 'Set the foot and support' execution rule.", "why": "A bounce changes loading rate and control." }, { "situation": "Alignment: Tendon adaptation checkpoint", "right": "Keep heel tracking over the forefoot.", "wrong": "Let the ankle roll and arch collapse.", "why": "Load shifts and the declared repetition fails." }, { "situation": "Lowering: Tendon adaptation checkpoint", "right": "Use the full slow count. It is correct when rear-view observation stays inside the provider's alignment tolerance.", "wrong": "Drop quickly at the hardest point.", "why": "The eccentric phase is lost. That changes tendon stiffness, elongation and function at a named site, with loading quality and symptoms. It is no longer the same test." }, { "situation": "Endpoint: Tendon adaptation checkpoint", "right": "Stop at first range/tempo/alignment failure. It is correct when both heels reach the marker without cramp or pain escalation.", "wrong": "Finish the set with partial fast repetitions.", "why": "Volume no longer represents the prescribed task." }, { "situation": "Progression: Tendon adaptation checkpoint", "right": "Use immediate and next-day response. It is correct when the full descent follows the tempo without a sudden fall.", "wrong": "Add load because the set felt easy at the time.", "why": "Delayed response is missing. That changes tendon stiffness, elongation and function at a named site, with loading quality and symptoms. It is no longer the same test." }, { "situation": "Counting an Achilles repetition", "right": "Require marked heel height, 2-1-3 cadence and calcaneal alignment together.", "wrong": "Count a low, fast raise because the calf still feels active.", "why": "Shortened excursion and bounce change the tendon-loading task." }, { "situation": "Claiming tendon adaptation", "right": "Use calibrated longitudinal mechanics or imaging when that outcome is justified.", "wrong": "Call soreness or more heel raises proof of increased Achilles stiffness.", "why": "Exercise response, performance and tendon mechanical adaptation are different observations." }, { "situation": "Achilles stiffness estimation", "right": "Pair each ultrasound landmark frame with its synchronised force timestamp.", "wrong": "Compare an unloaded image with whichever loaded frame looks longest.", "why": "Frame selection without synchronisation biases Achilles elongation." }, { "situation": "Probe movement", "right": "Invalidate the segment when the Achilles landmark or calcaneal reference shifts.", "wrong": "Manually realign a slipped image and keep the calculation.", "why": "Apparent elongation may come from probe or reference movement." }, { "situation": "Using the mechanics result", "right": "Let the provider interpret Achilles elongation and stiffness beside function.", "wrong": "Use a stiffness slope to prescribe a heavier heel-raise load independently.", "why": "Measurement does not supply an unsupervised tendon dose." } ], "common_mistakes": [ { "mistake": "Support carries too much body weight.", "fix": "Use fingertip contact or the provider's recorded support level and measure any change." }, { "mistake": "Heel height shrinks across repetitions.", "fix": "Use a visible range marker and stop on the first miss." }, { "mistake": "Tempo is counted inconsistently during 'Keep ankle alignment' in tendon adaptation.", "fix": "Use one audible timer for rise, pause and lowering." }, { "mistake": "Only session pain is logged.", "fix": "Record next-morning stiffness, swelling and push-off function." }, { "mistake": "A stiffer tendon is assumed safer.", "fix": "Keep mechanics, symptoms and function as separate outcomes." }, { "mistake": "Heel-rise height is judged by eye without a marker.", "fix": "Set and record a millimetre or fixed visual reference before the first repetition." }, { "mistake": "Next-morning stiffness is recorded without its duration.", "fix": "Log onset, minutes until usual movement and the paired push-off function at the scheduled time." }, { "mistake": "Ultrasound and force streams lack shared timestamps.", "fix": "Synchronise acquisition before calculating Achilles elongation or stiffness." }, { "mistake": "Calcaneal movement is treated as tendon elongation.", "fix": "Track the calcaneal reference and reject frames with unstable foot fixation." }, { "mistake": "A mechanics estimate replaces the heel-raise and morning-response ledger.", "fix": "Report Achilles imaging, heel-rise execution and delayed function as separate outcomes." } ], "practice": { "first_session": [ "Provider assesses the named tendon and sets flat-ground range/tempo.", "Practise two no-load repetitions with alignment feedback.", "Complete one short familiarisation set below the planned count.", "After rest, complete one prescribed set using the first-failure rule.", "Record immediate response and schedule the next-morning check.", "Measure resting and target heel position, then rehearse touching the marker while a rear view checks both calcanei.", "Create dated later-day and next-morning Achilles response prompts before the working set begins.", "Review sample Achilles ultrasound-force pairs and reject probe slip, calcaneal movement and timestamp mismatch before any stiffness calculation." ], "repeat_plan": "The provider controls load, repetitions, sets, frequency, range and progression. Increase only one of load, range or volume after the delayed response is acceptable; step-edge, single-leg and plyometric loading are separate progressions.", "progress_when": [ "All repetitions maintain range, tempo and heel/arch alignment.", "Walking, push-off and next-morning response remain inside the provider's rule.", "Provider-measured tendon mechanics or function changes beyond test error over the planned interval.", "Marked heel height and calcaneal alignment persist through the prescribed cadence while the time-anchored Achilles response stays acceptable.", "Achilles ultrasound landmarks, force timestamps and calcaneal reference remain synchronised across the declared force interval." ], "do_not_progress_when": [ "Sudden pain, swelling, warmth, loss of push-off or a pop occurs.", "Next-morning symptoms or function are worse beyond the agreed rule.", "More load is needed to mask shortened range, tempo loss or heavy support.", "Heel-rise height, footwear, rail pressure or next-morning stiffness duration is missing from the comparison record.", "Probe slip, missing Achilles landmark, calcaneal movement or force-time mismatch prevents a valid mechanics estimate." ] }, "self_check": [ "Can you name the exact tendon, setup and 2-1-3 tempo?", "Did every counted repetition meet range and alignment?", "Did the set stop at first technical failure?", "Was next-morning response recorded before progression?", "Can you distinguish heel-rise execution data from ultrasound elongation and stiffness-slope measurement?", "Can you report target height, first failed repetition and next-morning stiffness duration without guessing?", "Can you distinguish Achilles elongation from heel-rise height?", "Which four faults invalidate an ultrasound-force stiffness estimate?", "Why does a stiffness slope not prescribe the next heel-raise load?" ], "measurement": { "primary": "Tendon stiffness, elongation and function at a named site, with loading quality and symptoms", "how": "Use provider-calibrated imaging/mechanics when indicated and separately record heel-raise range, load, tempo, valid repetitions, symptoms and function. Keep an Achilles execution ledger for heel height, cadence, calcaneal alignment and support, plus a dated response ledger for push-off and stiffness minutes. Structural mechanics require calibrated imaging-force synchronisation. For Achilles mechanics, synchronise ultrasound landmarks, calcaneal reference and force timestamps across a declared interval; store rejected frames and calculation choices.", "good_result": "The prescribed task is repeatable with acceptable delayed response and any mechanical/functional change exceeds measurement error. Exercise fidelity and delayed response remain acceptable, while any stiffness or elongation change exceeds the site's imaging and force-measurement error.", "does_not_prove": "It does not prove injury prevention, pain cure, safe maximum strain or adaptation in another tendon." }, "stop_and_get_help": [ "Stop immediately for a pop, sudden sharp pain, rapid swelling, new gap/deformity or loss of normal push-off and seek urgent assessment.", "Stop the set for increasing pain, cramp, alignment collapse, range loss or inability to control the lowering phase.", "Stop the tendon-loading set for a sharp pain jump, new swelling, loss of push-off or a next-day reaction beyond the provider's rule, and return progression to that provider." ], "accessibility": [ "Use seated heel raise, bilateral support, a shorter provider-set range or an adaptive footplate when assessed, with a separate baseline.", "Use visual, spoken or vibration tempo cues and larger foot/range markers.", "Mark foot placement and heel-rise tempo with floor tape, a metronome or tactile support cue, keeping support level and symptom reporting unchanged in the log." ], "evidence_notes": [ { "claim": "Human Achilles tendon mechanics and morphology can change in response to a specified cyclic strain protocol, but the study does not establish injury immunity.", "source_title": "Plasticity of human Achilles tendon mechanical and morphological properties in response to cyclic strain", "source_url": "https://pubmed.ncbi.nlm.nih.gov/20863501/", "source_kind": "PRIMARY_RESEARCH" }, { "claim": "Isometric training can change tendon elasticity in a tested structure, showing that tendon adaptation is site- and loading-mode specific.", "source_title": "Effects of isometric training on the elasticity of human tendon structures in vivo", "source_url": "https://pubmed.ncbi.nlm.nih.gov/11408409/", "source_kind": "PRIMARY_RESEARCH" } ], "limits": [ "Tendon adaptation is slow, site-specific and dependent on measured load.", "Pain, structure, stiffness and function are separate outcomes.", "This lesson supplies no universal tendon-loading dose or safe strain limit." ], "orientation": { "bounded_definition": "Capability to develop or express tendon adaptation in a declared context without inheriting broader claims.", "evidence_summary": "Tendons are living tissues that adapt to load. That adaptation is slow, specific and nothing like becoming unbreakable.", "supportable_public_claim": "Tendons adapt to repeated mechanical loading, but the response is tendon- and dose-specific and does not make tissue unbreakable.", "measurement_boundary": "Stiffness, elongation and cross-sectional area characterize the tested tendon under load; they do not prove pain-free function or injury immunity.", "myth_to_metric": { "myth": "Build unbreakable tendons", "metric": "Tendon stiffness, elongation and function at a named site", "boundary": "Tissue metrics cannot prove immunity from rupture or pain." }, "limiting_findings": [ "The studies do not establish injury prevention, long-term retention or a safe maximum strain." ], "prohibited_claims": [ "Unbreakable tendons", "Pain hardens tissue", "Maximum strain grows the strongest tendon", "One protocol works for every tendon" ] }, "gold_source_lesson": null, "next_gate": "External confirmation is required before higher-authority use because: CLINICAL_HIGH_RISK_OR_REGULATED_CONFIGURATION; SUPERVISION_OR_NON_ATTEMPT_BOUNDARY; SAFETY_LEGITIMACY_RESTRICTED.", "evidence_count": 2 }, "full_training_programme": false, "independently_validated": false, "publication_state": "PUBLISHED_PUBLIC_RESEARCH_EDITION__EDITORIAL_REVIEW_PENDING", "related_power_ids": [ "PWR-034", "PWR-035", "PWR-036", "PWR-037" ] }, { "power_id": "PWR-034", "learning_unit_id": "TLU-PWR-034", "title": "Bone adaptation", "main_description": "The learner completes the provider-prescribed squat-to-box set with stable stance, controlled depth and return to the rack, while load and symptoms are recorded separately from site-specific DXA outcomes.", "main_description_source": "FULL_TUTORIAL_OUTCOME", "family_id": "FAM-05", "family": "Tissue Adaptation, Repair & Reacquisition", "superdomain": "Regulation & Recovery", "canonical_route": "/powers/pwr-034/", "treatment": "SPECIALIST_PROVIDER_ROUTE", "treatment_label": "Full supervised tutorial", "treatment_boundary": "Titan teaches the complete method; a qualified person controls the parts that require supervision, clearance, specialist equipment, load, dose or progression.", "tutorial_route": "/tutorials/pwr-034/", "governed_lesson_route": null, "self_attempt_status": "PROHIBITED_WITHOUT_QUALIFIED_SUPERVISION", "gold_pathway_ids": [], "route_membership": { "kind": "RETAINED_EXTERNAL_ROUTE", "id": "SP-HUB-002", "coverage_status": "RETAINED" }, "source_authority_tier": "G4", "source_build_state": "EXTERNAL_PROVIDER_ROUTE", "source_instructional_route": "LEARN_ELSEWHERE_TRACK_WITH_TITAN", "source_count": 2, "research_depth": "FOCUSED", "risk_level": "HIGH", "prerequisite_status": "QUALIFIED_PROVIDER_DETERMINES", "learning_route": { "mode": "FULL_SUPERVISED_TUTORIAL", "label": "Learn bone adaptation step by step", "summary": "The learner completes the provider-prescribed squat-to-box set with stable stance, controlled depth and return to the rack, while load and symptoms are recorded separately from site-specific DXA outcomes.", "steps": [ [ "Get ready", "Tell the provider about osteoporosis/osteopenia, fracture, falls, pain, balance limits, surgery and medicines affecting bone or dizziness." ], [ "Learn the method", "7 concrete steps teach the permitted method from start to finish." ], [ "See right and wrong", "5 comparisons show correct or safer execution beside common wrong or riskier choices." ], [ "Practise", "The qualified team sets resistance, impact, frequency and progression within an individual programme. Load is never increased from this page; DXA or clinical reassessment follows the clinician's interval, not session-to-session fluctuations." ], [ "Check progress", "Use clinician-directed DXA or other validated site-specific methods over time; record scanner/site/analysis and separately log exercise configuration, valid repetitions, falls and function." ] ], "practical_authority": false, "provider_required": true, "next_action_route": "/tutorials/pwr-034/" }, "path_builder": { "selectable": true, "completion_allowed": true, "warning": "Titan teaches the complete method; a qualified person controls the parts that require supervision, clearance, specialist equipment, load, dose or progression." }, "full_tutorial": { "version": "3.0", "authorship": "POWER_SPECIFIC_FULL_TUTORIAL", "tutorial_mode": "SUPERVISED", "promise": "Bone adaptation is change in bone density, geometry or fracture outcome at a named site over time. This lesson teaches one provider-controlled loading method used inside a broader bone-health programme: a squat to a fixed box with the load chosen and spotted by a qualified professional. The learner sets the feet, receives the load, sits the hips down under control, touches the box without collapsing, stands through the feet and returns the load on command. The provider controls clinical clearance, exercise choice, load, depth, repetitions, impact exposure and progression.", "power_id": "PWR-034", "title": "Bone adaptation", "lesson_type": "SUPERVISED", "headline": "Perform a provider-loaded squat-to-box while bone outcomes stay site-specific", "plain_english_summary": "Bone adaptation is change in bone density, geometry or fracture outcome at a named site over time. This lesson teaches one provider-controlled loading method used inside a broader bone-health programme: a squat to a fixed box with the load chosen and spotted by a qualified professional. The learner sets the feet, receives the load, sits the hips down under control, touches the box without collapsing, stands through the feet and returns the load on command. The provider controls clinical clearance, exercise choice, load, depth, repetitions, impact exposure and progression.", "outcome": "The learner completes the provider-prescribed squat-to-box set with stable stance, controlled depth and return to the rack, while load and symptoms are recorded separately from site-specific DXA outcomes.", "authority": { "learner_may": [ "Bone adaptation: The provider fixes box height and safety supports, then the learner places feet on recorded marks before taking load. Take the provider-selected load in the taught position, step or position only as instructed and become still before squatting.", "During an authorised attempt, Descend only until a light controlled box touch; do not drop, fully relax or rock backward. Take the prescribed breath/reset at the top and repeat only while stance, depth and speed meet the rule; stop at first technical failure.", "Match box, rack, stance and load to the plan and record whether the learner touched the box, stood without rocking and returned the load safely." ], "qualified_person_required_for": [ "Review fracture and fall risk, bone-health history, relevant medication and medical contraindications before choosing resistance or impact exposure.", "Review fracture/fall and medical risk, select exercise/impact mode, load, box height, equipment, spotting, repetitions, recovery and bone outcome monitoring.", "Keep box height and rack setup fixed, provide the declared spot, cue a controlled touch rather than a full sit and judge the next exposure from technique, symptoms and the wider bone-health plan." ], "never_do": [ "Begin high-intensity resistance or impact loading, jump, or lift to failure from this lesson, especially with osteoporosis, fracture risk or uncertain technique.", "Do not increase load or depth, add jumps or train to failure because the squat-to-box set felt manageable.", "Stop for pain, dizziness, loss of balance, a fall or near-fall, new fracture concern or inability to control the box touch and return to the rack." ] }, "materials": [ "Qualified provider and stable rack or approved loading device", "Fixed-height heavy box or bench", "Provider-selected bar/load and safety supports", "Training log plus site-specific DXA/clinical record when ordered", "A bone-loading record for site-specific goal, exercise, rack and box setup, stance, load, spotting, repetitions, technique, symptoms and separately scheduled bone outcomes." ], "before_you_start": [ "Tell the provider about osteoporosis/osteopenia, fracture, falls, pain, balance limits, surgery and medicines affecting bone or dizziness.", "Confirm box height, stance, load, rack/safety positions, repetitions and rack command.", "Practise the unloaded path and safe abort before receiving any load.", "Set the rack height, fixed box, stance and spotting position before loading. Rehearse a controlled box touch at an easy resistance and continue only when the whole setup matches the bone-loading plan.", "Rehearse receiving the load, sitting the hips toward the fixed box and standing without rocking at an easy provider-selected resistance." ], "steps": [ { "title": "Set rack and box", "instruction": "The provider fixes box height and safety supports, then the learner places feet on recorded marks before taking load.", "reason": "Depth and safety equipment define the task.", "success_check": "The box, rack and stance match the plan." }, { "title": "Receive and settle the load", "instruction": "Take the provider-selected load in the taught position, step or position only as instructed and become still before squatting.", "reason": "Movement under an unsettled load increases loss-of-balance risk.", "success_check": "The load is centred and the learner confirms ready." }, { "title": "Begin with hips and knees", "instruction": "Bend hips and knees together, keep the whole foot planted and let knees track with toes; breathe using the provider-taught pattern.", "reason": "A controlled descent keeps the load over the support base.", "success_check": "Feet stay flat and the trunk remains inside the taught range." }, { "title": "Touch the box without collapsing", "instruction": "Descend only until a light controlled box touch; do not drop, fully relax or rock backward.", "reason": "The box is a depth marker, not a seat for momentum.", "success_check": "Contact is quiet and body tension remains controlled." }, { "title": "Stand through the floor", "instruction": "Push through both feet and extend hips and knees together without knees collapsing or one side leading.", "reason": "Uneven or twisting ascent changes the loading pattern.", "success_check": "The learner rises smoothly to the declared finish." }, { "title": "Reset or stop", "instruction": "Take the prescribed breath/reset at the top and repeat only while stance, depth and speed meet the rule; stop at first technical failure.", "reason": "Bone-loading dose should not be filled with uncontrolled repetitions.", "success_check": "Every counted repetition is valid; the visible 'Reset or stop' check is satisfied." }, { "title": "Rack only on command", "instruction": "After the set, wait for the provider's rack cue, move into the support and confirm the load is secure before releasing it.", "reason": "The return is a high-consequence part of the lift.", "success_check": "Both supports hold the load and the learner steps clear safely." } ], "worked_example": { "scenario": "After clinical and technique assessment, a strength professional prescribes five squat-to-box repetitions at an individually selected load in a rack with safeties.", "walkthrough": [ "The learner rehearses the box touch and rack command with an unloaded training bar.", "The provider loads the assigned weight and confirms foot marks and safety height.", "Repetitions one to four are controlled; repetition five begins with the right knee moving inward.", "The provider calls stop before the repetition descends and the learner racks on command.", "Four valid repetitions and the aborted fifth are logged; DXA at the clinician-selected site remains a separate longitudinal measure." ], "result": "The learner completed four valid loaded repetitions in this configuration. That is a training-process result, not proof of increased BMD or reduced fracture risk." }, "right_vs_wrong": [ { "situation": "Depth aid", "right": "Touch the fixed box lightly while staying controlled.", "wrong": "Drop onto it and rock to stand.", "why": "Momentum and spinal/load pattern change. That changes site-specific bone density/geometry and fracture outcomes, with programme load and function separate. It is no longer the same test." }, { "situation": "Feet/knees: Bone adaptation checkpoint", "right": "Keep whole feet down and knees tracking with toes.", "wrong": "Let heels lift or knees collapse inward.", "why": "The support and loading path become unstable." }, { "situation": "Endpoint: Bone adaptation checkpoint", "right": "Stop at first technical failure. It is correct when feet stay flat and the trunk remains inside the taught range.", "wrong": "Complete all repetitions after form loss for bone stimulus.", "why": "Uncontrolled volume is not a valid dose." }, { "situation": "Rack: Bone adaptation checkpoint", "right": "Wait for the command and verify both supports.", "wrong": "Turn or release before the load is secure.", "why": "A rack miss can cause serious injury." }, { "situation": "Outcome: Bone adaptation checkpoint", "right": "Track training load and site-specific bone measures separately.", "wrong": "Assume a completed set increased bone density.", "why": "Bone change requires longitudinal measurement. That changes site-specific bone density/geometry and fracture outcomes, with programme load and function separate. It is no longer the same test." } ], "common_mistakes": [ { "mistake": "Box height changes between sessions.", "fix": "Measure and lock the height and stance." }, { "mistake": "The learner fully sits and rocks.", "fix": "Reduce load/depth and practise a light touch with continuous tension." }, { "mistake": "The load is progressed from effort alone.", "fix": "Use provider-set technique, symptoms and programme criteria." }, { "mistake": "The final technical failure is counted.", "fix": "Log only valid repetitions and the abort reason." }, { "mistake": "Total-body DXA is used to claim site-specific change.", "fix": "Report the clinician-selected site and scanner/analysis conditions." } ], "practice": { "first_session": [ "Provider reviews medical/fracture/fall risk and selects the exercise.", "Rehearse box touch, stand and rack at no or minimal load.", "Complete provider-selected warm-up sets with spotting.", "Complete one short prescribed working set and stop at first failure.", "Log technique, load, symptoms and the separate bone-monitoring plan." ], "repeat_plan": "The qualified team sets resistance, impact, frequency and progression within an individual programme. Load is never increased from this page; DXA or clinical reassessment follows the clinician's interval, not session-to-session fluctuations.", "progress_when": [ "Every repetition uses the same controlled depth, stance and rack sequence.", "Programme load advances only under provider criteria without new pain, falls or technique loss.", "Site-specific bone/functional outcomes are reviewed over the appropriate long interval." ], "do_not_progress_when": [ "Pain, new fracture concern, fall, dizziness or balance change appears.", "Depth, stance, knee tracking, trunk control or rack safety fails.", "Progress depends on unverified BMD change or a different scanner/site/protocol." ] }, "self_check": [ "Can you state box height, stance, load and rack command?", "Was contact a light touch rather than a sit and rock?", "Was the bone-loading set ended as soon as squat depth or rack control failed?", "Can you explain why the set does not prove bone-density or fracture change?" ], "measurement": { "primary": "Site-specific bone density/geometry and fracture outcomes, with programme load and function separate", "how": "Use clinician-directed DXA or other validated site-specific methods over time; record scanner/site/analysis and separately log exercise configuration, valid repetitions, falls and function.", "good_result": "Training is executed safely and any longitudinal site-specific change exceeds measurement error, with fracture/fall/function outcomes interpreted separately.", "does_not_prove": "A training set or single DXA value does not prove microarchitecture, individual fracture immunity, falls prevention or whole-skeleton adaptation." }, "stop_and_get_help": [ "Stop and seek urgent assessment after a fall or sudden severe back/hip/limb pain, deformity, inability to bear weight or suspected fracture.", "Stop the lift for dizziness, chest symptoms, loss of balance, sharp pain, equipment movement or rack/spotting failure.", "Cease loading after focal bone pain, a new impact injury, loss of normal weight bearing or a restriction change, and obtain prompt assessment instead of testing through it." ], "accessibility": [ "Use a provider-selected machine, supported sit-to-stand or alternative loading mode when a barbell/rack is inaccessible, with a separate programme record.", "Adjust box height, grip and communication while preserving qualified spotting and site-specific outcome boundaries.", "Identify rack height, box target and bracing sequence through large labels, demonstration or touch points, documenting spotting and equipment changes with every load exposure." ], "evidence_notes": [ { "claim": "A supervised high-intensity resistance and impact trial reported site-specific bone and function changes in postmenopausal women with low bone mass.", "source_title": "High-Intensity Resistance and Impact Training Improves Bone Mineral Density and Physical Function in Postmenopausal Women With Osteopenia and Osteoporosis: The LIFTMOR Randomized Controlled Trial", "source_url": "https://pubmed.ncbi.nlm.nih.gov/28975661/", "source_kind": "PRIMARY_RESEARCH" }, { "claim": "A separate nine-month trial found no resistance-training effect on several aBMD sites, so a loading programme cannot promise bone-density gain.", "source_title": "Effects of low-dose ibuprofen supplementation and resistance training on bone and muscle in postmenopausal women: A randomized controlled trial", "source_url": "https://pubmed.ncbi.nlm.nih.gov/28326351/", "source_kind": "PRIMARY_RESEARCH" } ], "limits": [ "Bone response is site-, population-, dose- and time-specific.", "DXA aBMD is a proxy and does not directly measure microarchitecture or individual fracture immunity.", "This lesson does not authorise unsupervised high-load or impact exercise." ], "orientation": { "bounded_definition": "Capability to develop or express bone adaptation in a declared context without inheriting broader claims.", "evidence_summary": "Bones respond to load, but not every programme changes every bone site. Strong training can be safe only in the screened, supervised configuration tested.", "supportable_public_claim": "Bone can adapt to loading, but measured gains are site- and programme-specific and high-impact routes need screening and supervision.", "measurement_boundary": "DXA aBMD is a clinically useful site-specific proxy; it does not directly measure microarchitecture, falls or individual fracture immunity.", "myth_to_metric": { "myth": "Forge unbreakable bones", "metric": "Site-specific BMD, geometry and fracture outcomes", "boundary": "A BMD change cannot prove fracture immunity." }, "limiting_findings": [ "A nine-month randomized trial found no resistance-training effect on lumbar-spine, femoral-neck or total-body aBMD." ], "prohibited_claims": [ "Make bones indestructible", "Jump away osteoporosis", "BMD proves fracture-proofing", "Stop medication and train instead" ] }, "gold_source_lesson": null, "next_gate": "External confirmation is required before higher-authority use because: CLINICAL_HIGH_RISK_OR_REGULATED_CONFIGURATION; SUPERVISION_OR_NON_ATTEMPT_BOUNDARY; SAFETY_LEGITIMACY_RESTRICTED.", "evidence_count": 2 }, "full_training_programme": false, "independently_validated": false, "publication_state": "PUBLISHED_PUBLIC_RESEARCH_EDITION__EDITORIAL_REVIEW_PENDING", "related_power_ids": [ "PWR-033", "PWR-035", "PWR-036", "PWR-037" ] }, { "power_id": "PWR-035", "learning_unit_id": "TLU-PWR-035", "title": "Muscle hypertrophy and atrophy resistance", "main_description": "The learner completes a provider-prescribed knee-extension set with every counted repetition meeting range and tempo, while muscle size, strength and function remain separate outcomes.", "main_description_source": "FULL_TUTORIAL_OUTCOME", "family_id": "FAM-05", "family": "Tissue Adaptation, Repair & Reacquisition", "superdomain": "Regulation & Recovery", "canonical_route": "/powers/pwr-035/", "treatment": "SPECIALIST_PROVIDER_ROUTE", "treatment_label": "Full supervised tutorial", "treatment_boundary": "Titan teaches the complete method; a qualified person controls the parts that require supervision, clearance, specialist equipment, load, dose or progression.", "tutorial_route": "/tutorials/pwr-035/", "governed_lesson_route": null, "self_attempt_status": "PROHIBITED_WITHOUT_QUALIFIED_SUPERVISION", "gold_pathway_ids": [], "route_membership": { "kind": "RETAINED_EXTERNAL_ROUTE", "id": "SP-HUB-002", "coverage_status": "RETAINED" }, "source_authority_tier": "G4", "source_build_state": "EXTERNAL_PROVIDER_ROUTE", "source_instructional_route": "LEARN_ELSEWHERE_TRACK_WITH_TITAN", "source_count": 2, "research_depth": "FOCUSED", "risk_level": "MODERATE", "prerequisite_status": "QUALIFIED_PROVIDER_DETERMINES", "learning_route": { "mode": "FULL_SUPERVISED_TUTORIAL", "label": "Learn muscle hypertrophy and atrophy resistance step by step", "summary": "The learner completes a provider-prescribed knee-extension set with every counted repetition meeting range and tempo, while muscle size, strength and function remain separate outcomes.", "steps": [ [ "Get ready", "Report knee/hip/back pain, recent surgery, swelling, weakness, illness and unusual delayed soreness." ], [ "Learn the method", "10 concrete steps teach the permitted method from start to finish." ], [ "See right and wrong", "10 comparisons show correct or safer execution beside common wrong or riskier choices." ], [ "Practise", "The provider controls exercises, sets, repetitions, load, rest, weekly frequency and nutrition/clinical referral. Progress only when full-range controlled repetitions and recovery are stable; detraining and maintenance require separate plans." ], [ "Check progress", "Use a consistent validated imaging or circumference method for size, a separate standard strength test and a separate function; log training configuration and assistance. For muscle size, reproduce anatomical coordinate, side, body position, hydration/rest conditions, operator and imaging settings. Maintain separate exposure, strength and stair-function timelines. Assign quadriceps image-validity codes for landmark, plane, pressure, fascia visibility, depth and gain before tracing muscle boundaries." ] ], "practical_authority": false, "provider_required": true, "next_action_route": "/tutorials/pwr-035/" }, "path_builder": { "selectable": true, "completion_allowed": true, "warning": "Titan teaches the complete method; a qualified person controls the parts that require supervision, clearance, specialist equipment, load, dose or progression." }, "full_tutorial": { "version": "3.0", "authorship": "POWER_SPECIFIC_FULL_TUTORIAL", "tutorial_mode": "SUPERVISED", "promise": "Muscle hypertrophy is an increase in declared muscle size; atrophy resistance is preservation during reduced stimulus. This lesson teaches one supervised resistance set on a knee-extension machine: reproduce the seat and lever, lift through the provider-set range without kicking, pause, lower on the full tempo and stop at the first repetition that misses range, speed or posture. The provider controls load, repetitions, sets, rest, weekly dose and whether the task is appropriate. Hypertrophy cannot be read from one hard machine set. The immediate method produces a quality-controlled knee-extension exposure; the longitudinal method compares quadriceps size at the same anatomical landmark, hydration state, side, operator and imaging settings. Strength and stair function remain different tracks. A pump, soreness, stack increase or extra forced repetition is not a size measurement. During reduced training, atrophy resistance means change from a documented size baseline, not the feeling that the thigh looks unchanged. Image quality receives a validity code before thickness is measured. A transverse or longitudinal frame must show the stored vastus lateralis landmark, consistent probe pressure, visible fascia boundaries and unchanged depth or gain settings. Compression flattens the muscle; oblique probe angle lengthens the apparent path; a moved landmark samples different tissue. These imaging errors are corrected at acquisition, never by choosing the thickest follow-up frame. During unloading, the baseline frame, follow-up frame and method error remain linked to the same quadriceps coordinate.", "power_id": "PWR-035", "title": "Muscle hypertrophy and atrophy resistance", "lesson_type": "SUPERVISED", "headline": "Use full controlled knee-extension repetitions for a provider-set hypertrophy set", "plain_english_summary": "Muscle hypertrophy is an increase in declared muscle size; atrophy resistance is preservation during reduced stimulus. This lesson teaches one supervised resistance set on a knee-extension machine: reproduce the seat and lever, lift through the provider-set range without kicking, pause, lower on the full tempo and stop at the first repetition that misses range, speed or posture. The provider controls load, repetitions, sets, rest, weekly dose and whether the task is appropriate. Hypertrophy cannot be read from one hard machine set. The immediate method produces a quality-controlled knee-extension exposure; the longitudinal method compares quadriceps size at the same anatomical landmark, hydration state, side, operator and imaging settings. Strength and stair function remain different tracks. A pump, soreness, stack increase or extra forced repetition is not a size measurement. During reduced training, atrophy resistance means change from a documented size baseline, not the feeling that the thigh looks unchanged. Image quality receives a validity code before thickness is measured. A transverse or longitudinal frame must show the stored vastus lateralis landmark, consistent probe pressure, visible fascia boundaries and unchanged depth or gain settings. Compression flattens the muscle; oblique probe angle lengthens the apparent path; a moved landmark samples different tissue. These imaging errors are corrected at acquisition, never by choosing the thickest follow-up frame. During unloading, the baseline frame, follow-up frame and method error remain linked to the same quadriceps coordinate.", "outcome": "The learner completes a provider-prescribed knee-extension set with every counted repetition meeting range and tempo, while muscle size, strength and function remain separate outcomes.", "authority": { "learner_may": [ "Muscle hypertrophy and atrophy resistance: Match the recorded seat, backrest, lever and shin-pad positions; keep pelvis and back against supports. Let the stack settle without losing tension or slamming; feet and hands stay in the taught positions.", "During an authorised attempt, Stop at the authorised top angle and pause briefly without forcing the knee into pain or lockout. End the set when range shortens, tempo breaks, posture changes or the provider's effort limit is reached; do not add forced help.", "Match every knee-extension machine setting to the log and retain full-range repetitions, technical failures, muscle-size measures, strength and function as separate records." ], "qualified_person_required_for": [ "Review knee and general exercise readiness, atrophy context and relevant medical constraints before prescribing a hypertrophy-oriented machine set.", "Assess readiness and set machine, range, load, repetitions, effort limit, sets, rest, frequency, progression and measurement schedule.", "Set and record seat, lever, range, load and tempo, stop counting at the first shortened or momentum-assisted repetition and schedule size and function reassessment independently of the workout." ], "never_do": [ "Train to involuntary failure, add forced repetitions or copy a load/repetition target from another person or this page.", "Do not add forced repetitions, train to failure or change load and range together to make the set appear more productive.", "End the set for pain, joint instability, loss of the declared range or tempo, breath-holding, kicking or any need for unplanned assistance." ] }, "materials": [ "Provider-checked knee-extension machine", "Recorded seat, backrest, pad and range settings", "Audible repetition tempo", "Training log plus provider-selected muscle-size, strength and function measures", "A knee-extension and outcome log for machine settings, load, range, cadence, valid repetitions, failure reason, rest, symptoms, muscle-size landmark, strength and function." ], "before_you_start": [ "Report knee/hip/back pain, recent surgery, swelling, weakness, illness and unusual delayed soreness.", "Confirm seat, lever, range, load, repetition target, effort stop and rest.", "Practise one easy repetition and verify that the machine axis/pad position is comfortable.", "Copy seat, lever, pad, range and tempo settings from the knee-extension log before choosing the work load. Use an easy repetition to confirm that the knee moves comfortably through the declared arc.", "Reproduce the machine setup and practise the full lift-pause-lower cadence at an easy load before the provider-set work set." ], "steps": [ { "title": "Rebuild the machine setup", "instruction": "Match the recorded seat, backrest, lever and shin-pad positions; keep pelvis and back against supports.", "reason": "Small setup changes alter range and leverage.", "success_check": "All settings match the log and the knee moves comfortably." }, { "title": "Start from the declared bottom", "instruction": "Let the stack settle without losing tension or slamming; feet and hands stay in the taught positions.", "reason": "A repeatable bottom position defines the range.", "success_check": "The lever reaches the same marker each repetition." }, { "title": "Lift without kicking", "instruction": "Extend the knees over the provider-set upward count; do not throw the torso, snap the start or use momentum.", "reason": "Momentum can inflate load while reducing controlled muscle work.", "success_check": "The stack rises smoothly and the body stays supported." }, { "title": "Reach the marked top", "instruction": "Stop at the authorised top angle and pause briefly without forcing the knee into pain or lockout.", "reason": "A fixed top makes range comparable.", "success_check": "Both sides reach the marker under control." }, { "title": "Lower for the full count", "instruction": "Return the lever slowly over the prescribed count until the bottom marker; do not let the stack crash.", "reason": "Controlled lowering is part of each valid repetition.", "success_check": "The plates remain controlled and quiet." }, { "title": "Stop at technical failure", "instruction": "End the set when range shortens, tempo breaks, posture changes or the provider's effort limit is reached; do not add forced help.", "reason": "Productive dose does not require uncontrolled failure.", "success_check": "No invalid repetition is counted; the visible 'Stop at technical failure' check is satisfied." }, { "title": "Track three outcomes", "instruction": "Log valid load/repetitions and symptoms. On the provider's schedule, measure declared muscle size, task-specific strength and a meaningful function separately.", "reason": "Size, strength and function can change differently.", "success_check": "The record has separate rows for all three." }, { "title": "Define the quadriceps landmark", "instruction": "With the qualified assessor, record side, distance from the knee landmark, probe or tape orientation, body position and imaging settings used for muscle thickness or cross-sectional area. Do not move the site to find a larger image.", "reason": "Small landmark and probe changes can mimic hypertrophy or conceal atrophy.", "success_check": "A photo and coordinate sheet allow the same quadriceps site to be relocated at follow-up." }, { "title": "Build three parallel timelines", "instruction": "Log training exposure by valid repetitions, muscle size by the declared imaging method, and function by the chosen stair task. Date each series and compare only like with like.", "reason": "Exercise performance, tissue size and daily function change at different rates and have different measurement error.", "success_check": "No machine-set value appears in the quadriceps-size or stair-function column." }, { "title": "Validate the muscle image first", "instruction": "Check quadriceps landmark, probe orientation, pressure, fascia visibility, image depth and gain before tracing thickness. Reject compressed, oblique or relocated frames without searching for a favourable replacement.", "reason": "Acquisition errors can mimic hypertrophy or atrophy at the vastus lateralis site.", "success_check": "Each retained frame has landmark, orientation and image-quality codes set before any boundary is traced." } ], "worked_example": { "scenario": "A provider sets one knee-extension set at 20 kg, eight-repetition cap, two seconds up, one-second pause, three seconds down and a stop before form breaks.", "walkthrough": [ "The learner matches all machine settings and practises two light repetitions.", "Repetitions one to six meet range, 2-1-3 tempo and stable posture.", "Repetition seven needs a torso swing to start, so it is not counted and the set ends.", "No forced eighth repetition is added.", "The log records six valid repetitions; ultrasound muscle thickness, strength test and stair function are assessed on separate provider schedules.", "The assessor records the right vastus lateralis landmark and ultrasound orientation before training, rather than scanning a convenient thicker-looking site afterward.", "Six valid 20 kg repetitions enter the exposure timeline; repetition seven remains a torso-swing failure and supplies no bonus volume.", "Quadriceps thickness, standard strength testing and stair time are scheduled under matched conditions and displayed in three separate longitudinal panels.", "A compressed follow-up frame looks 2 mm thinner but loses the superficial fascia boundary, so it is reacquired rather than labelled atrophy.", "An oblique frame produces a longer muscle path and fails orientation validity; the matched longitudinal frame is used instead.", "Baseline and follow-up quadriceps frames remain paired by coordinate and image settings before change is compared with method error." ], "result": "Six valid repetitions were completed at this load and setup. The set does not prove hypertrophy, atrophy resistance, health benefit or independence." }, "right_vs_wrong": [ { "situation": "Setup: Muscle hypertrophy and atrophy resistance checkpoint", "right": "Match seat, pad and lever settings.", "wrong": "Use whatever setting is free; it breaks the 'Rebuild the machine setup' execution rule.", "why": "Leverage and range change. That changes declared muscle size, task strength and meaningful function over training/detraining. It is no longer the same test." }, { "situation": "Lift: Muscle hypertrophy and atrophy resistance checkpoint", "right": "Raise smoothly with the body supported.", "wrong": "Kick the stack and swing the torso.", "why": "Momentum replaces the declared repetition. That changes declared muscle size, task strength and meaningful function over training/detraining. It is no longer the same test." }, { "situation": "Lower: Muscle hypertrophy and atrophy resistance checkpoint", "right": "Control the full lowering count. It is correct when the stack rises smoothly and the body stays supported.", "wrong": "Let the plates crash; it breaks the 'Lift without kicking' execution rule.", "why": "The repetition loses range and control." }, { "situation": "Endpoint: Muscle hypertrophy and atrophy resistance checkpoint", "right": "Stop at range/tempo/posture failure. It is correct when both sides reach the marker under control.", "wrong": "Add forced repetitions after failure; it breaks the 'Reach the marked top' execution rule.", "why": "Dose and risk leave the declared task." }, { "situation": "Outcome: Muscle hypertrophy and atrophy resistance checkpoint", "right": "Measure size, strength and function separately.", "wrong": "Call more weight proof of larger muscle or daily function.", "why": "These outcomes are related but distinct." }, { "situation": "Locating muscle size", "right": "Return to the same quadriceps coordinate, body position and image settings.", "wrong": "Search around the thigh until the thickest frame appears.", "why": "Site hunting creates apparent growth from measurement relocation." }, { "situation": "Interpreting a hard set", "right": "Call it a valid training exposure when range, cadence and posture pass.", "wrong": "Call a temporary pump or soreness proof of hypertrophy.", "why": "Acute fluid and sensation are not longitudinal muscle-size measurements." }, { "situation": "Assessing atrophy resistance", "right": "Compare follow-up size with a documented pre-unloading baseline and method error.", "wrong": "Rely on appearance or one strength-machine score.", "why": "Preservation is a measured change question, not an impression." }, { "situation": "Choosing an ultrasound frame", "right": "Apply landmark, pressure, orientation and fascia-visibility validity before tracing.", "wrong": "Select whichever follow-up image makes the quadriceps look thickest.", "why": "Frame selection after seeing size biases the hypertrophy estimate." }, { "situation": "Handling compression", "right": "Reacquire with consistent light probe pressure when fascia is flattened.", "wrong": "Call a compressed thin frame muscle loss.", "why": "Probe pressure can change apparent thickness without biological atrophy." } ], "common_mistakes": [ { "mistake": "Machine settings are missing during 'Rebuild the machine setup' in muscle hypertrophy and atrophy resistance.", "fix": "Photograph and record seat, back, lever and pad." }, { "mistake": "Range shortens as fatigue rises.", "fix": "Use visible range markers and stop at the first miss." }, { "mistake": "The final rep uses momentum.", "fix": "Do not count it; lower load next session only under provider direction." }, { "mistake": "Soreness is used as the success measure.", "fix": "Track valid training, recovery and objective outcomes instead." }, { "mistake": "One-repetition maximum is treated as muscle size.", "fix": "Use direct size measurement when justified and report strength separately." }, { "mistake": "Follow-up ultrasound uses a different thigh coordinate.", "fix": "Relocate the photographed anatomical landmark and reproduce orientation and machine settings." }, { "mistake": "A post-set pump is entered as permanent muscle gain.", "fix": "Use the scheduled rested size assessment and keep acute session observations separate." }, { "mistake": "Reduced-training preservation is claimed without a pre-unloading baseline.", "fix": "State that atrophy resistance is unquantified until matched baseline and follow-up values exist." }, { "mistake": "Image validity is decided after thickness is traced.", "fix": "Set landmark, pressure, orientation and fascia codes before opening the measurement tool." }, { "mistake": "Oblique and longitudinal frames are compared directly.", "fix": "Use the same declared imaging plane at baseline and follow-up." } ], "practice": { "first_session": [ "Provider fits the machine and explains the stop rule.", "Rehearse the full range and tempo at minimal load.", "Complete a light familiarisation set below the cap.", "After rest, complete one prescribed working set.", "Review valid repetitions, first error, symptoms and the long-term measurement plan.", "Create separate exposure, quadriceps-size and stair-function timelines before interpreting the working set.", "Photograph the anatomical measurement coordinate and store side, body position, orientation and imaging settings.", "Practise classifying matched, compressed, oblique and relocated quadriceps frames before reviewing longitudinal change." ], "repeat_plan": "The provider controls exercises, sets, repetitions, load, rest, weekly frequency and nutrition/clinical referral. Progress only when full-range controlled repetitions and recovery are stable; detraining and maintenance require separate plans.", "progress_when": [ "Every counted repetition meets range, tempo and posture rules.", "Provider-prescribed volume or load increases without worse symptoms or recovery.", "Declared muscle-size, strength and function outcomes change beyond measurement error over time.", "Matched quadriceps measurements change beyond method error while valid exposure and stair function remain acceptable on their own timelines.", "Matched valid frames exceed site-specific method error while exposure and function remain separately acceptable." ], "do_not_progress_when": [ "Load rises only through shortened range, momentum or forced help.", "Pain, swelling, neurological symptoms or problematic delayed soreness occurs.", "Only one outcome improves while function or safety worsens.", "Size landmark, hydration/rest conditions, operator method or pre-unloading baseline cannot be reproduced.", "Compression, obliquity, fascia loss or landmark relocation prevents a valid quadriceps comparison." ] }, "self_check": [ "Can you rebuild every machine setting?", "Did all counted reps use the full 2-1-3 range and tempo?", "Did the set stop before a forced repetition?", "Can you distinguish muscle size, strength and function?", "Can you relocate the declared quadriceps landmark without searching for the largest image?", "Can you explain why six valid repetitions, a muscle pump and ultrasound thickness are three different observations?", "Can you define atrophy resistance as change from a matched pre-unloading baseline?", "Can you reject compressed, oblique and relocated frames before seeing measured thickness?", "Which imaging settings and anatomical coordinate must match for an atrophy-resistance comparison?" ], "measurement": { "primary": "Declared muscle size, task strength and meaningful function over training/detraining", "how": "Use a consistent validated imaging or circumference method for size, a separate standard strength test and a separate function; log training configuration and assistance. For muscle size, reproduce anatomical coordinate, side, body position, hydration/rest conditions, operator and imaging settings. Maintain separate exposure, strength and stair-function timelines. Assign quadriceps image-validity codes for landmark, plane, pressure, fascia visibility, depth and gain before tracing muscle boundaries.", "good_result": "Changes exceed method error and occur without worse symptoms or function, with each outcome reported separately. A size change exceeds landmark-specific method error and is interpreted beside, not substituted by, valid knee-extension exposure, strength and function.", "does_not_prove": "More repetitions or load alone does not prove hypertrophy, health, independence or protection from atrophy." }, "stop_and_get_help": [ "Stop for sharp joint/muscle pain, a pop, swelling, sudden weakness, numbness or inability to control the machine.", "Pause and contact the provider for severe or persistent delayed soreness, dark urine, marked swelling or loss of function.", "Suspend the machine set for sudden strength loss, joint swelling, sharp pain or an unexplained systemic symptom, and obtain programme or clinical review before adding repetitions." ], "accessibility": [ "Use an accessible machine, cuff, unilateral/bilateral setup or supported alternative chosen by the provider and create a new baseline.", "Use visual, spoken or vibration tempo cues and preserve seating/transfers and ordinary aids.", "Photograph or diagram seat, pad and range settings and offer rep cues by sound or display, recording any assistance separately from completed repetitions." ], "evidence_notes": [ { "claim": "Different resistance loads can produce hypertrophic change under specific study conditions, so load alone does not determine muscle growth.", "source_title": "Resistance exercise load does not determine training-mediated hypertrophic gains in young men", "source_url": "https://pubmed.ncbi.nlm.nih.gov/22518835/", "source_kind": "PRIMARY_RESEARCH" }, { "claim": "Maintenance of strength and muscle size differs by age and outcome, so a universal reduced training dose is unsupported.", "source_title": "Exercise dosing to retain resistance training adaptations in young and older adults", "source_url": "https://pubmed.ncbi.nlm.nih.gov/21131862/", "source_kind": "PRIMARY_RESEARCH" } ], "limits": [ "Muscle-size change is muscle-, method- and time-specific.", "Strength and size do not guarantee meaningful function.", "This lesson supplies no universal load, repetition target, failure rule or nutrition prescription." ], "orientation": { "bounded_definition": "Capability to develop or express muscle hypertrophy and atrophy resistance in a declared context without inheriting broader claims.", "evidence_summary": "Muscle is highly trainable, but growth, strength and resistance to loss are different outcomes. Maintenance needs change with age and context.", "supportable_public_claim": "Muscle can grow with multiple resistance-training configurations, and some gains can be maintained with less training; exact needs differ by person and outcome.", "measurement_boundary": "Imaging or fiber area measures size; one-repetition maximum measures task-specific strength. Neither alone establishes health or independence.", "myth_to_metric": { "myth": "Build permanent muscle armor", "metric": "Declared muscle size, strength and function over training and detraining", "boundary": "Muscle size cannot prove permanent function or health." }, "limiting_findings": [ "Maintenance requirements differed between young and older adults and between strength and muscle-size outcomes." ], "prohibited_claims": [ "Guaranteed muscle growth", "Never lose muscle", "Heavy is always best", "Supplements replace training or food" ] }, "gold_source_lesson": null, "next_gate": "External confirmation is required before higher-authority use because: SUPERVISION_OR_NON_ATTEMPT_BOUNDARY.", "evidence_count": 2 }, "full_training_programme": false, "independently_validated": false, "publication_state": "PUBLISHED_PUBLIC_RESEARCH_EDITION__EDITORIAL_REVIEW_PENDING", "related_power_ids": [ "PWR-033", "PWR-034", "PWR-036", "PWR-037" ] }, { "power_id": "PWR-036", "learning_unit_id": "TLU-PWR-036", "title": "Connective-tissue resilience", "main_description": "The learner completes one supervised set of slow provider-prescribed knee loading with valid range, tempo and alignment, plus immediate and next-day symptom/function records.", "main_description_source": "FULL_TUTORIAL_OUTCOME", "family_id": "FAM-05", "family": "Tissue Adaptation, Repair & Reacquisition", "superdomain": "Regulation & Recovery", "canonical_route": "/powers/pwr-036/", "treatment": "SPECIALIST_PROVIDER_ROUTE", "treatment_label": "Full supervised tutorial", "treatment_boundary": "Titan teaches the complete method; a qualified person controls the parts that require supervision, clearance, specialist equipment, load, dose or progression.", "tutorial_route": "/tutorials/pwr-036/", "governed_lesson_route": null, "self_attempt_status": "PROHIBITED_WITHOUT_QUALIFIED_SUPERVISION", "gold_pathway_ids": [], "route_membership": { "kind": "RETAINED_EXTERNAL_ROUTE", "id": "SP-HUB-002", "coverage_status": "RETAINED" }, "source_authority_tier": "G4", "source_build_state": "EXTERNAL_PROVIDER_ROUTE", "source_instructional_route": "LEARN_ELSEWHERE_TRACK_WITH_TITAN", "source_count": 2, "research_depth": "FOCUSED", "risk_level": "HIGH", "prerequisite_status": "QUALIFIED_PROVIDER_DETERMINES", "learning_route": { "mode": "FULL_SUPERVISED_TUTORIAL", "label": "Learn connective-tissue resilience step by step", "summary": "The learner completes one supervised set of slow provider-prescribed knee loading with valid range, tempo and alignment, plus immediate and next-day symptom/function records.", "steps": [ [ "Get ready", "Name the exact tissue/site and the provider's reason for this task; do not use a generic resilience label." ], [ "Learn the method", "10 concrete steps teach the permitted method from start to finish." ], [ "See right and wrong", "11 comparisons show correct or safer execution beside common wrong or riskier choices." ], [ "Practise", "The clinician/provider controls exercise selection, load, volume, frequency and change. Progress only one of range, external load or repetitions after the delayed response and function are acceptable; other tissues need separate assessment." ], [ "Check progress", "Record exact site, fixture, range, tempo, load, assistance and valid reps; use validated symptom/function tools and provider-selected imaging/mechanics only when justified. Use separate patellar fixture, symptom-map and stair-descent cards; preserve wedge degrees, shoe condition, depth, rail force and cadence. Complete matched decline-wedge, slow-squat, patellar-site and stair-descent columns for every reviewed exposure." ] ], "practical_authority": false, "provider_required": true, "next_action_route": "/tutorials/pwr-036/" }, "path_builder": { "selectable": true, "completion_allowed": true, "warning": "Titan teaches the complete method; a qualified person controls the parts that require supervision, clearance, specialist equipment, load, dose or progression." }, "full_tutorial": { "version": "3.0", "authorship": "POWER_SPECIFIC_FULL_TUTORIAL", "tutorial_mode": "SUPERVISED", "promise": "Connective-tissue resilience is not a whole-body toughness score. It must name a tissue, load, symptoms, mechanics and function. This lesson teaches a provider-led slow squat for a declared patellar-tendon task: use a supported wedge or flat setup chosen by the clinician, keep the knee-foot line, descend and rise on fixed counts, stop at range or symptom failure and record later response and a separate functional task. The provider controls diagnosis/scope, load, range, support, dose and progression. For this lesson the named tissue is the patellar tendon, not generic connective tissue. The fixture card identifies decline-wedge angle, shoe condition, stance width, rail force, squat depth and 3-1-3 cadence. The response card identifies inferior-pole or tendon-body symptom location, immediate rating, stair-descent function and next-morning irritability. A change in pain location, swelling, joint locking or giving way is not normal progression data; it triggers clinical review. Patellar-tendon loading quality remains separate from imaging appearance and from Achilles heel-raise performance. The patellar-tendon review uses a four-column card: decline-wedge fixture, slow-squat execution, patellar symptom map and matched stair descent. Column one fixes wedge degrees, stance and rail contact. Column two fixes squat depth and cadence. Column three distinguishes inferior-pole, tendon-body, tibial-attachment and non-patellar locations. Column four repeats step height, descent side and handrail. A progression decision needs all four patellar columns; a comfortable decline squat cannot erase worse stair descent, and an easier stair result cannot excuse a changed patellar symptom site.", "power_id": "PWR-036", "title": "Connective-tissue resilience", "lesson_type": "SUPERVISED", "headline": "Perform one tissue-specific slow knee-loading repetition and track function", "plain_english_summary": "Connective-tissue resilience is not a whole-body toughness score. It must name a tissue, load, symptoms, mechanics and function. This lesson teaches a provider-led slow squat for a declared patellar-tendon task: use a supported wedge or flat setup chosen by the clinician, keep the knee-foot line, descend and rise on fixed counts, stop at range or symptom failure and record later response and a separate functional task. The provider controls diagnosis/scope, load, range, support, dose and progression. For this lesson the named tissue is the patellar tendon, not generic connective tissue. The fixture card identifies decline-wedge angle, shoe condition, stance width, rail force, squat depth and 3-1-3 cadence. The response card identifies inferior-pole or tendon-body symptom location, immediate rating, stair-descent function and next-morning irritability. A change in pain location, swelling, joint locking or giving way is not normal progression data; it triggers clinical review. Patellar-tendon loading quality remains separate from imaging appearance and from Achilles heel-raise performance. The patellar-tendon review uses a four-column card: decline-wedge fixture, slow-squat execution, patellar symptom map and matched stair descent. Column one fixes wedge degrees, stance and rail contact. Column two fixes squat depth and cadence. Column three distinguishes inferior-pole, tendon-body, tibial-attachment and non-patellar locations. Column four repeats step height, descent side and handrail. A progression decision needs all four patellar columns; a comfortable decline squat cannot erase worse stair descent, and an easier stair result cannot excuse a changed patellar symptom site.", "outcome": "The learner completes one supervised set of slow provider-prescribed knee loading with valid range, tempo and alignment, plus immediate and next-day symptom/function records.", "authority": { "learner_may": [ "Connective-tissue resilience: Place feet and support on the recorded flat or wedge setup; use only the provider-selected load and stance. Bend hips and knees through the prescribed range over the full lowering count, keeping whole feet supported.", "During an authorised attempt, Hold the bottom only for the prescribed pause; do not bounce or sink into extra range. End the set for missed range, tempo, alignment, support or symptom threshold; do not complete partial repetitions.", "Name the patellar-tendon site and match wedge, stance, rail contact and cadence to the reference; record symptoms and stair function in their own fields." ], "qualified_person_required_for": [ "Distinguish the intended patellar-tendon task from joint, muscle or other tissue problems and assess whether slow knee loading is clinically appropriate.", "Identify the target tissue and clinical scope, choose exercise, wedge/support, load, range, tempo, sets, frequency, response rule and alternative care.", "Fix wedge angle, stance, support, depth and cadence before the set, map any symptom to its exact site and combine the exercise response with the matched stair-descent check before changing load." ], "never_do": [ "Diagnose tendinopathy, inject, manipulate or self-prescribe a heavy-slow/eccentric programme from this lesson.", "Do not self-diagnose tendinopathy or prescribe a heavier slow-resistance, eccentric or injection pathway from this lesson.", "Stop for increasing or relocated pain, swelling, warmth, locking, giving way or loss of stair or walking function." ] }, "materials": [ "Provider-approved flat floor or stable decline wedge", "Fixed rail/support and foot/range marks", "Provider-selected external load if any", "Tempo cue plus pain, next-day response and function log", "A patellar-tendon card for site, wedge and stance, rail force, depth, cadence, load, valid repetitions, symptom map, immediate response, stair descent and next-morning status." ], "before_you_start": [ "Name the exact tissue/site and the provider's reason for this task; do not use a generic resilience label.", "Report recent injury, swelling, locking, giving way, warmth, redness, fever, surgery and medication changes.", "Agree on allowable symptoms, range, tempo, first-failure rule and next-day threshold.", "Name and mark the intended patellar-tendon site, then reproduce wedge, stance, rail contact and range from the clinical record. Start only when the setup is stable and symptoms still match the planned tissue task.", "Rehearse the fixed descent and rise counts with knee and foot aligned and only the prescribed rail support before loaded repetitions." ], "steps": [ { "title": "Set the tissue-specific fixture", "instruction": "Place feet and support on the recorded flat or wedge setup; use only the provider-selected load and stance.", "reason": "Tissue load changes with angle, stance and external load.", "success_check": "Setup matches the photo and remains stable." }, { "title": "Descend on the count", "instruction": "Bend hips and knees through the prescribed range over the full lowering count, keeping whole feet supported.", "reason": "A controlled descent makes load repeatable.", "success_check": "The bottom marker is reached at the correct time." }, { "title": "Keep knee-foot alignment", "instruction": "Track the knee over the declared foot line and keep the pelvis/trunk inside the provider's range; use the rail only at the recorded support level.", "reason": "Alignment and support drift change tissue demand.", "success_check": "Front/side observation meets the rule; the visible 'Keep knee-foot alignment' check is satisfied." }, { "title": "Pause without bouncing", "instruction": "Hold the bottom only for the prescribed pause; do not bounce or sink into extra range.", "reason": "A bounce adds a different loading rate.", "success_check": "The position stays controlled and symptoms remain within the rule." }, { "title": "Rise on the count", "instruction": "Push through the whole foot and straighten hips and knees smoothly over the upward count.", "reason": "Fast compensation can hide loss of controlled loading.", "success_check": "The top is reached without shift or acceleration spike." }, { "title": "Stop at the first failed rule", "instruction": "End the set for missed range, tempo, alignment, support or symptom threshold; do not complete partial repetitions.", "reason": "The dose is valid repetitions, not a promised count.", "success_check": "No invalid repetition is added; the visible 'Stop at the first failed rule' check is satisfied." }, { "title": "Track tissue and function separately", "instruction": "Record immediate/next-day symptoms and one function such as step-down or stairs; imaging or mechanics, if used, stay separate.", "reason": "Pain, structure, mechanics and function can disagree.", "success_check": "The record keeps each outcome in its own field." }, { "title": "Map the patellar symptom site", "instruction": "Before squatting, indicate whether symptoms sit at the inferior patellar pole, tendon body, tibial attachment or elsewhere. Record a new or diffuse location rather than assuming every anterior-knee symptom is patellar tendon.", "reason": "Location change may signal a different structure or a need for reassessment.", "success_check": "The fixture card names the patellar site and the provider agrees the declared loading task remains appropriate." }, { "title": "Pair squat response with stair descent", "instruction": "At the scheduled later-day and next-morning checks, repeat the same stair-descent item and log patellar symptom location, irritability and swelling. Preserve handrail and step height.", "reason": "A fixed function can reveal deterioration not captured by comfort during slow squats.", "success_check": "Matched stair setup and time-anchored patellar response are complete before any wedge, depth or load change." }, { "title": "Complete the four-column patellar card", "instruction": "Before reviewing progression, read aloud decline-wedge fixture, slow-squat execution, patellar symptom map and matched stair descent. Mark any missing column rather than filling it from memory.", "reason": "Patellar loading cannot be interpreted from squat repetitions or pain rating alone.", "success_check": "Wedge, squat, patellar-site and stair columns are dated, matched and complete for the same exposure." } ], "worked_example": { "scenario": "A physiotherapist prescribes six body-weight supported squats on a stable decline wedge: three seconds down, one pause, three up, with a pre-agreed symptom limit.", "walkthrough": [ "The learner sets feet and support exactly as photographed and rehearses one flat-ground squat.", "Repetitions one to four meet range, alignment and 3-1-3 tempo.", "On repetition five, the knee moves outside the marked line and symptoms rise beyond the agreed limit.", "The learner stops; repetition five is invalid and six is not attempted.", "Immediate symptoms, next-morning response and a separate stair rating are sent to the provider.", "The fixture card records a 20-degree decline wedge, shoes on, stance marks, fingertip rail contact, 70-degree knee target and 3-1-3 cadence.", "Four valid squats keep the patella over the second toe; repetition five changes symptom location and crosses the provider's irritability rule.", "The next-morning stair descent uses the same step and rail. Function is worse, so wedge angle and external load remain unchanged pending review.", "No Achilles heel-raise or generic tissue score is used to replace the patellar fixture and response cards.", "Column one confirms the 20-degree decline wedge, shoe condition, stance marks and fingertip rail contact.", "Column two records four valid 3-1-3 squats to the 70-degree knee marker and one invalid squat after patellar-site change.", "Column three maps the response at the inferior patellar pole rather than a generic knee-pain label.", "Column four repeats the same stair height, descent side and handrail; slower descent and worse irritability block wedge or load progression.", "The provider reviews all four patellar columns before keeping the current decline-squat fixture." ], "result": "Four valid tissue-specific loading repetitions were completed in this setup. The result does not prove tissue healing, structural change or whole-body resilience." }, "right_vs_wrong": [ { "situation": "Target: Connective-tissue resilience checkpoint", "right": "Name the tissue and exact loading task.", "wrong": "Call any painful exercise connective-tissue training.", "why": "Different tissues require different assessment. That changes tissue-specific symptoms, function and mechanics under a declared loading task. It is no longer the same test." }, { "situation": "Tempo: Connective-tissue resilience checkpoint", "right": "Use the full slow count. It is correct when the bottom marker is reached at the correct time.", "wrong": "Bounce or rush through symptoms; it breaks the 'Descend on the count' execution rule.", "why": "Loading rate and control change. That changes tissue-specific symptoms, function and mechanics under a declared loading task. It is no longer the same test." }, { "situation": "Support: Connective-tissue resilience checkpoint", "right": "Use the recorded rail assistance. It is correct when front/side observation meets the rule.", "wrong": "Pull harder as fatigue rises without recording it.", "why": "Actual limb load falls. That changes tissue-specific symptoms, function and mechanics under a declared loading task. It is no longer the same test." }, { "situation": "Outcome: Connective-tissue resilience checkpoint", "right": "Report symptoms, function and mechanics separately.", "wrong": "Use pain relief as proof of structural healing.", "why": "These outcomes may not move together." }, { "situation": "Treatment claim", "right": "Follow the provider's assessed plan. It is correct when the top is reached without shift or acceleration spike.", "wrong": "Use ultrasound or injection as a generic resilience shortcut.", "why": "Evidence and indications are tissue-specific. That changes tissue-specific symptoms, function and mechanics under a declared loading task. It is no longer the same test." }, { "situation": "Naming anterior knee symptoms", "right": "Map inferior-pole, tendon-body, tibial-attachment or other location.", "wrong": "Assume every anterior-knee sensation proves patellar tendinopathy.", "why": "Location alone is not a diagnosis, and a changed site needs provider review." }, { "situation": "Progressing the decline squat", "right": "Preserve wedge angle and stair response while the provider changes one load variable.", "wrong": "Increase wedge, depth and external weight together after one comfortable set.", "why": "Simultaneous changes hide the source of patellar response." }, { "situation": "Using imaging", "right": "Interpret imaging only within provider assessment and measurement limits.", "wrong": "Treat tendon appearance as a stand-alone healing or loading instruction.", "why": "Structure, symptom irritability, squat mechanics and stair function may disagree." }, { "situation": "Four-column patellar review", "right": "Require matched wedge, squat, symptom-map and stair entries.", "wrong": "Progress from a comfortable decline squat while stair descent is worse.", "why": "Patellar load response includes delayed matched function." }, { "situation": "Patellar symptom location", "right": "Keep inferior-pole, tendon-body and tibial-attachment labels separate.", "wrong": "Copy 'knee pain' into every patellar column.", "why": "A generic label hides location change that needs review." }, { "situation": "Decline-wedge comparison", "right": "Reproduce wedge degrees, shoes, stance and rail contact.", "wrong": "Compare a deeper barefoot squat on a steeper wedge with the original fixture.", "why": "Multiple fixture changes alter patellar demand." } ], "common_mistakes": [ { "mistake": "The tissue/site is not named.", "fix": "Write the anatomical site and provider-defined task before practice." }, { "mistake": "Wedge angle or stance changes.", "fix": "Measure and photograph the fixture; then confirm: The bottom marker is reached at the correct time." }, { "mistake": "Support increases across reps during 'Keep knee-foot alignment' in connective-tissue resilience.", "fix": "Mark the repetition invalid or measure the assistance." }, { "mistake": "Next-day function is missing during 'Pause without bouncing' in connective-tissue resilience.", "fix": "Log the declared function and symptoms before progression." }, { "mistake": "One modality is claimed to rebuild all connective tissue.", "fix": "Return to the exact tissue, comparison evidence and separate outcomes." }, { "mistake": "The fixture log says only 'decline squat'.", "fix": "Record wedge degrees, shoe condition, stance, rail force, depth marker and 3-1-3 cadence." }, { "mistake": "A new symptom location is averaged into the previous rating.", "fix": "Map the new site separately and pause progression for provider reassessment." }, { "mistake": "Stair descent is retested on a different step without the rail.", "fix": "Repeat the stored step height, side and handrail condition before comparing function." }, { "mistake": "The patellar card omits descent side for stairs.", "fix": "Repeat the stored side and handrail before comparing stair function." }, { "mistake": "A generic knee rating replaces the patellar symptom map.", "fix": "Record inferior pole, tendon body, tibial attachment or non-patellar site explicitly." }, { "mistake": "Slow-squat depth is changed while wedge angle also changes.", "fix": "Restore the stored decline fixture and let the provider alter one demand variable." } ], "practice": { "first_session": [ "Provider identifies the target tissue and sets the fixture/response rule.", "Rehearse range and tempo without external load.", "Complete a short familiarisation set with feedback.", "After rest, complete one prescribed set using first-failure termination.", "Record immediate and next-day symptoms plus the separate function.", "Complete a patellar fixture card and symptom map before the first decline-wedge familiarisation.", "Rehearse the stored stair-descent item once so its step height, side and rail condition are reproducible.", "Fill a practice four-column patellar card from fixture photos, squat video, symptom map and matched stair record before the working set." ], "repeat_plan": "The clinician/provider controls exercise selection, load, volume, frequency and change. Progress only one of range, external load or repetitions after the delayed response and function are acceptable; other tissues need separate assessment.", "progress_when": [ "All valid repetitions maintain range, tempo, alignment and support.", "Immediate and next-day response remains within the provider's rule.", "Meaningful function improves without relying on pain or imaging alone.", "Patellar symptom location remains stable and matched stair descent improves while wedge, depth and cadence stay reproducible.", "All four patellar columns remain matched while slow-squat validity and stair descent improve inside the provider's irritability rule." ], "do_not_progress_when": [ "Pain, swelling, warmth, locking, giving way or loss of function increases.", "Technique or support changes to meet the target.", "The provider has not identified the tissue or cannot distinguish a clinical condition requiring other care.", "Patellar-site change, swelling, locking, giving way or worse matched stair descent appears after the slow-squat exposure.", "Any patellar column is missing, symptom site changes, or stair descent worsens after the decline-wedge exposure." ] }, "self_check": [ "Can you name the exact tissue, wedge/support, range and tempo?", "Did every counted repetition meet alignment and symptom rules?", "Were next-day function and symptoms recorded?", "Can you explain why pain, structure and mechanics are separate?", "Can you state wedge degrees, shoe condition, stance, rail force, depth and cadence from the patellar fixture card?", "Can you distinguish inferior-pole symptoms, tendon-body symptoms and a new non-patellar location?", "Did next-morning stair descent use the same step, side and handrail?", "Can you name the four patellar-card columns without using a generic tissue score?", "Which decline-wedge details and stair details must match?", "What should happen when the patellar symptom map changes location?" ], "measurement": { "primary": "Tissue-specific symptoms, function and mechanics under a declared loading task", "how": "Record exact site, fixture, range, tempo, load, assistance and valid reps; use validated symptom/function tools and provider-selected imaging/mechanics only when justified. Use separate patellar fixture, symptom-map and stair-descent cards; preserve wedge degrees, shoe condition, depth, rail force and cadence. Complete matched decline-wedge, slow-squat, patellar-site and stair-descent columns for every reviewed exposure.", "good_result": "The task and function improve beyond measurement noise without worse delayed response, with structure/mechanics interpreted separately.", "does_not_prove": "It does not prove whole-body resilience, tissue healing, injury prevention or benefit of an untested modality." }, "stop_and_get_help": [ "Stop for a pop, sudden severe pain, rapid swelling, redness/warmth with fever, joint locking/giving way or marked loss of function.", "Stop the set on the first range, tempo, alignment, support or symptom failure.", "Stop the tissue-specific fixture for a sudden local pain change, swelling, instability or altered function, and ask the supervising clinician to decide whether the dose or movement should change." ], "accessibility": [ "Use a provider-selected seated, machine or reduced-range version and create a separate baseline rather than forcing a squat.", "Use larger marks, stable hand support and accessible tempo/response cues while recording assistance.", "Provide fixture placement and descent rhythm as close-up images, counted audio or tactile landmarks, while retaining the exact range, load and symptom scale in the record." ], "evidence_notes": [ { "claim": "Low-intensity pulsed ultrasound did not outperform sham for chronic patellar tendinopathy in a randomized trial.", "source_title": "Low-intensity pulsed ultrasound for chronic patellar tendinopathy: a randomized, double-blind, placebo-controlled trial", "source_url": "https://pubmed.ncbi.nlm.nih.gov/18270224/", "source_kind": "PRIMARY_RESEARCH" }, { "claim": "Corticosteroid injection, eccentric decline squat and heavy slow resistance produced different short- and longer-term outcomes, supporting treatment-specific comparison rather than generic resilience claims.", "source_title": "Corticosteroid injections, eccentric decline squat training and heavy slow resistance training in patellar tendinopathy", "source_url": "https://pubmed.ncbi.nlm.nih.gov/19793213/", "source_kind": "PRIMARY_RESEARCH" } ], "limits": [ "Connective tissue is not one system with one resilience score.", "Pain, function, structure and mechanics must be reported separately.", "This lesson is not diagnosis or a universal rehabilitation programme." ], "orientation": { "bounded_definition": "Capability to develop or express connective-tissue resilience in a declared context without inheriting broader claims.", "evidence_summary": "“Connective tissue” covers many different structures. Titan will not turn one tendon treatment into a claim of whole-body resilience.", "supportable_public_claim": "Some diagnosed tendon problems respond to progressive loading, but connective-tissue resilience is not a single trainable or measurable superpower.", "measurement_boundary": "Pain, function, structure and mechanics are separate outcomes; none alone validates a whole-body resilience score.", "myth_to_metric": { "myth": "Make all connective tissue invincible", "metric": "Tissue-specific symptoms, function and mechanics", "boundary": "One tendon result cannot establish whole-body resilience." }, "limiting_findings": [ "Low-intensity pulsed ultrasound did not outperform sham for chronic patellar tendinopathy." ], "prohibited_claims": [ "Harden every connective tissue", "Cure tendinopathy yourself", "Ultrasound heals tendons", "Pain proves adaptation" ] }, "gold_source_lesson": null, "next_gate": "External confirmation is required before higher-authority use because: CLINICAL_HIGH_RISK_OR_REGULATED_CONFIGURATION; SUPERVISION_OR_NON_ATTEMPT_BOUNDARY; SAFETY_LEGITIMACY_RESTRICTED.", "evidence_count": 2 }, "full_training_programme": false, "independently_validated": false, "publication_state": "PUBLISHED_PUBLIC_RESEARCH_EDITION__EDITORIAL_REVIEW_PENDING", "related_power_ids": [ "PWR-033", "PWR-034", "PWR-035", "PWR-037" ] }, { "power_id": "PWR-037", "learning_unit_id": "TLU-PWR-037", "title": "Wound and tissue recovery", "main_description": "Using the two supplied fictional scenario sets, the learner records only permitted observations and correctly chooses emergency, same-day, routine or continue-plan routing without opening, probing, cleaning or treating a wound.", "main_description_source": "FULL_TUTORIAL_OUTCOME", "family_id": "FAM-05", "family": "Tissue Adaptation, Repair & Reacquisition", "superdomain": "Regulation & Recovery", "canonical_route": "/powers/pwr-037/", "treatment": "RESTRICTED_EXPLAINER_ONLY", "treatment_label": "Full safety and decision tutorial", "treatment_boundary": "Titan teaches recognition, prevention, safe response and accountable routing without teaching the prohibited act.", "tutorial_route": "/tutorials/pwr-037/", "governed_lesson_route": null, "self_attempt_status": "PROHIBITED_ACT_EXCLUDED", "gold_pathway_ids": [], "route_membership": { "kind": "RETAINED_EXTERNAL_ROUTE", "id": "SP-HUB-002", "coverage_status": "RETAINED" }, "source_authority_tier": "G6", "source_build_state": "RESTRICTED", "source_instructional_route": "EXPLAINER_ONLY_RESTRICTED", "source_count": 2, "research_depth": "FOCUSED", "risk_level": "HIGH", "prerequisite_status": "NONE_FOR_READING__NO_PRACTICE_AUTHORITY", "learning_route": { "mode": "FULL_RESTRICTED_TUTORIAL", "label": "Learn wound and tissue recovery step by step", "summary": "Using the two supplied fictional scenario sets, the learner records only permitted observations and correctly chooses emergency, same-day, routine or continue-plan routing without opening, probing, cleaning or treating a wound.", "steps": [ [ "Get ready", "Identify the wound, procedure/injury date, responsible service and next planned review." ], [ "Learn the method", "8 concrete steps teach the permitted method from start to finish." ], [ "See right and wrong", "5 comparisons show correct or safer execution beside common wrong or riskier choices." ], [ "Practise", "After at least seven days without rereading the first answers, cover the answer strip and complete delayed Scenarios E–H in a shuffled order. Record the delayed result separately from the first session. Real wound checks, dressing changes and measurements follow only the treating service’s written schedule." ], [ "Check progress", "Score each card for plan/contact identification, emergency screen, factual description, protected-item rule, permitted measurement, correct route and complete handoff. Any probing, diagnosis, unprescribed treatment or delayed emergency route is an automatic failure for that card." ] ], "practical_authority": false, "provider_required": false, "next_action_route": "/tutorials/pwr-037/" }, "path_builder": { "selectable": true, "completion_allowed": true, "warning": "Titan teaches recognition, prevention, safe response and accountable routing without teaching the prohibited act." }, "full_tutorial": { "version": "3.0", "authorship": "POWER_SPECIFIC_FULL_TUTORIAL", "tutorial_mode": "RESTRICTED", "promise": "Wound recovery is a clinical process, not willpower or a trainable personal Power. This lesson teaches the permitted method: identify the wound and care team, follow the written dressing and hygiene plan, observe only what the plan allows, compare redness, drainage, pain, temperature and function with the prior record, recognise emergency and same-day warning signs, and contact the accountable service with a clear report. It does not teach diagnosis, debridement, closure, antibiotics, negative-pressure treatment or improvised dressings.", "power_id": "PWR-037", "title": "Wound and tissue recovery", "lesson_type": "RESTRICTED", "headline": "Check a wound against its care plan and route warning signs without treating it yourself", "plain_english_summary": "Wound recovery is a clinical process, not willpower or a trainable personal Power. This lesson teaches the permitted method: identify the wound and care team, follow the written dressing and hygiene plan, observe only what the plan allows, compare redness, drainage, pain, temperature and function with the prior record, recognise emergency and same-day warning signs, and contact the accountable service with a clear report. It does not teach diagnosis, debridement, closure, antibiotics, negative-pressure treatment or improvised dressings.", "outcome": "Using the two supplied fictional scenario sets, the learner records only permitted observations and correctly chooses emergency, same-day, routine or continue-plan routing without opening, probing, cleaning or treating a wound.", "authority": { "learner_may": [ "Read and follow the named clinician's written dressing, hygiene and activity instructions.", "Observe visible changes without touching or removing anything the plan says to leave in place.", "Contact the care team or emergency service using the plan's warning signs and provide a factual timeline." ], "qualified_person_required_for": [ "Diagnosis, wound probing, debridement, closure, staple/suture/drain removal and treatment selection.", "Choice or change of dressing, antiseptic, antibiotic, negative-pressure therapy or activity restriction unless already prescribed.", "Interpretation of infection, circulation, tissue death, allergic reaction or healing failure." ], "never_do": [ "Cut, scrape, squeeze, probe or attempt to close a wound.", "Apply peroxide, alcohol, bleach, powders, oils, supplements, glue or another person's dressing/antibiotic unless the treating service prescribed it.", "Delay urgent care because a photo, temperature or consumer app looks reassuring." ] }, "materials": [ "The current written care plan and the named care-team and emergency contact numbers.", "A clean observation area with good light and handwashing supplies.", "Clinician-approved supplies only when the written plan explicitly directs their use.", "A dated observation sheet and ruler or photograph reference only when the clinician permits measurement or photography.", "Scenario A — emergency: The fictional plan says to use emergency help for bleeding that remains uncontrolled after the prescribed first-aid action or for fainting. The dressing is rapidly soaking with bright-red blood and the person feels faint.", "Scenario B — same-day: Four days after lower-leg surgery, the fictional plan says to keep the dressing intact and contact the surgical service the same day for spreading redness, increased drainage, fever or worsening pain. Redness visible beyond the dressing has expanded from about 5 mm to 15 mm, pain rose from 3/10 to 6/10 and yellow drainage is visible on the outside.", "Scenario C — routine: There is no new redness, drainage, pain, fever or function change. Only one prescribed dressing remains, the next planned change is tomorrow and the next delivery is due in three days. The fictional plan gives a routine clinic or supply contact for non-urgent supply problems.", "Scenario D — continue the plan: The dressing is intact, the marked redness boundary is unchanged, pain fell from 2/10 to 1/10, there is no new drainage or fever and ordinary function is unchanged. The fictional plan says to continue the scheduled check.", "Scenario E — emergency delayed card: The fictional plan says to use emergency help for uncontrolled bleeding or a cold, pale or blue hand. Prescribed pressure has not stopped the bleeding and two fingers have become pale and cold.", "Scenario F — same-day delayed card: The fictional plan says to contact the team the same day if wound edges open, a drain leaks or pain worsens. The outer dressing has lifted over a newly opened edge, fluid is leaking around the drain and pain rose from 2/10 to 5/10.", "Scenario G — routine delayed card: There is mild adhesive itching away from the wound, no spreading redness, swelling, breathing problem, drainage, fever, pain increase or function loss. The fictional plan says persistent non-urgent adhesive questions go to the routine clinic.", "Scenario H — continue the plan delayed card: A small amount of clear drainage is unchanged and explicitly expected in the fictional plan. The dressing remains secure, pain is improving and there is no fever, spreading redness or function change.", "Covered answer strip — reveal only after every decision is locked: A and E = emergency; B and F = same-day clinical contact; C and G = routine contact; D and H = continue the written plan." ], "before_you_start": [ "Identify the wound, procedure/injury date, responsible service and next planned review.", "Read whether the dressing should stay dry/intact and whether it may be removed by the learner; if unclear, leave it in place and call.", "Wash and dry hands before and after any plan-authorised contact; keep pets and shared surfaces away.", "Know the emergency signs before beginning: severe bleeding, fainting/confusion, severe pain with rapidly worsening swelling, breathing difficulty or signs of severe infection." ], "steps": [ { "title": "Check the written plan", "instruction": "Read today's dressing, cleaning, activity and contact instructions and confirm the responsible service.", "reason": "The correct action depends on the wound and treatment.", "success_check": "The learner can state what may be touched and whom to call." }, { "title": "Screen emergency signs first", "instruction": "Before moving a dressing, look for uncontrolled bleeding, collapse/confusion, rapidly spreading swelling/redness with severe illness, breathing difficulty or a limb that is cold/pale/blue.", "reason": "Emergency problems should not wait for routine documentation.", "success_check": "The learner routes emergency signs immediately without continuing the check." }, { "title": "Prepare clean observation", "instruction": "Wash hands, use good light and open only clinician-approved supplies. Do not place items on an unclean surface.", "reason": "Basic contamination control matters when a plan permits handling.", "success_check": "The workspace follows the written plan and no unapproved item is present." }, { "title": "Leave protected items protected", "instruction": "If the plan says the dressing, steri-strips, staples, sutures, drain or negative-pressure seal stays in place, do not lift or adjust it. Observe the outside only.", "reason": "Disturbing treatment can cause bleeding, contamination or failure.", "success_check": "All protected items remain intact; the visible 'Leave protected items protected' check is satisfied." }, { "title": "Observe the declared features", "instruction": "Record visible redness boundary, swelling, warmth as noticed without risky touching, drainage amount/colour/odour, pain trend, fever reading if already advised, and ability to use the area.", "reason": "Change over time is more useful than a vague 'looks bad'.", "success_check": "The log uses factual descriptions and prior comparison." }, { "title": "Measure only if authorised", "instruction": "If the care plan permits, use the same ruler/photo distance and include a scale without exposing private identifiers; never probe depth or remove material to see more.", "reason": "Consistent external measurement can aid communication, while probing is clinical care.", "success_check": "The measurement method matches the prior record." }, { "title": "Choose the route", "instruction": "Use the care plan: emergency services for emergency signs; same-day clinical contact for spreading redness, pus/foul drainage, fever/feeling unwell, worsening pain, opening edges or loss of function; routine contact for slower concerns.", "reason": "Routing is the safe skill this restricted lesson teaches.", "success_check": "The decision matches the declared warning-sign table." }, { "title": "Give a concise handoff", "instruction": "State wound/procedure/date, what changed and when, measurements if authorised, pain/temperature/function, current dressing and what you have not done. Follow the service's next instruction.", "reason": "A complete handoff helps the accountable team triage.", "success_check": "The receiving service has the facts needed and the learner records the advice." } ], "worked_example": { "scenario": "Scenario B: four days after lower-leg surgery, the written fictional plan says to keep the dressing intact and contact the surgical service for spreading redness, increased drainage, fever or worsening pain. Redness has expanded from about 5 mm to 15 mm beyond the dressing edge, pain rose from 3/10 to 6/10 and yellow drainage is visible outside the dressing.", "walkthrough": [ "The learner checks first for uncontrolled bleeding, collapse, severe systemic illness or another emergency sign; none is present.", "They wash their hands but leave the prescribed dressing, staples and wound untouched.", "They record the redness boundary, pain change, visible drainage, temperature only if the plan already asks for it, and walking function.", "They match those facts to the fictional plan’s same-day criteria and contact the surgical service instead of waiting for the next appointment.", "They report the exact timeline and follow the service’s instruction. They do not open the dressing, apply antiseptic or claim that infection has been diagnosed." ], "result": "The correct result is same-day accountable clinical review with the prescribed dressing intact and a factual handoff. The exercise neither diagnoses infection nor chooses treatment." }, "right_vs_wrong": [ { "situation": "Dressing: Wound and tissue recovery checkpoint", "right": "Follow the written plan and leave it intact when instructed.", "wrong": "Peel it back to get a better photo.", "why": "Treatment may be disrupted or contaminated." }, { "situation": "Observation: Wound and tissue recovery checkpoint", "right": "Describe change in redness, drainage, pain and function.", "wrong": "Label it infected from appearance alone.", "why": "Diagnosis requires clinical assessment. That changes correct observation completeness and routing of wound warning signs. It is no longer the same test." }, { "situation": "Cleaning: Wound and tissue recovery checkpoint", "right": "Use only the prescribed method/supplies. It is correct when the workspace follows the written plan and no unapproved item is present.", "wrong": "Pour peroxide or alcohol on the wound by default.", "why": "Unprescribed agents can harm tissue or conflict with care." }, { "situation": "Routing: Wound and tissue recovery checkpoint", "right": "Call same day when the plan's signs appear.", "wrong": "Wait for a consumer app or social-media opinion.", "why": "Delay can worsen a serious problem." }, { "situation": "Measurement: Wound and tissue recovery checkpoint", "right": "Use consistent external measurement if authorised.", "wrong": "Probe depth or squeeze drainage to measure more.", "why": "Probing/squeezing is prohibited clinical action. That changes correct observation completeness and routing of wound warning signs. It is no longer the same test." } ], "common_mistakes": [ { "mistake": "The learner cannot name the responsible service.", "fix": "Put service and emergency contacts at the top of the care plan." }, { "mistake": "A dressing is removed despite a keep-intact instruction.", "fix": "Stop, leave protected items alone and call when the plan is unclear." }, { "mistake": "The log says only 'worse'.", "fix": "Record when the change began and the exact visible/symptom/function features." }, { "mistake": "A normal single temperature is treated as proof of no infection.", "fix": "Use the whole clinical pattern and care-plan routing signs." }, { "mistake": "An unprescribed antiseptic is added.", "fix": "Use only prescribed supplies and tell the clinician exactly what has contacted the wound." } ], "practice": { "first_session": [ "Cover the answer strip. Read Scenarios A–D and highlight the exact sentence in each fictional care plan that controls routing.", "For each card, complete the emergency screen before doing any other observation.", "Write only the permitted facts: plan, visible change, symptom trend, function, protected-item status and what was not touched.", "Lock one route for every card: emergency, same-day, routine or continue the plan.", "Practise a 30-second handoff for Scenario B, then reveal the answer strip and correct every missed or overcalled route." ], "repeat_plan": "After at least seven days without rereading the first answers, cover the answer strip and complete delayed Scenarios E–H in a shuffled order. Record the delayed result separately from the first session. Real wound checks, dressing changes and measurements follow only the treating service’s written schedule.", "progress_when": [ "All four first-session routes and all four delayed routes match the supplied fictional plans.", "Every record separates observation from diagnosis and treatment.", "No card causes opening, probing, squeezing, cleaning or use of an unprescribed product.", "The handoff includes the timeline, objective change, symptoms, function, current plan and what was not done." ], "do_not_progress_when": [ "A real emergency or same-day warning sign is present; route care instead of continuing the exercise.", "The written real-world plan is missing, contradictory or the responsible service cannot be identified.", "The learner intends to disturb a protected item or add an unprescribed product." ] }, "self_check": [ "What does the current care plan say may be touched or removed?", "Which signs require emergency help and which require same-day contact?", "Can you describe changes without diagnosing infection?", "Did you avoid probing, squeezing and unprescribed products?", "Can you give the care team the complete timeline and current function?" ], "measurement": { "primary": "Correct observation and care-plan routing across four immediate and four delayed fictional wound scenarios.", "how": "Score each card for plan/contact identification, emergency screen, factual description, protected-item rule, permitted measurement, correct route and complete handoff. Any probing, diagnosis, unprescribed treatment or delayed emergency route is an automatic failure for that card.", "good_result": "Scenarios A–D and, after at least seven days, Scenarios E–H are all routed correctly without opening, probing or treating anything. Immediate and delayed scores remain separate.", "does_not_prove": "It does not prove wound healing, absence of infection, treatment competence or authority to manage any real wound without its responsible clinical service." }, "stop_and_get_help": [ "Call emergency services for uncontrolled bleeding, collapse/confusion, severe systemic illness, breathing difficulty, a cold/pale/blue limb or rapidly worsening severe symptoms.", "Seek same-day clinical advice for spreading redness/warmth/swelling, pus or foul drainage, fever/feeling unwell, opening wound edges, worsening pain or loss of function.", "Stop handling and call if a drain, staple/suture, negative-pressure seal or dressing moves, leaks, breaks or the written instruction is unclear." ], "accessibility": [ "Provide the care plan in large print, plain language, audio or symbols with one clearly labelled contact route.", "Use a support person for photography/logging or dressing care only with consent and the same hygiene/plan boundaries.", "Use colour-independent descriptions, tactile-safe external markers or clinician-led review when vision makes wound observation unreliable." ], "evidence_notes": [ { "claim": "A large randomized trauma-surgery trial found incisional negative-pressure therapy did not significantly reduce deep surgical-site infection, so devices must not be presented as guaranteed recovery.", "source_title": "Effect of Incisional Negative Pressure Wound Therapy vs Standard Wound Dressing on Deep Surgical Site Infection After Surgery for Lower Limb Fractures Associated With Major Trauma: The WHIST Randomized Clinical Trial", "source_url": "https://pubmed.ncbi.nlm.nih.gov/32044942/", "source_kind": "PRIMARY_RESEARCH" }, { "claim": "NICE guidance places prevention and treatment of surgical-site infection within defined clinical recommendations rather than improvised self-treatment.", "source_title": "Surgical site infections: prevention and treatment (NICE guideline NG125)", "source_url": "https://www.nice.org.uk/guidance/ng125/chapter/recommendations", "source_kind": "OFFICIAL_GUIDANCE" } ], "limits": [ "Wound recovery is a clinical outcome, not a stable personal capability.", "External appearance alone cannot diagnose infection, tissue viability or closure quality.", "This tutorial teaches recognition, prevention of interference and accountable routing—not wound treatment." ], "orientation": { "bounded_definition": "Capability to develop or express wound and tissue recovery in a declared context without inheriting broader claims.", "evidence_summary": "Healing matters enormously, but it is not a voluntary superpower. Titan records the evidence and keeps wound care inside clinical governance.", "supportable_public_claim": "Wound recovery is a clinically important biological outcome, not a generally trainable voluntary capability.", "measurement_boundary": "Closure, infection and scar measures describe the wound in its clinical context; they do not measure willpower or a stable personal capability.", "myth_to_metric": { "myth": "Command your body to close wounds", "metric": "Clinical closure, infection and recovery outcomes", "boundary": "Healing outcomes cannot establish voluntary control." }, "limiting_findings": [ "In 1548 trauma-surgery participants, incisional negative-pressure therapy did not significantly reduce deep surgical-site infection." ], "prohibited_claims": [ "Heal wounds at will", "Biohack tissue repair", "Negative pressure makes anyone heal faster", "Ignore infection signs" ] }, "gold_source_lesson": null, "next_gate": "External confirmation is required before higher-authority use because: CLINICAL_HIGH_RISK_OR_REGULATED_CONFIGURATION; SUPERVISION_OR_NON_ATTEMPT_BOUNDARY; SAFETY_LEGITIMACY_RESTRICTED.", "evidence_count": 2 }, "full_training_programme": false, "independently_validated": false, "publication_state": "PUBLISHED_PUBLIC_RESEARCH_EDITION__EDITORIAL_REVIEW_PENDING", "related_power_ids": [ "PWR-033", "PWR-034", "PWR-035", "PWR-036" ] }, { "power_id": "PWR-038", "learning_unit_id": "TLU-PWR-038", "title": "Inflammation resolution and recovery", "main_description": "The learner produces a dated inflammation/recovery timeline that keeps clinical function and each named marker separate and makes the correct urgent, clinical-review or research-only interpretation.", "main_description_source": "FULL_TUTORIAL_OUTCOME", "family_id": "FAM-05", "family": "Tissue Adaptation, Repair & Reacquisition", "superdomain": "Regulation & Recovery", "canonical_route": "/powers/pwr-038/", "treatment": "RESTRICTED_EXPLAINER_ONLY", "treatment_label": "Full safety and decision tutorial", "treatment_boundary": "Titan teaches recognition, prevention, safe response and accountable routing without teaching the prohibited act.", "tutorial_route": "/tutorials/pwr-038/", "governed_lesson_route": null, "self_attempt_status": "PROHIBITED_ACT_EXCLUDED", "gold_pathway_ids": [], "route_membership": { "kind": "RETAINED_EXTERNAL_ROUTE", "id": "SP-HUB-002", "coverage_status": "RETAINED" }, "source_authority_tier": "G6", "source_build_state": "RESTRICTED", "source_instructional_route": "EXPLAINER_ONLY_RESTRICTED", "source_count": 2, "research_depth": "FOCUSED", "risk_level": "HIGH", "prerequisite_status": "NONE_FOR_READING__NO_PRACTICE_AUTHORITY", "learning_route": { "mode": "FULL_RESTRICTED_TUTORIAL", "label": "Learn inflammation resolution and recovery step by step", "summary": "The learner produces a dated inflammation/recovery timeline that keeps clinical function and each named marker separate and makes the correct urgent, clinical-review or research-only interpretation.", "steps": [ [ "Get ready", "Use only reports already ordered/provided by clinicians or published/de-identified research data; do not arrange self-sampling." ], [ "Learn the method", "8 concrete steps teach the permitted method from start to finish." ], [ "See right and wrong", "5 comparisons show correct or safer execution beside common wrong or riskier choices." ], [ "Practise", "Audit one additional dataset per session and revisit the first after one week. Real personal records are updated only when clinician-ordered results or meaningful symptoms/functions change; no serial self-testing or treatment experiment is authorised." ], [ "Check progress", "Score correct event/timeline, marker identity, units/method, matched timing, separate function, retained null findings, claim ceiling and routing." ] ], "practical_authority": false, "provider_required": false, "next_action_route": "/tutorials/pwr-038/" }, "path_builder": { "selectable": true, "completion_allowed": true, "warning": "Titan teaches recognition, prevention, safe response and accountable routing without teaching the prohibited act." }, "full_tutorial": { "version": "3.0", "authorship": "POWER_SPECIFIC_FULL_TUTORIAL", "tutorial_mode": "RESTRICTED", "promise": "Inflammation is a set of biological processes measured differently by symptoms, clinical findings, C-reactive protein, cytokines and specialised lipid mediators. Resolution is not simply 'lower inflammation' and cannot be read from one consumer score. This lesson teaches a safe evidence-and-care method: screen urgent symptoms, define the event and timeline, record symptoms and function, identify exactly which marker was measured and when, compare only like time points, check medication/exercise/illness context, and route clinical questions to the accountable clinician. It does not teach suppressing inflammation with drugs, supplements, fasting, cold, heat or exercise.", "power_id": "PWR-038", "title": "Inflammation resolution and recovery", "lesson_type": "RESTRICTED", "headline": "Build a time-based inflammation record and refuse a one-number cure claim", "plain_english_summary": "Inflammation is a set of biological processes measured differently by symptoms, clinical findings, C-reactive protein, cytokines and specialised lipid mediators. Resolution is not simply 'lower inflammation' and cannot be read from one consumer score. This lesson teaches a safe evidence-and-care method: screen urgent symptoms, define the event and timeline, record symptoms and function, identify exactly which marker was measured and when, compare only like time points, check medication/exercise/illness context, and route clinical questions to the accountable clinician. It does not teach suppressing inflammation with drugs, supplements, fasting, cold, heat or exercise.", "outcome": "The learner produces a dated inflammation/recovery timeline that keeps clinical function and each named marker separate and makes the correct urgent, clinical-review or research-only interpretation.", "authority": { "learner_may": [ "Record symptoms, function, illness/injury/exercise context and clinician-provided results without changing treatment.", "Audit a paper or laboratory report for marker, unit, timing, reference and uncertainty.", "Prepare questions and seek accountable clinical review when warning signs or unexplained changes appear." ], "qualified_person_required_for": [ "Diagnosis, blood or tissue sampling, interpretation of abnormal inflammatory results and investigation of infection, autoimmune disease or injury.", "Medication, NSAID, steroid, antibiotic, supplement, fasting, exercise, cold/heat or other treatment decisions.", "Design and ethics oversight of serial mediator research." ], "never_do": [ "Use one CRP, cytokine, wearable or 'inflammation score' as proof of whole-body inflammation or recovery.", "Start, stop or combine medicines/supplements or change training to manipulate a marker from this lesson.", "Delay urgent assessment for fever with severe illness, breathing difficulty, confusion, rapidly worsening redness/swelling or a hot swollen joint." ] }, "materials": [ "A dated timeline sheet for event, symptoms, function, interventions and samples", "Original clinician laboratory report or full primary paper with units and reference method", "Medication/supplement, illness, sleep and exercise context list", "Emergency and accountable clinician contact information" ], "before_you_start": [ "Use only reports already ordered/provided by clinicians or published/de-identified research data; do not arrange self-sampling.", "Write the clinical/research question before inspecting markers.", "Know urgent warning signs and stop the analysis if immediate care is needed.", "Do not change medicine, supplement, food, temperature exposure or exercise during the tutorial." ], "steps": [ { "title": "Screen urgent problems", "instruction": "Check for severe breathing difficulty, collapse/confusion, rapidly spreading redness/swelling, high fever with severe illness, a hot very painful swollen joint or sudden loss of function.", "reason": "Urgent illness must not wait for biomarker analysis.", "success_check": "Any urgent feature is routed immediately and the lesson stops." }, { "title": "Name the event and question", "instruction": "Write what happened—illness, surgery, injury, exercise or research challenge—and the exact question, such as whether function and a named marker changed over seven days.", "reason": "Without a trigger and time window, 'inflammation' is too vague.", "success_check": "The question names population/person, event, marker, function and dates." }, { "title": "Build the clinical timeline", "instruction": "For each day/time, record fever if clinically instructed, pain, swelling/redness, fatigue, sleep and one meaningful function, plus clinician-directed treatment.", "reason": "Symptoms and function can change differently from a marker.", "success_check": "Every entry has date/time and no missing treatment change." }, { "title": "Name every marker", "instruction": "Copy the exact test—such as CRP, IL-6 or a lipid mediator—plus sample type, unit, laboratory/method and reference range if supplied.", "reason": "Different markers sample different pathways and cannot be merged casually.", "success_check": "No entry says only 'inflammation level'." }, { "title": "Align sample timing", "instruction": "Place each sample relative to the event, meals/exercise/medication if relevant and prior sample. Compare only equivalent conditions or state the mismatch.", "reason": "Inflammatory signals can change quickly over time.", "success_check": "The timeline shows hours/days from the event." }, { "title": "Keep panels and function separate", "instruction": "Plot or list each marker in its own row and function/symptoms in separate rows; do not average them into a global recovery score.", "reason": "An average can hide opposing or null changes.", "success_check": "A reader can see which outcome improved, worsened or stayed uncertain." }, { "title": "Apply the claim ceiling", "instruction": "State whether the record shows a temporal association, a clinician-interpreted change or a study comparison. Do not call mechanism, cure or resolution unless the design and responsible clinician justify it.", "reason": "Timing and marker change alone do not establish cause or health benefit.", "success_check": "The conclusion includes one supported fact and at least two non-claims." }, { "title": "Route the next action", "instruction": "For personal clinical results, ask the ordering clinician what the pattern means and whether follow-up is needed. For research, specify the missing control or next measurement rather than prescribing an intervention.", "reason": "Accountable interpretation protects against self-treatment; this preserves the inflammation resolution and recovery rule for 'Route the next action'.", "success_check": "The record ends with named clinician/research next step or no-action reason." } ], "worked_example": { "scenario": "A fictional exercise trial measures VO2peak, CRP and stimulated cytokine response at baseline and 12 weeks. VO2peak rises 15%, while the prespecified inflammatory outcomes show no meaningful between-group improvement.", "walkthrough": [ "Define the event as a 12-week programme and the question as change in prespecified inflammatory outcomes, not general recovery.", "List VO2peak as a performance/fitness outcome and each inflammatory marker separately with timing and units.", "Record the 15% VO2peak change without copying it into the inflammation rows.", "Retain the null inflammatory comparisons and their uncertainty.", "Conclude that fitness improved in the studied group while the prespecified inflammation outcomes did not; do not recommend a self-treatment." ], "result": "The correct interpretation preserves a beneficial fitness outcome and null inflammatory findings at the same time. It does not prove inflammation was resolved, that exercise failed overall, or that an individual should change treatment." }, "right_vs_wrong": [ { "situation": "Urgent symptoms", "right": "Route care before analysing data. It is correct when any urgent feature is routed immediately and the lesson stops.", "wrong": "Wait for a CRP result while severe symptoms worsen.", "why": "Biomarkers do not replace urgent assessment." }, { "situation": "Marker naming", "right": "Report CRP, cytokine or mediator with unit and time.", "wrong": "Call them one inflammation score; it breaks the 'Name the event and question' execution rule.", "why": "They represent different pathways. That changes accuracy and safety of a time-based inflammation/recovery interpretation. It is no longer the same test." }, { "situation": "Timing: Inflammation resolution and recovery checkpoint", "right": "Compare matched time points and contexts.", "wrong": "Compare a post-exercise sample with a rested sample as equivalent.", "why": "Timing/context can drive differences. That changes accuracy and safety of a time-based inflammation/recovery interpretation. It is no longer the same test." }, { "situation": "Function: Inflammation resolution and recovery checkpoint", "right": "Keep fitness, pain and daily function separate.", "wrong": "Assume a lower marker means useful recovery.", "why": "Clinical value must be measured. That changes accuracy and safety of a time-based inflammation/recovery interpretation. It is no longer the same test." }, { "situation": "Action: Inflammation resolution and recovery checkpoint", "right": "Ask the ordering clinician or state a research gap.", "wrong": "Start NSAIDs, supplements or fasting to move the number.", "why": "Treatment is outside authority and may cause harm." } ], "common_mistakes": [ { "mistake": "The event time is missing.", "fix": "Anchor every sample and symptom to the trigger date/time." }, { "mistake": "Different markers are averaged during 'Name the event and question' in inflammation resolution and recovery.", "fix": "Keep one row per marker, method and unit." }, { "mistake": "A normal CRP is treated as absence of all inflammation.", "fix": "Use the clinician's interpretation and retain symptom/function context." }, { "mistake": "A fitness gain erases null inflammatory results.", "fix": "Report each prespecified outcome independently; then confirm: No entry says only 'inflammation level'." }, { "mistake": "The learner changes treatment before review.", "fix": "Make no intervention change and contact the accountable clinician." } ], "practice": { "first_session": [ "Use one published or fictional dataset and define the event/question.", "Build the dated symptom/function and sampling timeline.", "Enter every marker with method, unit and time in separate rows.", "Write the result for each outcome, including null findings.", "Choose urgent, clinician-review or research-next-step routing for four scenarios." ], "repeat_plan": "Audit one additional dataset per session and revisit the first after one week. Real personal records are updated only when clinician-ordered results or meaningful symptoms/functions change; no serial self-testing or treatment experiment is authorised.", "progress_when": [ "The learner correctly separates marker, timing, symptoms and function.", "Null/contrary findings remain visible beside positive outcomes.", "Every clinical scenario is routed without self-treatment." ], "do_not_progress_when": [ "Urgent symptoms are present.", "Sample method, units, timing or ordering context cannot be verified.", "The exercise is becoming a medicine, supplement, fasting or training experiment." ] }, "self_check": [ "What exact marker, sample, unit and time was measured?", "What urgent signs would stop this analysis?", "Are symptoms, function and each mediator kept separate?", "Does the conclusion retain null findings and uncertainty?", "Is the next action clinician/research routing rather than self-treatment?" ], "measurement": { "primary": "Accuracy and safety of a time-based inflammation/recovery interpretation", "how": "Score correct event/timeline, marker identity, units/method, matched timing, separate function, retained null findings, claim ceiling and routing.", "good_result": "All fields are correct across two datasets and all warning-sign scenarios are routed appropriately without a treatment recommendation.", "does_not_prove": "It does not prove biological resolution, diagnose disease, predict recovery or qualify the learner to order/interpret tests clinically." }, "stop_and_get_help": [ "Seek emergency care for severe breathing difficulty, collapse/confusion, rapidly worsening severe illness, a cold/pale/blue limb or other emergency symptoms.", "Seek same-day clinical assessment for a hot very painful swollen joint, rapidly spreading redness/swelling, fever with worsening illness or sudden loss of function.", "Contact the ordering clinician for unexpected/abnormal results or discordant worsening symptoms; do not adjust treatment from the number." ], "accessibility": [ "Use colour-independent tables, large print, screen-reader labels and plain definitions for every marker.", "Allow a support person to organise dates/results with consent while the learner retains interpretation and treatment boundaries.", "Use a one-page timeline and clinician-question template when memory or executive load is a barrier." ], "evidence_notes": [ { "claim": "Resistance exercise can produce time-dependent inflammatory and resolving-lipid mediator responses, so marker identity and sampling time must be declared.", "source_title": "Human inflammatory and resolving lipid mediator responses to resistance exercise and ibuprofen treatment", "source_url": "https://pubmed.ncbi.nlm.nih.gov/24089379/", "source_kind": "PRIMARY_RESEARCH" }, { "claim": "A randomized aerobic-training trial improved fitness without improving its prespecified inflammatory outcomes, demonstrating that function and inflammation cannot be collapsed.", "source_title": "Aerobic Exercise Training and Inducible Inflammation: Results of a Randomized Controlled Trial in Healthy, Young Adults", "source_url": "https://pubmed.ncbi.nlm.nih.gov/30371169/", "source_kind": "PRIMARY_RESEARCH" } ], "limits": [ "Inflammation is not one global score and resolution is not simple suppression.", "CRP, cytokines and lipid mediators answer different questions at different times.", "This tutorial teaches recognition, evidence interpretation and routing—not treatment or biomarker manipulation." ], "orientation": { "bounded_definition": "Capability to develop or express inflammation resolution and recovery in a declared context without inheriting broader claims.", "evidence_summary": "Inflammation is a coordinated biological response, not a dial you can simply turn down. Fitness can improve while common markers do not.", "supportable_public_claim": "Exercise can change inflammatory biology, but people do not have a demonstrated voluntary “inflammation off-switch,” and biomarkers do not equal recovery.", "measurement_boundary": "Cytokines, CRP and lipid mediators sample different pathways and time points; they cannot establish global inflammation or useful recovery alone.", "myth_to_metric": { "myth": "Switch inflammation off at will", "metric": "Predeclared mediator panel plus clinical function over time", "boundary": "A biomarker cannot prove immune mastery or faster healing." }, "limiting_findings": [ "A 12-week randomized training trial increased aerobic fitness by 15% without improving its prespecified inflammatory outcomes." ], "prohibited_claims": [ "Turn inflammation off", "Master your immune system", "One CRP result scores recovery", "Suppress inflammation to heal faster" ] }, "gold_source_lesson": null, "next_gate": "External confirmation is required before higher-authority use because: CLINICAL_HIGH_RISK_OR_REGULATED_CONFIGURATION.", "evidence_count": 2 }, "full_training_programme": false, "independently_validated": false, "publication_state": "PUBLISHED_PUBLIC_RESEARCH_EDITION__EDITORIAL_REVIEW_PENDING", "related_power_ids": [ "PWR-033", "PWR-034", "PWR-035", "PWR-036" ] }, { "power_id": "PWR-039", "learning_unit_id": "TLU-PWR-039", "title": "Capability preservation during unloading", "main_description": "The learner completes the prescribed quadriceps-set sequence without moving a restricted joint or holding the breath, and records valid holds, symptoms and a separate baseline function.", "main_description_source": "FULL_TUTORIAL_OUTCOME", "family_id": "FAM-05", "family": "Tissue Adaptation, Repair & Reacquisition", "superdomain": "Regulation & Recovery", "canonical_route": "/powers/pwr-039/", "treatment": "SPECIALIST_PROVIDER_ROUTE", "treatment_label": "Full supervised tutorial", "treatment_boundary": "Titan teaches the complete method; a qualified person controls the parts that require supervision, clearance, specialist equipment, load, dose or progression.", "tutorial_route": "/tutorials/pwr-039/", "governed_lesson_route": null, "self_attempt_status": "PROHIBITED_WITHOUT_QUALIFIED_SUPERVISION", "gold_pathway_ids": [], "route_membership": { "kind": "RETAINED_EXTERNAL_ROUTE", "id": "SP-HUB-002", "coverage_status": "RETAINED" }, "source_authority_tier": "G4", "source_build_state": "EXTERNAL_PROVIDER_ROUTE", "source_instructional_route": "LEARN_ELSEWHERE_TRACK_WITH_TITAN", "source_count": 3, "research_depth": "FOCUSED", "risk_level": "HIGH", "prerequisite_status": "QUALIFIED_PROVIDER_DETERMINES", "learning_route": { "mode": "FULL_SUPERVISED_TUTORIAL", "label": "Learn capability preservation during unloading step by step", "summary": "The learner completes the prescribed quadriceps-set sequence without moving a restricted joint or holding the breath, and records valid holds, symptoms and a separate baseline function.", "steps": [ [ "Get ready", "Confirm the diagnosis/reason for unloading and every movement, brace and weight-bearing restriction." ], [ "Learn the method", "7 concrete steps teach the permitted method from start to finish." ], [ "See right and wrong", "5 comparisons show correct or safer execution beside common wrong or riskier choices." ], [ "Practise", "Only the treating team sets daily frequency, hold/force, repetitions and additional resistance/aerobic countermeasures. Update the plan when restrictions, health, brace, wound or unloading exposure changes." ], [ "Check progress", "Record unloading cause/duration, restrictions, countermeasure dose, valid activation and assistance; use provider-selected longitudinal muscle/strength/fitness/function measures separately." ] ], "practical_authority": false, "provider_required": true, "next_action_route": "/tutorials/pwr-039/" }, "path_builder": { "selectable": true, "completion_allowed": true, "warning": "Titan teaches the complete method; a qualified person controls the parts that require supervision, clearance, specialist equipment, load, dose or progression." }, "full_tutorial": { "version": "3.0", "authorship": "POWER_SPECIFIC_FULL_TUTORIAL", "tutorial_mode": "SUPERVISED", "promise": "Capability preservation during unloading means limiting loss during bed rest, immobilisation, reduced weight-bearing or another named unloading state. This lesson teaches one provider-prescribed component: a supine quadriceps isometric set. The learner aligns the leg, gently presses the knee toward the support by tightening the front thigh, keeps the heel down, breathes through the timed hold and fully releases. The clinical team controls whether movement is allowed, force, hold time, repetitions, frequency and the wider countermeasure plan.", "power_id": "PWR-039", "title": "Capability preservation during unloading", "lesson_type": "SUPERVISED", "headline": "Perform a provider-prescribed quadriceps set during unloading and track what it preserves", "plain_english_summary": "Capability preservation during unloading means limiting loss during bed rest, immobilisation, reduced weight-bearing or another named unloading state. This lesson teaches one provider-prescribed component: a supine quadriceps isometric set. The learner aligns the leg, gently presses the knee toward the support by tightening the front thigh, keeps the heel down, breathes through the timed hold and fully releases. The clinical team controls whether movement is allowed, force, hold time, repetitions, frequency and the wider countermeasure plan.", "outcome": "The learner completes the prescribed quadriceps-set sequence without moving a restricted joint or holding the breath, and records valid holds, symptoms and a separate baseline function.", "authority": { "learner_may": [ "Capability preservation during unloading: Lie in the prescribed position with brace/cast/support unchanged and the leg aligned; do not straighten or bend beyond permission. At minimal effort, tighten the front thigh so the kneecap area draws upward and the back of the knee presses gently toward support.", "During an authorised attempt, Maintain the provider-set contraction for the timed hold while breathing normally and keeping face/shoulders relaxed. Count only holds with correct muscle, no forbidden movement, full duration and normal breathing; stop at first repeated substitution or symptom.", "Match leg position to the written unloading plan and record valid quadriceps holds, heel movement, breathing, symptoms and change from the pre-unloading baseline." ], "qualified_person_required_for": [ "Confirm current surgical, fracture, cast, brace, wound, clot and weight-bearing restrictions before authorising any quadriceps contraction during unloading.", "Confirm movement/weight-bearing restrictions, select limb position, force, hold, repetitions, sets, frequency, monitoring and the complete preservation programme.", "Read the current orders rather than relying on memory, position the limb accordingly, check that the heel stays down and observe the contraction and breathing before deciding whether another hold is allowed." ], "never_do": [ "Move a restricted joint, load through a prohibited limb, remove a brace/cast or copy a bed-rest/spaceflight countermeasure without the treating team's plan.", "Do not move a restricted joint, add resistance, change weight-bearing status or expand the countermeasure programme from this single exercise.", "Stop and escalate for new calf pain or swelling, chest symptoms, wound change, fever, pressure injury, neurological change or any breach of the written restriction." ] }, "materials": [ "Firm bed or plinth and provider-approved knee support/towel", "Brace/cast and positioning aids kept as prescribed", "Visible or tactile quadriceps cue and hold timer", "Pre-unloading baseline and daily symptom/function record", "An unloading-preservation sheet for current orders, limb position, hold force and time, repetitions, heel validity, breathing, symptoms and separate muscle, fitness and functional baselines." ], "before_you_start": [ "Confirm the diagnosis/reason for unloading and every movement, brace and weight-bearing restriction.", "Ask the treating team exactly where support goes and how hard/long to contract.", "Report new calf swelling/pain, chest symptoms, skin problems, numbness, fever, wound changes or sudden weakness.", "Read the current restriction sheet aloud and position the leg exactly as written. Ask the supervising clinician to confirm the brace, wound, weight-bearing and joint-position limits before the first contraction.", "Use a gentle provider-observed contraction to locate the front thigh while keeping heel, hip and breathing quiet before timed holds." ], "steps": [ { "title": "Protect restrictions", "instruction": "Lie in the prescribed position with brace/cast/support unchanged and the leg aligned; do not straighten or bend beyond permission.", "reason": "Preservation work must not violate tissue protection.", "success_check": "Position matches the clinical plan; the visible 'Protect restrictions' check is satisfied." }, { "title": "Find the front-thigh contraction", "instruction": "At minimal effort, tighten the front thigh so the kneecap area draws upward and the back of the knee presses gently toward support.", "reason": "The learner must distinguish muscle tension from whole-leg movement.", "success_check": "The provider sees/touches the quadriceps contract without joint motion." }, { "title": "Keep heel and hip quiet", "instruction": "Leave the heel on the support and avoid lifting the leg, squeezing the buttock hard or turning the hip.", "reason": "Substitution can move a restricted joint or hide weak activation.", "success_check": "Only the intended thigh contraction is observed." }, { "title": "Hold and breathe", "instruction": "Maintain the provider-set contraction for the timed hold while breathing normally and keeping face/shoulders relaxed.", "reason": "Breath-holding adds strain and changes the task.", "success_check": "The hold lasts the prescribed time with visible breathing." }, { "title": "Release fully", "instruction": "Let the thigh soften completely for the prescribed rest; confirm skin, pain and sensation are unchanged.", "reason": "Full release controls duty cycle and reveals symptoms.", "success_check": "The muscle returns to baseline before the next cue." }, { "title": "Repeat only valid holds", "instruction": "Count only holds with correct muscle, no forbidden movement, full duration and normal breathing; stop at first repeated substitution or symptom.", "reason": "Invalid volume does not preserve the target capability.", "success_check": "The record distinguishes valid and attempted holds." }, { "title": "Measure preservation against baseline", "instruction": "Track valid activation/force as available and the team's meaningful function, strength or muscle measure relative to pre-unloading baseline.", "reason": "One exercise completion does not prove preservation.", "success_check": "The record shows change from baseline and the support/restriction state." } ], "worked_example": { "scenario": "After knee surgery, the treating physiotherapist permits supine quadriceps sets with the brace locked and prescribes five 5-second holds with 10 seconds rest.", "walkthrough": [ "The learner confirms the brace stays locked and places the approved towel under the knee.", "Holds one to three tighten the quadriceps, keep the heel down and include normal breathing.", "Hold four lifts the heel, so it is invalid and the learner resets after rest.", "Two more valid holds complete five valid repetitions; no joint motion or pain increase occurs.", "The team records activation and later compares strength, thigh size and functional milestones separately." ], "result": "Five valid prescribed holds were completed within the surgical restrictions. This does not prove prevention of atrophy, preserved fitness or permission to add weight-bearing." }, "right_vs_wrong": [ { "situation": "Restrictions: Capability preservation during unloading checkpoint", "right": "Keep brace, joint and weight-bearing rules.", "wrong": "Remove support to make the muscle work harder.", "why": "Protection can be compromised. That changes change from pre-unloading baseline in muscle, strength, fitness and meaningful function. It is no longer the same test." }, { "situation": "Contraction: Capability preservation during unloading checkpoint", "right": "Tighten quadriceps with heel down. It is correct when the provider sees/touches the quadriceps contract without joint motion.", "wrong": "Lift the whole straight leg when that was not prescribed.", "why": "A different movement and load occurs." }, { "situation": "Breathing: Capability preservation during unloading checkpoint", "right": "Breathe through the timed hold. It is correct when only the intended thigh contraction is observed.", "wrong": "Hold the breath and strain; it breaks the 'Keep heel and hip quiet' execution rule.", "why": "Strain rises and validity changes. That changes change from pre-unloading baseline in muscle, strength, fitness and meaningful function. It is no longer the same test." }, { "situation": "Counting: Capability preservation during unloading checkpoint", "right": "Count only target-muscle holds without substitution.", "wrong": "Count every timed attempt; it breaks the 'Hold and breathe' execution rule.", "why": "Volume hides activation failure. That changes change from pre-unloading baseline in muscle, strength, fitness and meaningful function. It is no longer the same test." }, { "situation": "Claim: Capability preservation during unloading checkpoint", "right": "Compare multiple outcomes with baseline. It is correct when the muscle returns to baseline before the next cue.", "wrong": "Assume the set prevented all unloading loss.", "why": "Preservation requires direct longitudinal measurement. That changes change from pre-unloading baseline in muscle, strength, fitness and meaningful function. It is no longer the same test." } ], "common_mistakes": [ { "mistake": "Restrictions are assumed from memory.", "fix": "Keep the current written order visible and verify changes with the team." }, { "mistake": "The heel lifts during the set.", "fix": "Reduce effort and use tactile/visual quadriceps feedback." }, { "mistake": "The buttock or hip substitutes.", "fix": "Reposition and contract more gently until the provider sees the target muscle." }, { "mistake": "Rest is skipped during 'Hold and breathe' in capability preservation during unloading.", "fix": "Use a timer for both hold and full release." }, { "mistake": "Exercise completion is called preservation.", "fix": "Compare muscle, strength, fitness and function with pre-unloading baseline separately." } ], "practice": { "first_session": [ "Treating provider reviews restrictions and positions the limb.", "Practise three minimal contractions with tactile/visual feedback.", "Complete a short prescribed set with timed hold/rest.", "Stop and inspect symptoms, skin, circulation and wound/brace issues as directed.", "Record valid holds and the broader baseline/outcome plan." ], "repeat_plan": "Only the treating team sets daily frequency, hold/force, repetitions and additional resistance/aerobic countermeasures. Update the plan when restrictions, health, brace, wound or unloading exposure changes.", "progress_when": [ "Target quadriceps activation occurs without substitution or restricted motion.", "All holds meet duration/breathing rules with stable symptoms and skin/sensation.", "Strength, size, fitness or function is preserved or declines less under the team's measured plan." ], "do_not_progress_when": [ "New calf swelling/pain, chest symptoms, wound change, fever, skin pressure injury or neurological change appears.", "The heel/hip moves, the joint violates restriction or the brace/cast shifts.", "The learner has no current clinical order for the task or unloading state." ] }, "self_check": [ "Can you state every movement and weight-bearing restriction?", "Does the quadriceps tighten while heel and hip stay quiet?", "Can you breathe and fully release between holds?", "Can you explain why valid holds do not prove full preservation?" ], "measurement": { "primary": "Change from pre-unloading baseline in muscle, strength, fitness and meaningful function", "how": "Record unloading cause/duration, restrictions, countermeasure dose, valid activation and assistance; use provider-selected longitudinal muscle/strength/fitness/function measures separately.", "good_result": "The prescribed method is valid and measured outcomes are maintained or decline less than the predeclared clinical comparison without violating protection.", "does_not_prove": "It does not prove complete prevention of atrophy, insulin resistance, fitness loss or safe return to loading." }, "stop_and_get_help": [ "Seek urgent care for chest pain, sudden severe breathlessness, coughing blood, fainting or new one-sided calf swelling/pain under the clinical plan.", "Stop for wound bleeding/drainage change, fever, skin injury, new numbness/weakness, severe pain or brace/cast movement.", "Pause the unloading-preservation check if swelling, pain, wound status or the restriction order changes, and have the treating team re-authorise the contraction or supported task." ], "accessibility": [ "Use tactile, electrical or visual biofeedback only when selected and operated by the clinical team.", "Use accessible timing/communication and caregiver assistance only within the current written restrictions.", "Make the restriction and quadriceps-contraction cues available as a bedside card, spoken prompt or safe tactile cue, logging brace position and helper contact with each hold." ], "evidence_notes": [ { "claim": "Reduced resistance-training dose preserved some adaptations differently by age and outcome, so maintenance cannot be a universal single dose.", "source_title": "Exercise dosing to retain resistance training adaptations in young and older adults", "source_url": "https://pubmed.ncbi.nlm.nih.gov/21131862/", "source_kind": "PRIMARY_RESEARCH" }, { "claim": "One week of bed rest caused substantial muscle atrophy and insulin resistance in healthy young men, showing that short unloading can produce multi-system loss.", "source_title": "One Week of Bed Rest Leads to Substantial Muscle Atrophy and Induces Whole-Body Insulin Resistance in the Absence of Skeletal Muscle Lipid Accumulation", "source_url": "https://pubmed.ncbi.nlm.nih.gov/27358494/", "source_kind": "PRIMARY_RESEARCH" } ], "limits": [ "One quadriceps set is one component, not a complete countermeasure programme.", "Unloading effects depend on cause, duration, tissue, baseline and clinical restrictions.", "This lesson does not override surgical, fracture, cast, brace or bed-rest orders." ], "orientation": { "bounded_definition": "Capability to develop or express capability preservation during unloading in a declared context without inheriting broader claims.", "evidence_summary": "Use it or lose it is real—but preservation during bed rest or microgravity is a configured medical and engineering problem, not a willpower test.", "supportable_public_claim": "Capability can decline quickly during unloading, and configured countermeasures may preserve part of it; no method prevents every loss.", "measurement_boundary": "Change from a pre-unloading baseline in muscle, strength and meaningful tasks measures preservation; a single biomarker cannot.", "myth_to_metric": { "myth": "Become immune to deconditioning", "metric": "Change from baseline in muscle, strength, fitness and task function", "boundary": "Partial preservation cannot prove complete protection." }, "limiting_findings": [ "Seven days of strict bed rest caused substantial loss in healthy young men; NASA reports that current countermeasures do not protect every crew member fully." ], "prohibited_claims": [ "Never lose muscle on bed rest", "Beat microgravity at home", "One maintenance dose fits everyone", "Exercise against medical restrictions" ] }, "gold_source_lesson": null, "next_gate": "External confirmation is required before higher-authority use because: CLINICAL_HIGH_RISK_OR_REGULATED_CONFIGURATION; SUPERVISION_OR_NON_ATTEMPT_BOUNDARY; SAFETY_LEGITIMACY_RESTRICTED.", "evidence_count": 3 }, "full_training_programme": false, "independently_validated": false, "publication_state": "PUBLISHED_PUBLIC_RESEARCH_EDITION__EDITORIAL_REVIEW_PENDING", "related_power_ids": [ "PWR-033", "PWR-034", "PWR-035", "PWR-036" ] }, { "power_id": "PWR-040", "learning_unit_id": "TLU-PWR-040", "title": "Reacquisition after detraining", "main_description": "The learner completes a supervised return set at the current provider-selected load and updates distance to a predeclared prior strength/function threshold.", "main_description_source": "FULL_TUTORIAL_OUTCOME", "family_id": "FAM-05", "family": "Tissue Adaptation, Repair & Reacquisition", "superdomain": "Regulation & Recovery", "canonical_route": "/powers/pwr-040/", "treatment": "SPECIALIST_PROVIDER_ROUTE", "treatment_label": "Full supervised tutorial", "treatment_boundary": "Titan teaches the complete method; a qualified person controls the parts that require supervision, clearance, specialist equipment, load, dose or progression.", "tutorial_route": "/tutorials/pwr-040/", "governed_lesson_route": null, "self_attempt_status": "PROHIBITED_WITHOUT_QUALIFIED_SUPERVISION", "gold_pathway_ids": [], "route_membership": { "kind": "RETAINED_EXTERNAL_ROUTE", "id": "SP-HUB-002", "coverage_status": "RETAINED" }, "source_authority_tier": "G4", "source_build_state": "EXTERNAL_PROVIDER_ROUTE", "source_instructional_route": "LEARN_ELSEWHERE_TRACK_WITH_TITAN", "source_count": 2, "research_depth": "FOCUSED", "risk_level": "MODERATE_TO_HIGH", "prerequisite_status": "QUALIFIED_PROVIDER_DETERMINES", "learning_route": { "mode": "FULL_SUPERVISED_TUTORIAL", "label": "Learn reacquisition after detraining step by step", "summary": "The learner completes a supervised return set at the current provider-selected load and updates distance to a predeclared prior strength/function threshold.", "steps": [ [ "Get ready", "State why training stopped and report illness, injury, pain, medication, weight/activity or equipment changes." ], [ "Learn the method", "7 concrete steps teach the permitted method from start to finish." ], [ "See right and wrong", "5 comparisons show correct or safer execution beside common wrong or riskier choices." ], [ "Practise", "The provider controls frequency, load/volume increments, recovery and retest dates. Use several valid exposures before a threshold test and update the plan after pain, illness, missed sessions or equipment change." ], [ "Check progress", "Predeclare the threshold and matching configuration, record each valid exposure and date, and test strength/size/function separately with measurement error visible." ] ], "practical_authority": false, "provider_required": true, "next_action_route": "/tutorials/pwr-040/" }, "path_builder": { "selectable": true, "completion_allowed": true, "warning": "Titan teaches the complete method; a qualified person controls the parts that require supervision, clearance, specialist equipment, load, dose or progression." }, "full_tutorial": { "version": "3.0", "authorship": "POWER_SPECIFIC_FULL_TUTORIAL", "tutorial_mode": "SUPERVISED", "promise": "Reacquisition after detraining is the time and practice needed to regain a named prior threshold. This lesson teaches a provider-led return on a leg-press machine: rebuild the old setup, establish a current safe baseline below the former working load, press through the declared range without locking or shifting, lower under control, stop before technical failure and progress only by the provider's predeclared rule. The old best is a reference, not today's starting prescription.", "power_id": "PWR-040", "title": "Reacquisition after detraining", "lesson_type": "SUPERVISED", "headline": "Reacquire one detrained leg-press threshold without jumping back to the old load", "plain_english_summary": "Reacquisition after detraining is the time and practice needed to regain a named prior threshold. This lesson teaches a provider-led return on a leg-press machine: rebuild the old setup, establish a current safe baseline below the former working load, press through the declared range without locking or shifting, lower under control, stop before technical failure and progress only by the provider's predeclared rule. The old best is a reference, not today's starting prescription.", "outcome": "The learner completes a supervised return set at the current provider-selected load and updates distance to a predeclared prior strength/function threshold.", "authority": { "learner_may": [ "Reacquisition after detraining: Write the exact prior device, setup, load/repetitions and date plus one functional threshold; mark missing configuration as unknown. Let the provider choose a current load after warm-up and readiness, independent of pride or expected memory.", "During an authorised attempt, Push through the whole foot, extend hips/knees together and stop at the top marker without locking or lifting the pelvis. End the set at the provider's effort limit or first range, tempo, symmetry or posture failure; do not add a test rep at the old load.", "Document the detraining cause and prior leg-press setup, then record today's valid range and load, distance from the old threshold and the separate functional check." ], "qualified_person_required_for": [ "Review why training stopped, what changed medically or functionally and whether the historical leg-press result is reproducible enough to serve as a reference.", "Review detraining cause and current health, set machine/range/load/repetitions/rest, define prior/current thresholds, progression and functional checks.", "Reconstruct the previous machine settings when possible, establish a lower current baseline, prevent a return to the old load by memory alone and progress only through the predeclared rule." ], "never_do": [ "Resume the previous maximum, volume or sport exposure on the first session back or assume 'muscle memory' protects against injury.", "Do not begin at the former working load, add a test-to-failure set or declare full reacquisition from one familiar-feeling session.", "Stop for pain, instability, shortened range, bouncing, asymmetry, breath-holding or any symptom connected to the original interruption." ] }, "materials": [ "Provider-checked leg-press machine", "Previous training/test record with device and configuration", "Current setup photo and range markers", "Return log for load, valid reps, symptoms, recovery and functional threshold", "A reacquisition ledger for detraining cause and dates, prior and current machine setup, load, range, valid repetitions, symptoms, prior threshold, present difference and functional result." ], "before_you_start": [ "State why training stopped and report illness, injury, pain, medication, weight/activity or equipment changes.", "Verify whether the prior threshold used the same device, seat, range and repetition rule.", "Set a current starting load and stop rule without using the old performance as a mandatory target.", "Rebuild the historical leg-press setup from records rather than memory, then identify which old threshold is actually comparable. If the old reference cannot be reproduced, label that limitation before testing today's lower baseline.", "Rebuild the leg-press setup and establish today's controlled lower baseline before comparing anything with the historical load." ], "steps": [ { "title": "Define the old threshold honestly", "instruction": "Write the exact prior device, setup, load/repetitions and date plus one functional threshold; mark missing configuration as unknown.", "reason": "A vague old best cannot be a clean reacquisition target.", "success_check": "The reference is reproducible or explicitly limited." }, { "title": "Set today's lower baseline", "instruction": "Let the provider choose a current load after warm-up and readiness, independent of pride or expected memory.", "reason": "Capacity and tolerance may have changed during detraining.", "success_check": "The learner can perform easy full-range reps without symptoms." }, { "title": "Rebuild the leg-press setup", "instruction": "Match the current recorded seat/back/foot positions and safety stop; use the provider-set comfortable range.", "reason": "Leverage and range can make the same load a different task.", "success_check": "All settings and foot marks are recorded." }, { "title": "Press smoothly", "instruction": "Push through the whole foot, extend hips/knees together and stop at the top marker without locking or lifting the pelvis.", "reason": "Controlled range keeps the repetition comparable.", "success_check": "The body stays supported and both sides contribute as planned." }, { "title": "Return under control", "instruction": "Lower the platform through the full prescribed count to the bottom marker without bouncing or collapsing.", "reason": "The return phase tests regained control, not just load movement.", "success_check": "The load reaches the same bottom quietly." }, { "title": "Stop before old habits take over", "instruction": "End the set at the provider's effort limit or first range, tempo, symmetry or posture failure; do not add a test rep at the old load.", "reason": "Reacquisition is repeated valid exposure, not immediate proof.", "success_check": "Only valid current reps are logged." }, { "title": "Update threshold distance", "instruction": "Compare today's standardised result and function with the predeclared prior thresholds, including configuration and symptoms; compute time to regain only after the threshold is actually met.", "reason": "A partial return must not be labelled regained.", "success_check": "The record states current percentage/difference without a premature completion date." } ], "worked_example": { "scenario": "Before a 12-week detraining period, a learner completed eight valid leg-press repetitions at 80 kg on one machine and a 12-second stair task. The provider starts the return at 45 kg after assessment.", "walkthrough": [ "The old machine settings and validity rules are recovered from the log; the stair task remains a separate threshold.", "The learner warms up and completes six controlled repetitions at 45 kg with no symptoms.", "A seventh repetition shortens range, so the set ends and six are valid.", "The provider does not test 80 kg and schedules the next exposure under the return plan.", "The log shows current standard performance and stair function; no reacquisition date is claimed yet." ], "result": "The learner has established a safe current baseline, not regained the old threshold. Reacquisition is recorded only when the same declared threshold and any separate function are met under valid conditions." }, "right_vs_wrong": [ { "situation": "Old performance", "right": "Use it as a documented reference.", "wrong": "Start at the old load because it was once safe.", "why": "Detraining and health changes alter readiness." }, { "situation": "Current baseline", "right": "Use provider-selected submaximal full-range work; this meets 'Set today's lower baseline': The learner can perform easy full-range reps without symptoms.", "wrong": "Test a maximum on day one back.", "why": "A maximum is unnecessary and higher risk." }, { "situation": "Repetition: Reacquisition after detraining checkpoint", "right": "Keep range, tempo and symmetry. It is correct when all settings and foot marks are recorded.", "wrong": "Shorten range to move the previous load.", "why": "That is not reacquisition of the old task." }, { "situation": "Completion: Reacquisition after detraining checkpoint", "right": "Declare threshold regained only when matched validly.", "wrong": "Call rapid early improvement full return.", "why": "Learning and tolerance may precede stable recovery." }, { "situation": "Transfer: Reacquisition after detraining checkpoint", "right": "Retest function separately. It is correct when the load reaches the same bottom quietly.", "wrong": "Assume machine strength restores stairs or sport.", "why": "Functional transfer is not automatic. That changes time to regain a named strength, muscle-size or functional threshold. It is no longer the same test." } ], "common_mistakes": [ { "mistake": "The detraining cause is ignored.", "fix": "Review injury, illness, inactivity and current health before load selection." }, { "mistake": "The previous machine/settings are unknown.", "fix": "Treat the old number as non-comparable and create a new baseline." }, { "mistake": "First-session progress is chased by large load jumps.", "fix": "Follow the provider's predeclared small progression rule." }, { "mistake": "Partial-range reps are counted toward the old threshold.", "fix": "Use the original validity rule or label a new task." }, { "mistake": "Reacquisition is dated without retesting function.", "fix": "Track the named strength/size and meaningful function thresholds separately." } ], "practice": { "first_session": [ "Review detraining cause and reconstruct the prior threshold.", "Fit the machine and complete progressive low-load warm-ups.", "Complete one current-baseline set below technical failure.", "Cool down and record immediate/next-day response.", "Update distance to strength and functional thresholds without testing the old maximum." ], "repeat_plan": "The provider controls frequency, load/volume increments, recovery and retest dates. Use several valid exposures before a threshold test and update the plan after pain, illness, missed sessions or equipment change.", "progress_when": [ "Every repetition meets the prior or newly declared range/tempo rule.", "Load or volume rises under the provider rule with acceptable recovery.", "The named threshold is met on the same configuration and meaningful function is checked separately." ], "do_not_progress_when": [ "The learner needs shortened range, bounce, asymmetry or breath-holding to approach the old load.", "Pain, swelling, unusual fatigue or problematic next-day response appears.", "The old record is not comparable or the detraining cause still needs clinical management." ] }, "self_check": [ "Can you state the old threshold, date, machine and validity rule?", "Did today's set begin below the old load after provider assessment?", "Were all counted reps full-range and controlled?", "Can you explain why early improvement and machine strength do not equal full reacquisition?" ], "measurement": { "primary": "Time to regain a named strength, muscle-size or functional threshold", "how": "Predeclare the threshold and matching configuration, record each valid exposure and date, and test strength/size/function separately with measurement error visible.", "good_result": "The exact threshold is met or exceeded under the same valid conditions and is confirmed as the provider planned without worse symptoms/function.", "does_not_prove": "It does not prove a universal muscle-memory advantage, safe maximum, injury protection or return to sport/work." }, "stop_and_get_help": [ "Stop for sharp pain, a pop, swelling, sudden weakness/numbness, joint giving way or inability to control the machine.", "Pause the return and obtain review for illness relapse, chest symptoms, unexplained fatigue or a worsening next-day response.", "Delay the reacquisition session after illness relapse, an adverse next-day response or a new symptom that changes the reduced baseline, and seek the appropriate programme or health review." ], "accessibility": [ "Use the person's accessible prior device or a provider-selected alternative and create a new threshold rather than comparing unlike machines.", "Keep transfer, seating, communication and usual aids; record assistance as part of current capability.", "Show old and current thresholds on a simple graph, spoken scale or tactile number line, and preserve the representation and any assistance used when comparing sessions." ], "evidence_notes": [ { "claim": "Older men regained some strength/power after detraining and retraining under a specific protocol, but outcomes and time course were not universal.", "source_title": "The effect of resistance training, detraining and retraining on muscle strength and power, myofibre size, satellite cells and myonuclei in older men", "source_url": "https://pubmed.ncbi.nlm.nih.gov/32017951/", "source_kind": "PRIMARY_RESEARCH" }, { "claim": "A controlled human retraining study found the previously trained leg did not respond better than the untrained leg, limiting simple muscle-memory claims.", "source_title": "Effects of training, detraining, and retraining on strength, hypertrophy, and myonuclear number in human skeletal muscle", "source_url": "https://pubmed.ncbi.nlm.nih.gov/30991013/", "source_kind": "PRIMARY_RESEARCH" } ], "limits": [ "Reacquisition is outcome-, configuration- and detraining-cause specific.", "The previous best is not today's safe starting load.", "A regained gym threshold does not prove function, sport or occupational return." ], "orientation": { "bounded_definition": "Capability to develop or express reacquisition after detraining in a declared context without inheriting broader claims.", "evidence_summary": "“Muscle memory” is real in some senses and overstated in others. Strength can return, but a prior-trained limb has not always regained faster than a control limb.", "supportable_public_claim": "Previously trained people can regain lost strength, but human studies do not support a guaranteed biological shortcut or identical return curve.", "measurement_boundary": "Time to regain a predeclared strength, size or task threshold measures reacquisition of that endpoint only.", "myth_to_metric": { "myth": "Your muscles never forget", "metric": "Time to regain a named strength, size or functional threshold", "boundary": "A molecular trace cannot guarantee faster real-world recovery." }, "limiting_findings": [ "In one controlled human study, the previously trained leg did not respond better than the untrained leg during retraining." ], "prohibited_claims": [ "Muscle remembers forever", "Return at your old loads", "Rebuild twice as fast", "Prior fitness protects after illness" ] }, "gold_source_lesson": null, "next_gate": "External confirmation is required before higher-authority use because: CLINICAL_HIGH_RISK_OR_REGULATED_CONFIGURATION; SUPERVISION_OR_NON_ATTEMPT_BOUNDARY.", "evidence_count": 2 }, "full_training_programme": false, "independently_validated": false, "publication_state": "PUBLISHED_PUBLIC_RESEARCH_EDITION__EDITORIAL_REVIEW_PENDING", "related_power_ids": [ "PWR-033", "PWR-034", "PWR-035", "PWR-036" ] }, { "power_id": "PWR-041", "learning_unit_id": "TLU-PWR-041", "title": "Voluntary breathing regulation", "main_description": "The learner completes one two-minute gentle longer-exhale trial while breathing comfortably, counts the rate consistently and records comfort before and after.", "main_description_source": "FULL_TUTORIAL_OUTCOME", "family_id": "FAM-06", "family": "Autonomic & Physiological Self-Regulation", "superdomain": "Regulation & Recovery", "canonical_route": "/powers/pwr-041/", "treatment": "EVIDENCE_REVIEW_ROUTE", "treatment_label": "Full low-stakes tutorial", "treatment_boundary": "Titan teaches a concrete low-stakes method step by step while keeping evidence and transfer claims bounded.", "tutorial_route": "/tutorials/pwr-041/", "governed_lesson_route": null, "self_attempt_status": "PERMITTED_INSIDE_FULL_TUTORIAL_LIMITS", "gold_pathway_ids": [ "G-CUR-004" ], "route_membership": { "kind": "GOLD_PATHWAY", "id": "G-CUR-004", "coverage_status": "EXACT_ONCE" }, "source_authority_tier": "G2", "source_build_state": "TARGETED_REVIEW_REQUIRED", "source_instructional_route": "BOUNDED_GUIDED_EXERCISE", "source_count": 5, "research_depth": "DETAILED", "risk_level": "MODERATE_TO_HIGH", "prerequisite_status": "NONE_FOR_READING__NO_PRACTICE_AUTHORITY", "learning_route": { "mode": "FULL_SELF_GUIDED_TUTORIAL", "label": "Learn voluntary breathing regulation step by step", "summary": "The learner completes one two-minute gentle longer-exhale trial while breathing comfortably, counts the rate consistently and records comfort before and after.", "steps": [ [ "Get ready", "Choose a time when ordinary breathing feels comfortable and you are not driving, bathing or operating equipment." ], [ "Learn the method", "7 concrete steps teach the permitted method from start to finish." ], [ "See right and wrong", "5 comparisons show correct or safer execution beside common wrong or riskier choices." ], [ "Practise", "If the first trial is symptom-free, repeat one two-minute trial on three separate days, never more than once in a sitting. Compare the same one-minute counts and comfort scores. Do not pursue a universal target rate; seek qualified guidance for clinical or performance use." ], [ "Check progress", "Record the natural and post-trial cycles per minute, comfort from 0 to 10, trial duration, symptoms and any changed support. Compare only trials with the same counting window and posture." ] ], "practical_authority": true, "provider_required": false, "next_action_route": "/tutorials/pwr-041/" }, "path_builder": { "selectable": true, "completion_allowed": true, "warning": "Titan teaches a concrete low-stakes method step by step while keeping evidence and transfer claims bounded." }, "full_tutorial": { "version": "3.0", "authorship": "POWER_SPECIFIC_FULL_TUTORIAL", "tutorial_mode": "SELF_GUIDED", "promise": "Voluntary breathing is real and trainable in bounded settings; downstream health and autonomic claims remain limited. This lesson teaches a modest, seated pattern change: measure natural breathing, make the exhale slightly longer, keep each breath easy and return to normal breathing if symptoms appear. It does not teach hyperventilation, long breath holds or treatment of a condition.", "power_id": "PWR-041", "title": "Voluntary breathing regulation", "lesson_type": "SELF_GUIDED", "headline": "Slow the exhale gently without holding or over-breathing", "plain_english_summary": "Voluntary breathing is real and trainable in bounded settings; downstream health and autonomic claims remain limited. This lesson teaches a modest, seated pattern change: measure natural breathing, make the exhale slightly longer, keep each breath easy and return to normal breathing if symptoms appear. It does not teach hyperventilation, long breath holds or treatment of a condition.", "outcome": "The learner completes one two-minute gentle longer-exhale trial while breathing comfortably, counts the rate consistently and records comfort before and after.", "authority": { "learner_may": [ "While seated and supported, count natural breaths, try the exact gentle longer-exhale interval and complete recovery without holds or forced depth.", "Repeat one two-minute longer-exhale interval on a later day while keeping the one-minute baseline and recovery counts unchanged.", "Keep ordinary respiratory equipment, seating, mobility aids and communication supports in place during the breathing comparison." ], "qualified_person_required_for": [ "Clinical assessment, diagnosis or treatment related to voluntary breathing regulation.", "Any breathing practice involving breath holds, hyperventilation, cold exposure, sport, panic treatment, cardiorespiratory disease or another person's care.", "Changing prescribed respiratory equipment, medication or rehabilitation plans to influence the breathing comparison." ], "never_do": [ "Treat the six-minute breathing comparison as a clinical test, blood-gas measurement or proof of autonomic control.", "Add deep breaths, long pauses, rapid breathing, cold exposure or exertion to make the breath count change more.", "Continue the longer-exhale interval through air hunger, tingling, dizziness, chest discomfort, panic or a recovery gasp." ] }, "materials": [ "A supportive chair with feet able to rest on the floor or a stable foot support.", "A clock or timer with a seconds display.", "A one-page record for breath count, comfort and symptoms.", "A quiet room; no bath, pool, driving, standing balance task or cold exposure." ], "before_you_start": [ "Choose a time when ordinary breathing feels comfortable and you are not driving, bathing or operating equipment.", "Sit with the back and feet supported; loosen clothing that restricts an ordinary breath.", "Do not practise if you have new breathlessness, chest pain, faintness or an acute breathing problem.", "Predeclare the stop rule: return to normal breathing immediately for dizziness, tingling, air hunger, panic or chest discomfort." ], "steps": [ { "title": "Settle without changing the breath", "instruction": "Sit supported for one minute. Let breathing happen by itself; do not deepen or slow it yet.", "reason": "A true natural period gives a safer comparator and reduces performance pressure.", "success_check": "The shoulders stay quiet and breathing feels ordinary." }, { "title": "Count the natural rate", "instruction": "Count each completed inhale-and-exhale cycle for 60 seconds. Mark the count and comfort from 0 to 10.", "reason": "A full minute avoids guessing from a few breaths.", "success_check": "The record contains one whole-minute count and a comfort number." }, { "title": "Choose a small change", "instruction": "On the next breath, inhale normally and let the exhale last about one or two seconds longer. Do not take a bigger breath first.", "reason": "A small exhale change is less likely to cause over-breathing than repeated deep breaths.", "success_check": "The exhale is unforced and there is no breath hold." }, { "title": "Keep the breath easy", "instruction": "Repeat the easy inhale and slightly longer exhale. Let the jaw, neck and shoulders stay loose; reduce the change if you need to gulp air.", "reason": "Air hunger, large breaths and upper-body effort show that the pattern is too demanding.", "success_check": "You can speak a short sentence normally and do not need a recovery gasp." }, { "title": "Practise for two minutes", "instruction": "Continue for at most two minutes while the timer runs. Stop the pattern at the first symptom rather than finishing the clock.", "reason": "A short fixed trial makes the comparison clear without chasing a physiological effect.", "success_check": "The trial ends at two minutes or earlier under the declared stop rule." }, { "title": "Return to natural breathing", "instruction": "Let the breath return to its own rhythm for one minute. Do not add a hold or a final deep-breath challenge.", "reason": "A recovery minute reveals whether the trial left discomfort or abnormal breathing.", "success_check": "Breathing feels ordinary again and no dizziness or tingling is present." }, { "title": "Record without overclaiming", "instruction": "Count one more full minute and record comfort, symptoms and whether you changed posture or timing.", "reason": "Rate and comfort describe this configured trial; they do not prove autonomic control.", "success_check": "The before and after entries use the same chair, timing rule and counting method." } ], "worked_example": { "scenario": "Mara tries the lesson at a desk while well and seated. Her natural rate is 14 cycles per minute and comfort is 8/10.", "walkthrough": [ "She sits quietly for one minute and counts 14 complete cycles during the next minute.", "She keeps each inhale ordinary and lets each exhale finish about one second later, without pausing.", "After two minutes she returns to natural breathing; she has no tingling, air hunger or dizziness.", "One minute later she counts 12 cycles and records comfort 8/10, plus the exact chair and timing.", "Two days later she repeats with the same setup rather than forcing a six-breath-per-minute target." ], "result": "Mara demonstrated a comfortable voluntary pattern change in this seated task. The two-count difference is descriptive; it does not show treatment, vagal tone or whole-autonomic control." }, "right_vs_wrong": [ { "situation": "Size of the change", "right": "Use an ordinary inhale and only a slightly longer, unforced exhale.", "wrong": "Take repeated maximal breaths to make the rate fall quickly.", "why": "Large repeated breaths can produce dizziness or tingling and change the task." }, { "situation": "Pauses", "right": "Let the next inhale arrive naturally.", "wrong": "Add a long breath hold after every exhale.", "why": "The lesson does not test breath-hold tolerance or low oxygen." }, { "situation": "Counting", "right": "Count complete cycles for the same full minute before and after.", "wrong": "Estimate the rate from a few breaths or change the counting window.", "why": "Different counting rules make the comparison misleading." }, { "situation": "Symptoms", "right": "Stop the pattern and breathe normally at the first air hunger, dizziness or distress.", "wrong": "Push through symptoms to complete the timer.", "why": "Symptoms are a stop signal, not evidence that the method is working." }, { "situation": "Interpretation", "right": "Report rate, comfort and the exact seated setup.", "wrong": "Call a slower count proof of autonomic mastery or disease treatment.", "why": "A breathing count cannot establish broad physiological control." } ], "common_mistakes": [ { "mistake": "Take repeated maximal breaths to make the rate fall quickly.", "fix": "Use an ordinary inhale and only a slightly longer, unforced exhale." }, { "mistake": "Add a long breath hold after every exhale.", "fix": "Let the next inhale arrive naturally." }, { "mistake": "Estimate the rate from a few breaths or change the counting window.", "fix": "Count complete cycles for the same full minute before and after." }, { "mistake": "Push through symptoms to complete the timer.", "fix": "Stop the pattern and breathe normally at the first air hunger, dizziness or distress." }, { "mistake": "Call a slower count proof of autonomic mastery or disease treatment.", "fix": "Report rate, comfort and the exact seated setup." } ], "practice": { "first_session": [ "Read the stop rule aloud and set up the supported chair.", "Record one natural 60-second count and comfort score.", "Complete one two-minute longer-exhale trial, then one recovery minute.", "Record the second count, comfort and every symptom or deviation.", "Do not add another trial on the first day if the pattern felt effortful." ], "repeat_plan": "If the first trial is symptom-free, repeat one two-minute trial on three separate days, never more than once in a sitting. Compare the same one-minute counts and comfort scores. Do not pursue a universal target rate; seek qualified guidance for clinical or performance use.", "progress_when": [ "Three trials use an ordinary inhale, an unforced longer exhale and no hold.", "Counts are made over a full minute with the same rule.", "Comfort stays the same or improves and no stop symptom occurs." ], "do_not_progress_when": [ "A recovery gasp, tingling, dizziness, panic or chest discomfort appears.", "You feel compelled to take deeper breaths or hold the breath.", "A respiratory, cardiac, panic or other condition makes breathing practice uncertain." ] }, "self_check": [ "Can you demonstrate “Count the natural rate”? The record contains one whole-minute count and a comfort number.", "Can you demonstrate “Keep the breath easy”? You can speak a short sentence normally and do not need a recovery gasp.", "Can you demonstrate “Record without overclaiming”? The before and after entries use the same chair, timing rule and counting method." ], "measurement": { "primary": "Respiratory accuracy, blood-gas safety, HRV/baroreflex measures and delayed functional performance", "how": "Record the natural and post-trial cycles per minute, comfort from 0 to 10, trial duration, symptoms and any changed support. Compare only trials with the same counting window and posture.", "good_result": "Three separate symptom-free trials show accurate counting and the intended easy pattern; a lower rate is not required.", "does_not_prove": "Respiratory rate, volume, blood gases and declared cardiovascular measures index the configured task; HRV alone does not establish vagal tone, health or direct organ control." }, "stop_and_get_help": [ "Return to normal breathing and seek urgent help for severe or persistent breathlessness, chest pain, fainting, blue or grey lips, confusion or a medical emergency.", "Stop immediately for dizziness, tingling, air hunger, panic, palpitations or a need to gasp.", "Ask a clinician before further practice when pregnancy, heart or lung disease, panic episodes, recent illness or medication changes affect breathing." ], "accessibility": [ "Practise lying or semi-reclined only if that is the learner’s ordinary safe resting position.", "Use a spoken timer, tactile counter or helper to count cycles without staring at a clock.", "Keep respiratory equipment and ordinary supports in place; this lesson never asks a learner to remove them." ], "evidence_notes": [ { "claim": "Daily slow-breathing research measured time-linked autonomic changes under a defined protocol; it supports bounded study, not a universal personal rate.", "source_title": "Time sequence of autonomic changes induced by daily slow-breathing sessions", "source_url": "https://pubmed.ncbi.nlm.nih.gov/25345681/", "source_kind": "PRIMARY_RESEARCH" }, { "claim": "Signal-guided breathing can alter selected measured responses, but the finding belongs to the studied person-sensor-task system.", "source_title": "Heart rate variability biofeedback increases baroreflex gain and peak expiratory flow", "source_url": "https://pubmed.ncbi.nlm.nih.gov/14508023/", "source_kind": "PRIMARY_RESEARCH" } ], "limits": [ "Respiratory rate, volume, blood gases and declared cardiovascular measures index the configured task; HRV alone does not establish vagal tone, health or direct organ control.", "Unsupported claim: control the autonomic nervous system at will.", "Unsupported claim: one breathing rate works for everyone.", "Unsupported claim: breathing treats immune, cardiac or psychiatric disease.", "A comfortable seated result does not transfer to breath holds, hyperventilation, cold exposure, sport, panic treatment or medical care." ], "orientation": { "bounded_definition": "Capability to develop or express voluntary breathing regulation in a declared context without inheriting broader claims.", "evidence_summary": "Voluntary breathing is real and trainable in bounded settings; downstream health and autonomic claims remain limited.", "supportable_public_claim": "People can learn bounded control of breathing pattern, sometimes with measurable short-term physiological effects, when the method and population are declared.", "measurement_boundary": "Respiratory rate, volume, blood gases and declared cardiovascular measures index the configured task; HRV alone does not establish vagal tone, health or direct organ control.", "myth_to_metric": { "myth": "Master your autonomic system with breath", "metric": "Respiratory accuracy, blood-gas safety, HRV/baroreflex measures and delayed functional performance", "boundary": "A proxy change or bundled intervention does not establish whole-system control." }, "limiting_findings": [ "The endotoxaemia study bundled breathing, meditation and cold, so it cannot identify a breathing-only effect.", "No broad durable functional transfer is established." ], "prohibited_claims": [ "control the autonomic nervous system at will", "one breathing rate works for everyone", "breathing treats immune, cardiac or psychiatric disease", "safe hyperventilation or breath-hold challenge" ] }, "gold_source_lesson": null, "next_gate": "External confirmation is required before higher-authority use because: CLINICAL_HIGH_RISK_OR_REGULATED_CONFIGURATION; SUPERVISION_OR_NON_ATTEMPT_BOUNDARY.", "evidence_count": 5 }, "full_training_programme": false, "independently_validated": false, "publication_state": "PUBLISHED_PUBLIC_RESEARCH_EDITION__EDITORIAL_REVIEW_PENDING", "related_power_ids": [ "PWR-042", "PWR-043", "PWR-044", "PWR-045" ] }, { "power_id": "PWR-042", "learning_unit_id": "TLU-PWR-042", "title": "Autonomic arousal downregulation", "main_description": "This is a static research-lens exercise, not an autonomic-regulation guide. It supplies every fictional signal and threshold needed to classify four records. Do not change breathing, stare at a display, induce arousal, use a wearable, seek a lower heart-related value or treat the rows as personal targets. Respiratory pattern, pupil diameter, heart-rate variability, subjective arousal and task accuracy are non-equivalent. Several may move together, separately or in opposite directions. A configured short-term pattern does not prove emotion, safety, judgment, treatment effect, unique superiority, retention or durable real-world control. No practical biofeedback or regulation method is authorised here.", "main_description_source": "GOVERNED_TUTORIAL_PLAIN_ENGLISH_INTRO", "family_id": "FAM-06", "family": "Autonomic & Physiological Self-Regulation", "superdomain": "Regulation & Recovery", "canonical_route": "/powers/pwr-042/", "treatment": "RESEARCH_EXPLORATION_ROUTE", "treatment_label": "Full research tutorial", "treatment_boundary": "Titan teaches a complete Power-specific research method because operational capability practice is not currently justified.", "tutorial_route": "/tutorials/pwr-042/", "governed_lesson_route": "/tutorials/pwr-042/", "self_attempt_status": "NO_TRAINING_AUTHORITY", "gold_pathway_ids": [ "G-CUR-004" ], "route_membership": { "kind": "GOLD_PATHWAY", "id": "G-CUR-004", "coverage_status": "EXACT_ONCE" }, "source_authority_tier": "G2", "source_build_state": "RESEARCH_ONLY", "source_instructional_route": "EXPLAINER_ONLY_RESEARCH", "source_count": 3, "research_depth": "FOCUSED", "risk_level": "MODERATE", "prerequisite_status": "NONE_FOR_READING__NO_PRACTICE_AUTHORITY", "learning_route": { "mode": "RESEARCH_EXPLORATION", "label": "Explore the research frontier", "summary": "This is a static research-lens exercise, not an autonomic-regulation guide. It supplies every fictional signal and threshold needed to classify four records. Do not change breathing, stare at a display, induce arousal, use a wearable, seek a lower heart-related value or treat the rows as personal targets. Respiratory pattern, pupil diameter, heart-rate variability, subjective arousal and task accuracy are non-equivalent. Several may move together, separately or in opposite directions. A configured short-term pattern does not prove emotion, safety, judgment, treatment effect, unique superiority, retention or durable real-world control. No practical biofeedback or regulation method is authorised here.", "steps": [ [ "Frame the question", "State the capability claim narrowly enough that evidence could support or limit it." ], [ "Map the evidence", "Distinguish existence, measurement, trainability, retention, transfer, safety and functional value." ], [ "Find uncertainty", "Identify small samples, proxy measures, missing controls, null findings and unresolved authority questions." ], [ "Compare alternatives", "Consider competing explanations and what evidence would change the current treatment." ], [ "Stay non-operational", "Use the record for research literacy only until a separate gate authorises instruction." ] ], "practical_authority": false, "provider_required": false, "next_action_route": "/tutorials/pwr-042/" }, "path_builder": { "selectable": true, "completion_allowed": true, "warning": "Titan teaches a complete Power-specific research method because operational capability practice is not currently justified." }, "full_tutorial": { "version": "1.0", "authorship": "AUTHORED_GOVERNED_SOURCE", "practice_pack": { "power_id": "PWR-042", "title": "Autonomic arousal downregulation", "heading": "Audit fictional arousal-linked signal changes without practising biofeedback", "plain_english_intro": "This is a static research-lens exercise, not an autonomic-regulation guide. It supplies every fictional signal and threshold needed to classify four records. Do not change breathing, stare at a display, induce arousal, use a wearable, seek a lower heart-related value or treat the rows as personal targets. Respiratory pattern, pupil diameter, heart-rate variability, subjective arousal and task accuracy are non-equivalent. Several may move together, separately or in opposite directions. A configured short-term pattern does not prove emotion, safety, judgment, treatment effect, unique superiority, retention or durable real-world control. No practical biofeedback or regulation method is authorised here.", "authority_and_safety": [ "Governance ceiling: explanation and static fictional record analysis only. Capability self-practice, live administration, protocol delivery and efficacy claims are not authorised until the recorded next_gate adjudication changes.", "Use only the four supplied fictional signal records. Do not change breathing, induce arousal, use a sensor or feedback display, or attempt grounding as part of this lesson.", "The rows cannot diagnose emotion, anxiety, autonomic state, treatment response, safety or judgment." ], "materials": [ "The four fictional records A–D in the fixture; no sensor, breathing exercise, biofeedback device or personal measurement is used.", "Threshold card: flag respiratory change only when breaths per minute fall by at least 2; pupil change only when diameter falls by at least 0.3 mm; RMSSD change only when it rises by at least 5 ms; subjective change only when arousal falls by at least 2 points; task is preserved when accuracy falls by no more than 2 percentage points.", "Change worksheet with columns for respiratory difference, pupil difference, RMSSD difference, subjective difference, accuracy-point difference, four signal flags, task-preserved flag and bounded interpretation.", "Authority card: THIS SUPPLEMENT USES STATIC FICTIONAL DATA ONLY; no breathing pace, feedback method, dose, progression, diagnosis, anxiety treatment or safety decision.", "Calculator, optional, and the hidden answer key." ], "setup_steps": [ "Copy the five threshold rules exactly, including units and the word at least. A 0.2 mm pupil decrease does not meet the 0.3 mm flag.", "For every arrow, calculate post minus pre. Keep negative and positive signs before applying a threshold.", "Award signal flags separately; never add respiratory, pupil, RMSSD and self-report values into one calmness score.", "Calculate task accuracy change in percentage points, not percent. Mark preserved only when the drop is 2 points or less.", "Use the condition column to distinguish same-session feedback, same-session no-feedback comparison and a separate 48-hour replication row. Do not call the last row retention because identity, acquisition and matched configuration continuity are not supplied.", "Finish each record with a narrow evidence statement and at least one claim it cannot support." ], "fixture": { "caption": "Fictional arousal-linked signal records for static threshold classification", "headers": [ "Case", "Condition", "Respiration pre to post", "Pupil diameter pre to post", "RMSSD pre to post", "Subjective arousal pre to post", "Task accuracy pre to post" ], "rows": [ [ "A", "Same-session apparatus feedback", "18 to 12 breaths/min", "4.8 to 4.1 mm", "24 to 36 ms", "7 to 5 out of 10", "88% to 90%" ], [ "B", "Same-session apparatus feedback", "16 to 11 breaths/min", "4.5 to 4.6 mm", "30 to 31 ms", "6 to 6 out of 10", "92% to 84%" ], [ "C", "Same-session no-feedback comparison", "17 to 14 breaths/min", "4.6 to 4.3 mm", "26 to 35 ms", "7 to 4 out of 10", "86% to 89%" ], [ "D", "Separate 48-hour no-feedback replication row; participant identity and acquisition continuity are not supplied", "18 to 13 breaths/min", "4.9 to 4.2 mm", "23 to 34 ms", "8 to 5 out of 10", "90% to 91%" ] ] }, "scoring_rule": "For each case award 1 point for each of five signed changes, 1 for the correct number of signal flags, 1 for the task-preserved decision and 1 for a condition-appropriate bounded conclusion: 8 per case, 32 total. Passing requires B classified as one signal flag with task not preserved, C used to block unique-superiority claims and D labelled a separate delayed replication rather than retention. Any breathing instruction, feedback dose, self-measurement, diagnosis or treatment claim receives STOP.", "worked_example": { "steps": [ "For B, calculate respiration: 11 - 16 = -5 breaths/min, which meets the at-least-2 decrease threshold.", "Calculate pupil change: 4.6 - 4.5 = +0.1 mm. It increased, so the decrease threshold fails.", "Calculate RMSSD: 31 - 30 = +1 ms, below the required +5 ms; subjective change is 6 - 6 = 0, below the required 2-point decrease.", "Calculate task change: 84 - 92 = -8 percentage points, which is worse than the allowed 2-point drop.", "Count one of four signal flags and mark task NOT PRESERVED." ], "result": "B earns 8/8 only when reported as an isolated respiratory-threshold change with non-preserved task performance. It does not demonstrate broad autonomic downregulation, emotional recovery, treatment benefit or safe judgment." }, "right_vs_wrong": [ { "situation": "Reading B", "right": "Report one respiratory flag and an 8-point accuracy loss.", "wrong": "Call the row calm because breathing slowed.", "why": "Other declared signals did not meet thresholds and task performance worsened." }, { "situation": "Comparing A and C", "right": "Note that both meet the fictional pattern despite different feedback conditions.", "wrong": "Use A alone to claim feedback is uniquely effective.", "why": "The no-feedback comparison blocks that conclusion in this dataset." }, { "situation": "Reading D", "right": "Describe a narrow 48-hour no-feedback retest pattern in the same fictional fixture.", "wrong": "Claim durable everyday emotional mastery.", "why": "One configured delayed record is not broad or real-world transfer." }, { "situation": "Handling signals", "right": "Keep respiration, pupil, RMSSD, self-report and accuracy in separate columns.", "wrong": "Add unlike units into one autonomic score.", "why": "The signals are related but non-equivalent." }, { "situation": "Using the pack", "right": "Classify supplied numbers without changing any bodily signal.", "wrong": "Try to reproduce Case A by controlling breathing or using a wearable.", "why": "Guide and protocol permission are not ready." } ], "common_mistakes": [ { "mistake": "Any numerical movement is counted, even when it misses the predeclared threshold.", "fix": "Apply the exact threshold card; B's +1 ms RMSSD change does not earn a flag." }, { "mistake": "Accuracy change is reported as a relative percentage.", "fix": "Subtract percentage values directly and label the result percentage points." }, { "mistake": "Four signal flags are called proof of one emotion.", "fix": "Report the signal pattern and preserve the emotional-state non-claim." }, { "mistake": "The delayed D record is mixed with same-session A and C.", "fix": "Label acquisition, comparator and retention questions separately." }, { "mistake": "The fictional thresholds are turned into personal targets.", "fix": "Keep the worksheet static and use no sensor, breathing manipulation or self-experiment." } ], "answer_key_route": "/tutorials/pwr-042/answer-key/", "answer_key_delivery": "SEPARATE_NOINDEX_NOARCHIVE_CHECKING_PAGE" }, "tutorial_mode": "RESEARCH_EXPLORATION", "orientation": { "bounded_definition": "Capability to develop or express autonomic arousal downregulation in a declared context without inheriting broader claims.", "evidence_summary": "Biofeedback can make some arousal-linked signals more controllable for a short period; it does not confer emotional mastery.", "measurement_boundary": "Pupil diameter, respiratory pattern, HRV and subjective arousal are related but non-equivalent signals; none alone establishes emotional state or clinical recovery.", "myth_to_metric": { "myth": "Become unshakably calm", "metric": "Declared physiological recovery time plus calibrated task performance under stress", "boundary": "A lower signal does not prove safety, judgment or mental-health treatment." }, "limiting_findings": [ "No unique superiority over mindfulness or physical activity was shown in one comparative trial.", "Durable emotional and real-world transfer remains unestablished." ], "prohibited_claims": [ "switch off stress on command", "control adrenaline at will", "biofeedback cures anxiety", "calmness proves safety or competence" ] }, "outcomes": [ "Define autonomic arousal downregulation without inheriting mythology or broader claims.", "Explain what the current evidence supports and what it does not establish.", "Use the declared measurement boundary and recognise misleading proxies.", "Complete the current learning route without converting it into unauthorised capability practice.", "Make a retention, transfer, maintenance, provider or stop decision without overclaiming." ], "prerequisites": "NONE_FOR_READING__NO_PRACTICE_AUTHORITY", "baseline": { "instruction": "Before reading the sequence, record your current definition, confidence, assumed measure, expected value, known risks and intended next action. Do not attempt the capability.", "record": [ "date and context", "current definition", "confidence from 0 to 100", "assumed measure", "expected benefit", "known limitation", "intended next action" ] }, "modules": [ { "order": 1, "title": "Frame the question", "instruction": "State the capability claim narrowly enough that evidence could support or limit it.", "completion_evidence": "Record the decision or output from frame the question in one or two sentences." }, { "order": 2, "title": "Map the evidence", "instruction": "Distinguish existence, measurement, trainability, retention, transfer, safety and functional value.", "completion_evidence": "Record the decision or output from map the evidence in one or two sentences." }, { "order": 3, "title": "Find uncertainty", "instruction": "Identify small samples, proxy measures, missing controls, null findings and unresolved authority questions.", "completion_evidence": "Record the decision or output from find uncertainty in one or two sentences." }, { "order": 4, "title": "Compare alternatives", "instruction": "Consider competing explanations and what evidence would change the current treatment.", "completion_evidence": "Record the decision or output from compare alternatives in one or two sentences." }, { "order": 5, "title": "Stay non-operational", "instruction": "Use the record for research literacy only until a separate gate authorises instruction.", "completion_evidence": "Record the decision or output from stay non-operational in one or two sentences." } ], "lab": { "title": "Claim-audit lab", "instruction": "Choose one public claim about this Power. Compare it with the bounded definition, measurement limit, supporting evidence, limiting findings and prohibited wording.", "deliverable": "A one-page claim verdict: supported, partly supported, unresolved or contradicted, with the reason stated." }, "assessment": { "immediate": "Restate the bounded definition, evidence ceiling, measurement boundary and current authority route without looking.", "delayed_retention": "Repeat the explanation and route decision after at least 48 hours; record what changed or was forgotten.", "transfer": "Evaluate a new claim, provider option or research result using the same evidence and authority checklist; do not perform the capability.", "interpretation": "Completion demonstrates learning of this tutorial only. It does not prove capability, qualification, independent validation, safety clearance or far transfer." }, "maintenance": { "cadence": "Review after 48 hours, again after 2-4 weeks, and whenever the evidence or authority treatment changes.", "decisions": [ "retain", "refresh", "seek qualified support", "return to research", "retire" ] }, "accessibility": "Use text-to-speech, enlarged text, keyboard navigation, shorter sessions, a support person or an equivalent non-practical record format as needed. Accessibility changes must not enlarge practical authority.", "stopping_and_escalation": "Titan teaches a complete Power-specific research method because operational capability practice is not currently justified. Stop if the declared configuration cannot be maintained, uncertainty becomes material, adverse effects appear, or qualified authority is required.", "next_gate": "No external confirmation is required for the current bounded explainer permission. Guide permission remains NOT_READY; any guide, stronger efficacy, generalisation, protocol, promotion or independent-validation claim requires a new adjudication.", "evidence_count": 3 }, "full_training_programme": false, "independently_validated": false, "publication_state": "PUBLISHED_PUBLIC_RESEARCH_EDITION__EDITORIAL_REVIEW_PENDING", "related_power_ids": [ "PWR-041", "PWR-043", "PWR-044", "PWR-045" ] }, { "power_id": "PWR-043", "learning_unit_id": "TLU-PWR-043", "title": "Thermoregulatory influence", "main_description": "Under biofeedback-clinician control, the participant completes matched baseline, display-guided and hidden-display hand-warming intervals with a calibrated finger-temperature trace and no cold or heat exposure.", "main_description_source": "FULL_TUTORIAL_OUTCOME", "family_id": "FAM-06", "family": "Autonomic & Physiological Self-Regulation", "superdomain": "Regulation & Recovery", "canonical_route": "/powers/pwr-043/", "treatment": "SPECIALIST_PROVIDER_ROUTE", "treatment_label": "Full supervised tutorial", "treatment_boundary": "Titan teaches the complete method; a qualified person controls the parts that require supervision, clearance, specialist equipment, load, dose or progression.", "tutorial_route": "/tutorials/pwr-043/", "governed_lesson_route": null, "self_attempt_status": "PROHIBITED_WITHOUT_QUALIFIED_SUPERVISION", "gold_pathway_ids": [ "G-CUR-004" ], "route_membership": { "kind": "GOLD_PATHWAY", "id": "G-CUR-004", "coverage_status": "EXACT_ONCE" }, "source_authority_tier": "G4", "source_build_state": "EXTERNAL_PROVIDER_ROUTE", "source_instructional_route": "LEARN_ELSEWHERE_TRACK_WITH_TITAN", "source_count": 4, "research_depth": "DETAILED", "risk_level": "HIGH", "prerequisite_status": "QUALIFIED_PROVIDER_DETERMINES", "learning_route": { "mode": "FULL_SUPERVISED_TUTORIAL", "label": "Learn thermoregulatory influence step by step", "summary": "Under biofeedback-clinician control, the participant completes matched baseline, display-guided and hidden-display hand-warming intervals with a calibrated finger-temperature trace and no cold or heat exposure.", "steps": [ [ "Get ready", "The provider checks circulation symptoms, relevant diagnoses, medicines, skin condition and whether the task is appropriate." ], [ "Learn the method", "7 concrete steps teach the permitted method from start to finish." ], [ "See right and wrong", "5 comparisons show correct or safer execution beside common wrong or riskier choices." ], [ "Practise", "The qualified provider sets the number of sessions and intervals. Progression changes only one variable—cue, display availability or functional context—after stable, symptom-free measurements. No outdoor cold, ice or heat challenge is used as progression." ], [ "Check progress", "The biofeedback clinician records ambient temperature, acclimation time, sensor/site, median or predeclared interval temperature, artefacts, symptoms and the hidden-display result." ] ], "practical_authority": false, "provider_required": true, "next_action_route": "/tutorials/pwr-043/" }, "path_builder": { "selectable": true, "completion_allowed": true, "warning": "Titan teaches the complete method; a qualified person controls the parts that require supervision, clearance, specialist equipment, load, dose or progression." }, "full_tutorial": { "version": "3.0", "authorship": "POWER_SPECIFIC_FULL_TUTORIAL", "tutorial_mode": "SUPERVISED", "promise": "Some experts and biofeedback participants can shift measured temperature, but this is not cold immunity or a public challenge. The practical method is a room-temperature hand-warming biofeedback task led by a qualified provider. It teaches stable probe placement, one gentle mental cue, use of the temperature display and a hidden-display check. It never tests cold tolerance or immunity to hypothermia.", "power_id": "PWR-043", "title": "Thermoregulatory influence", "lesson_type": "SUPERVISED", "headline": "Learn temperature biofeedback without cold or heat exposure", "plain_english_summary": "Some experts and biofeedback participants can shift measured temperature, but this is not cold immunity or a public challenge. The practical method is a room-temperature hand-warming biofeedback task led by a qualified provider. It teaches stable probe placement, one gentle mental cue, use of the temperature display and a hidden-display check. It never tests cold tolerance or immunity to hypothermia.", "outcome": "Under biofeedback-clinician control, the participant completes matched baseline, display-guided and hidden-display hand-warming intervals with a calibrated finger-temperature trace and no cold or heat exposure.", "authority": { "learner_may": [ "Rest a supported hand in the agreed room, complete the no-imagery baseline and use the single clinician-selected warm-air image without rubbing or squeezing the finger.", "Follow the clinician-timed visible- and hidden-display intervals and keep probe site, posture and room condition unchanged.", "Report the temperature trace with movement artefacts, skin condition, comfort and symptoms rather than claiming whole-body temperature control." ], "qualified_person_required_for": [ "Screening vascular, neurological, skin, migraine, fainting or medication factors and deciding whether finger-temperature feedback is appropriate.", "Selecting and calibrating the probe, site, acclimation, room range, interval dose, imagery cue and skin/circulation stops.", "Interpreting a peripheral-temperature change or changing clinical treatment, thermal exposure or biofeedback equipment." ], "never_do": [ "Use ice, heating pads, hot water, outdoor cold, circulation restriction or deliberate hyperventilation to force the reading.", "Rub the finger, press the probe, move the lead or change room temperature during a scored interval.", "Treat a warmer digit as proof of disease treatment, core-temperature control or safety in heat/cold." ] }, "materials": [ "A calibrated skin-temperature sensor and its approved display.", "A temperature-stable room with an ambient thermometer.", "A supportive chair and a surface for the forearm and hand.", "A provider record for sensor site, room temperature, block timing, symptoms and signal change." ], "before_you_start": [ "The provider checks circulation symptoms, relevant diagnoses, medicines, skin condition and whether the task is appropriate.", "Use an ordinary room-temperature setting; no ice, cold bath, heater, hot pack or outdoor exposure is part of the lesson.", "Rest in the room for the provider-set acclimation period and remove tight items from the measured finger if instructed.", "Agree that pain, marked colour change, numbness, shivering, faintness or equipment error stops the session." ], "steps": [ { "title": "Stabilise the room and body", "instruction": "Sit with the tested forearm supported and the hand still during the biofeedback clinician-set acclimation period.", "reason": "Peripheral temperature changes with room conditions, movement and recent arrival.", "success_check": "Ambient temperature, posture and acclimation time are written down." }, { "title": "Place and check the thermistor probe", "instruction": "The biofeedback clinician places the thermistor probe on the same distal-finger site each time and checks contact against the device instructions.", "reason": "Moving or loosening a skin probe can imitate a temperature change.", "success_check": "The trace is stable before the baseline begins and the site is recorded." }, { "title": "Record a no-strategy baseline", "instruction": "Rest quietly for the declared interval without rubbing, clenching or using imagery. Breathe normally.", "reason": "A no-strategy interval shows drift that occurs without deliberate regulation.", "success_check": "The full baseline remains on the thermal log, including any drift." }, { "title": "Choose one gentle warming cue", "instruction": "With the biofeedback clinician, choose one neutral cue, such as imagining the hand resting in comfortably warm air while letting the fingers stay loose.", "reason": "One cue at a time lets the participant and provider see what was actually tested.", "success_check": "The cue uses no physical heat, vigorous breathing, friction or muscle squeezing." }, { "title": "Use feedback in short blocks", "instruction": "Apply the same cue during each provider-timed block. Look at the trend, not each flicker; rest with the hand still between blocks.", "reason": "Skin-temperature signals are slow and noisy, so chasing momentary changes creates artefact.", "success_check": "Interval starts, rests and the displayed trend are all recorded." }, { "title": "Fade the display", "instruction": "Repeat one matched interval with the display hidden while keeping the same cue, posture and room.", "reason": "A no-display-guided warming interval asks whether performance depends entirely on the display.", "success_check": "The biofeedback clinician can compare like with like and notes any configuration change." }, { "title": "Recover and inspect", "instruction": "Stop the cue, let the hand rest and have the biofeedback clinician inspect the skin and symptoms before removing the thermistor probe.", "reason": "The end check catches irritation and ensures the participant leaves at normal comfort.", "success_check": "Skin is intact, symptoms are absent and the final reading is labelled recovery, not training." } ], "worked_example": { "scenario": "A biofeedback clinician runs a hand-warming session for Luis in a 22 °C room using an approved finger probe.", "walkthrough": [ "Luis rests with his forearm supported for ten provider-set minutes.", "The clinician records three quiet baseline minutes at the same probe site.", "Luis uses one image—his hand resting in warm air—for three two-minute display-guided warming intervals, with rests.", "He repeats one two-minute block with the display covered and without changing posture.", "The clinician records ambient temperature, median block values, symptoms and probe site, then checks the skin." ], "result": "The displayed finger temperature rises during two display-guided warming intervals and less during the hidden-display interval. This is a provider-controlled peripheral-temperature response in one setup, not altered core temperature or cold safety." }, "right_vs_wrong": [ { "situation": "Temperature challenge", "right": "Use an ordinary stable room and a calibrated skin probe.", "wrong": "Use ice, cold water, heaters or hot packs to create a dramatic change.", "why": "External exposure both confounds the signal and can cause harm." }, { "situation": "Probe placement", "right": "Keep the same sensor, finger site and contact for every block.", "wrong": "Move the thermistor probe to a warmer spot between trials.", "why": "Placement changes can look like self-regulation." }, { "situation": "Cue use", "right": "Use one gentle mental cue while the hand remains loose.", "wrong": "Rub, clench or shake the hand while calling the change voluntary control.", "why": "Muscle work and friction change temperature by another route." }, { "situation": "Temperature-display reading", "right": "Compare declared interval summaries after allowing the slow temperature trace to settle.", "wrong": "Chase every second-to-second flicker.", "why": "Momentary noise encourages erratic effort and false conclusions." }, { "situation": "Claim", "right": "Call the result finger-temperature biofeedback in this room.", "wrong": "Call it proof of core-temperature control or cold immunity.", "why": "Peripheral and core temperature are different measurements." } ], "common_mistakes": [ { "mistake": "Use ice, cold water, heaters or hot packs to create a dramatic change.", "fix": "Use an ordinary stable room and a calibrated skin probe." }, { "mistake": "Move the thermistor probe to a warmer spot between trials.", "fix": "Keep the same sensor, finger site and contact for every block." }, { "mistake": "Rub, clench or shake the hand while calling the change voluntary control.", "fix": "Use one gentle mental cue while the hand remains loose." }, { "mistake": "Chase every second-to-second flicker.", "fix": "Compare declared interval summaries after allowing the slow temperature trace to settle." }, { "mistake": "Call it proof of core-temperature control or cold immunity.", "fix": "Call the result finger-temperature biofeedback in this room." } ], "practice": { "first_session": [ "The biofeedback clinician records the 22 °C room, ten-minute acclimation, distal-finger probe site and symptom stops.", "Luis rests his supported forearm and completes one three-minute no-imagery baseline without rubbing, squeezing or moving the hand.", "Luis uses the single warm-air image for up to three two-minute display-guided intervals separated by clinician-timed rests.", "One two-minute hidden-display interval repeats the same posture, probe, cue and room condition.", "The clinician labels median interval temperatures, artefact, symptoms and skin condition before removing the probe." ], "repeat_plan": "The qualified provider sets the number of sessions and intervals. Progression changes only one variable—cue, display availability or functional context—after stable, symptom-free measurements. No outdoor cold, ice or heat challenge is used as progression.", "progress_when": [ "Temperature traces are stable and placement is reproducible.", "The participant keeps the hand still and uses only the declared cue.", "A repeatable temperature-trace difference appears in matched intervals without symptoms." ], "do_not_progress_when": [ "Ambient Celsius reading, probe placement or medication has changed.", "Numbness, pain, marked colour change, shivering or skin irritation appears.", "The participant wants to test cold tolerance or core temperature." ] }, "self_check": [ "Can you demonstrate “Place and check the thermistor probe”? The trace is stable before the baseline begins and the site is recorded.", "Can you demonstrate “Choose one gentle warming cue”? The cue uses no physical heat, vigorous breathing, friction or muscle squeezing.", "Can you demonstrate “Recover and inspect”? Skin is intact, symptoms are absent and the final reading is labelled recovery, not training." ], "measurement": { "primary": "Distal-finger skin-temperature change across matched baseline, display-guided and hidden-display intervals in a recorded room condition", "how": "The biofeedback clinician records ambient temperature, acclimation time, sensor/site, median or predeclared interval temperature, artefacts, symptoms and the hidden-display result.", "good_result": "The biofeedback clinician sees a reproducible, artefact-checked peripheral signal across matched sessions and judges the hand-warming protocol safe and useful for the intended goal.", "does_not_prove": "A warmer distal-finger trace does not prove higher core temperature, cold immunity, protection from hypothermia or transfer beyond the recorded room, probe site and cue." }, "stop_and_get_help": [ "Stop for painful cold or heat sensation, numbness, marked pallor or blue colour, shivering, confusion, faintness or chest symptoms.", "Stop when the thermistor probe loses contact, the room changes materially or the trace cannot be distinguished from artefact.", "Seek urgent care for suspected hypothermia, severe circulation symptoms, collapse or confusion; do not use biofeedback as first aid." ], "accessibility": [ "Use a probe site and resting support selected for the person’s skin, circulation and limb function.", "Provide audio or haptic trend feedback instead of a visual graph when supported by the device.", "Use a supporter to operate the display while the participant supplies the chosen cue; assistance is part of the configuration." ], "evidence_notes": [ { "claim": "Peripheral-temperature biofeedback has been studied in a defined clinical population; that evidence does not justify unsupervised temperature challenges.", "source_title": "Behavioral treatment of Raynaud's phenomenon in scleroderma", "source_url": "https://pubmed.ncbi.nlm.nih.gov/6520866/", "source_kind": "PRIMARY_RESEARCH" }, { "claim": "Official hypothermia guidance supports avoiding cold-challenge interpretations and escalating shivering, confusion or other danger signs.", "source_title": "Preventing Hypothermia", "source_url": "https://www.cdc.gov/winter-weather/prevention/index.html", "source_kind": "OFFICIAL_GUIDANCE" } ], "limits": [ "Peripheral skin temperature and core temperature are different outcomes; both require calibrated instruments and environmental controls.", "Unsupported claim: generate mystical heat.", "Unsupported claim: become immune to cold.", "Unsupported claim: control core temperature at will.", "Finger-temperature change does not show safe cold exposure, core-temperature control or treatment of vascular disease." ], "orientation": { "bounded_definition": "Capability to develop or express thermoregulatory influence in a declared context without inheriting broader claims.", "evidence_summary": "Some experts and biofeedback participants can shift measured temperature, but this is not cold immunity or a public challenge.", "supportable_public_claim": "Measured temperature influence exists in selected expert and biofeedback settings, but it is narrow and configuration-dependent.", "measurement_boundary": "Peripheral skin temperature and core temperature are different outcomes; both require calibrated instruments and environmental controls.", "myth_to_metric": { "myth": "Become immune to freezing conditions", "metric": "Calibrated peripheral and core temperature change under controlled ambient conditions", "boundary": "A temperature shift does not establish survival, health benefit or safe cold exposure." }, "limiting_findings": [ "Temperature biofeedback did not produce significant clinical improvement in the Raynaud/scleroderma trial.", "Novice trainability, retention and cold-environment function are not established." ], "prohibited_claims": [ "generate mystical heat", "become immune to cold", "control core temperature at will", "treat Raynaud phenomenon with thought", "burn calories through thermogenesis practice" ] }, "gold_source_lesson": null, "next_gate": "External confirmation is required before higher-authority use because: CLINICAL_HIGH_RISK_OR_REGULATED_CONFIGURATION; SUPERVISION_OR_NON_ATTEMPT_BOUNDARY; CULTURAL_COMMUNITY_RIGHTS_OR_AFFECTED_PERSON_AUTHORITY; SAFETY_LEGITIMACY_RESTRICTED.", "evidence_count": 4 }, "full_training_programme": false, "independently_validated": false, "publication_state": "PUBLISHED_PUBLIC_RESEARCH_EDITION__EDITORIAL_REVIEW_PENDING", "related_power_ids": [ "PWR-041", "PWR-042", "PWR-044", "PWR-045" ] }, { "power_id": "PWR-044", "learning_unit_id": "TLU-PWR-044", "title": "Cardiovascular response regulation", "main_description": "With a clinician or trained provider, you recognise a personal warning, get into the agreed safe position, perform the selected manoeuvre without breath holding and escalate when symptoms do not clear.", "main_description_source": "FULL_TUTORIAL_OUTCOME", "family_id": "FAM-06", "family": "Autonomic & Physiological Self-Regulation", "superdomain": "Regulation & Recovery", "canonical_route": "/powers/pwr-044/", "treatment": "SPECIALIST_PROVIDER_ROUTE", "treatment_label": "Full supervised tutorial", "treatment_boundary": "Titan teaches the complete method; a qualified person controls the parts that require supervision, clearance, specialist equipment, load, dose or progression.", "tutorial_route": "/tutorials/pwr-044/", "governed_lesson_route": null, "self_attempt_status": "PROHIBITED_WITHOUT_QUALIFIED_SUPERVISION", "gold_pathway_ids": [ "G-CUR-004" ], "route_membership": { "kind": "GOLD_PATHWAY", "id": "G-CUR-004", "coverage_status": "EXACT_ONCE" }, "source_authority_tier": "G4", "source_build_state": "EXTERNAL_PROVIDER_ROUTE", "source_instructional_route": "LEARN_ELSEWHERE_TRACK_WITH_TITAN", "source_count": 5, "research_depth": "DETAILED", "risk_level": "HIGH", "prerequisite_status": "QUALIFIED_PROVIDER_DETERMINES", "learning_route": { "mode": "FULL_SUPERVISED_TUTORIAL", "label": "Learn cardiovascular response regulation step by step", "summary": "With a clinician or trained provider, you recognise a personal warning, get into the agreed safe position, perform the selected manoeuvre without breath holding and escalate when symptoms do not clear.", "steps": [ [ "Get ready", "A clinician must first decide that a counterpressure manoeuvre is appropriate and name the learner’s warning signs." ], [ "Learn the method", "7 concrete steps teach the permitted method from start to finish." ], [ "See right and wrong", "5 comparisons show correct or safer execution beside common wrong or riskier choices." ], [ "Practise", "Repeat only on the schedule set by your syncope clinician, using fictional cues or naturally occurring warnings—not provocation. Progress when the stop, position, tension, breathing and escalation sequence is accurate without prompting." ], [ "Check progress", "Your syncope clinician scores recognition, time to safe position, correct muscle group, normal breathing, release/reassessment and escalation choice; clinical vital signs are interpreted only by your syncope clinician." ] ], "practical_authority": false, "provider_required": true, "next_action_route": "/tutorials/pwr-044/" }, "path_builder": { "selectable": true, "completion_allowed": true, "warning": "Titan teaches the complete method; a qualified person controls the parts that require supervision, clearance, specialist equipment, load, dose or progression." }, "full_tutorial": { "version": "3.0", "authorship": "POWER_SPECIFIC_FULL_TUTORIAL", "tutorial_mode": "SUPERVISED", "promise": "Some cardiovascular responses are trainable in selected settings; this is not arbitrary heart control. This lesson teaches the full response sequence for a person whose clinician has identified vasovagal fainting and selected a counterpressure manoeuvre. The safest first action is to stop and get low; muscle tension is used only as taught. Unknown fainting, chest symptoms and collapse require medical assessment.", "power_id": "PWR-044", "title": "Cardiovascular response regulation", "lesson_type": "SUPERVISED", "headline": "Respond to a known faint warning with position and a taught counterpressure manoeuvre", "plain_english_summary": "Some cardiovascular responses are trainable in selected settings; this is not arbitrary heart control. This lesson teaches the full response sequence for a person whose clinician has identified vasovagal fainting and selected a counterpressure manoeuvre. The safest first action is to stop and get low; muscle tension is used only as taught. Unknown fainting, chest symptoms and collapse require medical assessment.", "outcome": "With a clinician or trained provider, you recognise a personal warning, get into the agreed safe position, perform the selected manoeuvre without breath holding and escalate when symptoms do not clear.", "authority": { "learner_may": [ "Rehearse the stop–announce–lie down sequence from a fictional version of the learner's already assessed vasovagal warning.", "Once safely lying, use only the leg-crossing or muscle-tension pattern taught by the syncope clinician while continuing to breathe and speak.", "Record position, prompt, contraction quality, recovery and any feature that differed from the familiar prodrome." ], "qualified_person_required_for": [ "Assessing fainting/near-fainting and confirming that the learner's warning pattern is vasovagal rather than cardiac, neurological or otherwise unexplained.", "Choosing the safe body position, muscle groups, contraction/release timing, assistance and supported-rise rule.", "Changing medication or deciding how recurrent, exertional, injury-associated or warning-free episodes are investigated." ], "never_do": [ "Provoke fainting through prolonged standing, heat, needles, dehydration, breath holding or medication changes for practice.", "Stay upright to finish a contraction drill when vision dims or balance fails; getting low safely comes first.", "Use the familiar-warning sequence for chest pain, exertional collapse, new palpitations, neurological signs or an episode without warning." ] }, "materials": [ "A clinician-approved written syncope plan.", "A clear area with a chair or firm surface for sitting or lying down.", "A timer for manoeuvre and recovery intervals.", "Provider-operated blood-pressure or heart-rate equipment only if clinically indicated." ], "before_you_start": [ "A clinician must first decide that a counterpressure manoeuvre is appropriate and name the learner’s warning signs.", "Do not provoke faintness by standing, heat, dehydration, breath holding or medication change.", "Clear the area so the learner can sit or lie down immediately without a fall.", "Agree the emergency signs: chest pain, severe breathlessness, injury, neurological symptoms, exertional fainting or no prompt recovery." ], "steps": [ { "title": "Name your personal prodrome", "instruction": "With your syncope clinician, write the earliest reliable warning, such as warmth, nausea, dimming vision or light-headedness.", "reason": "Early action works best before consciousness or balance is lost, and prodrome patterns differ.", "success_check": "You can name the cue and distinguish it from an emergency sign." }, { "title": "Stop the current task", "instruction": "At the prodrome, stop walking, driving, showering, cooking or operating equipment. Say clearly that you may faint.", "reason": "Continuing exposes you and others to a fall, burn or collision.", "success_check": "The hazardous task is off and another person knows what is happening." }, { "title": "Get low safely", "instruction": "Use your syncope clinician-approved first position: lie down, preferably with legs supported if appropriate, or sit immediately when lying down is not possible.", "reason": "Lowering the body removes the fall and can support blood flow to the brain.", "success_check": "You are stable and cannot fall from standing." }, { "title": "Apply selected tension", "instruction": "Only if your syncope clinician taught it, cross the legs and firmly tense leg, abdominal and buttock muscles, or use the selected handgrip/arm-tensing manoeuvre for the agreed interval.", "reason": "Large-muscle tension can raise blood pressure during a vasovagal prodrome in selected people.", "success_check": "Correct muscle groups tense while posture remains stable." }, { "title": "Keep breathing", "instruction": "Breathe normally during the contraction. Do not bear down, strain with a closed throat or perform a breath hold.", "reason": "Straining changes cardiovascular pressure and is not the studied manoeuvre.", "success_check": "You can speak a few words and the face and throat are not straining." }, { "title": "Release and reassess", "instruction": "Release for your syncope clinician-set interval and check the prodrome signs. Repeat only as personal plan allows.", "reason": "Symptoms, not pride or a timer, determine the next action.", "success_check": "You either improve while low or follow the escalation rule." }, { "title": "Recover slowly and record", "instruction": "Remain low for the agreed recovery period. Stand only with support and only after symptoms clear; record trigger, warning, response and recurrence.", "reason": "Rapid return to standing can bring symptoms back, while a record helps clinical review.", "success_check": "There is no recurrent warning on the supported recovery and the event is reported as planned." } ], "worked_example": { "scenario": "Nia has clinician-confirmed vasovagal syncope and has been taught leg crossing with lower-body tension. During a supervised rehearsal she uses a spoken fictional warning rather than inducing symptoms.", "walkthrough": [ "On the cue “vision dimming”, Nia says “I may faint” and stops the simulated kitchen task.", "She lies on the prepared mat instead of trying to walk to another room.", "At the clinician’s direction she crosses her legs, tenses legs and abdomen, and continues to breathe for the prescribed interval.", "She releases, states whether the fictional warning has cleared and remains lying for the recovery interval.", "She explains that chest pain or an actual collapse would bypass rehearsal and trigger urgent assessment." ], "result": "Nia demonstrates the prodrome response accurately without provoking faintness. This is procedural readiness for her clinician-approved plan, not control of heart rate or permission to self-diagnose future episodes." }, "right_vs_wrong": [ { "situation": "First warning", "right": "Stop and get low immediately.", "wrong": "Try to walk through the prodrome or finish the current activity.", "why": "Delay increases the chance of an uncontrolled fall." }, { "situation": "Muscle action", "right": "Use the exact large-muscle manoeuvre chosen by your syncope clinician.", "wrong": "Invent a neck strain, breath hold or maximal whole-body brace.", "why": "A different strain can change risk and is not the instructed method." }, { "situation": "Breathing", "right": "Keep the airway open and breathe normally.", "wrong": "Bear down against a closed throat.", "why": "Bearing down is not a substitute for counterpressure and can alter circulation." }, { "situation": "Recovery", "right": "Remain low and rise with support only after symptoms clear.", "wrong": "Jump up as soon as first wave passes.", "why": "Symptoms can recur during rapid standing." }, { "situation": "Unknown event", "right": "Seek medical assessment for a new, changed or emergency-pattern event.", "wrong": "Assume every faint feeling is benign vasovagal syncope.", "why": "Fainting has multiple causes, some urgent." } ], "common_mistakes": [ { "mistake": "The person stays upright while deciding whether the familiar prodrome is serious enough.", "fix": "Use first recognised prodrome as the cue to stop and get low; decision-making continues only after fall risk is removed." }, { "mistake": "Legs are crossed loosely but the thigh, buttock and abdominal muscles never contract.", "fix": "Rehearse the exact clinician-selected muscle groups while already lying or securely seated and verify firm contraction without pain." }, { "mistake": "The contraction becomes a closed-throat strain with a red face and no speech.", "fix": "Reduce effort until normal breathing and a short spoken phrase remain possible throughout the counterpressure interval." }, { "mistake": "The person rises as soon as nausea or visual dimming begins to ease.", "fix": "Complete personal recovery interval, reassess while low and use support for a gradual return only after symptoms clear." }, { "mistake": "A new palpitation or exertional collapse is labelled the usual vasovagal pattern.", "fix": "Treat any changed, exertional, chest-related or no-warning event as a new medical problem and obtain prompt assessment." }, { "mistake": "Supporters pull an unresponsive person upright to begin the counterpressure contraction.", "fix": "Call emergency help, protect from injury and follow first-aid guidance; counterpressure is for a conscious person with an early recognised prodrome." } ], "practice": { "first_session": [ "The syncope clinician confirms Nia’s familiar prodrome, safe lying position, lower-body contraction and urgent exceptions.", "From a spoken “vision dimming” cue, Nia stops the simulated kitchen action, announces possible fainting and gets onto the prepared mat.", "Already lying safely, Nia crosses her legs, contracts the clinician-selected muscles and speaks a short phrase to prove breathing remains open.", "Nia releases on the clinician’s cue, remains low for the personal recovery interval and rehearses a supported rise only after the fictional prodrome clears.", "A changed event—chest pain, exertional collapse, palpitation or no warning—is routed to medical assessment instead of another contraction rehearsal." ], "repeat_plan": "Repeat only on the schedule set by your syncope clinician, using fictional cues or naturally occurring warnings—not provocation. Progress when the stop, position, tension, breathing and escalation sequence is accurate without prompting.", "progress_when": [ "You get low before attempting the counterpressure contraction.", "Chosen muscles tense without breath holding or standing risk.", "You can state the urgent exceptions and recovery rule." ], "do_not_progress_when": [ "The diagnosis or prodrome pattern is uncertain or has changed.", "Symptoms occur during exertion, with chest pain, palpitations or neurological change.", "You cannot get low safely or need a different assistance plan." ] }, "self_check": [ "Can you demonstrate “Stop the current task”? The hazardous task is off and another person knows what is happening.", "Can you demonstrate “Apply selected tension”? Correct muscle groups tense while posture remains stable.", "Can you demonstrate “Recover slowly and record”? There is no recurrent warning on the supported recovery and the event is reported as planned." ], "measurement": { "primary": "Recognition of the familiar vasovagal prodrome, time to a fall-safe position, correct counterpressure contraction, breathing and escalation choice", "how": "Your syncope clinician scores recognition, time to safe position, correct muscle group, normal breathing, release/reassessment and escalation choice; clinical vital signs are interpreted only by your syncope clinician.", "good_result": "The full response is correct on three fictional-cue rehearsals and your syncope clinician confirms that the counterpressure contraction remains appropriate.", "does_not_prove": "A correct fictional-cue rehearsal does not diagnose vasovagal syncope, guarantee prevention of fainting, treat an unknown collapse or authorise the manoeuvre for another person." }, "stop_and_get_help": [ "Call emergency services for collapse without prompt recovery, chest pain, severe breathlessness, serious injury, seizure-like activity, new weakness/speech change or fainting during exertion.", "Stop a rehearsal for real light-headedness, visual dimming, nausea, palpitations or loss of balance and follow personal plan.", "Seek clinical review when episodes are new, more frequent, different, occur without warning or occur while seated or lying." ], "accessibility": [ "Practise the prodrome response from your usual mobility setup so the route to a safe low position is realistic.", "Use a handgrip or arm-tensing option only when your syncope clinician selects it for someone who cannot use leg crossing.", "Provide a visible or tactile cue card and train supporters in your exact escalation plan." ], "evidence_notes": [ { "claim": "A randomised trial supports physical counterpressure manoeuvres for selected people with vasovagal syncope and recognisable prodromes.", "source_title": "Effectiveness of physical counterpressure maneuvers in preventing vasovagal syncope: the Physical Counterpressure Manoeuvres Trial (PC-Trial)", "source_url": "https://pubmed.ncbi.nlm.nih.gov/17045903/", "source_kind": "PRIMARY_RESEARCH" }, { "claim": "Official heart guidance supports medical evaluation and distinguishes fainting from a general voluntary heart-control claim.", "source_title": "Syncope (Fainting)", "source_url": "https://www.heart.org/en/health-topics/arrhythmia/symptoms-diagnosis--monitoring-of-arrhythmia/syncope-fainting", "source_kind": "OFFICIAL_GUIDANCE" } ], "limits": [ "Heart rate, HRV, blood pressure and baroreflex sensitivity are non-equivalent; symptom recurrence and safe function are separate endpoints.", "Unsupported claim: control your heart at will.", "Unsupported claim: prevent every faint.", "Unsupported claim: replace blood-pressure treatment.", "The lesson does not teach arbitrary blood-pressure or heart-rate control and does not replace evaluation of fainting." ], "orientation": { "bounded_definition": "Capability to develop or express cardiovascular response regulation in a declared context without inheriting broader claims.", "evidence_summary": "Some cardiovascular responses are trainable in selected settings; this is not arbitrary heart control.", "supportable_public_claim": "Selected cardiovascular responses can be influenced through trained breathing, feedback or physical manoeuvres in declared populations.", "measurement_boundary": "Heart rate, HRV, blood pressure and baroreflex sensitivity are non-equivalent; symptom recurrence and safe function are separate endpoints.", "myth_to_metric": { "myth": "Control your heartbeat and never faint", "metric": "Declared HR/BP/baroreflex response plus recurrence and injury outcomes", "boundary": "A physiological shift does not diagnose the cause or guarantee safety." }, "limiting_findings": [ "Counterpressure evidence does not apply without a recognizable prodrome.", "Bundled autonomic studies do not show arbitrary control of heart rate or immunity." ], "prohibited_claims": [ "control your heart at will", "prevent every faint", "replace blood-pressure treatment", "HRV score proves cardiovascular health" ] }, "gold_source_lesson": null, "next_gate": "External confirmation is required before higher-authority use because: CLINICAL_HIGH_RISK_OR_REGULATED_CONFIGURATION; SUPERVISION_OR_NON_ATTEMPT_BOUNDARY; SAFETY_LEGITIMACY_RESTRICTED.", "evidence_count": 5 }, "full_training_programme": false, "independently_validated": false, "publication_state": "PUBLISHED_PUBLIC_RESEARCH_EDITION__EDITORIAL_REVIEW_PENDING", "related_power_ids": [ "PWR-041", "PWR-042", "PWR-043", "PWR-045" ] }, { "power_id": "PWR-045", "learning_unit_id": "TLU-PWR-045", "title": "Voluntary pupil modulation", "main_description": "The learner produces a two-study methods table and a justified conclusion separating direct voluntary control, feedback-assisted change, retention and practical value.", "main_description_source": "FULL_TUTORIAL_OUTCOME", "family_id": "FAM-06", "family": "Autonomic & Physiological Self-Regulation", "superdomain": "Regulation & Recovery", "canonical_route": "/powers/pwr-045/", "treatment": "RESEARCH_EXPLORATION_ROUTE", "treatment_label": "Full research tutorial", "treatment_boundary": "Titan teaches a complete Power-specific research method because operational capability practice is not currently justified.", "tutorial_route": "/tutorials/pwr-045/", "governed_lesson_route": null, "self_attempt_status": "NO_OPERATIONAL_SELF_EXPERIMENT", "gold_pathway_ids": [ "G-CUR-004" ], "route_membership": { "kind": "GOLD_PATHWAY", "id": "G-CUR-004", "coverage_status": "EXACT_ONCE" }, "source_authority_tier": "G5", "source_build_state": "RESEARCH_ONLY", "source_instructional_route": "EXPLAINER_ONLY_RESEARCH", "source_count": 2, "research_depth": "FOCUSED", "risk_level": "LOW_TO_MODERATE", "prerequisite_status": "NONE_FOR_READING__NO_PRACTICE_AUTHORITY", "learning_route": { "mode": "FULL_RESEARCH_TUTORIAL", "label": "Learn voluntary pupil modulation step by step", "summary": "The learner produces a two-study methods table and a justified conclusion separating direct voluntary control, feedback-assisted change, retention and practical value.", "steps": [ [ "Get ready", "State the question: existence in an exceptional person, learnability in a group, no-feedback retention and useful function are separate." ], [ "Learn the method", "7 concrete steps teach the permitted method from start to finish." ], [ "See right and wrong", "5 comparisons show correct or safer execution beside common wrong or riskier choices." ], [ "Practise", "Repeat the same appraisal when an independent study appears. Do not progress to practical teaching unless independent evidence demonstrates teachability, calibrated no-feedback retention, safety and a meaningful function under ethics review." ], [ "Check progress", "Count how many of the predeclared controls, comparison conditions and follow-up outcomes each study reports; record effect estimates and uncertainty rather than a yes/no headline." ] ], "practical_authority": false, "provider_required": false, "next_action_route": "/tutorials/pwr-045/" }, "path_builder": { "selectable": true, "completion_allowed": true, "warning": "Titan teaches a complete Power-specific research method because operational capability practice is not currently justified." }, "full_tutorial": { "version": "3.0", "authorship": "POWER_SPECIFIC_FULL_TUTORIAL", "tutorial_mode": "RESEARCH", "promise": "Voluntary pupil modulation exists and short-term biofeedback training is promising, but practical value is unknown. Because direct control rests partly on an exceptional case and short-term laboratory feedback, the useful skill here is research appraisal. The learner reconstructs the measurement, checks light and focusing confounds, separates feedback effects from direct control and writes a replication gate without attempting pupil manipulation.", "power_id": "PWR-045", "title": "Voluntary pupil modulation", "lesson_type": "RESEARCH", "headline": "Test whether a pupil-control claim survives lighting and camera controls", "plain_english_summary": "Voluntary pupil modulation exists and short-term biofeedback training is promising, but practical value is unknown. Because direct control rests partly on an exceptional case and short-term laboratory feedback, the useful skill here is research appraisal. The learner reconstructs the measurement, checks light and focusing confounds, separates feedback effects from direct control and writes a replication gate without attempting pupil manipulation.", "outcome": "The learner produces a two-study methods table and a justified conclusion separating direct voluntary control, feedback-assisted change, retention and practical value.", "authority": { "learner_may": [ "Extract participant selection, luminance, fixation distance, accommodation control, camera settings and feedback state from the two named pupil papers.", "Keep four conclusions separate: direct change in the exceptional case, feedback-assisted group change, delayed no-feedback retention and useful vision.", "Write a paper-only replication gate that states which missing control or outcome would change each conclusion." ], "qualified_person_required_for": [ "Any new pupillometry, eye imaging, visual exposure or feedback study involving a person.", "Ethics, biometric-data protection, ophthalmic safety and interpretation of calibrated pupil recordings.", "Any future pupil-feedback or direct-control acquisition protocol." ], "never_do": [ "Turn the appraisal into a home pupil experiment using bright or dark exposure, deliberate near focus, drugs, breath manipulation or arousal.", "Record another person's eyes or retain identifiable eye video for this lesson.", "Treat one exceptional participant or a short feedback effect as proof of permanent control, night vision or emotional mastery." ] }, "materials": [ "The two bound primary papers and their supplementary methods when available.", "A table with columns for participant selection, lighting, viewing distance, accommodation, camera, feedback, outcome and follow-up.", "A calculator or spreadsheet for reported effect sizes and uncertainty.", "A written non-practice rule: no light, drug, focusing or arousal manipulation." ], "before_you_start": [ "State the question: existence in an exceptional person, learnability in a group, no-feedback retention and useful function are separate.", "Use published data only; do not film another person’s eyes or collect identifiable biometric data.", "Record the paper version, sample and exclusions before reading the conclusion.", "Stop if the task drifts toward a home pupil-control experiment." ], "steps": [ { "title": "Write four separate claims", "instruction": "Create rows for direct voluntary change, feedback-assisted change, delayed no-feedback retention and everyday benefit.", "reason": "One positive finding cannot answer all four questions.", "success_check": "Each row has its own outcome and evidence status." }, { "title": "Map participant selection", "instruction": "Record sample size, recruitment, prior ability, exclusions and whether one unusual participant supplied the result.", "reason": "Exceptional preselected ability does not establish population trainability.", "success_check": "The table makes selected cases and ordinary participants visible." }, { "title": "Rebuild the viewing setup", "instruction": "Extract luminance, screen content, viewing distance, fixation, eye correction and instructions about focusing near or far.", "reason": "Light level and accommodation—the eye’s focusing response—change pupil size without direct iris control.", "success_check": "Every study has a complete setup row or an explicit missing-data mark." }, { "title": "Inspect the measurement chain", "instruction": "Record the camera or pupillometer, sampling rate, calibration, blink rejection, head stabilisation and whether auto-exposure was disabled.", "reason": "Camera behaviour, blinks and distance changes can imitate diameter change.", "success_check": "The outcome is tied to calibrated pupil units and an artefact rule." }, { "title": "Separate feedback from no feedback", "instruction": "Mark when participants saw the pupil signal, what strategy they used and whether a hidden-display or sham condition existed.", "reason": "Learning to influence a feedback display is not automatically direct control without the display.", "success_check": "Feedback, control and retention trials are not pooled." }, { "title": "Compare direction and repeatability", "instruction": "Check whether constriction and dilation were both demonstrated, how many trials succeeded and whether uncertainty overlaps chance or drift.", "reason": "Bidirectional, repeatable change is a stronger test than one favourable trace.", "success_check": "The conclusion reports direction, repetitions and uncertainty." }, { "title": "Write the next replication gate", "instruction": "Require independent recruitment, isoluminant stimuli, accommodation control, calibrated recording, sham or hidden feedback, delayed retention and a declared functional outcome.", "reason": "A concrete gate shows what evidence is missing without inventing a protocol for home use.", "success_check": "The final paragraph states what would change the conclusion and what remains prohibited." } ], "worked_example": { "scenario": "A learner compares the 2021 exploratory case study with the 2024 pupil-biofeedback study.", "walkthrough": [ "They place direct control, feedback learning, delayed retention and useful vision in separate rows.", "They note that the direct-control evidence involves an exceptional participant rather than a random training sample.", "They extract luminance, fixation, accommodation controls and pupillometry details from each methods section.", "They mark which trials displayed feedback and whether a later no-feedback test occurred.", "They conclude that existence and short-term feedback effects have support, while general learnability and useful transfer remain open." ], "result": "The output is an auditable research conclusion and replication gate. It contains no exercise for changing the learner’s own pupils." }, "right_vs_wrong": [ { "situation": "Claim structure", "right": "Separate existence, trainability, retention and usefulness.", "wrong": "Use one pupil trace to claim all four.", "why": "Those claims require different samples and outcomes." }, { "situation": "Lighting control", "right": "Extract exact luminance and isoluminance procedures.", "wrong": "Assume room lighting was irrelevant.", "why": "Pupil diameter responds strongly to light." }, { "situation": "Focusing control", "right": "Record fixation distance and accommodation/vergence controls.", "wrong": "Treat near focusing as direct iris control.", "why": "Focusing responses can constrict the pupil." }, { "situation": "Camera validity", "right": "Require calibrated diameter and artefact rejection.", "wrong": "Accept phone auto-exposure or a dramatic video as measurement.", "why": "Imaging changes can mimic pupil change." }, { "situation": "Generalisation", "right": "Call the direct result exploratory and participant-specific.", "wrong": "Present an exceptional case as a teachable population ability.", "why": "Selection prevents that inference." } ], "common_mistakes": [ { "mistake": "Use one pupil trace to claim all four.", "fix": "Separate existence, trainability, retention and usefulness." }, { "mistake": "Assume room lighting was irrelevant.", "fix": "Extract exact luminance and isoluminance procedures." }, { "mistake": "Treat near focusing as direct iris control.", "fix": "Record fixation distance and accommodation/vergence controls." }, { "mistake": "Accept phone auto-exposure or a dramatic video as measurement.", "fix": "Require calibrated diameter and artefact rejection." }, { "mistake": "Present an exceptional case as a teachable population ability.", "fix": "Call the direct result exploratory and participant-specific." } ], "practice": { "first_session": [ "Write the four-claim question before opening the papers.", "Extract the participant and setup rows from the first study.", "Extract the feedback, control and follow-up rows from the second study.", "Mark every absent control instead of guessing.", "Write a 150-word conclusion and a seven-part replication gate." ], "repeat_plan": "Repeat the same appraisal when an independent study appears. Do not progress to practical teaching unless independent evidence demonstrates teachability, calibrated no-feedback retention, safety and a meaningful function under ethics review.", "progress_when": [ "The methods table distinguishes direct and feedback-assisted change.", "Lighting, accommodation and artefact controls are explicitly extracted.", "The conclusion matches the sample and follow-up rather than the headline." ], "do_not_progress_when": [ "A full method or supplement cannot be obtained.", "The learner is tempted to test bright light, drugs, near focusing or emotional arousal.", "Identifiable eye video or health information would be collected without governance." ] }, "self_check": [ "Which result came from a pre-existing exceptional performer, and which came from feedback training in a group?", "For each paper, can you point to the luminance, viewing distance, accommodation control, calibrated pupil unit and blink/artefact rule or mark it missing?", "Does your replication gate require hidden or sham feedback, delayed no-feedback testing and a declared functional outcome while still prohibiting a home pupil trial?" ], "measurement": { "primary": "Calibrated bidirectional pupil-diameter change with delayed no-feedback reliability", "how": "Count how many of the predeclared controls, comparison conditions and follow-up outcomes each study reports; record effect estimates and uncertainty rather than a yes/no headline.", "good_result": "Another reader can reproduce every table entry from a cited methods or results passage and reaches the same bounded claim.", "does_not_prove": "Pupil diameter requires isoluminant stimuli and controls for accommodation, vergence, luminance, medication and cognitive effort; it is not a direct readout of one mental state." }, "stop_and_get_help": [ "Do not perform pupil manipulation; stop if the appraisal turns into exposure to bright light, darkness, drugs or deliberate visual strain.", "Seek eye care for new unequal pupils, eye pain, sudden visual change, head injury or neurological symptoms rather than experimenting.", "Stop and obtain ethics/privacy review before collecting eye images or biometric data from any person." ], "accessibility": [ "Use text or structured abstracts rather than pupil images when visual material is inaccessible.", "Permit a collaborator to extract graph values while the learner audits methods and logic.", "Use a screen reader-friendly table with one study per row and one control per column." ], "evidence_notes": [ { "claim": "Exploratory pupillometry documents direct bidirectional modulation in an exceptional case and therefore supports existence, not broad trainability.", "source_title": "Direct voluntary control of pupil constriction and dilation: Exploratory evidence from pupillometry, optometry, skin conductance, perception, and functional MRI", "source_url": "https://pubmed.ncbi.nlm.nih.gov/34391820/", "source_kind": "PRIMARY_RESEARCH" }, { "claim": "The pupil-biofeedback study supports short-term apparatus-mediated learning while leaving practical value and broad transfer uncertain.", "source_title": "Self-regulating arousal via pupil-based biofeedback", "source_url": "https://pubmed.ncbi.nlm.nih.gov/37904022/", "source_kind": "PRIMARY_RESEARCH" } ], "limits": [ "Pupil diameter requires isoluminant stimuli and controls for accommodation, vergence, luminance, medication and cognitive effort; it is not a direct readout of one mental state.", "Unsupported claim: control the iris like a muscle.", "Unsupported claim: gain night vision.", "Unsupported claim: read or control emotions through pupils.", "This research lesson does not authorise a home pupil experiment or claim improved night vision, emotion control or direct iris-muscle control." ], "orientation": { "bounded_definition": "Capability to develop or express voluntary pupil modulation in a declared context without inheriting broader claims.", "evidence_summary": "Voluntary pupil modulation exists and short-term biofeedback training is promising, but practical value is unknown.", "supportable_public_claim": "Some people can modulate pupil size directly or learn short-term pupil-linked regulation with laboratory feedback.", "measurement_boundary": "Pupil diameter requires isoluminant stimuli and controls for accommodation, vergence, luminance, medication and cognitive effort; it is not a direct readout of one mental state.", "myth_to_metric": { "myth": "Change your pupils to unlock enhanced vision", "metric": "Calibrated bidirectional pupil-diameter change with delayed no-feedback reliability", "boundary": "Diameter change alone does not establish direct iris control, night vision or emotional mastery." }, "limiting_findings": [ "The direct-control evidence is a single case.", "No delayed retention or real-world function is established." ], "prohibited_claims": [ "control the iris like a muscle", "gain night vision", "read or control emotions through pupils", "permanent pupil control" ] }, "gold_source_lesson": null, "next_gate": "No external confirmation is required for the current bounded explainer permission. Guide permission remains NOT_READY; any guide, stronger efficacy, generalisation, protocol, promotion or independent-validation claim requires a new adjudication.", "evidence_count": 2 }, "full_training_programme": false, "independently_validated": false, "publication_state": "PUBLISHED_PUBLIC_RESEARCH_EDITION__EDITORIAL_REVIEW_PENDING", "related_power_ids": [ "PWR-041", "PWR-042", "PWR-043", "PWR-044" ] }, { "power_id": "PWR-046", "learning_unit_id": "TLU-PWR-046", "title": "Voluntary piloerection", "main_description": "The learner builds an evidence map that identifies who already had the ability, how piloerection was verified, which confounds were controlled and what a trainability study would need.", "main_description_source": "FULL_TUTORIAL_OUTCOME", "family_id": "FAM-06", "family": "Autonomic & Physiological Self-Regulation", "superdomain": "Regulation & Recovery", "canonical_route": "/powers/pwr-046/", "treatment": "RESEARCH_EXPLORATION_ROUTE", "treatment_label": "Full research tutorial", "treatment_boundary": "Titan teaches a complete Power-specific research method because operational capability practice is not currently justified.", "tutorial_route": "/tutorials/pwr-046/", "governed_lesson_route": null, "self_attempt_status": "NO_OPERATIONAL_SELF_EXPERIMENT", "gold_pathway_ids": [ "G-CUR-004" ], "route_membership": { "kind": "GOLD_PATHWAY", "id": "G-CUR-004", "coverage_status": "EXACT_ONCE" }, "source_authority_tier": "G5", "source_build_state": "RESEARCH_ONLY", "source_instructional_route": "EXPLAINER_ONLY_RESEARCH", "source_count": 3, "research_depth": "FOCUSED", "risk_level": "LOW", "prerequisite_status": "NONE_FOR_READING__NO_PRACTICE_AUTHORITY", "learning_route": { "mode": "FULL_RESEARCH_TUTORIAL", "label": "Learn voluntary piloerection step by step", "summary": "The learner builds an evidence map that identifies who already had the ability, how piloerection was verified, which confounds were controlled and what a trainability study would need.", "steps": [ [ "Get ready", "Define piloerection as visible or instrument-detected raising of body hair, not only chills or a tingling feeling." ], [ "Learn the method", "7 concrete steps teach the permitted method from start to finish." ], [ "See right and wrong", "5 comparisons show correct or safer execution beside common wrong or riskier choices." ], [ "Practise", "Update the table only when a new primary study tests initially non-voluntary participants or provides independent objective replication. Practical progression remains closed until safety, teachability, retention and function are directly shown." ], [ "Check progress", "Score each study for recruitment clarity, objective detection, confound control, blinded assessment, acquisition design, delayed retest and functional outcome." ] ], "practical_authority": false, "provider_required": false, "next_action_route": "/tutorials/pwr-046/" }, "path_builder": { "selectable": true, "completion_allowed": true, "warning": "Titan teaches a complete Power-specific research method because operational capability practice is not currently justified." }, "full_tutorial": { "version": "3.0", "authorship": "POWER_SPECIFIC_FULL_TUTORIAL", "tutorial_mode": "RESEARCH", "promise": "A small selected subgroup can produce objectively observed goosebumps voluntarily, but evidence that other people can learn the response or gain a useful function is absent. This lesson teaches how to distinguish a felt chill, visible hair erection and instrumented recording while checking temperature, emotion, suggestion and self-selection.", "power_id": "PWR-046", "title": "Voluntary piloerection", "lesson_type": "RESEARCH", "headline": "Separate reported goosebumps from objectively verified voluntary piloerection", "plain_english_summary": "A small selected subgroup can produce objectively observed goosebumps voluntarily, but evidence that other people can learn the response or gain a useful function is absent. This lesson teaches how to distinguish a felt chill, visible hair erection and instrumented recording while checking temperature, emotion, suggestion and self-selection.", "outcome": "The learner builds an evidence map that identifies who already had the ability, how piloerection was verified, which confounds were controlled and what a trainability study would need.", "authority": { "learner_may": [ "Compare the three canonical piloerection papers using the claim ladder and observation-grade table in this lesson.", "Classify published outcomes as felt chill, visible hair erection or instrumented skin response and keep those categories separate.", "Use the published 31.8% self-report coincidence finding to explain why objective verification matters." ], "qualified_person_required_for": [ "Any new study that photographs skin, records physiology or asks people to attempt piloerection.", "Ethics, consent, privacy, temperature control, blinded image scoring and specialist interpretation of skin recordings.", "Any future induction, feedback or acquisition protocol for people who do not already report voluntary piloerection." ], "never_do": [ "Use cold, fear, pain, drugs or distressing material to provoke goosebumps for this research lesson.", "Photograph or film another person's skin without explicit consent and appropriate governance.", "Treat repeated success by pre-existing performers as evidence that non-performers can learn the response." ] }, "materials": [ "The three canonical primary papers: Individuals lack the ability to accurately detect emotional piloerection; Volitional Control of Piloerection: Objective Evidence and Its Potential Utility in Neuroscience Research; and The voluntary control of piloerection.", "A study table for prior ability, induction cue, room temperature, emotional stimulus, camera or sensor, blinded scoring and replication.", "A claim ladder for existence, prevalence, learnability, repeatability and function.", "A non-practice note prohibiting cold, fear or drug provocation." ], "before_you_start": [ "Define piloerection as visible or instrument-detected raising of body hair, not only chills or a tingling feeling.", "Keep naturally occurring emotional goosebumps separate from claimed voluntary onset.", "Use published, de-identified records only.", "Do not expose yourself or anyone else to cold, fear or distress." ], "steps": [ { "title": "Build the claim ladder", "instruction": "List existence, prevalence, voluntary onset, trainability in non-voluntary participants, delayed repeatability and useful function as separate claims.", "reason": "The literature may support one rung while leaving the next empty.", "success_check": "Every cited result is attached to only one claim rung." }, { "title": "Identify pre-existing ability", "instruction": "Record whether participants volunteered because they already reported the response and how many people were screened out.", "reason": "Self-selection can make a rare ability look common or teachable.", "success_check": "The sample description shows prior ability and recruitment route." }, { "title": "Extract the induction cue", "instruction": "Write the exact reported cue, onset time, body site and whether music, memory, cold or emotion was present.", "reason": "An emotional chill is not the same as voluntary piloerection without an external trigger.", "success_check": "The table distinguishes internal cue from external provocation." }, { "title": "Grade the observation", "instruction": "Classify each outcome as self-report only, visible response scored from images, or physiological/instrumented recording.", "reason": "People may not accurately detect their own piloerection.", "success_check": "The conclusion gives greater weight to objective and blinded observation." }, { "title": "Check confound controls", "instruction": "Extract room temperature, acclimation, skin site, clothing, suggestion, emotional material and assessor blinding.", "reason": "Temperature, emotion and expectation can all create the same visible endpoint.", "success_check": "Every major alternative cause is controlled or marked unresolved." }, { "title": "Look for learning evidence", "instruction": "Find whether people without the ability were trained, whether a control group existed and whether performance persisted after feedback.", "reason": "Existing voluntary performers do not prove that the response can be taught.", "success_check": "The trainability row says demonstrated, not tested or unsupported." }, { "title": "Write a non-operational next study", "instruction": "Specify independent recruitment, objective detection, neutral conditions, blinded scoring, sham feedback, delayed testing and a meaningful outcome without giving a home induction routine.", "reason": "This defines the evidence gate while preserving the no-practice boundary.", "success_check": "The proposal can be reviewed ethically and contains no provocation instructions." } ], "worked_example": { "scenario": "A learner reviews a survey of self-identified voluntary piloerection performers alongside objective laboratory evidence.", "walkthrough": [ "They mark that participants were selected because they already reported the ability.", "They separate a felt chill from visible hair erection and from instrumented skin evidence; the 31.8% coincidence finding means roughly 32 of 100 self-reports coincided with observed emotional piloerection, not that self-report is an objective detector.", "They check whether room temperature and emotional stimuli were standardised.", "They find no trial teaching the response to people who lacked it.", "They write “existence in a small selected subgroup: supported; general trainability and utility: not established.”" ], "result": "The research map preserves the real but narrow finding and prevents a rare pre-existing trait from becoming a public training claim." }, "right_vs_wrong": [ { "situation": "Outcome", "right": "Prefer blinded visible or instrumented piloerection plus self-report.", "wrong": "Treat a tingling feeling alone as objective goosebumps.", "why": "Self-detection can be inaccurate." }, { "situation": "Participants", "right": "State that performers were self-selected for prior ability.", "wrong": "Describe them as a normal training sample.", "why": "Selection changes the inference." }, { "situation": "Triggers", "right": "Control room temperature and emotional material.", "wrong": "Use cold or fear to make the response easier to see.", "why": "Those triggers create piloerection through another route." }, { "situation": "Trainability", "right": "Require training of initially non-voluntary participants with controls and follow-up.", "wrong": "Call repeated success by existing performers learned ability.", "why": "Repeatability and acquisition are different questions." }, { "situation": "Value", "right": "Ask for a declared functional outcome.", "wrong": "Assume a visible response improves health or performance.", "why": "Existence alone does not establish usefulness." } ], "common_mistakes": [ { "mistake": "Treat a tingling feeling alone as objective goosebumps.", "fix": "Prefer blinded visible or instrumented piloerection plus self-report." }, { "mistake": "Describe them as a normal training sample.", "fix": "State that performers were self-selected for prior ability." }, { "mistake": "Use cold or fear to make the response easier to see.", "fix": "Control room temperature and emotional material." }, { "mistake": "Call repeated success by existing performers learned ability.", "fix": "Require training of initially non-voluntary participants with controls and follow-up." }, { "mistake": "Assume a visible response improves health or performance.", "fix": "Ask for a declared functional outcome." } ], "practice": { "first_session": [ "Define the claim ladder and objective outcome.", "Extract recruitment and prior ability from each study.", "Grade every outcome by self-report, visible observation or instrument.", "Complete the temperature, emotion and suggestion control columns.", "Write the trainability verdict and next-study gate." ], "repeat_plan": "Update the table only when a new primary study tests initially non-voluntary participants or provides independent objective replication. Practical progression remains closed until safety, teachability, retention and function are directly shown.", "progress_when": [ "Self-report and objective response are never pooled.", "Pre-existing ability and learning are kept separate.", "The final verdict names the missing control or study rather than guessing." ], "do_not_progress_when": [ "Only a news story, video or testimonial is available.", "A proposed test uses cold, frightening material or distress.", "Images or physiological data would be collected from people without consent and governance." ] }, "self_check": [ "Which participants already reported voluntary piloerection before recruitment, and why does that prevent a trainability claim?", "For each paper, is the outcome a felt chill, visually scored hair erection or an instrumented response?", "Does the proposed next study use neutral temperature, blinded objective scoring and initially non-voluntary participants without giving an induction routine?" ], "measurement": { "primary": "Objectively detected piloerection onset, extent and repeatability", "how": "Score each study for recruitment clarity, objective detection, confound control, blinded assessment, acquisition design, delayed retest and functional outcome.", "good_result": "All evidence-map cells are source-traceable, and the learner correctly labels existence as supported in a selected subgroup while trainability and utility remain unproven.", "does_not_prove": "Objective hair/skin imaging is required; subjective chills, feeling moved and piloerection are non-equivalent." }, "stop_and_get_help": [ "Do not provoke goosebumps with cold, pain, fear or substances.", "Stop and obtain ethics review before collecting images or physiological signals from another person.", "Seek medical advice for persistent unexplained skin, temperature or autonomic symptoms rather than treating them as practice data." ], "accessibility": [ "Use written descriptions of visible responses when skin photographs are inaccessible.", "Allow a collaborator to review video methods while the learner audits design and inference.", "Use a simple claim ladder with plain labels and source links rather than dense statistical graphics." ], "evidence_notes": [ { "claim": "Primary research shows that people may not accurately detect their own emotional piloerection, supporting objective verification.", "source_title": "Individuals lack the ability to accurately detect emotional piloerection", "source_url": "https://pubmed.ncbi.nlm.nih.gov/38715216/", "source_kind": "PRIMARY_RESEARCH" }, { "claim": "Objective laboratory evidence supports voluntary piloerection in selected performers but does not establish acquisition by others.", "source_title": "Volitional Control of Piloerection: Objective Evidence and Its Potential Utility in Neuroscience Research", "source_url": "https://pubmed.ncbi.nlm.nih.gov/32581701/", "source_kind": "PRIMARY_RESEARCH" }, { "claim": "Survey and laboratory evidence describes people who already reported the ability; it does not show training of initially non-voluntary participants.", "source_title": "The voluntary control of piloerection", "source_url": "https://pubmed.ncbi.nlm.nih.gov/30083447/", "source_kind": "PRIMARY_RESEARCH" } ], "limits": [ "Objective hair/skin imaging is required; subjective chills, feeling moved and piloerection are non-equivalent.", "Unsupported claim: learn goosebumps on command.", "Unsupported claim: control emotion through goosebumps.", "Unsupported claim: regulate body temperature.", "No method here teaches goosebumps, and no health, thermal or emotional-regulation benefit is claimed." ], "orientation": { "bounded_definition": "Capability to develop or express voluntary piloerection in a declared context without inheriting broader claims.", "evidence_summary": "Voluntary goosebumps are real in a small subgroup; nobody has shown that others can learn them or that they do anything useful.", "supportable_public_claim": "A small subgroup can produce objectively observable piloerection voluntarily.", "measurement_boundary": "Objective hair/skin imaging is required; subjective chills, feeling moved and piloerection are non-equivalent.", "myth_to_metric": { "myth": "Switch on goosebumps as an emotional or thermal superpower", "metric": "Objectively detected piloerection onset, extent and repeatability", "boundary": "A goosebump report does not prove an event, control, trainability or function." }, "limiting_findings": [ "Self-report coincided with observed piloerection only 31.8% of the time in emotional-piloerection studies.", "No trainability, retention, transfer or function is established." ], "prohibited_claims": [ "learn goosebumps on command", "control emotion through goosebumps", "regulate body temperature", "proof of spiritual energy" ] }, "gold_source_lesson": null, "next_gate": "No external confirmation is required for the current bounded explainer permission. Guide permission remains NOT_READY; any guide, stronger efficacy, generalisation, protocol, promotion or independent-validation claim requires a new adjudication.", "evidence_count": 3 }, "full_training_programme": false, "independently_validated": false, "publication_state": "PUBLISHED_PUBLIC_RESEARCH_EDITION__EDITORIAL_REVIEW_PENDING", "related_power_ids": [ "PWR-041", "PWR-042", "PWR-043", "PWR-044" ] }, { "power_id": "PWR-047", "learning_unit_id": "TLU-PWR-047", "title": "Stress-state recovery", "main_description": "This tutorial teaches how to read a sparse fictional post-event time course. You will apply three declared bands, find the first sampled row that satisfies each band and report the first sampled row where all three are simultaneously in band. Because nothing was measured between rows, you must not call that timestamp the exact recovery time or use it for readiness.", "main_description_source": "GOVERNED_TUTORIAL_PLAIN_ENGLISH_INTRO", "family_id": "FAM-06", "family": "Autonomic & Physiological Self-Regulation", "superdomain": "Regulation & Recovery", "canonical_route": "/powers/pwr-047/", "treatment": "RESEARCH_EXPLORATION_ROUTE", "treatment_label": "Full research tutorial", "treatment_boundary": "Titan teaches a complete Power-specific research method because operational capability practice is not currently justified.", "tutorial_route": "/tutorials/pwr-047/", "governed_lesson_route": "/tutorials/pwr-047/", "self_attempt_status": "NO_TRAINING_AUTHORITY", "gold_pathway_ids": [ "G-CUR-004" ], "route_membership": { "kind": "GOLD_PATHWAY", "id": "G-CUR-004", "coverage_status": "EXACT_ONCE" }, "source_authority_tier": "G2", "source_build_state": "RESEARCH_ONLY", "source_instructional_route": "EXPLAINER_ONLY_RESEARCH", "source_count": 4, "research_depth": "DETAILED", "risk_level": "MODERATE", "prerequisite_status": "NONE_FOR_READING__NO_PRACTICE_AUTHORITY", "learning_route": { "mode": "RESEARCH_EXPLORATION", "label": "Explore the research frontier", "summary": "This tutorial teaches how to read a sparse fictional post-event time course. You will apply three declared bands, find the first sampled row that satisfies each band and report the first sampled row where all three are simultaneously in band. Because nothing was measured between rows, you must not call that timestamp the exact recovery time or use it for readiness.", "steps": [ [ "Frame the question", "State the capability claim narrowly enough that evidence could support or limit it." ], [ "Map the evidence", "Distinguish existence, measurement, trainability, retention, transfer, safety and functional value." ], [ "Find uncertainty", "Identify small samples, proxy measures, missing controls, null findings and unresolved authority questions." ], [ "Compare alternatives", "Consider competing explanations and what evidence would change the current treatment." ], [ "Stay non-operational", "Use the record for research literacy only until a separate gate authorises instruction." ] ], "practical_authority": false, "provider_required": false, "next_action_route": "/tutorials/pwr-047/" }, "path_builder": { "selectable": true, "completion_allowed": true, "warning": "Titan teaches a complete Power-specific research method because operational capability practice is not currently justified." }, "full_tutorial": { "version": "1.0", "authorship": "AUTHORED_GOVERNED_SOURCE", "practice_pack": { "power_id": "PWR-047", "title": "Stress-state recovery", "heading": "Find the first sampled all-domain in-band row in a fictional time course", "plain_english_intro": "This tutorial teaches how to read a sparse fictional post-event time course. You will apply three declared bands, find the first sampled row that satisfies each band and report the first sampled row where all three are simultaneously in band. Because nothing was measured between rows, you must not call that timestamp the exact recovery time or use it for readiness.", "authority_and_safety": [ "Governance ceiling: explanation and static fictional record analysis only. Capability self-practice, live administration, protocol delivery and efficacy claims are not authorised until the recorded next_gate adjudication changes.", "Use only the supplied fictional sampled time course. Do not create a stressor, repeat a task, measure personal physiology or use the bands for return-to-duty decisions.", "Sparse samples do not establish an exact recovery time, readiness, diagnosis or a recovery protocol." ], "materials": [ "The five supplied time-course rows in the fixture; no stress induction, timed pressure task, biofeedback or personal physiology is required.", "Recovery-band card: subjective tension is recovered at 3/10 or lower; pulse is recovered from 68 through 76 bpm inclusive; decision performance is recovered at 9/10 correct or higher.", "Recovery-fraction card: for tension and pulse, fraction recovered = (immediate-post value minus current value) divided by (immediate-post value minus baseline value), times 100; for decision performance, fraction recovered = (current correct minus immediate-post correct) divided by (baseline correct minus immediate-post correct), times 100.", "Time-course sheet with three yes/no band columns, three fraction columns for the 15-minute row, earliest-domain times and earliest all-domain time.", "Boundary card: FICTIONAL DATA ONLY; no stressor, exposure, breathing method, HRV method, dose, progression, trauma exercise or return-to-duty decision.", "Calculator, optional, and answer key hidden until the time course is complete." ], "setup_steps": [ "Copy the baseline row and all three inclusive bands before reading the post-event samples.", "For each sampled row, mark tension, pulse and decision performance IN or OUT separately.", "Find the first sampled row in band for each domain; write FIRST SAMPLED ROW, not exact recovery time.", "Define the all-domain result as the first sampled row where all three are simultaneously in band. The transition could have occurred anywhere between the previous sample and this one.", "Calculate the three 15-minute change fractions from the supplied formulas, keeping denominators visible.", "Finish with a bounded statement that names the fictional event, sparse sampling, declared task and missing continuous or clinical evidence." ], "fixture": { "caption": "Sparse fictional post-event samples; rows do not establish continuous or exact recovery time", "headers": [ "Time", "Subjective tension", "Pulse", "Decision task", "Interpretive role" ], "rows": [ [ "Rested baseline", "2/10", "72 bpm", "9/10 correct", "Reference for bands and recovery fractions" ], [ "0 minutes after fictional event", "8/10", "112 bpm", "5/10 correct", "Immediate-post anchor" ], [ "5 minutes", "6/10", "96 bpm", "7/10 correct", "Early time point" ], [ "15 minutes", "3/10", "80 bpm", "9/10 correct", "Mixed-domain recovery point" ], [ "30 minutes", "2/10", "75 bpm", "9/10 correct", "Later time point" ] ] }, "scoring_rule": "Award 1 point for each correct IN/OUT decision across three domains at four sampled rows (12), 1 for each first sampled domain row (3), 2 for the correct first sampled all-domain row at 30 minutes, 1 for each 15-minute change fraction (3), and 2 for a bounded sparse-sampling conclusion: 22 total. Calling 30 minutes the exact recovery time, or making a readiness decision, receives STOP.", "worked_example": { "steps": [ "At 15 minutes, compare tension 3 with the recovered band of 3 or lower: IN.", "Compare pulse 80 with 68–76 inclusive: OUT. Compare 9/10 correct with the task band of 9 or higher: IN.", "Calculate tension recovery: (8 - 3) / (8 - 2) = 5/6 = 83.3%.", "Calculate pulse recovery: (112 - 80) / (112 - 72) = 32/40 = 80.0%.", "Calculate task recovery: (9 - 5) / (9 - 5) = 4/4 = 100.0%.", "Because one domain remains out of band, continue reading the supplied table to 30 minutes rather than declaring full recovery at 15." ], "result": "At 15 minutes the sampled row is IN/OUT/IN with change fractions 83.3%, 80.0% and 100.0%. The first sampled all-domain row is 30 minutes; the exact transition time is unknown between samples." }, "right_vs_wrong": [ { "situation": "Reading 15 minutes", "right": "Report tension and decision recovery while pulse remains out of band.", "wrong": "Call the fictional person fully recovered because task accuracy is back to 9/10.", "why": "The predeclared outcome requires simultaneous recovery across all three domains." }, { "situation": "Using a recovery fraction", "right": "Keep the immediate-post and baseline anchors visible in the formula.", "wrong": "Divide the current value by baseline and call it percent recovered.", "why": "That is not the supplied recovery-fraction definition." }, { "situation": "Choosing a timestamp", "right": "Use the earliest row where the declared band is met.", "wrong": "Use 30 minutes for tension because it looks more completely recovered.", "why": "Tension first reaches its band at 15 minutes." }, { "situation": "Interpreting pulse", "right": "Treat pulse as one domain in a configured time course.", "wrong": "Use 75 bpm to certify emotional safety or wise judgment.", "why": "A physiological value cannot establish those outcomes." }, { "situation": "Using the fixture", "right": "Analyze the prewritten rows without creating an event or recovery method.", "wrong": "Induce stress to collect a personal time course.", "why": "This supplied exercise is the no-attempt alternative and authorises no stress induction or recovery protocol." } ], "common_mistakes": [ { "mistake": "A single domain defines the overall recovery time.", "fix": "Require all three IN flags on the same timestamp row." }, { "mistake": "Pulse 80 at 15 minutes is rounded into the 68–76 band.", "fix": "Use the inclusive numeric limits exactly; 80 remains OUT." }, { "mistake": "The immediate-post row is mistaken for the baseline denominator.", "fix": "Copy rested baseline and immediate-post anchors into separate formula fields." }, { "mistake": "Decision recovery is reported as proof of safe real-world judgment.", "fix": "Name the ten-item fictional task and preserve the transfer boundary." }, { "mistake": "The learner invents a stressor or calming technique to make the pack practical.", "fix": "Stop and return to the complete fictional time course; this supplement adds no stressor or recovery protocol." } ], "answer_key_route": "/tutorials/pwr-047/answer-key/", "answer_key_delivery": "SEPARATE_NOINDEX_NOARCHIVE_CHECKING_PAGE" }, "tutorial_mode": "RESEARCH_EXPLORATION", "orientation": { "bounded_definition": "Capability to develop or express stress-state recovery in a declared context without inheriting broader claims.", "evidence_summary": "Stress recovery can improve in bounded training settings, but no method makes a person stress-proof.", "measurement_boundary": "Recovery should be a time course across subjective state, physiology and task function; a single post-stressor reading is insufficient.", "myth_to_metric": { "myth": "Become unbreakable under stress", "metric": "Time to recover physiology, judgment and meaningful task performance after a declared stressor", "boundary": "Fast physiological recovery alone does not establish wisdom, safety or mental health." }, "limiting_findings": [ "HRV biofeedback was not superior to mindfulness or physical activity in one comparative trial.", "Long-term real-world recovery and functional benefit remain insufficiently tested." ], "prohibited_claims": [ "become immune to stress", "recover instantly", "a calm HRV pattern proves resilience", "biofeedback treats trauma" ] }, "outcomes": [ "Define stress-state recovery without inheriting mythology or broader claims.", "Explain what the current evidence supports and what it does not establish.", "Use the declared measurement boundary and recognise misleading proxies.", "Complete the current learning route without converting it into unauthorised capability practice.", "Make a retention, transfer, maintenance, provider or stop decision without overclaiming." ], "prerequisites": "NONE_FOR_READING__NO_PRACTICE_AUTHORITY", "baseline": { "instruction": "Before reading the sequence, record your current definition, confidence, assumed measure, expected value, known risks and intended next action. Do not attempt the capability.", "record": [ "date and context", "current definition", "confidence from 0 to 100", "assumed measure", "expected benefit", "known limitation", "intended next action" ] }, "modules": [ { "order": 1, "title": "Frame the question", "instruction": "State the capability claim narrowly enough that evidence could support or limit it.", "completion_evidence": "Record the decision or output from frame the question in one or two sentences." }, { "order": 2, "title": "Map the evidence", "instruction": "Distinguish existence, measurement, trainability, retention, transfer, safety and functional value.", "completion_evidence": "Record the decision or output from map the evidence in one or two sentences." }, { "order": 3, "title": "Find uncertainty", "instruction": "Identify small samples, proxy measures, missing controls, null findings and unresolved authority questions.", "completion_evidence": "Record the decision or output from find uncertainty in one or two sentences." }, { "order": 4, "title": "Compare alternatives", "instruction": "Consider competing explanations and what evidence would change the current treatment.", "completion_evidence": "Record the decision or output from compare alternatives in one or two sentences." }, { "order": 5, "title": "Stay non-operational", "instruction": "Use the record for research literacy only until a separate gate authorises instruction.", "completion_evidence": "Record the decision or output from stay non-operational in one or two sentences." } ], "lab": { "title": "Claim-audit lab", "instruction": "Choose one public claim about this Power. Compare it with the bounded definition, measurement limit, supporting evidence, limiting findings and prohibited wording.", "deliverable": "A one-page claim verdict: supported, partly supported, unresolved or contradicted, with the reason stated." }, "assessment": { "immediate": "Restate the bounded definition, evidence ceiling, measurement boundary and current authority route without looking.", "delayed_retention": "Repeat the explanation and route decision after at least 48 hours; record what changed or was forgotten.", "transfer": "Evaluate a new claim, provider option or research result using the same evidence and authority checklist; do not perform the capability.", "interpretation": "Completion demonstrates learning of this tutorial only. It does not prove capability, qualification, independent validation, safety clearance or far transfer." }, "maintenance": { "cadence": "Review after 48 hours, again after 2-4 weeks, and whenever the evidence or authority treatment changes.", "decisions": [ "retain", "refresh", "seek qualified support", "return to research", "retire" ] }, "accessibility": "Use text-to-speech, enlarged text, keyboard navigation, shorter sessions, a support person or an equivalent non-practical record format as needed. Accessibility changes must not enlarge practical authority.", "stopping_and_escalation": "Titan teaches a complete Power-specific research method because operational capability practice is not currently justified. Stop if the declared configuration cannot be maintained, uncertainty becomes material, adverse effects appear, or qualified authority is required.", "next_gate": "No external confirmation is required for the current bounded explainer permission. Guide permission remains NOT_READY; any guide, stronger efficacy, generalisation, protocol, promotion or independent-validation claim requires a new adjudication.", "evidence_count": 4 }, "full_training_programme": false, "independently_validated": false, "publication_state": "PUBLISHED_PUBLIC_RESEARCH_EDITION__EDITORIAL_REVIEW_PENDING", "related_power_ids": [ "PWR-041", "PWR-042", "PWR-043", "PWR-044" ] }, { "power_id": "PWR-048", "learning_unit_id": "TLU-PWR-048", "title": "Closed-loop physiological biofeedback", "main_description": "In a qualified session, Jo completes baseline, feedback, correction and display-hidden blocks for one declared signal with artefacts and symptoms recorded.", "main_description_source": "FULL_TUTORIAL_OUTCOME", "family_id": "FAM-06", "family": "Autonomic & Physiological Self-Regulation", "superdomain": "Regulation & Recovery", "canonical_route": "/powers/pwr-048/", "treatment": "SPECIALIST_PROVIDER_ROUTE", "treatment_label": "Full supervised tutorial", "treatment_boundary": "Titan teaches the complete method; a qualified person controls the parts that require supervision, clearance, specialist equipment, load, dose or progression.", "tutorial_route": "/tutorials/pwr-048/", "governed_lesson_route": null, "self_attempt_status": "PROHIBITED_WITHOUT_QUALIFIED_SUPERVISION", "gold_pathway_ids": [ "G-CUR-004" ], "route_membership": { "kind": "GOLD_PATHWAY", "id": "G-CUR-004", "coverage_status": "EXACT_ONCE" }, "source_authority_tier": "G4", "source_build_state": "EXTERNAL_PROVIDER_ROUTE", "source_instructional_route": "LEARN_ELSEWHERE_TRACK_WITH_TITAN", "source_count": 5, "research_depth": "DETAILED", "risk_level": "MODERATE_TO_HIGH", "prerequisite_status": "QUALIFIED_PROVIDER_DETERMINES", "learning_route": { "mode": "FULL_SUPERVISED_TUTORIAL", "label": "Learn closed-loop physiological biofeedback step by step", "summary": "In a qualified session, Jo completes baseline, feedback, correction and display-hidden blocks for one declared signal with artefacts and symptoms recorded.", "steps": [ [ "Get ready", "Name the single signal, target direction and reason for training; do not mix several displays into one score." ], [ "Learn the method", "10 concrete steps teach the permitted method from start to finish." ], [ "See right and wrong", "7 comparisons show correct or safer execution beside common wrong or riskier choices." ], [ "Practise", "Jo's EMG therapist sets signal-specific sessions and dose. Progress only after stable sensor quality and reproducible, symptom-free performance; then fade feedback or vary one task feature. Screen-hidden retention and functional value must be tested directly. For the next appointment, repeat matching supported object transfer and phase markers before changing reach distance or load; fade EMG screen only when artefact classification remains accurate." ], [ "Check progress", "Jo's EMG therapist records electrode site plus sensor type, calibration, block summary, artefact time, feedback state, the shoulder-release action, symptoms, burden and the separate supported-reach outcome. For Jo's surface-EMG fixture, retain the three signature snippets and phase markers for start, lift, place and return; report excluded cable-motion time separately from valid muscle activity." ] ], "practical_authority": false, "provider_required": true, "next_action_route": "/tutorials/pwr-048/" }, "path_builder": { "selectable": true, "completion_allowed": true, "warning": "Titan teaches the complete method; a qualified person controls the parts that require supervision, clearance, specialist equipment, load, dose or progression." }, "full_tutorial": { "version": "3.0", "authorship": "POWER_SPECIFIC_FULL_TUTORIAL", "tutorial_mode": "SUPERVISED", "promise": "Biofeedback can make selected body signals trainable; every claim belongs to a particular person–sensor–feedback–task system. Closed-loop biofeedback shows a measured body signal and lets Jo test one response strategy. Jo's EMG therapist selects a valid sensor, target and dose; Jo calibrates, practises in short blocks, names artefacts and tests a hidden-feedback block. A display change is not automatically a health change. In Jo's surface-EMG fixture, Jo learns the visual signature of quiet muscle activity, purposeful contraction and cable-motion artefact before trying to lower unnecessary shoulder recruitment during a reach.", "power_id": "PWR-048", "title": "Closed-loop physiological biofeedback", "lesson_type": "SUPERVISED", "headline": "Train one measured signal, then check whether learning survives without the display", "plain_english_summary": "Biofeedback can make selected body signals trainable; every claim belongs to a particular person–sensor–feedback–task system. Closed-loop biofeedback shows a measured body signal and lets Jo test one response strategy. Jo's EMG therapist selects a valid sensor, target and dose; Jo calibrates, practises in short blocks, names artefacts and tests a hidden-feedback block. A display change is not automatically a health change. In Jo's surface-EMG fixture, Jo learns the visual signature of quiet muscle activity, purposeful contraction and cable-motion artefact before trying to lower unnecessary shoulder recruitment during a reach.", "outcome": "In a qualified session, Jo completes baseline, feedback, correction and display-hidden blocks for one declared signal with artefacts and symptoms recorded.", "authority": { "learner_may": [ "Classify the clinician-recorded quiet-muscle, gentle-contraction and cable-motion traces before using the display during a supported foam-puck reach.", "Try the therapist-selected shoulder-release cue on matched visible-feedback reaches and then repeat one reach with the display hidden.", "Report reach phases, EMG artefacts, task quality, discomfort and assistance without equating a low graph with better function." ], "qualified_person_required_for": [ "Selecting the muscle/site, preparing skin, placing electrodes, checking impedance/signal quality and distinguishing movement artefact from muscle activity.", "Choosing the supported reach, cue, display scale, interval count, rest, symptom stops and whether feedback is clinically appropriate.", "Interpreting EMG change, altering rehabilitation load or using therapeutic electrical/biofeedback equipment beyond this recorded session." ], "never_do": [ "Move an electrode, change gain/filtering or tug a lead during a scored comparison to make the trace look quieter.", "Brace, hold the breath or sacrifice the puck reach merely to drive the displayed line downward.", "Use surface EMG to diagnose a condition or change treatment, medication, load or device settings without the responsible clinician." ] }, "materials": [ "One provider-approved sensor system for a single signal, such as surface EMG, peripheral temperature or respiratory rate.", "Manufacturer instructions and a calibration or signal-quality check.", "A supportive task position and provider-set timer.", "A block record for raw signal summary, cue, artefact, symptom, feedback state and functional outcome." ], "before_you_start": [ "Name the single signal, target direction and reason for training; do not mix several displays into one score.", "The provider checks contraindications, skin, device integrity, privacy and whether the signal has a clinically meaningful use.", "Agree one low-effort strategy and one stop rule before the baseline.", "Keep medication, prescribed devices and ordinary supports unchanged." ], "steps": [ { "title": "Name the loop", "instruction": "Say what the surface electrodes measure, how EMG display represents it, what action you will try and what outcome matters beyond EMG display.", "reason": "A clear person-sensor-feedback-task loop prevents vague “body control” claims.", "success_check": "Jo can point to each link and name the measurement unit." }, { "title": "Check signal quality", "instruction": "Jo's EMG therapist places surface electrodes, follows EMG unit check and asks Jo to make a known small action to confirm that EMG display responds as expected.", "reason": "Poor contact, motion and electrical noise can masquerade as physiology.", "success_check": "EMG trace is stable at rest and changes appropriately during the check." }, { "title": "Capture a quiet baseline", "instruction": "Complete a therapist-timed EMG interval without using shoulder-release cue. Record posture, support, signal and artefacts.", "reason": "A baseline shows drift and normal variation before feedback learning.", "success_check": "The raw baseline remains visible and is not discarded for looking untidy." }, { "title": "Apply one strategy", "instruction": "Use only the agreed action, such as releasing a selected muscle or making an easy breathing change, during the feedback block.", "reason": "Changing several things at once hides which action affected EMG waveform.", "success_check": "Shoulder-release cue is observable and stays within comfortable effort." }, { "title": "Read trends, not flicker", "instruction": "Watch the therapist-selected EMG trend and ignore isolated spikes. Pause when movement, speech or sensor contact creates an artefact.", "reason": "Closed-loop learning depends on valid feedback, not chasing noise.", "success_check": "Artefact periods are marked and excluded under the predeclared rule." }, { "title": "Correct one error", "instruction": "Use the EMG therapist’s feedback to change one feature—posture, effort, cue timing or sensor contact—and repeat a matched block.", "reason": "One controlled correction makes cause and effect easier to interpret.", "success_check": "EMG waveform log names the error and the single correction." }, { "title": "Hide EMG display", "instruction": "Repeat a matched block with EMG display hidden or delayed if Jo's EMG therapist approves, while using the same shoulder-release action.", "reason": "This tests immediate dependence on feedback.", "success_check": "Feedback state is labelled and the rest of the configuration is unchanged." }, { "title": "Check function and recovery", "instruction": "End the shoulder-release cue, inspect electrode site and complete the therapist-chosen supported-reach or symptom check.", "reason": "A better trace matters only if burden, safety and intended function are not worse.", "success_check": "Skin is intact, symptoms remain acceptable, and the supported-reach result is recorded separately." }, { "title": "Label three EMG signatures", "instruction": "While the arm is supported, Jo's EMG therapist records a quiet-muscle segment, one gentle shoulder activation and one deliberately marked lead-motion segment that does not pull on the skin. Jo names which trace segment is physiology and which is artefact before training begins.", "reason": "Jo cannot use an EMG graph safely if a cable bump and a muscle response look equally meaningful.", "success_check": "Quiet, activation and marked artefact segments are retained with time labels, and Jo classifies all three correctly." }, { "title": "Compare matching reach phases", "instruction": "Divide each supported reach into start, lift, place and return. Compare the chosen shoulder cue only within matching phase across resting-trace, visible-screen and hidden-screen intervals; do not compare a moving phase with quiet sitting.", "reason": "Surface EMG varies with shoulder action being performed, so phase matching is needed before a smaller trace can be attributed to the cue.", "success_check": "Every interval has matching object, reach distance, pace and four phase markers, with discomfort and movement quality recorded beside EMG trace." } ], "worked_example": { "scenario": "An occupational therapist uses surface EMG biofeedback to help Jo notice excess upper-shoulder tension during a supported reach.", "walkthrough": [ "Jo's EMG therapist explains that the electrodes measure local muscle electrical activity, not stress as a whole.", "Jo rests for a baseline, then reaches once while Jo's EMG therapist marks motion artefact.", "Jo repeats the reach while gently releasing the shoulder rather than forcing it down.", "After one posture correction, Jo repeats with EMG display hidden.", "Jo's EMG therapist records EMG summary, reach quality, discomfort, assistance and skin condition.", "Before coaching, Jo's EMG therapist saves three labelled snippets: supported rest, gentle shoulder lift and a cable-motion artefact; Jo correctly distinguishes the broad activation rise from the sharp lead disturbance.", "For the reach comparison, Jo's EMG therapist marks start, lift, place and return on every trace so Jo compares the lift phase with the lift phase rather than with resting baseline." ], "result": "Jo changes the selected EMG pattern during this supported reach and partly retains it without the EMG screen. The result belongs to this muscle, sensor placement and task; it is not proof of global relaxation or treatment success. The labelled trace snippets and phase-matched reaches show exactly what Jo learned from this EMG loop without turning the display into a general health reading." }, "right_vs_wrong": [ { "situation": "Signal definition", "right": "Use one named signal with units and a declared target.", "wrong": "Combine heart rate, temperature and a wellness score as if they were interchangeable.", "why": "Different signals have different meanings and artefacts." }, { "situation": "Sensor quality", "right": "Verify placement and mark motion or contact artefact.", "wrong": "Treat every spike as a body response.", "why": "Noise can drive false learning." }, { "situation": "Strategy", "right": "Change one comfortable action at a time.", "wrong": "Strain, hold the breath or change posture repeatedly to move EMG display.", "why": "Multiple or extreme actions obscure the mechanism and can cause symptoms." }, { "situation": "Learning test", "right": "Add a matched display-hidden block.", "wrong": "Claim learning from feedback-visible trials alone.", "why": "A screen-dependent change may disappear when feedback is removed." }, { "situation": "Outcome", "right": "Record signal, function, symptoms, plus burden separately.", "wrong": "Call a prettier graph proof of health improvement.", "why": "A proxy signal is not the functional outcome." }, { "situation": "A sharp EMG excursion when electrode lead moves", "right": "Mark the lead-motion interval as artefact and repeat after electrode lead is secured.", "wrong": "Treat the spike as a successful muscle contraction or a symptom flare.", "why": "A disturbed lead can change the displayed voltage without representing intended shoulder action." }, { "situation": "Visible-screen and hidden-screen transfer", "right": "Match foam puck, reach distance, pace and reach phase before comparing EMG traces.", "wrong": "Compare a seated rest value with an active reach and call the difference loss of control.", "why": "Action phase is part of the EMG measurement configuration." } ], "common_mistakes": [ { "mistake": "Electrode or probe contact changes between baseline and guided intervals.", "fix": "Recheck placement marks and signal quality before comparing intervals; label any reattachment as a new configuration." }, { "mistake": "Jo watches individual pixels and changes strategy after every spike.", "fix": "Use Jo's EMG therapist-selected interval trend and wait through EMG waveform’s response delay before judging the cue." }, { "mistake": "Breathing, posture, facial tension and limb effort all change together.", "fix": "Return to baseline, choose one observable regulation cue and hold other posture and breathing features constant." }, { "mistake": "Motion artefact is celebrated because it moves EMG graph in the target direction.", "fix": "Mark movement/speech epochs, exclude them under declared rule and repeat only after EMG trace stabilises." }, { "mistake": "A successful visible-screen interval is called learning.", "fix": "Require a matched hidden-screen interval and a separate functional check before describing retention or usefulness." }, { "mistake": "EMG waveform target becomes an absolute normal value copied from another person.", "fix": "Use Jo's EMG therapist-defined direction and personal task baseline; do not turn a training display into diagnosis." } ], "practice": { "first_session": [ "Jo and the EMG therapist name the upper-shoulder electrode site, supported foam-puck reach, shoulder-release cue and symptom stop.", "Save a quiet-muscle waveform, gentle-activation waveform and marked lead-motion artefact; Jo classifies all three before coaching.", "Record one supported reach without the screen cue, marking start, lift, place and return on the EMG trace.", "Run two visible-screen reaches with the same puck, distance and pace; change only the shoulder-release cue after the first comparison.", "Repeat one matched reach with the EMG screen hidden, then inspect the electrode site and score reach quality, discomfort and assistance." ], "repeat_plan": "Jo's EMG therapist sets signal-specific sessions and dose. Progress only after stable sensor quality and reproducible, symptom-free performance; then fade feedback or vary one task feature. Screen-hidden retention and functional value must be tested directly. For the next appointment, repeat matching supported object transfer and phase markers before changing reach distance or load; fade EMG screen only when artefact classification remains accurate.", "progress_when": [ "Jo correctly distinguishes quiet muscle activity, gentle activation and marked lead-motion artefact before changing the shoulder cue.", "The start, lift, place and return phases are marked consistently on every supported foam-puck reach.", "Lift-phase EMG changes in the intended direction on matched visible-screen and hidden-screen reaches without worse discomfort, assistance or movement quality." ], "do_not_progress_when": [ "The resting EMG waveform drifts, an electrode detaches or cable artefact cannot be separated from muscle activation.", "Jo must brace, hold the breath, force the shoulder downward or worsen pain to move the display.", "The waveform changes but the supported reach becomes less accurate, more effortful or more distressing." ] }, "self_check": [ "Can you demonstrate “Check signal quality”? EMG trace is stable at rest and changes appropriately during the check.", "Can you demonstrate “Read trends, not flicker”? Artefact periods are marked and excluded under the predeclared rule.", "Can you demonstrate “Check function and recovery”? Skin is intact, symptoms remain acceptable, and the supported-reach result is recorded separately.", "Can you point to the saved quiet-muscle, gentle-activation and cable-artefact snippets and explain why only first two reflect muscle-state examples?", "Can you compare lift with lift and return with return instead of comparing an active reach with supported rest?" ], "measurement": { "primary": "Signal-specific learning, screen-hidden retention, functional transfer, burden and harms", "how": "Jo's EMG therapist records electrode site plus sensor type, calibration, block summary, artefact time, feedback state, the shoulder-release action, symptoms, burden and the separate supported-reach outcome. For Jo's surface-EMG fixture, retain the three signature snippets and phase markers for start, lift, place and return; report excluded cable-motion time separately from valid muscle activity.", "good_result": "A reproducible signal-specific change appears in matched blocks, persists at least partly without visible feedback and does not worsen intended function or symptoms.", "does_not_prove": "A changed surface-EMG waveform does not diagnose stress, prove whole-body relaxation or establish transfer to another muscle, electrode placement, task or clinical outcome." }, "stop_and_get_help": [ "Stop for chest pain, faintness, severe breathlessness, neurological symptoms, panic, painful muscle spasm or a new concerning symptom.", "Stop for broken skin, allergic reaction, heat, shock sensation or EMG-unit malfunction or an electrode-site problem.", "Seek qualified review when feedback provokes compulsive monitoring, distress or a worsening clinical symptom." ], "accessibility": [ "Provide audio, haptic or simplified colour-safe feedback instead of a dense graph.", "Place sensors and supports around Jo’s mobility, skin and communication needs.", "Allow a support person to manage the equipment while Jo performs the chosen shoulder-release action." ], "evidence_notes": [ { "claim": "A randomised trial compared HRV biofeedback with other stress-reduction approaches, supporting signal- and protocol-specific interpretation.", "source_title": "Physical activity, mindfulness meditation, or heart rate variability biofeedback for stress reduction: a randomized controlled trial", "source_url": "https://pubmed.ncbi.nlm.nih.gov/26111942/", "source_kind": "PRIMARY_RESEARCH" }, { "claim": "Biofeedback learning under a defined technology and stress task supports configured training, not universal transfer.", "source_title": "Using a virtual reality game to train biofeedback-based regulation under stress conditions", "source_url": "https://pubmed.ncbi.nlm.nih.gov/39385361/", "source_kind": "PRIMARY_RESEARCH" } ], "limits": [ "The sensor, preprocessing, feedback rule and task form one versioned system; proxy validity and device-off performance must be tested separately.", "Unsupported claim: hack your nervous system.", "Unsupported claim: a high HRV score means health.", "Unsupported claim: wearables diagnose stress.", "Performance with one sensor, placement and task does not establish direct control of an organ, diagnosis, cure or transfer to another biofeedback system." ], "orientation": { "bounded_definition": "Capability to develop or express closed-loop physiological biofeedback in a declared context without inheriting broader claims.", "evidence_summary": "Biofeedback can make selected body signals trainable; every claim belongs to a particular person–sensor–feedback–task system.", "supportable_public_claim": "Closed-loop biofeedback can help people learn control of selected measured signals in bounded tasks.", "measurement_boundary": "The sensor, preprocessing, feedback rule and task form one versioned system; proxy validity and device-off performance must be tested separately.", "myth_to_metric": { "myth": "Hack your physiology with a wearable", "metric": "Signal-specific learning, device-off retention, functional transfer, burden and harms", "boundary": "A responsive graph does not establish diagnosis, health or general self-control." }, "limiting_findings": [ "Peripheral temperature acquisition did not improve Raynaud clinical outcomes.", "HRV biofeedback was not uniquely superior to active alternatives in one stress trial." ], "prohibited_claims": [ "hack your nervous system", "a high HRV score means health", "wearables diagnose stress", "permanent control after one session" ] }, "gold_source_lesson": null, "next_gate": "External confirmation is required before higher-authority use because: CLINICAL_HIGH_RISK_OR_REGULATED_CONFIGURATION; SUPERVISION_OR_NON_ATTEMPT_BOUNDARY.", "evidence_count": 5 }, "full_training_programme": false, "independently_validated": false, "publication_state": "PUBLISHED_PUBLIC_RESEARCH_EDITION__EDITORIAL_REVIEW_PENDING", "related_power_ids": [ "PWR-041", "PWR-042", "PWR-043", "PWR-044" ] }, { "power_id": "PWR-049", "learning_unit_id": "TLU-PWR-049", "title": "Sleep initiation", "main_description": "The learner follows the provider-agreed bedtime response for seven nights and records sleep-onset latency, adherence, next-day function and adverse effects.", "main_description_source": "FULL_TUTORIAL_OUTCOME", "family_id": "FAM-07", "family": "Sleep, Circadian & Recovery Regulation", "superdomain": "Regulation & Recovery", "canonical_route": "/powers/pwr-049/", "treatment": "SPECIALIST_PROVIDER_ROUTE", "treatment_label": "Full supervised tutorial", "treatment_boundary": "Titan teaches the complete method; a qualified person controls the parts that require supervision, clearance, specialist equipment, load, dose or progression.", "tutorial_route": "/tutorials/pwr-049/", "governed_lesson_route": null, "self_attempt_status": "PROHIBITED_WITHOUT_QUALIFIED_SUPERVISION", "gold_pathway_ids": [ "G-CUR-004" ], "route_membership": { "kind": "GOLD_PATHWAY", "id": "G-CUR-004", "coverage_status": "EXACT_ONCE" }, "source_authority_tier": "G4", "source_build_state": "EXTERNAL_PROVIDER_ROUTE", "source_instructional_route": "LEARN_ELSEWHERE_TRACK_WITH_TITAN", "source_count": 4, "research_depth": "DETAILED", "risk_level": "MODERATE_TO_HIGH", "prerequisite_status": "QUALIFIED_PROVIDER_DETERMINES", "learning_route": { "mode": "FULL_SUPERVISED_TUTORIAL", "label": "Learn sleep initiation step by step", "summary": "The learner follows the provider-agreed bedtime response for seven nights and records sleep-onset latency, adherence, next-day function and adverse effects.", "steps": [ [ "Get ready", "A sleep clinician or other qualified provider screens for sleep apnoea, mania, seizures, parasomnias, medication effects, shift work and other conditions that change the plan." ], [ "Learn the method", "8 concrete steps teach the permitted method from start to finish." ], [ "See right and wrong", "5 comparisons show correct or safer execution beside common wrong or riskier choices." ], [ "Practise", "Follow the same written cue sequence for seven consecutive nights. At clinician review, compare weekly median onset estimate, cue adherence, clock checking and daytime function with baseline; retain or change one plan feature. The next cycle uses another seven nights, not a progressively later bedtime chosen by the learner." ], [ "Check progress", "From the diary, estimate sleep-onset latency each night and report the weekly median alongside adherence, next-day function and adverse effects; keep tracker data secondary." ] ], "practical_authority": false, "provider_required": true, "next_action_route": "/tutorials/pwr-049/" }, "path_builder": { "selectable": true, "completion_allowed": true, "warning": "Titan teaches the complete method; a qualified person controls the parts that require supervision, clearance, specialist equipment, load, dose or progression." }, "full_tutorial": { "version": "3.0", "authorship": "POWER_SPECIFIC_FULL_TUTORIAL", "tutorial_mode": "SUPERVISED", "promise": "Sleep initiation can improve with structured insomnia treatment; it is not an on-command superpower. This lesson teaches the stimulus-control part of cognitive behavioural therapy for insomnia (CBT-I): track the pattern, keep a provider-agreed wake time, go to bed when sleepy, leave the bed when unable to sleep and return only when sleepy again. A clinician controls any sleep-window restriction and screens other causes.", "power_id": "PWR-049", "title": "Sleep initiation", "lesson_type": "SUPERVISED", "headline": "Use a fixed wake time and stimulus control to rebuild the bed–sleep link", "plain_english_summary": "Sleep initiation can improve with structured insomnia treatment; it is not an on-command superpower. This lesson teaches the stimulus-control part of cognitive behavioural therapy for insomnia (CBT-I): track the pattern, keep a provider-agreed wake time, go to bed when sleepy, leave the bed when unable to sleep and return only when sleepy again. A clinician controls any sleep-window restriction and screens other causes.", "outcome": "The learner follows the provider-agreed bedtime response for seven nights and records sleep-onset latency, adherence, next-day function and adverse effects.", "authority": { "learner_may": [ "Complete the morning sleep diary, prepare a dim quiet place and rehearse the difference between a clock time, genuine sleepiness and alert frustration.", "Follow the written sleepy-entry, alert-exit and sleepy-return cues selected with the insomnia clinician.", "Report onset estimates, adherence, daytime function and adverse effects without changing the sleep window independently." ], "qualified_person_required_for": [ "Screening insomnia symptoms for sleep apnoea, mania, seizures, parasomnia, restless legs, medication/substance effects, shift work and other causes that alter CBT-I.", "Setting any fixed wake tolerance, time-in-bed window or sleep-restriction component and reviewing dangerous daytime sleepiness.", "Adapting stimulus control when night transfers, falls, disability, caregiving, pregnancy or another health condition changes the ordinary exit-and-return plan." ], "never_do": [ "Cut time in bed, delay the agreed wake anchor or change sedating/stimulating medicine after one poor night.", "Force wakefulness, remain in bed as a willpower test or use alcohol, extra medication or bright-screen distraction to induce sleep.", "Drive or perform safety-critical work while fighting sleep, drifting attention or having involuntary sleep episodes." ] }, "materials": [ "A seven-night sleep diary with bedtime, estimated sleep onset, awakenings, final wake and out-of-bed time.", "A provider-agreed wake time and written stimulus-control plan.", "A dim, safe place outside the bed for a quiet activity.", "A low-stimulation activity such as a familiar paper book or calm audio; no clock-facing contest." ], "before_you_start": [ "A sleep clinician or other qualified provider screens for sleep apnoea, mania, seizures, parasomnias, medication effects, shift work and other conditions that change the plan.", "Do not reduce time in bed or change medicine without the provider.", "Make the route from bed to the quiet place safe and accessible at night.", "If drowsy driving or dangerous sleepiness is present, address transport and work safety before sleep practice." ], "steps": [ { "title": "Complete the baseline diary", "instruction": "For at least seven nights, estimate lights-out time, sleep onset, awakenings, final wake, out-of-bed time and next-day function.", "reason": "A pattern across nights is more useful than one difficult night or a wearable score.", "success_check": "All nights remain in the diary, including poor estimates." }, { "title": "Anchor the wake time", "instruction": "Rise at the provider-agreed time every day, within the agreed tolerance, and record deviations.", "reason": "A stable wake anchor supports a regular sleep opportunity and makes the plan testable.", "success_check": "Out-of-bed time is recorded rather than inferred from device data." }, { "title": "Enter bed when sleepy", "instruction": "Use the bed for sleep and sexual activity; begin the sleep attempt when you notice genuine sleepiness, not only frustration or a preferred clock time.", "reason": "Stimulus control aims to reconnect bed with sleeping rather than prolonged wakefulness.", "success_check": "The learner can name the sleepy cue used that night." }, { "title": "Remove the clock contest", "instruction": "Turn the clock face away and do not repeatedly calculate lost sleep. Estimate timing once in the morning diary.", "reason": "Clock watching increases effort and makes estimates falsely precise.", "success_check": "No repeated clock checks occur during the sleep attempt." }, { "title": "Leave when clearly awake", "instruction": "If you are unable to sleep and becoming alert or frustrated, follow the provider’s cue-based rule: leave the bed safely rather than waiting for an exact minute.", "reason": "Remaining awake and distressed in bed strengthens the wrong association.", "success_check": "The learner moves to the prepared safe place without starting stimulating work." }, { "title": "Use a quiet dim activity", "instruction": "Choose the prepared calm activity under low light. Avoid work, news, gaming, bright screens, meals or exercise unless the provider plan says otherwise.", "reason": "The aim is to wait for sleepiness, not reward or punish wakefulness.", "success_check": "A quiet activity is ready and the light remains low." }, { "title": "Return only when sleepy", "instruction": "Go back to bed when sleepiness returns. Repeat the leave-and-return sequence if alert wakefulness returns.", "reason": "Repeating the same contingency teaches the bed–sleep link over time.", "success_check": "Each return is triggered by sleepiness, not a forced deadline." }, { "title": "Review function and safety", "instruction": "In the morning, record estimates, adherence, mood, falls risk, driving sleepiness and next-day function; review weekly with the provider.", "reason": "A shorter sleep-onset estimate is not a success if daytime safety or health worsens.", "success_check": "The diary contains both night and daytime outcomes." } ], "worked_example": { "scenario": "A clinician and Arun agree on a 07:00 wake time and a safe chair with a familiar audiobook for alert periods.", "walkthrough": [ "Arun completes seven baseline diary nights before changing the response.", "At 23:10 he notices heavy eyelids and goes to bed without watching the clock.", "When he becomes alert and frustrated, he moves to the chair and listens quietly at low volume.", "He returns when sleepy, rises at 07:00 and estimates the night in the morning.", "At review, the clinician checks onset latency alongside daytime sleepiness and adherence." ], "result": "Arun has followed stimulus control; improvement is judged across repeated diary nights and daytime function, not from one quick sleep onset." }, "right_vs_wrong": [ { "situation": "Bed entry", "right": "Go to bed when sleepy within the provider plan.", "wrong": "Lie in bed early for hours trying to force sleep.", "why": "Extended alert time in bed weakens the bed–sleep association." }, { "situation": "Awake period", "right": "Leave safely when clearly awake or frustrated and use a quiet dim activity.", "wrong": "Stay in bed clock-watching and problem-solving.", "why": "Effort and monitoring can maintain alertness." }, { "situation": "Wake anchor", "right": "Keep the agreed wake time and record exceptions.", "wrong": "Sleep far into the day after each poor night without review.", "why": "A moving anchor makes the plan and sleep timing unstable." }, { "situation": "Treatment control", "right": "Let the provider set any sleep-window restriction.", "wrong": "Independently cut time in bed to chase sleep efficiency.", "why": "Sleep restriction can worsen sleepiness and needs individual screening." }, { "situation": "Measurement", "right": "Use diary estimates plus daytime function.", "wrong": "Treat a consumer tracker stage score as diagnosis.", "why": "Consumer devices are not a substitute for clinical evaluation." } ], "common_mistakes": [ { "mistake": "Lie in bed early for hours trying to force sleep.", "fix": "Go to bed when sleepy within the provider plan." }, { "mistake": "Stay in bed clock-watching and problem-solving.", "fix": "Leave safely when clearly awake or frustrated and use a quiet dim activity." }, { "mistake": "Sleep far into the day after each poor night without review.", "fix": "Keep the agreed wake time and record exceptions." }, { "mistake": "Independently cut time in bed to chase sleep efficiency.", "fix": "Let the provider set any sleep-window restriction." }, { "mistake": "Treat a consumer tracker stage score as diagnosis.", "fix": "Use diary estimates plus daytime function." } ], "practice": { "first_session": [ "The insomnia clinician reviews seven baseline diary rows, screening findings and next-day safety, then writes Arun's 07:00 wake anchor and cue-based exit rule.", "Arun clears the bed-to-chair route, places the familiar audiobook at the chair, sets low light and turns the clock face away while leaving an alarm available.", "With four paper prompts he responds: ‘22:45, alert but preferred bedtime’ = stay out of bed; ‘23:10, heavy eyelids’ = enter bed; ‘awake and frustrated’ = move to the chair; ‘yawning and losing the story’ = return to bed.", "That night Arun uses only those cues. In the morning he estimates lights-out, sleep onset, exits/returns, final wake and out-of-bed time, then records daytime sleepiness, mood and function.", "He repeats for seven plan nights and takes all rows, including deviations, to review before any timing or time-in-bed change." ], "repeat_plan": "Follow the same written cue sequence for seven consecutive nights. At clinician review, compare weekly median onset estimate, cue adherence, clock checking and daytime function with baseline; retain or change one plan feature. The next cycle uses another seven nights, not a progressively later bedtime chosen by the learner.", "progress_when": [ "The diary is complete enough to estimate the pattern.", "Bed entry and return are linked to sleepiness rather than clock pressure.", "Sleep onset and daytime function improve without dangerous sleepiness." ], "do_not_progress_when": [ "Daytime sleepiness, falls risk, mood elevation or seizure risk worsens.", "The learner cannot leave the bed safely at night.", "Snoring with breathing pauses, restless legs, parasomnia or medication effects need assessment." ] }, "self_check": [ "Can you demonstrate “Anchor the wake time”? Out-of-bed time is recorded rather than inferred from device data.", "Can you demonstrate “Leave when clearly awake”? The learner moves to the prepared safe place without starting stimulating work.", "Can you demonstrate “Review function and safety”? The diary contains both night and daytime outcomes." ], "measurement": { "primary": "Sleep-onset latency, insomnia severity, next-day function and adverse effects", "how": "From the diary, estimate sleep-onset latency each night and report the weekly median alongside adherence, next-day function and adverse effects; keep tracker data secondary.", "good_result": "Across at least seven plan nights, median sleep-onset latency or insomnia symptoms improve and next-day safety/function do not worsen.", "does_not_prove": "Sleep diary onset latency, actigraphy and polysomnography differ; insomnia is not diagnosed from one consumer metric." }, "stop_and_get_help": [ "Stop independent changes and contact the provider for severe daytime sleepiness, falls, mood elevation, suicidal thoughts, seizure change or distress.", "Do not drive; arrange a safe alternative if fighting sleep, drifting lanes, missing exits or having attention lapses.", "Seek assessment for loud snoring with pauses, choking, unusual night behaviours, persistent insomnia or unexplained sleepiness." ], "accessibility": [ "Use a bedside chair or a quiet activity in bed with an upright posture when transferring out of bed is unsafe, as agreed with the provider.", "Use audio, large print or tactile diary marks and complete details with a helper in the morning.", "A caregiver may support the route and reminders without policing or shaming sleep." ], "evidence_notes": [ { "claim": "Randomised evidence supports structured digital CBT-I effects in adults; the treatment is a multi-component programme, not a single trick.", "source_title": "The effects of digital cognitive behavioral therapy for insomnia on cognitive function: a randomized controlled trial", "source_url": "https://pubmed.ncbi.nlm.nih.gov/32128593/", "source_kind": "PRIMARY_RESEARCH" }, { "claim": "Official sleep-medicine guidance limits consumer sleep technology as a diagnostic or treatment substitute.", "source_title": "Consumer Sleep Technology: An American Academy of Sleep Medicine Position Statement", "source_url": "https://aasm.org/advocacy/position-statements/consumer-sleep-technology/", "source_kind": "OFFICIAL_GUIDANCE" } ], "limits": [ "Sleep diary onset latency, actigraphy and polysomnography differ; insomnia is not diagnosed from one consumer metric.", "Unsupported claim: fall asleep on command.", "Unsupported claim: cure insomnia with discipline.", "Unsupported claim: one perfect bedtime.", "This lesson teaches stimulus control but does not independently prescribe sleep restriction, diagnose insomnia or guarantee sleep on command." ], "orientation": { "bounded_definition": "Capability to develop or express sleep initiation in a declared context without inheriting broader claims.", "evidence_summary": "Sleep initiation can improve with structured insomnia treatment; it is not an on-command superpower.", "supportable_public_claim": "Structured CBT-I can improve insomnia and sleep initiation for many adults in defined treatment settings.", "measurement_boundary": "Sleep diary onset latency, actigraphy and polysomnography differ; insomnia is not diagnosed from one consumer metric.", "myth_to_metric": { "myth": "Fall asleep instantly whenever you choose", "metric": "Sleep-onset latency, insomnia severity, next-day function and adverse effects", "boundary": "A shorter diary estimate does not diagnose or cure insomnia." }, "limiting_findings": [ "In one large 2025 trial, sleep-onset latency was not significant at the adjusted threshold despite insomnia-severity improvement.", "Objective cognitive improvement did not accompany self-reported cognitive improvement in another trial." ], "prohibited_claims": [ "fall asleep on command", "cure insomnia with discipline", "one perfect bedtime", "wearable proves sleep onset" ] }, "gold_source_lesson": null, "next_gate": "External confirmation is required before higher-authority use because: CLINICAL_HIGH_RISK_OR_REGULATED_CONFIGURATION; SUPERVISION_OR_NON_ATTEMPT_BOUNDARY; SAFETY_LEGITIMACY_RESTRICTED.", "evidence_count": 4 }, "full_training_programme": false, "independently_validated": false, "publication_state": "PUBLISHED_PUBLIC_RESEARCH_EDITION__EDITORIAL_REVIEW_PENDING", "related_power_ids": [ "PWR-050", "PWR-051", "PWR-052", "PWR-053" ] }, { "power_id": "PWR-050", "learning_unit_id": "TLU-PWR-050", "title": "Sleep continuity", "main_description": "Across seven nights, Leah uses one insomnia-clinician-set response and reports wake-after-sleep-onset, remembered awakenings, suspected causes, adherence and next-day function without relying on tracker stages.", "main_description_source": "FULL_TUTORIAL_OUTCOME", "family_id": "FAM-07", "family": "Sleep, Circadian & Recovery Regulation", "superdomain": "Regulation & Recovery", "canonical_route": "/powers/pwr-050/", "treatment": "SPECIALIST_PROVIDER_ROUTE", "treatment_label": "Full supervised tutorial", "treatment_boundary": "Titan teaches the complete method; a qualified person controls the parts that require supervision, clearance, specialist equipment, load, dose or progression.", "tutorial_route": "/tutorials/pwr-050/", "governed_lesson_route": null, "self_attempt_status": "PROHIBITED_WITHOUT_QUALIFIED_SUPERVISION", "gold_pathway_ids": [ "G-CUR-004" ], "route_membership": { "kind": "GOLD_PATHWAY", "id": "G-CUR-004", "coverage_status": "EXACT_ONCE" }, "source_authority_tier": "G4", "source_build_state": "EXTERNAL_PROVIDER_ROUTE", "source_instructional_route": "LEARN_ELSEWHERE_TRACK_WITH_TITAN", "source_count": 4, "research_depth": "DETAILED", "risk_level": "MODERATE_TO_HIGH", "prerequisite_status": "QUALIFIED_PROVIDER_DETERMINES", "learning_route": { "mode": "FULL_SUPERVISED_TUTORIAL", "label": "Learn sleep continuity step by step", "summary": "Across seven nights, Leah uses one insomnia-clinician-set response and reports wake-after-sleep-onset, remembered awakenings, suspected causes, adherence and next-day function without relying on tracker stages.", "steps": [ [ "Get ready", "Screen urgent and treatable causes with the provider, including breathing pauses, pain, reflux, urinary symptoms, hot flushes, restless legs, medicine or substance effects." ], [ "Learn the method", "8 concrete steps teach the permitted method from start to finish." ], [ "See right and wrong", "5 comparisons show correct or safer execution beside common wrong or riskier choices." ], [ "Practise", "Complete one sub-row per remembered awakening for seven consecutive nights. At review, retain the route card if it was used safely; the insomnia clinician may change one waking response only after inspecting the trigger clusters. The next comparison is another seven-night ledger with the same WASO arithmetic, not a single ‘better night’ or a stricter self-imposed sleep window." ], [ "Check progress", "For each known awakening interval, subtract start from end and add intervals after first sleep onset but before final awakening: WASO = d1 + … + dn. Keep awakening count separate. For seven nights, sort the known WASO values; with an odd count choose the middle, with an even count average the two middle values. State the known-night range and number of unknown nights, then tabulate trigger × route alongside adherence, daytime sleepiness and function." ] ], "practical_authority": false, "provider_required": true, "next_action_route": "/tutorials/pwr-050/" }, "path_builder": { "selectable": true, "completion_allowed": true, "warning": "Titan teaches the complete method; a qualified person controls the parts that require supervision, clearance, specialist equipment, load, dose or progression." }, "full_tutorial": { "version": "3.0", "authorship": "POWER_SPECIFIC_FULL_TUTORIAL", "tutorial_mode": "SUPERVISED", "promise": "Sleep continuity means how sleep holds together after the first sleep onset. Repeated waking can reflect a brief drowsy transition, an addressable need, alert frustration or a symptom that needs clinical review. This lesson teaches a four-route night-waking card, a morning wake-after-sleep-onset calculation and a seven-night cause pattern; it does not treat every awakening as insomnia or tell the learner to ignore breathing equipment, pain or toileting.", "power_id": "PWR-050", "title": "Sleep continuity", "lesson_type": "SUPERVISED", "headline": "Respond to repeated waking consistently and measure wake after sleep onset", "plain_english_summary": "Sleep continuity means how sleep holds together after the first sleep onset. Repeated waking can reflect a brief drowsy transition, an addressable need, alert frustration or a symptom that needs clinical review. This lesson teaches a four-route night-waking card, a morning wake-after-sleep-onset calculation and a seven-night cause pattern; it does not treat every awakening as insomnia or tell the learner to ignore breathing equipment, pain or toileting.", "outcome": "Across seven nights, Leah uses one insomnia-clinician-set response and reports wake-after-sleep-onset, remembered awakenings, suspected causes, adherence and next-day function without relying on tracker stages.", "authority": { "learner_may": [ "Learn the four-route waking response and complete the clinician-approved seven-night continuity diary.", "Keep prescribed breathing, pain, continence and mobility supports in use and record which named need was addressed.", "Calculate remembered wake after sleep onset each morning and bring uncertain or recurring causes to the insomnia clinician." ], "qualified_person_required_for": [ "Screening repeated waking for sleep-disordered breathing, pain, reflux, urinary, movement, medication, mood or parasomnia causes.", "Selecting any stimulus-control response, time-in-bed window, wake anchor or equipment adjustment.", "Interpreting persistent symptoms and changing positive-airway-pressure equipment, medication or other treatment." ], "never_do": [ "Remove prescribed breathing equipment, delay a needed toilet trip or endure uncontrolled pain to improve a continuity score.", "Change medicine, fluids, light exposure or time in bed from one difficult night.", "Use a wearable sleep stage or diary estimate to diagnose the cause of repeated waking." ] }, "materials": [ "A seven-row continuity ledger. Each night has: first sleep onset; awakening start/end or unknown; suspected trigger; route 1, 2, 3 or 4; aid used; final awakening; known wake-after-sleep-onset sum; unknown interval count; equipment adherence; and next-day sleepiness/function. One awakening occupies one sub-row so duration, trigger and response cannot be merged.", "A four-route card: 1) still drowsy and comfortable → stay quiet with light low; 2) named need such as prescribed mask correction, toileting or approved pain position → address that need safely; 3) clearly alert or frustrated → use the clinician-approved quiet-place response; 4) choking, severe breathing difficulty, chest pain, acute confusion, serious fall or new neurological sign → use urgent/emergency help rather than the behavioural route.", "A provider-agreed wake time and night-waking plan.", "A safe low-light route and quiet activity.", "Environmental aids already used for pain, toileting, hearing, mobility or breathing." ], "before_you_start": [ "Screen urgent and treatable causes with the provider, including breathing pauses, pain, reflux, urinary symptoms, hot flushes, restless legs, medicine or substance effects.", "Do not stop prescribed breathing equipment or change medicine to test continuity.", "Prepare safe lighting and mobility supports for night waking.", "Agree when an awakening needs urgent help rather than the behavioural plan." ], "steps": [ { "title": "Map seven baseline nights", "instruction": "For seven mornings, give every remembered awakening its own ledger sub-row. Enter start/end estimates or unknown, likely trigger, selected route, aid used, final awakening and next-day effect; do not combine three wakings into one total before the causes are recorded.", "reason": "Repeated waking has different causes; a pattern prevents one-size-fits-all advice.", "success_check": "Every night has an entry, including “not remembered”." }, { "title": "Fix the morning anchor", "instruction": "Rise at the insomnia clinician-agreed time and record exceptions even after a fragmented night.", "reason": "A consistent anchor makes night-to-night comparisons interpretable.", "success_check": "Wake and out-of-bed times are distinct diary fields." }, { "title": "Handle brief drowsy waking quietly", "instruction": "If still drowsy and comfortable, keep light low, avoid the clock; allow drowsiness to deepen again without starting a task.", "reason": "Many brief awakenings resolve without added stimulation.", "success_check": "No bright screen, work or repeated time calculation is introduced." }, { "title": "Address the named need safely", "instruction": "Use the agreed aid for pain position, toileting, breathing equipment or environment, then return to that night-waking plan.", "reason": "Ignoring a real need or improvising treatment can prolong waking or cause harm.", "success_check": "The response addresses the documented pain, toileting, breathing-equipment or environmental need and remains inside the existing care plan." }, { "title": "Leave during alert wakefulness", "instruction": "When clearly alert or frustrated, move safely to the quiet place under the insomnia clinician’s cue-based rule.", "reason": "Alert struggle in bed can reinforce wakefulness.", "success_check": "The exit is based on state, not an exact clock-watched minute." }, { "title": "Return at the return-drowsiness cue", "instruction": "Use the prepared low-stimulation activity, then return to bed when sleepiness reappears; repeat if needed.", "reason": "The same response preserves the bedtime association across awakenings.", "success_check": "The activity ends at a return-drowsiness cue; it does not become a long night project." }, { "title": "Complete the morning estimate", "instruction": "For a known interval, subtract its start from end, then add only intervals after first sleep onset and before final awakening. Write WASO = d1 + d2 + … + dn, followed by ‘plus one unknown interval’ when needed; never enter unknown as zero. Count awakenings separately from minutes.", "reason": "A morning estimate is less disruptive than measuring each awakening overnight.", "success_check": "The arithmetic reproduces from the listed intervals and the diary includes uncertainty rather than false minute precision." }, { "title": "Review causes before changing dose", "instruction": "Sort the seven rows by suspected trigger and route before the review: drowsy/comfortable, named need, alert/frustrated or red flag. Calculate median and range from known WASO nights while listing excluded unknown nights; take repeated mask, pain, reflux, urinary or movement clusters to the responsible clinician before altering time in bed, fluids, medication, light or equipment.", "reason": "Behavioural adjustment cannot safely replace assessment of a recurring cause.", "success_check": "Each change has a stated rationale; each change affects only one major feature." } ], "worked_example": { "scenario": "Leah uses prescribed positive-airway-pressure equipment. On ledger Night 1, first sleep onset is 22:50 and final awakening is 06:30.", "walkthrough": [ "Her morning reconstruction has 01:10–01:22, mask leak, route 2 and the already-prescribed reseat; 03:40–03:48, comfortable/drowsy, route 1; and 05:05–05:20, alert/frustrated, route 3 and the approved dim-chair activity.", "The interval durations are 12, 8 and 15 minutes, so Night 1 WASO is 12 + 8 + 15 = 35 minutes and awakening count is 3. She does not turn that count into 35 awakenings or add time before 22:50.", "Night 2 contains one vaguely remembered awakening. Leah writes ‘WASO unknown; one unknown interval’ instead of zero minutes.", "The other known nightly WASO values are 44, 28, 30, 50 and 26 minutes. Sorted with Night 1 they are 26, 28, 30, 35, 44 and 50, giving a known-night median of (30 + 35) / 2 = 32.5 minutes and range 26–50; Night 2 remains visibly excluded.", "The trigger tally shows prescribed-mask corrections on three nights and pain on two. The clinician reviews those clusters, adherence and daytime function before deciding whether the equipment or pain teams, rather than a stronger behavioural rule, should act." ], "result": "Leah can execute each waking route and reproduce the weekly arithmetic. The ledger distinguishes six known WASO nights, one unknown night and recurring equipment/pain clusters; it neither diagnoses those causes nor rewards ignoring them." }, "right_vs_wrong": [ { "situation": "Brief waking", "right": "Keep stimulation low when still drowsy.", "wrong": "Check messages, news and the clock immediately.", "why": "Light and engagement can convert a brief waking into alert time." }, { "situation": "Known cause", "right": "Use the existing care plan for the named need.", "wrong": "Ignore breathing equipment, pain or toileting needs to preserve a score.", "why": "Safety and treatment needs outrank continuity metrics." }, { "situation": "Alert waking", "right": "Leave safely, then return at the return-drowsiness cue under the agreed rule.", "wrong": "Remain in bed angry while calculating minutes.", "why": "Struggle strengthens wakefulness and makes estimates less reliable." }, { "situation": "Record", "right": "Estimate in the morning; mark uncertainty.", "wrong": "Time every awakening with a bright clock.", "why": "Overnight measurement itself can disturb sleep." }, { "situation": "Interpretation", "right": "Review diary, symptoms and daytime function with a provider.", "wrong": "Diagnose the suspected waking cause from a wearable graph.", "why": "Consumer staging does not identify many clinical causes." } ], "common_mistakes": [ { "mistake": "Check messages, news and the clock immediately.", "fix": "Keep stimulation low when still drowsy." }, { "mistake": "Ignore breathing equipment, pain or toileting needs to preserve a score.", "fix": "Use the existing care plan for the named need." }, { "mistake": "Remain in bed angry while calculating minutes.", "fix": "Leave safely, then return at the return-drowsiness cue under the agreed rule." }, { "mistake": "Time every awakening with a bright clock.", "fix": "Estimate in the morning; mark uncertainty." }, { "mistake": "Diagnose the suspected waking cause from a wearable graph.", "fix": "Review diary, symptoms; daytime function with a provider." } ], "practice": { "first_session": [ "The insomnia clinician reviews Leah’s positive-airway-pressure plan, pain and toileting needs, safe night route and fixed morning anchor, then writes the four permitted routes on a bedside card.", "Leah labels seven ledger rows and four awakening sub-rows per night, prepares the dim chair and paper activity, and keeps clock faces out of view.", "With four printed cues she points to route 1 for comfortable drowsiness, route 2 for the prescribed mask reseat, route 3 for alert frustration and route 4 for choking plus severe breathlessness; only the first three continue into the behavioural plan.", "On the morning arithmetic rehearsal she converts 01:10–01:22, 03:40–03:48 and 05:05–05:20 to 12, 8 and 15 minutes and obtains WASO 35 minutes with three awakenings.", "She then practises an uncertainty row: a remembered waking without times becomes ‘unknown interval’, never zero and never an invented estimate.", "After seven actual nights, she sorts trigger/route clusters and brings the known-night median/range, unknown count, equipment adherence and next-day effects to review." ], "repeat_plan": "Complete one sub-row per remembered awakening for seven consecutive nights. At review, retain the route card if it was used safely; the insomnia clinician may change one waking response only after inspecting the trigger clusters. The next comparison is another seven-night ledger with the same WASO arithmetic, not a single ‘better night’ or a stricter self-imposed sleep window.", "progress_when": [ "Likely causes plus responses are recorded, not merged.", "Alert wakefulness is handled consistently without unsafe transfers.", "Wake-after-sleep-onset improves across the seven nights while next-day function remains acceptable." ], "do_not_progress_when": [ "Breathing equipment fails or pauses/choking are reported.", "Night transfers create falls risk or confusion.", "A new clinical symptom, medication change or severe daytime drowsiness appears." ] }, "self_check": [ "Can you demonstrate “Fix the morning anchor”? Wake and out-of-bed times are distinct diary fields.", "Can you demonstrate “Leave during alert wakefulness”? The exit is based on state, not an exact clock-watched minute.", "Can you demonstrate “Review causes before changing dose”? Each change has a stated rationale; each change affects only one major feature." ], "measurement": { "primary": "Seven-night wake-after-sleep-onset, remembered awakenings, suspected waking causes, response adherence and next-day function", "how": "For each known awakening interval, subtract start from end and add intervals after first sleep onset but before final awakening: WASO = d1 + … + dn. Keep awakening count separate. For seven nights, sort the known WASO values; with an odd count choose the middle, with an even count average the two middle values. State the known-night range and number of unknown nights, then tabulate trigger × route alongside adherence, daytime sleepiness and function.", "good_result": "The weekly record shows either improved continuity without worse daytime function or a clear cause requiring appropriate provider action.", "does_not_prove": "A more continuous week does not identify every waking cause, validate consumer sleep-stage labels or authorise independent changes to medication, breathing equipment or time in bed." }, "stop_and_get_help": [ "Seek urgent help for severe breathing difficulty, chest pain, acute confusion, serious fall or neurological symptoms at night.", "Contact the insomnia clinician for witnessed breathing pauses, choking, new parasomnia, worsening pain, repeated falls or dangerous daytime drowsiness.", "Do not drive or do safety-critical work when attention lapses or involuntary sleep appears." ], "accessibility": [ "Adapt stimulus control so a person with limited mobility can change posture/activity safely without an unnecessary transfer.", "Use voice notes or a helper-completed morning diary instead of writing in darkness.", "Keep prescribed breathing, continence, pain and mobility supports available and within reach." ], "evidence_notes": [ { "claim": "Randomised evidence supports structured CBT-I, while continuity outcomes must be interpreted as part of the full intervention.", "source_title": "The Effectiveness of Digital Cognitive Behavioral Therapy to Treat Insomnia Disorder in US Adults: Nationwide Decentralized Randomized Controlled Trial", "source_url": "https://pubmed.ncbi.nlm.nih.gov/41343796/", "source_kind": "PRIMARY_RESEARCH" }, { "claim": "Official sleep-medicine guidance cautions that consumer trackers do not diagnose sleep disorders.", "source_title": "Consumer Sleep Technology: An American Academy of Sleep Medicine Position Statement", "source_url": "https://aasm.org/advocacy/position-statements/consumer-sleep-technology/", "source_kind": "OFFICIAL_GUIDANCE" } ], "limits": [ "Wake after sleep onset, awakening count, sleep efficiency and restorative quality are distinct; consumer stage labels are not diagnostic.", "Unsupported claim: sleep through anything.", "Unsupported claim: eliminate every awakening.", "Unsupported claim: tracker sleep score equals restorative sleep.", "A diary-guided response does not diagnose the cause of waking or authorise stopping prescribed treatment." ], "orientation": { "bounded_definition": "Capability to develop or express sleep continuity in a declared context without inheriting broader claims.", "evidence_summary": "Sleep continuity can improve, especially through structured insomnia care, but repeated waking has many causes.", "supportable_public_claim": "Structured insomnia treatment can improve sleep continuity in diagnosed adults.", "measurement_boundary": "Wake after sleep onset, awakening count, sleep efficiency and restorative quality are distinct; consumer stage labels are not diagnostic.", "myth_to_metric": { "myth": "Train yourself never to wake", "metric": "Validated wake-after-sleep-onset, sleep efficiency, symptoms and daytime function", "boundary": "Fewer detected awakenings do not prove restorative or safe sleep." }, "limiting_findings": [ "Consumer trackers vary against polysomnography and cannot diagnose causes.", "Objective cognitive benefit can remain absent despite subjective improvement." ], "prohibited_claims": [ "sleep through anything", "eliminate every awakening", "tracker sleep score equals restorative sleep", "fix fragmented sleep without assessment" ] }, "gold_source_lesson": null, "next_gate": "External confirmation is required before higher-authority use because: CLINICAL_HIGH_RISK_OR_REGULATED_CONFIGURATION; SUPERVISION_OR_NON_ATTEMPT_BOUNDARY; SAFETY_LEGITIMACY_RESTRICTED.", "evidence_count": 4 }, "full_training_programme": false, "independently_validated": false, "publication_state": "PUBLISHED_PUBLIC_RESEARCH_EDITION__EDITORIAL_REVIEW_PENDING", "related_power_ids": [ "PWR-049", "PWR-051", "PWR-052", "PWR-053" ] }, { "power_id": "PWR-051", "learning_unit_id": "TLU-PWR-051", "title": "Circadian phase alignment", "main_description": "The learner completes a 14-day timing record and follows a provider-set light and wake schedule with adherence, sleep timing and daytime function measured.", "main_description_source": "FULL_TUTORIAL_OUTCOME", "family_id": "FAM-07", "family": "Sleep, Circadian & Recovery Regulation", "superdomain": "Regulation & Recovery", "canonical_route": "/powers/pwr-051/", "treatment": "SPECIALIST_PROVIDER_ROUTE", "treatment_label": "Full supervised tutorial", "treatment_boundary": "Titan teaches the complete method; a qualified person controls the parts that require supervision, clearance, specialist equipment, load, dose or progression.", "tutorial_route": "/tutorials/pwr-051/", "governed_lesson_route": null, "self_attempt_status": "PROHIBITED_WITHOUT_QUALIFIED_SUPERVISION", "gold_pathway_ids": [ "G-CUR-004" ], "route_membership": { "kind": "GOLD_PATHWAY", "id": "G-CUR-004", "coverage_status": "EXACT_ONCE" }, "source_authority_tier": "G4", "source_build_state": "EXTERNAL_PROVIDER_ROUTE", "source_instructional_route": "LEARN_ELSEWHERE_TRACK_WITH_TITAN", "source_count": 3, "research_depth": "FOCUSED", "risk_level": "MODERATE_TO_HIGH", "prerequisite_status": "QUALIFIED_PROVIDER_DETERMINES", "learning_route": { "mode": "FULL_SUPERVISED_TUTORIAL", "label": "Learn circadian phase alignment step by step", "summary": "The learner completes a 14-day timing record and follows a provider-set light and wake schedule with adherence, sleep timing and daytime function measured.", "steps": [ [ "Get ready", "A qualified provider determines whether the goal is to advance earlier or delay later and screens bipolar disorder, eye disease, photosensitivity, migraine, medications and shift-work constraints." ], [ "Learn the method", "8 concrete steps teach the permitted method from start to finish." ], [ "See right and wrong", "5 comparisons show correct or safer execution beside common wrong or riskier choices." ], [ "Practise", "Follow the prescribed daily timing until review, commonly over one to two weeks. Change only the provider-named cue or increment. Objective phase testing and medication decisions remain clinical." ], [ "Check progress", "Plot daily sleep midpoint and final wake relative to the target; add adherence to each light window, sleepiness, mood and function. Treat device sleep estimates as supportive only." ] ], "practical_authority": false, "provider_required": true, "next_action_route": "/tutorials/pwr-051/" }, "path_builder": { "selectable": true, "completion_allowed": true, "warning": "Titan teaches the complete method; a qualified person controls the parts that require supervision, clearance, specialist equipment, load, dose or progression." }, "full_tutorial": { "version": "3.0", "authorship": "POWER_SPECIFIC_FULL_TUTORIAL", "tutorial_mode": "SUPERVISED", "promise": "Circadian timing can shift, but direction and benefit depend on when, for whom and toward what schedule. Circadian alignment requires a target schedule and correct timing. The learner first maps sleep, light and activity, then follows a provider-selected phase-advance or phase-delay plan. Light at the wrong biological time can move the clock the wrong way; medication and melatonin remain clinician-controlled.", "power_id": "PWR-051", "title": "Circadian phase alignment", "lesson_type": "SUPERVISED", "headline": "Move sleep timing by placing light and daily anchors on the correct side of the clock", "plain_english_summary": "Circadian timing can shift, but direction and benefit depend on when, for whom and toward what schedule. Circadian alignment requires a target schedule and correct timing. The learner first maps sleep, light and activity, then follows a provider-selected phase-advance or phase-delay plan. Light at the wrong biological time can move the clock the wrong way; medication and melatonin remain clinician-controlled.", "outcome": "The learner completes a 14-day timing record and follows a provider-set light and wake schedule with adherence, sleep timing and daytime function measured.", "authority": { "learner_may": [ "Complete the 14-day sleep/light/activity diary, write the earlier-or-later target and rehearse one provider-written day of cue timing.", "Use the approved wake anchor, light window, light-avoidance window, activity/meal anchors and increment exactly as written.", "Record adherence, sleep timing, mood, headache, eye symptoms, sleepiness and work/school function each day." ], "qualified_person_required_for": [ "Determining advance versus delay and screening bipolar disorder, eye disease, photosensitivity, migraine, medication and shift-work constraints.", "Selecting light timing, intensity, distance, duration, avoidance window, schedule increment and whether an objective phase marker is needed.", "Starting or retiming melatonin/medicine and interpreting persistent non-shift, mood change, eye symptoms or dangerous sleepiness." ], "never_do": [ "Improvise high-intensity light, stare into a lamp, reverse the prescribed window or use an all-nighter to force a shift.", "Start, stop or retime melatonin, sedatives, stimulants or other medicine from the diary alone.", "Keep advancing/delaying through mood elevation, sharply reduced sleep need, eye pain, visual change, severe headache or unsafe daytime function." ] }, "materials": [ "A 14-day sleep, light, activity and symptom diary.", "The target sleep and wake schedule tied to work, school or care needs.", "A provider-approved light source, outdoor-light plan or light-avoidance aid.", "A clock and alarms accessible to the learner." ], "before_you_start": [ "A qualified provider determines whether the goal is to advance earlier or delay later and screens bipolar disorder, eye disease, photosensitivity, migraine, medications and shift-work constraints.", "Do not buy or improvise high-intensity light exposure without a plan for intensity, distance and duration.", "Do not start or retime melatonin or sedating/stimulating medicine from this lesson.", "Agree stop rules for mood elevation, eye symptoms, severe headache, worsening sleepiness or unsafe function." ], "steps": [ { "title": "Name the target phase", "instruction": "Write the required sleep and wake times and whether the current pattern needs to move earlier or later.", "reason": "“Better sleep” is not a timing direction.", "success_check": "The plan shows a clock-time target and direction." }, { "title": "Map fourteen days", "instruction": "Record sleep attempt, estimated sleep, final wake, naps, outdoor/bright light, exercise, meals, work and symptoms.", "reason": "Timing patterns and social constraints must be visible before intervention.", "success_check": "At least fourteen dated days use the same fields." }, { "title": "Select the phase cue with the provider", "instruction": "The provider chooses the timing, intensity, distance and duration of light or light avoidance, using clinical phase information when needed.", "reason": "The same light can advance or delay the circadian clock depending on timing.", "success_check": "The prescription states when, how bright, how close and how long." }, { "title": "Anchor the wake period", "instruction": "Rise within the agreed window and use the provider-selected light, activity and meal anchors in the planned order.", "reason": "A stable cluster of morning or evening cues strengthens the intended schedule.", "success_check": "The diary shows whether each anchor occurred in its window." }, { "title": "Block the opposite cue", "instruction": "Use the agreed dim-light or light-avoidance step at the time that would oppose the intended shift.", "reason": "Unplanned bright light can cancel or reverse the desired movement.", "success_check": "The learner can name which light window is being protected and why." }, { "title": "Shift in provider-set increments", "instruction": "Move schedule cues only by the amount and frequency in the written plan; keep naps inside the agreed rule.", "reason": "Large jumps can worsen sleep loss and adherence.", "success_check": "No unscheduled jump or all-nighter is used." }, { "title": "Record response and adverse effects", "instruction": "Each day record sleep timing, sleepiness, mood, headache, eye symptoms and real-world function.", "reason": "Clock change is not worthwhile if safety, mood or function worsens.", "success_check": "The response record includes both timing and burden." }, { "title": "Review and verify", "instruction": "After the set interval, the provider compares the diary with the target and decides whether objective phase testing or plan adjustment is needed.", "reason": "Sleep time is an imperfect proxy for internal circadian phase.", "success_check": "The conclusion says aligned, partly shifted, unchanged or unsafe—not “clock reset”." } ], "worked_example": { "scenario": "Sam’s sleep is consistently 02:30–10:30, but a new class requires a 07:30 wake. A sleep clinician plans a gradual advance.", "walkthrough": [ "Sam records fourteen baseline days of sleep, morning light, evening screens, meals and mood.", "The clinician sets a 07:30 wake anchor, prescribed morning light window and earlier dim-light period.", "Sam changes cues only by the written increment and does not use an all-nighter.", "Daily records show wake time, adherence, headache, sleepiness and class function.", "At review, the clinician sees a partial earlier shift without mood symptoms and sets the next increment." ], "result": "The plan moves timing toward a declared schedule under supervision. It does not prove a measured biological phase without an appropriate phase marker." }, "right_vs_wrong": [ { "situation": "Direction", "right": "Write “advance earlier” or “delay later” before placing light.", "wrong": "Use bright light whenever convenient.", "why": "Timing determines the direction of circadian effect." }, { "situation": "Dose", "right": "Follow specified intensity, distance, duration and clock window.", "wrong": "Sit close to an unverified lamp for longer to accelerate change.", "why": "Uncontrolled light can cause symptoms and an unintended phase shift." }, { "situation": "Schedule change", "right": "Use gradual provider-set increments.", "wrong": "Use an all-nighter or abrupt multi-hour jump.", "why": "Abrupt sleep loss adds impairment and obscures the phase response." }, { "situation": "Medication", "right": "Discuss melatonin and medicines with a clinician.", "wrong": "Self-select dose and timing from a generic chart.", "why": "Timing, interaction and contraindication matter." }, { "situation": "Outcome", "right": "Measure target timing plus mood, sleepiness and function.", "wrong": "Call an earlier bedtime proof of circadian alignment.", "why": "Behavioural timing is not identical to internal phase." } ], "common_mistakes": [ { "mistake": "Use bright light whenever convenient.", "fix": "Write “advance earlier” or “delay later” before placing light." }, { "mistake": "Sit close to an unverified lamp for longer to accelerate change.", "fix": "Follow specified intensity, distance, duration and clock window." }, { "mistake": "Use an all-nighter or abrupt multi-hour jump.", "fix": "Use gradual provider-set increments." }, { "mistake": "Self-select dose and timing from a generic chart.", "fix": "Discuss melatonin and medicines with a clinician." }, { "mistake": "Call an earlier bedtime proof of circadian alignment.", "fix": "Measure target timing plus mood, sleepiness and function." } ], "practice": { "first_session": [ "Sam and the sleep clinician plot 14 baseline days showing the 02:30–10:30 pattern against the required 07:30 class-day wake time and label the goal ‘advance earlier’.", "They copy onto one timing card: 07:30 wake anchor; provider-written light start/end, intensity, distance and duration; dim-light start; activity/meal anchors; schedule increment; review date; and symptom stops.", "Using a clock-face sheet, Sam points through wake, approved light, activity/meal anchors and opposite-light avoidance in order and explains which window supports the advance.", "Sam begins only the first written increment and records actual sleep, light-window adherence, mood, headache, eye symptoms, sleepiness and class function the next day.", "The same card is followed daily until the scheduled review; no further increment, light-dose change or medication timing change is made independently." ], "repeat_plan": "Follow the prescribed daily timing until review, commonly over one to two weeks. Change only the provider-named cue or increment. Objective phase testing and medication decisions remain clinical.", "progress_when": [ "Wake and light anchors are followed consistently.", "Sleep timing moves toward the declared target without accumulating dangerous sleep loss.", "Mood, eye comfort, headache and daytime function remain acceptable." ], "do_not_progress_when": [ "Mood becomes unusually elevated, agitated or sleepless.", "Eye pain, visual symptoms, severe headache or photosensitive symptoms occur.", "The schedule creates drowsy driving, work risk or worsening impairment." ] }, "self_check": [ "Can you demonstrate “Map fourteen days”? At least fourteen dated days use the same fields.", "Can you demonstrate “Block the opposite cue”? The learner can name which light window is being protected and why.", "Can you demonstrate “Review and verify”? The conclusion says aligned, partly shifted, unchanged or unsafe—not “clock reset”." ], "measurement": { "primary": "Change in verified circadian phase plus sleep and real-world function relative to a declared target", "how": "Plot daily sleep midpoint and final wake relative to the target; add adherence to each light window, sleepiness, mood and function. Treat device sleep estimates as supportive only.", "good_result": "Timing approaches the target across at least one week and daytime function is maintained; the provider confirms the plan remains appropriate.", "does_not_prove": "Clock time, chronotype questionnaires, actigraphy and DLMO are not interchangeable; phase alignment requires a declared target schedule." }, "stop_and_get_help": [ "Stop light exposure and contact the provider for eye pain, visual change, severe headache, agitation, mood elevation or sharply reduced need for sleep.", "Do not drive or do hazardous work when the schedule change causes involuntary sleep or attention lapses.", "Seek clinical reassessment when timing does not shift, symptoms worsen or a medicine/health change alters the plan." ], "accessibility": [ "Use an approved light source and distance compatible with visual, mobility and sensory needs.", "Provide audio alarms and a supporter-assisted cue sequence when time tracking is difficult.", "Adapt work, meal and activity anchors to caregiving, disability and cultural routines rather than assuming one schedule." ], "evidence_notes": [ { "claim": "Primary research shows that phase shifts from a timed cue can vary with chronotype, supporting person- and timing-specific plans.", "source_title": "Circadian rhythm phase shifts caused by timed exercise vary with chronotype", "source_url": "https://pubmed.ncbi.nlm.nih.gov/31895695/", "source_kind": "PRIMARY_RESEARCH" }, { "claim": "Official guidance limits consumer sleep trackers as substitutes for clinical phase assessment.", "source_title": "Consumer Sleep Technology: An American Academy of Sleep Medicine Position Statement", "source_url": "https://aasm.org/advocacy/position-statements/consumer-sleep-technology/", "source_kind": "OFFICIAL_GUIDANCE" } ], "limits": [ "Clock time, chronotype questionnaires, actigraphy and DLMO are not interchangeable; phase alignment requires a declared target schedule.", "Unsupported claim: reset your body clock instantly.", "Unsupported claim: one timing works for everyone.", "Unsupported claim: morning exercise fixes every circadian problem.", "Following a clock schedule does not prove measured circadian phase, and the lesson does not prescribe light therapy or melatonin independently." ], "orientation": { "bounded_definition": "Capability to develop or express circadian phase alignment in a declared context without inheriting broader claims.", "evidence_summary": "Circadian timing can shift, but direction and benefit depend on when, for whom and toward what schedule.", "supportable_public_claim": "Circadian phase is modifiable by timed cues, and response depends on internal phase and chronotype.", "measurement_boundary": "Clock time, chronotype questionnaires, actigraphy and DLMO are not interchangeable; phase alignment requires a declared target schedule.", "myth_to_metric": { "myth": "Reset your body clock in one move", "metric": "Change in verified circadian phase plus sleep and real-world function relative to a declared target", "boundary": "A clock-time routine or wearable estimate does not prove internal phase or benefit." }, "limiting_findings": [ "Evening exercise advanced later chronotypes but delayed earlier chronotypes in the cited study.", "No delayed retention or functional benefit followed from the phase-marker result alone." ], "prohibited_claims": [ "reset your body clock instantly", "one timing works for everyone", "morning exercise fixes every circadian problem", "wearable knows your circadian phase" ] }, "gold_source_lesson": null, "next_gate": "External confirmation is required before higher-authority use because: CLINICAL_HIGH_RISK_OR_REGULATED_CONFIGURATION; SUPERVISION_OR_NON_ATTEMPT_BOUNDARY; SAFETY_LEGITIMACY_RESTRICTED.", "evidence_count": 3 }, "full_training_programme": false, "independently_validated": false, "publication_state": "PUBLISHED_PUBLIC_RESEARCH_EDITION__EDITORIAL_REVIEW_PENDING", "related_power_ids": [ "PWR-049", "PWR-050", "PWR-052", "PWR-053" ] }, { "power_id": "PWR-052", "learning_unit_id": "TLU-PWR-052", "title": "Nap efficiency", "main_description": "This tutorial teaches how to read a completed fictional nap-or-quiet-rest record. You will check the safety gate, reconstruct what was actually done, separate immediate change from grogginess and later sleep cost, and choose a cautious next-step label. You will not take a nap, change a sleep schedule, test alertness for driving or copy a duration. The lesson is a record-analysis and decision-safety method only.", "main_description_source": "GOVERNED_TUTORIAL_PLAIN_ENGLISH_INTRO", "family_id": "FAM-07", "family": "Sleep, Circadian & Recovery Regulation", "superdomain": "Regulation & Recovery", "canonical_route": "/powers/pwr-052/", "treatment": "RESEARCH_EXPLORATION_ROUTE", "treatment_label": "Full research tutorial", "treatment_boundary": "Titan teaches a complete Power-specific research method because operational capability practice is not currently justified.", "tutorial_route": "/tutorials/pwr-052/", "governed_lesson_route": "/tutorials/pwr-052/", "self_attempt_status": "NO_TRAINING_AUTHORITY", "gold_pathway_ids": [ "G-CUR-004" ], "route_membership": { "kind": "GOLD_PATHWAY", "id": "G-CUR-004", "coverage_status": "EXACT_ONCE" }, "source_authority_tier": "G2", "source_build_state": "RESEARCH_ONLY", "source_instructional_route": "EXPLAINER_ONLY_RESEARCH", "source_count": 2, "research_depth": "FOCUSED", "risk_level": "MODERATE", "prerequisite_status": "NONE_FOR_READING__NO_PRACTICE_AUTHORITY", "learning_route": { "mode": "RESEARCH_EXPLORATION", "label": "Explore the research frontier", "summary": "This tutorial teaches how to read a completed fictional nap-or-quiet-rest record. You will check the safety gate, reconstruct what was actually done, separate immediate change from grogginess and later sleep cost, and choose a cautious next-step label. You will not take a nap, change a sleep schedule, test alertness for driving or copy a duration. The lesson is a record-analysis and decision-safety method only.", "steps": [ [ "Frame the question", "State the capability claim narrowly enough that evidence could support or limit it." ], [ "Map the evidence", "Distinguish existence, measurement, trainability, retention, transfer, safety and functional value." ], [ "Find uncertainty", "Identify small samples, proxy measures, missing controls, null findings and unresolved authority questions." ], [ "Compare alternatives", "Consider competing explanations and what evidence would change the current treatment." ], [ "Stay non-operational", "Use the record for research literacy only until a separate gate authorises instruction." ] ], "practical_authority": false, "provider_required": false, "next_action_route": "/tutorials/pwr-052/" }, "path_builder": { "selectable": true, "completion_allowed": true, "warning": "Titan teaches a complete Power-specific research method because operational capability practice is not currently justified." }, "full_tutorial": { "version": "1.0", "authorship": "AUTHORED_GOVERNED_SOURCE", "practice_pack": { "power_id": "PWR-052", "title": "Nap efficiency", "heading": "Audit a fictional nap-or-rest record and make a safe next-step decision", "plain_english_intro": "This tutorial teaches how to read a completed fictional nap-or-quiet-rest record. You will check the safety gate, reconstruct what was actually done, separate immediate change from grogginess and later sleep cost, and choose a cautious next-step label. You will not take a nap, change a sleep schedule, test alertness for driving or copy a duration. The lesson is a record-analysis and decision-safety method only.", "authority_and_safety": [ "Governance ceiling: explanation and static fictional record analysis only. Capability self-practice, live administration, protocol delivery and efficacy claims are not authorised until the recorded next_gate adjudication changes.", "Use only the supplied fictional sleep/rest records. Do not nap, schedule rest, change sleep, take a substance or copy any recorded duration.", "A benign task cannot clear driving or hazardous work; dangerous sleepiness or concerning sleep/mood features require an appropriate safe or qualified route." ], "materials": [ "The three completed fictional records below", "A four-column audit sheet: safety gate, configuration, immediate result, later cost", "The decision labels STOP AND MAKE SAFE, INSUFFICIENT RECORD, BOUNDED REVIEW and SEEK QUALIFIED ASSESSMENT", "The staged answer key, kept closed until every decision and reason is written" ], "setup_steps": [ "Write STATIC RECORD ANALYSIS ONLY at the top of the sheet. Do not plan or perform sleep, rest or alertness testing.", "Read the safety context first. Mark STOP AND MAKE SAFE when the record includes dangerous sleepiness, an approaching safety-critical duty or a conflicting clinical plan.", "Reconstruct the configuration exactly: nap or quiet rest, time in bed, estimated sleep if known, end cue, prior sleep opportunity and any support. Write UNKNOWN instead of guessing.", "Keep time in bed separate from estimated sleep. The two values are not interchangeable.", "Separate the immediate record into task change, burden, grogginess and time until ordinary alertness. One better task score does not erase grogginess.", "Read the later record separately: bedtime, sleep onset, nighttime sleep, mood, symptoms and next-day function. Do not merge immediate and later outcomes into one score.", "Choose one decision label and cite the exact facts that support it. BOUNDED REVIEW means the fictional record is coherent enough for qualified review; it is not permission to repeat the nap.", "Finish with two non-claims: no universal duration and no clearance for driving, treatment or schedule change." ], "fixture": { "caption": "Completed fictional sleep/rest records. Analyse them; do not reproduce any configuration.", "headers": [ "Case", "Safety context", "Recorded configuration", "Immediate record", "Later record" ], "rows": [ [ "N1", "Severe sleepiness; planned motorway drive in 45 minutes; no alternative transport recorded", "A nap was being considered, but no interval or end cue was selected", "No result", "No result" ], [ "N2", "No safety-critical duty; no conflicting plan recorded", "Quiet rest; 20 minutes in a chair; alarm used; no sleep reported", "Symbol check 7/10 before and 8/10 after; burden 5/10 to 3/10; no grogginess", "Usual bedtime and sleep onset; no new symptom recorded" ], [ "N3", "No safety-critical duty; existing clinician-agreed nap plan noted", "27 minutes in bed; estimated 18 minutes asleep; two end cues", "Symbol check 7/10 before and 8/10 after; grogginess 7/10; ordinary alertness returned after 34 minutes", "Sleep onset was 75 minutes later than the person's recorded usual time; no other cause established" ] ] }, "scoring_rule": "For each case award 1 point for the safety decision, 1 for preserving the exact configuration, 1 for separating immediate benefit from grogginess, 1 for separating later cost, and 1 for a bounded non-claim: 15 points total. Passing requires N1 stopped, N3 not labelled an uncomplicated success, and no duration or driving recommendation. This scores record analysis, not a person's sleep.", "worked_example": { "steps": [ "Read N3's authority field first: the interval came from an existing clinician-agreed plan, not from this tutorial.", "Write the configuration as 27 minutes in bed and an estimated 18 minutes asleep. Do not call them the same duration.", "Record the immediate changes separately: one additional symbol correct, burden not supplied, grogginess 7/10 and 34 minutes until ordinary alertness.", "Record the later observation separately: sleep onset was 75 minutes later than the fictional usual value, with causation unresolved.", "Choose PAUSE/QUALIFIED REVIEW and write that neither the immediate change nor the later observation proves a general nap effect." ], "result": "N3 is a coherent but mixed fictional record. The correct method preserves the plan source, grogginess, recovery time and later cost; it does not tell anyone to reproduce the interval." }, "right_vs_wrong": [ { "situation": "Reading a duration", "right": "Call it a historical value in this fictional configuration.", "wrong": "Copy 20 or 27 minutes as the correct nap length.", "why": "The dataset supplies no universal dose or personal recommendation." }, { "situation": "Safety-critical duty", "right": "Stop the analysis path and choose a safe alternative for the fictional duty.", "wrong": "Use a symbol score to decide whether driving is safe.", "why": "A benign task cannot provide safety clearance." }, { "situation": "Waking", "right": "Keep grogginess and recovery time visible beside task change.", "wrong": "Report only the improved task item.", "why": "Selective reporting hides an immediate cost." }, { "situation": "Later sleep", "right": "Record later onset as an observation with causation unresolved.", "wrong": "Declare that the nap caused insomnia from one row.", "why": "A single uncontrolled record cannot establish cause." }, { "situation": "Authority", "right": "Limit the output to a record-audit decision.", "wrong": "Turn the record into a personal sleep schedule.", "why": "Guide permission is not ready." } ], "common_mistakes": [ { "mistake": "Time in bed is copied into the estimated-sleep field.", "fix": "Keep both values and write UNKNOWN when sleep is uncertain." }, { "mistake": "A better immediate score is called successful recovery.", "fix": "Report task, burden, grogginess, recovery time and later effects separately." }, { "mistake": "The fictional interval becomes advice.", "fix": "Label every duration descriptive-only and make no reproduction instruction." }, { "mistake": "A dangerous-duty record continues to scoring.", "fix": "Stop at the safety gate and record the safe-alternative requirement." } ], "answer_key_route": "/tutorials/pwr-052/answer-key/", "answer_key_delivery": "SEPARATE_NOINDEX_NOARCHIVE_CHECKING_PAGE" }, "tutorial_mode": "RESEARCH_EXPLORATION", "orientation": { "bounded_definition": "Capability to develop or express nap efficiency in a declared context without inheriting broader claims.", "evidence_summary": "Naps can help some outcomes for a few hours, but there is no universal perfect nap.", "measurement_boundary": "Sleep achieved, timing, prior sleep, inertia, vigilance and the target task must all be measured; planned time in bed is not nap sleep.", "myth_to_metric": { "myth": "Take the perfect power nap and fully recharge", "metric": "Polysomnographic sleep, post-wake inertia, vigilance and target-task performance", "boundary": "Feeling better does not certify safe or fully restored performance." }, "limiting_findings": [ "Processing speed did not improve and only one tested nap condition improved memory encoding.", "Longer naps produced short-lived sleep inertia." ], "prohibited_claims": [ "perfect power nap", "ten minutes restores every brain", "nap instead of sleep", "nap makes fatigued driving safe" ] }, "outcomes": [ "Define nap efficiency without inheriting mythology or broader claims.", "Explain what the current evidence supports and what it does not establish.", "Use the declared measurement boundary and recognise misleading proxies.", "Complete the current learning route without converting it into unauthorised capability practice.", "Make a retention, transfer, maintenance, provider or stop decision without overclaiming." ], "prerequisites": "NONE_FOR_READING__NO_PRACTICE_AUTHORITY", "baseline": { "instruction": "Before reading the sequence, record your current definition, confidence, assumed measure, expected value, known risks and intended next action. Do not attempt the capability.", "record": [ "date and context", "current definition", "confidence from 0 to 100", "assumed measure", "expected benefit", "known limitation", "intended next action" ] }, "modules": [ { "order": 1, "title": "Frame the question", "instruction": "State the capability claim narrowly enough that evidence could support or limit it.", "completion_evidence": "Record the decision or output from frame the question in one or two sentences." }, { "order": 2, "title": "Map the evidence", "instruction": "Distinguish existence, measurement, trainability, retention, transfer, safety and functional value.", "completion_evidence": "Record the decision or output from map the evidence in one or two sentences." }, { "order": 3, "title": "Find uncertainty", "instruction": "Identify small samples, proxy measures, missing controls, null findings and unresolved authority questions.", "completion_evidence": "Record the decision or output from find uncertainty in one or two sentences." }, { "order": 4, "title": "Compare alternatives", "instruction": "Consider competing explanations and what evidence would change the current treatment.", "completion_evidence": "Record the decision or output from compare alternatives in one or two sentences." }, { "order": 5, "title": "Stay non-operational", "instruction": "Use the record for research literacy only until a separate gate authorises instruction.", "completion_evidence": "Record the decision or output from stay non-operational in one or two sentences." } ], "lab": { "title": "Claim-audit lab", "instruction": "Choose one public claim about this Power. Compare it with the bounded definition, measurement limit, supporting evidence, limiting findings and prohibited wording.", "deliverable": "A one-page claim verdict: supported, partly supported, unresolved or contradicted, with the reason stated." }, "assessment": { "immediate": "Restate the bounded definition, evidence ceiling, measurement boundary and current authority route without looking.", "delayed_retention": "Repeat the explanation and route decision after at least 48 hours; record what changed or was forgotten.", "transfer": "Evaluate a new claim, provider option or research result using the same evidence and authority checklist; do not perform the capability.", "interpretation": "Completion demonstrates learning of this tutorial only. It does not prove capability, qualification, independent validation, safety clearance or far transfer." }, "maintenance": { "cadence": "Review after 48 hours, again after 2-4 weeks, and whenever the evidence or authority treatment changes.", "decisions": [ "retain", "refresh", "seek qualified support", "return to research", "retire" ] }, "accessibility": "Use text-to-speech, enlarged text, keyboard navigation, shorter sessions, a support person or an equivalent non-practical record format as needed. Accessibility changes must not enlarge practical authority.", "stopping_and_escalation": "Titan teaches a complete Power-specific research method because operational capability practice is not currently justified. Stop if the declared configuration cannot be maintained, uncertainty becomes material, adverse effects appear, or qualified authority is required.", "next_gate": "No external confirmation is required for the current bounded explainer permission. Guide permission remains NOT_READY; any guide, stronger efficacy, generalisation, protocol, promotion or independent-validation claim requires a new adjudication.", "evidence_count": 2 }, "full_training_programme": false, "independently_validated": false, "publication_state": "PUBLISHED_PUBLIC_RESEARCH_EDITION__EDITORIAL_REVIEW_PENDING", "related_power_ids": [ "PWR-049", "PWR-050", "PWR-051", "PWR-053" ] }, { "power_id": "PWR-053", "learning_unit_id": "TLU-PWR-053", "title": "Function under partial sleep loss", "main_description": "For Cards A, B and C, a learner builds an accurate three-column duty matrix, names one failure consequence per action, assigns supplied rested checker or replacement, preserves alert ride plus recovery block, and activates a prewritten transfer when each scenario reveals its error cue. Nobody reproduces fictional short sleep.", "main_description_source": "FULL_TUTORIAL_OUTCOME", "family_id": "FAM-07", "family": "Sleep, Circadian & Recovery Regulation", "superdomain": "Regulation & Recovery", "canonical_route": "/powers/pwr-053/", "treatment": "RESTRICTED_EXPLAINER_ONLY", "treatment_label": "Full safety and decision tutorial", "treatment_boundary": "Titan teaches recognition, prevention, safe response and accountable routing without teaching the prohibited act.", "tutorial_route": "/tutorials/pwr-053/", "governed_lesson_route": null, "self_attempt_status": "PROHIBITED_ACT_EXCLUDED", "gold_pathway_ids": [ "G-CUR-004" ], "route_membership": { "kind": "GOLD_PATHWAY", "id": "G-CUR-004", "coverage_status": "EXACT_ONCE" }, "source_authority_tier": "G6", "source_build_state": "RESTRICTED", "source_instructional_route": "EXPLAINER_ONLY_RESTRICTED", "source_count": 6, "research_depth": "DEEP", "risk_level": "HIGH", "prerequisite_status": "NONE_FOR_READING__NO_PRACTICE_AUTHORITY", "learning_route": { "mode": "FULL_RESTRICTED_TUTORIAL", "label": "Learn function under partial sleep loss step by step", "summary": "For Cards A, B and C, a learner builds an accurate three-column duty matrix, names one failure consequence per action, assigns supplied rested checker or replacement, preserves alert ride plus recovery block, and activates a prewritten transfer when each scenario reveals its error cue. Nobody reproduces fictional short sleep.", "steps": [ [ "Get ready", "Use Cards A–C as paper simulations while rested; do not recreate their two-night sleep ledgers." ], [ "Learn the method", "9 concrete steps teach the permitted method from start to finish." ], [ "See right and wrong", "6 comparisons show correct or safer execution beside common wrong or riskier choices." ], [ "Practise", "Complete A, B and C as three rested paper sessions. For quarterly refreshers or a real roster change, write a new three-action card with one reversible, one independently checked and one pre-reassigned action, then have the responsible workplace role verify the classifications. Difficulty grows through less obvious consequences, never through less sleep or later transfer." ], [ "Check progress", "For each rested card, calculate classification mismatches = number of action rows whose R/I/X differs from the folded key (possible 0–3). Calculate control omissions by counting blank checker/operator, verification source, acceptance time, review, ride or restoration fields. After revealing the cue, mark an activation defect if last verified item or unfinished item is absent, an I release proceeds unchecked, an X action returns to the character, or restoration changes. Preserve raw defect labels and corrections; produce no alertness, deprivation-duration or fitness score." ] ], "practical_authority": false, "provider_required": false, "next_action_route": "/tutorials/pwr-053/" }, "path_builder": { "selectable": true, "completion_allowed": true, "warning": "Titan teaches recognition, prevention, safe response and accountable routing without teaching the prohibited act." }, "full_tutorial": { "version": "3.0", "authorship": "POWER_SPECIFIC_FULL_TUTORIAL", "tutorial_mode": "RESTRICTED", "promise": "Partial sleep loss becomes a planning constraint, never an endurance contest. While fully rested, a learner copies a fictional two-night sleep ledger, decomposes upcoming duty into concrete actions and asks what one missed step could do. Reversible paperwork stays visible; a consequential calculation receives independent rested verification; vehicle or machinery control moves to a rested operator before simulated roster start. Checker, review time, replacement, ride and restoration block are booked on paper. A later cue tests activation of those controls; no short-sleep worker pushes through.", "power_id": "PWR-053", "title": "Function under partial sleep loss", "lesson_type": "RESTRICTED", "headline": "Redesign a known short-rest roster before its irreversible tasks begin", "plain_english_summary": "Partial sleep loss becomes a planning constraint, never an endurance contest. While fully rested, a learner copies a fictional two-night sleep ledger, decomposes upcoming duty into concrete actions and asks what one missed step could do. Reversible paperwork stays visible; a consequential calculation receives independent rested verification; vehicle or machinery control moves to a rested operator before simulated roster start. Checker, review time, replacement, ride and restoration block are booked on paper. A later cue tests activation of those controls; no short-sleep worker pushes through.", "outcome": "For Cards A, B and C, a learner builds an accurate three-column duty matrix, names one failure consequence per action, assigns supplied rested checker or replacement, preserves alert ride plus recovery block, and activates a prewritten transfer when each scenario reveals its error cue. Nobody reproduces fictional short sleep.", "authority": { "learner_may": [ "While adequately rested, turn each supplied fictional roster into reversible, independently checked and pre-reassigned actions.", "Fill the supplied names and times for checker, review, replacement, ride and restoration, then rehearse the written change request.", "Use a real employer fatigue-reporting channel to disclose a known short-rest schedule and request controls; the worksheet itself never grants fitness for duty." ], "qualified_person_required_for": [ "Actual roster design, fitness-for-duty decisions and approval of safety-critical task reassignment.", "Medical assessment when impairment is disproportionate, persistent, recurrent or unexplained by the declared short-sleep schedule.", "Medication, stimulant, sleep-treatment or occupational-health decisions." ], "never_do": [ "Copy the cards' sleep schedules into real life, extend a shift or create fatigue to see whether the worksheet works.", "Put an irreversible action into the self-check column or choose a second checker who shares the curtailed-rest exposure.", "Restore a reassigned vehicle, stock-release, mailing-release or medication action because the fictional worker reports confidence, caffeine use or one error-free period." ] }, "materials": [ "Three exact cards, used only while rested. A: print-shop sleep 23:30–04:30 and 23:10–04:40; simulated duty 06:00–13:00; actions are proofread an unpublished draft, release a 200-address mailing file and drive the van; Lena is rested backup; review 08:00; taxi 13:00; restoration 13:30–19:30. Its later cue reads ‘07:40: the character loses the proof line twice and leaves one correction mark unfinished.’ B: ward sleep 00:00–05:00 and 00:15–05:00; duty 06:30; actions are file blank forms, check a fictional dose calculation and drive between sites; Dev is rested backup; review 08:30; alert ride 14:00; restoration 14:30–20:30. Its cue reads ‘08:10: the character rereads the same blank form three times and cannot name the last completed row.’ C: warehouse sleep 22:45–04:45 and 23:30–04:30; duty 05:30; actions are relabel an unshipped sample box, authorise a stock release and operate a forklift; Mo is rested backup; review 07:00; alert ride 12:00; restoration 12:30–18:30. Its cue reads ‘06:40: the character omits the suffix on the current sample label.’", "A folded R/I/X key. R means reversible before release: A draft proof, B blank-form filing, C unshipped sample relabelling. I means independent rested verification before release: Lena compares the 200-address source with the mailing total; Dev recalculates the fictional dose from supplied inputs; Mo compares stock code, quantity and authorisation. X means removed exposure: Lena receives the van, Dev receives inter-site driving and Mo receives the forklift before each stated duty start.", "One roster-matrix sheet per card with columns: card code; sleep interval 1; sleep interval 2; duty start; atomic action; missed-step consequence; R/I/X; checker or operator; source used for verification; acceptance time; scheduled review; later cue; last verified item; unfinished item; ride; restoration start/end; key mismatch; correction.", "A control-request script with blanks: ‘Because this roster contains [two copied intervals], assign [action] to [name] before [start]; [name] independently verifies [row] against [source] before release; review at [time]; transport is [ride]; restoration is [block].’", "For real-world discussion only, the applicable workplace fatigue, duty-reassignment and driving procedure; the responsible employer or occupational role verifies authority before any actual schedule." ], "before_you_start": [ "Use Cards A–C as paper simulations while rested; do not recreate their two-night sleep ledgers.", "Keep the classification key folded until the complete matrix, names and times are committed.", "For a real roster, obtain the employer's fatigue procedure and identify who has authority to reassign each named duty.", "A medical or occupational decision about actual duty belongs to the responsible clinician/employer, not to this exercise." ], "steps": [ { "title": "Copy exposure facts", "instruction": "From a chosen card, copy both actual sleep intervals, fictional duty start, planned review, named backup, ride time and restoration block. Do not convert those nights to a personal tolerance label.", "reason": "This matrix applies to one declared roster configuration; ‘I cope well’ removes information needed to plan controls.", "success_check": "Both sleep intervals and all five supplied control facts reproduce their source card exactly." }, { "title": "Split duty into actions", "instruction": "Write each supplied action on its own row. Replace broad labels such as ‘ward work’ or ‘warehouse work’ with a named action—blank-form filing, fictional dose calculation, driving, relabelling, stock release or forklift operation.", "reason": "One job can contain actions with very different error consequences.", "success_check": "Every supplied action has one and only one matrix row." }, { "title": "Write failed-step consequence", "instruction": "Beside each row, finish this sentence: ‘If one step is missed, then…’. Name rework for a reversible paper error, a wrong downstream decision for an unchecked calculation/release, or collision/crush injury for vehicle/machinery control.", "reason": "A concrete consequence, not prestige or familiarity, determines its safeguard.", "success_check": "No consequential row says only ‘important’, ‘risky’ or ‘be careful’." }, { "title": "Assign one control column", "instruction": "Put work correctable before release in reversible; put a supplied consequential calculation or release in independent rested check; put driving or forklift operation in pre-reassigned. Do not let one row occupy two columns.", "reason": "These columns encode different barriers: correction, independent detection or removal of exposure.", "success_check": "All three card actions occupy their keyed columns, with no vehicle or machinery row left to self-check." }, { "title": "Test checker independence", "instruction": "For the middle column, write the supplied rested person's name and what they must compare before release. Reject a checker who shares the fictional short-rest schedule, merely watches the first worker or checks after the consequence has escaped.", "reason": "A nominal second pair of eyes is not an independent barrier when exposure or timing is shared.", "success_check": "The named checker is rested, receives the source information and signs before the fictional release." }, { "title": "Book the replacement and ride", "instruction": "Write who assumes each pre-reassigned action before the fictional duty begins and copy the supplied alert ride time. The curtailed-rest character never operates the vehicle to reach the restoration location.", "reason": "A reassignment without an operator and travel arrangement is only a label.", "success_check": "Every red-column action has a named rested operator and the commute does not return to the fictional worker." }, { "title": "Prewrite the review decision", "instruction": "At the card's review time, compare completed rows, rereading, omitted fields and changed workload. Write in advance that an error cue freezes new work and activates the named replacement; it does not reopen the red column.", "reason": "A prewritten branch prevents confidence after several quiet hours from undoing the controls.", "success_check": "The sheet has one clock review and an error-trigger branch that preserves every reassignment." }, { "title": "Activate the supplied cue", "instruction": "When the card later reveals repeated rereading or another stated error, stop adding rows, circle the last verified item and transfer the worksheet, unfinished item and next check to the named backup. Keep the originally reassigned action outside the worker's role.", "reason": "The cue tests whether the planned control is executable; it is not a challenge to recover performance.", "success_check": "The backup can identify the last verified item and the exact unfinished action without reconstructing the sheet." }, { "title": "Protect and audit restoration", "instruction": "Copy the card's restoration start/end, move optional errands outside it and, after the paper scenario, check whether any classification, checker, ride or rest block changed after the cue. Correct the plan while rested and record the mismatch.", "reason": "The final audit measures control-plan fidelity, not how long the fictional worker endured.", "success_check": "The restoration block remains intact and every key mismatch is visible beside its correction." } ], "worked_example": { "scenario": "On fictional Card B, a ward worker has recorded 5 hours and 4 hours 45 minutes of sleep and begins the rested paper simulation at 06:30.", "walkthrough": [ "The learner copies 00:00–05:00 = 5 hours and 00:15–05:00 = 4 hours 45 minutes, then enters 06:30 duty start and 08:30 formal review.", "The three atomic rows are filing blank forms, checking a fictional dose calculation and driving between sites; ‘ward work’ is too broad to classify.", "A misfiled blank sheet can be found before use, so it is reversible. An unchecked calculation could propagate a wrong fictional decision, so Dev must independently recalculate it. A drowsy-driving error can collide before correction, so Dev receives the driving assignment in advance.", "The worksheet records Dev's pre-duty acceptance, the 14:00 alert ride and an uninterrupted 14:30–20:30 restoration block.", "When the paper card reveals repeated rereading at 08:10, the learner circles the last verified form, clips it to the unopened stack and gives Dev the next check field; driving does not return to the fictional worker after a later ‘I feel fine’ message.", "The unfolded key matches all three columns. The learner records zero classification mismatches and leaves the original entries visible.", "For comparison, completed A reads R draft proof / I 200-address release checked by Lena / X van assigned to Lena, review 08:00, taxi 13:00, restoration 13:30–19:30. At the 07:40 cue, the unfinished correction mark and last verified proof line go to Lena; the mailing file remains unreleased pending comparison.", "Completed C reads R unshipped sample relabelling / I stock release checked by Mo against code, quantity and authorisation / X forklift assigned to Mo, review 07:00, ride 12:00, restoration 12:30–18:30. At the 06:40 missing-suffix cue, the box remains unshipped and the incorrect label is quarantined for correction; neither release nor forklift returns to the original character." ], "result": "Card B now has an executable consequence matrix: one correctable action, one pre-release independent calculation and one removed driving exposure, plus named times for review, ride and restoration. It measures planning fidelity, never sleep-loss tolerance." }, "right_vs_wrong": [ { "situation": "Roster fact", "right": "Copy both short-sleep intervals and the supplied duty times.", "wrong": "Replace the ledger with ‘I usually manage five hours’.", "why": "A trait claim cannot specify which roster the controls cover." }, { "situation": "Action row", "right": "Separate filing, calculation and driving into three rows.", "wrong": "Classify the whole shift as ‘important work’.", "why": "Different actions require correction, checking or removal." }, { "situation": "Reversible column", "right": "Use it only when an error remains visible and correctable before release.", "wrong": "Call a stock release reversible because a later apology is possible.", "why": "Reversibility concerns the consequence, not whether paperwork can be amended." }, { "situation": "Independent check", "right": "Name a rested checker who recalculates from the source before release.", "wrong": "Ask a colleague on the same curtailed roster to glance at the answer afterward.", "why": "Shared exposure and post-release timing defeat the barrier." }, { "situation": "Vehicle row", "right": "Transfer the van, inter-site drive or forklift before the simulation begins.", "wrong": "Keep the familiar route until the first visible error.", "why": "The first driving error may already be irreversible." }, { "situation": "Later confidence statement", "right": "Keep the original checker, reassignment, ride and rest block in force.", "wrong": "Erase controls because the character says caffeine worked.", "why": "The exercise tests the precommitted plan, not subjective recovery." } ], "common_mistakes": [ { "mistake": "You write “important work” without naming the single failure that could harm a patient, colleague or road user.", "fix": "Name the irreversible action and its consequence, then place it in checked or reassigned work before the scheduled duty begins." }, { "mistake": "A second checker is listed but is also assigned the same curtailed-sleep schedule.", "fix": "Choose an alert independent checker whose scheduled rest window and workload are not coupled to this simulated worker." }, { "mistake": "Vehicle operation is placed in the low-stakes column because the route is familiar.", "fix": "Classify vehicle operation by collision consequence, not familiarity, and arrange alert travel before the shift." }, { "mistake": "The review time is “when tired”.", "fix": "Choose a clock time and also retain behavioural triggers such as a lost step, head nod or repeated rereading." }, { "mistake": "This simulated character plans to finish the critical work quickly before impairment grows.", "fix": "Reassign the critical work first; speed pressure does not remove sleep-loss vulnerability." }, { "mistake": "Restoration window begins only after errands and housework.", "fix": "Protect the first feasible scheduled rest window and move optional errands outside it." } ], "practice": { "first_session": [ "While rested, copy Card B's 00:00–05:00 and 00:15–05:00 sleep intervals, 06:30 duty start, 08:30 review, Dev, 14:00 ride and 14:30–20:30 restoration block.", "Create three rows, write one missed-step consequence per row and assign blank-form filing to reversible, fictional dose calculation to independent check and driving to pre-reassigned.", "Write that Dev recalculates from the fictional source before release and separately accepts the driving transfer before 06:30; one vague ‘Dev helps’ entry is not enough.", "Reveal the 08:10 repeated-rereading cue, circle the last verified form and complete the transfer fields while preserving the red-column driving assignment.", "Unfold the key only after the ride and restoration block are filled; record each mismatch next to its correction.", "Use Card A at the next rested session and Card C after that, with at least 48 hours between cards; record whether A becomes R/I/X and C becomes R/I/X without viewing B's completed sheet, and never reproduce their sleep schedules." ], "repeat_plan": "Complete A, B and C as three rested paper sessions. For quarterly refreshers or a real roster change, write a new three-action card with one reversible, one independently checked and one pre-reassigned action, then have the responsible workplace role verify the classifications. Difficulty grows through less obvious consequences, never through less sleep or later transfer.", "progress_when": [ "Each action and failed-step consequence is specific enough for another reader to classify.", "The rested checker works from source material before the consequential release.", "The vehicle or machinery assignment moves before the fictional start time.", "The ride and restoration block survive the later confidence or error cue." ], "do_not_progress_when": [ "Someone proposes creating curtailed sleep to validate the matrix.", "A consequential row has neither a rested checker nor an authorised replacement.", "The person assigned to drive or check shares the fictional exposure.", "The protected restoration period is treated as spare time for deferred duties." ] }, "self_check": [ "Can you reproduce Card B's two sleep intervals, review, ride and restoration times without replacing them with a readiness adjective?", "Can you explain why the fictional calculation needs Dev's independent recomputation but blank-form filing remains reversible?", "Can you show that driving was assigned away before 06:30 and did not return after the confidence cue?", "Can another reader locate the last verified item and the unfinished item from your activated worksheet?" ], "measurement": { "primary": "Accuracy and completeness of the pre-duty consequence-control matrix", "how": "For each rested card, calculate classification mismatches = number of action rows whose R/I/X differs from the folded key (possible 0–3). Calculate control omissions by counting blank checker/operator, verification source, acceptance time, review, ride or restoration fields. After revealing the cue, mark an activation defect if last verified item or unfinished item is absent, an I release proceeds unchecked, an X action returns to the character, or restoration changes. Preserve raw defect labels and corrections; produce no alertness, deprivation-duration or fitness score.", "good_result": "A complete sheet reproduces A as R/I/X, B as R/I/X and C as R/I/X; names Lena, Dev and Mo in their checker/operator fields; and retains each printed review, transport and restoration time after its later cue. Any mismatch or omission is useful feedback and remains visible after correction; this is not fitness-for-duty clearance.", "does_not_prove": "Correct rested-scenario decisions do not prove tolerance to curtailed sleep, fitness to drive, clinical clearance or safe performance during an actual sleep-restricted duty." }, "stop_and_get_help": [ "For an actual known short-rest roster, do not begin a vehicle, machinery, medication, release or other irreversible action when the required checker/replacement has not accepted control; notify the authorised supervisor.", "Escalate a workplace design that offers neither independent checking nor reassignment through the employer's fatigue and occupational-safety process rather than improvising a self-test.", "A sudden unexplained episode, collapse or persistent sleepiness despite adequate opportunity is outside this scheduled-roster worksheet and needs medical assessment on the appropriate timescale." ], "accessibility": [ "Present each action as a large-print, audio or tactile card that can be physically placed in one of the three consequence columns.", "Let a scribe enter names and times, but require the learner to state the failed-step consequence and selected control.", "Book an accessible alert ride and restoration location as explicit matrix fields rather than assuming independent navigation." ], "evidence_notes": [ { "claim": "Primary research supports stable individual differences in vulnerability while not making self-perceived resilience a safe operational test.", "source_title": "Robust stability of trait-like vulnerability or resilience to common types of sleep deprivation in a large sample of adults", "source_url": "https://pubmed.ncbi.nlm.nih.gov/31784748/", "source_kind": "PRIMARY_RESEARCH" }, { "claim": "NIOSH guidance supports stopping fatigued driving, obtaining temporary rest and recognising that sleep is the needed recovery.", "source_title": "Driver Fatigue on the Job", "source_url": "https://www.cdc.gov/niosh/motor-vehicle/driver-fatigue/index.html", "source_kind": "OFFICIAL_GUIDANCE" } ], "limits": [ "Use objective vigilance and task error, prior sleep, circadian time and recovery—not self-rated alertness alone.", "Unsupported claim: train yourself to need less sleep.", "Unsupported claim: elite sleep-loss resilience.", "Unsupported claim: caffeine restores full performance.", "This lesson never teaches deprivation tolerance, stimulant compensation or fitness for duty." ], "orientation": { "bounded_definition": "Capability to develop or express function under partial sleep loss in a declared context without inheriting broader claims.", "evidence_summary": "People differ under sleep loss, but nobody should treat deprivation tolerance as a trainable superpower.", "supportable_public_claim": "Individuals differ in vulnerability to sleep loss, but functioning under deprivation is not established as a safely trainable capability.", "measurement_boundary": "Use objective vigilance and task error, prior sleep, circadian time and recovery—not self-rated alertness alone.", "myth_to_metric": { "myth": "Train to function perfectly without sleep", "metric": "Objective lapses, errors, judgment, health and recovery under declared sleep history", "boundary": "Subjective alertness or stimulant-assisted performance does not prove safety." }, "limiting_findings": [ "Caffeine did not restore well-rested performance.", "Caffeine impaired subsequent recovery sleep.", "Subjective and objective vulnerability did not align." ], "prohibited_claims": [ "train yourself to need less sleep", "elite sleep-loss resilience", "caffeine restores full performance", "prove toughness by staying awake" ] }, "gold_source_lesson": null, "next_gate": "External confirmation is required before higher-authority use because: CLINICAL_HIGH_RISK_OR_REGULATED_CONFIGURATION; SUPERVISION_OR_NON_ATTEMPT_BOUNDARY; CULTURAL_COMMUNITY_RIGHTS_OR_AFFECTED_PERSON_AUTHORITY; SAFETY_LEGITIMACY_RESTRICTED.", "evidence_count": 6 }, "full_training_programme": false, "independently_validated": false, "publication_state": "PUBLISHED_PUBLIC_RESEARCH_EDITION__EDITORIAL_REVIEW_PENDING", "related_power_ids": [ "PWR-049", "PWR-050", "PWR-051", "PWR-052" ] }, { "power_id": "PWR-054", "learning_unit_id": "TLU-PWR-054", "title": "Dream recall and lucid-dream skill", "main_description": "This is a phenomenon-and-measurement worksheet, not a dream-induction lesson. It supplies five fictional sleep-laboratory records and a complete verification key. Do not change bedtime, interrupt sleep, set awakenings, restrict sleep opportunity, attempt a reality-check routine, treat nightmares or use dreams for trauma work. This page remains static classification only and authorises neither lucid-dream induction nor a natural-awakening practice. Dream recall, a retrospective lucid-dream report, polysomnographic REM and a correctly detected prearranged signal are separate records. A verified signal event is stronger than report alone, but it does not prove reliable trainability, control of every dream, daytime benefit or harmless sleep disruption.", "main_description_source": "GOVERNED_TUTORIAL_PLAIN_ENGLISH_INTRO", "family_id": "FAM-07", "family": "Sleep, Circadian & Recovery Regulation", "superdomain": "Regulation & Recovery", "canonical_route": "/powers/pwr-054/", "treatment": "RESEARCH_EXPLORATION_ROUTE", "treatment_label": "Full research tutorial", "treatment_boundary": "Titan teaches a complete Power-specific research method because operational capability practice is not currently justified.", "tutorial_route": "/tutorials/pwr-054/", "governed_lesson_route": "/tutorials/pwr-054/", "self_attempt_status": "NO_TRAINING_AUTHORITY", "gold_pathway_ids": [ "G-CUR-005" ], "route_membership": { "kind": "GOLD_PATHWAY", "id": "G-CUR-005", "coverage_status": "EXACT_ONCE" }, "source_authority_tier": "G2", "source_build_state": "RESEARCH_ONLY", "source_instructional_route": "EXPLAINER_ONLY_RESEARCH", "source_count": 2, "research_depth": "FOCUSED", "risk_level": "MODERATE", "prerequisite_status": "NONE_FOR_READING__NO_PRACTICE_AUTHORITY", "learning_route": { "mode": "RESEARCH_EXPLORATION", "label": "Explore the research frontier", "summary": "This is a phenomenon-and-measurement worksheet, not a dream-induction lesson. It supplies five fictional sleep-laboratory records and a complete verification key. Do not change bedtime, interrupt sleep, set awakenings, restrict sleep opportunity, attempt a reality-check routine, treat nightmares or use dreams for trauma work. This page remains static classification only and authorises neither lucid-dream induction nor a natural-awakening practice. Dream recall, a retrospective lucid-dream report, polysomnographic REM and a correctly detected prearranged signal are separate records. A verified signal event is stronger than report alone, but it does not prove reliable trainability, control of every dream, daytime benefit or harmless sleep disruption.", "steps": [ [ "Frame the question", "State the capability claim narrowly enough that evidence could support or limit it." ], [ "Map the evidence", "Distinguish existence, measurement, trainability, retention, transfer, safety and functional value." ], [ "Find uncertainty", "Identify small samples, proxy measures, missing controls, null findings and unresolved authority questions." ], [ "Compare alternatives", "Consider competing explanations and what evidence would change the current treatment." ], [ "Stay non-operational", "Use the record for research literacy only until a separate gate authorises instruction." ] ], "practical_authority": false, "provider_required": false, "next_action_route": "/tutorials/pwr-054/" }, "path_builder": { "selectable": true, "completion_allowed": true, "warning": "Titan teaches a complete Power-specific research method because operational capability practice is not currently justified." }, "full_tutorial": { "version": "1.0", "authorship": "AUTHORED_GOVERNED_SOURCE", "practice_pack": { "power_id": "PWR-054", "title": "Dream recall and lucid-dream skill", "heading": "Classify fictional dream reports and REM signal records without changing sleep", "plain_english_intro": "This is a phenomenon-and-measurement worksheet, not a dream-induction lesson. It supplies five fictional sleep-laboratory records and a complete verification key. Do not change bedtime, interrupt sleep, set awakenings, restrict sleep opportunity, attempt a reality-check routine, treat nightmares or use dreams for trauma work. This page remains static classification only and authorises neither lucid-dream induction nor a natural-awakening practice. Dream recall, a retrospective lucid-dream report, polysomnographic REM and a correctly detected prearranged signal are separate records. A verified signal event is stronger than report alone, but it does not prove reliable trainability, control of every dream, daytime benefit or harmless sleep disruption.", "authority_and_safety": [ "Governance ceiling: explanation and static fictional record analysis only. Capability self-practice, live administration, protocol delivery and efficacy claims are not authorised until the recorded next_gate adjudication changes.", "Use only the supplied fictional laboratory records. Do not set alarms, interrupt or restrict sleep, attempt induction, provoke nightmares or use substances.", "The classifications cannot establish dream control, treatment, durable training, daytime benefit or safety of sleep disruption." ], "materials": [ "The five fictional records D1–D5 in the fixture; no dream diary, sleep change, alarm, wearable or induction attempt is needed.", "Verification key: assign VR only when the stage is polysomnographically scored REM, the complete prearranged left-right-left-right eye sequence is detected, and two independent scorers agree 4/4; assign UR when a lucid-dream report exists but VR criteria are absent; assign DR when any dream content is recalled; assign SQ when the record shows shortened sleep opportunity or worse next-day sleepiness.", "Classification sheet with four yes/no columns labelled VR, UR, DR and SQ, plus one evidence sentence and one non-claim per case.", "Boundary card: STATIC FICTIONAL RECORDS ONLY; no induction, awakening, sleep restriction, trauma processing, nightmare treatment, universal trainability or daytime-benefit claim.", "Answer key hidden until all five cases are labelled." ], "setup_steps": [ "Copy the four labels and the full three-part VR rule. A report saying ‘I knew I was dreaming’ cannot replace REM stage evidence or signal agreement.", "Read stage, signal detection and scorer agreement before reading the retrospective report.", "Assign VR, UR, DR and SQ independently. More than one label may apply, but UR is used only when a lucid report lacks VR.", "Keep dream recall separate: a verified signal can exist without next-morning recalled content, and recalled content can exist without verification.", "Treat reduced sleep opportunity or next-day sleepiness as a separate concern even when VR criteria pass.", "Finish each case with a bounded statement about the record, not a claim about dream mastery, treatment or daytime function." ], "fixture": { "caption": "Fictional sleep-laboratory records for recall and verification classification", "headers": [ "Case", "Sleep-stage record", "Prearranged eye-signal record", "Independent scoring", "Retrospective report", "Sleep opportunity and next-day note" ], "rows": [ [ "D1", "Polysomnography: REM during signal window", "Complete left-right-left-right sequence detected", "Two scorers agree 4/4", "Dream content recalled; report says awareness of dreaming", "Usual 7-hour opportunity; no extra sleepiness noted" ], [ "D2", "No polysomnography available", "No signal channel", "No independent signal score", "Detailed dream recalled; report says awareness of dreaming", "Usual 7-hour opportunity; no extra sleepiness noted" ], [ "D3", "Polysomnography: N2, not REM", "Two of four movements resemble the sequence", "Scorers do not agree on a complete signal", "Dream content recalled; report says awareness of dreaming", "Usual 7-hour opportunity; no extra sleepiness noted" ], [ "D4", "Polysomnography: REM during signal window", "Complete left-right-left-right sequence detected", "Two scorers agree 4/4", "No dream content recalled next morning", "Usual 7-hour opportunity; no extra sleepiness noted" ], [ "D5", "Polysomnography: REM during signal window", "Complete left-right-left-right sequence detected", "Two scorers agree 4/4", "Dream content recalled; report says awareness of dreaming", "Opportunity shortened from usual 7 hours to 5 hours; worse next-day sleepiness recorded" ] ] }, "scoring_rule": "For each case award 1 point for correct REM-stage use, 1 for correct complete-signal use, 1 for correct scorer-agreement use, 1 for the exact VR/UR/DR/SQ label set and 1 for a bounded non-claim: 5 points each, 25 total. Passing requires at least 23, D2 and D3 not labelled VR, D4 not labelled DR and D5 labelled SQ. Any sleep interruption, induction routine, restriction advice, nightmare or trauma treatment, or claim of reliable dream control receives STOP.", "worked_example": { "steps": [ "Read D3 stage first: polysomnography says N2, so the REM requirement for VR fails.", "Read signal quality: only two of four movements resemble the planned sequence, so the complete-signal requirement also fails.", "Read independent scoring: the scorers do not agree on a complete signal, creating a third VR failure.", "Read the report separately: dream content was recalled and the report claims awareness of dreaming, so DR and UR apply.", "Check sleep concern: usual opportunity and no extra sleepiness mean SQ does not apply." ], "result": "D3 is UR + DR, not VR. This correctly preserves a lucid-dream report and dream recall while rejecting REM-signal verification. It says nothing about reliable trainability or daytime value." }, "right_vs_wrong": [ { "situation": "Reading D2", "right": "Label the detailed account DR + UR and state that verification is unavailable.", "wrong": "Call a vivid report laboratory-verified lucidity.", "why": "Report detail cannot replace REM stage and a prearranged signal." }, { "situation": "Reading D3", "right": "Reject VR because REM, complete sequence and scorer agreement all fail.", "wrong": "Count any two eye movements as close enough.", "why": "The operational key requires the complete prearranged pattern and agreement." }, { "situation": "Reading D4", "right": "Record the verified REM signal while leaving dream recall absent.", "wrong": "Invent recalled content because the signal passed.", "why": "Verification and next-morning recall are separate measurements." }, { "situation": "Reading D5", "right": "Keep VR and the sleep-quality concern visible together.", "wrong": "Ignore reduced sleep because the event was verified.", "why": "Phenomenon verification does not establish acceptable burden or benefit." }, { "situation": "Using the worksheet", "right": "Classify supplied records without changing sleep.", "wrong": "Set an alarm or shorten sleep to generate a personal case.", "why": "The governed route permits natural dream-recall recording, but induction guidance remains outside authority." } ], "common_mistakes": [ { "mistake": "Dream recall is treated as proof that REM was recorded.", "fix": "Read the independent stage channel and report channel separately." }, { "mistake": "A partial eye pattern is rounded up to a complete signal.", "fix": "Apply the exact four-movement sequence and scorer-agreement rule." }, { "mistake": "No recalled dream is used to erase a valid signal event.", "fix": "Keep D4 as VR while leaving DR absent and interpretation narrow." }, { "mistake": "A verified event is called successful training despite shortened sleep.", "fix": "Add SQ and keep burden separate from event verification." }, { "mistake": "The learner invents a lucid-dream induction procedure.", "fix": "Stop; the complete task here is static classification, and the governed route does not authorise induction." } ], "answer_key_route": "/tutorials/pwr-054/answer-key/", "answer_key_delivery": "SEPARATE_NOINDEX_NOARCHIVE_CHECKING_PAGE" }, "tutorial_mode": "RESEARCH_EXPLORATION", "orientation": { "bounded_definition": "Capability to develop or express dream recall and lucid-dream skill in a declared context without inheriting broader claims.", "evidence_summary": "Lucid dreams are real and can sometimes support verified communication, but reliable training and daytime benefit remain open.", "measurement_boundary": "Polysomnographic REM plus prearranged signals is stronger than retrospective report; dream recall and lucid-dream verification are separate.", "myth_to_metric": { "myth": "Master your dreams and unlock hidden powers", "metric": "Verified REM lucidity rate, signal accuracy, sleep quality and delayed repeatability", "boundary": "Dream report alone does not establish REM verification, trainability or daytime value." }, "limiting_findings": [ "One induction condition yielded zero lucid dreams; other rates were low.", "No durable training or daytime functional benefit is established." ], "prohibited_claims": [ "control every dream", "learn lucid dreaming reliably overnight", "use dreams to treat trauma alone", "unlock daytime genius" ] }, "outcomes": [ "Define dream recall and lucid-dream skill without inheriting mythology or broader claims.", "Explain what the current evidence supports and what it does not establish.", "Use the declared measurement boundary and recognise misleading proxies.", "Complete the current learning route without converting it into unauthorised capability practice.", "Make a retention, transfer, maintenance, provider or stop decision without overclaiming." ], "prerequisites": "NONE_FOR_READING__NO_PRACTICE_AUTHORITY", "baseline": { "instruction": "Before reading the sequence, record your current definition, confidence, assumed measure, expected value, known risks and intended next action. Do not attempt the capability.", "record": [ "date and context", "current definition", "confidence from 0 to 100", "assumed measure", "expected benefit", "known limitation", "intended next action" ] }, "modules": [ { "order": 1, "title": "Frame the question", "instruction": "State the capability claim narrowly enough that evidence could support or limit it.", "completion_evidence": "Record the decision or output from frame the question in one or two sentences." }, { "order": 2, "title": "Map the evidence", "instruction": "Distinguish existence, measurement, trainability, retention, transfer, safety and functional value.", "completion_evidence": "Record the decision or output from map the evidence in one or two sentences." }, { "order": 3, "title": "Find uncertainty", "instruction": "Identify small samples, proxy measures, missing controls, null findings and unresolved authority questions.", "completion_evidence": "Record the decision or output from find uncertainty in one or two sentences." }, { "order": 4, "title": "Compare alternatives", "instruction": "Consider competing explanations and what evidence would change the current treatment.", "completion_evidence": "Record the decision or output from compare alternatives in one or two sentences." }, { "order": 5, "title": "Stay non-operational", "instruction": "Use the record for research literacy only until a separate gate authorises instruction.", "completion_evidence": "Record the decision or output from stay non-operational in one or two sentences." } ], "lab": { "title": "Claim-audit lab", "instruction": "Choose one public claim about this Power. Compare it with the bounded definition, measurement limit, supporting evidence, limiting findings and prohibited wording.", "deliverable": "A one-page claim verdict: supported, partly supported, unresolved or contradicted, with the reason stated." }, "assessment": { "immediate": "Restate the bounded definition, evidence ceiling, measurement boundary and current authority route without looking.", "delayed_retention": "Repeat the explanation and route decision after at least 48 hours; record what changed or was forgotten.", "transfer": "Evaluate a new claim, provider option or research result using the same evidence and authority checklist; do not perform the capability.", "interpretation": "Completion demonstrates learning of this tutorial only. It does not prove capability, qualification, independent validation, safety clearance or far transfer." }, "maintenance": { "cadence": "Review after 48 hours, again after 2-4 weeks, and whenever the evidence or authority treatment changes.", "decisions": [ "retain", "refresh", "seek qualified support", "return to research", "retire" ] }, "accessibility": "Use text-to-speech, enlarged text, keyboard navigation, shorter sessions, a support person or an equivalent non-practical record format as needed. Accessibility changes must not enlarge practical authority.", "stopping_and_escalation": "Titan teaches a complete Power-specific research method because operational capability practice is not currently justified. Stop if the declared configuration cannot be maintained, uncertainty becomes material, adverse effects appear, or qualified authority is required.", "next_gate": "No external confirmation is required for the current bounded explainer permission. Guide permission remains NOT_READY; any guide, stronger efficacy, generalisation, protocol, promotion or independent-validation claim requires a new adjudication.", "evidence_count": 2 }, "full_training_programme": false, "independently_validated": false, "publication_state": "PUBLISHED_PUBLIC_RESEARCH_EDITION__EDITORIAL_REVIEW_PENDING", "related_power_ids": [ "PWR-049", "PWR-050", "PWR-051", "PWR-052" ] }, { "power_id": "PWR-055", "learning_unit_id": "TLU-PWR-055", "title": "Recovery forecasting", "main_description": "The learner completes ten prospective predictions for the supplied 60-second code-check cards and reports signed error, mean absolute error, prediction-band calibration and whether one revised rule helped on fresh cards.", "main_description_source": "FULL_TUTORIAL_OUTCOME", "family_id": "FAM-07", "family": "Sleep, Circadian & Recovery Regulation", "superdomain": "Regulation & Recovery", "canonical_route": "/powers/pwr-055/", "treatment": "EVIDENCE_REVIEW_ROUTE", "treatment_label": "Full low-stakes tutorial", "treatment_boundary": "Titan teaches a concrete low-stakes method step by step while keeping evidence and transfer claims bounded.", "tutorial_route": "/tutorials/pwr-055/", "governed_lesson_route": null, "self_attempt_status": "PERMITTED_INSIDE_FULL_TUTORIAL_LIMITS", "gold_pathway_ids": [ "G-CUR-004" ], "route_membership": { "kind": "GOLD_PATHWAY", "id": "G-CUR-004", "coverage_status": "EXACT_ONCE" }, "source_authority_tier": "G2", "source_build_state": "TARGETED_REVIEW_REQUIRED", "source_instructional_route": "BOUNDED_GUIDED_EXERCISE", "source_count": 7, "research_depth": "DEEP", "risk_level": "MODERATE_TO_HIGH", "prerequisite_status": "NONE_FOR_READING__NO_PRACTICE_AUTHORITY", "learning_route": { "mode": "FULL_SELF_GUIDED_TUTORIAL", "label": "Learn recovery forecasting step by step", "summary": "The learner completes ten prospective predictions for the supplied 60-second code-check cards and reports signed error, mean absolute error, prediction-band calibration and whether one revised rule helped on fresh cards.", "steps": [ [ "Get ready", "Choose a task whose poor result cannot harm anyone; do not use driving, medication, water, heights or work clearance." ], [ "Learn the method", "8 concrete steps teach the permitted method from start to finish." ], [ "See right and wrong", "5 comparisons show correct or safer execution beside common wrong or riskier choices." ], [ "Practise", "Collect one forecast per day or per comparable occasion until ten are complete. Review bias and absolute error, change one rule, then collect ten new forecasts. Retire the rule if it does not improve or creates burden." ], [ "Check progress", "For each row calculate signed error = actual score − predicted score and absolute error = |signed error|. Mean absolute error is the sum of all absolute errors divided by the number of completed rows. Also report mean prediction and mean actual score within the predeclared low, middle and high prediction bands." ] ], "practical_authority": true, "provider_required": false, "next_action_route": "/tutorials/pwr-055/" }, "path_builder": { "selectable": true, "completion_allowed": true, "warning": "Titan teaches a concrete low-stakes method step by step while keeping evidence and transfer claims bounded." }, "full_tutorial": { "version": "3.0", "authorship": "POWER_SPECIFIC_FULL_TUTORIAL", "tutorial_mode": "SELF_GUIDED", "promise": "Recovery forecasts may help planning, but a score is only as good as its device, model, context and calibration. A recovery forecast is useful only when made before the outcome and checked later. The learner predicts one benign task from declared inputs, measures the actual result, calculates error across repeated days and changes only one forecast rule. Wearable scores remain inputs, not authority.", "power_id": "PWR-055", "title": "Recovery forecasting", "lesson_type": "SELF_GUIDED", "headline": "Calibrate a recovery prediction against what actually happens", "plain_english_summary": "Recovery forecasts may help planning, but a score is only as good as its device, model, context and calibration. A recovery forecast is useful only when made before the outcome and checked later. The learner predicts one benign task from declared inputs, measures the actual result, calculates error across repeated days and changes only one forecast rule. Wearable scores remain inputs, not authority.", "outcome": "The learner completes ten prospective predictions for the supplied 60-second code-check cards and reports signed error, mean absolute error, prediction-band calibration and whether one revised rule helped on fresh cards.", "authority": { "learner_may": [ "Write a 0/5/10 prospective score before opening each benign 60-second code-check card, then run the card while ordinarily rested.", "Calculate hits, misses, false alarms, actual score, signed error and absolute error from the supplied key/formula and test one revised forecast rule only on fresh cards.", "Record sleep/wearable/context inputs as clues while keeping the forecast away from driving, medicine, work clearance or another consequential decision." ], "qualified_person_required_for": [ "Interpreting persistent fatigue, sleepiness, illness or unexpectedly poor function and deciding whether medical assessment/treatment is needed.", "Any fitness-for-duty, driving, sport-risk, medication, patient-care or occupational use of a readiness forecast.", "Changing sleep treatment, medication, workload or rehabilitation from wearable/recovery scores." ], "never_do": [ "Shorten sleep, intensify exercise or create illness/fatigue to generate harder forecast days.", "View the key before predicting, rewrite a prediction after the card or omit a bad day from calibration.", "Let a predicted 10 or a wearable badge override symptoms, an objective error, a safety rule or professional restriction." ] }, "materials": [ "A ten-row forecast sheet and ten exact 60-second code-check cards. Each card has eight left/right code pairs and exactly two mismatches: A 4821/4821, 7306/7306, 9145/9154, 2680/2680, 5573/5573, 6419/6419, 8032/8033, 1194/1194; B 3148/3148, 7250/7520, 6681/6681, 9024/9024, 1573/1573, 4862/4867, 2395/2395, 8106/8106; C 5740/5748, 1326/1326, 9951/9951, 4073/4073, 6812/6812, 2509/2509, 7438/7438, 3264/3624; D 8610/8610, 2457/2457, 7039/7039, 1186/1816, 9342/9432, 5270/5270, 6604/6604, 3891/3891; E 4408/4408, 1725/1729, 6931/6931, 8264/8264, 3510/3510, 9072/9072, 5846/5486, 2183/2183; F 7602/7602, 3319/3319, 8457/8475, 1096/1096, 6243/6243, 5780/5788, 2925/2925, 4137/4137; G 9350/9358, 2046/2046, 7812/7812, 5684/5684, 3279/3729, 6501/6501, 1198/1198, 4423/4423; H 2861/2861, 7705/7705, 5314/5314, 9402/9042, 1638/1638, 6257/6257, 8091/8091, 3746/3748; I 6173/6173, 2085/2805, 9541/9541, 4860/4860, 7329/7392, 1507/1507, 8634/8634, 3298/3298; J 7031/7031, 2648/2648, 8195/8159, 4470/4470, 5362/5362, 1904/1904, 6827/6872, 3251/3251.", "A folded key giving mismatch positions A 3,7; B 2,6; C 1,8; D 4,5; E 2,7; F 3,6; G 1,5; H 4,8; I 2,5; J 3,7. For each card count hits, misses and false alarms, then calculate actual task score = maximum of 0 and 10 − 2×misses − false alarms. Keep raw counts beside this non-clinical 0–10 score.", "A fixed readiness-prediction scale: 0 means expect no reliable code checking today, 5 means expect several uncertain pairs, and 10 means expect all eight decisions correct without a false alarm.", "Optional wearable value recorded as one input, with device and version named." ], "before_you_start": [ "Choose a task whose poor result cannot harm anyone; do not use driving, medication, water, heights or work clearance.", "Use the supplied 60-second card rule and actual-score formula unchanged on all ten rows.", "Keep task difficulty and time similar across days.", "If severe or unexplained symptoms exist, seek care rather than running a forecast." ], "steps": [ { "title": "Define the future task", "instruction": "Write the next unused card letter, 60-second limit, mismatch-marking rule, actual-score formula and planned clock time before looking at the folded key.", "reason": "A forecast needs a fixed target, not a general feeling.", "success_check": "Another person could run the same task from the description." }, { "title": "Choose declared inputs", "instruction": "Record only the inputs chosen in advance: sleep opportunity, symptoms, prior load, caffeine timing and optional named device score.", "reason": "Adding favourable inputs afterward creates hindsight bias.", "success_check": "The row has the same input columns each day." }, { "title": "Make the prediction first", "instruction": "Before the task, predict readiness from 0 to 10 and the concrete task result, then lock the row.", "reason": "Prospective prediction can be tested; retrospective explanation cannot.", "success_check": "The prediction has a timestamp earlier than the task result." }, { "title": "Perform the benign task", "instruction": "Open the named code card, compare its eight pairs for exactly 60 seconds and circle every suspected mismatch without opening the key or changing aids.", "reason": "A stable outcome makes forecast error interpretable.", "success_check": "Time, item version and support are recorded." }, { "title": "Score the actual result", "instruction": "Open the folded key, count hits, misses and false alarms, then compute actual score = maximum of 0 and 10 − 2×misses − false alarms.", "reason": "Confidence and effort are not the outcome.", "success_check": "The raw counts remain beside the converted score." }, { "title": "Calculate forecast error", "instruction": "Subtract predicted from actual score and also record the absolute difference.", "reason": "Signed error shows optimistic or pessimistic bias; absolute error shows size.", "success_check": "Both numbers are calculated for every row." }, { "title": "Check calibration after ten rows", "instruction": "Group low, middle and high predictions and compare each group with its mean actual result.", "reason": "One lucky forecast does not establish a useful model.", "success_check": "The report includes all ten rows and group averages." }, { "title": "Change one rule", "instruction": "If consistently optimistic or pessimistic, alter one input weight or decision threshold and predeclare the next ten-row test.", "reason": "A single change can be evaluated; wholesale rewriting cannot.", "success_check": "The revised rule is written before new outcomes occur." } ], "worked_example": { "scenario": "Priya forecasts her score before using code-check Card A for 60 seconds.", "walkthrough": [ "Before opening Card A, she records sleep opportunity and symptoms, predicts 8/10 and timestamps the row.", "In 60 seconds she circles pairs 3, 6 and 7; the folded key says only positions 3 and 7 differ.", "She records two hits, zero misses and one false alarm, so actual score = 10 − 2×0 − 1 = 9.", "Signed error is actual minus predicted = 9 − 8 = +1; absolute error is 1. She keeps the false alarm rather than editing the circle.", "After Cards A–J, her high-prediction rows average 8.5 predicted and 7.0 actual, so she predeclares one revision: a prediction above 8 requires both her stated sleep opportunity and low symptom input, then tests fresh cards rather than refitting A–J." ], "result": "Priya has a calibrated personal forecast for this proofreading task. It is not permission to drive, work unsafely or treat the device score as recovery." }, "right_vs_wrong": [ { "situation": "Timing", "right": "Lock the prediction before the task.", "wrong": "Explain afterward why the result was predictable.", "why": "Hindsight cannot test forecast accuracy." }, { "situation": "Outcome", "right": "Use raw errors and a fixed scoring rule.", "wrong": "Use confidence as the actual result.", "why": "Confidence can be miscalibrated." }, { "situation": "Wearable", "right": "Name the device score as one optional input.", "wrong": "Let the device label override symptoms or hazards.", "why": "Consumer scores have device-specific error and are not clearance." }, { "situation": "Sample", "right": "Evaluate at least ten prospective rows.", "wrong": "Promote one correct prediction as a reliable model.", "why": "Calibration needs repeated outcomes." }, { "situation": "Update", "right": "Change one rule and retest prospectively.", "wrong": "Rewrite the rule after every miss.", "why": "Continuous hindsight fitting hides failure." } ], "common_mistakes": [ { "mistake": "Explain afterward why the result was predictable.", "fix": "Lock the prediction before the task." }, { "mistake": "Use confidence as the actual result.", "fix": "Use raw errors and a fixed scoring rule." }, { "mistake": "Let the device label override symptoms or hazards.", "fix": "Name the device score as one optional input." }, { "mistake": "Promote one correct prediction as a reliable model.", "fix": "Evaluate at least ten prospective rows." }, { "mistake": "Rewrite the rule after every miss.", "fix": "Change one rule and retest prospectively." } ], "practice": { "first_session": [ "Copy the three readiness anchors, actual-score formula and fixed input columns onto the forecast sheet.", "Write Card A, the planned clock time and a 0–10 prediction before opening the card.", "Compare all eight Card A pairs for 60 seconds and freeze the circles when the timer ends.", "Use the folded A key to count hits, misses and false alarms, calculate actual score, signed error and absolute error, then check the arithmetic.", "Schedule Cards B–J on comparable occasions before interpreting the low, middle and high prediction bands." ], "repeat_plan": "Collect one forecast per day or per comparable occasion until ten are complete. Review bias and absolute error, change one rule, then collect ten new forecasts. Retire the rule if it does not improve or creates burden.", "progress_when": [ "Predictions are timestamped before outcomes.", "All raw task errors and contextual deviations are retained.", "A revised rule reduces error on a new set rather than the old rows." ], "do_not_progress_when": [ "The predicted task becomes safety-critical or consequential.", "Illness, medication or device change makes old rows incomparable.", "Forecasting increases anxiety, compulsive checking or pressure to ignore symptoms." ] }, "self_check": [ "Can you demonstrate “Choose declared inputs”? The row has the same input columns each day.", "Can you demonstrate “Score the actual result”? The raw counts remain beside the converted score.", "Can you demonstrate “Change one rule”? The revised rule is written before new outcomes occur." ], "measurement": { "primary": "Prospective calibration and decision benefit for a declared future task", "how": "For each row calculate signed error = actual score − predicted score and absolute error = |signed error|. Mean absolute error is the sum of all absolute errors divided by the number of completed rows. Also report mean prediction and mean actual score within the predeclared low, middle and high prediction bands.", "good_result": "All predictions precede their unused cards, every score reproduces from the folded key and formula, and any revised rule is judged only on fresh cards. A lower fresh-card mean absolute error is task-specific evidence to continue checking, not recovery or safety clearance.", "does_not_prove": "Forecast discrimination, calibration and decision utility must be tested against a future declared outcome; a readiness score is not the outcome itself." }, "stop_and_get_help": [ "Do not use the forecast to override drowsiness, acute illness or a workplace stop rule.", "Seek clinical advice for persistent fatigue, sudden sleep episodes, chest symptoms, breathlessness or marked functional decline.", "Stop forecasting if it drives compulsive checking, sleep loss or risky attempts to prove the score wrong." ], "accessibility": [ "Use a spoken or pictorial task with an objective key if proofreading is inaccessible.", "Let a helper timestamp and score while keeping the learner blind to the answer key.", "Retain normal aids and score supported performance as the declared configuration." ], "evidence_notes": [ { "claim": "Direct comparison with polysomnography shows that consumer sleep devices differ in performance, so device output should be treated as an input with error.", "source_title": "Performance of seven consumer sleep-tracking devices compared with polysomnography", "source_url": "https://pubmed.ncbi.nlm.nih.gov/33378539/", "source_kind": "PRIMARY_RESEARCH" }, { "claim": "Primary evidence of individual vulnerability to sleep loss supports personal prospective calibration rather than universal readiness rules.", "source_title": "Robust stability of trait-like vulnerability or resilience to common types of sleep deprivation in a large sample of adults", "source_url": "https://pubmed.ncbi.nlm.nih.gov/31784748/", "source_kind": "PRIMARY_RESEARCH" } ], "limits": [ "Forecast discrimination, calibration and decision utility must be tested against a future declared outcome; a readiness score is not the outcome itself.", "Unsupported claim: your wearable knows when you are recovered.", "Unsupported claim: readiness score guarantees safety.", "Unsupported claim: AI predicts your body perfectly.", "A calibrated low-stakes forecast is not a medical diagnosis, recovery measure or safety clearance." ], "orientation": { "bounded_definition": "Capability to develop or express recovery forecasting in a declared context without inheriting broader claims.", "evidence_summary": "Recovery forecasts may help planning, but a score is only as good as its device, model, context and calibration.", "supportable_public_claim": "Recovery and fatigue can be forecast probabilistically, but forecasts are configuration-specific and uncertain.", "measurement_boundary": "Forecast discrimination, calibration and decision utility must be tested against a future declared outcome; a readiness score is not the outcome itself.", "myth_to_metric": { "myth": "Your readiness score knows your limits", "metric": "Prospective calibration and decision benefit for a declared future task", "boundary": "A wearable estimate cannot diagnose sleep or guarantee safe performance." }, "limiting_findings": [ "Consumer device accuracy varies by device and metric.", "Caffeine can improve apparent performance while worsening recovery sleep.", "Subjective and objective vulnerability can diverge." ], "prohibited_claims": [ "your wearable knows when you are recovered", "readiness score guarantees safety", "AI predicts your body perfectly", "one metric proves recovery" ] }, "gold_source_lesson": null, "next_gate": "External confirmation is required before higher-authority use because: CLINICAL_HIGH_RISK_OR_REGULATED_CONFIGURATION; CULTURAL_COMMUNITY_RIGHTS_OR_AFFECTED_PERSON_AUTHORITY.", "evidence_count": 7 }, "full_training_programme": false, "independently_validated": false, "publication_state": "PUBLISHED_PUBLIC_RESEARCH_EDITION__EDITORIAL_REVIEW_PENDING", "related_power_ids": [ "PWR-049", "PWR-050", "PWR-051", "PWR-052" ] }, { "power_id": "PWR-056", "learning_unit_id": "TLU-PWR-056", "title": "Wakefulness stabilisation", "main_description": "The learner completes the correct response to three fictional sleepiness scenarios, including driving, work and persistent unexplained sleepiness. The learner also classifies the onset pattern and routes sudden or medically concerning loss of wakefulness without treating it as routine fatigue.", "main_description_source": "FULL_TUTORIAL_OUTCOME", "family_id": "FAM-07", "family": "Sleep, Circadian & Recovery Regulation", "superdomain": "Regulation & Recovery", "canonical_route": "/powers/pwr-056/", "treatment": "RESTRICTED_EXPLAINER_ONLY", "treatment_label": "Full safety and decision tutorial", "treatment_boundary": "Titan teaches recognition, prevention, safe response and accountable routing without teaching the prohibited act.", "tutorial_route": "/tutorials/pwr-056/", "governed_lesson_route": null, "self_attempt_status": "PROHIBITED_ACT_EXCLUDED", "gold_pathway_ids": [ "G-CUR-004" ], "route_membership": { "kind": "GOLD_PATHWAY", "id": "G-CUR-004", "coverage_status": "EXACT_ONCE" }, "source_authority_tier": "G6", "source_build_state": "RESTRICTED", "source_instructional_route": "EXPLAINER_ONLY_RESTRICTED", "source_count": 8, "research_depth": "DEEP", "risk_level": "HIGH", "prerequisite_status": "NONE_FOR_READING__NO_PRACTICE_AUTHORITY", "learning_route": { "mode": "FULL_RESTRICTED_TUTORIAL", "label": "Learn wakefulness stabilisation step by step", "summary": "The learner completes the correct response to three fictional sleepiness scenarios, including driving, work and persistent unexplained sleepiness. The learner also classifies the onset pattern and routes sudden or medically concerning loss of wakefulness without treating it as routine fatigue.", "steps": [ [ "Get ready", "Rehearse while rested and never create sleepiness as practice." ], [ "Learn the method", "9 concrete steps teach the permitted method from start to finish." ], [ "See right and wrong", "6 comparisons show correct or safer execution beside common wrong or riskier choices." ], [ "Practise", "Review the response every three months and after schedule, medication or role changes. A real event triggers recovery and review, never more wakefulness practice. Rotate onset features and associated symptoms at each rehearsal; do not add longer wake periods or stimulant tests as difficulty." ], [ "Check progress", "Score each rested scenario for warning recognition, physical safe state, direct notification, handover, transport/rest and clinical or workplace escalation. Add onset category, associated emergency features, driving suspension and assessment destination to the response score." ] ], "practical_authority": false, "provider_required": false, "next_action_route": "/tutorials/pwr-056/" }, "path_builder": { "selectable": true, "completion_allowed": true, "warning": "Titan teaches recognition, prevention, safe response and accountable routing without teaching the prohibited act." }, "full_tutorial": { "version": "3.0", "authorship": "POWER_SPECIFIC_FULL_TUTORIAL", "tutorial_mode": "RESTRICTED", "promise": "Wakefulness can be supported temporarily, but sleep cannot be hacked away. The prohibited act is extending wakefulness or testing how long someone can resist sleep. The method is a safety response for unexpected or unavoidable sleepiness: recognise a lapse, stop the hazardous task, notify another person, obtain safe transport and protected rest, then seek assessment when sleepiness persists. Unexpected sleepiness is handled as a change in state, not as a known roster problem. The learner distinguishes gradual drowsiness from sudden sleep attacks, fainting, seizure warning or neurological change, then chooses emergency care, prompt clinical review or ordinary fatigue recovery.", "power_id": "PWR-056", "title": "Wakefulness stabilisation", "lesson_type": "RESTRICTED", "headline": "Stabilise safety by stopping, handing over and arranging sleep—not by fighting wakefulness", "plain_english_summary": "Wakefulness can be supported temporarily, but sleep cannot be hacked away. The prohibited act is extending wakefulness or testing how long someone can resist sleep. The method is a safety response for unexpected or unavoidable sleepiness: recognise a lapse, stop the hazardous task, notify another person, obtain safe transport and protected rest, then seek assessment when sleepiness persists. Unexpected sleepiness is handled as a change in state, not as a known roster problem. The learner distinguishes gradual drowsiness from sudden sleep attacks, fainting, seizure warning or neurological change, then chooses emergency care, prompt clinical review or ordinary fatigue recovery.", "outcome": "The learner completes the correct response to three fictional sleepiness scenarios, including driving, work and persistent unexplained sleepiness. The learner also classifies the onset pattern and routes sudden or medically concerning loss of wakefulness without treating it as routine fatigue.", "authority": { "learner_may": [ "While rested, sort the supplied onset cards into expected gradual drowsiness, recurrent unexplained sleepiness or emergency-pattern change.", "Rehearse stopping the immediate hazard, stating the observed signs and choosing the keyed transport and assessment route.", "Use the direct statement ‘I cannot stay reliably awake and cannot continue safely’ to request an alert replacement or escort." ], "qualified_person_required_for": [ "Assessment of sudden, recurrent or persistent sleepiness, loss of consciousness, confusion or impaired function.", "Emergency evaluation of collapse, new neurological signs, chest symptoms or severe breathing difficulty.", "Medication, sleep-disorder treatment and any decision about return to driving or hazardous work." ], "never_do": [ "Create drowsiness, delay sleep or provoke an episode in order to practise the routing method.", "Drive, use machinery, work at height or continue a critical procedure after head nods, involuntary sleep or an unexplained episode.", "Use coffee, music, cold air, pain or a short nap as proof that the cause has resolved or driving is safe." ] }, "materials": [ "Three exact cards, read only while rested. Card G: after a known four-hour sleep opportunity, Alex develops heavy eyelids, two head nods and a missed exit while driving; there is no collapse, confusion, weakness, chest symptom or breathing difficulty, and an alert passenger is present. Card U: after an ordinary eight-hour sleep opportunity, Bo has an abrupt irresistible sleep episode at a desk, cannot respond for about one minute and remains newly confused; a colleague is present. Card R: Casey reports three irresistible daytime sleep episodes in two weeks despite roughly eight-hour sleep opportunities, with no collapse or emergency sign, and plans to drive tomorrow.", "A folded routing key. G = take the next safe stopping place, transfer driving to the alert passenger, obtain recovery sleep and review the schedule; U = call emergency services, keep Bo safe, do not give food/drink or transport Bo alone; R = suspend driving now and arrange prompt clinical assessment before any return-to-driving decision.", "A stop statement and handover card with observed sign, onset pattern, consciousness, associated signs, secured hazard, person contacted and transport restriction.", "Local emergency number, an alert escort option and any applicable workplace fatigue procedure." ], "before_you_start": [ "Rehearse while rested and never create sleepiness as practice.", "Identify the nearest safe stopping places and handover route for ordinary travel/work.", "Do not use the lesson to change prescribed stimulants, sedatives or sleep treatment.", "Call emergency services for collapse, severe breathing difficulty or new neurological symptoms." ], "steps": [ { "title": "Recognise loss of stable wakefulness", "instruction": "Treat head nods, heavy eyelids, drifting attention, repeated rereading, lane drift, missed steps or involuntary sleep as loss of stable wakefulness.", "reason": "Waiting for total sleep can be too late.", "success_check": "The learner identifies a behavioural sign rather than only “tired”." }, { "title": "Stop the hazardous action", "instruction": "At the first safe opportunity, pull over, shut down equipment, step away from heat/water/heights or pause the critical procedure.", "reason": "Physical safe state comes before attempts to feel more alert.", "success_check": "The hazard is stationary, isolated or transferred." }, { "title": "Tell someone directly", "instruction": "Say “I cannot stay reliably awake and cannot continue safely” to the driver, supervisor or support person.", "reason": "Direct language activates help and resists minimising the problem.", "success_check": "A named person receives and acknowledges the message." }, { "title": "Hand over completely", "instruction": "Give task state, hazards, people affected, unfinished steps and when the next check is due.", "reason": "An incomplete handover can create a new error after the learner stops.", "success_check": "The receiver repeats back critical points." }, { "title": "Choose safe transport and rest", "instruction": "Do not drive yourself. Use an alert driver or safe stopping place and obtain protected sleep opportunity.", "reason": "Sleep restores wakefulness more fundamentally than stimulation.", "success_check": "The plan does not depend on the sleepy person navigating or driving." }, { "title": "Bound temporary countermeasures", "instruction": "Where official or clinical guidance allows, a brief nap and ordinary caffeine may provide temporary alertness; neither proves fitness or replaces recovery sleep.", "reason": "Temporary effects can fade and caffeine can affect later sleep.", "success_check": "The record labels the measure temporary and includes the sleep plan." }, { "title": "Escalate the cause", "instruction": "Seek clinical assessment when sleepiness is sudden, recurrent or persists despite adequate sleep; report roster-related fatigue for system correction.", "reason": "Sleep disorders, medication, illness and schedule design require different responses.", "success_check": "The trigger, destination and timescale for review are written down." }, { "title": "Classify how wakefulness changed", "instruction": "After the scene is secure, identify whether sleepiness built gradually after inadequate sleep, appeared suddenly despite adequate rest, included loss of consciousness, or came with weakness, speech change, severe headache, chest symptoms or breathing difficulty.", "reason": "A routine fatigue response is not enough for collapse, sudden sleep episodes or neurological and cardiopulmonary warning signs.", "success_check": "The event is labelled gradual expected drowsiness, recurrent unexplained sleepiness or emergency-pattern change, with the observed feature quoted." }, { "title": "Choose the correct assessment route", "instruction": "For emergency-pattern change, call emergency services and keep the person safe. For recurrent sudden sleepiness despite adequate opportunity, arrange prompt clinical assessment and suspend driving. For expected schedule-related drowsiness, document the schedule and complete protected recovery.", "reason": "Routing by onset and associated signs prevents a potentially serious condition from being normalised as poor motivation.", "success_check": "The chosen route, transport restriction and person contacted match the onset category and are recorded before the scenario ends." } ], "worked_example": { "scenario": "On Card G, Alex has two head nods and misses an exit after a known four-hour sleep opportunity; an alert passenger is present.", "walkthrough": [ "Alex recognises head nods and a missed exit as loss of stable wakefulness and takes the next safe stopping place rather than opening a window.", "Alex parks legally, stops the vehicle and says, ‘I cannot stay reliably awake and cannot continue safely.’", "The alert passenger receives the route, vehicle state and destination, then takes over; Alex does not perform a coffee-based clearance test.", "The learner labels Card G gradual expected drowsiness because the short sleep opportunity and behavioural warnings are supplied and no emergency sign appears.", "When Card U is uncovered, the unresponsive minute and new confusion route to emergency services; when Card R is uncovered, recurrent episodes despite adequate opportunity route to driving suspension and prompt clinical assessment." ], "result": "Wakefulness is stabilised by removing Alex from the driving task and routing recurrent or emergency-pattern symptoms to care. No endurance method is taught." }, "right_vs_wrong": [ { "situation": "Driving sign", "right": "Stop at the first safe place after lane drift, head nod or attention gap.", "wrong": "Open a window, turn up music and continue.", "why": "Stimulation does not make microsleep risk disappear." }, { "situation": "Work response", "right": "Secure the task and hand over.", "wrong": "Hide fatigue to finish a critical step.", "why": "Concealment leaves the hazard active." }, { "situation": "Transport", "right": "Use an alert driver or accessible safe alternative.", "wrong": "Drive home because the shift is over.", "why": "Risk continues during the journey." }, { "situation": "Caffeine", "right": "Treat it as a temporary adjunct with a recovery plan.", "wrong": "Escalate repeated doses to replace sleep.", "why": "Effects are incomplete and can disrupt recovery." }, { "situation": "Persistent sleepiness", "right": "Seek assessment despite adequate sleep.", "wrong": "Assume weak willpower and train harder.", "why": "Unexplained sleepiness can reflect a health condition." }, { "situation": "Sudden episode after adequate sleep", "right": "Suspend driving and route new confusion, collapse or neurological signs to urgent assessment.", "wrong": "Assume every loss of wakefulness is shift fatigue and sleep it off.", "why": "Onset and associated symptoms can indicate a different, more urgent problem." } ], "common_mistakes": [ { "mistake": "The learner labels an abrupt episode “tired” without recording whether consciousness was lost.", "fix": "Ask whether the person could respond throughout, whether there was a fall and whether confusion remained afterward; route uncertainty to medical assessment." }, { "mistake": "Music, cold air or pinching is used as a wakefulness check.", "fix": "Secure the hazard and use observed state plus onset history; stimulation is neither a diagnosis nor clearance." }, { "mistake": "A recurrent sleep attack is managed only by avoiding long drives.", "fix": "Suspend all driving and arrange clinical assessment because short familiar journeys can still contain involuntary sleep." }, { "mistake": "The handover ends after saying “I am sleepy”.", "fix": "Name the secured equipment, people exposed, unfinished action and the alert receiver who accepted control." }, { "mistake": "The learner sends the drowsy person alone on public transport despite disorientation.", "fix": "Arrange an alert escort or accessible door-to-door option when navigation or personal safety is impaired." }, { "mistake": "A short nap is treated as evidence that the underlying cause has resolved.", "fix": "Label the nap as temporary recovery and keep the medical or schedule-review trigger active." } ], "practice": { "first_session": [ "Read Card G while rested, quote the two behavioural warnings and rehearse the next-safe-place stop plus passenger handover.", "Fill the handover card with observed sign, known short-sleep onset, intact consciousness, secured vehicle and alert replacement.", "Sort Cards U and R before viewing the key: U must include emergency services and supervised safety; R must include immediate driving suspension and prompt assessment.", "Uncover the routing key, correct any normalised collapse, missing transport restriction or stimulant-based clearance, and keep the original answer visible.", "Repeat the three-card sort after 48 hours with card order concealed; no actual drowsiness or episode is created." ], "repeat_plan": "Review the response every three months and after schedule, medication or role changes. A real event triggers recovery and review, never more wakefulness practice. Rotate onset features and associated symptoms at each rehearsal; do not add longer wake periods or stimulant tests as difficulty.", "progress_when": [ "The stop occurs before a simulated incident.", "The handover is complete and acknowledged.", "The plan ends in safe transport, sleep opportunity and appropriate review.", "The learner routes sudden unexplained sleepiness differently from predictable schedule-related drowsiness." ], "do_not_progress_when": [ "A scenario is being enacted with actual sleep deprivation.", "Safe transport or an alert replacement has not been arranged.", "The workplace lacks authority for a fatigue stop; escalate this system gap.", "The scenario omits onset, loss-of-consciousness or associated-symptom information needed to choose a clinical route." ] }, "self_check": [ "Can you demonstrate “Stop the hazardous action”? The hazard is stationary, isolated or transferred.", "Can you demonstrate “Hand over completely”? The receiver repeats back critical points.", "Can you demonstrate “Escalate the cause”? The trigger, destination and timescale for review are written down.", "Can you explain why abrupt sleepiness with confusion after adequate rest is not handled as an ordinary end-of-shift fatigue event?" ], "measurement": { "primary": "Objective vigilance, error rate, recovery sleep and adverse effects", "how": "Score each rested scenario for warning recognition, physical safe state, direct notification, handover, transport/rest and clinical or workplace escalation. Add onset category, associated emergency features, driving suspension and assessment destination to the response score.", "good_result": "Each supplied card reaches its keyed route, with the hazard secured first, the observed onset features quoted, driving restriction retained and no stimulation test proposed. A routing error is corrected and retested; the exercise does not clear anyone to resume a hazardous task.", "does_not_prove": "Correct scenario routing does not prove that stimulation restores wakefulness, identify the medical cause of sudden sleepiness or clear anyone to resume driving or hazardous work." }, "stop_and_get_help": [ "Stop driving or hazardous work for involuntary sleep, head nods, lane drift, repeated errors or inability to track the task.", "Call emergency services for collapse, severe breathlessness, chest pain, confusion or new neurological symptoms.", "Arrange clinical review for recurrent or sudden sleepiness, especially when it persists despite adequate sleep or affects driving/work." ], "accessibility": [ "Pre-book accessible transport options and an emergency contact.", "Use a speech device or card with the direct fatigue stop statement.", "Write handover prompts in large print, audio or symbols and allow a supporter to deliver them." ], "evidence_notes": [ { "claim": "Primary research shows that caffeine during sleep deprivation can change recovery sleep, limiting its use as a simple replacement for sleep.", "source_title": "Caffeine Intake Alters Recovery Sleep after Sleep Deprivation", "source_url": "https://pubmed.ncbi.nlm.nih.gov/39458438/", "source_kind": "PRIMARY_RESEARCH" }, { "claim": "NIOSH guidance supports stopping fatigued driving and notes that temporary nap/caffeine effects do not replace sleep.", "source_title": "Driver Fatigue on the Job", "source_url": "https://www.cdc.gov/niosh/motor-vehicle/driver-fatigue/index.html", "source_kind": "OFFICIAL_GUIDANCE" } ], "limits": [ "Objective vigilance, microsleeps, errors and recovery must accompany subjective wakefulness; stimulant use is part of the configuration.", "Unsupported claim: stay awake indefinitely.", "Unsupported claim: caffeine makes sleep optional.", "Unsupported claim: train your brain never to tire.", "The lesson does not teach wakefulness extension, stimulant dosing, deprivation tolerance or fitness for duty." ], "orientation": { "bounded_definition": "Capability to develop or express wakefulness stabilisation in a declared context without inheriting broader claims.", "evidence_summary": "Wakefulness can be supported temporarily, but sleep cannot be hacked away.", "supportable_public_claim": "Short-term wakefulness can be supported, but no countermeasure replaces sleep or produces a durable sleep-loss capability.", "measurement_boundary": "Objective vigilance, microsleeps, errors and recovery must accompany subjective wakefulness; stimulant use is part of the configuration.", "myth_to_metric": { "myth": "Stay perfectly alert for as long as needed", "metric": "Objective vigilance, error rate, recovery sleep and adverse effects", "boundary": "Feeling awake or taking a stimulant does not prove safe performance." }, "limiting_findings": [ "Repeated caffeine did not restore well-rested performance.", "Caffeine altered recovery sleep.", "Repeated caffeine showed adaptation/withdrawal effects and not clear-cut benefit in one study." ], "prohibited_claims": [ "stay awake indefinitely", "caffeine makes sleep optional", "train your brain never to tire", "readiness score clears you to drive" ] }, "gold_source_lesson": null, "next_gate": "External confirmation is required before higher-authority use because: CLINICAL_HIGH_RISK_OR_REGULATED_CONFIGURATION; SUPERVISION_OR_NON_ATTEMPT_BOUNDARY; CULTURAL_COMMUNITY_RIGHTS_OR_AFFECTED_PERSON_AUTHORITY; SAFETY_LEGITIMACY_RESTRICTED.", "evidence_count": 8 }, "full_training_programme": false, "independently_validated": false, "publication_state": "PUBLISHED_PUBLIC_RESEARCH_EDITION__EDITORIAL_REVIEW_PENDING", "related_power_ids": [ "PWR-049", "PWR-050", "PWR-051", "PWR-052" ] }, { "power_id": "PWR-057", "learning_unit_id": "TLU-PWR-057", "title": "Motor recovery", "main_description": "Under rehabilitation supervision, you complete a prescribed reach-and-place block with declared support, cue, repetitions and symptom limits.", "main_description_source": "FULL_TUTORIAL_OUTCOME", "family_id": "FAM-08", "family": "Health, Rehabilitation & Adaptive Independence", "superdomain": "Regulation & Recovery", "canonical_route": "/powers/pwr-057/", "treatment": "SPECIALIST_PROVIDER_ROUTE", "treatment_label": "Full supervised tutorial", "treatment_boundary": "Titan teaches the complete method; a qualified person controls the parts that require supervision, clearance, specialist equipment, load, dose or progression.", "tutorial_route": "/tutorials/pwr-057/", "governed_lesson_route": null, "self_attempt_status": "PROHIBITED_WITHOUT_QUALIFIED_SUPERVISION", "gold_pathway_ids": [], "route_membership": { "kind": "RETAINED_EXTERNAL_ROUTE", "id": "SP-HUB-003", "coverage_status": "RETAINED" }, "source_authority_tier": "G4", "source_build_state": "EXTERNAL_PROVIDER_ROUTE", "source_instructional_route": "LEARN_ELSEWHERE_TRACK_WITH_TITAN", "source_count": 3, "research_depth": "FOCUSED", "risk_level": "HIGH", "prerequisite_status": "QUALIFIED_PROVIDER_DETERMINES", "learning_route": { "mode": "FULL_SUPERVISED_TUTORIAL", "label": "Learn motor recovery step by step", "summary": "Under rehabilitation supervision, you complete a prescribed reach-and-place block with declared support, cue, repetitions and symptom limits.", "steps": [ [ "Get ready", "The treating professional selects the limb, movement, range, load, assistance and repetition dose for the diagnosis and stage of recovery." ], [ "Learn the method", "8 concrete steps teach the permitted method from start to finish." ], [ "See right and wrong", "5 comparisons show correct or safer execution beside common wrong or riskier choices." ], [ "Practise", "Rehabilitation professional sets session frequency and progression. Change only one of distance, object, support, speed or context after stable quality. Record real-world arm use separately from clinic performance." ], [ "Check progress", "Record successful placements out of prescribed trials, movement-quality error, assistance level, time, effort, symptoms; note whether each reach-and-place trial appears in real-world arm use." ] ], "practical_authority": false, "provider_required": true, "next_action_route": "/tutorials/pwr-057/" }, "path_builder": { "selectable": true, "completion_allowed": true, "warning": "Titan teaches the complete method; a qualified person controls the parts that require supervision, clearance, specialist equipment, load, dose or progression." }, "full_tutorial": { "version": "3.0", "authorship": "POWER_SPECIFIC_FULL_TUTORIAL", "tutorial_mode": "SUPERVISED", "promise": "Motor recovery is diagnosis- and task-specific: the movement, dose, timing and support all matter. This lesson teaches a full reach-and-place trial. A rehabilitation professional selects the trajectory and assistance; you set a stable start, aim at a real object, use one cue, rest before quality collapses and measure movement separately from real-world arm use.", "power_id": "PWR-057", "title": "Motor recovery", "lesson_type": "SUPERVISED", "headline": "Practise one meaningful movement with the right support, feedback and rest", "plain_english_summary": "Motor recovery is diagnosis- and task-specific: the movement, dose, timing and support all matter. This lesson teaches a full reach-and-place trial. A rehabilitation professional selects the trajectory and assistance; you set a stable start, aim at a real object, use one cue, rest before quality collapses and measure movement separately from real-world arm use.", "outcome": "Under rehabilitation supervision, you complete a prescribed reach-and-place block with declared support, cue, repetitions and symptom limits.", "authority": { "learner_may": [ "Prepare the therapist-set supported seat, foam cup, 20 cm path and target, then rehearse approach–grasp–move–release without chasing speed.", "Complete only the declared trial count with the stated forearm/trunk support and therapist assistance.", "Record target placement, trunk lean, grip/release, help, discomfort and whether the reach helped the selected daily task." ], "qualified_person_required_for": [ "Assessing weakness, tone, pain, joint protection, sensation, neglect, cognition and medical precautions before selecting the reach.", "Choosing posture, object, distance, repetitions, rest, manual assistance and the one cue changed between matched blocks.", "Progressing load, speed, support or daily-task complexity and interpreting recovery beyond this one reach-and-place record." ], "never_do": [ "Increase cup weight, path, speed or repetitions because one reach looked good, or remove a support to manufacture independence.", "Pull the affected arm, force a painful range or continue through new weakness, severe headache, chest symptoms, dizziness or loss of control.", "Treat target hits in the clinic as proof of safe cooking, driving, lifting or unsupervised arm use." ] }, "materials": [ "A stable chair and table set to provider-selected heights.", "One light, unbreakable object with an accessible grip and a marked start/finish area.", "Prescribed brace, support, stimulation or assistance if part of the plan.", "A trial sheet for success, movement quality, assistance, effort, pain and rest." ], "before_you_start": [ "The treating professional selects the limb, movement, range, load, assistance and repetition dose for the diagnosis and stage of recovery.", "Check sitting/standing stability, joint position, skin, lines/tubes and prescribed equipment.", "Clear the route and use a helper when loss of balance or dropping is possible.", "Agree stops for new weakness, severe pain, dizziness, chest symptoms, marked fatigue or abnormal movement." ], "steps": [ { "title": "Name functional goal", "instruction": "State the daily action this reach supports, such as moving a cup to a marked place, and your treating therapist-set success feature.", "reason": "A meaningful target links movement practice to use rather than isolated repetitions.", "success_check": "You can name the reach-and-place task and one trajectory goal." }, { "title": "Set starting position", "instruction": "Place your body, limb and object exactly as your therapist specifies; keep prescribed support in place.", "reason": "Start position changes range, balance and difficulty.", "success_check": "Feet/body support, object and limb match this setup card." }, { "title": "Preview one correct trial", "instruction": "Watch or feel your therapist demonstrate the reach path and rehearse it once with prescribed assistance.", "reason": "A clear model reduces guessing and compensatory movement.", "success_check": "You identify starting, path and finish." }, { "title": "Reach on one cue", "instruction": "On the chosen cue, move toward the practice object at a controllable speed while your therapist provides only the planned assistance.", "reason": "One cue and stable assistance make errors interpretable.", "success_check": "Your hand or device reaches the landing zone without an unsafe loss of balance." }, { "title": "Grasp, then place", "instruction": "Use the selected grip or adaptive aid, lift only as prescribed, then place the practice object fully inside the landing-zone mark.", "reason": "Each reach-and-place trial includes useful object control, not movement for its own sake.", "success_check": "The practice object is secure, arrives in the landing zone; release occurs under control." }, { "title": "Reset without rushing", "instruction": "Return your working limb and object to starting with help as planned; do not add a fast return repetition.", "reason": "Reset quality and fatigue affect next attempt.", "success_check": "The original configuration is restored before next cue." }, { "title": "Use one correction", "instruction": "After provider feedback, change one feature such as trunk support, reach direction or grip timing, then repeat.", "reason": "One correction teaches the largest error without overloading attention.", "success_check": "The movement tally names the error and shows whether it changed." }, { "title": "Rest and check transfer", "instruction": "Stop at prescribed repetition or quality limit, rest, then test one provider-approved daily variant if appropriate.", "reason": "Fatigued repetitions can rehearse compensation; transfer must be tested separately.", "success_check": "Quality remains within the agreed rule and any variant is labelled new." } ], "worked_example": { "scenario": "After stroke, Elena’s therapist selects moving a foam cup 20 cm across a table using her affected arm with forearm support.", "walkthrough": [ "The therapist positions Elena, the cup and a target circle; logs the amount of forearm support.", "Elena watches one demonstration and rehearses the reach path with assistance.", "She reaches on the cue, secures the foam cup, then places it inside the circle.", "After a trunk-lean error, the therapist adds one support cue and Elena repeats.", "They stop after five prescribed trials, record successes and test no heavier object." ], "result": "Elena completes four of five placements with declared support and less trunk lean. This demonstrates progress on the prescribed task, not recovery across all arm use." }, "right_vs_wrong": [ { "situation": "Task choice", "right": "Use each reach trajectory selected for this diagnosis and goal.", "wrong": "Copy a generic exercise or force a weak limb through range.", "why": "Dose and movement safety depend on the person and recovery stage." }, { "situation": "Assistance", "right": "Keep motor planned assistance visible in movement tally.", "wrong": "Hide help to claim independence.", "why": "Unrecorded assistance makes change uninterpretable." }, { "situation": "Speed", "right": "Move slowly enough to keep balance and object control.", "wrong": "Use momentum to finish the reach.", "why": "Momentum can mask control and increase risk." }, { "situation": "Compensation", "right": "Accept or correct trunk movement according to your therapist’s goal.", "wrong": "Assume every successful placement uses intended movement.", "why": "A result can improve by compensation rather than recovery." }, { "situation": "Dose", "right": "Stop when trajectory quality or symptom rule is reached.", "wrong": "Continue until exhaustion.", "why": "Fatigue can worsen movement and safety." } ], "common_mistakes": [ { "mistake": "Copy a generic exercise or force a weak limb through range.", "fix": "Use each reach trajectory selected for this diagnosis and goal." }, { "mistake": "Hide help to claim independence.", "fix": "Keep motor planned assistance visible in movement tally." }, { "mistake": "Use momentum to finish the reach.", "fix": "Move slowly enough to keep balance and object control." }, { "mistake": "Assume every successful placement uses intended movement.", "fix": "Accept or correct trunk movement according to your therapist’s goal." }, { "mistake": "Continue until exhaustion.", "fix": "Stop when trajectory quality or symptom rule is reached." } ], "practice": { "first_session": [ "Elena’s therapist fixes the supported sitting position, foam cup, 20 cm path, target circle, assistance level, five-trial limit and symptom stops.", "Elena watches one approach–grasp–move–release demonstration and completes one therapist-assisted rehearsal without chasing speed.", "A first three-trial block records cup placement, trunk lean, forearm support, grip release and discomfort on every attempt.", "The therapist changes only the trunk-support cue, then Elena completes two matched trials with the same cup and distance.", "After rest, a daily-use check is attempted only if trajectory quality and symptoms remain inside the therapist’s rule." ], "repeat_plan": "Rehabilitation professional sets session frequency and progression. Change only one of distance, object, support, speed or context after stable quality. Record real-world arm use separately from clinic performance.", "progress_when": [ "More prescribed placements succeed with equal or less assistance.", "Trajectory quality remains within your therapist’s rule across the full block.", "The skill appears in a provider-approved daily object transfer without worse symptoms." ], "do_not_progress_when": [ "New weakness, loss of coordination, pain, swelling, dizziness or unusual fatigue appears.", "Compensation or assistance rises across this repetition block.", "You or helper cannot reproduce the safe setup." ] }, "self_check": [ "Can you demonstrate “Set starting position”? Feet/body support, object and limb match this setup card.", "Can you demonstrate “Grasp, then place”? The practice object is secure, arrives in the landing zone; release occurs under control.", "Can you demonstrate “Rest and check transfer”? Quality remains within the agreed rule and any variant is labelled new." ], "measurement": { "primary": "Successful 20 cm foam-cup placements with trunk compensation, assistance, grip release, symptoms and separate real-world arm use", "how": "Record successful placements out of prescribed trials, movement-quality error, assistance level, time, effort, symptoms; note whether each reach-and-place trial appears in real-world arm use.", "good_result": "Your treating therapist confirms meaningful improvement on repeated matched trials and at least one relevant daily object transfer without increased harm or burden.", "does_not_prove": "Better supported foam-cup placement does not prove full neurological recovery, independent arm use, safe handling of heavier objects or transfer to an untested daily activity." }, "stop_and_get_help": [ "Stop and seek urgent help for sudden new weakness, facial droop, speech change, severe headache, collapse, chest pain or severe breathlessness.", "Stop this repetition block for increasing pain, unsafe balance, uncontrolled spasm, joint strain or sharp decline in trajectory quality.", "Contact rehabilitation team after a fall, new swelling, skin injury or sustained loss of function." ], "accessibility": [ "Use your prescribed seating, brace, grip aid and communication method.", "Change object size, contrast or target position while preserving the same functional goal; log the change.", "Allow hand-over-hand or robotic assistance when prescribed; supported performance remains valid when labelled." ], "evidence_notes": [ { "claim": "The EXCITE trial supports task-specific upper-limb practice for selected stroke survivors, not a universal dose or unsupervised forcing.", "source_title": "Effect of constraint-induced movement therapy on upper extremity function 3 to 9 months after stroke: the EXCITE randomized clinical trial", "source_url": "https://pubmed.ncbi.nlm.nih.gov/17077374/", "source_kind": "PRIMARY_RESEARCH" }, { "claim": "AVERT shows that timing and dose can change rehabilitation safety, supporting provider control of early progression.", "source_title": "Efficacy and safety of very early mobilisation within 24 h of stroke onset (AVERT): a randomised controlled trial", "source_url": "https://pubmed.ncbi.nlm.nih.gov/25892679/", "source_kind": "PRIMARY_RESEARCH" } ], "limits": [ "Use impairment and meaningful activity/participation outcomes; laboratory movement speed alone does not establish independence.", "Unsupported claim: recover from paralysis through willpower.", "Unsupported claim: more and earlier therapy is always better.", "Unsupported claim: one exercise repairs the brain.", "Success on one reach does not prove neurological recovery, safe independent mobility or transfer to other objects and environments." ], "orientation": { "bounded_definition": "Capability to develop or express motor recovery in a declared context without inheriting broader claims.", "evidence_summary": "Motor recovery is possible for selected people, but the right task, dose, timing and support matter.", "supportable_public_claim": "Selected people can regain meaningful motor function through diagnosis-specific rehabilitation.", "measurement_boundary": "Use impairment and meaningful activity/participation outcomes; laboratory movement speed alone does not establish independence.", "myth_to_metric": { "myth": "Force the brain to rewire and recover any movement", "metric": "Diagnosis-specific motor and daily-use outcomes, harms and one-year retention", "boundary": "One improved clinic task does not establish full recovery or independence." }, "limiting_findings": [ "High-dose very early mobilisation within 24 hours of stroke reduced favorable outcomes in AVERT.", "EXCITE applies only to an eligible post-stroke subgroup." ], "prohibited_claims": [ "recover from paralysis through willpower", "more and earlier therapy is always better", "one exercise repairs the brain", "assistance means failure" ] }, "gold_source_lesson": null, "next_gate": "External confirmation is required before higher-authority use because: CLINICAL_HIGH_RISK_OR_REGULATED_CONFIGURATION; SUPERVISION_OR_NON_ATTEMPT_BOUNDARY; CULTURAL_COMMUNITY_RIGHTS_OR_AFFECTED_PERSON_AUTHORITY; SAFETY_LEGITIMACY_RESTRICTED.", "evidence_count": 3 }, "full_training_programme": false, "independently_validated": false, "publication_state": "PUBLISHED_PUBLIC_RESEARCH_EDITION__EDITORIAL_REVIEW_PENDING", "related_power_ids": [ "PWR-058", "PWR-059", "PWR-060", "PWR-061" ] }, { "power_id": "PWR-058", "learning_unit_id": "TLU-PWR-058", "title": "Sensory recovery and retraining", "main_description": "With a rehabilitation professional, Amir completes coded S/R foam trials and uses vision plus a temperature indicator for a cup instead of trusting impaired heat sensation.", "main_description_source": "FULL_TUTORIAL_OUTCOME", "family_id": "FAM-08", "family": "Health, Rehabilitation & Adaptive Independence", "superdomain": "Regulation & Recovery", "canonical_route": "/powers/pwr-058/", "treatment": "SPECIALIST_PROVIDER_ROUTE", "treatment_label": "Full supervised tutorial", "treatment_boundary": "Titan teaches the complete method; a qualified person controls the parts that require supervision, clearance, specialist equipment, load, dose or progression.", "tutorial_route": "/tutorials/pwr-058/", "governed_lesson_route": null, "self_attempt_status": "PROHIBITED_WITHOUT_QUALIFIED_SUPERVISION", "gold_pathway_ids": [], "route_membership": { "kind": "RETAINED_EXTERNAL_ROUTE", "id": "SP-HUB-003", "coverage_status": "RETAINED" }, "source_authority_tier": "G4", "source_build_state": "EXTERNAL_PROVIDER_ROUTE", "source_instructional_route": "LEARN_ELSEWHERE_TRACK_WITH_TITAN", "source_count": 4, "research_depth": "DETAILED", "risk_level": "HIGH", "prerequisite_status": "QUALIFIED_PROVIDER_DETERMINES", "learning_route": { "mode": "FULL_SUPERVISED_TUTORIAL", "label": "Learn sensory recovery and retraining step by step", "summary": "With a rehabilitation professional, Amir completes coded S/R foam trials and uses vision plus a temperature indicator for a cup instead of trusting impaired heat sensation.", "steps": [ [ "Get ready", "The clinician identifies the affected modality and skin/nerve condition and chooses a non-injurious stimulus." ], [ "Learn the method", "8 concrete steps teach the permitted method from start to finish." ], [ "See right and wrong", "5 comparisons show correct or safer execution beside common wrong or riskier choices." ], [ "Practise", "The clinician sets frequency and advances from obvious to closer contrasts or to a related daily object only after matched random-order blocks show reproducible discrimination beyond the learner’s first block without skin harm. Compensation remains until functional safety is directly established." ], [ "Check progress", "Record correct, incorrect and no-response trials for the named modality, confidence, presentation rule, skin condition and use of compensation in a declared functional task." ] ], "practical_authority": false, "provider_required": true, "next_action_route": "/tutorials/pwr-058/" }, "path_builder": { "selectable": true, "completion_allowed": true, "warning": "Titan teaches the complete method; a qualified person controls the parts that require supervision, clearance, specialist equipment, load, dose or progression." }, "full_tutorial": { "version": "3.0", "authorship": "POWER_SPECIFIC_FULL_TUTORIAL", "tutorial_mode": "SUPERVISED", "promise": "Sensation can sometimes be retrained or supplied through technology, but recovery and substitution must not be confused. Sensory recovery and sensory substitution are different. This lesson teaches a provider-selected discrimination trial with safe objects, controlled vision, immediate feedback and a functional protection check. Numb skin is never tested with heat, sharpness or injury.", "power_id": "PWR-058", "title": "Sensory recovery and retraining", "lesson_type": "SUPERVISED", "headline": "Tell smooth foam from ribbed foam and keep heat compensation", "plain_english_summary": "Sensation can sometimes be retrained or supplied through technology, but recovery and substitution must not be confused. Sensory recovery and sensory substitution are different. This lesson teaches a provider-selected discrimination trial with safe objects, controlled vision, immediate feedback and a functional protection check. Numb skin is never tested with heat, sharpness or injury.", "outcome": "With a rehabilitation professional, Amir completes coded S/R foam trials and uses vision plus a temperature indicator for a cup instead of trusting impaired heat sensation.", "authority": { "learner_may": [ "Inspect and name the smooth and ribbed foam blocks, then identify one concealed clinician-presented block per random trial before looking.", "Use immediate paired feedback and preserve ordinary visual, temperature, skin and mobility compensation in daily activity.", "Record smooth/ribbed answers, presentation order, cues, skin response and whether the protective strategy was used." ], "qualified_person_required_for": [ "Identifying the affected sensory modality and choosing a non-injurious site, objects, presentation pressure/time, random order and trial dose.", "Assessing wounds, circulation, nerve/brain injury, neglect or protective-sensation loss and deciding which compensation remains necessary.", "Progressing to closer textures, weights or functional objects and interpreting whether discrimination changed clinically." ], "never_do": [ "Use hot/cold extremes, needles, blades, painful pressure, vibration overload or an injured skin area to ‘wake up’ sensation.", "Peek selectively, let the presenter cue the answer or replace the random key after seeing the response.", "Remove heat checks, vision, gloves, fall protection or another prescribed compensation because foam-block accuracy improved." ] }, "materials": [ "A smooth foam block S and ribbed foam block R, equal in size and weight and approved for the tested skin/hand.", "A screen or eye closure method selected for safe testing.", "A folded ten-trial texture key S,R,R,S,R,S,S,R,S,R; the clinician presents one block for the same interval and hand position on each trial and rests after trial 5.", "Prescribed protective, visual or technology-based compensation aids." ], "before_you_start": [ "The clinician identifies the affected modality and skin/nerve condition and chooses a non-injurious stimulus.", "Inspect the test area for redness, wound, swelling or pressure injury.", "Never use hot/cold extremes, needles, blades or painful pressure to “wake up” sensation.", "Keep fall protection and usual visual or mobility aids for the functional part." ], "steps": [ { "title": "Declare S versus R", "instruction": "Write S = smooth foam and R = ribbed foam. Keep shape, size, weight, tested hand and contact interval matched.", "reason": "A single texture contrast makes each error interpretable.", "success_check": "Trial card names texture, S/R labels, tested hand and contact rule." }, { "title": "Learn both foam anchors", "instruction": "With vision available, Amir looks at and feels S once, then R once, and points to each printed label.", "reason": "Visible anchors link each safe texture to one response.", "success_check": "Amir labels both unscored anchors correctly before screening begins." }, { "title": "Support hand behind screen", "instruction": "Rest Amir's forearm on its support, inspect contact skin and place clinician-selected screen so eyes cannot reveal S or R.", "reason": "Stable hand/contact plus hidden vision prevent position and visual clues replacing texture.", "success_check": "Forearm, contact area and screen remain fixed for every coded presentation." }, { "title": "Follow concealed ten-item key", "instruction": "Clinician presents S,R,R,S,R, rests, then S,S,R,S,R using identical contact time and hand placement; Amir cannot see order.", "reason": "Five of each texture in a concealed order prevents an alternating or majority guess.", "success_check": "Ten rows reproduce folded order and any changed contact is marked void." }, { "title": "Commit label before reveal", "instruction": "After each contact, Amir says S, R or no response and rates confidence before screen moves.", "reason": "Committed texture label separates discrimination from recognition after looking.", "success_check": "Each row contains label plus confidence before keyed feedback." }, { "title": "Give one paired texture correction", "instruction": "Reveal block, state keyed S/R, let Amir look and feel it once, then cover again without overwriting original response.", "reason": "Immediate pairing teaches texture–label link while keeping raw miss.", "success_check": "Baseline answer remains visible beside keyed label and correction." }, { "title": "Total S/R responses and recheck skin", "instruction": "After trial 10, total correct, incorrect and no-response without converting void contacts to misses; clinician reinspects contact skin.", "reason": "Separate response categories plus skin status preserve both interpretation and protection.", "success_check": "Ten valid/void rows reconcile with totals and post-block skin check is documented." }, { "title": "Keep hot-cup protection", "instruction": "For a cup, Amir looks and uses prescribed temperature indicator; he does not judge heat with affected hand even after correct S/R trials.", "reason": "Foam texture learning does not restore protective temperature sensation.", "success_check": "Vision/indicator is used and heat remains outside texture score." } ], "worked_example": { "scenario": "A therapist works with Amir after a stroke on distinguishing a smooth foam block from a ribbed foam block in his affected hand.", "walkthrough": [ "Amir sees and names both blocks first.", "The therapist supports his hand behind a screen and presents one block for the same interval each trial.", "Amir answers before looking, then sees and feels the correct block for feedback.", "They complete ten random trials with a rest after five.", "For a daily-task check, Amir uses vision and a temperature indicator rather than trusting the hand to judge a hot cup." ], "result": "Amir identifies seven of ten textures and consistently uses protection for heat. The discrimination result does not prove full sensation recovery." }, "right_vs_wrong": [ { "situation": "Stimulus", "right": "Use safe, broad differences chosen by the clinician.", "wrong": "Use sharp, very hot or very cold items.", "why": "Absent sensation removes a protective warning." }, { "situation": "Modality", "right": "Test one contrast at a time.", "wrong": "Mix texture, weight and location into one score.", "why": "A mixed score cannot show what changed." }, { "situation": "Answer timing", "right": "Commit the answer before visual feedback.", "wrong": "Look first and report the known answer.", "why": "That tests recognition with vision, not sensory discrimination." }, { "situation": "Miss", "right": "Preserve the miss and give one paired correction.", "wrong": "Erase misses after feedback.", "why": "Raw misses are needed to measure learning." }, { "situation": "Function", "right": "Use compensation for untrusted sensation.", "wrong": "Stop using protection after one good score.", "why": "Clinic discrimination does not guarantee hazard detection." } ], "common_mistakes": [ { "mistake": "Use sharp, very hot or very cold items.", "fix": "Use safe, broad differences chosen by the clinician." }, { "mistake": "Mix texture, weight and location into one score.", "fix": "Test one contrast at a time." }, { "mistake": "Look first and report the known answer.", "fix": "Commit the answer before visual feedback." }, { "mistake": "Erase misses after feedback.", "fix": "Preserve the miss and give one paired correction." }, { "mistake": "Stop using protection after one good score.", "fix": "Use compensation for untrusted sensation." } ], "practice": { "first_session": [ "The clinician inspects Amir's hand, approves the equal-size smooth S and ribbed R foam blocks, supports the forearm and records the ten-item folded order.", "With vision available, Amir looks at and feels S then R and points to the correct printed label for both anchors.", "Behind the screen, the clinician presents S,R,R,S,R, rests, then S,S,R,S,R with fixed contact; Amir answers and rates confidence before each reveal.", "Every response remains on the sheet; the clinician totals correct, incorrect and no-response and checks for examiner cueing or position changes.", "For the related cup task, Amir keeps vision and the prescribed temperature indicator rather than trusting the affected hand, then both inspect skin." ], "repeat_plan": "The clinician sets frequency and advances from obvious to closer contrasts or to a related daily object only after matched random-order blocks show reproducible discrimination beyond the learner’s first block without skin harm. Compensation remains until functional safety is directly established.", "progress_when": [ "Accuracy improves on a new random order.", "Confidence becomes better calibrated to correct and incorrect responses.", "The learner applies protection reliably in the related daily task." ], "do_not_progress_when": [ "Skin redness, wound, swelling or pain appears.", "Performance depends on visual, sound or examiner clues not in the declared task.", "The learner wants to test temperature or sharpness without clinical controls." ] }, "self_check": [ "Can you demonstrate ‘Learn both foam anchors’? Amir labels visible S and R before concealed trials.", "Can you demonstrate ‘Commit label before reveal’? S/R/no-response and confidence precede screen movement.", "Can you demonstrate ‘Total S/R responses and recheck skin’? Ten rows reconcile with response totals and skin check.", "Can you demonstrate ‘Keep hot-cup protection’? Vision and prescribed indicator remain in use regardless of foam score." ], "measurement": { "primary": "Correct, incorrect and no-response trials for one named safe sensory contrast, plus use of the paired protection routine", "how": "Record correct, incorrect and no-response trials for the named modality, confidence, presentation rule, skin condition and use of compensation in a declared functional task.", "good_result": "The provider sees repeatable improvement above the baseline on novel random orders plus reliable safety compensation.", "does_not_prove": "Psychophysical thresholds, discrimination, proprioception, task function and embodiment are separate; device-on effects are not biological recovery." }, "stop_and_get_help": [ "Stop for new skin injury, burning, swelling, severe pain or rapid sensory loss.", "Seek urgent assessment for sudden numbness with weakness, speech/vision change, severe headache or loss of balance.", "Contact the rehabilitation or prosthetic team when a device causes pressure, shock sensation or altered skin condition." ], "accessibility": [ "Use spoken, symbol or eye-gaze responses; motor speech is not required to show discrimination.", "Choose larger objects or alternate safe body sites while recording the change.", "Use high-contrast visual feedback or tactile reference boards for learners with combined sensory needs." ], "evidence_notes": [ { "claim": "A randomised pilot trial supports studying structured sensory retraining after stroke while leaving dose and generalisation bounded.", "source_title": "Sensory retraining of the lower limb after acute stroke: a randomized controlled pilot trial", "source_url": "https://pubmed.ncbi.nlm.nih.gov/17826453/", "source_kind": "PRIMARY_RESEARCH" }, { "claim": "WHO guidance supports assistive products as a valid route to function, distinct from biological sensory recovery.", "source_title": "Assistive technology", "source_url": "https://www.who.int/news-room/fact-sheets/detail/assistive-technology", "source_kind": "OFFICIAL_GUIDANCE" } ], "limits": [ "Psychophysical thresholds, discrimination, proprioception, task function and embodiment are separate; device-on effects are not biological recovery.", "Unsupported claim: regrow lost nerves through practice.", "Unsupported claim: restore every sense.", "Unsupported claim: prosthesis becomes biologically identical.", "Object discrimination does not establish pain, temperature or protective sensation, and device-assisted sensation is not biological restoration." ], "orientation": { "bounded_definition": "Capability to develop or express sensory recovery and retraining in a declared context without inheriting broader claims.", "evidence_summary": "Sensation can sometimes be retrained or supplied through technology, but recovery and substitution must not be confused.", "supportable_public_claim": "Selected sensory functions can be retrained or supplied through a configured rehabilitation/device pathway.", "measurement_boundary": "Psychophysical thresholds, discrimination, proprioception, task function and embodiment are separate; device-on effects are not biological recovery.", "myth_to_metric": { "myth": "Restore lost sensation completely", "metric": "Modality-specific thresholds, discrimination, task function, device state and user value", "boundary": "A reported percept does not establish natural sensation, broad recovery or independence." }, "limiting_findings": [ "The lower-limb stroke pilot found no between-group differences for most outcomes.", "Home prosthesis evidence involved only two participants and device interruptions." ], "prohibited_claims": [ "regrow lost nerves through practice", "restore every sense", "prosthesis becomes biologically identical", "sensory games cure stroke" ] }, "gold_source_lesson": null, "next_gate": "External confirmation is required before higher-authority use because: CLINICAL_HIGH_RISK_OR_REGULATED_CONFIGURATION; SUPERVISION_OR_NON_ATTEMPT_BOUNDARY; CULTURAL_COMMUNITY_RIGHTS_OR_AFFECTED_PERSON_AUTHORITY; SAFETY_LEGITIMACY_RESTRICTED.", "evidence_count": 4 }, "full_training_programme": false, "independently_validated": false, "publication_state": "PUBLISHED_PUBLIC_RESEARCH_EDITION__EDITORIAL_REVIEW_PENDING", "related_power_ids": [ "PWR-057", "PWR-059", "PWR-060", "PWR-061" ] }, { "power_id": "PWR-059", "learning_unit_id": "TLU-PWR-059", "title": "Pain self-management", "main_description": "The learner completes one clinician-agreed activity dose with planned supports and reports pain interference, function, recovery time and adverse effects.", "main_description_source": "FULL_TUTORIAL_OUTCOME", "family_id": "FAM-08", "family": "Health, Rehabilitation & Adaptive Independence", "superdomain": "Regulation & Recovery", "canonical_route": "/powers/pwr-059/", "treatment": "SPECIALIST_PROVIDER_ROUTE", "treatment_label": "Full supervised tutorial", "treatment_boundary": "Titan teaches the complete method; a qualified person controls the parts that require supervision, clearance, specialist equipment, load, dose or progression.", "tutorial_route": "/tutorials/pwr-059/", "governed_lesson_route": null, "self_attempt_status": "PROHIBITED_WITHOUT_QUALIFIED_SUPERVISION", "gold_pathway_ids": [], "route_membership": { "kind": "RETAINED_EXTERNAL_ROUTE", "id": "SP-HUB-003", "coverage_status": "RETAINED" }, "source_authority_tier": "G4", "source_build_state": "EXTERNAL_PROVIDER_ROUTE", "source_instructional_route": "LEARN_ELSEWHERE_TRACK_WITH_TITAN", "source_count": 2, "research_depth": "FOCUSED", "risk_level": "HIGH", "prerequisite_status": "QUALIFIED_PROVIDER_DETERMINES", "learning_route": { "mode": "FULL_SUPERVISED_TUTORIAL", "label": "Learn pain self-management step by step", "summary": "The learner completes one clinician-agreed activity dose with planned supports and reports pain interference, function, recovery time and adverse effects.", "steps": [ [ "Get ready", "The clinician checks red flags, diagnosis, medication and whether the selected activity is safe." ], [ "Learn the method", "8 concrete steps teach the permitted method from start to finish." ], [ "See right and wrong", "5 comparisons show correct or safer execution beside common wrong or riskier choices." ], [ "Practise", "Repeat the same dose two or three times at provider-set intervals. Increase only one feature after predictable recovery and meaningful function; reduce or redesign when delayed worsening or burden grows." ], [ "Check progress", "Record planned and actual dose, task completion, assistance, pain interference, effort, immediate symptoms and delayed recovery at the agreed interval." ] ], "practical_authority": false, "provider_required": true, "next_action_route": "/tutorials/pwr-059/" }, "path_builder": { "selectable": true, "completion_allowed": true, "warning": "Titan teaches the complete method; a qualified person controls the parts that require supervision, clearance, specialist equipment, load, dose or progression." }, "full_tutorial": { "version": "3.0", "authorship": "POWER_SPECIFIC_FULL_TUTORIAL", "tutorial_mode": "SUPERVISED", "promise": "Pain self-management aims to improve life around pain without denying pain or promising a cure. The learner and clinician select one valued activity, set a repeatable starting dose, use planned pauses and recovery, record the delayed effect and adjust from function rather than turning the task into a pain contest.", "power_id": "PWR-059", "title": "Pain self-management", "lesson_type": "SUPERVISED", "headline": "Use a time-based activity plan to protect function without denying pain", "plain_english_summary": "Pain self-management aims to improve life around pain without denying pain or promising a cure. The learner and clinician select one valued activity, set a repeatable starting dose, use planned pauses and recovery, record the delayed effect and adjust from function rather than turning the task into a pain contest.", "outcome": "The learner completes one clinician-agreed activity dose with planned supports and reports pain interference, function, recovery time and adverse effects.", "authority": { "learner_may": [ "Choose the clinician-approved valued activity, prepare prescribed chair/tools and follow the written work–pause–work dose even on a good day.", "Stop at the planned finish point and keep medication, mobility aid, positioning and assistance unchanged during the comparison.", "Record completed function, pain interference, effort, help and the agreed delayed recovery check." ], "qualified_person_required_for": [ "Screening red flags and deciding whether the activity, posture, starting dose, pause and delayed-check interval are appropriate.", "Interpreting new or worsening pain, neurological change, inflammatory/medical symptoms or delayed deterioration and adjusting the plan.", "Changing medication, mobility equipment, physical load or rehabilitation treatment." ], "never_do": [ "Use the best day as the next starting dose, skip the planned pause or keep going to prove pain tolerance.", "Stop prescribed medicine or remove an aid to discover the learner's ‘true’ capacity.", "Treat a completed activity as proof that pain is harmless, psychological, cured or safe to ignore when red flags appear." ] }, "materials": [ "One valued, low-risk activity and a clear finish point.", "Timer and provider-set starting duration or task amount.", "Prescribed medication, mobility aids, supports and positioning aids unchanged.", "Activity record for function, pain interference, effort and delayed response." ], "before_you_start": [ "The clinician checks red flags, diagnosis, medication and whether the selected activity is safe.", "Choose an activity that can stop or pause without leaving a hazard.", "Define the starting dose from recent repeatable ability, not the best day.", "Agree urgent and non-urgent stop signs before starting." ], "steps": [ { "title": "Name the valued function", "instruction": "Choose one concrete activity that matters, such as preparing part of a meal or walking to the garden chair.", "reason": "A meaningful function prevents practice becoming a pain-tolerance test.", "success_check": "The goal describes an action and finish point." }, { "title": "Set a repeatable dose", "instruction": "With the clinician, choose time, distance or steps below the level that has recently caused uncontrolled worsening.", "reason": "A stable starting dose can be repeated and adjusted.", "success_check": "Dose and rationale are written before activity." }, { "title": "Prepare supports", "instruction": "Place aids, seat, water, tools and help so the task does not require last-minute strain.", "reason": "Environment can reduce unnecessary pain load without invalidating the activity.", "success_check": "All planned supports are present and recorded." }, { "title": "Begin at an even pace", "instruction": "Start without rushing to “get it over with”; use the planned sequence and normal breathing.", "reason": "Boom-and-bust pacing often adds bursts of load that are hard to repeat.", "success_check": "Speed and technique remain steady enough to stop safely." }, { "title": "Pause on schedule", "instruction": "Use the planned pause or task switch even if pain is temporarily low; apply the clinician-approved settling strategy.", "reason": "Time-based pauses reduce decisions made only at peak pain.", "success_check": "The pause occurs at the predeclared point." }, { "title": "Stop at the declared finish", "instruction": "End the dose instead of adding more because the day feels good or forcing completion because pain rose.", "reason": "Keeping the dose stable reveals delayed response and repeatability.", "success_check": "Actual dose matches the plan or the deviation is named." }, { "title": "Record function and interference", "instruction": "Record what was completed, assistance, pain interference, distress, effort and recovery actions—not pain intensity alone.", "reason": "Self-management success can be better function even when pain remains.", "success_check": "The record separates function, pain and assistance." }, { "title": "Check delayed response", "instruction": "At the clinician-set later time, record symptom change and recovery duration, then adjust only one feature with the clinician.", "reason": "Immediate tolerance can miss delayed worsening.", "success_check": "Progression uses both immediate and delayed data." } ], "worked_example": { "scenario": "With a pain clinician, Rosa chooses ten minutes of seated meal preparation using pre-positioned tools.", "walkthrough": [ "They set ten minutes from her repeatable week, not her best day.", "Rosa places ingredients and uses the prescribed chair before starting.", "She works evenly for five minutes, takes the planned two-minute posture break, then completes the second block.", "She stops at ten minutes although she could do more and records function, interference and help.", "That evening she records recovery; the clinician keeps the same dose for three trials before any change." ], "result": "Rosa completes a meaningful activity predictably without a major delayed worsening. The result is improved management of one task, not a cure or proof that pain is psychological." }, "right_vs_wrong": [ { "situation": "Goal", "right": "Choose a valued function with a clear finish.", "wrong": "Use maximum pain tolerance as the target.", "why": "Tolerance testing can worsen symptoms without improving life." }, { "situation": "Starting dose", "right": "Base it on repeatable recent ability.", "wrong": "Use the best day or an arbitrary target.", "why": "An unstable dose invites boom-and-bust cycles." }, { "situation": "Pace", "right": "Use planned support and pauses.", "wrong": "Rush until pain forces collapse.", "why": "Reactive stopping occurs after control is lost." }, { "situation": "Good day", "right": "Keep the declared dose and observe recovery.", "wrong": "Double the task because pain is low.", "why": "Immediate feeling may not predict delayed response." }, { "situation": "Interpretation", "right": "Track function, interference and burden.", "wrong": "Treat less pain as the only valid success or deny persistent pain.", "why": "Pain and function are related but distinct outcomes." } ], "common_mistakes": [ { "mistake": "Use maximum pain tolerance as the target.", "fix": "Choose a valued function with a clear finish." }, { "mistake": "Use the best day or an arbitrary target.", "fix": "Base it on repeatable recent ability." }, { "mistake": "Rush until pain forces collapse.", "fix": "Use planned support and pauses." }, { "mistake": "Double the task because pain is low.", "fix": "Keep the declared dose and observe recovery." }, { "mistake": "Treat less pain as the only valid success or deny persistent pain.", "fix": "Track function, interference and burden." } ], "practice": { "first_session": [ "After screening, Rosa and the pain clinician select ten minutes of seated meal preparation with pre-positioned ingredients as the finishable valued task.", "They write two five-minute work blocks, a two-minute posture break between them, the prescribed chair/tools and an evening recovery check.", "Rosa completes the first block evenly, takes the scheduled break even if pain is low and stops after the second block rather than adding washing-up.", "She records ingredients prepared, actual 10-minute dose, chair/help, pain interference, effort and immediate symptoms as separate fields.", "At the evening check she records change and recovery; dose stays unchanged for the next matched trial unless the clinician reduces/redesigns it." ], "repeat_plan": "Repeat the same dose two or three times at provider-set intervals. Increase only one feature after predictable recovery and meaningful function; reduce or redesign when delayed worsening or burden grows.", "progress_when": [ "The same activity dose is repeatable without escalating recovery time.", "Function or participation improves with equal or lower burden.", "The learner can use supports without shame or unplanned overexertion." ], "do_not_progress_when": [ "New neurological, systemic or injury red flags appear.", "Pain, distress or recovery time rises across repeated attempts.", "The plan drives medicine changes or avoidance of needed care." ] }, "self_check": [ "Can you demonstrate “Set a repeatable dose”? Dose and rationale are written before activity.", "Can you demonstrate “Pause on schedule”? The pause occurs at the predeclared point.", "Can you demonstrate “Check delayed response”? Progression uses both immediate and delayed data." ], "measurement": { "primary": "Pain interference, meaningful function, participation, medication burden and harms", "how": "Record planned and actual dose, task completion, assistance, pain interference, effort, immediate symptoms and delayed recovery at the agreed interval.", "good_result": "The chosen function becomes more repeatable or less disruptive across three matched trials without a concerning symptom or longer recovery.", "does_not_prove": "Pain intensity, interference, function, participation, medication burden and adverse events are distinct; biomarker absence does not invalidate pain." }, "stop_and_get_help": [ "Seek urgent help for pain with chest symptoms, severe breathlessness, sudden weakness/numbness, loss of bladder/bowel control, major trauma or other emergency signs.", "Stop the activity for new sharp pain, rapidly increasing symptoms, faintness, loss of safe movement or severe distress.", "Contact the care team when pain pattern changes, function declines, medication use changes unexpectedly or recovery keeps lengthening." ], "accessibility": [ "Break the activity into seated, supported or helper-directed parts while preserving the valued goal.", "Use voice, symbols or a supporter to record interference and delayed response.", "Count directing assistance as a valid form of self-management and independence." ], "evidence_notes": [ { "claim": "A randomised trial found functional and pain-related effects of structured MBSR and CBT for chronic low back pain; it does not establish one universal method or cure.", "source_title": "Effect of Mindfulness-Based Stress Reduction vs Cognitive Behavioral Therapy or Usual Care on Back Pain and Functional Limitations in Adults With Chronic Low Back Pain", "source_url": "https://pubmed.ncbi.nlm.nih.gov/27002445/", "source_kind": "PRIMARY_RESEARCH" }, { "claim": "A randomised internet intervention supports studying education and psychological skills as adjuncts while pain and safety remain real.", "source_title": "The Effects of a Pain Psychology and Neuroscience Self-Evaluation Internet Intervention: A Randomized Controlled Trial", "source_url": "https://pubmed.ncbi.nlm.nih.gov/32520816/", "source_kind": "PRIMARY_RESEARCH" } ], "limits": [ "Pain intensity, interference, function, participation, medication burden and adverse events are distinct; biomarker absence does not invalidate pain.", "Unsupported claim: pain is all in your brain.", "Unsupported claim: think pain away.", "Unsupported claim: ignore pain signals.", "Pacing one activity does not diagnose pain, replace medical treatment or promise pain elimination." ], "orientation": { "bounded_definition": "Capability to develop or express pain self-management in a declared context without inheriting broader claims.", "evidence_summary": "Pain self-management can improve life and function without denying pain or promising a cure.", "supportable_public_claim": "People can learn strategies that reduce chronic-pain interference and improve function in selected clinical pathways.", "measurement_boundary": "Pain intensity, interference, function, participation, medication burden and adverse events are distinct; biomarker absence does not invalidate pain.", "myth_to_metric": { "myth": "Master pain through mindset", "metric": "Pain interference, meaningful function, participation, medication burden and harms", "boundary": "A lower rating or changed belief does not prove cure or absence of tissue/neurological disease." }, "limiting_findings": [ "Most brief online-intervention effects were absent at ten months.", "Effects were weaker in the fibromyalgia subgroup and several psychosocial endpoints were null." ], "prohibited_claims": [ "pain is all in your brain", "think pain away", "ignore pain signals", "self-manage instead of seeking diagnosis" ] }, "gold_source_lesson": null, "next_gate": "External confirmation is required before higher-authority use because: CLINICAL_HIGH_RISK_OR_REGULATED_CONFIGURATION; SUPERVISION_OR_NON_ATTEMPT_BOUNDARY; CULTURAL_COMMUNITY_RIGHTS_OR_AFFECTED_PERSON_AUTHORITY; SAFETY_LEGITIMACY_RESTRICTED.", "evidence_count": 2 }, "full_training_programme": false, "independently_validated": false, "publication_state": "PUBLISHED_PUBLIC_RESEARCH_EDITION__EDITORIAL_REVIEW_PENDING", "related_power_ids": [ "PWR-057", "PWR-058", "PWR-060", "PWR-061" ] }, { "power_id": "PWR-060", "learning_unit_id": "TLU-PWR-060", "title": "Energy conservation and pacing", "main_description": "With an occupational therapist or qualified clinician, the learner completes one planned day segment within an agreed energy budget and records immediate and delayed response.", "main_description_source": "FULL_TUTORIAL_OUTCOME", "family_id": "FAM-08", "family": "Health, Rehabilitation & Adaptive Independence", "superdomain": "Regulation & Recovery", "canonical_route": "/powers/pwr-060/", "treatment": "SPECIALIST_PROVIDER_ROUTE", "treatment_label": "Full supervised tutorial", "treatment_boundary": "Titan teaches the complete method; a qualified person controls the parts that require supervision, clearance, specialist equipment, load, dose or progression.", "tutorial_route": "/tutorials/pwr-060/", "governed_lesson_route": null, "self_attempt_status": "PROHIBITED_WITHOUT_QUALIFIED_SUPERVISION", "gold_pathway_ids": [], "route_membership": { "kind": "RETAINED_EXTERNAL_ROUTE", "id": "SP-HUB-003", "coverage_status": "RETAINED" }, "source_authority_tier": "G4", "source_build_state": "EXTERNAL_PROVIDER_ROUTE", "source_instructional_route": "LEARN_ELSEWHERE_TRACK_WITH_TITAN", "source_count": 3, "research_depth": "FOCUSED", "risk_level": "HIGH", "prerequisite_status": "QUALIFIED_PROVIDER_DETERMINES", "learning_route": { "mode": "FULL_SUPERVISED_TUTORIAL", "label": "Learn energy conservation and pacing step by step", "summary": "With an occupational therapist or qualified clinician, the learner completes one planned day segment within an agreed energy budget and records immediate and delayed response.", "steps": [ [ "Get ready", "The clinician checks diagnosis, post-exertional symptoms, orthostatic issues, nutrition/hydration needs and activities that cannot safely be deferred." ], [ "Learn the method", "8 concrete steps teach the permitted method from start to finish." ], [ "See right and wrong", "5 comparisons show correct or safer execution beside common wrong or riskier choices." ], [ "Practise", "Use the agreed budget across comparable days and review weekly or after a flare. Progress may mean more predictable recovery, better participation or less assistance—not necessarily more activity. Change one task or support at a time." ], [ "Check progress", "Record planned versus completed essential activities, personal cost, aids/help, immediate symptoms, 24–48-hour change and time back to baseline." ] ], "practical_authority": false, "provider_required": true, "next_action_route": "/tutorials/pwr-060/" }, "path_builder": { "selectable": true, "completion_allowed": true, "warning": "Titan teaches the complete method; a qualified person controls the parts that require supervision, clearance, specialist equipment, load, dose or progression." }, "full_tutorial": { "version": "3.0", "authorship": "POWER_SPECIFIC_FULL_TUTORIAL", "tutorial_mode": "SUPERVISED", "promise": "Pacing is not an automatic weekly increase. It uses available energy to protect meaningful life without triggering avoidable worsening. The learner maps one day, protects essential activity, breaks a task into parts, places rest before exhaustion and checks delayed symptoms. For post-exertional malaise or complex illness, the clinician controls the budget and progression.", "power_id": "PWR-060", "title": "Energy conservation and pacing", "lesson_type": "SUPERVISED", "headline": "Plan activity and rest around available energy, including delayed worsening", "plain_english_summary": "Pacing is not an automatic weekly increase. It uses available energy to protect meaningful life without triggering avoidable worsening. The learner maps one day, protects essential activity, breaks a task into parts, places rest before exhaustion and checks delayed symptoms. For post-exertional malaise or complex illness, the clinician controls the budget and progression.", "outcome": "With an occupational therapist or qualified clinician, the learner completes one planned day segment within an agreed energy budget and records immediate and delayed response.", "authority": { "learner_may": [ "Map one real day, label essential/optional/deferrable activities and estimate each segment with the agreed personal cost anchors.", "Prepare seating, mobility aids, supplies and planned recovery before completing only the selected essential segment.", "Record immediate and 24–48-hour response, participation and help before moving or resizing another task." ], "qualified_person_required_for": [ "Screening post-exertional worsening, orthostatic symptoms, cardiopulmonary risk, nutrition/hydration needs and non-deferrable care.", "Setting the initial activity/rest pattern, supports and monitoring window when delayed symptoms or collapse risk complicate pacing.", "Changing rehabilitation, exercise, medication, mobility equipment or return-to-work/care demands." ], "never_do": [ "Apply a fixed weekly increase when exertion causes delayed worsening or use a brief good period to empty the whole task list.", "Defer food, fluids, medication, hygiene, dependent care or another essential need merely to keep an energy score low.", "Remove a chair, mobility aid, helper or task adaptation to prove independent stamina." ] }, "materials": [ "A one-day timeline with essential, optional and deferrable activities.", "A simple personal energy-cost scale with fixed anchors.", "Timers, seating, mobility aids and task tools.", "A 24–48-hour symptom and recovery record when delayed exacerbation is relevant." ], "before_you_start": [ "The clinician checks diagnosis, post-exertional symptoms, orthostatic issues, nutrition/hydration needs and activities that cannot safely be deferred.", "Do not use a fixed graded-exercise increase when symptoms worsen after exertion.", "Identify essential self-care and caregiving needs before optional tasks.", "Agree an abort plan for dizziness, collapse, severe symptom escalation or inability to complete basic care." ], "steps": [ { "title": "Map the day honestly", "instruction": "List activities from waking through rest, including washing, thinking, travel, sensory load and emotional demands.", "reason": "Energy use is broader than exercise and hidden tasks can exhaust the budget.", "success_check": "The timeline contains physical, cognitive and social demands." }, { "title": "Mark priorities", "instruction": "Label each item essential today, important but movable, or optional.", "reason": "Protecting meaningful essentials is different from trying to complete everything.", "success_check": "Every activity has a priority label." }, { "title": "Estimate personal cost", "instruction": "Use the agreed scale to rate expected cost and note which symptoms appeared after similar tasks.", "reason": "Personal cost and delayed response matter more than a generic calorie estimate.", "success_check": "Ratings use the same anchors and cite recent experience." }, { "title": "Break the chosen task", "instruction": "Divide one essential task into setup, action, pause and finish; move supplies close and use aids.", "reason": "Task design can remove avoidable demand.", "success_check": "Each part can stop safely and necessary items are ready." }, { "title": "Place rest before the crash", "instruction": "Schedule a low-demand rest or task switch at the planned point, not only after symptoms peak.", "reason": "Pre-emptive rest can make the day more predictable.", "success_check": "The rest point is on the timeline before activity begins." }, { "title": "Alternate demand types", "instruction": "Where helpful, alternate physical, cognitive, upright and sensory tasks rather than stacking one type.", "reason": "Different demands can accumulate in different ways.", "success_check": "The schedule avoids an unplanned cluster of high-cost tasks." }, { "title": "Perform only the planned segment", "instruction": "Use the aids and finish rule; defer the optional item rather than borrowing from tomorrow.", "reason": "Staying inside the plan allows a fair delayed-response check.", "success_check": "Actual activity and deviations are recorded." }, { "title": "Check now and later", "instruction": "Record function and symptoms immediately and at the agreed 24–48-hour times, then revise the budget with the clinician.", "reason": "Post-exertional worsening may be delayed.", "success_check": "No progression decision is made from immediate feeling alone." } ], "worked_example": { "scenario": "An occupational therapist helps Devon plan showering on a day that also includes a medical appointment.", "walkthrough": [ "They map washing, dressing, travel, waiting, conversation and recovery—not only walking.", "Showering and the appointment are marked essential; housework is deferrable.", "They prepare a shower chair and clothes, split washing from dressing and schedule seated rest.", "Devon completes the planned segment and defers vacuuming despite feeling briefly able.", "They record symptoms that evening and the next day before changing the plan." ], "result": "Devon preserves essential participation with declared aids and no avoidable delayed worsening. The plan does not require doing more each week." }, "right_vs_wrong": [ { "situation": "Energy map", "right": "Include thinking, sensory and social demand.", "wrong": "Count only steps or exercise minutes.", "why": "Non-physical demand can consume the same limited capacity." }, { "situation": "Rest timing", "right": "Rest before the personal crash point.", "wrong": "Wait until symptoms force total shutdown.", "why": "Late rest makes the response less predictable." }, { "situation": "Good moment", "right": "Protect the written budget and deferred items.", "wrong": "Use all available energy because it is there now.", "why": "Borrowing can worsen later function." }, { "situation": "Progression", "right": "Use immediate and delayed response with the clinician.", "wrong": "Increase activity on a fixed schedule despite worsening.", "why": "Fixed increments can be inappropriate, especially with post-exertional malaise." }, { "situation": "Independence", "right": "Use aids or direct help to preserve the goal.", "wrong": "Remove support to make the task count.", "why": "Support can reduce energy cost and increase participation." } ], "common_mistakes": [ { "mistake": "Count only steps or exercise minutes.", "fix": "Include thinking, sensory and social demand." }, { "mistake": "Wait until symptoms force total shutdown.", "fix": "Rest before the personal crash point." }, { "mistake": "Use all available energy because it is there now.", "fix": "Protect the written budget and deferred items." }, { "mistake": "Increase activity on a fixed schedule despite worsening.", "fix": "Use immediate and delayed response with the clinician." }, { "mistake": "Remove support to make the task count.", "fix": "Use aids or direct help to preserve the goal." } ], "practice": { "first_session": [ "Devon and the occupational therapist map showering, dressing, travel, waiting, appointment conversation, food and recovery on the appointment-day timeline.", "They mark showering and the medical appointment essential, vacuuming deferrable, and rate each segment with Devon's agreed recent-experience anchors.", "A shower chair, towel and clothes are pre-positioned; washing and dressing are split by a seated low-demand rest before travel.", "Devon completes only the shower/dressing plan and defers vacuuming even if a brief energy lift appears.", "Immediate, evening, next-day and 48-hour symptoms/function are recorded before one segment or support is revised." ], "repeat_plan": "Use the agreed budget across comparable days and review weekly or after a flare. Progress may mean more predictable recovery, better participation or less assistance—not necessarily more activity. Change one task or support at a time.", "progress_when": [ "Essential activities become more predictable.", "Delayed exacerbation and recovery time are stable or reduced.", "The learner can defer optional work and use supports consistently." ], "do_not_progress_when": [ "Delayed symptoms grow in intensity or duration.", "Basic nutrition, hygiene, medication or safety needs cannot be met.", "A fixed-increase rule overrides the person’s symptom response." ] }, "self_check": [ "Can you demonstrate “Mark priorities”? Every activity has a priority label.", "Can you demonstrate “Place rest before the crash”? The rest point is on the timeline before activity begins.", "Can you demonstrate “Check now and later”? No progression decision is made from immediate feeling alone." ], "measurement": { "primary": "Meaningful activity, delayed symptom exacerbation, recovery and participation", "how": "Record planned versus completed essential activities, personal cost, aids/help, immediate symptoms, 24–48-hour change and time back to baseline.", "good_result": "Meaningful essential participation is maintained or improved across comparable days without a longer or more severe delayed exacerbation.", "does_not_prove": "Track personally meaningful activity, delayed symptom exacerbation, recovery time and participation; steps or heart rate alone do not define capacity." }, "stop_and_get_help": [ "Seek urgent help for collapse, severe breathlessness, chest pain, acute confusion, new neurological symptoms or inability to meet essential medical needs.", "Stop the activity for presyncope, loss of safe movement, severe symptom surge or the predeclared personal threshold.", "Contact the care team when recovery no longer returns toward baseline, essential function declines or the plan repeatedly triggers delayed worsening." ], "accessibility": [ "Use a visual, tactile or audio day timeline and a supporter to move task cards.", "Treat seated work, mobility devices, ready-prepared items and directed assistance as valid conservation tools.", "Reduce sensory and communication demand as well as physical demand." ], "evidence_notes": [ { "claim": "A pilot randomised trial compared distinct pacing approaches, showing that pacing is a defined treatment rather than a generic instruction to do more.", "source_title": "Operant Learning Versus Energy Conservation Activity Pacing Treatments in a Sample of Patients With Fibromyalgia Syndrome: A Pilot Randomized Controlled Trial", "source_url": "https://pubmed.ncbi.nlm.nih.gov/30326271/", "source_kind": "PRIMARY_RESEARCH" }, { "claim": "NICE guidance supports personalised energy management and advises against fixed incremental exercise for ME/CFS.", "source_title": "Myalgic encephalomyelitis (or encephalopathy)/chronic fatigue syndrome: diagnosis and management — Recommendations", "source_url": "https://www.nice.org.uk/guidance/NG206/chapter/recommendations", "source_kind": "OFFICIAL_GUIDANCE" } ], "limits": [ "Track personally meaningful activity, delayed symptom exacerbation, recovery time and participation; steps or heart rate alone do not define capacity.", "Unsupported claim: increase activity every week.", "Unsupported claim: pacing cures fatigue.", "Unsupported claim: push through to expand your energy envelope.", "An energy budget does not cure fatigue, establish exercise capacity or justify fixed progression through post-exertional worsening." ], "orientation": { "bounded_definition": "Capability to develop or express energy conservation and pacing in a declared context without inheriting broader claims.", "evidence_summary": "Pacing is not doing more every week; it is using available energy to protect meaningful life without triggering avoidable worsening.", "supportable_public_claim": "Person-led, condition-specific pacing and energy conservation can support meaningful activity, but no universal dose exists.", "measurement_boundary": "Track personally meaningful activity, delayed symptom exacerbation, recovery time and participation; steps or heart rate alone do not define capacity.", "myth_to_metric": { "myth": "Expand your energy envelope by steadily pushing harder", "metric": "Meaningful activity, delayed symptom exacerbation, recovery and participation", "boundary": "More activity or steps do not prove health, and fixed increases can cause harm." }, "limiting_findings": [ "Two pacing treatments did not reduce average pain or usual fatigue in the fibromyalgia trial.", "NICE refuses fixed incremental activity programmes for ME/CFS." ], "prohibited_claims": [ "increase activity every week", "pacing cures fatigue", "push through to expand your energy envelope", "everyone has the same energy budget" ] }, "gold_source_lesson": null, "next_gate": "External confirmation is required before higher-authority use because: CLINICAL_HIGH_RISK_OR_REGULATED_CONFIGURATION; SUPERVISION_OR_NON_ATTEMPT_BOUNDARY; CULTURAL_COMMUNITY_RIGHTS_OR_AFFECTED_PERSON_AUTHORITY; SAFETY_LEGITIMACY_RESTRICTED.", "evidence_count": 3 }, "full_training_programme": false, "independently_validated": false, "publication_state": "PUBLISHED_PUBLIC_RESEARCH_EDITION__EDITORIAL_REVIEW_PENDING", "related_power_ids": [ "PWR-057", "PWR-058", "PWR-059", "PWR-061" ] }, { "power_id": "PWR-061", "learning_unit_id": "TLU-PWR-061", "title": "Communication recovery", "main_description": "With a speech-language professional, the learner reliably communicates one chosen need or fact to a partner using the preferred mode and a verification step.", "main_description_source": "FULL_TUTORIAL_OUTCOME", "family_id": "FAM-08", "family": "Health, Rehabilitation & Adaptive Independence", "superdomain": "Regulation & Recovery", "canonical_route": "/powers/pwr-061/", "treatment": "SPECIALIST_PROVIDER_ROUTE", "treatment_label": "Full supervised tutorial", "treatment_boundary": "Titan teaches the complete method; a qualified person controls the parts that require supervision, clearance, specialist equipment, load, dose or progression.", "tutorial_route": "/tutorials/pwr-061/", "governed_lesson_route": null, "self_attempt_status": "PROHIBITED_WITHOUT_QUALIFIED_SUPERVISION", "gold_pathway_ids": [], "route_membership": { "kind": "RETAINED_EXTERNAL_ROUTE", "id": "SP-HUB-003", "coverage_status": "RETAINED" }, "source_authority_tier": "G4", "source_build_state": "EXTERNAL_PROVIDER_ROUTE", "source_instructional_route": "LEARN_ELSEWHERE_TRACK_WITH_TITAN", "source_count": 3, "research_depth": "FOCUSED", "risk_level": "MODERATE_TO_HIGH", "prerequisite_status": "QUALIFIED_PROVIDER_DETERMINES", "learning_route": { "mode": "FULL_SUPERVISED_TUTORIAL", "label": "Learn communication recovery step by step", "summary": "With a speech-language professional, the learner reliably communicates one chosen need or fact to a partner using the preferred mode and a verification step.", "steps": [ [ "Get ready", "The speech-language professional selects the language/communication goal and screens hearing, vision, motor access, fatigue and consent." ], [ "Learn the method", "8 concrete steps teach the permitted method from start to finish." ], [ "See right and wrong", "5 comparisons show correct or safer execution beside common wrong or riskier choices." ], [ "Practise", "Practise a small set of meaningful messages at the frequency set by the SLP. Progress from known partner/topic to one changed feature at a time, while preserving AAC and other successful modes." ], [ "Check progress", "Record correctly verified messages out of trials, missing meaning units, modality, partner prompts, time, fatigue and learner-rated usefulness." ] ], "practical_authority": false, "provider_required": true, "next_action_route": "/tutorials/pwr-061/" }, "path_builder": { "selectable": true, "completion_allowed": true, "warning": "Titan teaches the complete method; a qualified person controls the parts that require supervision, clearance, specialist equipment, load, dose or progression." }, "full_tutorial": { "version": "3.0", "authorship": "POWER_SPECIFIC_FULL_TUTORIAL", "tutorial_mode": "SUPERVISED", "promise": "Communication recovery can restore a skill or reroute meaning through another channel; speech is only one valid path. This lesson teaches a complete supported exchange: choose one message, prepare a usable modality, give time, verify meaning and repair only the failed part. Partner behaviour is measured alongside the learner's response.", "power_id": "PWR-061", "title": "Communication recovery", "lesson_type": "SUPERVISED", "headline": "Send one message using speech, gesture, writing or AAC—and verify that it arrived", "plain_english_summary": "Communication recovery can restore a skill or reroute meaning through another channel; speech is only one valid path. This lesson teaches a complete supported exchange: choose one message, prepare a usable modality, give time, verify meaning and repair only the failed part. Partner behaviour is measured alongside the learner's response.", "outcome": "With a speech-language professional, the learner reliably communicates one chosen need or fact to a partner using the preferred mode and a verification step.", "authority": { "learner_may": [ "Choose the personally meaningful clinic-date message and use preferred speech, gesture, writing, drawing or AAC to send it.", "Ask the communication partner to use one short prompt, wait the agreed interval and verify the complete meaning rather than guessing.", "Repair a breakdown through a second communication route and record message accuracy, modes, cues, time and fatigue." ], "qualified_person_required_for": [ "Assessing language, speech, cognition, hearing, vision, motor access, fatigue and consent and selecting the communication goal.", "Teaching partner behaviour, choosing prompt/wait dose and deciding how accuracy or support should progress across messages.", "Programming/prescribing AAC access or interpreting sudden/new communication change medically." ], "never_do": [ "Remove AAC, glasses, hearing aids or a successful gesture to make speech-only performance look independent.", "Rush, finish the learner's sentence, ask repeated broad questions or accept an unverified guess as the message.", "Use an urgent medical, legal or financial message as the first practice exchange or infer global competence from one topic." ] }, "materials": [ "A personally meaningful message card or topic.", "Preferred speech, gesture, writing, drawing or augmentative and alternative communication (AAC) system.", "A communication-partner cue card.", "A record for message accuracy, modality, cues, time, fatigue and repair." ], "before_you_start": [ "The speech-language professional selects the language/communication goal and screens hearing, vision, motor access, fatigue and consent.", "Ensure the AAC device, glasses and hearing aids are available and working.", "Choose a low-pressure topic; do not test urgent medical communication for the first trial.", "Agree a stop signal and a way to communicate pain or distress." ], "steps": [ { "title": "Choose one exact message", "instruction": "Select a message with a verifiable meaning, such as “I want tea, not coffee” or “the appointment is Friday”.", "reason": "A precise message can be checked; “communicate better” cannot.", "success_check": "The clinician has an answer key for the intended meaning." }, { "title": "Choose the best mode", "instruction": "The learner selects speech, gesture, key word, drawing, writing, AAC or a combination before starting.", "reason": "Communication success matters more than forcing one channel.", "success_check": "The chosen mode is available, positioned and accessible." }, { "title": "Set the partner’s behaviour", "instruction": "The partner faces the learner, reduces background noise, uses one short prompt and then waits the agreed time.", "reason": "Rushing and repeated questions can block a message that is forming.", "success_check": "The partner can state the prompt and wait rule." }, { "title": "Send the message", "instruction": "The learner gives the message with the chosen mode; the partner does not guess or finish it early.", "reason": "An unhurried attempt reveals what the learner can convey with declared support.", "success_check": "A complete attempt occurs before correction." }, { "title": "Verify meaning", "instruction": "The partner repeats or points to the understood message and asks for yes/no confirmation.", "reason": "Verification catches fluent but incorrect or incomplete understanding.", "success_check": "The learner confirms or rejects the partner’s interpretation." }, { "title": "Locate the breakdown", "instruction": "If wrong, identify whether the key person, action, object, time or yes/no choice was missed.", "reason": "Repairing one missing unit is easier than restarting everything.", "success_check": "One missing meaning unit is named." }, { "title": "Repair with another route", "instruction": "Add a written key word, gesture, picture or constrained choice while preserving the learner’s agency.", "reason": "A second route can carry meaning when one channel is impaired.", "success_check": "The corrected message is confirmed without pretending no help was used." }, { "title": "Record participation and fatigue", "instruction": "Record whether the message succeeded, which cues and modes were used, time, effort and whether the learner would choose this method in daily life.", "reason": "A clinic response is useful only if acceptable and usable.", "success_check": "Accuracy and user preference are recorded separately." } ], "worked_example": { "scenario": "After stroke, Mei wants to tell her daughter that the clinic appointment is Friday, not Thursday.", "walkthrough": [ "Mei selects her AAC calendar plus speech.", "Her daughter asks one short question, faces her and waits ten agreed seconds.", "Mei points to Friday and says a partial word.", "Her daughter verifies, “Friday, not Thursday?” and Mei confirms yes.", "The SLP records accurate message exchange, AAC use, one prompt, time and fatigue." ], "result": "The message arrived accurately with a preferred combined mode. That is successful communication even though speech alone was incomplete." }, "right_vs_wrong": [ { "situation": "Response mode", "right": "Use the learner’s most effective speech, gesture, writing or AAC.", "wrong": "Require speech alone to make the attempt count.", "why": "Forcing one channel can hide real communication ability." }, { "situation": "Partner timing", "right": "Ask one clear question and wait.", "wrong": "Repeat, rephrase and finish the sentence immediately.", "why": "Too much partner speech adds processing load and steals the turn." }, { "situation": "Understanding", "right": "Verify the exact meaning.", "wrong": "Assume a nod or fluent phrase was understood.", "why": "Apparent fluency can still carry the wrong message." }, { "situation": "Repair", "right": "Fix the missing meaning unit with another route.", "wrong": "Restart repeatedly or pretend to understand.", "why": "Targeted repair is more efficient and honest." }, { "situation": "Score", "right": "Record partner prompts, mode and fatigue.", "wrong": "Call supported success independent speech recovery.", "why": "Support is part of the communication system." } ], "common_mistakes": [ { "mistake": "Require speech alone to make the attempt count.", "fix": "Use the learner’s most effective speech, gesture, writing or AAC." }, { "mistake": "Repeat, rephrase and finish the sentence immediately.", "fix": "Ask one clear question and wait." }, { "mistake": "Assume a nod or fluent phrase was understood.", "fix": "Verify the exact meaning." }, { "mistake": "Restart repeatedly or pretend to understand.", "fix": "Fix the missing meaning unit with another route." }, { "mistake": "Call supported success independent speech recovery.", "fix": "Record partner prompts, mode and fatigue." } ], "practice": { "first_session": [ "Mei and the SLP set the keyed meaning ‘the clinic appointment is Friday, not Thursday’ and place Mei's AAC calendar within reach beside her speech response.", "Her daughter practises facing Mei, asking one short question, waiting ten seconds and then stating the understood day for yes/no verification.", "Mei attempts the message once; her daughter does not complete a word or point to a day before Mei responds.", "If day or negation is missed, Mei repairs with the calendar while preserving her speech attempt; her daughter verifies ‘Friday, not Thursday?’", "They repeat with the separately keyed message ‘I want tea, not coffee’ and record correct meaning units, modes, partner prompts, time, fatigue and preference." ], "repeat_plan": "Practise a small set of meaningful messages at the frequency set by the SLP. Progress from known partner/topic to one changed feature at a time, while preserving AAC and other successful modes.", "progress_when": [ "More messages are verified correctly with equal or fewer cues.", "The learner initiates or repairs using a chosen route.", "Success transfers to a meaningful partner or setting without excessive fatigue." ], "do_not_progress_when": [ "Communication becomes coercive, humiliating or rushed.", "Sudden new language, speech or understanding loss appears.", "AAC, hearing or visual access is missing and makes the task invalid." ] }, "self_check": [ "Can you demonstrate “Choose the best mode”? The chosen mode is available, positioned and accessible.", "Can you demonstrate “Verify meaning”? The learner confirms or rejects the partner’s interpretation.", "Can you demonstrate “Record participation and fatigue”? Accuracy and user preference are recorded separately." ], "measurement": { "primary": "Reliable message exchange, participation, fatigue and person-chosen modality", "how": "Record correctly verified messages out of trials, missing meaning units, modality, partner prompts, time, fatigue and learner-rated usefulness.", "good_result": "A new meaningful message is verified accurately with the declared speech/AAC/partner supports and acceptable fatigue; prompt count and user preference remain visible rather than becoming a universal communication pass score.", "does_not_prove": "Message success, participation, partner burden and person-defined communication matter alongside impairment tests; speech output alone is insufficient." }, "stop_and_get_help": [ "Treat sudden new speech/language loss, facial weakness or confusion as an emergency and seek urgent help.", "Stop a session for distress, severe fatigue, pain, escalating frustration or loss of consent.", "Contact the SLP when communication declines, the AAC system fails or supporters cannot use the agreed method." ], "accessibility": [ "Offer eye-gaze, partner-assisted scanning, switches, gesture, drawing and yes/no signalling.", "Reduce visual clutter, background noise and sentence length while keeping adult meaning.", "Count a partner-directed message as valid communication; independence does not require unaided speech." ], "evidence_notes": [ { "claim": "A randomised trial supports intensive speech-language therapy for selected people with chronic aphasia under a defined clinical programme.", "source_title": "Intensive speech and language therapy in patients with chronic aphasia after stroke: a randomised, open-label, blinded-endpoint, controlled trial in a health-care setting", "source_url": "https://pubmed.ncbi.nlm.nih.gov/28256356/", "source_kind": "PRIMARY_RESEARCH" }, { "claim": "ASHA clinical guidance supports person-centred language intervention and compensatory communication approaches.", "source_title": "Aphasia", "source_url": "https://www.asha.org/practice-portal/clinical-topics/aphasia/", "source_kind": "OFFICIAL_GUIDANCE" } ], "limits": [ "Message success, participation, partner burden and person-defined communication matter alongside impairment tests; speech output alone is insufficient.", "Unsupported claim: restore normal speech for everyone.", "Unsupported claim: speech is the only real recovery.", "Unsupported claim: aphasia means reduced intelligence.", "Accurate supported exchange does not prove speech recovery or transfer to every partner, topic and setting." ], "orientation": { "bounded_definition": "Capability to develop or express communication recovery in a declared context without inheriting broader claims.", "evidence_summary": "Communication can be recovered, supported or rerouted—and speech is only one valid path.", "supportable_public_claim": "Communication can improve or be effectively supported after neurological injury through multiple legitimate routes.", "measurement_boundary": "Message success, participation, partner burden and person-defined communication matter alongside impairment tests; speech output alone is insufficient.", "myth_to_metric": { "myth": "Restore speech and return to normal", "metric": "Reliable message exchange, participation, fatigue and person-chosen modality", "boundary": "More spoken words do not alone establish communication, cognition or autonomy." }, "limiting_findings": [ "The intensive-trial population and comparison interval were narrow.", "No single modality fits all people or contexts." ], "prohibited_claims": [ "restore normal speech for everyone", "speech is the only real recovery", "aphasia means reduced intelligence", "AAC prevents recovery" ] }, "gold_source_lesson": null, "next_gate": "External confirmation is required before higher-authority use because: CLINICAL_HIGH_RISK_OR_REGULATED_CONFIGURATION; SUPERVISION_OR_NON_ATTEMPT_BOUNDARY; CULTURAL_COMMUNITY_RIGHTS_OR_AFFECTED_PERSON_AUTHORITY; SAFETY_LEGITIMACY_RESTRICTED.", "evidence_count": 3 }, "full_training_programme": false, "independently_validated": false, "publication_state": "PUBLISHED_PUBLIC_RESEARCH_EDITION__EDITORIAL_REVIEW_PENDING", "related_power_ids": [ "PWR-057", "PWR-058", "PWR-059", "PWR-060" ] }, { "power_id": "PWR-062", "learning_unit_id": "TLU-PWR-062", "title": "Cognitive rehabilitation", "main_description": "With a rehabilitation clinician, Tariq packs water bottle, notebook, glasses and appointment card, resumes at the correct unchecked row after a phone interruption, and preserves any omission plus its one checklist correction.", "main_description_source": "FULL_TUTORIAL_OUTCOME", "family_id": "FAM-08", "family": "Health, Rehabilitation & Adaptive Independence", "superdomain": "Regulation & Recovery", "canonical_route": "/powers/pwr-062/", "treatment": "SPECIALIST_PROVIDER_ROUTE", "treatment_label": "Full supervised tutorial", "treatment_boundary": "Titan teaches the complete method; a qualified person controls the parts that require supervision, clearance, specialist equipment, load, dose or progression.", "tutorial_route": "/tutorials/pwr-062/", "governed_lesson_route": null, "self_attempt_status": "PROHIBITED_WITHOUT_QUALIFIED_SUPERVISION", "gold_pathway_ids": [], "route_membership": { "kind": "RETAINED_EXTERNAL_ROUTE", "id": "SP-HUB-003", "coverage_status": "RETAINED" }, "source_authority_tier": "G4", "source_build_state": "EXTERNAL_PROVIDER_ROUTE", "source_instructional_route": "LEARN_ELSEWHERE_TRACK_WITH_TITAN", "source_count": 2, "research_depth": "FOCUSED", "risk_level": "MODERATE_TO_HIGH", "prerequisite_status": "QUALIFIED_PROVIDER_DETERMINES", "learning_route": { "mode": "FULL_SUPERVISED_TUTORIAL", "label": "Learn cognitive rehabilitation step by step", "summary": "With a rehabilitation clinician, Tariq packs water bottle, notebook, glasses and appointment card, resumes at the correct unchecked row after a phone interruption, and preserves any omission plus its one checklist correction.", "steps": [ [ "Get ready", "The clinician screens cognition, insight, behaviour, fatigue and task hazards." ], [ "Learn the method", "8 concrete steps teach the permitted method from start to finish." ], [ "See right and wrong", "5 comparisons show correct or safer execution beside common wrong or riskier choices." ], [ "Practise", "At the clinician-set frequency, repack a matched four-object bag with one harmless object changed and the phone sound after a different completed row. Keep CARD tray and restart marker for the first comparison; fade only one sheet feature after the clinician sees correct row–object matching, and restore it if omissions or duplicate placements return." ], [ "Check progress", "Record required objects present out of four; missing/duplicate/out-of-order rows; whether restart used last tick then first blank row; CARD tray, prompt and clinician help; time and burden. Preserve baseline tick pattern beside the one corrected sheet feature." ] ], "practical_authority": false, "provider_required": true, "next_action_route": "/tutorials/pwr-062/" }, "path_builder": { "selectable": true, "completion_allowed": true, "warning": "Titan teaches the complete method; a qualified person controls the parts that require supervision, clearance, specialist equipment, load, dose or progression." }, "full_tutorial": { "version": "3.0", "authorship": "POWER_SPECIFIC_FULL_TUTORIAL", "tutorial_mode": "SUPERVISED", "promise": "This clinician-guided Goal–Plan–Do–Check exercise is a bag-packing procedure. Tariq defines four required objects, gives each object one checklist row, puts the often-missed appointment card on a labelled tray, ticks only after placement, and uses a restart marker after a planned phone sound. Final Check compares bag contents with all four rows. The exercise teaches supported task organisation; it does not test whether reminders can be removed or whether memory recovered everywhere.", "power_id": "PWR-062", "title": "Cognitive rehabilitation", "lesson_type": "SUPERVISED", "headline": "Pack a four-item therapy bag and restart from the last tick after interruption", "plain_english_summary": "This clinician-guided Goal–Plan–Do–Check exercise is a bag-packing procedure. Tariq defines four required objects, gives each object one checklist row, puts the often-missed appointment card on a labelled tray, ticks only after placement, and uses a restart marker after a planned phone sound. Final Check compares bag contents with all four rows. The exercise teaches supported task organisation; it does not test whether reminders can be removed or whether memory recovered everywhere.", "outcome": "With a rehabilitation clinician, Tariq packs water bottle, notebook, glasses and appointment card, resumes at the correct unchecked row after a phone interruption, and preserves any omission plus its one checklist correction.", "authority": { "learner_may": [ "Define the safe bag-packing finish state, write its four steps and place one external aid at the predicted omission point.", "Use the Goal–Plan–Do–Check bag sheet, planned phone interruption and restart marker while a clinician observes the low-consequence task.", "Preserve omitted/repeated steps, cues, completion, time and burden and revise one sheet feature before a matched repeat." ], "qualified_person_required_for": [ "Assessing cognition, insight, behaviour, fatigue and hazards and deciding which real task can be rehearsed safely.", "Selecting prompts, supervision, interruption, aid placement, practice dose and whether or when a checklist support may be faded.", "Interpreting cognitive change or extending the method to medication, cooking, finance, driving, work or unsupervised consequential tasks." ], "never_do": [ "Use medication dosing, hot cooking, financial/legal action or another consequential task for an unassisted baseline.", "Hide the checklist, timer or labelled tray to test unaided memory when those supports are part of safe performance.", "Erase an omission after correction or treat one supported bag task as proof of restored memory everywhere." ] }, "materials": [ "A therapy bag plus water bottle, notebook, glasses case and a fictional appointment card; medication, money and real identity details are excluded.", "A Goal–Plan–Do–Check sheet with finish line ‘all four objects are in the bag’ and four rows: bottle, notebook, glasses, appointment card.", "A labelled CARD tray, thick tick box beside each row and one harmless phone sound scheduled after two placements.", "A record for omitted/repeated steps, cues, completion, time and burden." ], "before_you_start": [ "The clinician screens cognition, insight, behaviour, fatigue and task hazards.", "Choose a task that can pause safely; exclude medication dosing, cooking heat and financial/legal action for first practice.", "Keep normal supports and a supervisor present when errors could matter.", "Define an immediate halt word for confusion, agitation, unsafe action or fatigue; this differs from the ordinary restart marker after the phone sound." ], "steps": [ { "title": "Write four-object finish", "instruction": "Write ‘bag ready = bottle + notebook + glasses + appointment card’ and place those four harmless objects on the table.", "reason": "A named inventory makes finish visible and countable.", "success_check": "Tariq and clinician can point to four required objects and one empty bag." }, { "title": "Make one placement row per object", "instruction": "Write four rows in agreed order. Each reads ‘place [object] in bag; look inside; tick once.’ Do not combine notebook and card on one row.", "reason": "One object per row exposes an omission or duplicate tick.", "success_check": "Sheet has exactly four unticked placement rows matching finish inventory." }, { "title": "Stage the often-missed card", "instruction": "Circle appointment-card row and place its object on the labelled CARD tray beside the sheet; keep other objects in their ordinary start positions.", "reason": "A targeted tray supports the known omission without reorganising every row.", "success_check": "Circled row, CARD tray and appointment card visibly correspond." }, { "title": "Rehearse the restart marker", "instruction": "Touch the words ‘last tick → next blank row’, point to a sample tick, then say the following object without moving it.", "reason": "Restart comes from visible completion evidence rather than guessing or starting over.", "success_check": "Given a sample tick on row 2, Tariq points to row 3." }, { "title": "Place, verify and tick", "instruction": "Read one row, place that object, look inside the bag to verify it, then make one tick before reading another row.", "reason": "Ticking after visible placement keeps checklist and bag state aligned.", "success_check": "Every tick has one matching object inside; no unticked object is silently packed." }, { "title": "Restart after the phone sound", "instruction": "After two verified placements, clinician plays the harmless phone sound. Tariq pauses, touches ‘last tick → next blank row’, states that row's object and resumes there.", "reason": "A controlled interruption tests checklist restart without using medicine, heat or money.", "success_check": "Third placement follows first blank row; neither packed object is repeated." }, { "title": "Audit sheet against bag", "instruction": "At Check, read all four names and touch each matching object inside. Circle an unticked, missing or duplicate row before correcting anything.", "reason": "Object-by-object audit catches a false sense of completion and preserves its location.", "success_check": "Four row–object pairs match, or a specific bottle/notebook/glasses/card mismatch remains circled." }, { "title": "Correct one checklist feature", "instruction": "Keep original circle and tick pattern. Change only one relevant feature—wider row spacing, stronger CARD label or clearer restart arrow—and schedule a matched bag with a different notebook.", "reason": "One visible edit can be tested against the exact omission or restart error.", "success_check": "Correction points to recorded error while all other rows and supports stay unchanged." } ], "worked_example": { "scenario": "A neuropsychologist helps Tariq prepare a bag for a therapy appointment without including medication or money.", "walkthrough": [ "Tariq defines finished as “water bottle, notebook, glasses and appointment card are in the bag.”", "He writes four placement steps and circles the appointment card as the item often missed.", "He puts the appointment card on its labelled tray and rehearses ‘last tick → next blank row’ before starting.", "After the planned phone sound he touches the last tick, names the next blank-row object and resumes there.", "At Check, he notices the notebook is absent, keeps the error and revises the checklist spacing." ], "result": "Tariq completes the second matched bag task with the four-row sheet, CARD tray and restart marker. This is supported bag-packing performance, not proof of restored memory in every context." }, "right_vs_wrong": [ { "situation": "Bag finish", "right": "Name bottle, notebook, glasses and appointment card.", "wrong": "Write only ‘pack for therapy’.", "why": "An unnamed inventory cannot expose which object was omitted." }, { "situation": "Memory support", "right": "Tick one row only after its object is visibly inside.", "wrong": "Hide the bag sheet to test unaided recall.", "why": "The sheet is a selected rehabilitation support and aligns row state with bag state." }, { "situation": "Interruption", "right": "Touch last tick and continue at first blank row.", "wrong": "Restart at bottle after the phone sound.", "why": "Restarting from row 1 can duplicate packed objects; guessing can skip one." }, { "situation": "Error", "right": "Circle the missing notebook before widening its checklist row.", "wrong": "Slip the notebook into the bag and score completion.", "why": "Hidden rescue erases the omission that should determine the correction." }, { "situation": "Transfer", "right": "Repeat with a different notebook but the same four-row rule.", "wrong": "Infer safe medication or financial planning from the therapy bag.", "why": "Transfer beyond this harmless packing routine needs separate clinical assessment." } ], "common_mistakes": [ { "mistake": "The finish says only ‘pack for therapy’.", "fix": "Write bottle, notebook, glasses and appointment card as four visible requirements." }, { "mistake": "A tick is made before its object enters the bag.", "fix": "Use place → look inside → tick for every object." }, { "mistake": "Tariq starts again at row 1 after the phone sound.", "fix": "Touch last tick and say the first blank-row object before moving." }, { "mistake": "A helper quietly adds the missing notebook.", "fix": "Circle the omission, leave it visible and change one relevant checklist feature." }, { "mistake": "Bag completion is called restored memory for all daily tasks.", "fix": "Report four-item packing with its sheet/tray; test any related task separately with the clinician." } ], "practice": { "first_session": [ "Tariq and the neuropsychologist choose a bag task with no medication or money and write the finish state: water bottle, notebook, glasses and appointment card in the bag.", "Tariq writes four placement steps, circles the often-missed appointment card and puts it on a labelled tray beside the checklist.", "After placing two items, a planned phone sound interrupts the task; Tariq touches ‘last tick → next blank row’, names that object and resumes without guessing.", "At Check he compares all four finish-state objects, records any omission/repetition and leaves a missing notebook visible rather than silently adding it.", "Checklist spacing is changed once, and a matched bag with a different notebook is scheduled; the labelled tray stays if it prevented the card omission." ], "repeat_plan": "At the clinician-set frequency, repack a matched four-object bag with one harmless object changed and the phone sound after a different completed row. Keep CARD tray and restart marker for the first comparison; fade only one sheet feature after the clinician sees correct row–object matching, and restore it if omissions or duplicate placements return.", "progress_when": [ "Omissions/repetitions fall on new task instances.", "Tariq independently uses last-tick/next-blank restart after the phone sound.", "Four required objects match four ticks with acceptable burden." ], "do_not_progress_when": [ "The task includes an unmanaged safety, medicine or financial consequence.", "Fatigue, agitation or confusion grows during the sequence.", "Removing a checklist, tray or restart marker increases errors or distress." ] }, "self_check": [ "Can you demonstrate ‘Make one placement row per object’? Four unticked rows match bottle, notebook, glasses and appointment card.", "Can you demonstrate ‘Restart after the phone sound’? Last tick leads to the first blank row without a duplicate placement.", "Can you demonstrate ‘Audit sheet against bag’? Every tick has its object, or the exact mismatch remains circled.", "Can you demonstrate ‘Correct one checklist feature’? The single edit addresses the preserved omission/restart error." ], "measurement": { "primary": "Four-object bag completion, row–object agreement and restart accuracy with supports declared", "how": "Record required objects present out of four; missing/duplicate/out-of-order rows; whether restart used last tick then first blank row; CARD tray, prompt and clinician help; time and burden. Preserve baseline tick pattern beside the one corrected sheet feature.", "good_result": "On a matched bag, row–object mismatches or restart errors fall while the declared sheet/tray support remains available and burden stays acceptable; this is supported packing performance, not a memory clearance score.", "does_not_prove": "Separate impairment tests, strategy use, device-on function, device-off retention and everyday participation." }, "stop_and_get_help": [ "Seek urgent assessment for sudden new confusion, memory loss, speech change, weakness or severe headache.", "Stop for escalating agitation, unsafe action, severe fatigue or loss of consent.", "Ask the rehabilitation team to redesign tasks when errors create medication, fire, financial, wandering or exploitation risk." ], "accessibility": [ "Use pictures, objects, audio prompts, colour coding or partner-assisted scanning instead of text.", "Use fewer harmless bag objects only when the clinician relabels the finish inventory and records assistance.", "Keep external aids in everyday use; do not withdraw them merely to create an independence test." ], "evidence_notes": [ { "claim": "A randomised trial supports combining goal management, external cues and emotional regulation after acquired brain injury.", "source_title": "Rehabilitation of Executive Functions in Patients with Chronic Acquired Brain Injury with Goal Management Training, External Cuing, and Emotional Regulation: A Randomized Controlled Trial", "source_url": "https://pubmed.ncbi.nlm.nih.gov/26812574/", "source_kind": "PRIMARY_RESEARCH" }, { "claim": "WHO guidance supports assistive products as valid enablers of daily function.", "source_title": "Assistive technology", "source_url": "https://www.who.int/news-room/fact-sheets/detail/assistive-technology", "source_kind": "OFFICIAL_GUIDANCE" } ], "limits": [ "Separate impairment tests, strategy use, device-on function, device-off retention and everyday participation.", "Unsupported claim: restore your whole brain.", "Unsupported claim: unlock executive function.", "Unsupported claim: text reminders prove unaided recovery.", "Completing one planned task does not establish global cognitive recovery, capacity or safety for consequential decisions." ], "orientation": { "bounded_definition": "Capability to develop or express cognitive rehabilitation in a declared context without inheriting broader claims.", "evidence_summary": "Cognitive rehabilitation can improve daily functioning—often by combining learning with external supports.", "supportable_public_claim": "Selected people with acquired brain injury can learn strategies that improve everyday executive functioning, often with external cues.", "measurement_boundary": "Separate impairment tests, strategy use, device-on function, device-off retention and everyday participation.", "myth_to_metric": { "myth": "Retrain the brain back to full power", "metric": "Everyday goal completion, test performance, cue dependence, burden and retention", "boundary": "A brain-game score or aided gain does not establish global or unaided recovery." }, "limiting_findings": [ "Both trial groups improved on most neuropsychological tests.", "The effect belongs to a programme including external cueing, not an unaided faculty." ], "prohibited_claims": [ "restore your whole brain", "unlock executive function", "text reminders prove unaided recovery", "brain games cure injury" ] }, "gold_source_lesson": null, "next_gate": "External confirmation is required before higher-authority use because: CLINICAL_HIGH_RISK_OR_REGULATED_CONFIGURATION; SUPERVISION_OR_NON_ATTEMPT_BOUNDARY; CULTURAL_COMMUNITY_RIGHTS_OR_AFFECTED_PERSON_AUTHORITY; SAFETY_LEGITIMACY_RESTRICTED.", "evidence_count": 2 }, "full_training_programme": false, "independently_validated": false, "publication_state": "PUBLISHED_PUBLIC_RESEARCH_EDITION__EDITORIAL_REVIEW_PENDING", "related_power_ids": [ "PWR-057", "PWR-058", "PWR-059", "PWR-060" ] }, { "power_id": "PWR-063", "learning_unit_id": "TLU-PWR-063", "title": "Prosthetic embodiment", "main_description": "With Kai's prosthetic team, Kai completes the prescribed foam-cube transfer and reports control, embodiment, burden and skin condition as separate outcomes.", "main_description_source": "FULL_TUTORIAL_OUTCOME", "family_id": "FAM-08", "family": "Health, Rehabilitation & Adaptive Independence", "superdomain": "Regulation & Recovery", "canonical_route": "/powers/pwr-063/", "treatment": "SPECIALIST_PROVIDER_ROUTE", "treatment_label": "Full supervised tutorial", "treatment_boundary": "Titan teaches the complete method; a qualified person controls the parts that require supervision, clearance, specialist equipment, load, dose or progression.", "tutorial_route": "/tutorials/pwr-063/", "governed_lesson_route": null, "self_attempt_status": "PROHIBITED_WITHOUT_QUALIFIED_SUPERVISION", "gold_pathway_ids": [], "route_membership": { "kind": "RETAINED_EXTERNAL_ROUTE", "id": "SP-HUB-003", "coverage_status": "RETAINED" }, "source_authority_tier": "G4", "source_build_state": "EXTERNAL_PROVIDER_ROUTE", "source_instructional_route": "LEARN_ELSEWHERE_TRACK_WITH_TITAN", "source_count": 3, "research_depth": "FOCUSED", "risk_level": "HIGH", "prerequisite_status": "QUALIFIED_PROVIDER_DETERMINES", "learning_route": { "mode": "FULL_SUPERVISED_TUTORIAL", "label": "Learn prosthetic embodiment step by step", "summary": "With Kai's prosthetic team, Kai completes the prescribed foam-cube transfer and reports control, embodiment, burden and skin condition as separate outcomes.", "steps": [ [ "Get ready", "The prosthetist confirms fit, component integrity, battery/connection and permitted wear time." ], [ "Learn the method", "10 concrete steps teach the permitted method from start to finish." ], [ "See right and wrong", "7 comparisons show correct or safer execution beside common wrong or riskier choices." ], [ "Practise", "At the next prosthetic-team appointment, repeat the same socket, alignment, seated posture, foam cube, 30 cm path and vision condition. Compare body-map displacement and the five separate ratings only after skin remains acceptable; any component, fit or feedback change starts a new profile." ], [ "Check progress", "Record device/configuration, successful moves, slips/collisions, assistance, wear time, skin response and separate agency, ownership, location, comfort and usefulness ratings. Add the two-colour body-map displacement, vision condition and neutral agency, ownership, location-confidence and usefulness ratings to foam-cube transfer and skin record." ] ], "practical_authority": false, "provider_required": true, "next_action_route": "/tutorials/pwr-063/" }, "path_builder": { "selectable": true, "completion_allowed": true, "warning": "Titan teaches the complete method; a qualified person controls the parts that require supervision, clearance, specialist equipment, load, dose or progression." }, "full_tutorial": { "version": "3.0", "authorship": "POWER_SPECIFIC_FULL_TUTORIAL", "tutorial_mode": "SUPERVISED", "promise": "Prosthetic embodiment can include ownership, agency and perceived location, but none is required for useful prosthesis use. Kai’s prosthetic team checks residual-limb skin, fit and terminal-hand calibration. Kai then maps where the hand feels located, moves a foam cube, and rates command agency, ownership, comfort and usefulness separately. Neutral questions preserve low or mixed ratings instead of coaching a natural-limb claim.", "power_id": "PWR-063", "title": "Prosthetic embodiment", "lesson_type": "SUPERVISED", "headline": "Use a fitted prosthesis in a controlled task while checking skin, control and ownership separately", "plain_english_summary": "Prosthetic embodiment can include ownership, agency and perceived location, but none is required for useful prosthesis use. Kai’s prosthetic team checks residual-limb skin, fit and terminal-hand calibration. Kai then maps where the hand feels located, moves a foam cube, and rates command agency, ownership, comfort and usefulness separately. Neutral questions preserve low or mixed ratings instead of coaching a natural-limb claim.", "outcome": "With Kai's prosthetic team, Kai completes the prescribed foam-cube transfer and reports control, embodiment, burden and skin condition as separate outcomes.", "authority": { "learner_may": [ "Inspect residual-limb skin, don at the approved alignment marks and calibrate open/close while seated after the prosthetist clears the device.", "Move the foam cube along the guarded 30 cm path with the minimum reliable grip and log slips, collisions and assistance.", "Mark felt terminal-hand location and rate agency, ownership, location confidence, comfort and usefulness as separate observations." ], "qualified_person_required_for": [ "Checking socket/liner fit, alignment, skin, component integrity, battery/connection and the permitted wear interval.", "Selecting calibration, guarding, object, grip, path, feedback condition and progression to another functional task.", "Adjusting the socket, electrodes, alignment, firmware, control strategy or other prosthetic component and interpreting persistent pain/skin change." ], "never_do": [ "Use a damaged, wet-outside-rating, poorly fitting or faulting device or continue through pressure pain, skin change or electrical sensation.", "Change alignment, gain, electrode position, grip force or wear time to chase a higher agency/ownership rating.", "Coach the learner to report ownership or treat low ownership as failed device control; embodiment dimensions may differ." ] }, "materials": [ "The individually fitted prosthesis and approved liner/socket/components.", "A mirror or visual feedback setup selected by the team.", "One light, non-breakable practice object and stable work surface.", "Skin-check aid and record for device state, task, control errors, embodiment ratings and burden." ], "before_you_start": [ "The prosthetist confirms fit, component integrity, battery/connection and permitted wear time.", "Inspect residual limb and contact areas using a mirror or helper.", "Do not use a damaged, misfitting, uncharged or wet device outside its rating.", "Agree stops for pain, pressure, skin change, electrical sensation, fall risk or device fault." ], "steps": [ { "title": "Inspect before donning", "instruction": "Check skin, liner, socket and component surfaces using the team-approved sequence; mark any redness or wound.", "reason": "Skin condition and fit can change from one session to the next.", "success_check": "No unapproved skin issue or damaged component is present." }, { "title": "Don with the trained sequence", "instruction": "Apply liner/socket and secure components exactly as fitted; do not add padding or alter alignment.", "reason": "Small fit changes affect control, pressure and safety.", "success_check": "Terminal hand is seated at the team-set alignment marks and feels as expected." }, { "title": "Calibrate control", "instruction": "Run prosthetist-approved opening/closing or signal calibration in the supported position.", "reason": "Control settings must match the current terminal-hand configuration and residual-limb state.", "success_check": "Terminal hand responds predictably before handling an object." }, { "title": "Locate terminal hand in space", "instruction": "With chosen visual or sensory feedback, point to the terminal hand and rehearse approaching foam cube without grasping.", "reason": "Spatial prediction supports controlled contact and distinguishes location from ownership feeling.", "success_check": "Approach stops beside foam cube without collision." }, { "title": "Contact and grasp lightly", "instruction": "Use prosthetist-set command to contact and hold the foam cube with the minimum reliable force.", "reason": "Excess grip can damage objects and increase effort.", "success_check": "Foam cube is secure without crushing, slip or unexpected activation." }, { "title": "Move and release", "instruction": "Transport along the marked short path and release inside the blue landing square while prosthetist guards safety.", "reason": "A complete functional loop includes controlled release.", "success_check": "Foam cube lands inside the blue square and terminal hand stops as commanded." }, { "title": "Rate separate experiences", "instruction": "Report agency (“I caused it”), ownership (“felt like mine”), location and comfort separately on the agreed scale.", "reason": "These experiences can differ and should not be forced into one embodiment score.", "success_check": "All ratings are recorded even when ownership is low." }, { "title": "Remove and inspect", "instruction": "End at the prescribed wear time, doff with the trained sequence and recheck skin after the prosthetist-set interval.", "reason": "Pressure effects may appear after removal.", "success_check": "Skin and symptoms meet the prosthetic-team continuation rule." }, { "title": "Mark perceived location before the grasp", "instruction": "With the terminal hand supported and eyes closed only if Kai and the prosthetic team approve, ask Kai to point on a large body-map sheet to the felt location of the terminal hand. Then uncover the terminal hand and mark the physical terminal-hand location in a second colour.", "reason": "A location mismatch is useful fitting or feedback information and is not the same as weak agency or ownership.", "success_check": "Felt and physical marks are preserved separately with posture, vision condition and prosthesis configuration." }, { "title": "Probe agency without demanding ownership", "instruction": "After the foam-cube transfer, ask two neutral questions in random order: “How much did you feel you caused that movement?” and “How much did the terminal hand feel like part of you?” Record each answer before discussion.", "reason": "A wearer may command the terminal hand reliably without experiencing it as owned, or may report familiarity without precise control.", "success_check": "Agency and ownership retain separate scale values and the occupational therapist does not suggest the preferred direction." } ], "worked_example": { "scenario": "A prosthetist and occupational therapist support Kai using a myoelectric hand to move a foam block 30 cm.", "walkthrough": [ "Kai inspects residual-limb skin while the prosthetic team checks socket, alignment and battery.", "He dons at the alignment marks and calibrates open/close signals while seated.", "He approaches, grasps foam cube lightly and releases it in the target under guarding.", "He rates agency high, ownership neutral and comfort acceptable instead of being coached to feel ownership.", "After the prescribed wear interval he doffs the prosthesis and Kai's prosthetic team checks skin.", "Before the transfer, Kai marks felt terminal-hand location slightly nearer the body than the visible hand; the occupational therapist retains both marks rather than moving Kai’s answer.", "After release, Kai rates agency 8/10, ownership 3/10 and usefulness 7/10, demonstrating that reliable command, body ownership and practical value are different observations." ], "result": "Kai demonstrates controlled device use and reports embodiment dimensions honestly. Utility does not depend on claiming terminal hand feels fully biological. Kai’s profile documents a stable command experience and a modest ownership feeling; it does not collapse those dimensions into prosthetic-control success." }, "right_vs_wrong": [ { "situation": "Fit", "right": "Use the fitted liner/socket and alignment.", "wrong": "Add padding or change alignment to fix discomfort alone.", "why": "Unapproved changes alter pressure and control." }, { "situation": "Task object", "right": "Begin with a light, unbreakable object.", "wrong": "Test hot liquid, glass or maximum grip.", "why": "Failure consequences and loads are not yet controlled." }, { "situation": "Grip", "right": "Use minimum reliable force and confirm release.", "wrong": "Squeeze harder whenever uncertain.", "why": "Excess force can damage objects and raise effort." }, { "situation": "Embodiment report", "right": "Rate agency, ownership, location and comfort separately.", "wrong": "Say terminal hand must feel like a body part to count.", "why": "Useful control and ownership feelings are not identical." }, { "situation": "Skin", "right": "Inspect before and after prescribed wear block.", "wrong": "Continue through redness or pressure pain.", "why": "Skin injury can worsen under the socket." }, { "situation": "Body-map mismatch", "right": "Keep felt-location mark and physical-location mark as two observations.", "wrong": "Erase felt mark because Kai pointed to the wrong place.", "why": "The mismatch is the phenomenon being measured and may guide a fit or feedback review." }, { "situation": "Reliable command with low ownership", "right": "Report high agency and low ownership exactly as stated.", "wrong": "Average both ratings into a single embodiment pass score.", "why": "A composite would hide Kai’s actual experience and imply that ownership is compulsory." } ], "common_mistakes": [ { "mistake": "Kai is asked, “Does it feel like your real hand?” until a positive answer is given.", "fix": "Use separate neutral prompts for ownership, agency, perceived location, comfort and usefulness; “not at all” is a valid response." }, { "mistake": "A successful grasp is automatically scored as strong ownership.", "fix": "Record task completion under function and ask the ownership question independently after foam cube is safe." }, { "mistake": "Terminal hand is visually aligned but Kai points to a different felt location.", "fix": "Preserve both marks on body-map sheet and ask the prosthetist to review fit or feedback instead of correcting embodiment report." }, { "mistake": "A skin-pressure complaint is treated as resistance to embodiment practice.", "fix": "Stop wear, inspect the residual limb and route the fit concern to Kai's prosthetic team before another body-map probe." }, { "mistake": "The asynchronous comparison is announced in advance, inviting the expected rating.", "fix": "Conceal the order when Kai's prosthetic team has authorised a comparison and record the raw rating before explaining the condition." }, { "mistake": "Low ownership leads a helper to remove a prosthesis that Kai finds functionally useful.", "fix": "Let Kai decide whether usefulness, comfort and maintenance justify use; embodiment is not a pass requirement." } ], "practice": { "first_session": [ "The prosthetist inspects Kai’s residual-limb skin, socket, liner, alignment and battery, then confirms the permitted wear interval.", "Kai dons at the alignment marks, calibrates open and close while seated and performs three empty approach–release rehearsals.", "Before object handling, Kai marks the felt terminal-hand location on a body map; the occupational therapist overlays physical location in a second colour.", "Kai moves the foam cube 30 cm into the blue square with minimum reliable grip while slips, collisions and assistance are logged.", "Kai rates agency, ownership, location confidence, comfort and usefulness separately, then doffs and completes the timed skin recheck." ], "repeat_plan": "At the next prosthetic-team appointment, repeat the same socket, alignment, seated posture, foam cube, 30 cm path and vision condition. Compare body-map displacement and the five separate ratings only after skin remains acceptable; any component, fit or feedback change starts a new profile.", "progress_when": [ "Object-control errors fall without increasing grip force or burden.", "Skin remains within the prosthetic team’s skin criteria.", "The terminal hand supports a chosen daily task, regardless of ownership rating.", "Felt-location marks and separate experience ratings are reproducible enough to discuss without prompting Kai toward a preferred answer.", "Kai can state whether changes concern command agency, ownership, perceived location, comfort or usefulness." ], "do_not_progress_when": [ "Fit, alignment, battery or control becomes unreliable.", "Redness persists beyond the prosthetic team’s time limit, skin breaks or pain rises.", "Kai is pressured to report embodiment or stop using a preferred aid." ] }, "self_check": [ "Can you demonstrate “Don with the trained sequence”? Terminal hand is seated at the team-set alignment marks and feels as expected.", "Can you demonstrate “Contact and grasp lightly”? Foam cube is secure without crushing, slip or unexpected activation.", "Can you demonstrate “Remove and inspect”? Skin and symptoms meet the prosthetic-team continuation rule.", "Can you describe a case with high agency and low ownership without calling either rating incorrect?", "Can you preserve a felt-location mismatch as data and still stop immediately for skin pressure?" ], "measurement": { "primary": "Foam-cube control, two-colour perceived-location displacement, separate agency and ownership ratings, skin response and wearer-chosen usefulness", "how": "Record device/configuration, successful moves, slips/collisions, assistance, wear time, skin response and separate agency, ownership, location, comfort and usefulness ratings. Add the two-colour body-map displacement, vision condition and neutral agency, ownership, location-confidence and usefulness ratings to foam-cube transfer and skin record.", "good_result": "Kai's prosthetic team confirms repeatable safe control on the declared task, acceptable skin and Kai’s chosen value; high ownership is not required.", "does_not_prove": "High agency, ownership or foam-cube success does not prove biological integration, safe fit in a new wear schedule, control of heavier objects or readiness to change prosthetic settings." }, "stop_and_get_help": [ "Stop for skin breakdown, persistent redness, swelling, severe pain, electrical shock sensation, overheating or device malfunction.", "Stop foam-cube transfer for unexpected activation, repeated object drop or loss of balance.", "Contact Kai's prosthetic team before further wear after fit change, fall, component damage or sustained loss of control." ], "accessibility": [ "Use alternate control sites, switches, voice/supporter assistance or positioning only as configured by Kai's prosthetic team.", "Provide mirror, camera, tactile or auditory feedback compatible with Kai’s senses.", "Respect non-use or part-time use as a valid choice and preserve other mobility/self-care aids." ], "evidence_notes": [ { "claim": "Home-use research supports person-device functional and psychosocial experience in a specific neural-connected prosthesis system.", "source_title": "Home Use of a Neural-connected Sensory Prosthesis Provides the Functional and Psychosocial Experience of Having a Hand Again", "source_url": "https://pubmed.ncbi.nlm.nih.gov/29959334/", "source_kind": "PRIMARY_RESEARCH" }, { "claim": "WHO guidance frames assistive products around function and participation, not compulsory embodiment.", "source_title": "Assistive technology", "source_url": "https://www.who.int/news-room/fact-sheets/detail/assistive-technology", "source_kind": "OFFICIAL_GUIDANCE" } ], "limits": [ "Report ownership/agency scales, task function, wear time, device state, maintenance burden, adverse events and the user’s own value judgment.", "Unsupported claim: prosthesis becomes a natural limb.", "Unsupported claim: cyborg upgrade.", "Unsupported claim: everyone should embody a device.", "Embodiment ratings do not prove biological integration, device safety in new tasks or readiness to change fit or controls." ], "orientation": { "bounded_definition": "Capability to develop or express prosthetic embodiment in a declared context without inheriting broader claims.", "evidence_summary": "A prosthesis can sometimes feel and function more like part of the body—but only within a fitted, supported person-device system.", "supportable_public_claim": "Some users can develop a stronger functional and experiential relationship with a fitted sensory prosthesis.", "measurement_boundary": "Report ownership/agency scales, task function, wear time, device state, maintenance burden, adverse events and the user’s own value judgment.", "myth_to_metric": { "myth": "Merge with a prosthesis and regain a natural limb", "metric": "User-defined embodiment, task function, wear choice, device state and burden", "boundary": "Embodiment scores do not prove biological restoration, universal preference or effortless use." }, "limiting_findings": [ "The home study involved two participants and device interruptions.", "Device-off persistence and broad population benefit are not established." ], "prohibited_claims": [ "prosthesis becomes a natural limb", "cyborg upgrade", "everyone should embody a device", "implant restores the biological hand" ] }, "gold_source_lesson": null, "next_gate": "External confirmation is required before higher-authority use because: CLINICAL_HIGH_RISK_OR_REGULATED_CONFIGURATION; SUPERVISION_OR_NON_ATTEMPT_BOUNDARY; CULTURAL_COMMUNITY_RIGHTS_OR_AFFECTED_PERSON_AUTHORITY; SAFETY_LEGITIMACY_RESTRICTED.", "evidence_count": 3 }, "full_training_programme": false, "independently_validated": false, "publication_state": "PUBLISHED_PUBLIC_RESEARCH_EDITION__EDITORIAL_REVIEW_PENDING", "related_power_ids": [ "PWR-057", "PWR-058", "PWR-059", "PWR-060" ] }, { "power_id": "PWR-064", "learning_unit_id": "TLU-PWR-064", "title": "Adaptive self-care independence", "main_description": "With an occupational therapist, Bea completes or directs the agreed shirt-dressing sequence with declared aids and assistance and no unsafe balance loss.", "main_description_source": "FULL_TUTORIAL_OUTCOME", "family_id": "FAM-08", "family": "Health, Rehabilitation & Adaptive Independence", "superdomain": "Regulation & Recovery", "canonical_route": "/powers/pwr-064/", "treatment": "SPECIALIST_PROVIDER_ROUTE", "treatment_label": "Full supervised tutorial", "treatment_boundary": "Titan teaches the complete method; a qualified person controls the parts that require supervision, clearance, specialist equipment, load, dose or progression.", "tutorial_route": "/tutorials/pwr-064/", "governed_lesson_route": null, "self_attempt_status": "PROHIBITED_WITHOUT_QUALIFIED_SUPERVISION", "gold_pathway_ids": [], "route_membership": { "kind": "RETAINED_EXTERNAL_ROUTE", "id": "SP-HUB-003", "coverage_status": "RETAINED" }, "source_authority_tier": "G4", "source_build_state": "EXTERNAL_PROVIDER_ROUTE", "source_instructional_route": "LEARN_ELSEWHERE_TRACK_WITH_TITAN", "source_count": 4, "research_depth": "DETAILED", "risk_level": "MODERATE_TO_HIGH", "prerequisite_status": "QUALIFIED_PROVIDER_DETERMINES", "learning_route": { "mode": "FULL_SUPERVISED_TUTORIAL", "label": "Learn adaptive self-care independence step by step", "summary": "With an occupational therapist, Bea completes or directs the agreed shirt-dressing sequence with declared aids and assistance and no unsafe balance loss.", "steps": [ [ "Get ready", "The occupational therapist checks balance, skin, joint precautions, lines/tubes, cognition and preferred clothing." ], [ "Learn the method", "10 concrete steps teach the permitted method from start to finish." ], [ "See right and wrong", "7 comparisons show correct or safer execution beside common wrong or riskier choices." ], [ "Practise", "Use the same loose shirt, stable chair, collar marker and dressing stick for three safe dressing occasions. When the limited-side cuff remains untwisted and button help is directed precisely, the OT may test one preferred home garment while keeping the seated base and step-level tally." ], [ "Check progress", "Record completed steps, type/amount of assistance by step, time, effort, pain, balance events, Bea’s choice and whether the dressing method works at home. On the dressing tally, mark cuff orientation, sleeve twist, unsupported reach, assistance at each closure, chosen open buttons and whether shirt matched Bea’s preferred appearance." ] ], "practical_authority": false, "provider_required": true, "next_action_route": "/tutorials/pwr-064/" }, "path_builder": { "selectable": true, "completion_allowed": true, "warning": "Titan teaches the complete method; a qualified person controls the parts that require supervision, clearance, specialist equipment, load, dose or progression." }, "full_tutorial": { "version": "3.0", "authorship": "POWER_SPECIFIC_FULL_TUTORIAL", "tutorial_mode": "SUPERVISED", "promise": "Independence can mean completing a self-care step, directing assistance or redesigning the setup—not doing everything alone. This lesson analyses one seated front-opening-shirt sequence. Bea chooses which sleeves and buttons she will manage, positions a stable chair and dressing stick, stages the limited-side cuff at her supported hand, delegates only named closures and records effort, pain, balance and preferred appearance.", "power_id": "PWR-064", "title": "Adaptive self-care independence", "lesson_type": "SUPERVISED", "headline": "Redesign one self-care task so the person can do or direct it safely", "plain_english_summary": "Independence can mean completing a self-care step, directing assistance or redesigning the setup—not doing everything alone. This lesson analyses one seated front-opening-shirt sequence. Bea chooses which sleeves and buttons she will manage, positions a stable chair and dressing stick, stages the limited-side cuff at her supported hand, delegates only named closures and records effort, pain, balance and preferred appearance.", "outcome": "With an occupational therapist, Bea completes or directs the agreed shirt-dressing sequence with declared aids and assistance and no unsafe balance loss.", "authority": { "learner_may": [ "Choose which shirt steps to do, complete with an aid, direct to a helper or intentionally leave open; those choices define independence for this task.", "Use the stable seated limited-side-first sleeve sequence, dressing stick, collar marker and button loop selected with the OT.", "Tally self, aid, directed help or intentionally open at each closure, plus fabric twist, pain, effort and preference." ], "qualified_person_required_for": [ "Assessing sitting balance, skin, joint precautions, lines/tubes, cognition, painful reach and whether the chosen garment is appropriate.", "Selecting chair support, shirt orientation, dressing aid, assistance and the single barrier changed between attempts.", "Progressing to a tighter/preferred garment or changing orthoses, precautions, equipment or rehabilitation goals." ], "never_do": [ "Dress standing beside stairs, use an unlocked wheeled chair or pull a painful/limited arm through a hanging sleeve.", "Remove a dressing aid or refuse directed button help merely to lower an assistance score.", "Force fabric around a line, tube, wound, joint precaution or painful range; stop and obtain the responsible clinician's plan." ] }, "materials": [ "A stable chair with provider-selected support.", "A loose front-opening shirt and prescribed dressing aid if used.", "Mirror, reach aid or labelled step card as selected.", "A record for steps completed, assistance, time, effort, pain and preference." ], "before_you_start": [ "The occupational therapist checks balance, skin, joint precautions, lines/tubes, cognition and preferred clothing.", "Place the chair away from stairs and lock wheels when applicable.", "Choose a garment and aid that do not require painful force or unsafe reach.", "Agree whether the goal is doing, directing assistance or reducing burden." ], "steps": [ { "title": "Define independence for this task", "instruction": "Ask Bea which parts she wants to do, direct or delegate and what a successful dressed state looks like.", "reason": "Independence is person-chosen control, not absence of help.", "success_check": "The dressing goal names the shirt, assistance and finish state." }, { "title": "Prepare seated setup", "instruction": "Position the chair, feet/support, shirt, aid and helper on the side approved by Bea's OT before dressing starts.", "reason": "Preparation prevents reaching and standing while entangled in clothing.", "success_check": "All items are reachable without losing the safe base." }, { "title": "Orient shirt", "instruction": "Lay the shirt with collar and inside/outside markers visible; identify the first sleeve using the OT-taught method.", "reason": "Orientation errors create repeated reaching and frustration.", "success_check": "Bea can point to collar, inside and first sleeve." }, { "title": "Dress selected side first", "instruction": "Guide the prescribed arm or limb into the first sleeve using approved aid or helper support; never pull forcefully on a painful joint.", "reason": "Order can reduce range and protect a vulnerable side.", "success_check": "The limb is supported and fabric is not twisted." }, { "title": "Bring shirt around", "instruction": "Use selected reach, aid or helper handoff to bring the shirt across the back while remaining seated and stable.", "reason": "Moving the shirt behind the back should be planned rather than improvised mid-task.", "success_check": "No unsupported standing or extreme shoulder pull occurs." }, { "title": "Complete second side", "instruction": "Place the other arm and settle the shirt using Bea’s preferred method and the minimum useful help.", "reason": "Separating the steps lets assistance target the actual barrier.", "success_check": "Both sleeves are on and assistance is recorded by step." }, { "title": "Fasten or choose an adaptation", "instruction": "Use large fasteners, loop aid, magnetic adaptation or directed help as approved; fasten only what is needed for the chosen finish.", "reason": "Equipment or delegated help can preserve choice and reduce burden.", "success_check": "Chosen finish is met without unsafe strain." }, { "title": "Review effort and redesign", "instruction": "Record difficult steps, pain, time, balance and preference. Change dressing setup or aid before asking Bea to try harder.", "reason": "Task and environment are valid treatment targets.", "success_check": "One specific redesign follows the largest barrier." }, { "title": "Stage fabric at affected hand", "instruction": "Open the cuff and gather limited-side sleeve into a short fabric ring. Keep the affected forearm supported on the lap or approved surface, then bring the sleeve opening to the affected hand instead of reaching the arm toward loose fabric.", "reason": "Gathering the sleeve reduces shoulder travel, prevents the affected hand from searching inside a twisted sleeve and makes the first barrier visible.", "success_check": "Affected hand enters the correct cuff, the seam remains untwisted and the affected shoulder stays inside its prescribed range." }, { "title": "Use a button-by-button handoff", "instruction": "At each required closure, Bea either fastens it with the approved loop, directs the button helper to that exact button or chooses to leave it open. Button helper waits for the instruction before touching the shirt.", "reason": "Step-specific direction preserves control and shows whether the obstacle is alignment, pinch, vision, fatigue or time.", "success_check": "Each required button has a recorded method—self, aid, directed help or intentionally open—and the chosen finish is met." } ], "worked_example": { "scenario": "An occupational therapist helps Bea, who has limited movement in one shoulder, put on a loose front-opening shirt while seated.", "walkthrough": [ "Bea chooses to put on both sleeves herself and ask for help only with two buttons.", "They prepare the stable chair, lay the shirt in the correct orientation and place a dressing stick within reach.", "Bea dresses the limited side first without button helper pulling her arm.", "She brings the shirt around with dressing stick, completes the other sleeve and directs button help.", "They record one cue, button help, effort and no pain increase, then add a collar marker for next time.", "Bea gathers limited-side sleeve over her supported hand before advancing fabric, which prevents affected shoulder pull that occurred when she reached into a hanging sleeve.", "At the button stage, Bea uses the loop for the top button, directs help for the middle button and intentionally leaves the lowest button open because coverage and comfort are already achieved." ], "result": "Bea controls the full task and completes chosen portions safely. Directed button help is part of her independence rather than a failure. Bea completes the sleeve sequence and controls each closure decision, so the dressing tally describes real shirt-dressing independence rather than a generic completion time." }, "right_vs_wrong": [ { "situation": "Goal", "right": "Ask what Bea wants to do and direct.", "wrong": "Define independence as no help at any cost.", "why": "Removing help can increase risk and reduce participation." }, { "situation": "Setup", "right": "Place clothing and aids before starting.", "wrong": "Search or reach while partly dressed.", "why": "Entanglement and unstable reach increase fall and joint risk." }, { "situation": "Affected side", "right": "Use Bea's OT-selected order and support.", "wrong": "Pull a painful or weak arm through quickly.", "why": "Force can injure tissue and does not teach control." }, { "situation": "Assistance", "right": "Record and target help to one step.", "wrong": "Have button helper take over without asking.", "why": "Unplanned takeover removes agency and hides the barrier." }, { "situation": "Progress", "right": "Redesign garment, environment or aid.", "wrong": "Demand faster unaided performance first.", "why": "Task adaptation may provide the meaningful gain." }, { "situation": "Limited-side cuff", "right": "Bring a gathered sleeve opening to the supported hand and advance fabric gradually.", "wrong": "Reach the painful arm into a hanging sleeve while button helper pulls from cuff.", "why": "Moving fabric over a supported limb avoids unnecessary shoulder traction." }, { "situation": "Button assistance", "right": "Name the exact closure and whether to use the loop, helper or open option.", "wrong": "Let button helper fasten the entire shirt as soon as one button is difficult.", "why": "A button-level handoff preserves Bea’s direction and reveals the real barrier." } ], "common_mistakes": [ { "mistake": "The front-opening shirt begins inside out and the error is discovered after one sleeve is on.", "fix": "Add a tactile or high-contrast collar mark, lay the label side upward and point to both sleeve openings before lifting shirt." }, { "mistake": "The button helper pulls the cuff while the painful shoulder is unsupported.", "fix": "Support affected forearm, open sleeve over affected hand and advance fabric toward affected shoulder without traction on the joint." }, { "mistake": "Bea reaches behind the stable chair for a dropped dressing stick while partly entangled.", "fix": "Stop, regain the seated base and have the item returned to the prepared reachable zone before continuing." }, { "mistake": "Every button is attempted even though the agreed finish needs only two closures.", "fix": "Fasten only the buttons required for comfort, coverage and Bea’s chosen appearance; direct help for the rest." }, { "mistake": "A helper completes both sleeves after one slow attempt.", "fix": "Ask permission at the named barrier and assist only that step so Bea retains chosen portions." }, { "mistake": "A faster time is praised despite more shoulder pain and less choice.", "fix": "Compare finish state, step-level help, effort, pain and preference together; time alone does not define dressing independence." } ], "practice": { "first_session": [ "Bea tells the OT which sleeves and buttons she wants to complete, use an aid for, delegate or intentionally leave open.", "Place the stable chair, front-opening shirt, collar marker, pre-gathered limited-side sleeve, dressing stick and button helper inside the safe reach zone.", "Complete the seated sleeve sequence once while marking cuff orientation, fabric twist, shoulder discomfort and assistance at each step.", "Correct the largest barrier—for example, move the collar marker or gather the cuff more tightly—then repeat only that shirt section.", "Finish with a button-by-button tally of self, aid, directed help or intentionally open, plus Bea’s effort and appearance rating." ], "repeat_plan": "Use the same loose shirt, stable chair, collar marker and dressing stick for three safe dressing occasions. When the limited-side cuff remains untwisted and button help is directed precisely, the OT may test one preferred home garment while keeping the seated base and step-level tally.", "progress_when": [ "Bea finds the collar marker and advances the limited-side cuff without a sleeve twist, unsupported reach or shoulder traction.", "Every required button is marked self, dressing aid, directed help or intentionally open, and the chosen appearance is achieved.", "A preferred home shirt can be managed from the same seated base with equal or lower pain, effort and helper burden." ], "do_not_progress_when": [ "The affected shoulder becomes painful, the seated base is lost or fabric entanglement requires an unsafe reach.", "The home garment, chair, dressing stick or named helper differs before the OT has checked the new setup.", "Reducing help conflicts with Bea’s chosen appearance, comfort or direction of the button handoff." ] }, "self_check": [ "Can you demonstrate “Prepare seated setup”? All items are reachable without losing the safe base.", "Can you demonstrate “Bring shirt around”? No unsupported standing or extreme shoulder pull occurs.", "Can you demonstrate “Review effort and redesign”? One specific redesign follows the largest barrier.", "Can you gather limited-side sleeve and bring it to the supported hand without pulling affected shoulder toward the shirt?", "Can you name which buttons are self-fastened, aided, delegated or intentionally open for the chosen finish?" ], "measurement": { "primary": "Completion of Bea’s chosen front-opening-shirt steps with cuff orientation, button-level assistance, pain, balance, effort and preferred appearance", "how": "Record completed steps, type/amount of assistance by step, time, effort, pain, balance events, Bea’s choice and whether the dressing method works at home. On the dressing tally, mark cuff orientation, sleeve twist, unsupported reach, assistance at each closure, chosen open buttons and whether shirt matched Bea’s preferred appearance.", "good_result": "Bea safely completes or directs the chosen shirt-dressing outcome on three occasions with acceptable effort and preferred support.", "does_not_prove": "Completing one front-opening shirt does not prove independence with bathing, toileting, pullovers, fasteners, standing dressing or a different home setup; reduced helper time is not automatically the wearer’s preferred outcome." }, "stop_and_get_help": [ "Stop for loss of balance, new severe pain, joint strain, skin injury, dizziness or shortness of breath.", "Seek urgent help for sudden new weakness, speech change, collapse or other acute neurological signs.", "Ask the OT to reassess after a fall, surgery/precaution change, new equipment or a sustained decline in self-care." ], "accessibility": [ "Use larger fasteners, loops, colour/tactile orientation marks, seated supports or dressing aids.", "Use spoken, pictured or one-step-at-a-time cues and allow extra processing time.", "Treat directing a trusted helper as a valid completion method and preserve consent at every handoff." ], "evidence_notes": [ { "claim": "A randomised clinical trial supports addressing person and home environment together to reduce disability.", "source_title": "Effect of a Biobehavioral Environmental Approach on Disability Among Low-Income Older Adults: A Randomized Clinical Trial", "source_url": "https://pubmed.ncbi.nlm.nih.gov/30615024/", "source_kind": "PRIMARY_RESEARCH" }, { "claim": "A randomised home intervention supports combining occupational-therapy strategies, devices and environmental change for function.", "source_title": "A randomized trial of a multicomponent home intervention to reduce functional difficulties in older adults", "source_url": "https://pubmed.ncbi.nlm.nih.gov/16696748/", "source_kind": "PRIMARY_RESEARCH" } ], "limits": [ "Use person-chosen ADLs, safety, effort, time, assistance, participation and caregiver burden; lower help does not automatically mean better outcome.", "Unsupported claim: become fully independent.", "Unsupported claim: need no help.", "Unsupported claim: overcome disability through effort.", "Success with one garment and setup does not establish independence across bathing, toileting, cooking or a different environment." ], "orientation": { "bounded_definition": "Capability to develop or express adaptive self-care independence in a declared context without inheriting broader claims.", "evidence_summary": "Independence can mean doing a task, directing assistance or redesigning the environment—not doing everything alone.", "supportable_public_claim": "Adaptive self-care can improve through person-led strategies, assistance and environmental modification.", "measurement_boundary": "Use person-chosen ADLs, safety, effort, time, assistance, participation and caregiver burden; lower help does not automatically mean better outcome.", "myth_to_metric": { "myth": "Become independent enough to need no help", "metric": "Safe completion of chosen activities with declared effort, assistance, environment and burden", "boundary": "Reduced help is not automatically safer, preferred or more autonomous." }, "limiting_findings": [ "The post-hospitalization CAPABLE trial did not improve overall ADLs.", "IADL improvement in the 2019 CAPABLE trial was not statistically significant." ], "prohibited_claims": [ "become fully independent", "need no help", "overcome disability through effort", "assistive technology fixes access" ] }, "gold_source_lesson": null, "next_gate": "External confirmation is required before higher-authority use because: CLINICAL_HIGH_RISK_OR_REGULATED_CONFIGURATION; SUPERVISION_OR_NON_ATTEMPT_BOUNDARY; CULTURAL_COMMUNITY_RIGHTS_OR_AFFECTED_PERSON_AUTHORITY.", "evidence_count": 4 }, "full_training_programme": false, "independently_validated": false, "publication_state": "PUBLISHED_PUBLIC_RESEARCH_EDITION__EDITORIAL_REVIEW_PENDING", "related_power_ids": [ "PWR-057", "PWR-058", "PWR-059", "PWR-060" ] }, { "power_id": "PWR-065", "learning_unit_id": "TLU-PWR-065", "title": "Visual acuity", "main_description": "The learner completes the supplied A and B symbol ladders with fixed configuration and reports four-group accuracy and confidence at each displayed size.", "main_description_source": "FULL_TUTORIAL_OUTCOME", "family_id": "FAM-09", "family": "Visual Perception & Search", "superdomain": "Perception & Sensorimotor", "canonical_route": "/powers/pwr-065/", "treatment": "EVIDENCE_REVIEW_ROUTE", "treatment_label": "Full low-stakes tutorial", "treatment_boundary": "Titan teaches a concrete low-stakes method step by step while keeping evidence and transfer claims bounded.", "tutorial_route": "/tutorials/pwr-065/", "governed_lesson_route": null, "self_attempt_status": "PERMITTED_INSIDE_FULL_TUTORIAL_LIMITS", "gold_pathway_ids": [ "G-CUR-006" ], "route_membership": { "kind": "GOLD_PATHWAY", "id": "G-CUR-006", "coverage_status": "EXACT_ONCE" }, "source_authority_tier": "G2", "source_build_state": "TARGETED_REVIEW_REQUIRED", "source_instructional_route": "BOUNDED_GUIDED_EXERCISE", "source_count": 6, "research_depth": "DEEP", "risk_level": "LOW_TO_MODERATE; CLINICAL_WHEN_VISUAL_DISORDER_OR_PRISM", "prerequisite_status": "NONE_FOR_READING__NO_PRACTICE_AUTHORITY", "learning_route": { "mode": "FULL_SELF_GUIDED_TUTORIAL", "label": "Learn visual acuity step by step", "summary": "The learner completes the supplied A and B symbol ladders with fixed configuration and reports four-group accuracy and confidence at each displayed size.", "steps": [ [ "Get ready", "Use the same eye correction normally used for the selected viewing distance." ], [ "Learn the method", "7 concrete steps teach the permitted method from start to finish." ], [ "See right and wrong", "5 comparisons show correct or safer execution beside common wrong or riskier choices." ], [ "Practise", "Use at most two ladders per session, two sessions per week, with a new item order. Progress only by better novel-ladder consistency at the same setup; clinical treatment follows an eye professional." ], [ "Check progress", "For each ladder and size, report correct positions out of four, the four original responses, confidence, font, pixel size, zoom, viewing distance, correction, lighting and symptoms. Compare A and B size by size; never convert the result to clinical units." ] ], "practical_authority": true, "provider_required": false, "next_action_route": "/tutorials/pwr-065/" }, "path_builder": { "selectable": true, "completion_allowed": true, "warning": "Titan teaches a concrete low-stakes method step by step while keeping evidence and transfer claims bounded." }, "full_tutorial": { "version": "3.0", "authorship": "POWER_SPECIFIC_FULL_TUTORIAL", "tutorial_mode": "SELF_GUIDED", "promise": "Visual acuity can improve in selected amblyopia treatment settings, but this is not a route to superhuman eyesight. The low-risk teachable version is a symbol-discrimination fixture, not home measurement of visual acuity. The learner fixes screen, distance, lighting and usual correction, answers once per row, records errors and repeats with a novel ladder. Clinical visual acuity requires standardised charts and qualified interpretation.", "power_id": "PWR-065", "title": "Visual acuity", "lesson_type": "SELF_GUIDED", "headline": "Identify symbol detail under a fixed display setup without calling it a clinical eye test", "plain_english_summary": "Visual acuity can improve in selected amblyopia treatment settings, but this is not a route to superhuman eyesight. The low-risk teachable version is a symbol-discrimination fixture, not home measurement of visual acuity. The learner fixes screen, distance, lighting and usual correction, answers once per row, records errors and repeats with a novel ladder. Clinical visual acuity requires standardised charts and qualified interpretation.", "outcome": "The learner completes the supplied A and B symbol ladders with fixed configuration and reports four-group accuracy and confidence at each displayed size.", "authority": { "learner_may": [ "Use ladder A at 60 cm and 100% zoom with ordinary correction, naming the odd-arrow position in each of four groups from largest to smallest row.", "Score four group answers at every pixel size, keep guessed/skipped groups visible and run concealed ladder B after 48 hours at identical setup.", "Use large pointing, speech or a helper-recorded 1–5 response without changing arrow size or viewing distance." ], "qualified_person_required_for": [ "Measuring clinical visual acuity, prescribing/changing lenses or assessing a new, asymmetric or function-limiting vision change.", "Using vision results for driving, occupational clearance, mobility safety or treatment decisions.", "Adapting the task for eye disease, diplopia, field loss, recent surgery or another condition requiring an eye professional." ], "never_do": [ "Move closer, enlarge zoom, remove prescribed correction or peek at the folded position key after reaching a hard row.", "Call the smallest correct row a Snellen/logMAR value or proof of safe reading, driving or disease improvement.", "Continue through eye pain, new double vision, sudden blur/vision loss, severe headache or marked visual strain." ] }, "materials": [ "An exact two-ladder construction sheet. A helper makes six rows per ladder at 72, 60, 48, 36, 30 and 24 px in DejaVu Sans or the same available sans-serif font. Each row has four separated groups of five identical arrows except one arrow pointing in the opposite direction; group base directions cycle up, right, down and left. Odd-arrow positions for ladder A, largest to smallest, are [3,5,2,4], [1,4,5,2], [2,5,3,1], [4,1,5,3], [5,2,4,1], [3,1,2,5]. Ladder B uses [2,4,1,5], [5,3,2,1], [4,2,1,3], [1,5,3,2], [2,3,5,4], [4,5,1,2]. The helper folds this position key and labels rows only by size.", "One screen or printed card kept at a marked distance and size.", "Ordinary prescribed glasses or contact lenses.", "A ruler/tape and record for lighting, correction, row accuracy and symptoms." ], "before_you_start": [ "Use the same eye correction normally used for the selected viewing distance.", "Choose even comfortable lighting without glare and mark the viewing position.", "Do not cover or patch an eye if a clinician has told you not to; record whether one or both eyes are used.", "New or sudden visual loss, eye pain, flashes, a curtain-like shadow or double vision needs prompt eye care, not practice." ], "steps": [ { "title": "Lock the configuration", "instruction": "Record display, zoom, card size, distance, lighting, correction and whether one or both eyes are used.", "reason": "Symbol size changes with every one of these choices.", "success_check": "A second person could reproduce the setup." }, { "title": "Learn the response rule", "instruction": "For each of the four groups on a row, say the odd arrow's position from 1 to 5 before the helper reveals the folded key. Do not revise a blurred answer after feedback.", "reason": "One fixed question keeps the score about detail discrimination.", "success_check": "The learner gives four position answers on each of two large practice rows and can explain how positions are counted." }, { "title": "Start with obvious rows", "instruction": "Begin at 72 px and give all four group positions before checking or moving to the next size.", "reason": "Easy rows establish the task without forcing strain.", "success_check": "Each row has four recorded positions and one confidence rating before feedback." }, { "title": "Descend one row at a time", "instruction": "Continue toward smaller rows while keeping head and card at the mark and using the same allowed viewing time.", "reason": "Leaning or zooming makes a smaller symbol larger.", "success_check": "Distance and zoom remain unchanged." }, { "title": "Use a stopping rule", "instruction": "Stop at the 24 px row or earlier for blur that persists after ordinary blinking, headache, eye pain, nausea or other visual discomfort; never repeat a row to improve its count.", "reason": "The fixture reports performance by size and does not need a clinical-style threshold chase.", "success_check": "The end reason is 24 px or a named symptom, and no row is replayed." }, { "title": "Score from the key", "instruction": "Compare the four positions with the folded key, record 0–4 correct for each size and retain every wrong position; do not convert a home row to Snellen or logMAR.", "reason": "The fixture lacks clinical calibration.", "success_check": "Raw row accuracy and confidence remain visible." }, { "title": "Retest with a new ladder", "instruction": "After at least 48 hours, use the second ladder in the identical setup.", "reason": "A new item reduces memorisation of the symbol sequence.", "success_check": "Configuration matches and item order is unfamiliar." } ], "worked_example": { "scenario": "Jules uses two laptop ladders at 60 cm, 100% zoom, desk lamp unchanged and ordinary reading glasses.", "walkthrough": [ "Jules records screen, zoom, 60 cm distance, lighting and both-eye viewing.", "They answer four odd-arrow positions per row from 72 px to 24 px and lock each row before the helper opens the key.", "They score 0–4 at every size, stop at 24 px without replay and do not convert any row to clinical acuity.", "Two days later they use ladder B at the same 60 cm setup.", "They compare row-level accuracy and symptoms, not a “20/20” label." ], "result": "Jules becomes more consistent on this symbol fixture. The record does not establish corrected visual acuity or an eye-health change." }, "right_vs_wrong": [ { "situation": "Distance", "right": "Keep the marked viewing distance.", "wrong": "Lean closer on difficult rows.", "why": "Moving closer enlarges the symbol." }, { "situation": "Display", "right": "Keep screen, zoom and brightness fixed.", "wrong": "Zoom or switch devices mid-test.", "why": "A display change creates a new task." }, { "situation": "Answer", "right": "Commit one response before the key.", "wrong": "Study the answer and then report certainty.", "why": "That trains the item rather than measures discrimination." }, { "situation": "Stop", "right": "End after the declared errors or discomfort.", "wrong": "Squint and repeat until the row is memorised.", "why": "Strain and repetition distort the score." }, { "situation": "Claim", "right": "Call it odd-symbol discrimination at this setup.", "wrong": "Call the row clinical acuity or superhuman eyesight.", "why": "The fixture is not a calibrated eye chart." } ], "common_mistakes": [ { "mistake": "Lean closer on difficult rows.", "fix": "Keep the marked viewing distance." }, { "mistake": "Zoom or switch devices mid-test.", "fix": "Keep screen, zoom and brightness fixed." }, { "mistake": "Study the answer and then report certainty.", "fix": "Commit one response before the key." }, { "mistake": "Squint and repeat until the row is memorised.", "fix": "End after the declared errors or discomfort." }, { "mistake": "Call the row clinical acuity or superhuman eyesight.", "fix": "Call it odd-symbol discrimination at this setup." } ], "practice": { "first_session": [ "Have a helper construct ladders A and B from the six sizes and folded position keys before the learner sees either ladder.", "Set 100% zoom, mark 60 cm, record lighting, ordinary correction and the font actually used.", "Practise counting odd-arrow positions on two unscored 72 px groups, then run ladder A once from 72 to 24 px without replay.", "For every size, score all four positions, retain errors and record confidence and symptoms.", "After at least 48 hours, run concealed ladder B with the same font, zoom, distance, lighting and correction." ], "repeat_plan": "Use at most two ladders per session, two sessions per week, with a new item order. Progress only by better novel-ladder consistency at the same setup; clinical treatment follows an eye professional.", "progress_when": [ "Novel-ladder accuracy improves at fixed distance and size.", "Confidence better matches correct answers.", "No leaning, zooming or discomfort occurs." ], "do_not_progress_when": [ "The setup cannot be held constant.", "Visual symptoms, headache or eye strain appear.", "A clinical vision problem or prescription change is suspected." ] }, "self_check": [ "Can you demonstrate “Learn the response rule”? The learner answers two large practice rows correctly.", "Can you demonstrate “Descend one row at a time”? Distance and zoom remain unchanged.", "Can you demonstrate “Retest with a new ladder”? Configuration matches and item order is unfamiliar." ], "measurement": { "primary": "Odd-arrow position accuracy at each of six non-clinical display sizes", "how": "For each ladder and size, report correct positions out of four, the four original responses, confidence, font, pixel size, zoom, viewing distance, correction, lighting and symptoms. Compare A and B size by size; never convert the result to clinical units.", "good_result": "Both ladders are completed under matched settings and the size-by-size record can be reproduced from the folded keys. Any difference is described as fixture performance, not a visual-acuity pass or prescription result.", "does_not_prove": "Use calibrated logMAR or equivalent acuity with declared correction and test conditions; acuity does not establish contrast, field, search, depth, low-light or functional safety." }, "stop_and_get_help": [ "Seek urgent eye care for sudden vision loss, a curtain/shadow, new flashes/floaters with loss, severe eye pain or new double vision.", "Stop the fixture for headache, nausea, eye pain, persistent blur or visual distortion.", "Arrange an eye examination when everyday vision changes, one eye differs unexpectedly or correction no longer works." ], "accessibility": [ "Use large practice symbols and a screen reader for instructions while keeping the visual response itself unchanged.", "Use a chin/forehead distance marker only if comfortable and non-restrictive.", "Allow pointing, speech, switch or eye-gaze responses; motor speed is not scored." ], "evidence_notes": [ { "claim": "Primary research in adults with amblyopia found task-specific changes in contrast sensitivity and visual acuity under controlled training.", "source_title": "Perceptual learning improves contrast sensitivity and visual acuity in adults with anisometropic amblyopia", "source_url": "https://pubmed.ncbi.nlm.nih.gov/16153674/", "source_kind": "PRIMARY_RESEARCH" }, { "claim": "A controlled study found no added fluoxetine benefit, illustrating that perceptual learning findings do not justify medication or universal enhancement claims.", "source_title": "Fluoxetine does not enhance the effect of perceptual learning on visual function in adults with amblyopia", "source_url": "https://pubmed.ncbi.nlm.nih.gov/30150750/", "source_kind": "PRIMARY_RESEARCH" } ], "limits": [ "Use calibrated logMAR or equivalent acuity with declared correction and test conditions; acuity does not establish contrast, field, search, depth, low-light or functional safety.", "Unsupported claim: Train eyesight beyond human limits.", "Unsupported claim: Throw away glasses.", "Unsupported claim: Cure every lazy eye.", "Home symbol performance does not diagnose amblyopia, set a prescription or replace calibrated clinical acuity testing." ], "orientation": { "bounded_definition": "Capability to develop or express visual acuity in a declared context without inheriting broader claims.", "evidence_summary": "Visual acuity can improve in selected amblyopia treatment settings, but this is not a route to superhuman eyesight.", "supportable_public_claim": "Selected people with amblyopia can improve measured visual acuity through structured treatment that includes perceptual practice; this is clinical recovery, not proof of eagle-like vision.", "measurement_boundary": "Use calibrated logMAR or equivalent acuity with declared correction and test conditions; acuity does not establish contrast, field, search, depth, low-light or functional safety.", "myth_to_metric": { "myth": "Eagle eyesight", "metric": "Corrected logMAR acuity change plus delayed functional vision", "boundary": "A smaller chart threshold does not prove superior vision across contrast, depth, periphery, motion or low light." }, "limiting_findings": [ "Fluoxetine did not add a visual-training benefit in a phase 2 trial.", "Not every visual outcome or treatment comparison favoured perceptual learning." ], "prohibited_claims": [ "Train eyesight beyond human limits", "Throw away glasses", "Cure every lazy eye", "Medication unlocks adult visual plasticity" ] }, "gold_source_lesson": null, "next_gate": "External confirmation is required before higher-authority use because: CLINICAL_HIGH_RISK_OR_REGULATED_CONFIGURATION; SUPERVISION_OR_NON_ATTEMPT_BOUNDARY.", "evidence_count": 6 }, "full_training_programme": false, "independently_validated": false, "publication_state": "PUBLISHED_PUBLIC_RESEARCH_EDITION__EDITORIAL_REVIEW_PENDING", "related_power_ids": [ "PWR-066", "PWR-067", "PWR-068", "PWR-069" ] }, { "power_id": "PWR-066", "learning_unit_id": "TLU-PWR-066", "title": "Contrast sensitivity", "main_description": "The learner completes two novel contrast ladders and reports correct orientation by level, false guesses, configuration and symptoms.", "main_description_source": "FULL_TUTORIAL_OUTCOME", "family_id": "FAM-09", "family": "Visual Perception & Search", "superdomain": "Perception & Sensorimotor", "canonical_route": "/powers/pwr-066/", "treatment": "EVIDENCE_REVIEW_ROUTE", "treatment_label": "Full low-stakes tutorial", "treatment_boundary": "Titan teaches a concrete low-stakes method step by step while keeping evidence and transfer claims bounded.", "tutorial_route": "/tutorials/pwr-066/", "governed_lesson_route": null, "self_attempt_status": "PERMITTED_INSIDE_FULL_TUTORIAL_LIMITS", "gold_pathway_ids": [ "G-CUR-006" ], "route_membership": { "kind": "GOLD_PATHWAY", "id": "G-CUR-006", "coverage_status": "EXACT_ONCE" }, "source_authority_tier": "G2", "source_build_state": "TARGETED_REVIEW_REQUIRED", "source_instructional_route": "BOUNDED_GUIDED_EXERCISE", "source_count": 6, "research_depth": "DEEP", "risk_level": "LOW_TO_MODERATE; CLINICAL_WHEN_VISUAL_DISORDER_OR_PRISM", "prerequisite_status": "NONE_FOR_READING__NO_PRACTICE_AUTHORITY", "learning_route": { "mode": "FULL_SELF_GUIDED_TUTORIAL", "label": "Learn contrast sensitivity step by step", "summary": "The learner completes two novel contrast ladders and reports correct orientation by level, false guesses, configuration and symptoms.", "steps": [ [ "Get ready", "Set comfortable room light and eliminate screen glare." ], [ "Learn the method", "8 concrete steps teach the permitted method from start to finish." ], [ "See right and wrong", "6 comparisons show correct or safer execution beside common wrong or riskier choices." ], [ "Practise", "Practise one short ladder on up to two days per week. Use new orders and hold the display constant. Progress means reliable novel-item accuracy, not lower contrast at any cost." ], [ "Check progress", "Record correct/incorrect orientation and confidence by contrast level, plus display, luminance setting, distance and symptoms. Report catch-trial accuracy and response counts for each orientation so an orientation-key bias is visible." ] ], "practical_authority": true, "provider_required": false, "next_action_route": "/tutorials/pwr-066/" }, "path_builder": { "selectable": true, "completion_allowed": true, "warning": "Titan teaches a concrete low-stakes method step by step while keeping evidence and transfer claims bounded." }, "full_tutorial": { "version": "3.0", "authorship": "POWER_SPECIFIC_FULL_TUTORIAL", "tutorial_mode": "SELF_GUIDED", "promise": "Contrast sensitivity can be trained in some clinical settings, but a better test threshold is not generally enhanced vision. This fixture teaches contrast discrimination for one pattern set. The learner begins with obvious stripes, reports orientation before feedback, descends a fixed ladder and retests unfamiliar items. It is not a clinical contrast-sensitivity function and should not be used to clear night driving. The learner also uses catch trials at clearly visible contrast to tell a true low-contrast limit from loss of attention or a habitual orientation response.", "power_id": "PWR-066", "title": "Contrast sensitivity", "lesson_type": "SELF_GUIDED", "headline": "Judge stripe orientation as contrast falls while keeping luminance and size fixed", "plain_english_summary": "Contrast sensitivity can be trained in some clinical settings, but a better test threshold is not generally enhanced vision. This fixture teaches contrast discrimination for one pattern set. The learner begins with obvious stripes, reports orientation before feedback, descends a fixed ladder and retests unfamiliar items. It is not a clinical contrast-sensitivity function and should not be used to clear night driving. The learner also uses catch trials at clearly visible contrast to tell a true low-contrast limit from loss of attention or a habitual orientation response.", "outcome": "The learner completes two novel contrast ladders and reports correct orientation by level, false guesses, configuration and symptoms.", "authority": { "learner_may": [ "Identify H, V or D on the supplied fixed-display grey-stripe patches in concealed Set A while keeping distance, brightness and ordinary correction fixed.", "Score all three orientations at each declared grey pair, mark attention-affected groups after a failed level-1 catch and transfer to Set B later.", "Respond by speech, symbols or switch and take rests without brightening a difficult patch." ], "qualified_person_required_for": [ "Clinical contrast-sensitivity testing, refraction, eye-disease assessment or interpretation of new low-contrast difficulty.", "Decisions about night driving, steps/curbs, occupational vision, mobility or treatment based on contrast function.", "Changing lenses, display/access technology or rehabilitation because the home patch score changed." ], "never_do": [ "Raise screen brightness, change viewing distance/zoom or inspect filenames to rescue a low-contrast answer.", "Call one level-6 guess a contrast threshold or infer safe night travel, corrected acuity or eye health.", "Continue after failed catch trials with fatigue, eye pain, sudden haze/vision change, double vision or severe headache." ] }, "materials": [ "An exact patch recipe for a helper using a slide or drawing program. Make every patch 8 cm square with ten equal stripes and a mean grey of RGB 128/128/128. Alternate stripe greys by level: 1 = 64 and 192; 2 = 96 and 160; 3 = 112 and 144; 4 = 120 and 136; 5 = 124 and 132; 6 = 126 and 130. Rotate the same stripe tile to horizontal H, vertical V or 45-degree diagonal D; export all patches at one pixel size with no labels visible to the learner.", "Two folded 18-trial keys. Set A is 1H,1V,1D,2V,2D,2H,3D,3H,3V,4H,4V,4D,5V,5H,5D,6D,6V,6H. Set B is 1D,1H,1V,2H,2V,2D,3V,3D,3H,4D,4H,4V,5H,5D,5V,6V,6H,6D. The helper inserts an unscored level-1 catch patch after trials 4, 8, 12 and 16, with concealed H/V/D order.", "A fixed viewing-distance marker and ordinary correction.", "Answer key and trial sheet." ], "before_you_start": [ "Set comfortable room light and eliminate screen glare.", "Fix display brightness, colour mode, zoom and viewing distance.", "Use the ordinary correction for that distance.", "Do not use the fixture during migraine aura, acute eye symptoms or a photosensitive episode." ], "steps": [ { "title": "Fix luminance and geometry", "instruction": "Record screen, brightness, room light, patch size and viewing distance.", "reason": "Contrast depends on background luminance and display behaviour.", "success_check": "All configuration fields are filled." }, { "title": "Learn orientations", "instruction": "Practise naming the high-contrast horizontal, vertical and diagonal patches.", "reason": "The response labels must be known before contrast falls.", "success_check": "All practice orientations are named correctly." }, { "title": "Begin above threshold", "instruction": "Start with an obvious contrast level and view each patch for the same declared time.", "reason": "Starting easy confirms the task and avoids immediate guessing.", "success_check": "The first two trials are correct without strain." }, { "title": "Answer before feedback", "instruction": "State orientation and confidence, then reveal the key.", "reason": "A committed response preserves discrimination data.", "success_check": "Every trial has a pre-feedback answer." }, { "title": "Descend the ladder", "instruction": "Present the three concealed H/V/D patches at level 1, then levels 2 through 6 in the supplied set order. Give one H, V or D answer per patch and do not skip a level after an error.", "reason": "A fixed adaptive rule and mixed directions reduce pattern guessing.", "success_check": "Each level has exactly one valid H, V and D trial before the next level begins." }, { "title": "Stop at repeated uncertainty", "instruction": "Stop after level 6 or earlier for glare, headache, visual disturbance or a missed level-1 catch trial that remains wrong after rest; do not raise brightness or repeat faint patches.", "reason": "Changing brightness invalidates contrast and chasing faint items adds strain.", "success_check": "The stop reason is recorded." }, { "title": "Retest novel patterns", "instruction": "After a delay, use a new orientation order at identical settings.", "reason": "Novel order distinguishes task learning from memorising the sequence.", "success_check": "Settings match and items are unfamiliar." }, { "title": "Insert visible catch trials", "instruction": "After every four difficult patches, present one clearly visible patch in a concealed orientation. If that catch trial is wrong, pause and mark the preceding difficult group as attention-affected rather than lowering contrast again.", "reason": "A high-contrast catch trial should remain easy. Missing it suggests fatigue, response-key confusion or a lapse rather than a new contrast threshold.", "success_check": "Catch-trial orientation is correct, or the affected group is labelled and the learner rests before continuing." } ], "worked_example": { "scenario": "Ari views striped patches at 70 cm on one monitor at fixed brightness.", "walkthrough": [ "Ari records the monitor, brightness, room lamp, patch size and correction.", "They correctly name three high-contrast practice orientations.", "They descend the ladder, answer before feedback and retain every error.", "They stop after three errors across four low-contrast trials without changing brightness.", "At the next session, a novel direction order gives slightly better accuracy at the same middle levels.", "At the midpoint, Ari misses a clearly visible diagonal catch patch, so the preceding four faint trials are labelled attention-affected and are not used as the best level." ], "result": "The result is improved orientation discrimination for this fixed patch set. It is not a clinical contrast-sensitivity curve or evidence of safer low-light vision. The catch-trial rule prevents a tired response run from being mistaken for a change in visual contrast processing." }, "right_vs_wrong": [ { "situation": "Luminance", "right": "Keep display brightness and room light fixed.", "wrong": "Increase brightness when a patch fades.", "why": "That changes the physical contrast task." }, { "situation": "Orientation", "right": "Mix directions and answer before feedback.", "wrong": "Use a repeating orientation order.", "why": "Order guessing can inflate accuracy." }, { "situation": "Threshold", "right": "Use a declared error rule across several trials.", "wrong": "Call one lucky faint answer the threshold.", "why": "Threshold-like estimates require repeated choices." }, { "situation": "Symptoms", "right": "Stop for glare, headache or visual disturbance.", "wrong": "Push through because faintness is expected.", "why": "Discomfort is not a training target." }, { "situation": "Claim", "right": "Report levels on this display.", "wrong": "Infer safe night driving or clinical recovery.", "why": "Display-specific discrimination does not establish function." }, { "situation": "Visible catch trial", "right": "Use an occasional easy patch to confirm attention and response mapping.", "wrong": "Keep descending after an easy patch is missed and call the result poorer contrast sensitivity.", "why": "An easy-item miss signals that the trial block, not only contrast, has changed." } ], "common_mistakes": [ { "mistake": "Increase brightness when a patch fades.", "fix": "Keep display brightness and room light fixed." }, { "mistake": "Use a repeating orientation order.", "fix": "Mix directions and answer before feedback." }, { "mistake": "Call one lucky faint answer the threshold.", "fix": "Use a declared error rule across several trials." }, { "mistake": "Push through because faintness is expected.", "fix": "Stop for glare, headache or visual disturbance." }, { "mistake": "Infer safe night driving or clinical recovery.", "fix": "Report levels on this display." }, { "mistake": "The learner repeatedly presses the same orientation key on uncertain patches, creating a response bias.", "fix": "Count answers by orientation, rebalance the concealed order and pause after any run of four identical responses." } ], "practice": { "first_session": [ "A helper builds all six RGB stripe levels, exports one H/V/D patch at each level and folds the A and B keys before the learner sees filenames.", "Lock the display mode, brightness, 70 cm distance, room lighting and ordinary correction, then practise H, V and D on level 1.", "Run Set A in its 18-trial concealed order with the four unscored catch patches and one answer before feedback.", "Score H/V/D separately at every level and label any four-trial group before a missed catch as attention-affected.", "After at least 48 hours, run Set B at unchanged settings and compare level-by-level orientation counts rather than declaring a clinical threshold." ], "repeat_plan": "Practise one short ladder on up to two days per week. Use new orders and hold the display constant. Progress means reliable novel-item accuracy, not lower contrast at any cost.", "progress_when": [ "Accuracy improves across several adjacent levels on novel items.", "Orientation errors fall without brightness or distance changes.", "No glare, headache or visual symptom occurs." ], "do_not_progress_when": [ "A device, colour mode or lighting change makes sessions incomparable.", "One-eye difference, persistent blur or contrast difficulty affects daily life.", "The learner uses the score for driving or clinical clearance." ] }, "self_check": [ "Can you demonstrate “Learn orientations”? All practice orientations are named correctly.", "Can you demonstrate “Answer before feedback”? Every trial has a pre-feedback answer.", "Can you demonstrate “Retest novel patterns”? Settings match and items are unfamiliar.", "When a visible catch patch is missed, can you explain why the nearby faint trials must be held out instead of being interpreted as a contrast limit?" ], "measurement": { "primary": "H/V/D orientation accuracy across the six supplied display-grey pairs", "how": "Record correct/incorrect orientation and confidence by contrast level, plus display, luminance setting, distance and symptoms. Report catch-trial accuracy and response counts for each orientation so an orientation-key bias is visible.", "good_result": "Both concealed sets reproduce from their keys, easy catch trials remain correct and level-by-level errors are reported at unchanged display settings. Better Set B accuracy is a fixture result, not a contrast-sensitivity threshold or driving clearance.", "does_not_prove": "Record a full contrast-sensitivity function or validated bounded threshold at declared luminance and correction; do not substitute chart acuity or subjective sharpness." }, "stop_and_get_help": [ "Stop for eye pain, migraine aura, nausea, headache, persistent afterimage or sudden visual change.", "Seek urgent eye care for sudden vision loss, new field loss or painful red eye.", "Arrange professional testing when contrast problems affect mobility, faces or driving." ], "accessibility": [ "Use spoken orientation answers or switches without adding a speed score.", "Increase the physical patch size only as a declared new accessibility configuration.", "Provide non-glare surrounds and breaks while keeping the tested contrast values unchanged." ], "evidence_notes": [ { "claim": "Controlled perceptual-learning research supports task-specific contrast-sensitivity change in amblyopia.", "source_title": "Perceptual learning improves contrast sensitivity and visual acuity in adults with anisometropic amblyopia", "source_url": "https://pubmed.ncbi.nlm.nih.gov/16153674/", "source_kind": "PRIMARY_RESEARCH" }, { "claim": "Primary research reports transfer from contrast training to a defined motion task, showing that transfer must be measured rather than assumed.", "source_title": "Training in contrast detection improves motion perception of sinewave gratings in amblyopia", "source_url": "https://pubmed.ncbi.nlm.nih.gov/21693615/", "source_kind": "PRIMARY_RESEARCH" } ], "limits": [ "Record a full contrast-sensitivity function or validated bounded threshold at declared luminance and correction; do not substitute chart acuity or subjective sharpness.", "Unsupported claim: See through darkness.", "Unsupported claim: Make every visual task sharper.", "Unsupported claim: Repair the retina by gaming.", "A home display cannot provide a clinical contrast-sensitivity function or prove safe performance in traffic or dim environments." ], "orientation": { "bounded_definition": "Capability to develop or express contrast sensitivity in a declared context without inheriting broader claims.", "evidence_summary": "Contrast sensitivity can be trained in some clinical settings, but a better test threshold is not generally enhanced vision.", "supportable_public_claim": "Defined contrast-sensitivity measures can improve with perceptual learning in selected amblyopic populations; transfer beyond related visual tests is incomplete.", "measurement_boundary": "Record a full contrast-sensitivity function or validated bounded threshold at declared luminance and correction; do not substitute chart acuity or subjective sharpness.", "myth_to_metric": { "myth": "See every hidden detail", "metric": "Contrast-sensitivity function by spatial frequency and luminance", "boundary": "A trained threshold does not confer night vision, field expansion or universal object recognition." }, "limiting_findings": [ "Clinical improvements do not establish enhancement in healthy eyes.", "Fluoxetine offered no added benefit over placebo in the reviewed visual-learning trial." ], "prohibited_claims": [ "See through darkness", "Make every visual task sharper", "Repair the retina by gaming", "Biohack contrast with prescription drugs" ] }, "gold_source_lesson": null, "next_gate": "External confirmation is required before higher-authority use because: CLINICAL_HIGH_RISK_OR_REGULATED_CONFIGURATION; SUPERVISION_OR_NON_ATTEMPT_BOUNDARY.", "evidence_count": 6 }, "full_training_programme": false, "independently_validated": false, "publication_state": "PUBLISHED_PUBLIC_RESEARCH_EDITION__EDITORIAL_REVIEW_PENDING", "related_power_ids": [ "PWR-065", "PWR-067", "PWR-068", "PWR-069" ] }, { "power_id": "PWR-067", "learning_unit_id": "TLU-PWR-067", "title": "Peripheral target detection", "main_description": "The learner completes a randomised 24-trial peripheral-card block with fixation-valid trials and calculates sensitivity-relevant hit and false-alarm counts.", "main_description_source": "FULL_TUTORIAL_OUTCOME", "family_id": "FAM-09", "family": "Visual Perception & Search", "superdomain": "Perception & Sensorimotor", "canonical_route": "/powers/pwr-067/", "treatment": "EVIDENCE_REVIEW_ROUTE", "treatment_label": "Full low-stakes tutorial", "treatment_boundary": "Titan teaches a concrete low-stakes method step by step while keeping evidence and transfer claims bounded.", "tutorial_route": "/tutorials/pwr-067/", "governed_lesson_route": null, "self_attempt_status": "PERMITTED_INSIDE_FULL_TUTORIAL_LIMITS", "gold_pathway_ids": [ "G-CUR-006" ], "route_membership": { "kind": "GOLD_PATHWAY", "id": "G-CUR-006", "coverage_status": "EXACT_ONCE" }, "source_authority_tier": "G1", "source_build_state": "TARGETED_REVIEW_REQUIRED", "source_instructional_route": "SELF_GUIDED_TUTORIAL", "source_count": 6, "research_depth": "DEEP", "risk_level": "LOW_TO_MODERATE; CLINICAL_WHEN_VISUAL_DISORDER_OR_PRISM", "prerequisite_status": "NONE_FOR_READING__NO_PRACTICE_AUTHORITY", "learning_route": { "mode": "FULL_SELF_GUIDED_TUTORIAL", "label": "Learn peripheral target detection step by step", "summary": "The learner completes a randomised 24-trial peripheral-card block with fixation-valid trials and calculates sensitivity-relevant hit and false-alarm counts.", "steps": [ [ "Get ready", "Sit supported; do not perform while walking, balancing or near traffic." ], [ "Learn the method", "8 concrete steps teach the permitted method from start to finish." ], [ "See right and wrong", "6 comparisons show correct or safer execution beside common wrong or riskier choices." ], [ "Practise", "Use one 24-trial block once or twice weekly with novel orders and the same prevalence. Progress only when hits rise without more false alarms and fixation remains valid." ], [ "Check progress", "For valid trials, hit rate = correct L or R locations divided by all target presentations; blank false-alarm rate = L or R answers on N trials divided by valid N trials. Also report left and right accuracy separately, side confusions, correct rejections, voids, replacements, 20 cm offsets, 60 cm distance and 750 ms reveal time." ] ], "practical_authority": true, "provider_required": false, "next_action_route": "/tutorials/pwr-067/" }, "path_builder": { "selectable": true, "completion_allowed": true, "warning": "Titan teaches a concrete low-stakes method step by step while keeping evidence and transfer claims bounded." }, "full_tutorial": { "version": "3.0", "authorship": "POWER_SPECIFIC_FULL_TUTORIAL", "tutorial_mode": "SELF_GUIDED", "promise": "Peripheral targets can be practised, but clutter and rarity create stubborn miss risks; this is not wider vision. The method trains a defined seated detection task. The learner fixes a central marker while a helper reveals a target or blank in a prespecified sector, answers before checking and records hits, misses and false alarms. Moving the eyes changes the task, and this does not establish safe walking or driving. A balanced sector schedule is part of the method: each side and blank state appears often enough that a preferred answer cannot masquerade as peripheral detection.", "power_id": "PWR-067", "title": "Peripheral target detection", "lesson_type": "SELF_GUIDED", "headline": "Keep the centre visible, report the target sector, and count both misses and false alarms", "plain_english_summary": "Peripheral targets can be practised, but clutter and rarity create stubborn miss risks; this is not wider vision. The method trains a defined seated detection task. The learner fixes a central marker while a helper reveals a target or blank in a prespecified sector, answers before checking and records hits, misses and false alarms. Moving the eyes changes the task, and this does not establish safe walking or driving. A balanced sector schedule is part of the method: each side and blank state appears often enough that a preferred answer cannot masquerade as peripheral detection.", "outcome": "The learner completes a randomised 24-trial peripheral-card block with fixation-valid trials and calculates sensitivity-relevant hit and false-alarm counts.", "authority": { "learner_may": [ "While seated, look at the 5 mm centre dot and report L, R or N after each 750-ms two-sector reveal from the supplied 24-state order.", "Void any trial with an eye/head movement, then score left/right hits, misses and no-target false alarms separately before concealed Set B.", "Use ordinary correction, a spoken/switch response and a stable head support if needed without moving the sector cards." ], "qualified_person_required_for": [ "Visual-field examination and assessment of a new side miss, neglect, neurological symptom or functional collision.", "Using peripheral detection for driving, road crossing, machinery, sport, mobility or occupational clearance.", "Changing lenses, prisms, scanning rehabilitation or other treatment from this card task." ], "never_do": [ "Look toward a sector, accept a fixation-loss trial or reduce no-target prevalence after seeing false alarms.", "Place targets in traffic or a walking route or call home-card hits a normal visual field.", "Continue with sudden side loss, new weakness/speech change, severe headache, double vision, dizziness or eye pain." ] }, "materials": [ "A 60 cm viewing setup: one 5 mm black fixation dot at eye level and two 6 cm square white sector cards centred 20 cm left and right of the dot. The target is a 2 cm black circle centred on an otherwise identical sector card; the blank card is plain white. A cardboard shutter lets a helper reveal the two sectors together for 750 ms without moving the centre dot.", "Two folded 24-trial state lists with eight L, eight R and eight N (no target) states. Order A: L,R,N,R,N,L,N,L,R,L,N,R,R,L,N,N,R,L,L,R,N,R,N,L. Order B: N,R,L,L,N,R,R,L,N,N,L,R,L,R,N,R,N,L,N,R,L,L,N,R. For L or R, the helper places the target at that sector and a blank opposite; for N, both sectors are blank. Any void trial is reinserted later as the same state at a concealed position.", "A helper, 750 ms timer or metronome cue, and an opaque cover over the folded list.", "A trial sheet for target sector, answer, fixation loss, hit, miss and false alarm." ], "before_you_start": [ "Sit supported; do not perform while walking, balancing or near traffic.", "Fix card distance, sector angles, target size, lighting and correction.", "Practise saying “left”, “right” or “none” without looking away from centre.", "Do not use this fixture to assess new field loss; new field symptoms need eye care." ], "steps": [ { "title": "Mark centre and sectors", "instruction": "At 60 cm, place the fixation dot at eye level and centre the two sector cards exactly 20 cm left and right of it; mark the chair and board positions.", "reason": "Eccentricity—the distance from central gaze—defines the task.", "success_check": "Positions and distance are measured and recorded." }, { "title": "Learn the three answers", "instruction": "With eyes free, view examples of left, right and blank, then return gaze to centre.", "reason": "Clear labels prevent response confusion.", "success_check": "The learner identifies all practice states." }, { "title": "Lock fixation", "instruction": "Keep the centre marker visible throughout each brief trial; do not chase the side card with the eyes.", "reason": "An eye movement turns peripheral detection into direct viewing.", "success_check": "The learner reports any fixation loss and the helper watches when possible." }, { "title": "Present random target or blank", "instruction": "The helper follows folded Order A or B and lifts the shutter for 750 ms: target left, target right or both cards blank. The next state stays concealed until the learner has answered.", "reason": "Blank trials are needed to measure false alarms.", "success_check": "Order is concealed and all three states occur." }, { "title": "Answer before checking", "instruction": "Say left, right or none, plus confidence, while still looking at centre.", "reason": "Committed responses separate detection from confirmation.", "success_check": "The answer is written before the card is shown centrally." }, { "title": "Classify the result", "instruction": "Mark hit, miss, correct rejection or false alarm; void any trial with lost fixation.", "reason": "Accuracy alone hides response bias and invalid trials.", "success_check": "Every valid trial has one classification." }, { "title": "Retest a novel order", "instruction": "After rest or a later day, use a new random order with the same sectors and target prevalence.", "reason": "Novel order prevents memorising where targets appear.", "success_check": "Target frequency and geometry match the baseline." }, { "title": "Audit sector balance", "instruction": "After the block, count how many valid left, right and blank trials were presented and how often each answer was used. If one state is underrepresented or one answer dominates, create a balanced new order before interpreting change.", "reason": "Sector imbalance and a habitual left, right or none response can produce an attractive overall score without reliable target detection.", "success_check": "Valid trial counts meet the declared sector balance and no response dominates without matching the actual target order." } ], "worked_example": { "scenario": "Sofia sits 60 cm from a centre dot while a helper uses left, right and blank cards at marked sectors.", "walkthrough": [ "They measure the two sector locations and create a concealed 24-trial order with eight blanks.", "Sofia practises the three answers, then keeps the dot visible.", "The helper reveals each card briefly and Sofia answers before checking.", "Two trials with eye movement are voided rather than counted as hits.", "They count hits, misses, false alarms and correct rejections separately and save a new order for later.", "They verify that valid trials remain balanced after two fixation-loss voids; one replacement left and one replacement blank trial are added at concealed positions." ], "result": "Sofia improves hits without more false alarms on the matched seated task. This is not a visual-field examination or evidence of safe hazard detection while moving. The balanced valid set supports sector-specific hit and false-alarm interpretation rather than a preferred-answer score." }, "right_vs_wrong": [ { "situation": "Gaze", "right": "Keep the central marker visible and void fixation-loss trials.", "wrong": "Look toward the target to be sure.", "why": "Direct viewing tests a different ability." }, { "situation": "Blanks", "right": "Include unpredictable blank trials.", "wrong": "Show a target every time.", "why": "Without blanks, false alarms and guessing bias are invisible." }, { "situation": "Score", "right": "Separate hits, misses, false alarms and correct rejections.", "wrong": "Report one percent correct only.", "why": "The same accuracy can hide very different biases." }, { "situation": "Order", "right": "Use a novel random order with fixed prevalence.", "wrong": "Repeat a memorised left-right sequence.", "why": "Sequence memory can mimic detection." }, { "situation": "Transfer", "right": "Call it seated sector-card performance.", "wrong": "Infer walking, balance, driving or clinical field status.", "why": "Those contexts add movement and consequence." }, { "situation": "Replacement after a void", "right": "Add a concealed trial of the same state later so sector balance is preserved.", "wrong": "Repeat the voided target immediately in the same place.", "why": "An immediate repeat reveals the answer and turns the replacement into a memory cue." } ], "common_mistakes": [ { "mistake": "Look toward the target to be sure.", "fix": "Keep the central marker visible and void fixation-loss trials." }, { "mistake": "Show a target every time.", "fix": "Include unpredictable blank trials." }, { "mistake": "Report one percent correct only.", "fix": "Separate hits, misses, false alarms and correct rejections." }, { "mistake": "Repeat a memorised left-right sequence.", "fix": "Use a novel random order with fixed prevalence." }, { "mistake": "Infer walking, balance, driving or clinical field status.", "fix": "Call it seated sector-card performance." }, { "mistake": "A fixation-loss trial is deleted without replacing its left, right or blank state, leaving the block unbalanced.", "fix": "Schedule a concealed replacement of the same state later and report both the void and the replacement." } ], "practice": { "first_session": [ "Mark the 60 cm chair position, fixation dot, two 20 cm sector offsets and shutter; record lighting and ordinary correction.", "With direct viewing, practise one L, R and N state and the three spoken answers.", "Run the first 12 concealed states of Order A with 750 ms reveals and no immediate repetition after a fixation loss.", "Rest, run the remaining 12 states, then insert any same-state replacements later at concealed positions.", "Count valid L, R and N presentations, correct target locations, target misses or side confusions, blank false alarms and correct rejections.", "Keep the original Order B folded for the delayed matched retest." ], "repeat_plan": "Use one 24-trial block once or twice weekly with novel orders and the same prevalence. Progress only when hits rise without more false alarms and fixation remains valid.", "progress_when": [ "Hits improve on new orders at the same sector.", "False alarms do not increase.", "Fixation-loss and symptom rates remain low." ], "do_not_progress_when": [ "Fixation cannot be maintained or observed.", "Target geometry or prevalence changes.", "The learner has new missing-field symptoms or wants to test mobility." ] }, "self_check": [ "Can you demonstrate “Learn the three answers”? The learner identifies all practice states.", "Can you demonstrate “Present random target or blank”? Order is concealed and all three states occur.", "Can you demonstrate “Retest a novel order”? Target frequency and geometry match the baseline.", "After voiding a fixation-loss trial, can you restore sector balance without revealing which state will be replaced next?" ], "measurement": { "primary": "Sensitivity and false alarms for prespecified peripheral targets by eccentricity and prevalence", "how": "For valid trials, hit rate = correct L or R locations divided by all target presentations; blank false-alarm rate = L or R answers on N trials divided by valid N trials. Also report left and right accuracy separately, side confusions, correct rejections, voids, replacements, 20 cm offsets, 60 cm distance and 750 ms reveal time.", "good_result": "On two novel orders, hit rate improves or remains high without increased false alarms or fixation loss.", "does_not_prove": "Predeclare eccentricity, target, clutter, prevalence, sensitivity and false alarms; a reaction-time gain alone may reflect criterion shift rather than better perception." }, "stop_and_get_help": [ "Seek urgent eye/medical care for sudden field loss, curtain-like shadow, new neurological symptoms or acute double vision.", "Stop for eye strain, nausea, headache or inability to keep the centre clear.", "Use qualified orientation/mobility or vision care for moving, driving or clinical applications." ], "accessibility": [ "Use larger response labels or switches; response speed is not the outcome.", "A helper may watch fixation or operate cards while following the concealed order.", "Change sector position for field accessibility only as a clearly labelled new configuration." ], "evidence_notes": [ { "claim": "Primary visual-search research shows low-prevalence targets are disproportionately missed, supporting explicit prevalence and miss reporting.", "source_title": "Cognitive psychology: rare items often missed in visual searches", "source_url": "https://pubmed.ncbi.nlm.nih.gov/15917795/", "source_kind": "PRIMARY_RESEARCH" }, { "claim": "Perceptual-learning research supports specific improvement in crowded visual tasks while leaving broad field expansion unsupported.", "source_title": "Two-stage perceptual learning to break visual crowding", "source_url": "https://pubmed.ncbi.nlm.nih.gov/27105062/", "source_kind": "PRIMARY_RESEARCH" } ], "limits": [ "Predeclare eccentricity, target, clutter, prevalence, sensitivity and false alarms; a reaction-time gain alone may reflect criterion shift rather than better perception.", "Unsupported claim: Expand your visual field.", "Unsupported claim: Develop 360-degree vision.", "Unsupported claim: Never miss a hazard.", "Seated card detection does not measure a clinical visual field or safe detection during mobility, aviation or driving." ], "orientation": { "bounded_definition": "Capability to develop or express peripheral target detection in a declared context without inheriting broader claims.", "evidence_summary": "Peripheral targets can be practised, but clutter and rarity create stubborn miss risks; this is not wider vision.", "supportable_public_claim": "Peripheral detection can improve on selected crowding tasks, while rare, unexpected targets remain a major failure mode.", "measurement_boundary": "Predeclare eccentricity, target, clutter, prevalence, sensitivity and false alarms; a reaction-time gain alone may reflect criterion shift rather than better perception.", "myth_to_metric": { "myth": "Eyes in the back of your head", "metric": "Sensitivity and false alarms for prespecified peripheral targets by eccentricity and prevalence", "boundary": "No task demonstrates a larger anatomical visual field or zero-miss hazard detection." }, "limiting_findings": [ "Rare targets are often missed even by practised observers.", "Crowding-task improvement does not establish broader peripheral awareness." ], "prohibited_claims": [ "Expand your visual field", "Develop 360-degree vision", "Never miss a hazard", "Cure neglect with a home drill" ] }, "gold_source_lesson": { "curriculum_id": "G-CUR-006", "source_heading": "Tool 4 - Peripheral target detection", "source_html_sha256": "dff7f78726edeecf9c3b42a1739e7e0d1585186588b28cb8935b7c9b162447e4", "html": "Loss of fixation changes the task. Seated performance does not establish performance while walking, driving or balancing.
" }, "next_gate": "External confirmation is required before higher-authority use because: CLINICAL_HIGH_RISK_OR_REGULATED_CONFIGURATION.", "evidence_count": 6 }, "full_training_programme": false, "independently_validated": false, "publication_state": "PUBLISHED_PUBLIC_RESEARCH_EDITION__EDITORIAL_REVIEW_PENDING", "related_power_ids": [ "PWR-065", "PWR-066", "PWR-068", "PWR-069" ] }, { "power_id": "PWR-068", "learning_unit_id": "TLU-PWR-068", "title": "Motion perception", "main_description": "The learner completes two matched motion-clip sets and reports direction accuracy, confidence, display configuration and symptom burden.", "main_description_source": "FULL_TUTORIAL_OUTCOME", "family_id": "FAM-09", "family": "Visual Perception & Search", "superdomain": "Perception & Sensorimotor", "canonical_route": "/powers/pwr-068/", "treatment": "EVIDENCE_REVIEW_ROUTE", "treatment_label": "Full low-stakes tutorial", "treatment_boundary": "Titan teaches a concrete low-stakes method step by step while keeping evidence and transfer claims bounded.", "tutorial_route": "/tutorials/pwr-068/", "governed_lesson_route": null, "self_attempt_status": "PERMITTED_INSIDE_FULL_TUTORIAL_LIMITS", "gold_pathway_ids": [ "G-CUR-006" ], "route_membership": { "kind": "GOLD_PATHWAY", "id": "G-CUR-006", "coverage_status": "EXACT_ONCE" }, "source_authority_tier": "G2", "source_build_state": "TARGETED_REVIEW_REQUIRED", "source_instructional_route": "BOUNDED_GUIDED_EXERCISE", "source_count": 2, "research_depth": "FOCUSED", "risk_level": "LOW_TO_MODERATE; CLINICAL_WHEN_VISUAL_DISORDER_OR_PRISM", "prerequisite_status": "NONE_FOR_READING__NO_PRACTICE_AUTHORITY", "learning_route": { "mode": "FULL_SELF_GUIDED_TUTORIAL", "label": "Learn motion perception step by step", "summary": "The learner completes two matched motion-clip sets and reports direction accuracy, confidence, display configuration and symptom burden.", "steps": [ [ "Get ready", "Use comfortable brightness and a seated stable position." ], [ "Learn the method", "8 concrete steps teach the permitted method from start to finish." ], [ "See right and wrong", "6 comparisons show correct or safer execution beside common wrong or riskier choices." ], [ "Practise", "Use one short set once or twice weekly. Progress to a single changed feature only after novel baseline clips are accurate and symptom-free." ], [ "Check progress", "Record correct direction, confusion pair, confidence, replay, clip feature, display configuration and symptom rating. Add a true-direction by chosen-direction confusion table and stratify misses by the one declared transfer feature." ] ], "practical_authority": true, "provider_required": false, "next_action_route": "/tutorials/pwr-068/" }, "path_builder": { "selectable": true, "completion_allowed": true, "warning": "Titan teaches a concrete low-stakes method step by step while keeping evidence and transfer claims bounded." }, "full_tutorial": { "version": "3.0", "authorship": "POWER_SPECIFIC_FULL_TUTORIAL", "tutorial_mode": "SELF_GUIDED", "promise": "Motion perception is trainable on defined tasks, but ‘faster eyes’ is not supported. This lesson teaches direction discrimination for brief moving-dot clips at a fixed display. The learner starts each clip, chooses direction once, records confidence and symptoms, then retests unfamiliar clips. It does not train “faster eyes” or diagnose motion-perception problems. Direction errors are grouped by axis and stimulus feature, so a left–right confusion is not merged with an up–down confusion or with a failure limited to one screen location.", "power_id": "PWR-068", "title": "Motion perception", "lesson_type": "SELF_GUIDED", "headline": "Judge motion direction before feedback and retest unfamiliar speeds and locations", "plain_english_summary": "Motion perception is trainable on defined tasks, but ‘faster eyes’ is not supported. This lesson teaches direction discrimination for brief moving-dot clips at a fixed display. The learner starts each clip, chooses direction once, records confidence and symptoms, then retests unfamiliar clips. It does not train “faster eyes” or diagnose motion-perception problems. Direction errors are grouped by axis and stimulus feature, so a left–right confusion is not merged with an up–down confusion or with a failure limited to one screen location.", "outcome": "The learner completes two matched motion-clip sets and reports direction accuracy, confidence, display configuration and symptom burden.", "authority": { "learner_may": [ "View each one-second centre-lane disk clip once and commit L, R, U or D before opening the Set A direction key.", "Score each direction and exact confusion, repeat with concealed Set B and later test only the 10-mm-lower lane at unchanged speed/size.", "Use ordinary correction and accessible direction cards while keeping field, duration and display fixed." ], "qualified_person_required_for": [ "Assessing new motion distortion, oscillopsia, dizziness, neurological/eye symptoms or real-world motion difficulty.", "Using motion perception for driving, road crossing, machinery, sport, mobility or return-to-work decisions.", "Changing vestibular/visual rehabilitation, lenses, medication or display aids from the clip result." ], "never_do": [ "Slow, replay or add a trail to hard clips, or compare the 10-mm transfer after changing disk speed/size.", "Use moving vehicles/people as stimuli or call clip accuracy proof of safe traffic judgement.", "Continue when clips provoke nausea, vertigo, headache, eye pain, new visual motion or loss of postural control." ] }, "materials": [ "An exact clip recipe for a helper using a slide-animation or video tool. On a 160×120 mm white field, a 12 mm black disk travels 80 mm in a straight line over exactly 1,000 ms, starting and ending 40 mm on either side of the field centre. Export four centre-lane masters: left L, right R, up U and down D, with no label, trail or sound. Duplicate masters under neutral filenames to make Set A L,R,U,D,R,D,L,U,U,L,D,R,D,U,R,L and Set B D,L,R,U,U,R,D,L,R,U,L,D,L,D,U,R; keep those folded keys from the learner. A transfer set may move the whole 80 mm path 10 mm lower while retaining duration, disk, field and direction balance; even the vertical disk then stays inside the 120 mm field.", "One fixed display at a marked distance and refresh setting.", "Ordinary visual correction.", "Trial sheet and pause control." ], "before_you_start": [ "Use comfortable brightness and a seated stable position.", "Record display, refresh rate, window size, distance and correction.", "Do not use flashing, high-speed or immersive motion if it provokes migraine, vertigo or seizures.", "Agree to stop at nausea, dizziness, headache, aura or visual discomfort." ], "steps": [ { "title": "Lock the display", "instruction": "Keep device, refresh, window size, distance and brightness unchanged.", "reason": "Motion appearance depends on display timing and geometry.", "success_check": "The configuration card is complete." }, { "title": "Learn direction labels", "instruction": "View one obvious example in each allowed direction and practise the answer controls.", "reason": "Response confusion should not count as perception error.", "success_check": "All obvious examples are labelled correctly." }, { "title": "Start each clip yourself", "instruction": "Begin one clip when ready and watch it once without scrubbing or replay unless the rule permits.", "reason": "Self-start reduces surprise while preserving one exposure.", "success_check": "Each trial has the declared number of plays." }, { "title": "Commit direction and confidence", "instruction": "Choose the motion direction and confidence before revealing the key.", "reason": "A committed response preserves uncertainty and error data.", "success_check": "Answer and confidence are timestamped before feedback." }, { "title": "Use specific feedback", "instruction": "Reveal the correct direction and replay once only when the training rule allows, looking for the directional cue.", "reason": "One controlled replay teaches the error without turning the item into memory.", "success_check": "Replay status is recorded." }, { "title": "Mix speed and location carefully", "instruction": "After stable baseline, use a new set that changes only speed or screen location—not both.", "reason": "One changed feature tests near transfer cleanly.", "success_check": "The changed feature is named and all others stay fixed." }, { "title": "Rest and retest novel clips", "instruction": "After at least 48 hours, run unfamiliar clips at the baseline configuration before any feedback.", "reason": "Delayed novel performance tests retention better than repeating old clips.", "success_check": "No old clip appears in the retest." }, { "title": "Build a direction-confusion table", "instruction": "At the end of the set, place true direction on the rows and chosen direction on the columns. Mark clip speed and screen location beside each miss, then look for one repeated confusion before selecting feedback.", "reason": "A total percent correct hides whether the learner reverses one axis, misses one speed band or struggles only in a peripheral location.", "success_check": "The table contains every true/chosen pair and identifies one repeated pattern or states that errors are scattered." } ], "worked_example": { "scenario": "Niko uses the 16 supplied Set A clips on one monitor, with L/R/U/D as the four answers.", "walkthrough": [ "Niko records monitor, 60 Hz refresh, 70 cm distance, window size and brightness.", "They practise one obvious clip in each of the four directions.", "They view each baseline clip once, commit direction/confidence and then check.", "A second set changes location but not speed; nausea remains zero.", "Two days later they run novel clips before feedback and compare accuracy and confidence.", "Niko’s table shows that both errors were rightward clips shown low on the screen, so the next matched set changes location while keeping speed and direction balance fixed." ], "result": "Niko improves on unfamiliar clips at the same configuration. The result is task-specific direction learning, not enhanced real-world motion vision. The axis-specific table supports a precise transfer test instead of the vague claim that all motion perception improved." }, "right_vs_wrong": [ { "situation": "Exposure", "right": "Use one declared play before answering.", "wrong": "Replay until the direction is obvious.", "why": "Repeated exposure changes the task." }, { "situation": "Configuration", "right": "Keep refresh, size and distance fixed.", "wrong": "Switch phones or window sizes between trials.", "why": "Display changes alter apparent motion." }, { "situation": "Transfer", "right": "Change one feature at a time on novel clips.", "wrong": "Change speed, direction set and location together.", "why": "A multi-change failure cannot be interpreted." }, { "situation": "Symptoms", "right": "Pause and stop for nausea, aura or dizziness.", "wrong": "Treat discomfort as adaptation training.", "why": "Provoking symptoms is not the goal." }, { "situation": "Claim", "right": "Report direction accuracy for this clip set.", "wrong": "Call it globally faster visual processing.", "why": "Perceptual learning is often specific." }, { "situation": "Error analysis", "right": "Compare true and chosen direction by axis, speed and location.", "wrong": "Pool every miss into “slow visual processing”.", "why": "Specific confusion patterns suggest a testable next clip set; a global label does not." } ], "common_mistakes": [ { "mistake": "Replay until the direction is obvious.", "fix": "Use one declared play before answering." }, { "mistake": "Switch phones or window sizes between trials.", "fix": "Keep refresh, size and distance fixed." }, { "mistake": "Change speed, direction set and location together.", "fix": "Change one feature at a time on novel clips." }, { "mistake": "Treat discomfort as adaptation training.", "fix": "Pause and stop for nausea, aura or dizziness." }, { "mistake": "Call it globally faster visual processing.", "fix": "Report direction accuracy for this clip set." }, { "mistake": "The learner practises only the direction that was missed, making the next order predictable.", "fix": "Keep all directions balanced and change only the implicated speed or location feature in a concealed order." } ], "practice": { "first_session": [ "A helper builds the four 1,000 ms disk-motion masters, duplicates them in concealed Set A and Set B orders and verifies that every direction appears four times.", "Record display, refresh, 70 cm distance, 160×120 mm field size, brightness and symptom baseline; practise one unscored L/R/U/D master.", "Run all 16 Set A clips once each, committing direction and confidence before the helper checks the folded key.", "Build the true-by-chosen table and replay only one example of the most common confusion under the declared feedback rule.", "After at least 48 hours, run concealed Set B at the unchanged centre location before feedback.", "Only then test the 10 mm-lower transfer set, keeping speed, field, disk and direction counts fixed." ], "repeat_plan": "Use one short set once or twice weekly. Progress to a single changed feature only after novel baseline clips are accurate and symptom-free.", "progress_when": [ "Novel-clip accuracy rises at fixed configuration.", "Confidence becomes calibrated to errors.", "One-feature transfer appears without symptoms." ], "do_not_progress_when": [ "Display timing or geometry changes.", "Symptoms appear or persist after the screen stops.", "The task is being used as diagnosis or mobility clearance." ] }, "self_check": [ "Can you demonstrate “Learn direction labels”? All obvious examples are labelled correctly.", "Can you demonstrate “Commit direction and confidence”? Answer and confidence are timestamped before feedback.", "Can you demonstrate “Rest and retest novel clips”? No old clip appears in the retest.", "Can you point to the exact direction pair, speed band and location associated with the most common miss?" ], "measurement": { "primary": "L/R/U/D direction accuracy and confusion pattern for the supplied 1,000 ms moving-disk clips", "how": "Record correct direction, confusion pair, confidence, replay, clip feature, display configuration and symptom rating. Add a true-direction by chosen-direction confusion table and stratify misses by the one declared transfer feature.", "good_result": "Accuracy improves on a novel delayed set without more replay, overconfidence or symptoms.", "does_not_prove": "Declare motion type, speed, coherence, direction, retinal location and threshold method; do not equate one motion threshold with optic flow, pursuit or reaction speed." }, "stop_and_get_help": [ "Stop immediately for migraine aura, seizure warning, vertigo, nausea, severe headache or persistent visual disturbance.", "Seek urgent care for sudden new motion-induced neurological symptoms or acute vision loss.", "Seek qualified assessment when motion sensitivity affects walking, driving or daily function." ], "accessibility": [ "Use large direction buttons, speech or switches; motor speed is not scored.", "Reduce clip count and add longer rests without changing clip parameters.", "Use non-immersive, windowed clips and preserve ordinary correction." ], "evidence_notes": [ { "claim": "Primary research supports learning on defined motion-direction tasks and directly tests transfer conditions.", "source_title": "Perceptual learning of motion direction discrimination transfers to an opposite direction with TPE training", "source_url": "https://pubmed.ncbi.nlm.nih.gov/24184566/", "source_kind": "PRIMARY_RESEARCH" }, { "claim": "Amblyopia research shows transfer from contrast training to defined motion stimuli, not universal motion enhancement.", "source_title": "Training in contrast detection improves motion perception of sinewave gratings in amblyopia", "source_url": "https://pubmed.ncbi.nlm.nih.gov/21693615/", "source_kind": "PRIMARY_RESEARCH" } ], "limits": [ "Declare motion type, speed, coherence, direction, retinal location and threshold method; do not equate one motion threshold with optic flow, pursuit or reaction speed.", "Unsupported claim: Bullet-time vision.", "Unsupported claim: Track anything at any speed.", "Unsupported claim: Train motion perception to prevent every collision.", "Clip performance does not diagnose motion blindness, establish safe driving or generalise to all speeds, displays and environments." ], "orientation": { "bounded_definition": "Capability to develop or express motion perception in a declared context without inheriting broader claims.", "evidence_summary": "Motion perception is trainable on defined tasks, but ‘faster eyes’ is not supported.", "supportable_public_claim": "Motion-direction discrimination can improve through task-specific perceptual learning; transfer depends on the training and exposure configuration.", "measurement_boundary": "Declare motion type, speed, coherence, direction, retinal location and threshold method; do not equate one motion threshold with optic flow, pursuit or reaction speed.", "myth_to_metric": { "myth": "See the world in slow motion", "metric": "Direction/coherence threshold for an unfamiliar motion configuration", "boundary": "A lower laboratory threshold does not slow subjective time or guarantee sport and traffic anticipation." }, "limiting_findings": [ "Standard motion learning can remain specific to the trained direction.", "No mapped study established broad sport, driving or mobility transfer." ], "prohibited_claims": [ "Bullet-time vision", "Track anything at any speed", "Train motion perception to prevent every collision", "Motion games cure amblyopia" ] }, "gold_source_lesson": null, "next_gate": "External confirmation is required before higher-authority use because: CLINICAL_HIGH_RISK_OR_REGULATED_CONFIGURATION.", "evidence_count": 2 }, "full_training_programme": false, "independently_validated": false, "publication_state": "PUBLISHED_PUBLIC_RESEARCH_EDITION__EDITORIAL_REVIEW_PENDING", "related_power_ids": [ "PWR-065", "PWR-066", "PWR-067", "PWR-069" ] }, { "power_id": "PWR-069", "learning_unit_id": "TLU-PWR-069", "title": "Depth perception", "main_description": "The learner classifies near/far relations in two novel image sets and correctly identifies the dominant pictorial cue and cue-conflict errors.", "main_description_source": "FULL_TUTORIAL_OUTCOME", "family_id": "FAM-09", "family": "Visual Perception & Search", "superdomain": "Perception & Sensorimotor", "canonical_route": "/powers/pwr-069/", "treatment": "EVIDENCE_REVIEW_ROUTE", "treatment_label": "Full low-stakes tutorial", "treatment_boundary": "Titan teaches a concrete low-stakes method step by step while keeping evidence and transfer claims bounded.", "tutorial_route": "/tutorials/pwr-069/", "governed_lesson_route": null, "self_attempt_status": "PERMITTED_INSIDE_FULL_TUTORIAL_LIMITS", "gold_pathway_ids": [ "G-CUR-006" ], "route_membership": { "kind": "GOLD_PATHWAY", "id": "G-CUR-006", "coverage_status": "EXACT_ONCE" }, "source_authority_tier": "G2", "source_build_state": "TARGETED_REVIEW_REQUIRED", "source_instructional_route": "BOUNDED_GUIDED_EXERCISE", "source_count": 2, "research_depth": "FOCUSED", "risk_level": "LOW_TO_MODERATE; CLINICAL_WHEN_VISUAL_DISORDER_OR_PRISM", "prerequisite_status": "NONE_FOR_READING__NO_PRACTICE_AUTHORITY", "learning_route": { "mode": "FULL_SELF_GUIDED_TUTORIAL", "label": "Learn depth perception step by step", "summary": "The learner classifies near/far relations in two novel image sets and correctly identifies the dominant pictorial cue and cue-conflict errors.", "steps": [ [ "Get ready", "Use images only; no stairs, catching, pouring or real distance judgement is tested." ], [ "Learn the method", "8 concrete steps teach the permitted method from start to finish." ], [ "See right and wrong", "6 comparisons show correct or safer execution beside common wrong or riskier choices." ], [ "Practise", "Use one 10–15-image set once or twice weekly. Progress from single-cue to cue-conflict images, then novel scenes; clinical binocular treatment stays with eye professionals." ], [ "Check progress", "Record correct near/far relation, correct cue identification, cue conflicts, confidence, image setup and symptoms. Count whether cue-removal predictions correctly anticipate unchanged, weaker or reversed judgments." ] ], "practical_authority": true, "provider_required": false, "next_action_route": "/tutorials/pwr-069/" }, "path_builder": { "selectable": true, "completion_allowed": true, "warning": "Titan teaches a concrete low-stakes method step by step while keeping evidence and transfer claims bounded." }, "full_tutorial": { "version": "3.0", "authorship": "POWER_SPECIFIC_FULL_TUTORIAL", "tutorial_mode": "SELF_GUIDED", "promise": "Stereopsis can sometimes be recovered in selected adults, but depth perception is larger than binocular disparity. Depth perception uses binocular disparity, motion, overlap, size, perspective and other cues. The safe fixture teaches cue analysis in flat images: choose the nearer object, name the cue, check the key and compare a cue-conflict image. It does not measure stereopsis or justify driving claims. The learner verifies cue use by predicting what would happen if overlap, relative size or perspective were removed from the image, which makes the depth judgment explainable rather than intuitive.", "power_id": "PWR-069", "title": "Depth perception", "lesson_type": "SELF_GUIDED", "headline": "Name which object looks nearer and identify the cue that created the judgment", "plain_english_summary": "Stereopsis can sometimes be recovered in selected adults, but depth perception is larger than binocular disparity. Depth perception uses binocular disparity, motion, overlap, size, perspective and other cues. The safe fixture teaches cue analysis in flat images: choose the nearer object, name the cue, check the key and compare a cue-conflict image. It does not measure stereopsis or justify driving claims. The learner verifies cue use by predicting what would happen if overlap, relative size or perspective were removed from the image, which makes the depth judgment explainable rather than intuitive.", "outcome": "The learner classifies near/far relations in two novel image sets and correctly identifies the dominant pictorial cue and cue-conflict errors.", "authority": { "learner_may": [ "Judge the keyed near/far relation on A1–A5, name overlap, relative size or linear perspective and record conflict confidence before feedback.", "Predict stay, weaken or reverse before viewing the A1/A4 cue-removal companion, then transfer to concealed Set B.", "Use ordinary correction and speech, pointing or tactile labels while keeping card size, distance and lighting fixed." ], "qualified_person_required_for": [ "Testing stereopsis/binocular vision, prescribing prisms/lenses or assessing new double vision, eye alignment or neurological change.", "Using depth judgement for stairs, driving, machinery, sport, mobility, work-at-height or other consequential action.", "Changing vision treatment or rehabilitation because a pictorial cue answer changed." ], "never_do": [ "Call overlap/size/perspective card accuracy normal stereopsis or claim a flat image proves safe real-space depth.", "Practise at stairs, ledges, traffic or moving objects or remove prescribed correction to create difficulty.", "Continue through new double vision, eye pain, severe headache, nausea, vertigo or an abrupt depth/coordination change." ] }, "materials": [ "An exact A5-card construction sheet. Set A: A1 draw a 4 cm red square covering the left 1 cm of a 4 cm blue circle (red nearer; overlap); A2 reverse which shape covers the other (blue nearer; overlap); A3 draw two otherwise identical black circles, 4 cm and 2 cm diameter (larger circle intended nearer; relative size); A4 draw two rails 12 cm apart at the bottom converging to 3 cm apart at the top and place identical 1.5 cm squares low and high between them (lower square intended nearer; linear perspective); A5 use a 2 cm red square that covers a 1 cm edge of a 5 cm blue circle (overlap says red nearer while relative size says red farther; cue conflict). Set B repeats those five structures with triangle/hexagon shapes, left/right positions exchanged and new colours.", "A folded key naming the relations above plus two cue-removal companions: A1-crop hides the overlap edge while preserving visible areas of both shapes, and A4-crop hides the converging rail edges. The learner predicts stay, weaken or reverse before each companion is shown. A separate unscored shadow example shows two identical balls, one with an attached ground shadow and one with its shadow displaced, solely to learn the shadow label; it has no keyed near/far answer.", "Fixed display/print size, distance, lighting and ordinary correction.", "Trial sheet for answer, cue, confidence and symptoms." ], "before_you_start": [ "Use images only; no stairs, catching, pouring or real distance judgement is tested.", "Keep screen/print size, distance and correction fixed.", "Define the allowed cue labels with examples.", "New double vision, eye misalignment or sudden depth difficulty needs professional assessment." ], "steps": [ { "title": "Learn the cue labels", "instruction": "Review overlap, relative size, perspective and shadow with one obvious example each.", "reason": "Naming the cue separates reasoning from a vague depth feeling.", "success_check": "The learner matches all four cue labels to examples." }, { "title": "Lock the image setup", "instruction": "Record device/print, image size, distance, lighting and correction.", "reason": "Scaling and viewing conditions can alter pictorial cues.", "success_check": "The same setup can be reproduced." }, { "title": "Choose nearer before checking", "instruction": "For one image, state which named object appears nearer.", "reason": "A committed relation is needed before explanation or feedback.", "success_check": "One near/far answer is recorded." }, { "title": "Name the supporting cue", "instruction": "State the visible feature used, such as one shape blocking another or converging lines.", "reason": "A correct answer for the wrong reason may not transfer.", "success_check": "The answer includes one observable cue." }, { "title": "Reveal and compare", "instruction": "Check both relation and cue against the key, preserving the original response.", "reason": "Feedback should correct the specific inference, not only mark right/wrong.", "success_check": "The missed cue is named on every error." }, { "title": "Use a cue-conflict image", "instruction": "Compare an image where size and overlap suggest different relations and state which cue you trust and why.", "reason": "Conflicts reveal that depth is constructed from multiple signals.", "success_check": "The learner identifies the conflict rather than forcing certainty." }, { "title": "Retest novel scenes", "instruction": "After a delay, classify unfamiliar scenes with the same cue labels and no feedback first.", "reason": "Novel images test the cue method rather than picture memory.", "success_check": "No baseline image appears in the retest." }, { "title": "Run a cue-removal check", "instruction": "For one answered image, cover or crop the feature named as the main cue without changing the objects themselves. Predict whether the near–far answer should stay, weaken or reverse, then inspect the edited companion image.", "reason": "If the judgment survives removal of the claimed cue unchanged, another cue may actually be driving the answer.", "success_check": "The learner predicts the effect before viewing the companion and can name the cue that remains after the edit." } ], "worked_example": { "scenario": "Lin compares drawings of two boxes using overlap and perspective.", "walkthrough": [ "Lin reviews the four cue labels and fixes the tablet at 60 cm.", "In image one, box A overlaps box B, so Lin selects A as nearer and names overlap.", "In a conflict image, A is smaller but overlaps B; Lin records both cues and lower confidence.", "After checking the key, Lin preserves the original answer and writes which cue dominated.", "Two days later Lin uses new room scenes before feedback.", "Lin predicts that hiding the overlap edge will reduce certainty; in the companion image, relative size remains and Lin records that the answer now depends on size rather than overlap." ], "result": "Lin improves at explaining pictorial depth relations. This does not show stereoacuity or reliable real-world distance estimation. Lin now demonstrates not only a correct relation but a falsifiable explanation of which flat-image cue produced it." }, "right_vs_wrong": [ { "situation": "Cue", "right": "Name the visible overlap, size, perspective or shadow evidence.", "wrong": "Answer “it just looks closer”.", "why": "Cue naming makes the method checkable." }, { "situation": "Conflict", "right": "Record competing cues and lower confidence.", "wrong": "Force a certain answer while ignoring conflict.", "why": "Depth cues can disagree." }, { "situation": "Setup", "right": "Keep image scale and distance fixed.", "wrong": "Zoom difficult pictures.", "why": "Zoom changes relative visual size." }, { "situation": "Retest", "right": "Use unfamiliar scenes.", "wrong": "Repeat the same drawings until memorised.", "why": "Picture memory is not cue transfer." }, { "situation": "Claim", "right": "Call it pictorial-cue reasoning.", "wrong": "Call it stereopsis recovery.", "why": "Flat-image cues do not measure binocular disparity." }, { "situation": "Testing the explanation", "right": "Remove the named pictorial cue and predict the changed judgment.", "wrong": "Accept a cue label because it sounds plausible without manipulating the image.", "why": "A cue-removal comparison checks whether that visible feature actually carried the decision." } ], "common_mistakes": [ { "mistake": "Answer “it just looks closer”.", "fix": "Name the visible overlap, size, perspective or shadow evidence." }, { "mistake": "Force a certain answer while ignoring conflict.", "fix": "Record competing cues and lower confidence." }, { "mistake": "Zoom difficult pictures.", "fix": "Keep image scale and distance fixed." }, { "mistake": "Repeat the same drawings until memorised.", "fix": "Use unfamiliar scenes." }, { "mistake": "Call it stereopsis recovery.", "fix": "Call it pictorial-cue reasoning." }, { "mistake": "The learner names several cues after seeing the key, so no cue could have been wrong.", "fix": "Commit one primary cue and one backup cue before checking, then test the primary cue with a cropped companion." } ], "practice": { "first_session": [ "Construct or have a helper construct A1–A5, B1–B5, A1-crop and A4-crop from the stated centimetre measurements and fold the relation key.", "Review one overlap, relative-size, perspective and unscored shadow example, then lock print/display size, 60 cm distance, lighting and correction.", "Classify A1–A5, naming nearer object, primary cue, backup cue and confidence before checking the key; A5 must be marked conflict rather than forced certainty.", "Predict stay, weaken or reverse for A1-crop and A4-crop before revealing each companion and record which cue remains.", "After at least 48 hours, classify concealed B1–B5 under the same setup before feedback." ], "repeat_plan": "Use one 10–15-image set once or twice weekly. Progress from single-cue to cue-conflict images, then novel scenes; clinical binocular treatment stays with eye professionals.", "progress_when": [ "Near/far accuracy improves on novel images.", "Cue labels match visible features.", "Confidence falls appropriately when cues conflict." ], "do_not_progress_when": [ "Double vision, nausea or eye strain appears.", "Image scale or correction changes.", "The learner uses the fixture for stairs, driving or clinical claims." ] }, "self_check": [ "Can you demonstrate “Lock the image setup”? The same setup can be reproduced.", "Can you demonstrate “Name the supporting cue”? The answer includes one observable cue.", "Can you demonstrate “Retest novel scenes”? No baseline image appears in the retest.", "If your named overlap cue is covered, can you predict which remaining cue should control the near–far answer?" ], "measurement": { "primary": "Correct near/far relation, cue label and cue-conflict recognition on the supplied flat-image cards", "how": "Record correct near/far relation, correct cue identification, cue conflicts, confidence, image setup and symptoms. Count whether cue-removal predictions correctly anticipate unchanged, weaker or reversed judgments.", "good_result": "A novel set shows better relation and cue accuracy, including correct recognition of conflicts, without symptoms.", "does_not_prove": "Report stereoacuity/disparity threshold and task, plus monocular cues and functional configuration; stereoacuity cannot diagnose or summarise all depth perception." }, "stop_and_get_help": [ "Seek urgent assessment for sudden double vision, eye movement change, severe headache or acute neurological symptoms.", "Stop for eye strain, nausea, dizziness or persistent blur.", "Use an eye professional for suspected stereopsis or binocular-vision problems." ], "accessibility": [ "Use high-contrast, simplified images while retaining the same cue.", "Allow spoken, pointing or switch answers without time pressure.", "Describe non-target image content aloud while leaving the tested depth cue for the learner to judge." ], "evidence_notes": [ { "claim": "Primary research reports stereopsis recovery in selected adults with abnormal binocular vision under controlled training.", "source_title": "Recovery of stereopsis through perceptual learning in human adults with abnormal binocular vision", "source_url": "https://pubmed.ncbi.nlm.nih.gov/21896742/", "source_kind": "PRIMARY_RESEARCH" }, { "claim": "A controlled amblyopia treatment trial supports clinical specificity and does not validate a flat-image home task as treatment.", "source_title": "Randomised trial of three treatments for amblyopia: Vision therapy and patching, perceptual learning and patching alone", "source_url": "https://pubmed.ncbi.nlm.nih.gov/39396111/", "source_kind": "PRIMARY_RESEARCH" } ], "limits": [ "Report stereoacuity/disparity threshold and task, plus monocular cues and functional configuration; stereoacuity cannot diagnose or summarise all depth perception.", "Unsupported claim: Unlock 3D vision for everyone.", "Unsupported claim: Depth perception is one stereo score.", "Unsupported claim: Patching yourself retrains both eyes.", "Pictorial cue analysis does not measure stereoacuity, diagnose binocular disorder or prove safe real-world distance judgement." ], "orientation": { "bounded_definition": "Capability to develop or express depth perception in a declared context without inheriting broader claims.", "evidence_summary": "Stereopsis can sometimes be recovered in selected adults, but depth perception is larger than binocular disparity.", "supportable_public_claim": "Some adults with abnormal binocular vision have recovered measurable stereopsis through intensive supervised perceptual learning; general recovery and daily-life transfer remain unproven.", "measurement_boundary": "Report stereoacuity/disparity threshold and task, plus monocular cues and functional configuration; stereoacuity cannot diagnose or summarise all depth perception.", "myth_to_metric": { "myth": "Unlock perfect 3D vision", "metric": "Stereoacuity plus an unfamiliar functional depth task", "boundary": "Stereo improvement does not establish every form of depth perception or remove need for correction and adaptations." }, "limiting_findings": [ "A paediatric randomised comparison did not show a between-treatment stereoacuity advantage.", "Evidence does not erase legitimate monocular and assistive depth strategies." ], "prohibited_claims": [ "Unlock 3D vision for everyone", "Depth perception is one stereo score", "Patching yourself retrains both eyes", "No stereopsis means no usable depth" ] }, "gold_source_lesson": null, "next_gate": "External confirmation is required before higher-authority use because: CLINICAL_HIGH_RISK_OR_REGULATED_CONFIGURATION; SUPERVISION_OR_NON_ATTEMPT_BOUNDARY; SAFETY_LEGITIMACY_RESTRICTED.", "evidence_count": 2 }, "full_training_programme": false, "independently_validated": false, "publication_state": "PUBLISHED_PUBLIC_RESEARCH_EDITION__EDITORIAL_REVIEW_PENDING", "related_power_ids": [ "PWR-065", "PWR-066", "PWR-067", "PWR-068" ] }, { "power_id": "PWR-070", "learning_unit_id": "TLU-PWR-070", "title": "Visual search", "main_description": "The learner completes target-present and target-absent grids using a declared scan path and improves sensitivity without more false alarms or revisits.", "main_description_source": "FULL_TUTORIAL_OUTCOME", "family_id": "FAM-09", "family": "Visual Perception & Search", "superdomain": "Perception & Sensorimotor", "canonical_route": "/powers/pwr-070/", "treatment": "EVIDENCE_REVIEW_ROUTE", "treatment_label": "Full low-stakes tutorial", "treatment_boundary": "Titan teaches a concrete low-stakes method step by step while keeping evidence and transfer claims bounded.", "tutorial_route": "/tutorials/pwr-070/", "governed_lesson_route": null, "self_attempt_status": "PERMITTED_INSIDE_FULL_TUTORIAL_LIMITS", "gold_pathway_ids": [ "G-CUR-006" ], "route_membership": { "kind": "GOLD_PATHWAY", "id": "G-CUR-006", "coverage_status": "EXACT_ONCE" }, "source_authority_tier": "G1", "source_build_state": "TARGETED_REVIEW_REQUIRED", "source_instructional_route": "SELF_GUIDED_TUTORIAL", "source_count": 6, "research_depth": "DEEP", "risk_level": "LOW_TO_MODERATE; CLINICAL_WHEN_VISUAL_DISORDER_OR_PRISM", "prerequisite_status": "NONE_FOR_READING__NO_PRACTICE_AUTHORITY", "learning_route": { "mode": "FULL_SELF_GUIDED_TUTORIAL", "label": "Learn visual search step by step", "summary": "The learner completes target-present and target-absent grids using a declared scan path and improves sensitivity without more false alarms or revisits.", "steps": [ [ "Get ready", "Use a seated, low-stakes task; no medical images, baggage screening or hazards." ], [ "Learn the method", "8 concrete steps teach the permitted method from start to finish." ], [ "See right and wrong", "6 comparisons show correct or safer execution beside common wrong or riskier choices." ], [ "Practise", "Use four to eight new grids once or twice weekly. Progress only after accuracy and false alarms are stable; vary prevalence or clutter one at a time." ], [ "Check progress", "On target-present grids, a hit requires the exact keyed row and column; an absent answer or wrong coordinate is a miss/localisation error. On absent grids, any marked location is a false alarm and absent is a correct rejection. Report hits divided by present grids and false alarms divided by absent grids, plus stopping time, revisits, skipped rows, first path break, prevalence and grid configuration." ] ], "practical_authority": true, "provider_required": false, "next_action_route": "/tutorials/pwr-070/" }, "path_builder": { "selectable": true, "completion_allowed": true, "warning": "Titan teaches a concrete low-stakes method step by step while keeping evidence and transfer claims bounded." }, "full_tutorial": { "version": "3.0", "authorship": "POWER_SPECIFIC_FULL_TUTORIAL", "tutorial_mode": "SELF_GUIDED", "promise": "Search practice can sharpen a defined search, but rare things remain disproportionately easy to miss. Visual search requires finding a declared target among distractors and knowing when to stop on target-absent trials. The learner studies a template, uses one scan path, marks revisits and records hits, misses, false alarms and target-absent time on new grids. Rare targets remain easy to miss. A simple coverage map makes the scan path observable: skipped cells, immediate backtracking and end-of-row overshoot are marked, then one path correction is rehearsed on a fresh grid.", "power_id": "PWR-070", "title": "Visual search", "lesson_type": "SELF_GUIDED", "headline": "Scan a grid systematically and use a target-absent stopping rule", "plain_english_summary": "Search practice can sharpen a defined search, but rare things remain disproportionately easy to miss. Visual search requires finding a declared target among distractors and knowing when to stop on target-absent trials. The learner studies a template, uses one scan path, marks revisits and records hits, misses, false alarms and target-absent time on new grids. Rare targets remain easy to miss. A simple coverage map makes the scan path observable: skipped cells, immediate backtracking and end-of-row overshoot are marked, then one path correction is rehearsed on a fresh grid.", "outcome": "The learner completes target-present and target-absent grids using a declared scan path and improves sensitivity without more false alarms or revisits.", "authority": { "learner_may": [ "Apply the declared row-by-row or column-by-column scan to coded 8×8 T-among-L grids and point to the target or answer absent once.", "Record hit, miss, false alarm, revisited cells and stop time on A/B, then test the one-present/five-absent C set without changing prevalence.", "Use ordinary correction, a tracking overlay, large pointer or scribe while preserving grid layout and target key." ], "qualified_person_required_for": [ "Assessing visual field, neglect, attention or reading/search impairment and deciding on clinical scanning rehabilitation.", "Using search performance for driving, radiology/security work, medication selection, road crossing or hazard clearance.", "Changing lenses, prisms, assistive technology or rehabilitation from these letter grids." ], "never_do": [ "Peek at target coordinates, stop present grids early after a guess or omit absent grids because they take longer.", "Turn a letter-grid score into clearance for real hazards, traffic, work screening or medication checking.", "Continue through sudden side loss, severe headache, new confusion/weakness, double vision, eye pain or marked fatigue." ] }, "materials": [ "An exact grid recipe for a helper. Make each grid an 8×8 array of uppercase L characters in one 18-point monospaced font with 1 cm cells. A target-present grid replaces exactly one L with T; an absent grid contains only L. Fold this key: baseline A1 target row 2 column 6, A2 absent, A3 target row 7 column 3, A4 absent; practice B1 target row 4 column 8, B2 absent, B3 target row 1 column 2, B4 absent; delayed low-prevalence C1 target row 6 column 5 and C2–C6 absent. Present grids within each lettered set in a concealed shuffled order and retain the grid label for scoring.", "A target template shown before each grid.", "Pointer or erasable overlay for tracking the scan path.", "Timer and sheet for hits, misses, false alarms, revisits and stopping time." ], "before_you_start": [ "Use a seated, low-stakes task; no medical images, baggage screening or hazards.", "Fix grid size, viewing distance, lighting and correction.", "Predeclare the scan path and target-absent stop rule.", "Do not add speed pressure until accuracy and false alarms are stable." ], "steps": [ { "title": "Study the exact template", "instruction": "Look at the target T and name how it differs from the L distractors.", "reason": "A precise template reduces searching for a vague shape.", "success_check": "The learner identifies target and two distractors correctly." }, { "title": "Choose a scan path", "instruction": "Select rows, columns or quadrants and state the order before revealing the grid.", "reason": "A systematic path reduces skipped regions and revisits.", "success_check": "The path covers the full grid once." }, { "title": "Start the timer and scan", "instruction": "Move through the declared path at a controllable pace, pointing or tracking each region.", "reason": "External tracking makes coverage visible.", "success_check": "The scan follows the path rather than jumping to salient items." }, { "title": "Commit target present", "instruction": "If a target is found, mark its location and stop before checking.", "reason": "A committed location distinguishes a hit from vague suspicion.", "success_check": "One exact location is recorded." }, { "title": "Apply the absent rule", "instruction": "If no target appears after one complete scan plus the predeclared verification pass, answer absent and stop.", "reason": "Endless searching inflates time without eliminating misses.", "success_check": "Target-absent decisions use the same rule." }, { "title": "Classify and mark revisits", "instruction": "Use the key to record hit, miss, false alarm or correct rejection and count repeated regions.", "reason": "Accuracy, bias and inefficient scanning are different errors.", "success_check": "Every grid has outcome, time and revisit count." }, { "title": "Retest rare novel targets", "instruction": "After practice, use new grids with the predeclared lower target prevalence and the same scan rule.", "reason": "Low prevalence can increase misses and must be tested directly.", "success_check": "Prevalence and new-grid status are recorded." }, { "title": "Draw a coverage trace", "instruction": "On a transparent overlay or duplicate grid, draw a light line through each inspected row or quadrant and put a dot where the eyes or pointer return to an earlier region. Keep this trace separate from the target answer.", "reason": "A coverage trace distinguishes a missed target from an unvisited region and shows where the declared path breaks down.", "success_check": "Every sector has one pass mark, revisits have dots and the target answer remains unaltered by the trace." } ], "worked_example": { "scenario": "Eva searches four 8×8 T-among-L grids, two without a target.", "walkthrough": [ "Eva studies the T template and chooses a left-to-right row scan.", "She tracks rows with a pointer and marks one target location before checking.", "On an absent grid she completes one scan and one verification pass, then stops.", "The key shows one miss and no false alarms; she also records three revisits.", "On a delayed novel set with rarer targets, she keeps the same path and compares misses.", "Eva’s overlay reveals that she jumps from row four to row six and revisits row two; the next fresh grid uses a row-number card to correct only that transition." ], "result": "Eva reduces revisits and maintains accuracy on novel grids. This is grid-specific search learning, not competence in rare real-world hazard detection. Eva can link the miss to a broken row transition rather than simply trying to search faster." }, "right_vs_wrong": [ { "situation": "Template", "right": "Study the exact target before each grid.", "wrong": "Search for “anything unusual”.", "why": "Vague search criteria increase misses and false alarms." }, { "situation": "Path", "right": "Cover rows or sectors systematically.", "wrong": "Jump around toward visually interesting items.", "why": "Unstructured search skips regions and repeats others." }, { "situation": "Absent decision", "right": "Stop after the declared coverage and verification pass.", "wrong": "Search indefinitely or quit when bored.", "why": "A stable rule makes time and errors comparable." }, { "situation": "Score", "right": "Count misses, false alarms and revisits separately.", "wrong": "Use speed alone.", "why": "Fast search can conceal dangerous misses." }, { "situation": "Rarity", "right": "Test low prevalence on novel grids.", "wrong": "Assume practice removes rare-target misses.", "why": "Rare targets remain disproportionately missed." }, { "situation": "Coverage evidence", "right": "Use an overlay or pointer trace to show visited and revisited regions.", "wrong": "Assume the whole grid was scanned because the timer ran for long enough.", "why": "Elapsed time cannot reveal a skipped row or repeated quadrant." } ], "common_mistakes": [ { "mistake": "Search for “anything unusual”.", "fix": "Study the exact target before each grid." }, { "mistake": "Jump around toward visually interesting items.", "fix": "Cover rows or sectors systematically." }, { "mistake": "Search indefinitely or quit when bored.", "fix": "Stop after the declared coverage and verification pass." }, { "mistake": "Use speed alone.", "fix": "Count misses, false alarms and revisits separately." }, { "mistake": "Assume practice removes rare-target misses.", "fix": "Test low prevalence on novel grids." }, { "mistake": "The pointer marks the target while searching, revealing likely answers during a later verification pass.", "fix": "Use a separate coverage overlay and mark the final target location only after the search decision is committed." } ], "practice": { "first_session": [ "A helper builds and conceals A1–A4, B1–B4 and C1–C6 from the 8×8 recipe and folded coordinate key.", "Study the T template, choose a left-to-right row scan and state that absent means one full scan plus one verification pass.", "Run shuffled A1–A4, committing an exact row/column or absent answer before the key is opened for each grid.", "Trace one A grid on a clean overlay, mark the first skipped row or revisit and rehearse that path transition on shuffled B1–B4.", "After at least 48 hours, run shuffled C1–C6 without feedback first and compare the one-present/five-absent results with their declared prevalence." ], "repeat_plan": "Use four to eight new grids once or twice weekly. Progress only after accuracy and false alarms are stable; vary prevalence or clutter one at a time.", "progress_when": [ "Misses and revisits decline on novel grids.", "False alarms do not rise.", "The absent stopping rule is followed consistently." ], "do_not_progress_when": [ "Speed pressure increases misses.", "The target template or grid size changes without being recorded.", "The learner transfers the score to a safety-critical search." ] }, "self_check": [ "Can you demonstrate “Choose a scan path”? The path covers the full grid once.", "Can you demonstrate “Commit target present”? One exact location is recorded.", "Can you demonstrate “Retest rare novel targets”? Prevalence and new-grid status are recorded.", "Can your coverage trace show the difference between a target miss in a visited cell and a target located in a skipped cell?" ], "measurement": { "primary": "Sensitivity, miss and false-alarm rates on rare unfamiliar targets", "how": "On target-present grids, a hit requires the exact keyed row and column; an absent answer or wrong coordinate is a miss/localisation error. On absent grids, any marked location is a false alarm and absent is a correct rejection. Report hits divided by present grids and false alarms divided by absent grids, plus stopping time, revisits, skipped rows, first path break, prevalence and grid configuration.", "good_result": "Two novel sets show fewer misses or revisits without increased false alarms, using the same stopping rule.", "does_not_prove": "Predeclare target class, prevalence, sensitivity, false alarms, response time and unfamiliar-scene transfer; keep speed–accuracy trade-offs visible." }, "stop_and_get_help": [ "Stop for headache, eye strain, nausea or visual disturbance.", "Seek professional assessment for new everyday search failure, field loss or neglect symptoms.", "Do not use the fixture as clearance for radiology, security, driving or other consequential search." ], "accessibility": [ "Use larger grids with the same target/distractor relation as a labelled configuration.", "Use pointer, row guide, speech or switch response without adding a motor-speed requirement.", "Reduce visual clutter for instruction, then measure any clutter change separately." ], "evidence_notes": [ { "claim": "Primary research demonstrates a low-prevalence effect in visual search, supporting explicit miss and prevalence tracking.", "source_title": "Cognitive psychology: rare items often missed in visual searches", "source_url": "https://pubmed.ncbi.nlm.nih.gov/15917795/", "source_kind": "PRIMARY_RESEARCH" }, { "claim": "Primary research distinguishes contextual and perceptual learning in visual search, limiting broad transfer claims.", "source_title": "Dissociating electrophysiological correlates of contextual and perceptual learning in a visual search task", "source_url": "https://pubmed.ncbi.nlm.nih.gov/32525986/", "source_kind": "PRIMARY_RESEARCH" } ], "limits": [ "Predeclare target class, prevalence, sensitivity, false alarms, response time and unfamiliar-scene transfer; keep speed–accuracy trade-offs visible.", "Unsupported claim: Photographic scanning.", "Unsupported claim: Never miss an anomaly.", "Unsupported claim: One game trains every search job.", "Grid improvement does not establish safe rare-target search in professional, medical or mobility settings." ], "orientation": { "bounded_definition": "Capability to develop or express visual search in a declared context without inheriting broader claims.", "evidence_summary": "Search practice can sharpen a defined search, but rare things remain disproportionately easy to miss.", "supportable_public_claim": "Visual search is trainable for defined targets and contexts, yet low-prevalence targets remain easy to miss and broad transfer is not guaranteed.", "measurement_boundary": "Predeclare target class, prevalence, sensitivity, false alarms, response time and unfamiliar-scene transfer; keep speed–accuracy trade-offs visible.", "myth_to_metric": { "myth": "Human anomaly scanner", "metric": "Sensitivity, miss and false-alarm rates on rare unfamiliar targets", "boundary": "Fast finding of frequent trained targets does not establish expert anomaly detection." }, "limiting_findings": [ "Rare targets were missed at disturbingly high rates.", "Contextual learning can improve a repeated scene without improving a new one." ], "prohibited_claims": [ "Photographic scanning", "Never miss an anomaly", "One game trains every search job", "Reaction time proves safer inspection" ] }, "gold_source_lesson": { "curriculum_id": "G-CUR-006", "source_heading": "F. Visual search", "source_html_sha256": "05de88e5e12c50b908cdca90540bd7a5143c081912b7dad34cf36ae7977c0a5c", "html": "Use a target template before each grid. Record target-present accuracy, target-absent stopping time, false alarms and revisits.
\nFixture description: Four visual search grids containing a T target among L-shaped distractors.
" }, "next_gate": "External confirmation is required before higher-authority use because: CLINICAL_HIGH_RISK_OR_REGULATED_CONFIGURATION.", "evidence_count": 6 }, "full_training_programme": false, "independently_validated": false, "publication_state": "PUBLISHED_PUBLIC_RESEARCH_EDITION__EDITORIAL_REVIEW_PENDING", "related_power_ids": [ "PWR-065", "PWR-066", "PWR-067", "PWR-068" ] }, { "power_id": "PWR-071", "learning_unit_id": "TLU-PWR-071", "title": "Low-light adaptation", "main_description": "The learner completes two matched dim-panel sets with controlled prior light, display settings and symptom-free object identification.", "main_description_source": "FULL_TUTORIAL_OUTCOME", "family_id": "FAM-09", "family": "Visual Perception & Search", "superdomain": "Perception & Sensorimotor", "canonical_route": "/powers/pwr-071/", "treatment": "EVIDENCE_REVIEW_ROUTE", "treatment_label": "Full low-stakes tutorial", "treatment_boundary": "Titan teaches a concrete low-stakes method step by step while keeping evidence and transfer claims bounded.", "tutorial_route": "/tutorials/pwr-071/", "governed_lesson_route": null, "self_attempt_status": "PERMITTED_INSIDE_FULL_TUTORIAL_LIMITS", "gold_pathway_ids": [ "G-CUR-006" ], "route_membership": { "kind": "GOLD_PATHWAY", "id": "G-CUR-006", "coverage_status": "EXACT_ONCE" }, "source_authority_tier": "G2", "source_build_state": "TARGETED_REVIEW_REQUIRED", "source_instructional_route": "BOUNDED_GUIDED_EXERCISE", "source_count": 3, "research_depth": "FOCUSED", "risk_level": "LOW_TO_MODERATE; CLINICAL_WHEN_VISUAL_DISORDER_OR_PRISM", "prerequisite_status": "NONE_FOR_READING__NO_PRACTICE_AUTHORITY", "learning_route": { "mode": "FULL_SELF_GUIDED_TUTORIAL", "label": "Learn low-light adaptation step by step", "summary": "The learner completes two matched dim-panel sets with controlled prior light, display settings and symptom-free object identification.", "steps": [ [ "Get ready", "Keep the room safely lit enough to move; remain seated." ], [ "Learn the method", "8 concrete steps teach the permitted method from start to finish." ], [ "See right and wrong", "6 comparisons show correct or safer execution beside common wrong or riskier choices." ], [ "Practise", "Use one short panel set no more than twice weekly. Progress only by novel-item accuracy at identical settings; do not make the room darker as progression." ], [ "Check progress", "Record correct object identification and confidence by declared panel level, plus prior light, display settings, distance and symptoms. Include the number and timing of light interruptions and exclude any panel attempted before the full reset interval." ] ], "practical_authority": true, "provider_required": false, "next_action_route": "/tutorials/pwr-071/" }, "path_builder": { "selectable": true, "completion_allowed": true, "warning": "Titan teaches a concrete low-stakes method step by step while keeping evidence and transfer claims bounded." }, "full_tutorial": { "version": "3.0", "authorship": "POWER_SPECIFIC_FULL_TUTORIAL", "tutorial_mode": "SELF_GUIDED", "promise": "Dark adaptation is a temporary physiological process, not a permanent superpower, and recent bright light changes it. This safe fixture keeps the room navigable and dims only a set of fixed screen panels. The learner identifies simple shapes at declared display-grey levels after a matched light-history interval and resets after an accidental bright screen. It is not a rod threshold or night-driving test.", "power_id": "PWR-071", "title": "Low-light adaptation", "lesson_type": "SELF_GUIDED", "headline": "Compare visibility across dim display panels without entering real darkness", "plain_english_summary": "Dark adaptation is a temporary physiological process, not a permanent superpower, and recent bright light changes it. This safe fixture keeps the room navigable and dims only a set of fixed screen panels. The learner identifies simple shapes at declared display-grey levels after a matched light-history interval and resets after an accidental bright screen. It is not a rod threshold or night-driving test.", "outcome": "The learner completes two matched dim-panel sets with controlled prior light, display settings and symptom-free object identification.", "authority": { "learner_may": [ "After the fixed 15-minute ordinary-room-light history, identify circle, triangle, square or star on Set A from level 1 through 6 at locked brightness.", "Record shape answers, confidence and interruptions, reset for five minutes after accidental bright light and repeat concealed Set B later.", "Use ordinary correction and accessible four-choice symbols without entering a dark walking environment." ], "qualified_person_required_for": [ "Assessing new night-vision difficulty, delayed dark adaptation, eye disease, medication effects or unequal vision between eyes.", "Decisions about night driving, dark stairs/routes, occupational night work or mobility safety.", "Changing eye treatment, lenses, medication, illumination aids or rehabilitation from a home panel result." ], "never_do": [ "Walk in darkness, cover emergency lighting, test while driving or stare into a bright lamp to create a harder adaptation history.", "Raise display brightness after errors or call the darkest named shape a clinical scotopic threshold.", "Continue with sudden night-vision loss, flashes/curtain, eye pain, severe headache, dizziness or unsafe disorientation." ] }, "materials": [ "An exact panel recipe for a helper using a slide or drawing program. Make every panel 8 cm square with background RGB 16/16/16 and one centred 4 cm shape: circle, equilateral triangle, square or five-point star. Shape grey levels are 1 = 112, 2 = 80, 3 = 56, 4 = 40, 5 = 32 and 6 = 24 in all three RGB channels. Export one of each shape at every level under neutral filenames. Fold the Set A order by level: 1 circle/triangle/square/star; 2 star/square/circle/triangle; 3 triangle/circle/star/square; 4 square/star/triangle/circle; 5 circle/star/square/triangle; 6 triangle/square/star/circle. Set B uses at each level: 1 star/circle/triangle/square; 2 triangle/star/square/circle; 3 square/triangle/circle/star; 4 circle/square/star/triangle; 5 star/triangle/circle/square; 6 square/circle/triangle/star.", "One non-HDR display with brightness locked.", "A normally lit room and fixed viewing distance.", "Timer and record for prior light, panel level, accuracy, confidence and symptoms." ], "before_you_start": [ "Keep the room safely lit enough to move; remain seated.", "Do not walk in darkness, drive, cover hazards or use extreme bright-light exposure.", "Spend and record 15 minutes under the same ordinary room lamp with no full-screen white display before either set; this fixture standardises recent light but does not create clinical dark adaptation.", "Use professional care for new night-vision difficulty." ], "steps": [ { "title": "Make the room safe", "instruction": "Remove trip hazards and keep navigation lighting on; only the panel is dim.", "reason": "The lesson tests an image, not movement in darkness.", "success_check": "The route remains fully visible." }, { "title": "Lock display and history", "instruction": "Record display, brightness, room light, distance and the prior-light interval.", "reason": "Display luminance and recent bright light strongly affect the result.", "success_check": "The same history rule can be repeated." }, { "title": "Learn the object set", "instruction": "View clear versions of the allowed silhouettes and response labels.", "reason": "The task should test visibility, not vocabulary.", "success_check": "All clear objects are identified." }, { "title": "Begin with visible panels", "instruction": "Identify each object and confidence before checking, starting above the difficult level.", "reason": "A visible start establishes the task without prolonged staring.", "success_check": "The first panels are answered without strain." }, { "title": "Step down one level", "instruction": "Move through fixed brightness/contrast levels without changing display controls or leaning closer.", "reason": "Manual adjustment destroys the physical comparison.", "success_check": "Panel level and answer are recorded unchanged." }, { "title": "Stop rather than stare", "instruction": "Use the declared viewing time and stop after repeated errors or symptoms.", "reason": "Long staring and guessing do not create a valid dark-adaptation measure.", "success_check": "The timer and error rule determine the endpoint." }, { "title": "Retest after matched light history", "instruction": "On another day, use novel silhouettes after the same prior-light interval.", "reason": "Matched history and new items make the comparison less confounded.", "success_check": "Prior light and configuration match within the declared tolerance." }, { "title": "Reset after a light interruption", "instruction": "If a notification flash, bright display menu, window glare or room-light change occurs, stop the panel sequence. Restore the original settings, sit under the original room lamp for five minutes, then begin with a new panel rather than the interrupted one.", "reason": "A brief bright exposure can alter temporary visibility and make the next low-level panel incomparable with earlier trials.", "success_check": "The interruption, clock time and completed reset interval are logged, and the resumed item is unfamiliar." } ], "worked_example": { "scenario": "Noah uses a laptop with brightness locked and a room lamp left on.", "walkthrough": [ "Noah clears the seated area and records the prior 15 minutes indoors.", "He learns four clear silhouettes at 70 cm.", "He answers fixed dim panels before feedback without altering brightness.", "He stops after the declared repeated-error rule and records no symptoms.", "On another day he repeats novel objects after the same light-history interval.", "A bright notification appears before panel six, so Noah closes it, restores the locked display, waits the full reset interval and resumes with a replacement silhouette." ], "result": "Noah becomes more consistent at this display task. The result is not physiological dark adaptation, scotopic threshold or safe night vision. The reset log shows that the second-day comparison used a matched recent-light state rather than an unrecorded screen flash." }, "right_vs_wrong": [ { "situation": "Environment", "right": "Keep the room navigable and dim only the panel.", "wrong": "Turn off all lights and move around.", "why": "Real darkness introduces fall and navigation risk." }, { "situation": "Display", "right": "Lock brightness and HDR/colour mode.", "wrong": "Raise brightness on difficult items.", "why": "That changes the stimulus." }, { "situation": "Light history", "right": "Use the same declared prior-light interval.", "wrong": "Compare after bright sun one day and darkness the next.", "why": "Recent light changes adaptation state." }, { "situation": "Viewing time", "right": "Use a fixed brief interval.", "wrong": "Stare until a shape appears.", "why": "Duration changes detectability and encourages guessing." }, { "situation": "Claim", "right": "Report panel identification at this setup.", "wrong": "Claim improved rods or night-driving safety.", "why": "The display fixture is not a physiological test." }, { "situation": "Unexpected bright light", "right": "Stop, restore the setup, wait the declared reset interval and use a replacement panel.", "wrong": "Continue immediately and call the next miss worse dark adaptation.", "why": "The learner’s recent light history changed, so the next result cannot share the old baseline." } ], "common_mistakes": [ { "mistake": "Turn off all lights and move around.", "fix": "Keep the room navigable and dim only the panel." }, { "mistake": "Raise brightness on difficult items.", "fix": "Lock brightness and HDR/colour mode." }, { "mistake": "Compare after bright sun one day and darkness the next.", "fix": "Use the same declared prior-light interval." }, { "mistake": "Stare until a shape appears.", "fix": "Use a fixed brief interval." }, { "mistake": "Claim improved rods or night-driving safety.", "fix": "Report panel identification at this setup." }, { "mistake": "The display menu is opened between faint panels, briefly showing a bright white screen.", "fix": "Prepare controls before the block, suppress notifications and invoke the full reset rule after any bright menu appears." } ], "practice": { "first_session": [ "A helper builds all 24 panels at the six RGB levels and prepares concealed A and B orders from the folded key.", "Secure a safely lit seated setup, lock display mode/brightness and 70 cm distance, and complete the 15-minute ordinary-room-light history.", "Practise the four shapes at level 1, then run Set A from level 1 through 6 with one shape answer and confidence before feedback.", "If any bright interruption occurs, log it, complete the five-minute original-lamp reset and resume on an unused panel; otherwise finish at level 6 or a symptom stop.", "After at least 48 hours, repeat the 15-minute light history and run concealed Set B at identical settings." ], "repeat_plan": "Use one short panel set no more than twice weekly. Progress only by novel-item accuracy at identical settings; do not make the room darker as progression.", "progress_when": [ "Novel-panel accuracy improves at matched levels.", "Confidence becomes calibrated.", "No staring, display changes or symptoms occur." ], "do_not_progress_when": [ "Prior light or display cannot be matched.", "Night-vision difficulty affects daily function.", "Headache, afterimage or eye discomfort occurs." ] }, "self_check": [ "Can you demonstrate “Lock display and history”? The same history rule can be repeated.", "Can you demonstrate “Begin with visible panels”? The first panels are answered without strain.", "Can you demonstrate “Retest after matched light history”? Prior light and configuration match within the declared tolerance.", "Can you name the light events that invalidate the current panel and demonstrate the complete reset without navigating in darkness?" ], "measurement": { "primary": "Circle/triangle/square/star identification across the six supplied dark-panel grey levels", "how": "Record correct object identification and confidence by declared panel level, plus prior light, display settings, distance and symptoms. Include the number and timing of light interruptions and exclude any panel attempted before the full reset interval.", "good_result": "Both concealed sets reproduce from their keys, every interruption triggers the five-minute reset and level-by-level accuracy is reported without symptoms or display adjustment. The result remains a lit-room panel comparison, not a scotopic threshold.", "does_not_prove": "Use rod/cone recovery curves or declared low-luminance thresholds after standardised bleach and adaptation; do not use subjective confidence or a daytime chart." }, "stop_and_get_help": [ "Seek eye care for new or worsening night blindness, sudden visual change, flashes, field loss or eye pain.", "Stop for headache, afterimage, nausea, dizziness or persistent blur.", "Never use this task to decide whether to drive, fly or walk in low light." ], "accessibility": [ "Use larger clear-training objects but keep test-panel geometry declared.", "Use spoken or switch answers with no motor-speed score.", "Maintain mobility lighting and allow a helper to operate panels." ], "evidence_notes": [ { "claim": "Primary research shows dark-adaptation measures vary with ageing, supporting person- and condition-specific interpretation.", "source_title": "Aging and dark adaptation", "source_url": "https://pubmed.ncbi.nlm.nih.gov/10748929/", "source_kind": "PRIMARY_RESEARCH" }, { "claim": "FAA official guidance treats night vision and dark adaptation as safety-relevant and vulnerable to bright-light disruption.", "source_title": "Aeronautical Information Manual, Chapter 8: Medical Facts for Pilots", "source_url": "https://www.faa.gov/air_traffic/publications/atpubs/aim/aim0801.html", "source_kind": "OFFICIAL_GUIDANCE" } ], "limits": [ "Use rod/cone recovery curves or declared low-luminance thresholds after standardised bleach and adaptation; do not use subjective confidence or a daytime chart.", "Unsupported claim: Train permanent night vision.", "Unsupported claim: See in total darkness.", "Unsupported claim: Megadose vitamin A for superior sight.", "A lit-room display task does not measure rod function, clinical dark adaptation or safe low-light mobility." ], "orientation": { "bounded_definition": "Capability to develop or express low-light adaptation in a declared context without inheriting broader claims.", "evidence_summary": "Dark adaptation is a temporary physiological state, not a permanent superpower—and bright light can erase it quickly.", "supportable_public_claim": "Humans naturally become more light-sensitive in darkness, but the state takes time, is age- and health-dependent and can be lost within seconds of bright light.", "measurement_boundary": "Use rod/cone recovery curves or declared low-luminance thresholds after standardised bleach and adaptation; do not use subjective confidence or a daytime chart.", "myth_to_metric": { "myth": "Night vision", "metric": "Time-resolved scotopic threshold under standardised lighting", "boundary": "Temporary sensitivity does not permit vision without light or establish safe night driving." }, "limiting_findings": [ "Most dark-adaptation outcomes did not improve with short high-dose retinol.", "Bright light rapidly destroys the adapted state." ], "prohibited_claims": [ "Train permanent night vision", "See in total darkness", "Megadose vitamin A for superior sight", "Practise driving blind to adapt" ] }, "gold_source_lesson": null, "next_gate": "External confirmation is required before higher-authority use because: CLINICAL_HIGH_RISK_OR_REGULATED_CONFIGURATION; SAFETY_LEGITIMACY_RESTRICTED.", "evidence_count": 3 }, "full_training_programme": false, "independently_validated": false, "publication_state": "PUBLISHED_PUBLIC_RESEARCH_EDITION__EDITORIAL_REVIEW_PENDING", "related_power_ids": [ "PWR-065", "PWR-066", "PWR-067", "PWR-068" ] }, { "power_id": "PWR-072", "learning_unit_id": "TLU-PWR-072", "title": "Visuomotor integration", "main_description": "The learner completes baseline, mild-remapping and washout blocks with endpoint errors, misses, time and symptoms recorded.", "main_description_source": "FULL_TUTORIAL_OUTCOME", "family_id": "FAM-09", "family": "Visual Perception & Search", "superdomain": "Perception & Sensorimotor", "canonical_route": "/powers/pwr-072/", "treatment": "EVIDENCE_REVIEW_ROUTE", "treatment_label": "Full low-stakes tutorial", "treatment_boundary": "Titan teaches a concrete low-stakes method step by step while keeping evidence and transfer claims bounded.", "tutorial_route": "/tutorials/pwr-072/", "governed_lesson_route": null, "self_attempt_status": "PERMITTED_INSIDE_FULL_TUTORIAL_LIMITS", "gold_pathway_ids": [ "G-CUR-006" ], "route_membership": { "kind": "GOLD_PATHWAY", "id": "G-CUR-006", "coverage_status": "EXACT_ONCE" }, "source_authority_tier": "G1", "source_build_state": "TARGETED_REVIEW_REQUIRED", "source_instructional_route": "SELF_GUIDED_TUTORIAL", "source_count": 3, "research_depth": "FOCUSED", "risk_level": "LOW_TO_MODERATE; CLINICAL_WHEN_VISUAL_DISORDER_OR_PRISM", "prerequisite_status": "NONE_FOR_READING__NO_PRACTICE_AUTHORITY", "learning_route": { "mode": "FULL_SELF_GUIDED_TUTORIAL", "label": "Learn visuomotor integration step by step", "summary": "The learner completes baseline, mild-remapping and washout blocks with endpoint errors, misses, time and symptoms recorded.", "steps": [ [ "Get ready", "Use only a mild software remapping while seated; no prism glasses, walking, tools or real-world aiming." ], [ "Learn the method", "8 concrete steps teach the permitted method from start to finish." ], [ "See right and wrong", "5 comparisons show correct or safer execution beside common wrong or riskier choices." ], [ "Practise", "Use one short session weekly at first. Progress by new target order or one small provider-approved angle change only after symptom-free washout and accurate baseline restoration." ], [ "Check progress", "For each click, calculate target angle and displayed-endpoint angle about the centre; signed angular error is the displayed angle minus target angle wrapped to −180° to +180°, and absolute error is its magnitude. Report median signed and absolute error for baseline, the first and last eight adaptation trials and the first and last eight washout trials, plus misses, support, time and symptoms." ] ], "practical_authority": true, "provider_required": false, "next_action_route": "/tutorials/pwr-072/" }, "path_builder": { "selectable": true, "completion_allowed": true, "warning": "Titan teaches a concrete low-stakes method step by step while keeping evidence and transfer claims bounded." }, "full_tutorial": { "version": "3.0", "authorship": "POWER_SPECIFIC_FULL_TUTORIAL", "tutorial_mode": "SELF_GUIDED", "promise": "The brain can adapt movement to altered visual feedback, but the learning is structured and often task-specific. Visuomotor adaptation means learning a declared mapping between seen feedback and movement. The learner uses approved software with a mild fixed cursor rotation, records baseline endpoint error, practises accurate reaches, removes the rotation and observes the after-effect. It remains a seated computer task, not general hand–eye ability or clinical prism therapy.", "power_id": "PWR-072", "title": "Visuomotor integration", "lesson_type": "SELF_GUIDED", "headline": "Adapt pointing to a small cursor rotation, then measure the after-effect when normal feedback returns", "plain_english_summary": "The brain can adapt movement to altered visual feedback, but the learning is structured and often task-specific. Visuomotor adaptation means learning a declared mapping between seen feedback and movement. The learner uses approved software with a mild fixed cursor rotation, records baseline endpoint error, practises accurate reaches, removes the rotation and observes the after-effect. It remains a seated computer task, not general hand–eye ability or clinical prism therapy.", "outcome": "The learner completes baseline, mild-remapping and washout blocks with endpoint errors, misses, time and symptoms recorded.", "authority": { "learner_may": [ "While seated, run the offline 0° baseline, 10° clockwise display-rotation and restored-0° washout using one click per supplied target.", "Compute signed angular error and block medians from target/physical endpoint, keep misses visible and use the restore key before leaving the task.", "Use the familiar pointing device, large targets, ordinary correction and rests without changing sensitivity between phases." ], "qualified_person_required_for": [ "Assessing new coordination, weakness, tremor, neglect, vision or neurological symptoms and selecting rehabilitation for them.", "Using visuomotor performance for driving, machinery, surgery, weapon/tool control, occupational clearance or another safety-critical action.", "Changing clinical feedback rotation, assistive input devices, medication or rehabilitation progression." ], "never_do": [ "Use the rotated cursor to control a real application, increase beyond 10°, hide the restore control or continue with a mis-mapped desktop cursor.", "Change target radius, device sensitivity or hand between phases and still call the block an adaptation comparison.", "Continue when remapping provokes nausea, vertigo, severe headache, visual disturbance, pain or loss of safe device control." ] }, "materials": [ "A local offline cursor task configured exactly as follows: 600×600 px field; centre 300,300; eight 40 px targets on a 180 px radius at mathematical angles 0° right, 45° up-right, 90° up, 135° up-left, 180° left, 225° down-left, 270° down and 315° down-right. It hides the operating-system cursor inside the field, displays one artificial cursor rotated about the centre, accepts one click per target and logs target angle, physical endpoint, displayed endpoint and phase. Baseline uses 0° rotation; adaptation rotates displayed feedback 10° clockwise; washout restores 0°. The restore key must work before a scored trial begins.", "Folded target orders: baseline 0,180,90,270,45,225,135,315,180,0,270,90,225,45,315,135; adaptation 0,90,180,270,45,135,225,315,180,270,0,90,225,315,45,135,90,0,270,180,135,45,315,225; washout 45,225,0,180,315,135,90,270,225,45,180,0,135,315,270,90. A delayed retest uses the adaptation targets in reverse order, not the original file order.", "Large radial targets and a pointing device already comfortable for the learner.", "A fixed chair, desk and device sensitivity.", "Trial log for angular/endpoint error, misses, time and symptoms." ], "before_you_start": [ "Use only a mild software remapping while seated; no prism glasses, walking, tools or real-world aiming.", "Fix device sensitivity, target size, arm support and rotation angle.", "Practise an emergency exit key and restore-normal command.", "Do not use if altered visual feedback provokes vertigo, migraine or seizures." ], "steps": [ { "title": "Lock the movement setup", "instruction": "Record device, sensitivity, target size, start point, support and screen distance.", "reason": "Motor errors depend on both software and physical setup.", "success_check": "The configuration is reproducible." }, { "title": "Record normal-mapping baseline", "instruction": "With rotation at 0°, complete the 16 supplied baseline targets from the centre, one click per target, prioritising first endpoint over speed.", "reason": "Baseline separates ordinary pointing error from remapping error.", "success_check": "Endpoint error, misses and time are saved." }, { "title": "Apply the declared rotation", "instruction": "Set the artificial cursor to exactly 10° clockwise, verify the displayed test vector against the software readout and load the 24 supplied adaptation targets.", "reason": "The mapping must be known and stable.", "success_check": "The software reports the expected angle and restore command works." }, { "title": "Aim, observe, reset", "instruction": "For each target, aim once, observe the endpoint, return to centre and wait for the next target.", "reason": "One movement per target preserves error information.", "success_check": "No dragging, correction loop or extra click hides the initial error." }, { "title": "Correct gradually", "instruction": "Use endpoint feedback to adjust the next reach; do not consciously rotate the device or body setup.", "reason": "Trial-by-trial error reduction is the learning signal.", "success_check": "Median endpoint error falls across the provider-defined block." }, { "title": "Stop the remapping block", "instruction": "End at the fixed trial count or first nausea, dizziness, headache or loss of control.", "reason": "More trials are not better when symptoms or fatigue alter movement.", "success_check": "The stop reason and trial count are recorded." }, { "title": "Remove rotation and test after-effect", "instruction": "Press restore, confirm 0° and complete the 16 supplied washout targets with endpoint feedback withheld until each click; preserve any early error opposite the trained rotation.", "reason": "An after-effect helps distinguish adaptation from memorising target locations.", "success_check": "Normal mapping is confirmed and early washout error is preserved." }, { "title": "Wash out and retest later", "instruction": "Continue only until ordinary pointing returns, then use novel target order after a delay.", "reason": "The learner should leave with normal control; novel order tests retention.", "success_check": "End performance is near baseline and the delayed order is unfamiliar." } ], "worked_example": { "scenario": "Tess uses a mouse task with eight large radial targets and a fixed 10° cursor rotation.", "walkthrough": [ "Tess records mouse sensitivity, arm support and unrotated baseline errors.", "She activates the 10° mapping and verifies the escape/restore control.", "Across 24 random reaches she makes one initial movement per target and error falls.", "She restores normal mapping; the first reaches show a small opposite after-effect that washes out.", "Two days later she uses a novel target order at the same mild rotation." ], "result": "Tess shows adaptation and washout in this cursor system. The result does not establish sports, driving, tool or rehabilitation transfer." }, "right_vs_wrong": [ { "situation": "Context", "right": "Use a seated cursor task with a mild declared mapping.", "wrong": "Wear prisms or walk while vision is altered.", "why": "Real movement under remapping adds fall and collision risk." }, { "situation": "Baseline", "right": "Save normal-mapping endpoint error first.", "wrong": "Start rotated and call later improvement ability.", "why": "Without baseline, ordinary pointing error is unknown." }, { "situation": "Reach", "right": "Record the first endpoint.", "wrong": "Drag and correct until the cursor lands.", "why": "Online correction hides adaptation error." }, { "situation": "After-effect", "right": "Restore normal mapping and preserve early error.", "wrong": "Skip washout and leave the device altered.", "why": "After-effect is informative and normal control must be restored." }, { "situation": "Claim", "right": "Report the exact angle, device and target set.", "wrong": "Call it general hand–eye coordination.", "why": "Adaptation is structured and task-specific." } ], "common_mistakes": [ { "mistake": "Wear prisms or walk while vision is altered.", "fix": "Use a seated cursor task with a mild declared mapping." }, { "mistake": "Start rotated and call later improvement ability.", "fix": "Save normal-mapping endpoint error first." }, { "mistake": "Drag and correct until the cursor lands.", "fix": "Record the first endpoint." }, { "mistake": "Skip washout and leave the device altered.", "fix": "Restore normal mapping and preserve early error." }, { "mistake": "Call it general hand–eye coordination.", "fix": "Report the exact angle, device and target set." } ], "practice": { "first_session": [ "Verify the cursor tool's 600 px field, centre, target radius, 10° clockwise setting, endpoint log and restore key; lock device sensitivity and arm support.", "Run the exact 16-target 0° baseline order and save the first endpoint for every target.", "Run the exact 24-target 10° adaptation order without dragging or changing posture.", "Restore 0°, confirm the readout and run the exact 16-target washout order before viewing endpoint feedback.", "Check that ordinary pointing returns near the learner's own baseline, then schedule the reversed-order 10° retest after at least 48 hours." ], "repeat_plan": "Use one short session weekly at first. Progress by new target order or one small provider-approved angle change only after symptom-free washout and accurate baseline restoration.", "progress_when": [ "Endpoint error falls across the rotated block.", "A measured after-effect appears and washes out safely.", "Novel-order performance improves without added misses or symptoms." ], "do_not_progress_when": [ "Normal mapping does not restore ordinary control promptly.", "Symptoms, tremor, pain or fatigue rise.", "The learner wants to transfer altered feedback to walking or tools." ] }, "self_check": [ "Can you demonstrate “Record normal-mapping baseline”? Endpoint error, misses and time are saved.", "Can you demonstrate “Correct gradually”? Median endpoint error falls across the provider-defined block.", "Can you demonstrate “Wash out and retest later”? End performance is near baseline and the delayed order is unfamiliar." ], "measurement": { "primary": "Error, after-effect and delayed transfer under a declared remapping", "how": "For each click, calculate target angle and displayed-endpoint angle about the centre; signed angular error is the displayed angle minus target angle wrapped to −180° to +180°, and absolute error is its magnitude. Report median signed and absolute error for baseline, the first and last eight adaptation trials and the first and last eight washout trials, plus misses, support, time and symptoms.", "good_result": "Error falls in the rotated block, normal control returns during washout and delayed novel-order performance improves without symptoms.", "does_not_prove": "Separate online error reduction, after-effects, explicit strategy, retention, savings and untrained function; a lower endpoint error alone does not identify mechanism." }, "stop_and_get_help": [ "Stop and restore normal mapping for dizziness, nausea, aura, headache, disorientation or loss of motor control.", "Seek urgent care for sudden new coordination loss, weakness, speech change or severe headache.", "Use a rehabilitation professional for prism adaptation, neglect, gait or functional motor treatment." ], "accessibility": [ "Use trackball, switch, stylus or alternative pointing device as a declared configuration.", "Increase target size or arm support while keeping those values fixed within comparisons.", "Allow rest and slower target presentation; initial endpoint accuracy remains the measure." ], "evidence_notes": [ { "claim": "Primary research shows explicit access to structure in a defined visuomotor adaptation task, supporting mapping-specific measurement.", "source_title": "Structural Learning in a Visuomotor Adaptation Task Is Explicitly Accessible", "source_url": "https://pubmed.ncbi.nlm.nih.gov/28856241/", "source_kind": "PRIMARY_RESEARCH" }, { "claim": "Clinical prism-adaptation trials show that rehabilitation use is a separate supervised configuration with mixed outcomes.", "source_title": "Rehabilitation of visuospatial neglect by prism adaptation: effects of a mild treatment regime. A randomised controlled trial", "source_url": "https://pubmed.ncbi.nlm.nih.gov/27425388/", "source_kind": "PRIMARY_RESEARCH" } ], "limits": [ "Separate online error reduction, after-effects, explicit strategy, retention, savings and untrained function; a lower endpoint error alone does not identify mechanism.", "Unsupported claim: Instant hand-eye mastery.", "Unsupported claim: Prism goggles cure neglect.", "Unsupported claim: Train while driving or using machinery.", "A cursor-remapping after-effect does not establish general hand–eye skill or authorise prism, gait, driving or tool practice." ], "orientation": { "bounded_definition": "Capability to develop or express visuomotor integration in a declared context without inheriting broader claims.", "evidence_summary": "The brain can adapt movement to altered visual feedback, but the learning is structured and often task-specific.", "supportable_public_claim": "People adapt to altered visual–movement mappings and can reuse related task structure, but this is configured adaptation rather than a universal hand-eye upgrade.", "measurement_boundary": "Separate online error reduction, after-effects, explicit strategy, retention, savings and untrained function; a lower endpoint error alone does not identify mechanism.", "myth_to_metric": { "myth": "Perfect hand-eye coordination", "metric": "Error, after-effect and delayed transfer under a declared remapping", "boundary": "Adaptation to one rotation or prism does not confer expert coordination across tools and environments." }, "limiting_findings": [ "A small acute-neglect trial did not show a durable one-month treatment advantage.", "Some measured change reflects explicit re-aiming rather than implicit recalibration." ], "prohibited_claims": [ "Instant hand-eye mastery", "Prism goggles cure neglect", "Train while driving or using machinery", "One remapping transfers to every motor skill" ] }, "gold_source_lesson": null, "next_gate": "External confirmation is required before higher-authority use because: CLINICAL_HIGH_RISK_OR_REGULATED_CONFIGURATION; SUPERVISION_OR_NON_ATTEMPT_BOUNDARY; SAFETY_LEGITIMACY_RESTRICTED.", "evidence_count": 3 }, "full_training_programme": false, "independently_validated": false, "publication_state": "PUBLISHED_PUBLIC_RESEARCH_EDITION__EDITORIAL_REVIEW_PENDING", "related_power_ids": [ "PWR-065", "PWR-066", "PWR-067", "PWR-068" ] }, { "power_id": "PWR-073", "learning_unit_id": "TLU-PWR-073", "title": "Sound localisation", "main_description": "The learner completes two randomised stereo-clip sets and reports direction accuracy, confusion, confidence, replay and listening symptoms.", "main_description_source": "FULL_TUTORIAL_OUTCOME", "family_id": "FAM-10", "family": "Auditory Perception, Localization & Echolocation", "superdomain": "Perception & Sensorimotor", "canonical_route": "/powers/pwr-073/", "treatment": "EVIDENCE_REVIEW_ROUTE", "treatment_label": "Full low-stakes tutorial", "treatment_boundary": "Titan teaches a concrete low-stakes method step by step while keeping evidence and transfer claims bounded.", "tutorial_route": "/tutorials/pwr-073/", "governed_lesson_route": null, "self_attempt_status": "PERMITTED_INSIDE_FULL_TUTORIAL_LIMITS", "gold_pathway_ids": [ "G-CUR-007" ], "route_membership": { "kind": "GOLD_PATHWAY", "id": "G-CUR-007", "coverage_status": "EXACT_ONCE" }, "source_authority_tier": "G2", "source_build_state": "TARGETED_REVIEW_REQUIRED", "source_instructional_route": "BOUNDED_GUIDED_EXERCISE", "source_count": 5, "research_depth": "DETAILED", "risk_level": "LOW_TO_MODERATE; MOBILITY_OR_CLINICAL_CONFIGURATION_CAN_BE_HIGH", "prerequisite_status": "NONE_FOR_READING__NO_PRACTICE_AUTHORITY", "learning_route": { "mode": "FULL_SELF_GUIDED_TUTORIAL", "label": "Learn sound localisation step by step", "summary": "The learner completes two randomised stereo-clip sets and reports direction accuracy, confusion, confidence, replay and listening symptoms.", "steps": [ [ "Get ready", "Confirm left/right headphone orientation and equal channel function at low level." ], [ "Learn the method", "9 concrete steps teach the permitted method from start to finish." ], [ "See right and wrong", "6 comparisons show correct or safer execution beside common wrong or riskier choices." ], [ "Practise", "Use one short set once or twice weekly at the same comfortable level. Progress to new pan positions only after novel left/centre/right accuracy is stable." ], [ "Check progress", "Record correct direction, exact confusion, confidence, replay, device/headphones/level and symptoms. Add direction-specific denominators, a true-to-chosen confusion table and the result of the two unscored centred channel checks." ] ], "practical_authority": true, "provider_required": false, "next_action_route": "/tutorials/pwr-073/" }, "path_builder": { "selectable": true, "completion_allowed": true, "warning": "Titan teaches a concrete low-stakes method step by step while keeping evidence and transfer claims bounded." }, "full_tutorial": { "version": "3.0", "authorship": "POWER_SPECIFIC_FULL_TUTORIAL", "tutorial_mode": "SELF_GUIDED", "promise": "Spatial hearing can adapt, but it is a calibrated skill—not a universal sonar upgrade. The low-risk fixture uses headphone panning, not free-field sound localisation. The learner fixes device, headphones and level, faces forward, plays each clip once, answers left/centre/right before feedback and retests a novel random order. It must never be used for traffic, alarms or mobility. Channel-check and level-equalisation trials are kept separate from the scored panning set, and centre errors are analysed independently from left–right reversals.", "power_id": "PWR-073", "title": "Sound localisation", "lesson_type": "SELF_GUIDED", "headline": "Judge left, centre or right from fixed stereo clips without calling it real-world localisation", "plain_english_summary": "Spatial hearing can adapt, but it is a calibrated skill—not a universal sonar upgrade. The low-risk fixture uses headphone panning, not free-field sound localisation. The learner fixes device, headphones and level, faces forward, plays each clip once, answers left/centre/right before feedback and retests a novel random order. It must never be used for traffic, alarms or mobility. Channel-check and level-equalisation trials are kept separate from the scored panning set, and centre errors are analysed independently from left–right reversals.", "outcome": "The learner completes two randomised stereo-clip sets and reports direction accuracy, confusion, confidence, replay and listening symptoms.", "authority": { "learner_may": [ "With correctly oriented headphones, label each coded 500-Hz clip L, C or R once at the locked comfortable setting.", "Score six trials per panning position, retain exact confusions such as C→L and run concealed Set B after 48 hours.", "Keep usual hearing devices only if compatible with the declared headphone setup and use accessible L/C/R response cards." ], "qualified_person_required_for": [ "Assessing asymmetric/sudden hearing change, true free-field localisation, hearing-device fitting or persistent daily difficulty.", "Using sound direction for traffic, alarms, workplace safety, open water, navigation or another consequential setting.", "Changing hearing-aid/cochlear-implant programmes or clinical auditory rehabilitation." ], "never_do": [ "Reverse headphones between trials, inspect filenames, replay errors selectively or raise volume to force a side answer.", "Call headphone panning a room-angle measurement or use it to locate vehicles, people, alarms or obstacles.", "Continue through ear pain, sudden hearing change, louder tinnitus, severe vertigo, headache or distorted output." ] }, "materials": [ "An exact clip recipe for a helper using an audio editor: generate a 500 Hz sine tone lasting 500 ms with 20 ms fade-in and fade-out. Export three otherwise identical stereo files at 100% left L, equal left/right centre C and 100% right R. Duplicate them under neutral filenames to make folded Set A L,C,R,R,L,C,C,R,L,L,R,C,R,C,L,C,L,R and Set B R,L,C,C,R,L,L,C,R,R,C,L,C,L,R,L,R,C. Each set contains six of each direction; the learner never sees filenames or the folded key before answering.", "The same correctly oriented headphones and playback device.", "A locked comfortable level below the learner’s ordinary maximum.", "Trial sheet and answer key." ], "before_you_start": [ "Confirm left/right headphone orientation and equal channel function at low level.", "Use a quiet seated room; keep the head facing forward.", "Set one comfortable level and never raise it to solve an item.", "Do not use the task for navigation, alarms, hearing diagnosis or unilateral hearing change." ], "steps": [ { "title": "Lock the audio chain", "instruction": "Record device, app/file version, headphones, channel orientation and volume setting.", "reason": "Direction in this task is created by the exact stereo chain.", "success_check": "A repeat uses the same named chain." }, { "title": "Learn three anchors", "instruction": "Play one obvious left, centre and right example at the locked level.", "reason": "Anchor clips verify channels and response labels.", "success_check": "All three anchors are identified comfortably." }, { "title": "Face forward and stay still", "instruction": "Keep head centred during each clip and do not swap earcups.", "reason": "Head movement is useful in real life but changes this panning fixture.", "success_check": "Head and headphone orientation remain fixed." }, { "title": "Play once", "instruction": "Start one random clip and listen once unless the predeclared replay rule permits a second play.", "reason": "Variable replay gives some items more evidence.", "success_check": "Play count is recorded for every trial." }, { "title": "Commit direction and confidence", "instruction": "Answer left, centre or right and confidence before opening the key.", "reason": "A committed choice reveals confusions and calibration.", "success_check": "Answer precedes feedback." }, { "title": "Classify the confusion", "instruction": "Mark correct or the exact confusion pair, such as centre called left; lower level if discomfort appears rather than changing it mid-set.", "reason": "Error type is more useful than one overall score.", "success_check": "Every miss has a named pair and symptoms are recorded." }, { "title": "Retest a new order", "instruction": "After at least 48 hours, use unfamiliar clips or random order with the same panning values and level.", "reason": "Novel order limits sequence memorisation.", "success_check": "The retest contains no known order cue." }, { "title": "Check for a channel imbalance", "instruction": "Before the scored set, play the same centred anchor twice, once normally and once with the earcups reversed. If the perceived centre shifts with the hardware, stop and inspect the playback chain instead of training direction answers.", "reason": "A loose cable, balance control or unequal transducer can create a persistent side bias that is not spatial learning.", "success_check": "Both centred checks remain centred, or the audio chain is removed from use and the scored block does not begin." }, { "title": "Calculate direction-specific accuracy", "instruction": "After the block, count left, centre and right trials separately and list every true-to-chosen confusion. Do not average away a centre bias with easy side trials.", "reason": "A person can identify left and right while systematically assigning centre clips to one side.", "success_check": "Each true direction has its own denominator, and the most frequent confusion is named before the next set." } ], "worked_example": { "scenario": "Inez uses twelve synthetic stereo clips on one laptop with over-ear headphones at a locked comfortable setting.", "walkthrough": [ "She verifies earcup orientation and identifies obvious anchor clips.", "Facing forward, she plays each random clip once.", "She answers left, centre or right and confidence before checking.", "She records two centre-to-left confusions and no symptoms without raising volume.", "Two days later she uses a new order at the same level and audio chain.", "Inez finds that both centre anchors remain centred when the earcups are reversed, then calculates left, centre and right accuracy separately rather than using only ten correct out of twelve." ], "result": "Inez improves on stereo panning. This is not angular localisation in a room, echolocation or safe navigation. The separate centre analysis makes the result specific to headphone panning categories rather than a flattering overall percentage." }, "right_vs_wrong": [ { "situation": "Level", "right": "Use one comfortable locked level.", "wrong": "Raise volume on difficult clips.", "why": "Loudness changes audibility and exposure." }, { "situation": "Channels", "right": "Verify left/right orientation once.", "wrong": "Swap earcups or channels mid-set.", "why": "That reverses the answer mapping." }, { "situation": "Replay", "right": "Follow one declared replay rule.", "wrong": "Replay misses until certain.", "why": "Extra evidence inflates selected trials." }, { "situation": "Score", "right": "Record centre-left-right confusions and confidence.", "wrong": "Use one vague spatial-hearing score.", "why": "Different direction confusions reveal different errors." }, { "situation": "Transfer", "right": "Call it headphone panning.", "wrong": "Use it to navigate traffic or judge alarms.", "why": "Headphone panning is not free-field localisation." }, { "situation": "Persistent side bias", "right": "Check the centred anchor and device balance before changing the learner’s strategy.", "wrong": "Drill more left answers when every centre clip drifts left.", "why": "A hardware or hearing asymmetry must be separated from a learned response bias." } ], "common_mistakes": [ { "mistake": "Raise volume on difficult clips.", "fix": "Use one comfortable locked level." }, { "mistake": "Swap earcups or channels mid-set.", "fix": "Verify left/right orientation once." }, { "mistake": "Replay misses until certain.", "fix": "Follow one declared replay rule." }, { "mistake": "Use one vague spatial-hearing score.", "fix": "Record centre-left-right confusions and confidence." }, { "mistake": "Use it to navigate traffic or judge alarms.", "fix": "Call it headphone panning." }, { "mistake": "A centred clip is treated as half-right when the learner says “slightly left”.", "fix": "Use the three exact categories; mark centre-to-left as its own confusion and retain the confidence statement separately." } ], "practice": { "first_session": [ "A helper generates the 500 Hz L/C/R masters, prepares concealed Set A and Set B orders and confirms six trials per direction.", "Lock device, headphones, channel orientation and a comfortable level, then complete the unscored L/C/R anchors and two centred channel checks.", "Run all 18 Set A clips once each while facing forward, committing L/C/R and confidence before the folded key is opened.", "Build the true-to-chosen confusion table and calculate separate L, C and R accuracy without raising level.", "After at least 48 hours, run concealed Set B at the same audio chain and compare direction-specific errors." ], "repeat_plan": "Use one short set once or twice weekly at the same comfortable level. Progress to new pan positions only after novel left/centre/right accuracy is stable.", "progress_when": [ "Novel-order accuracy improves.", "Confidence better matches correctness.", "Listening remains comfortable with no level increase." ], "do_not_progress_when": [ "Headphones, channel balance or device changes.", "Tinnitus, pain, fullness or dizziness appears.", "The learner wants to use the score for mobility or clinical decisions." ] }, "self_check": [ "Can you demonstrate “Learn three anchors”? All three anchors are identified comfortably.", "Can you demonstrate “Play once”? Play count is recorded for every trial.", "Can you demonstrate “Retest a new order”? The retest contains no known order cue.", "Can you distinguish a left–right reversal, a centre-to-side bias and a hardware channel shift from the trial record?" ], "measurement": { "primary": "Left, centre and right accuracy and confusion for the supplied headphone-panning clips", "how": "Record correct direction, exact confusion, confidence, replay, device/headphones/level and symptoms. Add direction-specific denominators, a true-to-chosen confusion table and the result of the two unscored centred channel checks.", "good_result": "Two novel sets show higher accuracy or fewer systematic confusions at the same level without symptoms.", "does_not_prove": "Declare azimuth/elevation/distance, source spectrum, room, head movement, device state and error distribution; no single localisation score covers spatial hearing." }, "stop_and_get_help": [ "Stop for ear pain, tinnitus increase, fullness, dizziness, headache or distorted sound.", "Seek urgent assessment for sudden hearing loss, severe vertigo or neurological symptoms.", "Use an audiologist and orientation/mobility professional for real-world localisation or navigation needs." ], "accessibility": [ "Use larger response buttons, speech or switches; response speed is not scored.", "Allow monaural participation only as a separately labelled research observation, not the same localisation task.", "Use captions for instructions but not for the auditory answer." ], "evidence_notes": [ { "claim": "Primary research shows adaptive reweighting of localisation cues under a specific altered-hearing condition.", "source_title": "Adaptive reweighting of auditory localization cues in response to chronic unilateral earplugging in humans", "source_url": "https://pubmed.ncbi.nlm.nih.gov/20371808/", "source_kind": "PRIMARY_RESEARCH" }, { "claim": "WHO official guidance supports controlling both sound level and listening duration.", "source_title": "Deafness and hearing loss: Safe listening", "source_url": "https://www.who.int/news-room/questions-and-answers/item/deafness-and-hearing-loss-safe-listening", "source_kind": "OFFICIAL_GUIDANCE" } ], "limits": [ "Declare azimuth/elevation/distance, source spectrum, room, head movement, device state and error distribution; no single localisation score covers spatial hearing.", "Unsupported claim: Supernatural 3D hearing.", "Unsupported claim: Locate anything through walls.", "Unsupported claim: Earplug one ear to strengthen the other.", "Stereo-panning accuracy does not measure free-field angle, distance, echolocation or safe mobility." ], "orientation": { "bounded_definition": "Capability to develop or express sound localisation in a declared context without inheriting broader claims.", "evidence_summary": "Spatial hearing can adapt, but it is a calibrated skill—not a universal sonar upgrade.", "supportable_public_claim": "Sound localisation can adapt to a changed or asymmetric cue configuration, but improvement remains task-, anatomy-, hearing- and environment-specific.", "measurement_boundary": "Declare azimuth/elevation/distance, source spectrum, room, head movement, device state and error distribution; no single localisation score covers spatial hearing.", "myth_to_metric": { "myth": "Hear exactly where anything is", "metric": "Angular/distance error for unfamiliar sources and rooms", "boundary": "One trained array cannot establish accurate localisation across every spectrum, elevation and reverberant space." }, "limiting_findings": [ "Ten weeks of click-echolocation practice did not improve two ordinary sound-localisation measures.", "Some no-training change and cue specificity limit causal and transfer claims." ], "prohibited_claims": [ "Supernatural 3D hearing", "Locate anything through walls", "Earplug one ear to strengthen the other", "Echolocation automatically improves ordinary localisation" ] }, "gold_source_lesson": { "curriculum_id": "G-CUR-007", "source_heading": "Tool 3 - Relative sound localisation", "source_html_sha256": "625ea353966ef0540b2f51d0944ca5074aac5bd66b737502e52aa561a0150e2d", "html": "Use only the supplied stereo clips.
\nThis is a headphone panning fixture. It does not measure real-world free-field localisation or safe navigation.
" }, "next_gate": "External confirmation is required before higher-authority use because: CLINICAL_HIGH_RISK_OR_REGULATED_CONFIGURATION.", "evidence_count": 5 }, "full_training_programme": false, "independently_validated": false, "publication_state": "PUBLISHED_PUBLIC_RESEARCH_EDITION__EDITORIAL_REVIEW_PENDING", "related_power_ids": [ "PWR-074", "PWR-075", "PWR-076", "PWR-077" ] }, { "power_id": "PWR-074", "learning_unit_id": "TLU-PWR-074", "title": "Pitch discrimination", "main_description": "The learner completes two 18-pair higher/lower sets and reports correct responses by 20-, 10- and 5-Hz difference, upward/downward direction, base frequency, confidence and symptoms.", "main_description_source": "FULL_TUTORIAL_OUTCOME", "family_id": "FAM-10", "family": "Auditory Perception, Localization & Echolocation", "superdomain": "Perception & Sensorimotor", "canonical_route": "/powers/pwr-074/", "treatment": "EVIDENCE_REVIEW_ROUTE", "treatment_label": "Full low-stakes tutorial", "treatment_boundary": "Titan teaches a concrete low-stakes method step by step while keeping evidence and transfer claims bounded.", "tutorial_route": "/tutorials/pwr-074/", "governed_lesson_route": null, "self_attempt_status": "PERMITTED_INSIDE_FULL_TUTORIAL_LIMITS", "gold_pathway_ids": [ "G-CUR-007" ], "route_membership": { "kind": "GOLD_PATHWAY", "id": "G-CUR-007", "coverage_status": "EXACT_ONCE" }, "source_authority_tier": "G1", "source_build_state": "TARGETED_REVIEW_REQUIRED", "source_instructional_route": "SELF_GUIDED_TUTORIAL", "source_count": 4, "research_depth": "DETAILED", "risk_level": "LOW_TO_MODERATE; MOBILITY_OR_CLINICAL_CONFIGURATION_CAN_BE_HIGH", "prerequisite_status": "NONE_FOR_READING__NO_PRACTICE_AUTHORITY", "learning_route": { "mode": "FULL_SELF_GUIDED_TUTORIAL", "label": "Learn pitch discrimination step by step", "summary": "The learner completes two 18-pair higher/lower sets and reports correct responses by 20-, 10- and 5-Hz difference, upward/downward direction, base frequency, confidence and symptoms.", "steps": [ [ "Get ready", "Use only the supplied question ‘is the second tone higher or lower?’; a same/different task would require another fixture and score." ], [ "Learn the method", "9 concrete steps teach the permitted method from start to finish." ], [ "See right and wrong", "6 comparisons show correct or safer execution beside common wrong or riskier choices." ], [ "Practise", "Run Set A once, wait at least 48 hours, then run Set B once. A later helper-built pack may add one smaller difference only after two fresh base-frequency sets show a coherent neighbouring pattern; keep U/D balance, level and one-play rule unchanged." ], [ "Check progress", "For each set, report correct out of three upward and correct out of three downward at 20, 10 and 5 Hz; retain each base pair, answer, confidence, level and symptom entry. Compare Set A with new-base Set B without turning any one cell into an audiometric threshold." ] ], "practical_authority": true, "provider_required": false, "next_action_route": "/tutorials/pwr-074/" }, "path_builder": { "selectable": true, "completion_allowed": true, "warning": "Titan teaches a concrete low-stakes method step by step while keeping evidence and transfer claims bounded." }, "full_tutorial": { "version": "3.0", "authorship": "POWER_SPECIFIC_FULL_TUTORIAL", "tutorial_mode": "SELF_GUIDED", "promise": "Pitch discrimination asks whether a second tone is higher or lower than the first. In this exact task, the learner hears balanced 20-, 10- and 5-Hz upward and downward pairs, commits U or D before feedback, keeps direction errors separate and retests unfamiliar base frequencies. The result is a profile for this tone pack, not a hearing threshold or pitch-memory score. Matched upward/downward evidence prevents a habitual ‘higher’ response from looking like fine discrimination.", "power_id": "PWR-074", "title": "Pitch discrimination", "lesson_type": "SELF_GUIDED", "headline": "Judge whether a second comfortable tone moved up or down", "plain_english_summary": "Pitch discrimination asks whether a second tone is higher or lower than the first. In this exact task, the learner hears balanced 20-, 10- and 5-Hz upward and downward pairs, commits U or D before feedback, keeps direction errors separate and retests unfamiliar base frequencies. The result is a profile for this tone pack, not a hearing threshold or pitch-memory score. Matched upward/downward evidence prevents a habitual ‘higher’ response from looking like fine discrimination.", "outcome": "The learner completes two 18-pair higher/lower sets and reports correct responses by 20-, 10- and 5-Hz difference, upward/downward direction, base frequency, confidence and symptoms.", "authority": { "learner_may": [ "Practise the supplied higher/lower tone-pair pack at one comfortable locked playback setting.", "Score upward and downward answers separately at 20, 10 and 5 Hz, then compare the new-base Set B.", "Keep usual hearing devices and communication supports in place and record their settings with the U/D sheet." ], "qualified_person_required_for": [ "Clinical assessment, diagnosis or treatment related to pitch discrimination.", "Interpreting a home U/D pack as a hearing assessment or changing care because one frequency-difference cell changed.", "Changing a prescribed hearing-device programme or designing clinical pitch testing, especially when hearing changed suddenly." ], "never_do": [ "Treat correct U/D answers as an audiogram, auditory-processing diagnosis, absolute pitch or proof of speech/music improvement.", "Raise volume, add repeated plays or discard a downward error to make a small difference appear reliable.", "Continue tone pairs through ear pain, rising tinnitus, fullness, dizziness, distortion or marked listening fatigue." ] }, "materials": [ "An exact higher/lower pair recipe for a helper using a tone generator or audio editor: every sine tone lasts 500 ms with 20 ms fades and the two tones are separated by 250 ms. Concealed Set A pairs, in Hz with answer: 500/520 U, 620/610 D, 740/745 U, 800/780 D, 920/930 U, 1040/1035 D, 600/580 D, 720/730 U, 840/835 D, 900/920 U, 1020/1010 D, 540/545 U, 700/720 U, 820/810 D, 940/945 U, 1000/980 D, 520/530 U, 640/635 D. Set B: 550/530 D, 670/680 U, 790/785 D, 850/870 U, 970/960 D, 1090/1095 U, 650/670 U, 770/760 D, 890/895 U, 950/930 D, 1070/1080 U, 590/585 D, 750/730 D, 870/880 U, 990/985 D, 1050/1070 U, 570/560 D, 690/695 U. Each set has three U and three D examples at 20, 10 and 5 Hz differences.", "Same playback device and headphones/speakers.", "The folded U/D keys above and a trial sheet grouped by 20, 10 and 5 Hz differences; this supplied fixture uses only the question ‘is the second tone higher or lower?’", "Trial record for base tone, interval, answer, confidence and symptoms." ], "before_you_start": [ "Use only the supplied question ‘is the second tone higher or lower?’; a same/different task would require another fixture and score.", "Set and lock a comfortable level; never increase it for small differences.", "Use the same device/audio path and quiet seated setting.", "Hearing loss, tinnitus or sudden change belongs with an audiologist." ], "steps": [ { "title": "Choose one question", "instruction": "Write ‘is the second tone higher or lower?’ above the sheet and use only U or D for all 18 trials.", "reason": "Changing the question would make the supplied U/D key unusable.", "success_check": "Every scored row has exactly one U or D response." }, { "title": "Verify easy anchors", "instruction": "Before Set A, play one unscored 500/600-Hz upward pair and one 600/500-Hz downward pair at the locked level.", "reason": "The two anchors confirm U/D labels and playback without revealing a scored file.", "success_check": "The learner calls the anchors U then D without replay or discomfort." }, { "title": "Start with a large interval", "instruction": "Begin where difference is obvious rather than at the finest pair.", "reason": "Easy trials establish the task before threshold-like testing.", "success_check": "The first trials are correct without replay." }, { "title": "Conceal upward and downward order", "instruction": "Use Set A's printed order so U and D cannot be guessed from an alternating sequence; filenames and key remain hidden until all responses are committed.", "reason": "Balanced random order reduces response bias.", "success_check": "The completed block has nine U and nine D keyed rows." }, { "title": "Answer before feedback", "instruction": "Play each pair once under the fixed rule, answer and rate confidence, then check.", "reason": "Committed answers preserve discrimination data.", "success_check": "No key or repeated tone precedes the answer." }, { "title": "Step interval by rule", "instruction": "Run every supplied pair once in its concealed order, then group results by 20, 10 and 5 Hz after the block; do not skip a hard pair, repeat a miss or adapt volume.", "reason": "Fixed balanced evidence at all three differences is interpretable without a home staircase pretending to be an audiometric threshold.", "success_check": "All 18 pairs remain in the record and each difference has three upward and three downward trials." }, { "title": "Retest unfamiliar base tones", "instruction": "After delay, use new base frequencies with matched interval sizes.", "reason": "This tests relational discrimination beyond memorised tones.", "success_check": "Base tones are new and level is unchanged." }, { "title": "Pair upward and downward reversals", "instruction": "For each tested interval, include a matched upward pair and downward pair with the same base-frequency region at separate concealed positions. Score the interval as stable only when both directions are identified under the declared rule.", "reason": "A learner who always chooses higher can score well in an upward-heavy set without reliably hearing the relation.", "success_check": "Each interval has direction-balanced evidence, and a one-direction success is labelled asymmetric rather than passed." }, { "title": "Describe the neighbouring pattern", "instruction": "For each set, place the U and D counts for 20, 10 and 5 Hz side by side. Describe whether errors increase as differences shrink and flag a one-direction asymmetry; do not choose a pass cutoff or publish the smallest correct pair as a threshold.", "reason": "Neighbouring counts show gradual task difficulty without inventing a clinical rule from six trials per difference.", "success_check": "All six direction-by-difference counts remain visible and any claimed pattern can be checked from them." } ], "worked_example": { "scenario": "Malik answers whether the second tone is higher or lower in the 18 concealed Set A pairs.", "walkthrough": [ "He locks device and volume and verifies obvious upward and downward anchors.", "He starts with large intervals, then the file interleaves smaller upward/downward pairs.", "He answers once before feedback and records confidence.", "He groups results into six cells: U and D at 20, 10 and 5 Hz, without selecting a pass cutoff.", "At the delayed retest, new base tones test the same interval sizes.", "Malik is correct on the three upward 5-Hz pairs but misses two of the three matched downward 5-Hz pairs, so 5 Hz is labelled direction-asymmetric rather than his pitch threshold." ], "result": "Malik’s six-cell U/D pattern improves partly on new base tones. The 5-Hz direction asymmetry remains visible, so he does not call 5 Hz a threshold. Nothing here establishes hearing as a whole, absolute pitch or clinical change." }, "right_vs_wrong": [ { "situation": "Question", "right": "Use U or D for every supplied pair.", "wrong": "Switch some rows to same/different even though no same pairs exist.", "why": "The tasks have different answers and chance rates." }, { "situation": "Order", "right": "Balance and randomise directions.", "wrong": "Use a predictable up-down sequence.", "why": "Sequence guessing inflates accuracy." }, { "situation": "Level", "right": "Lock a comfortable level.", "wrong": "Make subtle tones louder.", "why": "Level changes audibility and safety." }, { "situation": "Threshold", "right": "Use repeated trials near each interval.", "wrong": "Call one correct tiny difference the threshold.", "why": "Lucky guesses occur." }, { "situation": "Memory", "right": "Use new base tones to test relation.", "wrong": "Call discrimination pitch memory.", "why": "Comparing two immediate tones differs from remembering one later." }, { "situation": "Interval evidence", "right": "Require matched upward and downward trials around the provisional level.", "wrong": "Accept a small interval after several upward trials and no downward reversal.", "why": "Direction imbalance can reward one response habit instead of pitch comparison." } ], "common_mistakes": [ { "mistake": "Switch some rows to same/different even though the supplied pack has no same pairs.", "fix": "Use only U or D; build and score a separate balanced fixture if same/different is later studied." }, { "mistake": "Use a predictable up-down sequence.", "fix": "Balance and randomise directions." }, { "mistake": "Make subtle tones louder.", "fix": "Lock a comfortable level." }, { "mistake": "Call one correct tiny difference the threshold.", "fix": "Use repeated trials near each interval." }, { "mistake": "Call discrimination pitch memory.", "fix": "Use new base tones to test relation." }, { "mistake": "The base tone rises across the whole file, allowing the learner to predict that the next answer is higher.", "fix": "Shuffle base-frequency regions and directions independently while keeping the declared interval sizes balanced." } ], "practice": { "first_session": [ "A helper generates the exact 18 Set A and 18 Set B tone pairs, hides neutral filenames and keeps the U/D keys folded.", "Write the higher/lower question, lock the audio chain and comfortable level, and complete one obvious U and D anchor.", "Run all 18 concealed Set A pairs once each with answer and confidence committed before feedback.", "Group the results by 20, 10 and 5 Hz and by U/D, keeping every miss and any response bias.", "After at least 48 hours, run Set B's new base frequencies at the same level and compare each balanced difference without publishing a threshold." ], "repeat_plan": "Run Set A once, wait at least 48 hours, then run Set B once. A later helper-built pack may add one smaller difference only after two fresh base-frequency sets show a coherent neighbouring pattern; keep U/D balance, level and one-play rule unchanged.", "progress_when": [ "Accuracy improves across repeated nearby intervals.", "Higher/lower response bias falls.", "Performance transfers to unfamiliar base tones at the same interval." ], "do_not_progress_when": [ "Volume or device changes.", "Ear symptoms or listening fatigue appears.", "The learner merges memory, naming or musical skill into the score." ] }, "self_check": [ "Can you demonstrate “Verify easy anchors”? The unscored 500/600 and 600/500 pairs are called U then D without replay.", "Can you demonstrate “Conceal upward and downward order”? The completed sheet contains nine keyed U rows and nine keyed D rows.", "Can you demonstrate “Retest unfamiliar base tones”? Base tones are new and level is unchanged.", "Can you show that the provisional interval works in both upward and downward directions at unfamiliar base frequencies?" ], "measurement": { "primary": "Higher/lower accuracy pattern across declared frequency difference, direction and base tone", "how": "For each set, report correct out of three upward and correct out of three downward at 20, 10 and 5 Hz; retain each base pair, answer, confidence, level and symptom entry. Compare Set A with new-base Set B without turning any one cell into an audiometric threshold.", "good_result": "Both 18-pair keys reproduce, U and D results remain separate at 20, 10 and 5 Hz, and any Set B change occurs without extra plays, volume increase or symptoms. The counts describe this tone pack and are not an audiometric pass threshold.", "does_not_prove": "Use a calibrated just-noticeable difference with declared carrier, harmonic structure, level and procedure; keep naming, memory and discrimination separate." }, "stop_and_get_help": [ "Stop for ear pain, tinnitus increase, fullness, dizziness or sound distortion.", "Seek urgent assessment for sudden hearing loss or severe vertigo.", "Use an audiologist when pitch difficulty is new, asymmetric or functionally important." ], "accessibility": [ "Use speech, symbols or switches for answers with no speed requirement.", "Extend inter-pair rest while preserving within-pair timing.", "Use hearing devices in their ordinary setting and record that configuration." ], "evidence_notes": [ { "claim": "Primary research supports pitch-discrimination learning with specificity to pitch and harmonic resolvability.", "source_title": "Pitch discrimination learning: specificity for pitch and harmonic resolvability, and electrophysiological correlates", "source_url": "https://pubmed.ncbi.nlm.nih.gov/21484466/", "source_kind": "PRIMARY_RESEARCH" }, { "claim": "WHO guidance supports fixed low exposure and avoidance of volume escalation.", "source_title": "Deafness and hearing loss: Safe listening", "source_url": "https://www.who.int/news-room/questions-and-answers/item/deafness-and-hearing-loss-safe-listening", "source_kind": "OFFICIAL_GUIDANCE" } ], "limits": [ "Use a calibrated just-noticeable difference with declared carrier, harmonic structure, level and procedure; keep naming, memory and discrimination separate.", "Unsupported claim: Hear every frequency perfectly.", "Unsupported claim: Develop perfect pitch by discrimination drills.", "Unsupported claim: Superior pitch means superior musician.", "Tone-pair discrimination does not establish absolute pitch, pitch memory, musical superiority or clinical hearing status." ], "orientation": { "bounded_definition": "Capability to develop or express pitch discrimination in a declared context without inheriting broader claims.", "evidence_summary": "Pitch thresholds can sharpen, usually for what was actually practised—not hearing as a whole.", "supportable_public_claim": "Pitch discrimination can improve with practice on a defined frequency or harmonic stimulus, while generalisation is limited.", "measurement_boundary": "Use a calibrated just-noticeable difference with declared carrier, harmonic structure, level and procedure; keep naming, memory and discrimination separate.", "myth_to_metric": { "myth": "Perfect ears", "metric": "Pitch/frequency difference threshold across trained and unfamiliar stimuli", "boundary": "A smaller just-noticeable difference does not confer note naming, memory, musicianship or general hearing acuity." }, "limiting_findings": [ "Frequency learning can be tightly centred on the trained frequency.", "Absolute-pitch naming practice did not improve fine pitch discrimination or relative-pitch judgement." ], "prohibited_claims": [ "Hear every frequency perfectly", "Develop perfect pitch by discrimination drills", "Superior pitch means superior musician", "Louder practice trains faster" ] }, "gold_source_lesson": { "curriculum_id": "G-CUR-007", "source_heading": "Tool 4 - Pitch discrimination", "source_html_sha256": "0be88b9827a3919961783ae228b60e7ae2b19911957f5c01a95974a06d62b679", "html": "Use a comfortable tone pair.
\nAsk one question only:
\nDo not mix pitch discrimination with pitch memory in the same score. A person can distinguish two tones well without being able to recall one hours later.
" }, "next_gate": "External confirmation is required before higher-authority use because: CLINICAL_HIGH_RISK_OR_REGULATED_CONFIGURATION.", "evidence_count": 4 }, "full_training_programme": false, "independently_validated": false, "publication_state": "PUBLISHED_PUBLIC_RESEARCH_EDITION__EDITORIAL_REVIEW_PENDING", "related_power_ids": [ "PWR-073", "PWR-075", "PWR-076", "PWR-077" ] }, { "power_id": "PWR-075", "learning_unit_id": "TLU-PWR-075", "title": "Speech-in-noise understanding", "main_description": "The learner completes two novel sentence sets and reports key-word accuracy, false words, replay, burden and configuration.", "main_description_source": "FULL_TUTORIAL_OUTCOME", "family_id": "FAM-10", "family": "Auditory Perception, Localization & Echolocation", "superdomain": "Perception & Sensorimotor", "canonical_route": "/powers/pwr-075/", "treatment": "EVIDENCE_REVIEW_ROUTE", "treatment_label": "Full low-stakes tutorial", "treatment_boundary": "Titan teaches a concrete low-stakes method step by step while keeping evidence and transfer claims bounded.", "tutorial_route": "/tutorials/pwr-075/", "governed_lesson_route": null, "self_attempt_status": "PERMITTED_INSIDE_FULL_TUTORIAL_LIMITS", "gold_pathway_ids": [ "G-CUR-007" ], "route_membership": { "kind": "GOLD_PATHWAY", "id": "G-CUR-007", "coverage_status": "EXACT_ONCE" }, "source_authority_tier": "G2", "source_build_state": "TARGETED_REVIEW_REQUIRED", "source_instructional_route": "BOUNDED_GUIDED_EXERCISE", "source_count": 4, "research_depth": "DETAILED", "risk_level": "LOW_TO_MODERATE; MOBILITY_OR_CLINICAL_CONFIGURATION_CAN_BE_HIGH", "prerequisite_status": "NONE_FOR_READING__NO_PRACTICE_AUTHORITY", "learning_route": { "mode": "FULL_SELF_GUIDED_TUTORIAL", "label": "Learn speech-in-noise understanding step by step", "summary": "The learner completes two novel sentence sets and reports key-word accuracy, false words, replay, burden and configuration.", "steps": [ [ "Get ready", "Choose a quiet room and one comfortable level; lock voice, noise and level." ], [ "Learn the method", "8 concrete steps teach the permitted method from start to finish." ], [ "See right and wrong", "6 comparisons show correct or safer execution beside common wrong or riskier choices." ], [ "Practise", "Use 5–10 novel sentences once or twice weekly with breaks. Progress by a single noise/SNR change only after key-word accuracy is stable and burden acceptable." ], [ "Check progress", "Record correct key words, substitutions, omissions, added words, replay, effort, fatigue, voice/noise/SNR and device configuration. Add the preserved heard word and substitution category for every incorrect key word." ] ], "practical_authority": true, "provider_required": false, "next_action_route": "/tutorials/pwr-075/" }, "path_builder": { "selectable": true, "completion_allowed": true, "warning": "Titan teaches a concrete low-stakes method step by step while keeping evidence and transfer claims bounded." }, "full_tutorial": { "version": "3.0", "authorship": "POWER_SPECIFIC_FULL_TUTORIAL", "tutorial_mode": "SELF_GUIDED", "promise": "Listening in noise can improve on selected tasks; an app score is not the same as easier real conversation. Speech-in-noise understanding is tested with a fixed synthetic sentence/noise mix at comfortable level. The learner transcribes before checking, scores key words rather than confidence, records replay and listening burden, and retests a new sentence. It is not a hearing treatment or a substitute for conversation outcomes. The scoring sheet distinguishes acoustic confusions from language reconstruction by marking the exact substituted consonant, vowel or content word and whether the sentence remained plausible.", "power_id": "PWR-075", "title": "Speech-in-noise understanding", "lesson_type": "SELF_GUIDED", "headline": "Write exactly what you heard, score key words, and keep replay and noise fixed", "plain_english_summary": "Listening in noise can improve on selected tasks; an app score is not the same as easier real conversation. Speech-in-noise understanding is tested with a fixed synthetic sentence/noise mix at comfortable level. The learner transcribes before checking, scores key words rather than confidence, records replay and listening burden, and retests a new sentence. It is not a hearing treatment or a substitute for conversation outcomes. The scoring sheet distinguishes acoustic confusions from language reconstruction by marking the exact substituted consonant, vowel or content word and whether the sentence remained plausible.", "outcome": "The learner completes two novel sentence sets and reports key-word accuracy, false words, replay, burden and configuration.", "authority": { "learner_may": [ "Transcribe each concealed Set A synthetic sentence once over the fixed −6 dB pink-noise mix before seeing its five keyed words.", "Score keyed words, preserve heard substitutions/omissions/additions, classify each error and run novel Set B at the unchanged mix.", "Use ordinary hearing devices, writing, typing or AAC and rest after five sentences without raising playback level." ], "qualified_person_required_for": [ "Assessing sudden/asymmetric hearing change or persistent speech-understanding difficulty and selecting clinical audiology or communication treatment.", "Interpreting performance for hearing-device programming, work/communication accommodation, alarms or other consequential listening.", "Changing hearing-aid/cochlear-implant settings or clinical auditory rehabilitation from this synthetic corpus." ], "never_do": [ "Inspect transcripts before listening, replay selected misses, change the voice/noise ratio or raise volume to rescue key words.", "Use a synthetic pink-noise score as proof of real-conversation, alarm, workplace or clinical hearing ability.", "Continue through ear pain, louder tinnitus, fullness, dizziness, distorted output or marked listening fatigue." ] }, "materials": [ "An exact 20-sentence corpus with five keyed words each. Set A: A1 ‘The red kite crossed the quiet lake’ [red,kite,crossed,quiet,lake]; A2 ‘Mina placed seven blue cups beside the window’ [Mina,seven,blue,cups,window]; A3 ‘A small dog waited under the wooden bridge’ [small,dog,waited,wooden,bridge]; A4 ‘The baker carried warm bread to the market’ [baker,carried,warm,bread,market]; A5 ‘Three green buses left before the heavy rain’ [three,green,buses,left,rain]; A6 ‘Jon found the silver key behind the sofa’ [Jon,silver,key,behind,sofa]; A7 ‘The nurse packed clean towels in the yellow bag’ [nurse,clean,towels,yellow,bag]; A8 ‘Two white boats passed the old lighthouse’ [two,white,boats,old,lighthouse]; A9 ‘Sara sent the final letter on Monday morning’ [Sara,final,letter,Monday,morning]; A10 ‘The tall tree shaded the stone garden path’ [tall,tree,shaded,stone,path]. Set B: B1 ‘The black cat watched three birds near the fence’ [black,cat,three,birds,fence]; B2 ‘Omar moved the round table into the kitchen’ [Omar,round,table,into,kitchen]; B3 ‘Four red trains crossed the narrow valley’ [four,red,trains,narrow,valley]; B4 ‘Lena stored the glass jar above the sink’ [Lena,glass,jar,above,sink]; B5 ‘The young farmer closed the gate before sunset’ [young,farmer,closed,gate,sunset]; B6 ‘Maya chose a purple scarf for the concert’ [Maya,purple,scarf,for,concert]; B7 ‘Six grey stones lined the river bank’ [six,grey,stones,river,bank]; B8 ‘The driver left the empty box near reception’ [driver,empty,box,near,reception]; B9 ‘Noah wrote the short answer with a pencil’ [Noah,short,answer,with,pencil]; B10 ‘The bright moon lit the snowy field’ [bright,moon,lit,snowy,field].", "A helper creates the clips in one audio editor using the same synthetic voice, speaking rate and mono pink-noise track. Normalise all voice clips to the same RMS level, mix the continuous pink noise 6 dB below that voice level, add 250 ms noise before and after each sentence, export under neutral A1–A10/B1–B10 codes and fold the transcript/key. If the editor cannot preserve the same voice/noise ratio, label the new mix a different configuration rather than comparing it.", "Same playback device and headphones/speakers at locked comfortable level.", "Transcript keys with premarked key words.", "Writing/AAC method and trial record." ], "before_you_start": [ "Choose a quiet room and one comfortable level; lock voice, noise and level.", "Use one replay rule for every sentence.", "Keep hearing aids or implants in the ordinary declared programme.", "Do not raise level through discomfort or use the task as a hearing-aid fitting check." ], "steps": [ { "title": "Lock voice, noise and level", "instruction": "Record speaker, noise type, signal-to-noise mix, device, output and hearing-device setting.", "reason": "Each element changes intelligibility.", "success_check": "The audio configuration is complete." }, { "title": "Learn the scoring rule", "instruction": "Mark only exact key words as correct; keep substitutions and omissions visible.", "reason": "A fixed word rule is more reliable than “understood the gist”.", "success_check": "A clear practice sentence is scored correctly." }, { "title": "Listen under one replay rule", "instruction": "Play each sentence at the fixed level once, or twice only if that rule applies to all trials.", "reason": "Selective replay gives difficult items extra evidence.", "success_check": "Play count is recorded." }, { "title": "Write before checking", "instruction": "Transcribe exactly what was heard, including uncertain words, before seeing options or the key.", "reason": "Free report reveals real substitutions rather than recognition from choices.", "success_check": "A full response is locked before feedback." }, { "title": "Score words and errors", "instruction": "Count correct key words, substitutions, omissions and added words separately.", "reason": "Different errors can yield the same percent correct.", "success_check": "Raw word-level errors remain available." }, { "title": "Record burden", "instruction": "Rate listening effort, fatigue and discomfort after each short block.", "reason": "Accuracy gained through unsustainable effort may not help conversation.", "success_check": "Burden is separate from word score." }, { "title": "Retest a new mix", "instruction": "After delay, use unfamiliar sentences and, only after stable baseline, change one noise feature.", "reason": "New language prevents sentence memorisation; one change tests transfer.", "success_check": "No sentence repeats and the changed feature is declared." }, { "title": "Classify each word substitution", "instruction": "For every wrong key word, write the heard word beside the target and mark sound-neighbour, omitted, inserted or meaning-based guess. Do this before replaying any isolated word.", "reason": "Two people with the same key-word score may have different problems: one misses speech sounds while another fills gaps with a plausible sentence.", "success_check": "Every wrong key word has one preserved heard form and one error category, or is explicitly marked unintelligible." } ], "worked_example": { "scenario": "Dara uses Set A's ten synthetic sentences mixed with the specified continuous mono pink noise at one locked level.", "walkthrough": [ "Dara records the synthetic voice, pink-noise track at 6 dB below the voice RMS, headphones and hearing-aid programme.", "They listen once and type exactly what they heard before checking.", "The key scores five words per sentence; substitutions and omissions remain visible.", "After five sentences Dara records effort and rests, without raising level.", "A week later new sentences use the same mix before any different-noise transfer set.", "On A1 Dara writes “coat” for keyed word “kite” and marks the preserved heard form as a sound-neighbour candidate; an invented but plausible location word is marked a meaning-based guess." ], "result": "Dara improves key-word accuracy on novel sentences at the same mix with stable effort. This does not prove easier real conversation or clinical hearing improvement. The error profile identifies what changed in the listening task instead of treating all wrong sentences as equivalent." }, "right_vs_wrong": [ { "situation": "Level", "right": "Keep the comfortable level fixed.", "wrong": "Raise volume on difficult sentences.", "why": "That changes audibility and exposure." }, { "situation": "Response", "right": "Write free recall before the key.", "wrong": "Choose from options after seeing likely words.", "why": "Options provide language cues not present in listening." }, { "situation": "Replay", "right": "Apply the same replay rule to all items.", "wrong": "Replay only misses.", "why": "Selective replay biases comparison." }, { "situation": "Score", "right": "Count key words and error types.", "wrong": "Score confidence or gist as accuracy.", "why": "Confidence and gist can hide wrong words." }, { "situation": "Transfer", "right": "Use new sentences and measure conversation separately.", "wrong": "Call app improvement hearing treatment.", "why": "Task gains may not transfer to daily participation." }, { "situation": "Wrong key word", "right": "Preserve the exact heard word and classify the substitution.", "wrong": "Replace every error with a blank or mark only sentence wrong.", "why": "The heard form shows whether noise obscured a sound or the listener reconstructed meaning." } ], "common_mistakes": [ { "mistake": "Raise volume on difficult sentences.", "fix": "Keep the comfortable level fixed." }, { "mistake": "Choose from options after seeing likely words.", "fix": "Write free recall before the key." }, { "mistake": "Replay only misses.", "fix": "Apply the same replay rule to all items." }, { "mistake": "Score confidence or gist as accuracy.", "fix": "Count key words and error types." }, { "mistake": "Call app improvement hearing treatment.", "fix": "Use new sentences and measure conversation separately." }, { "mistake": "The transcript is corrected for grammar before scoring, hiding what the learner actually perceived.", "fix": "Freeze the verbatim first transcript, score it, and place any grammatical interpretation in a separate note." } ], "practice": { "first_session": [ "A helper creates and conceals the A and B mixes from the exact corpus, same synthetic voice and pink-noise rule, then folds the five-word keys.", "Lock the audio chain, hearing-device setting, comfortable level and one-play rule; practise scoring one clear unscored sentence.", "Run A1–A5, freeze each verbatim transcript before feedback and count the five keyed words.", "Rest and record burden, then run A6–A10 under the same rule.", "Classify every wrong keyed word before reviewing total accuracy, and after at least 48 hours run novel B1–B10 at the unchanged mix." ], "repeat_plan": "Use 5–10 novel sentences once or twice weekly with breaks. Progress by a single noise/SNR change only after key-word accuracy is stable and burden acceptable.", "progress_when": [ "Novel-sentence key-word accuracy improves.", "Substitutions/omissions decline without more replay.", "Listening effort stays stable or falls." ], "do_not_progress_when": [ "Volume or hearing-device programme changes.", "Tinnitus, pain, fatigue or distress rises.", "The score replaces clinical or real-conversation evaluation." ] }, "self_check": [ "Can you demonstrate “Learn the scoring rule”? A clear practice sentence is scored correctly.", "Can you demonstrate “Write before checking”? A full response is locked before feedback.", "Can you demonstrate “Retest a new mix”? No sentence repeats and the changed feature is declared.", "Can you show one acoustic substitution and one meaning-based guess in the transcript without changing the learner’s original wording?" ], "measurement": { "primary": "Exact keyed-word accuracy and preserved substitution types on the supplied sentence-in-pink-noise corpus", "how": "Record correct key words, substitutions, omissions, added words, replay, effort, fatigue, voice/noise/SNR and device configuration. Add the preserved heard word and substitution category for every incorrect key word.", "good_result": "Novel-sentence accuracy improves without increased level, replay or burden and a separate real-conversation goal is not worse.", "does_not_prove": "Declare speech corpus, language, masker, spatial layout, SNR, device state and fatigue; separate trained-material accuracy from new-speaker and real-conversation outcomes." }, "stop_and_get_help": [ "End the sentence block if the speech/noise mix distorts or provokes ear pain, new fullness, louder tinnitus, dizziness or headache.", "Seek urgent care for sudden hearing loss or severe vertigo.", "See an audiologist when speech understanding changes, differs by ear or causes meaningful participation difficulty." ], "accessibility": [ "Use typing, handwriting, speech-to-text correction, AAC or partner transcription while preserving the learner’s words.", "Provide visual instructions and non-auditory break cues.", "Keep usual hearing technology and communication strategies as declared supports." ], "evidence_notes": [ { "claim": "A randomised trial found benefits from a defined phoneme-discrimination programme in older adults with mild hearing loss.", "source_title": "Benefits of phoneme discrimination training in a randomized controlled trial of 50- to 74-year-olds with mild hearing loss", "source_url": "https://pubmed.ncbi.nlm.nih.gov/24752284/", "source_kind": "PRIMARY_RESEARCH" }, { "claim": "WHO guidance supports controlling sound level and cumulative duration during headphone tasks.", "source_title": "Deafness and hearing loss: Safe listening", "source_url": "https://www.who.int/news-room/questions-and-answers/item/deafness-and-hearing-loss-safe-listening", "source_kind": "OFFICIAL_GUIDANCE" } ], "limits": [ "Declare speech corpus, language, masker, spatial layout, SNR, device state and fatigue; separate trained-material accuracy from new-speaker and real-conversation outcomes.", "Unsupported claim: Hear any conversation anywhere.", "Unsupported claim: Train away hearing loss.", "Unsupported claim: Stop using hearing aids or captions.", "Synthetic sentence gains do not diagnose hearing, fit a device or guarantee easier conversation in new speakers and rooms." ], "orientation": { "bounded_definition": "Capability to develop or express speech-in-noise understanding in a declared context without inheriting broader claims.", "evidence_summary": "Listening in noise can improve on selected tasks; an app score is not the same as easier real conversation.", "supportable_public_claim": "Speech-in-noise training can improve selected materials or configured tasks, but broad everyday listening transfer is inconsistent.", "measurement_boundary": "Declare speech corpus, language, masker, spatial layout, SNR, device state and fatigue; separate trained-material accuracy from new-speaker and real-conversation outcomes.", "myth_to_metric": { "myth": "Hear every word in a crowd", "metric": "Untrained speech reception threshold plus real-conversation participation", "boundary": "Trained-item accuracy does not establish effortless listening, cure hearing loss or replace preferred communication access." }, "limiting_findings": [ "A large at-home trial found durable trained-word learning without broad nontrained or self-report transfer.", "A phoneme-training trial did not produce consistent general speech-in-noise benefit." ], "prohibited_claims": [ "Hear any conversation anywhere", "Train away hearing loss", "Stop using hearing aids or captions", "One app fixes auditory processing" ] }, "gold_source_lesson": { "curriculum_id": "G-CUR-007", "source_heading": "Tool 5 - Speech in noise", "source_html_sha256": "398acacaf6e879f890e43d69c3d2b4b8dbfe6fbba714fae164b9f31eafa070dd", "html": "The private fixture contains one synthetic spoken sentence mixed with low-level noise.
\nComputer-based auditory training can improve some speech-in-noise outcomes, but the evidence is heterogeneous and low-certainty in systematic review. Titan does not turn one training score into a hearing-treatment claim.
" }, "next_gate": "External confirmation is required before higher-authority use because: CLINICAL_HIGH_RISK_OR_REGULATED_CONFIGURATION; SUPERVISION_OR_NON_ATTEMPT_BOUNDARY.", "evidence_count": 4 }, "full_training_programme": false, "independently_validated": false, "publication_state": "PUBLISHED_PUBLIC_RESEARCH_EDITION__EDITORIAL_REVIEW_PENDING", "related_power_ids": [ "PWR-073", "PWR-074", "PWR-076", "PWR-077" ] }, { "power_id": "PWR-076", "learning_unit_id": "TLU-PWR-076", "title": "Auditory scene analysis", "main_description": "On coded eight-second mixtures A and B, the learner inventories the three generated sources, marks each supplied onset or offset to the nearest one-second grid line, names the pitch, timing or timbre cue used, and tests one written unmasking prediction against the companion file.", "main_description_source": "FULL_TUTORIAL_OUTCOME", "family_id": "FAM-10", "family": "Auditory Perception, Localization & Echolocation", "superdomain": "Perception & Sensorimotor", "canonical_route": "/powers/pwr-076/", "treatment": "EVIDENCE_REVIEW_ROUTE", "treatment_label": "Full low-stakes tutorial", "treatment_boundary": "Titan teaches a concrete low-stakes method step by step while keeping evidence and transfer claims bounded.", "tutorial_route": "/tutorials/pwr-076/", "governed_lesson_route": null, "self_attempt_status": "PERMITTED_INSIDE_FULL_TUTORIAL_LIMITS", "gold_pathway_ids": [ "G-CUR-007" ], "route_membership": { "kind": "GOLD_PATHWAY", "id": "G-CUR-007", "coverage_status": "EXACT_ONCE" }, "source_authority_tier": "G1", "source_build_state": "TARGETED_REVIEW_REQUIRED", "source_instructional_route": "SELF_GUIDED_TUTORIAL", "source_count": 3, "research_depth": "FOCUSED", "risk_level": "LOW_TO_MODERATE; MOBILITY_OR_CLINICAL_CONFIGURATION_CAN_BE_HIGH", "prerequisite_status": "NONE_FOR_READING__NO_PRACTICE_AUTHORITY", "learning_route": { "mode": "FULL_SELF_GUIDED_TUTORIAL", "label": "Learn auditory scene analysis step by step", "summary": "On coded eight-second mixtures A and B, the learner inventories the three generated sources, marks each supplied onset or offset to the nearest one-second grid line, names the pitch, timing or timbre cue used, and tests one written unmasking prediction against the companion file.", "steps": [ [ "Get ready", "Use synthetic or consented learner-owned audio only." ], [ "Learn the method", "8 concrete steps teach the permitted method from start to finish." ], [ "See right and wrong", "6 comparisons show correct or safer execution beside common wrong or riskier choices." ], [ "Practise", "After 48 hours, analyse Scene B with the identical inventory/replay limits and predict what B-probe will do to the 3-second burst. On later weeks, a helper may move one burst time or one steady-track onset while preserving three tracks and eight seconds; change only that overlap feature, never playback level." ], [ "Check progress", "Record correct, missed and false sources, onset/offset error, named cue, replay, burden and exact scene/audio configuration. Record whether the one-stem continuity probe confirmed the predicted masking or grouping relation." ] ], "practical_authority": true, "provider_required": false, "next_action_route": "/tutorials/pwr-076/" }, "path_builder": { "selectable": true, "completion_allowed": true, "warning": "Titan teaches a concrete low-stakes method step by step while keeping evidence and transfer claims bounded." }, "full_tutorial": { "version": "3.0", "authorship": "POWER_SPECIFIC_FULL_TUTORIAL", "tutorial_mode": "SELF_GUIDED", "promise": "The brain can learn a specific sound pattern without becoming a universal noise filter. Auditory scene analysis means organising mixed sound into streams. The learner hears a synthetic scene, lists sources and when they change, names the cue—pitch, timing, spatial position or timbre—then checks isolated stems. The task never uses covert recordings or surveillance. A stream-continuity probe temporarily removes one source segment; the learner predicts whether the remaining sound will split, merge or reveal a previously masked event.", "power_id": "PWR-076", "title": "Auditory scene analysis", "lesson_type": "SELF_GUIDED", "headline": "Separate a sound scene into sources, time courses and distinguishing cues", "plain_english_summary": "The brain can learn a specific sound pattern without becoming a universal noise filter. Auditory scene analysis means organising mixed sound into streams. The learner hears a synthetic scene, lists sources and when they change, names the cue—pitch, timing, spatial position or timbre—then checks isolated stems. The task never uses covert recordings or surveillance. A stream-continuity probe temporarily removes one source segment; the learner predicts whether the remaining sound will split, merge or reveal a previously masked event.", "outcome": "On coded eight-second mixtures A and B, the learner inventories the three generated sources, marks each supplied onset or offset to the nearest one-second grid line, names the pitch, timing or timbre cue used, and tests one written unmasking prediction against the companion file.", "authority": { "learner_may": [ "Inventory sources in coded Scene A on one listen, mark their time boxes on one replay and name pitch, timing or timbre evidence before stems are revealed.", "Score source misses, false sources and one-second timing errors, then write and test one A/B probe unmasking prediction.", "Use synthetic or consented learner-owned audio, usual hearing support and an accessible timeline response at fixed comfortable level." ], "qualified_person_required_for": [ "Assessing a new/persistent hearing or auditory-processing complaint and selecting clinical testing or hearing-device treatment.", "Using scene separation for alarms, surveillance, traffic, work monitoring, mobility or another safety/privacy-sensitive activity.", "Changing hearing-device programmes or clinical listening therapy because a synthetic mixture changed." ], "never_do": [ "Covertly record people/private places, study isolated stems before the inventory or loop the mix until every burst is memorised.", "Raise level or claim one confirmed probe creates a universal noise filter, alarm skill or professional monitoring ability.", "Continue through ear pain, louder tinnitus, vertigo, headache, distorted sound or marked listening burden." ] }, "materials": [ "A helper-built mono Scene A, eight seconds long: pink noise runs from 0.0–8.0 seconds at −18 dBFS; a 120-Hz sine runs from 0.0–8.0 at −24 dBFS; and an 880-Hz sine makes 100-ms bursts beginning at 2.0, 5.0 and 7.0 seconds at −12 dBFS. Give every generated track a 10-ms fade at its outer edges, mix the tracks, label the learner file only A and keep the three isolated tracks hidden until scoring.", "A helper-built mono Scene B, eight seconds long: a 180-Hz sine runs from 0.0–8.0 seconds at −24 dBFS; 600-Hz, 150-ms bursts begin at 1.0, 3.0 and 6.0 seconds at −15 dBFS; and a 1,200-Hz sine starts at 4.0 seconds and ends at 8.0 seconds at −21 dBFS. Use 10-ms outer fades, mix, code the learner file B and retain isolated tracks as the key.", "Two companion files made without changing the mix level: A-probe mutes only the 120-Hz track from 4.0–6.0 seconds; B-probe mutes only the 180-Hz track from 2.0–4.0 seconds. The learner receives a probe only after committing the original analysis.", "The same headphones or speakers at a comfortable locked setting, plus a sheet with an eight-box one-second timeline and columns for source description, start, stop/change, cue, confidence, miss and false source." ], "before_you_start": [ "Use synthetic or consented learner-owned audio only.", "Lock level, device and hearing-device setting.", "Set one replay rule and a maximum short block.", "Do not use the method for covert listening, professional monitoring or safety alarms." ], "steps": [ { "title": "Learn the cue vocabulary", "instruction": "Review pitch, timing, spatial position and timbre—the sound quality that distinguishes sources.", "reason": "Cue labels make stream separation explicit.", "success_check": "The learner can match each cue to an example." }, { "title": "Lock the scene setup", "instruction": "Record coded file A or B, device, headphones/speakers, level and the fixed rule of one inventory listen plus one timeline replay.", "reason": "Scene composition and playback define the task.", "success_check": "The exact scene version is named." }, { "title": "First pass: list sources", "instruction": "Listen once to coded mixture A or B and list each perceived source without checking the stems or timeline key.", "reason": "A first pass captures spontaneous segregation.", "success_check": "Sources and uncertain guesses are both recorded." }, { "title": "Second pass: map time", "instruction": "Replay exactly once and shade the one-second boxes in which each source starts, stops or produces a burst; use a question mark when the boundary is uncertain.", "reason": "Time course helps separate overlapping streams.", "success_check": "Each listed source has a timeline mark." }, { "title": "Name the separating cue", "instruction": "For each source, state whether pitch, timing, position or timbre made it distinct.", "reason": "A source label without the cue does not teach the method.", "success_check": "Every confident source has at least one cue." }, { "title": "Check against stems", "instruction": "After committing the scene analysis, uncover the source recipe and play the three isolated tracks. Mark a missing real track as a miss, an invented track as a false source and a boundary more than one grid box away as a timing error.", "reason": "Stems provide specific feedback without erasing the mixture response.", "success_check": "Original scene answers remain visible." }, { "title": "Retest a novel arrangement", "instruction": "At least 48 hours later, analyse the other coded scene using the same two-listen rule before viewing its recipe.", "reason": "A novel scene tests the analysis method rather than memorised content.", "success_check": "The retest arrangement is unfamiliar." }, { "title": "Use a continuity probe", "instruction": "After scoring the original mixture, write which burst or onset should be easier to hear when the named low-frequency track is removed during the marked interval. Then play A-probe or B-probe once and record whether the predicted event became clearer, unchanged or less clear.", "reason": "Removing one source tests the proposed grouping cue and reveals masking that an isolated-stem review cannot show.", "success_check": "The prediction names the affected source and interval, and the companion result is recorded without changing the original scene score." } ], "worked_example": { "scenario": "Mika receives coded Scene A without its recipe and uses the eight-box timeline.", "walkthrough": [ "Mika writes device and level, hears A once and lists a hiss, a low hum and two high beeps; the last item is marked uncertain.", "On the one permitted replay, Mika shades the hiss and hum across boxes 0–8 and puts beep marks at 2, 5 and 7 seconds.", "Mika labels timbre as the hiss-versus-hum cue and timing plus higher pitch as the beep cue.", "The hidden recipe confirms all three tracks and all three burst times. Because the inventory said only two beeps but the timeline has three, Mika records one inconsistent count rather than erasing either answer.", "Before hearing A-probe, Mika predicts that removing the 120-Hz hum from 4–6 seconds will make the 5-second burst clearer.", "The probe makes that burst clearer, so the prediction is confirmed for this file; Mika does not infer that all background noise can be filtered." ], "result": "Mika improves source and timing identification in synthetic scenes. This does not create a universal noise filter or professional monitoring skill. The probe connects a missed bell to masking by the steady fan rather than to a general listening deficit." }, "right_vs_wrong": [ { "situation": "Audio source", "right": "Use synthetic or consented audio.", "wrong": "Record people or environments covertly.", "why": "Privacy and legality control the material." }, { "situation": "First pass", "right": "Commit a source inventory before stems.", "wrong": "Study isolated stems first.", "why": "Pre-exposure turns the task into recognition memory." }, { "situation": "Cue", "right": "Name pitch, timing, position or timbre evidence.", "wrong": "Say only “I heard it”.", "why": "Cue naming makes segregation teachable." }, { "situation": "Replay", "right": "Use the same limited replay rule.", "wrong": "Loop the scene until all stems are memorised.", "why": "Unlimited replay changes burden and evidence." }, { "situation": "Score", "right": "Count missed and false sources plus timing errors.", "wrong": "Use a vague listening score.", "why": "Specific errors show what changed." }, { "situation": "Testing stream interaction", "right": "Mute one declared synthetic stem interval and predict the change.", "wrong": "Turn every stem on and off repeatedly until the answer is obvious.", "why": "One controlled probe tests masking; repeated dismantling becomes stem memorisation." } ], "common_mistakes": [ { "mistake": "Record people or environments covertly.", "fix": "Use synthetic or consented audio." }, { "mistake": "Study isolated stems first.", "fix": "Commit a source inventory before stems." }, { "mistake": "Say only “I heard it”.", "fix": "Name pitch, timing, position or timbre evidence." }, { "mistake": "Loop the scene until all stems are memorised.", "fix": "Use the same limited replay rule." }, { "mistake": "Use a vague listening score.", "fix": "Count missed and false sources plus timing errors." }, { "mistake": "The learner uses spatial position as the cue even though the scene is presented in mono.", "fix": "Check the file/channel metadata and restrict cue labels to pitch, timing or timbre when spatial information is absent." } ], "practice": { "first_session": [ "A helper generates Scene A and its three stems from the stated recipe, codes the mixture A and keeps the recipe, stems and A-probe out of view.", "The learner draws eight one-second boxes, records the playback chain and completes the first-listen inventory without pausing.", "On exactly one replay, the learner draws each steady span and each short-event mark, then assigns pitch, timing or timbre to every confident row.", "The helper reveals the A recipe and stems; the learner separately totals source hits out of three, misses, false sources and burst marks within one second of 2, 5 and 7.", "The learner writes the 5-second-burst prediction, hears A-probe once and records clearer, unchanged or less clear.", "Scene B stays sealed for a transfer session at least 48 hours later." ], "repeat_plan": "After 48 hours, analyse Scene B with the identical inventory/replay limits and predict what B-probe will do to the 3-second burst. On later weeks, a helper may move one burst time or one steady-track onset while preserving three tracks and eight seconds; change only that overlap feature, never playback level.", "progress_when": [ "Target-source accuracy rises on novel scenes.", "False sources and timing errors decline.", "Listening burden remains acceptable at the same level." ], "do_not_progress_when": [ "Only covert or non-consented audio is available.", "Listening fatigue or ear symptoms rise.", "The learner changes level or unlimited replay to maintain score." ] }, "self_check": [ "Can you demonstrate “Lock the scene setup”? The exact scene version is named.", "Can you demonstrate “Second pass: map time”? Each listed source has a timeline mark.", "Can you demonstrate “Retest a novel arrangement”? The retest arrangement is unfamiliar.", "Can you predict which source and time interval will change when one synthetic stem is briefly muted?" ], "measurement": { "primary": "Target-source accuracy in novel multi-source scenes with fatigue", "how": "Record correct, missed and false sources, onset/offset error, named cue, replay, burden and exact scene/audio configuration. Record whether the one-stem continuity probe confirmed the predicted masking or grouping relation.", "good_result": "On Scene B or a newly timed three-track file, source hits or one-second boundary marks improve without extra listens, more false sources or greater burden.", "does_not_prove": "Predeclare number/type of sources, cue dimensions, target, masker, accuracy and new-scene transfer; neural responses remain mechanism measures." }, "stop_and_get_help": [ "Stop for ear pain, tinnitus increase, dizziness, headache or marked fatigue.", "A new one-sided hearing drop, spinning sensation with inability to stand or other abrupt ear/neurological change is not a scene-analysis problem; stop and seek urgent assessment.", "Stop and review consent/privacy if real people or private recordings enter the task." ], "accessibility": [ "Use visual timeline markers, tactile tokens or a scribe for source/time responses.", "Reduce source count as a declared level while keeping level comfortable.", "Preserve usual hearing devices and caption only the instructions, not the scene content." ], "evidence_notes": [ { "claim": "Primary research shows perceptual learning can alter responses during a defined vowel-segregation task.", "source_title": "Perceptual learning modulates sensory evoked response during vowel segregation", "source_url": "https://pubmed.ncbi.nlm.nih.gov/14561463/", "source_kind": "PRIMARY_RESEARCH" }, { "claim": "WHO guidance supports fixed comfortable level and limited duration.", "source_title": "Deafness and hearing loss: Safe listening", "source_url": "https://www.who.int/news-room/questions-and-answers/item/deafness-and-hearing-loss-safe-listening", "source_kind": "OFFICIAL_GUIDANCE" } ], "limits": [ "Predeclare number/type of sources, cue dimensions, target, masker, accuracy and new-scene transfer; neural responses remain mechanism measures.", "Unsupported claim: Isolate any sound at will.", "Unsupported claim: Switch off background noise with the brain.", "Unsupported claim: Train universal auditory scene analysis.", "Synthetic scene analysis does not authorise surveillance or prove universal filtering, alarm detection or real-conversation performance." ], "orientation": { "bounded_definition": "Capability to develop or express auditory scene analysis in a declared context without inheriting broader claims.", "evidence_summary": "The brain can learn a specific sound pattern without becoming a universal noise filter.", "supportable_public_claim": "People can learn to separate selected auditory patterns, but the learning may be tightly tuned and does not establish general ‘cocktail-party’ mastery.", "measurement_boundary": "Predeclare number/type of sources, cue dimensions, target, masker, accuracy and new-scene transfer; neural responses remain mechanism measures.", "myth_to_metric": { "myth": "Choose one voice in any crowd", "metric": "Target-source accuracy in novel multi-source scenes with fatigue", "boundary": "A trained vowel or modulation threshold does not create universal selective hearing." }, "limiting_findings": [ "Learning on one spectrotemporal modulation did not generalise broadly and some untrained detection worsened.", "No mapped study established daily multi-speaker transfer." ], "prohibited_claims": [ "Isolate any sound at will", "Switch off background noise with the brain", "Train universal auditory scene analysis", "Neural change proves real-world benefit" ] }, "gold_source_lesson": { "curriculum_id": "G-CUR-007", "source_heading": "Tool 6 - Auditory scene analysis", "source_html_sha256": "f3b7e275f9595f8a709367caaa719c0d933f95cf48087075702b986a2cda0788", "html": "A scene is more than a loudness mixture. Ask:
\nThe supplied scene is synthetic. No covert recording, surveillance or professional monitoring is part of this route.
" }, "next_gate": "External confirmation is required before higher-authority use because: CLINICAL_HIGH_RISK_OR_REGULATED_CONFIGURATION.", "evidence_count": 3 }, "full_training_programme": false, "independently_validated": false, "publication_state": "PUBLISHED_PUBLIC_RESEARCH_EDITION__EDITORIAL_REVIEW_PENDING", "related_power_ids": [ "PWR-073", "PWR-074", "PWR-075", "PWR-077" ] }, { "power_id": "PWR-077", "learning_unit_id": "TLU-PWR-077", "title": "Auditory temporal resolution", "main_description": "The learner completes two supplied 24-trial gap/no-gap blocks and reports hits by 80-, 40-, 20- and 12-ms gap, early/centre/late position, misses, false alarms, confidence and symptoms without calling the home result a hearing threshold.", "main_description_source": "FULL_TUTORIAL_OUTCOME", "family_id": "FAM-10", "family": "Auditory Perception, Localization & Echolocation", "superdomain": "Perception & Sensorimotor", "canonical_route": "/powers/pwr-077/", "treatment": "EVIDENCE_REVIEW_ROUTE", "treatment_label": "Full low-stakes tutorial", "treatment_boundary": "Titan teaches a concrete low-stakes method step by step while keeping evidence and transfer claims bounded.", "tutorial_route": "/tutorials/pwr-077/", "governed_lesson_route": null, "self_attempt_status": "PERMITTED_INSIDE_FULL_TUTORIAL_LIMITS", "gold_pathway_ids": [ "G-CUR-007" ], "route_membership": { "kind": "GOLD_PATHWAY", "id": "G-CUR-007", "coverage_status": "EXACT_ONCE" }, "source_authority_tier": "G2", "source_build_state": "TARGETED_REVIEW_REQUIRED", "source_instructional_route": "BOUNDED_GUIDED_EXERCISE", "source_count": 4, "research_depth": "DETAILED", "risk_level": "LOW_TO_MODERATE; MOBILITY_OR_CLINICAL_CONFIGURATION_CAN_BE_HIGH", "prerequisite_status": "NONE_FOR_READING__NO_PRACTICE_AUTHORITY", "learning_route": { "mode": "FULL_SELF_GUIDED_TUTORIAL", "label": "Learn auditory temporal resolution step by step", "summary": "The learner completes two supplied 24-trial gap/no-gap blocks and reports hits by 80-, 40-, 20- and 12-ms gap, early/centre/late position, misses, false alarms, confidence and symptoms without calling the home result a hearing threshold.", "steps": [ [ "Get ready", "Use one comfortable level and do not raise it for shorter gaps." ], [ "Learn the method", "9 concrete steps teach the permitted method from start to finish." ], [ "See right and wrong", "6 comparisons show correct or safer execution beside common wrong or riskier choices." ], [ "Practise", "Run Set B once after at least 48 hours, then wait a week before a helper generates another balanced order. Progress by adding a new carrier while preserving the four durations and three positions; only after two fresh blocks show a coherent neighbouring-duration pattern may the helper add one shorter duration, still at the same level." ], [ "Check progress", "For each 24-file block, report gap hits out of three at 80, 40, 20 and 12 ms; total misses; false alarms and correct rejections out of 12 no-gap files; and the E/C/L result inside each duration. Keep confidence, device setting, carrier and symptoms beside the counts rather than calculating a clinical threshold." ] ], "practical_authority": true, "provider_required": false, "next_action_route": "/tutorials/pwr-077/" }, "path_builder": { "selectable": true, "completion_allowed": true, "warning": "Titan teaches a concrete low-stakes method step by step while keeping evidence and transfer claims bounded." }, "full_tutorial": { "version": "3.0", "authorship": "POWER_SPECIFIC_FULL_TUTORIAL", "tutorial_mode": "SELF_GUIDED", "promise": "People can learn a particular auditory timing test; that does not prove a universally faster ear. Auditory temporal resolution can be practised on a defined gap-detection task. The learner distinguishes continuous from interrupted sounds, begins with obvious gaps, uses random gap/no-gap trials, answers before feedback and retests unfamiliar carriers. A home result is not an auditory diagnosis. Gap position is varied separately from gap duration because a centred break and a break near sound onset may have different detection difficulty even when the silent interval is identical.", "power_id": "PWR-077", "title": "Auditory temporal resolution", "lesson_type": "SELF_GUIDED", "headline": "Judge whether one sound contains a gap, using random trials and a repeatable rule", "plain_english_summary": "People can learn a particular auditory timing test; that does not prove a universally faster ear. Auditory temporal resolution can be practised on a defined gap-detection task. The learner distinguishes continuous from interrupted sounds, begins with obvious gaps, uses random gap/no-gap trials, answers before feedback and retests unfamiliar carriers. A home result is not an auditory diagnosis. Gap position is varied separately from gap duration because a centred break and a break near sound onset may have different detection difficulty even when the silent interval is identical.", "outcome": "The learner completes two supplied 24-trial gap/no-gap blocks and reports hits by 80-, 40-, 20- and 12-ms gap, early/centre/late position, misses, false alarms, confidence and symptoms without calling the home result a hearing threshold.", "authority": { "learner_may": [ "Answer continuous or interrupted once for every coded Set A carrier and score hits by 80/40/20/12 ms plus no-gap false alarms.", "Compare early/centre/late positions, reject click-contaminated files and run the 750-Hz Set B after 48 hours at the same comfortable setting.", "Use usual hearing support and speech, symbols or switches while preserving carrier timing and one-play rule." ], "qualified_person_required_for": [ "Audiological assessment of temporal processing, hearing loss or speech-understanding difficulty and interpretation of a sudden/new symptom.", "Using timing performance for communication treatment, hearing-device settings, work safety or another consequential judgment.", "Changing hearing-device/cochlear-implant programmes or clinical auditory training." ], "never_do": [ "Raise volume for shorter gaps, replay misses, leave an edit click or reveal the N/gap code before the response.", "Call one 12-ms hit a threshold, diagnosis or proof of faster speech/music processing.", "Continue with ear pain, louder tinnitus, fullness, dizziness, headache, distorted carrier or listening fatigue." ] }, "materials": [ "A helper or audio editor creates 1,000-ms mono carriers at a comfortable exported level. Set A uses pink noise; Set B uses a 750-Hz sine. Give every file identical 20-ms outer fades. For gap files, insert a fully silent interval of 80, 40, 20 or 12 ms centred at 250 ms (E), 500 ms (C) or 750 ms (L), with matched 5-ms fade-out and fade-in immediately outside that silence; N files have no internal edit.", "Coded 24-file order A: N, 80C, 40E, N, N, 20L, 12C, N, 80E, N, N, 40L, 20C, N, 12E, N, 80L, N, N, 40C, 20E, N, 12L, N. The helper hides the codes; this gives 12 no-gap trials and three trials at each gap duration with all three positions represented.", "Coded 24-file transfer order B: 20E, N, N, 80L, 40C, N, 12L, N, N, 20C, 80E, N, 40L, N, N, 12C, 80C, N, 20L, N, N, 40E, 12E, N. Use it at least 48 hours later; it has the same balance but a new carrier and order.", "The same playback device at one locked comfortable setting, a concealed A/B answer key and a 24-row sheet for continuous/interrupted, confidence, actual code, hit/miss/false alarm/correct rejection and symptoms." ], "before_you_start": [ "Use one comfortable level and do not raise it for shorter gaps.", "Choose one question: continuous or interrupted?", "Record device, output, carrier sound and within-sound timing.", "Do not use the fixture for hearing diagnosis or sudden hearing change." ], "steps": [ { "title": "Lock audio and timing", "instruction": "Record device, output, level, carrier duration and where the gap can occur.", "reason": "Temporal resolution depends on the exact waveform and playback chain.", "success_check": "All timing/configuration fields are present." }, { "title": "Learn obvious anchors", "instruction": "Hear one continuous sound and one with a clearly long gap, then name each.", "reason": "Anchors establish the response labels at safe level.", "success_check": "Both anchors are correct without replay." }, { "title": "Balance gap and no-gap trials", "instruction": "Use a concealed random order with equal or declared proportions.", "reason": "No-gap trials reveal false reports of gaps.", "success_check": "The order and prevalence are documented." }, { "title": "Listen once and answer", "instruction": "Play one sound, answer continuous or interrupted, and rate confidence before feedback.", "reason": "One exposure and committed response preserve the trial.", "success_check": "Answer precedes the key on every trial." }, { "title": "Step gap duration by rule", "instruction": "Run every supplied A trial in order without selecting durations from earlier answers. After scoring, compare the three opportunities at each of 80, 40, 20 and 12 ms; do not promote the shortest lucky response to a threshold.", "reason": "A fixed balanced block exposes the neighbouring-duration pattern without an improvised staircase or cherry-picked stopping point.", "success_check": "The sheet contains three keyed gap trials at every duration and all 12 no-gap controls." }, { "title": "Classify miss and false alarm", "instruction": "A missed gap and a reported gap in a continuous sound are scored separately.", "reason": "One percent correct hides response bias.", "success_check": "Each error has one category." }, { "title": "Retest a new carrier", "instruction": "At least 48 hours later, run supplied Set B once. Its 750-Hz carrier is new but durations, positions, ramps, response question and comfortable level rule match Set A.", "reason": "New carrier tests limited transfer beyond a memorised waveform.", "success_check": "Carrier is new and level remains fixed." }, { "title": "Balance gap position", "instruction": "For each duration, compare its E, C and L trial rather than grouping only by milliseconds. Mark a position pattern as descriptive because there is only one trial per duration-position cell.", "reason": "A timing-position weakness can be mistaken for a shorter gap limit if every hard gap occurs near one edge.", "success_check": "Each gap position has valid trials and the learner names any position-specific miss pattern." }, { "title": "Confirm the carrier edge", "instruction": "Add no-gap controls with the same onset and offset ramps as the gap trials, and listen to an unscored waveform check before the block.", "reason": "Clicks or ramp differences can reveal the answer without genuine silent-gap detection.", "success_check": "Gap and no-gap files share the declared ramps and produce no obvious click cue at comfortable level." } ], "worked_example": { "scenario": "Ruth judges the supplied 24-file pink-noise Set A; she cannot see codes such as 20L or N.", "walkthrough": [ "Ruth locks the level and learns the labels from a separate N anchor and an 80C anchor; neither anchor is counted in A.", "For trials 1–4 she answers continuous, interrupted, interrupted, interrupted. The key N, 80C, 40E, N therefore gives one correct rejection, two hits and one false alarm.", "She finishes all 24 trials before looking at duration totals and leaves each original answer visible.", "Her gap hits are 3/3 at 80 ms, 2/3 at 40 ms, 2/3 at 20 ms and 1/3 at 12 ms; she also has two false alarms among 12 N trials.", "The single 12C hit alongside 12E and 12L misses is recorded as a possible position pattern, not proof that centred 12-ms gaps are reliably detected.", "After 48 hours Ruth runs Set B once at the same device setting and compares the new hit and false-alarm pattern with A." ], "result": "Ruth has a complete task profile: performance weakens as the named silence shortens, and no-gap false alarms remain visible. Set B tests whether that pattern survives a sine carrier; neither set is an audiological threshold." }, "right_vs_wrong": [ { "situation": "Level", "right": "Keep one comfortable locked level.", "wrong": "Raise volume for short gaps.", "why": "Level changes audibility and exposure." }, { "situation": "Controls", "right": "Include random no-gap sounds.", "wrong": "Present a gap every time.", "why": "Without controls, a “gap” answer cannot be a false alarm." }, { "situation": "Threshold", "right": "Use repeated trials and a declared step rule.", "wrong": "Call one lucky tiny-gap answer the threshold.", "why": "Chance responses occur." }, { "situation": "Score", "right": "Separate misses and false alarms.", "wrong": "Use overall accuracy only.", "why": "Bias can hide inside one percentage." }, { "situation": "Claim", "right": "Report carrier, gap location and duration.", "wrong": "Call it global auditory speed.", "why": "Learning is often specific to timing configuration." }, { "situation": "Gap position", "right": "Compare early, centred and late gaps at one duration before claiming a duration limit.", "wrong": "Place every short gap near onset and every long gap in the centre.", "why": "Position becomes a hidden difficulty cue that confounds duration." } ], "common_mistakes": [ { "mistake": "Raise volume for short gaps.", "fix": "Keep one comfortable locked level." }, { "mistake": "Present a gap every time.", "fix": "Include random no-gap sounds." }, { "mistake": "Call one lucky tiny-gap answer the threshold.", "fix": "Use repeated trials and a declared step rule." }, { "mistake": "Use overall accuracy only.", "fix": "Separate misses and false alarms." }, { "mistake": "Call it global auditory speed.", "fix": "Report carrier, gap location and duration." }, { "mistake": "A click at the edited gap edge gives away the interrupted file.", "fix": "Use matched ramps, inspect the waveform and discard any file with a detectable edit transient." } ], "practice": { "first_session": [ "The helper renders every A file from the recipe, listens for clicks without disclosing codes and replaces any defective edit; the learner records the playback device and comfortable setting.", "The learner hears one extra N anchor and one extra 80C anchor, says continuous and interrupted, and confirms that the response labels—not gap duration—are understood.", "The helper presents A's 24 files in the printed order with codes hidden; the learner hears each once, records a binary answer and confidence, and receives no trial feedback.", "After the last response, the learner uncovers the key and totals hits separately at 80, 40, 20 and 12 ms, false alarms among the 12 N files, and correct rejections.", "The learner also lays out the E, C and L results within each duration and flags, but does not overinterpret, a cell represented by one trial.", "Set B remains concealed until the transfer session at least 48 hours later." ], "repeat_plan": "Run Set B once after at least 48 hours, then wait a week before a helper generates another balanced order. Progress by adding a new carrier while preserving the four durations and three positions; only after two fresh blocks show a coherent neighbouring-duration pattern may the helper add one shorter duration, still at the same level.", "progress_when": [ "Accurate performance extends across several nearby gap durations.", "False alarms do not rise.", "Some improvement appears on a new carrier at fixed level." ], "do_not_progress_when": [ "Playback timing, level or device changes.", "Ear symptoms or fatigue appears.", "The score is being treated as clinical diagnosis." ] }, "self_check": [ "Can you demonstrate “Learn obvious anchors”? Both anchors are correct without replay.", "Can you demonstrate “Listen once and answer”? Answer precedes the key on every trial.", "Can you demonstrate “Retest a new carrier”? Carrier is new and level remains fixed.", "Can you show that gap and no-gap files have matched ramps and that performance is not limited to centred gaps?" ], "measurement": { "primary": "Gap/no-gap response pattern across declared duration, within-sound position and carrier", "how": "For each 24-file block, report gap hits out of three at 80, 40, 20 and 12 ms; total misses; false alarms and correct rejections out of 12 no-gap files; and the E/C/L result inside each duration. Keep confidence, device setting, carrier and symptoms beside the counts rather than calculating a clinical threshold.", "good_result": "A fresh Set B or later balanced carrier shows a coherent pattern across neighbouring durations with no increase in no-gap false alarms, listening burden or playback level; isolated shortest-gap hits are reported but not used as a pass rule.", "does_not_prove": "Declare marker spectrum, gap/interval, ear, adaptive rule and reliability; use multiple measures before any broader interpretation." }, "stop_and_get_help": [ "End the gap block if edited carriers distort or provoke ear pain, new fullness, louder tinnitus, dizziness or headache.", "If hearing drops abruptly, one ear suddenly feels markedly different or severe spinning begins, stop gap practice and seek time-sensitive clinical assessment.", "Use an audiologist when timing difficulties affect speech understanding or daily function." ], "accessibility": [ "Use symbols, speech or switches for continuous/interrupted answers.", "Lengthen rests and reduce trial count while preserving waveform timing.", "Keep ordinary hearing devices and record their programme." ], "evidence_notes": [ { "claim": "Primary research supports rapid learning on a defined temporal gap-detection task.", "source_title": "Rapid auditory learning of temporal gap detection", "source_url": "https://pubmed.ncbi.nlm.nih.gov/27475211/", "source_kind": "PRIMARY_RESEARCH" }, { "claim": "WHO guidance supports limiting sound level and exposure duration.", "source_title": "Deafness and hearing loss: Safe listening", "source_url": "https://www.who.int/news-room/questions-and-answers/item/deafness-and-hearing-loss-safe-listening", "source_kind": "OFFICIAL_GUIDANCE" } ], "limits": [ "Declare marker spectrum, gap/interval, ear, adaptive rule and reliability; use multiple measures before any broader interpretation.", "Unsupported claim: Speed up the auditory brain.", "Unsupported claim: Hear microscopic gaps in all sound.", "Unsupported claim: A gap test diagnoses auditory processing.", "Home gap detection does not diagnose auditory processing or establish speech, music or real-world temporal performance." ], "orientation": { "bounded_definition": "Capability to develop or express auditory temporal resolution in a declared context without inheriting broader claims.", "evidence_summary": "People can learn a particular auditory timing test; that does not prove a universally faster ear.", "supportable_public_claim": "Auditory gap and interval thresholds can improve, but the gain is tied to the test configuration and has not been shown to sharpen hearing generally.", "measurement_boundary": "Declare marker spectrum, gap/interval, ear, adaptive rule and reliability; use multiple measures before any broader interpretation.", "myth_to_metric": { "myth": "Hear between milliseconds", "metric": "Reliable threshold across untrained gap and interval configurations", "boundary": "A lower trained threshold does not establish speech, music or global processing-speed benefit." }, "limiting_findings": [ "Two accepted temporal-resolution tests do not classify performance identically.", "Transfer failed across some spectral-marker changes and remained interval-specific." ], "prohibited_claims": [ "Speed up the auditory brain", "Hear microscopic gaps in all sound", "A gap test diagnoses auditory processing", "Temporal drills guarantee better speech" ] }, "gold_source_lesson": null, "next_gate": "External confirmation is required before higher-authority use because: CLINICAL_HIGH_RISK_OR_REGULATED_CONFIGURATION.", "evidence_count": 4 }, "full_training_programme": false, "independently_validated": false, "publication_state": "PUBLISHED_PUBLIC_RESEARCH_EDITION__EDITORIAL_REVIEW_PENDING", "related_power_ids": [ "PWR-073", "PWR-074", "PWR-075", "PWR-076" ] }, { "power_id": "PWR-078", "learning_unit_id": "TLU-PWR-078", "title": "Human echolocation", "main_description": "Status correction: PWR-078 remains held from explanatory publication and current operational use. Titan does not authorise this material as training, navigation or mobility instruction. It does not establish safe independent navigation and does not advise replacing a cane, guide dog, live assistance or qualified orientation-and-mobility support. Legacy protocol-like material is superseded for current actionability and retained only as historical lineage.", "main_description_source": "PWR078_CORRECTION_STATUS_NOTICE", "family_id": "FAM-10", "family": "Auditory Perception, Localization & Echolocation", "superdomain": "Perception & Sensorimotor", "canonical_route": "/powers/pwr-078/", "treatment": "STATUS_ONLY_HOLD", "treatment_label": "Status-only hold", "treatment_boundary": "Only the controlling status notice is published; no explainer or practical instruction is authorised.", "tutorial_route": null, "governed_lesson_route": null, "self_attempt_status": "PROHIBITED", "gold_pathway_ids": [ "G-CUR-007" ], "route_membership": { "kind": "GOLD_PATHWAY", "id": "G-CUR-007", "coverage_status": "EXACT_ONCE" }, "source_authority_tier": "HOLD", "source_build_state": "HOLD", "source_instructional_route": "STATUS_ONLY_HOLD", "source_count": 0, "research_depth": "FOCUSED", "risk_level": "LOW_TO_MODERATE; MOBILITY_OR_CLINICAL_CONFIGURATION_CAN_BE_HIGH", "prerequisite_status": "NOT_APPLICABLE", "learning_route": { "mode": "STATUS_ONLY", "label": "Status notice only", "summary": "Status correction: PWR-078 remains held from explanatory publication and current operational use. Titan does not authorise this material as training, navigation or mobility instruction. It does not establish safe independent navigation and does not advise replacing a cane, guide dog, live assistance or qualified orientation-and-mobility support. Legacy protocol-like material is superseded for current actionability and retained only as historical lineage.", "steps": [], "practical_authority": false, "provider_required": false, "next_action_route": "/powers/pwr-078/" }, "path_builder": { "selectable": true, "completion_allowed": false, "warning": "Status-only hold: no explainer, practice or completion action is authorised." }, "full_tutorial": null, "full_training_programme": false, "independently_validated": false, "publication_state": "PUBLISHED_PUBLIC_RESEARCH_EDITION__EDITORIAL_REVIEW_PENDING", "related_power_ids": [] }, { "power_id": "PWR-079", "learning_unit_id": "TLU-PWR-079", "title": "Absolute and relational pitch memory", "main_description": "For eight supplied four-note sequences, the learner writes all three up/down/same transitions after a 20-second symbol task, classifies the first contour error, and later tests the same eight relational shapes from different starting notes.", "main_description_source": "FULL_TUTORIAL_OUTCOME", "family_id": "FAM-10", "family": "Auditory Perception, Localization & Echolocation", "superdomain": "Perception & Sensorimotor", "canonical_route": "/powers/pwr-079/", "treatment": "EVIDENCE_REVIEW_ROUTE", "treatment_label": "Full low-stakes tutorial", "treatment_boundary": "Titan teaches a concrete low-stakes method step by step while keeping evidence and transfer claims bounded.", "tutorial_route": "/tutorials/pwr-079/", "governed_lesson_route": null, "self_attempt_status": "PERMITTED_INSIDE_FULL_TUTORIAL_LIMITS", "gold_pathway_ids": [ "G-CUR-007" ], "route_membership": { "kind": "GOLD_PATHWAY", "id": "G-CUR-007", "coverage_status": "EXACT_ONCE" }, "source_authority_tier": "G1", "source_build_state": "TARGETED_REVIEW_REQUIRED", "source_instructional_route": "SELF_GUIDED_TUTORIAL", "source_count": 4, "research_depth": "DETAILED", "risk_level": "LOW_TO_MODERATE; MOBILITY_OR_CLINICAL_CONFIGURATION_CAN_BE_HIGH", "prerequisite_status": "NONE_FOR_READING__NO_PRACTICE_AUTHORITY", "learning_route": { "mode": "FULL_SELF_GUIDED_TUTORIAL", "label": "Learn absolute and relational pitch memory step by step", "summary": "For eight supplied four-note sequences, the learner writes all three up/down/same transitions after a 20-second symbol task, classifies the first contour error, and later tests the same eight relational shapes from different starting notes.", "steps": [ [ "Get ready", "Choose relational contour as the main outcome; absolute note naming stays separate." ], [ "Learn the method", "8 concrete steps teach the permitted method from start to finish." ], [ "See right and wrong", "6 comparisons show correct or safer execution beside common wrong or riskier choices." ], [ "Practise", "Use A5–A8 at the next weekly practice, then run B1–B8 after at least 48 hours without reopening A. Progress first from four to eight coded items, then vary delay to 30 seconds on newly generated four-note contours; do not change delay and starting pitch in the same comparison." ], [ "Check progress", "For each code, score correct U/D/S transitions out of three and whole-contour correct/incorrect after exactly one listen and 20 seconds. Report first-error position plus reversal, previous-sequence intrusion, flattening or omission; compare A and transposed B while keeping exact-note naming in its own column." ] ], "practical_authority": true, "provider_required": false, "next_action_route": "/tutorials/pwr-079/" }, "path_builder": { "selectable": true, "completion_allowed": true, "warning": "Titan teaches a concrete low-stakes method step by step while keeping evidence and transfer claims bounded." }, "full_tutorial": { "version": "3.0", "authorship": "POWER_SPECIFIC_FULL_TUTORIAL", "tutorial_mode": "SELF_GUIDED", "promise": "Pitch memory is more widespread than note naming, and some adults can learn the labels—without becoming musically superior. Relational pitch memory tracks whether notes went up, down or stayed similar, separate from naming exact pitches. The learner hears a four-note synthetic sequence once, completes a filled delay, reproduces its contour with arrows, humming or note relations, checks the reference and retests a new starting pitch. Adult absolute-pitch claims remain limited. Contour scoring includes intrusion analysis: a repeated old melody, reversed final interval or preserved rhythm with wrong pitch shape is marked separately from a complete memory failure.", "power_id": "PWR-079", "title": "Absolute and relational pitch memory", "lesson_type": "SELF_GUIDED", "headline": "Remember the shape of a short melody after a filled delay, then transpose it", "plain_english_summary": "Pitch memory is more widespread than note naming, and some adults can learn the labels—without becoming musically superior. Relational pitch memory tracks whether notes went up, down or stayed similar, separate from naming exact pitches. The learner hears a four-note synthetic sequence once, completes a filled delay, reproduces its contour with arrows, humming or note relations, checks the reference and retests a new starting pitch. Adult absolute-pitch claims remain limited. Contour scoring includes intrusion analysis: a repeated old melody, reversed final interval or preserved rhythm with wrong pitch shape is marked separately from a complete memory failure.", "outcome": "For eight supplied four-note sequences, the learner writes all three up/down/same transitions after a 20-second symbol task, classifies the first contour error, and later tests the same eight relational shapes from different starting notes.", "authority": { "learner_may": [ "Hear one coded four-note Set A sequence, complete the exact 20-second symbol task and commit three U/D/S arrows before feedback.", "Score transition errors, first-error position and intrusion/reversal/flattening separately, then test transposed Set B after 48 hours.", "Respond with arrows, tactile tokens, instrument keys or gentle humming while keeping ordinary hearing support and one-listen timing." ], "qualified_person_required_for": [ "Assessing sudden hearing/memory change or a persistent functional complaint and selecting clinical hearing, neurological or memory evaluation.", "Interpreting pitch-memory performance for music education qualification, hearing treatment, work or another consequential decision.", "Changing hearing-device settings, medication or cognitive/auditory rehabilitation." ], "never_do": [ "Loop a melody, rehearse during the symbol delay, merge exact note names with contour or count a correction as fresh baseline.", "Raise level, strain the voice or claim transposed contour recall proves absolute pitch or musical superiority.", "Continue through ear pain, louder tinnitus, dizziness, vocal strain, severe headache or abrupt hearing/memory change." ] }, "materials": [ "Set A, played with one piano/tone sound at 500 ms per note and a 200-ms silent gap: A1 C4–D4–E4–D4 (UUD), A2 E4–D4–D4–F4 (DSU), A3 G4–E4–F4–F4 (DUS), A4 D4–D4–C4–E4 (SDU), A5 A4–C5–B4–D5 (UDU), A6 F4–E4–G4–F4 (DUD), A7 C5–B4–A4–A4 (DDS), A8 E4–G4–G4–F4 (USD). A helper codes files A1–A8 and hides the parenthesised contour key.", "Transposed Set B with the same durations, sound and contour order: B1 F4–G4–A4–G4 (UUD), B2 A4–G4–G4–B4 (DSU), B3 C5–A4–B4–B4 (DUS), B4 G4–G4–F4–A4 (SDU), B5 D4–F4–E4–G4 (UDU), B6 B3–A3–C4–B3 (DUD), B7 F5–E5–D5–D5 (DDS), B8 A3–C4–C4–B3 (USD). Keep B sealed for at least 48 hours.", "A 20-second interference strip numbered 1–20 with symbols ○ △ □ ○ ◇ △ ○ □ △ ◇ ○ □ ○ △ ◇ □ ○ △ □ ○. At one symbol per second, the learner says its position number only when it is ○; the helper or timer maintains the pace. No humming, finger tracing of pitch or note rehearsal occurs.", "Three arrow cards U, D and S; a response sheet with sequence code, three-arrow response, confidence, three keyed transitions, first wrong position, error class and optional exact-note answer kept in a separate column." ], "before_you_start": [ "Choose relational contour as the main outcome; absolute note naming stays separate.", "Set one comfortable level and fixed playback chain.", "Use the same filled-delay duration and task.", "Do not sing loudly or strain; humming is optional." ], "steps": [ { "title": "Learn contour symbols", "instruction": "Practise up, down and same arrows on obvious two-note examples.", "reason": "A shared notation lets non-singers show the relation.", "success_check": "All practice relations are labelled correctly." }, { "title": "Lock one exposure", "instruction": "Play one coded A sequence once at the fixed level: each note lasts 500 ms and each inter-note silence lasts 200 ms. Cover the player when playback ends and do not loop it.", "reason": "One exposure defines the memory demand.", "success_check": "Play count is recorded as one." }, { "title": "Fill the delay", "instruction": "Immediately follow the numbered symbol strip at one symbol per second for 20 seconds, saying only the number of each ○. Do not hum, tap the contour or rehearse note names.", "reason": "A filled delay reduces immediate echo and standardises retention time.", "success_check": "Delay duration and task are completed." }, { "title": "Reproduce the relation", "instruction": "Use three arrows, relative note labels, an instrument or gentle humming to show how note 2–4 moved from the previous note.", "reason": "Contour is the intended memory, not exact frequency.", "success_check": "A complete three-transition response is committed." }, { "title": "Check transition by transition", "instruction": "Reveal the reference and mark each up/down/same relation correct or wrong; keep absolute-note labels separate.", "reason": "Specific transition feedback identifies the memory error.", "success_check": "Three relation scores remain visible." }, { "title": "Use spaced correction", "instruction": "Replay once, wait through the same delay and reproduce again only under the planned feedback trial.", "reason": "One spaced correction teaches without endless looping.", "success_check": "Correction exposure and result are labelled." }, { "title": "Transpose the test", "instruction": "At least 48 hours later, use B1–B8 in a newly shuffled code order. Each B item preserves one A contour but starts on other notes; keep timing, sound, delay strip and one-listen rule unchanged.", "reason": "Transposition tests relational memory rather than one recording.", "success_check": "Starting pitch changes while contour rule stays explicit." }, { "title": "Classify the contour error", "instruction": "When a response is wrong, mark the first incorrect transition and classify reversal, repeated previous contour, flattened transition or missing response. Keep rhythm or note-name errors in separate columns.", "reason": "A whole-contour score alone cannot show whether interference from an earlier melody or one transition caused the failure.", "success_check": "Each missed sequence has a first-error position and one pitch-contour category without rewriting the original arrows." } ], "worked_example": { "scenario": "Ana receives coded A1, C4–D4–E4–D4, whose hidden contour is UUD.", "walkthrough": [ "Ana practises U, D and S on unscored two-note examples and records the comfortable playback setting.", "She hears A1 once, then follows all 20 symbols and says 1, 4, 7, 11, 13, 17 and 20 because those positions contain ○.", "Ana commits UDD with confidence 2/3. The key UUD gives transition scores correct, wrong, correct; first error position 2 is a reversal from U to D.", "For the planned correction only, she replays A1 once, completes the same 20-second strip and now writes UUD; the correction is not substituted for baseline.", "Two days later B1, F4–G4–A4–G4, tests UUD from another starting note with the same one-listen and filled-delay rules.", "If Ana writes the entire previous trial’s contour instead, she marks previous-sequence intrusion; if only a moving interval becomes S, she marks flattening." ], "result": "Ana retains the relational shape better after spacing and transposition. This does not demonstrate categorical absolute pitch or musical superiority. The added error profile shows whether spaced practice reduced interference rather than only raising whole-sequence scores." }, "right_vs_wrong": [ { "situation": "Outcome", "right": "Score up/down/same contour separately.", "wrong": "Mix exact note names and contour into one score.", "why": "Absolute naming and relational memory are different abilities." }, { "situation": "Exposure", "right": "Use one declared listen before the delay.", "wrong": "Loop until memorised.", "why": "Extra exposures reduce the memory demand." }, { "situation": "Delay", "right": "Use the same filled interval.", "wrong": "Rehearse the notes during an empty variable delay.", "why": "Rehearsal and time change the task." }, { "situation": "Reproduction", "right": "Use arrows, instrument or gentle humming.", "wrong": "Require accurate singing to count memory.", "why": "Vocal control is a separate skill." }, { "situation": "Transfer", "right": "Transpose the contour to a new starting pitch.", "wrong": "Repeat one recording and claim general pitch memory.", "why": "Recording memory may not preserve relations elsewhere." }, { "situation": "Memory error", "right": "Mark the first wrong transition and whether an old contour intruded.", "wrong": "Score the whole sequence zero and discard the response shape.", "why": "The retained shape shows what was remembered and what interfered." } ], "common_mistakes": [ { "mistake": "Mix exact note names and contour into one score.", "fix": "Score up/down/same contour separately." }, { "mistake": "Loop until memorised.", "fix": "Use one declared listen before the delay." }, { "mistake": "Rehearse the notes during an empty variable delay.", "fix": "Use the same filled interval." }, { "mistake": "Require accurate singing to count memory.", "fix": "Use arrows, instrument or gentle humming." }, { "mistake": "Repeat one recording and claim general pitch memory.", "fix": "Transpose the contour to a new starting pitch." }, { "mistake": "Sequences with the same rhythm are grouped together, allowing rhythm to cue the contour.", "fix": "Use matched rhythm across balanced contours or vary rhythm independently and report it as a separate feature." } ], "practice": { "first_session": [ "A helper renders A1–A8 with the stated notes and timing, codes the files and checks each hidden contour against the printed key.", "The learner practises U, D and S on three unscored two-note pairs, then rehearses the interference strip once without any melody.", "In a concealed A1–A4 order, the learner hears each file once, completes all 20 seconds of symbols and commits three arrows plus confidence before the next file.", "After all four, the helper reveals their keys. The learner scores 12 transitions, four whole contours and the first wrong transition/error class for each miss.", "Only a missed item receives one correction exposure followed by the same filled delay; the corrected row stays separate from baseline.", "A5–A8 form the next fresh practice block, while transposed B files remain sealed for the 48-hour transfer check." ], "repeat_plan": "Use A5–A8 at the next weekly practice, then run B1–B8 after at least 48 hours without reopening A. Progress first from four to eight coded items, then vary delay to 30 seconds on newly generated four-note contours; do not change delay and starting pitch in the same comparison.", "progress_when": [ "Contour accuracy improves after the fixed delay.", "Confidence becomes calibrated.", "Relations survive a new starting pitch or novel sequence." ], "do_not_progress_when": [ "Exact pitch and contour scores are merged.", "The learner loops recordings or changes delay.", "Ear, voice or fatigue symptoms appear." ] }, "self_check": [ "Can you demonstrate “Lock one exposure”? Play count is recorded as one.", "Can you demonstrate “Reproduce the relation”? A complete three-transition response is committed.", "Can you demonstrate “Transpose the test”? Starting pitch changes while contour rule stays explicit.", "Can you distinguish forgetting one transition from reproducing the previous trial’s complete contour?" ], "measurement": { "primary": "Relational contour retained after the fixed filled delay", "how": "For each code, score correct U/D/S transitions out of three and whole-contour correct/incorrect after exactly one listen and 20 seconds. Report first-error position plus reversal, previous-sequence intrusion, flattening or omission; compare A and transposed B while keeping exact-note naming in its own column.", "good_result": "On concealed B files or new four-note contours, more transitions or complete contours are retained under the same delay and exposure rule, without louder playback or increased symptoms; a correction trial is never counted as a fresh baseline.", "does_not_prove": "Separate familiar-pitch memory, isolated-note naming, relational interval judgement, timbre/octave transfer and delayed retention; avoid a single binary label." }, "stop_and_get_help": [ "Stop for ear pain, tinnitus increase, dizziness or vocal strain.", "Stop the pitch task and obtain prompt assessment for an abrupt hearing change, a new marked difference between ears or severe vertigo rather than retesting the melody.", "Seek professional support when pitch or memory change is sudden or affects daily function." ], "accessibility": [ "Use arrows, tactile tokens, note names, instrument keys or humming; no single output mode is required.", "Use a nonvisual filled-delay task and audio/tactile response system.", "Keep hearing devices and comfortable vocal range as declared supports." ], "evidence_notes": [ { "claim": "Primary research supports widespread memory for pitch in familiar melodies without equating it with categorical absolute-pitch naming.", "source_title": "Absolute memory for musical pitch: evidence from the production of learned melodies", "source_url": "https://doi.org/10.3758/BF03206733", "source_kind": "PRIMARY_RESEARCH" }, { "claim": "Adult-learning research suggests some note-label acquisition while leaving universality, retention and musical value bounded.", "source_title": "Is it impossible to acquire absolute pitch in adulthood?", "source_url": "https://doi.org/10.3758/s13414-019-01869-3", "source_kind": "PRIMARY_RESEARCH" } ], "limits": [ "Separate familiar-pitch memory, isolated-note naming, relational interval judgement, timbre/octave transfer and delayed retention; avoid a single binary label.", "Unsupported claim: Anyone can acquire perfect pitch.", "Unsupported claim: Absolute pitch makes a better musician.", "Unsupported claim: Pitch naming improves all hearing.", "Relational contour memory does not establish absolute pitch, exact-Hz recall, musical talent or broad auditory memory." ], "orientation": { "bounded_definition": "Capability to develop or express absolute and relational pitch memory in a declared context without inheriting broader claims.", "evidence_summary": "Pitch memory is more widespread than note naming, and some adults can learn the labels—without becoming musically superior.", "supportable_public_claim": "Adults can possess latent long-term pitch memory and some can learn accurate reference-free pitch labels, but gains are variable and do not confer perfect or superior musical hearing.", "measurement_boundary": "Separate familiar-pitch memory, isolated-note naming, relational interval judgement, timbre/octave transfer and delayed retention; avoid a single binary label.", "myth_to_metric": { "myth": "Perfect pitch", "metric": "Accuracy, calibration and retention across memory, naming and relation tasks", "boundary": "Reference-free labelling is neither perfect nor a general measure of hearing or musicianship." }, "limiting_findings": [ "Explicit naming practice did not improve relative-pitch judgement or fine discrimination.", "Only a minority reached stringent all-category criteria and methods vary." ], "prohibited_claims": [ "Anyone can acquire perfect pitch", "Absolute pitch makes a better musician", "Pitch naming improves all hearing", "Use medication to reopen a critical period" ] }, "gold_source_lesson": { "curriculum_id": "G-CUR-007", "source_heading": "Tool 8 - Relative pitch memory", "source_html_sha256": "4d031588c63b908fd85fd524260b53855b9cafe684f6bbb9663940a0dbf71c27", "html": "Use the four-note synthetic sequence.
\nTitan does not promise adult acquisition of categorical absolute pitch.
" }, "next_gate": "External confirmation is required before higher-authority use because: CLINICAL_HIGH_RISK_OR_REGULATED_CONFIGURATION.", "evidence_count": 4 }, "full_training_programme": false, "independently_validated": false, "publication_state": "PUBLISHED_PUBLIC_RESEARCH_EDITION__EDITORIAL_REVIEW_PENDING", "related_power_ids": [ "PWR-073", "PWR-074", "PWR-075", "PWR-076" ] }, { "power_id": "PWR-080", "learning_unit_id": "TLU-PWR-080", "title": "Auditory navigation and substitution", "main_description": "Under direct specialist supervision, Noor completes a controlled indoor route segment using the doorway code plus established mobility aids and executes the ambiguity-stop and fallback response.", "main_description_source": "FULL_TUTORIAL_OUTCOME", "family_id": "FAM-10", "family": "Auditory Perception, Localization & Echolocation", "superdomain": "Perception & Sensorimotor", "canonical_route": "/powers/pwr-080/", "treatment": "SPECIALIST_PROVIDER_ROUTE", "treatment_label": "Full supervised tutorial", "treatment_boundary": "Titan teaches the complete method; a qualified person controls the parts that require supervision, clearance, specialist equipment, load, dose or progression.", "tutorial_route": "/tutorials/pwr-080/", "governed_lesson_route": null, "self_attempt_status": "PROHIBITED_WITHOUT_QUALIFIED_SUPERVISION", "gold_pathway_ids": [ "G-CUR-007" ], "route_membership": { "kind": "GOLD_PATHWAY", "id": "G-CUR-007", "coverage_status": "EXACT_ONCE" }, "source_authority_tier": "G4", "source_build_state": "EXTERNAL_PROVIDER_ROUTE", "source_instructional_route": "LEARN_ELSEWHERE_TRACK_WITH_TITAN", "source_count": 6, "research_depth": "DEEP", "risk_level": "LOW_TO_MODERATE; MOBILITY_OR_CLINICAL_CONFIGURATION_CAN_BE_HIGH", "prerequisite_status": "QUALIFIED_PROVIDER_DETERMINES", "learning_route": { "mode": "FULL_SUPERVISED_TUTORIAL", "label": "Learn auditory navigation and substitution step by step", "summary": "Under direct specialist supervision, Noor completes a controlled indoor route segment using the doorway code plus established mobility aids and executes the ambiguity-stop and fallback response.", "steps": [ [ "Get ready", "A qualified orientation-and-mobility professional checks device, hearing access, primary mobility skill, route and consent." ], [ "Learn the method", "10 concrete steps teach the permitted method from start to finish." ], [ "See right and wrong", "7 comparisons show correct or safer execution beside common wrong or riskier choices." ], [ "Practise", "At later clinic appointments, the O&M specialist may rotate the doorway among cleared corridor positions while retaining the tactile marker, five-metre boundary and full cane arc. Controlled chatter is added only after every reflected, masked or conflicting code produces a no-step fallback; stairs, platforms and traffic require separate assessment." ], [ "Check progress", "Record device/version/settings, route, correct/missed/false cues, stops, contacts and near misses, primary-aid use, assistance, time, burden and device-on/off difference. Add tactile-landmark arrival, cane-arc continuity, doorway-side prediction, primary-aid agreement and feet-moved-after-ambiguity to each corridor segment record." ] ], "practical_authority": false, "provider_required": true, "next_action_route": "/tutorials/pwr-080/" }, "path_builder": { "selectable": true, "completion_allowed": true, "warning": "Titan teaches the complete method; a qualified person controls the parts that require supervision, clearance, specialist equipment, load, dose or progression." }, "full_tutorial": { "version": "3.0", "authorship": "POWER_SPECIFIC_FULL_TUTORIAL", "tutorial_mode": "SUPERVISED", "promise": "Sensory-substitution tools can add real spatial information—but the capability belongs to person, device, training, mobility tools and environment together. Auditory navigation and sensory substitution belong to a person–device–training–environment system. A qualified orientation-and-mobility professional selects the clinic route, fits the doorway code into existing mobility tools, rehearses one segment, stops on ambiguity and compares device-on with the established long-cane fallback. The audio-substitution unit never replaces traffic judgment or a cane, dog or guide without formal assessment. The taught travel chain is concrete: establish the clinic-corridor shoreline with Noor's long cane, stop at the tactile floor marker, listen for the one trained doorway code, predict the doorway-opening side, confirm it with Noor's long cane and cross only on the O&M specialist’s instruction.", "power_id": "PWR-080", "title": "Auditory navigation and substitution", "lesson_type": "SUPERVISED", "headline": "Use a fitted sound-substitution device as an added cue while preserving the primary mobility method", "plain_english_summary": "Sensory-substitution tools can add real spatial information—but the capability belongs to person, device, training, mobility tools and environment together. Auditory navigation and sensory substitution belong to a person–device–training–environment system. A qualified orientation-and-mobility professional selects the clinic route, fits the doorway code into existing mobility tools, rehearses one segment, stops on ambiguity and compares device-on with the established long-cane fallback. The audio-substitution unit never replaces traffic judgment or a cane, dog or guide without formal assessment. The taught travel chain is concrete: establish the clinic-corridor shoreline with Noor's long cane, stop at the tactile floor marker, listen for the one trained doorway code, predict the doorway-opening side, confirm it with Noor's long cane and cross only on the O&M specialist’s instruction.", "outcome": "Under direct specialist supervision, Noor completes a controlled indoor route segment using the doorway code plus established mobility aids and executes the ambiguity-stop and fallback response.", "authority": { "learner_may": [ "While guarded indoors, learn the configured doorway code from a stationary position and predict its direction before cane/guide confirmation.", "Travel the approved five-metre corridor segment while retaining the long cane, shoreline landmarks and qualified spotter.", "Stop at an unclear/masked cue, state ‘cue unclear’ and return to the cane, landmark and guide fallback; log contacts, stops and help." ], "qualified_person_required_for": [ "Selecting/fitting/configuring the substitution aid, verifying hearing access and teaching its code and blind spots.", "Assessing cane/guide skill, guarding the route, placing soft static obstacles and deciding when another route feature may be introduced.", "Any training near stairs, platforms, roads, crowds, water, moving objects or an unfamiliar public environment." ], "never_do": [ "Replace the long cane, guide dog, sighted guide or primary mobility method with the electronic cue during this lesson.", "Walk through uncertainty, raise audio to mask discomfort or change device mapping/software/settings mid-route to rescue a score.", "Use this corridor result as permission for independent street crossing, stairs, platforms, traffic or hazard detection." ] }, "materials": [ "The individually selected and configured sensory-substitution or electronic travel aid.", "Established cane, guide dog, sighted guide or other primary mobility method.", "A quiet controlled indoor training route with soft/static obstacles and no stairs or traffic.", "Route map and record for cue interpretation, stops, contacts/near misses, assistance, device state and burden." ], "before_you_start": [ "A qualified orientation-and-mobility professional checks device, hearing access, primary mobility skill, route and consent.", "Charge, update and inspect the device; record model, software, settings and audio output.", "Keep the established mobility aid in use and identify a sighted/qualified safety spotter.", "No road crossing, platform, stair, crowd, water or moving-vehicle environment is used." ], "steps": [ { "title": "Name the doorway code and its limit", "instruction": "Noor's O&M specialist explains exactly what the trained sound feature represents and what it fails to detect.", "reason": "A sound map is only useful when its coding and blind spots are explicit.", "success_check": "Noor can state doorway code meaning and one failure mode." }, { "title": "Check long-cane fallback", "instruction": "Demonstrate the established cane, dog, guide or stop-and-wait method before the audio-substitution unit is turned on.", "reason": "The added device must not remove a proven mobility route.", "success_check": "Long-cane fallback is immediately available and works on the clinic route." }, { "title": "Calibrate while stationary", "instruction": "In a fixed safe position, aim the audio-substitution unit at a known wall/opening or place the configured sensor and identify the corresponding cue.", "reason": "Stationary calibration separates cue learning from walking demand.", "success_check": "Noor identifies the known doorway code on repeated checks." }, { "title": "Point before moving", "instruction": "For the first route landmark, state the predicted open direction or obstacle location while stationary and confirm with long-cane sweep.", "reason": "Prediction plus confirmation teaches how cues relate to the environment.", "success_check": "The doorway prediction and long-cane check agree or the discrepancy is named." }, { "title": "Move one guarded segment", "instruction": "On the O&M specialist’s command, travel only the marked short segment at the set pace using Noor’s long cane plus the doorway code.", "reason": "Short segments bound errors and keep the professional able to stop the trial.", "success_check": "Noor reaches the corridor-segment marker without unplanned contact." }, { "title": "Stop on ambiguity", "instruction": "When the doorway code is absent, conflicting, overloaded or surprising, stop immediately, state “cue unclear” and use the long-cane fallback or ask for help.", "reason": "Safe navigation depends on recognising device uncertainty, not guessing.", "success_check": "Noor stops before stepping into the uncertain area." }, { "title": "Record error and recalibrate", "instruction": "Noor's O&M specialist classifies wrong-side code, missed code, positioning, environment or device fault; change one factor before a matched retry.", "reason": "Specific errors guide correction without hiding a near miss.", "success_check": "The raw event and one correction are recorded." }, { "title": "Compare device on and off", "instruction": "On a safe matched segment, compare added value and burden with Noor’s usual long-cane method, then end with an equipment check and route debrief.", "reason": "Device-on performance must be better or meaningfully different without weakening fallback.", "success_check": "Benefit, failures, assistance and burden are all explicit." }, { "title": "Anchor at last known landmark", "instruction": "Approach the tactile floor marker using Noor’s normal cane arc and shoreline technique. Stop with both feet behind the floor marker, name the wall side and point back toward the start before interpreting any synthetic sound.", "reason": "Auditory substitution is safer when each decision begins from a known orientation rather than from continuous uncertain walking.", "success_check": "Noor identifies the floor marker, shoreline and return direction while stationary and without narrowing cane coverage." }, { "title": "Confirm doorway before crossing", "instruction": "Listen once for the trained opening code, state left, centre or right, then confirm the predicted threshold with Noor's long cane or guide. Cross only when the synthetic tone and long-cane check agree; otherwise invoke the ambiguity stop.", "reason": "A reflected or masked code can suggest an opening where the safe threshold is absent.", "success_check": "The doorway threshold is confirmed by long-cane sweep, and any disagreement ends movement rather than prompting a test step." } ], "worked_example": { "scenario": "An orientation-and-mobility specialist trains Noor with a visual-to-auditory device in a quiet clinic corridor while Noor keeps a long cane.", "walkthrough": [ "Noor's O&M specialist explains doorway code for an open doorway and one blind spot, then checks Noor’s cane fallback.", "Stationary, Noor identifies doorway code and confirms it with the cane/guide.", "Noor travels one five-metre guarded segment using both systems.", "When overlapping sounds become unclear, Noor stops, says “cue unclear” and returns to the cane/guide method.", "They compare a matched device-off segment and record cue accuracy, stops, assistance and fatigue.", "Noor shorelines to the tactile marker, stops with both feet behind it and points back toward starting chair before listening for doorway code.", "Noor predicts “opening left,” confirms doorway threshold with Noor's long cane and crosses only after Noor's O&M specialist verifies that cane and auditory information agree.", "On a later pass, corridor chatter masks doorway code; Noor keeps the feet still, restores the full cane arc and returns to last landmark with the guide." ], "result": "Noor uses Audio-substitution unit as an added indoor cue and demonstrates a safe fallback. This does not authorise independent street navigation or replacement of established mobility tools. Noor demonstrates a repeatable landmark–listen–predict–confirm chain with a preserved long-cane fallback; the result remains specific to this clinic corridor and doorway code." }, "right_vs_wrong": [ { "situation": "Role of device", "right": "Use it as an added cue within the mobility plan.", "wrong": "Replace cane, dog or guide immediately.", "why": "A new device has blind spots and uncertain transfer." }, { "situation": "Calibration", "right": "Learn one known cue while stationary.", "wrong": "Start walking while guessing what complex sounds mean.", "why": "Combined cue learning and movement increases risk." }, { "situation": "Uncertainty", "right": "Stop and switch to fallback.", "wrong": "Step forward to test doorway code.", "why": "A failed test can cause collision or fall." }, { "situation": "Route", "right": "Use a controlled indoor segment with a specialist.", "wrong": "Practise near traffic, stairs or platforms.", "why": "Consequences exceed the current evidence and authority." }, { "situation": "Outcome", "right": "Record added value, failures, assistance and burden.", "wrong": "Count only completed routes.", "why": "Completion can hide near misses and specialist intervention." }, { "situation": "At tactile landmark", "right": "Stop, name shoreline and return direction, then interpret doorway code.", "wrong": "Keep walking while decoding synthetic tone from memory.", "why": "A stationary known position bounds the consequence of a wrong auditory interpretation." }, { "situation": "Sound predicts an opening", "right": "Confirm doorway threshold with Noor's long cane or guide before crossing.", "wrong": "Step toward the predicted gap to see whether doorway code was right.", "why": "Noor's long cane verifies the physical travel surface; the substituted cue remains supplementary." } ], "common_mistakes": [ { "mistake": "Noor follows doorway tone while the long-cane arc narrows.", "fix": "Stop at the last confirmed landmark, restore full cane coverage and resume only when cane and sound information can both be used." }, { "mistake": "A reflected corridor sound is accepted as the trained opening code.", "fix": "Verify the doorway opening from a stationary position with cane or guide contact before crossing doorway threshold." }, { "mistake": "Two overlapping tones are averaged into a guessed direction.", "fix": "Say “cue unclear,” freeze the feet and use the agreed cane, guide or return-to-landmark fallback." }, { "mistake": "The doorway code is practised after its loudness is increased above environmental sounds.", "fix": "Return to the fitted audio level and simplify clinic corridor; alarms, speech and traffic-relevant sound must remain audible." }, { "mistake": "Noor memorises five steps and succeeds without identifying the landmark.", "fix": "Vary the starting mark under specialist control and require a stationary cue prediction plus primary-aid confirmation." }, { "mistake": "A quiet clinic success is used to authorise stairs or a street crossing.", "fix": "Keep the conclusion corridor-specific and require a separate orientation-and-mobility assessment for every higher-consequence setting." } ], "practice": { "first_session": [ "The O&M specialist verifies Noor’s audio-substitution unit, comfortable output, long cane, quiet five-metre corridor and no-step ambiguity rule.", "Noor reaches the tactile floor marker with a full cane arc, names the wall shoreline and points toward the return chair.", "From the stationary marker, Noor completes four concealed left/centre/right doorway-code predictions and confirms each threshold with the long cane or guide.", "Noor travels one guarded corridor segment while keeping the cane sweep; any masked or conflicting code triggers “cue unclear” with both feet still.", "A matched device-off pass and one staged audio-loss response are logged for side accuracy, cane continuity, stops, contact, assistance and fatigue." ], "repeat_plan": "At later clinic appointments, the O&M specialist may rotate the doorway among cleared corridor positions while retaining the tactile marker, five-metre boundary and full cane arc. Controlled chatter is added only after every reflected, masked or conflicting code produces a no-step fallback; stairs, platforms and traffic require separate assessment.", "progress_when": [ "Noor reaches the tactile floor marker with a full cane arc, names the wall shoreline and points toward the return chair before listening.", "Left, centre and right doorway-code predictions are confirmed with the long cane or guide without a wrong-threshold crossing.", "Every masked, reflected, absent or conflicting code produces “cue unclear,” still feet and a return to the last confirmed landmark.", "The device-on corridor pass adds useful doorway information without narrowing the cane sweep, increasing contact or masking environmental sound." ], "do_not_progress_when": [ "Noor steps after an ambiguous code, loses the shoreline or narrows the long-cane arc while listening.", "The audio mapping, output level, hearing access, route marker or primary mobility support changes.", "The proposed setting contains stairs, platforms, traffic, moving obstacles or another hazard outside this clinic-corridor assessment." ] }, "self_check": [ "Can you demonstrate “Check long-cane fallback”? Long-cane fallback is immediately available and works on the clinic route.", "Can you demonstrate “Move one guarded segment”? Noor reaches the corridor-segment marker without unplanned contact.", "Can you demonstrate “Compare device on and off”? Benefit, failures, assistance and burden are all explicit.", "Can you demonstrate floor marker stop, name wall shoreline and point toward the return route before using doorway sound?", "If the tone suggests left but the cane finds a wall, can you keep both feet still and execute the agreed fallback?" ], "measurement": { "primary": "Doorway-side prediction, long-cane confirmation, cane-arc continuity, no-step ambiguity response, contact, assistance and burden on one clinic corridor", "how": "Record device/version/settings, route, correct/missed/false cues, stops, contacts and near misses, primary-aid use, assistance, time, burden and device-on/off difference. Add tactile-landmark arrival, cane-arc continuity, doorway-side prediction, primary-aid agreement and feet-moved-after-ambiguity to each corridor segment record.", "good_result": "Noor's O&M specialist observes repeatable added value in the clinic corridor, reliable ambiguity stops and preserved primary mobility skill without adverse effects.", "does_not_prove": "A successful clinic-corridor doorway code does not prove sight restoration, street navigation, traffic judgment, safe stair or platform travel, replacement of a cane or benefit with another audio mapping." }, "stop_and_get_help": [ "Stop movement immediately for an unclear/conflicting cue, device failure, loss of orientation, obstacle contact, dizziness or hearing discomfort.", "Seek urgent help after a fall, head injury, sudden hearing/vision change or acute neurological symptoms.", "Do not enter traffic, stairs, platforms or unfamiliar public routes until Noor's O&M specialist explicitly assesses that configuration." ], "accessibility": [ "Keep Noor’s cane, guide dog, guide and communication supports; Audio-substitution unit is additive.", "Use bone-conduction, speaker or hearing-device integration only when fitted and safe for environmental sound awareness.", "Reduce cue density, route length or pace while preserving the ambiguity-stop and fallback goal." ], "evidence_notes": [ { "claim": "A pilot study supports feasibility of a specific visual-to-auditory navigation aid and does not establish universal independent mobility.", "source_title": "Navigation aid for blind persons by visual-to-auditory sensory substitution: a pilot study", "source_url": "https://doi.org/10.1371/journal.pone.0237344", "source_kind": "PRIMARY_RESEARCH" }, { "claim": "Official CNIB guidance supports specialist orientation-and-mobility instruction and established travel skills.", "source_title": "Getting around: orientation and mobility", "source_url": "https://www.cnib.ca/en/getting-around", "source_kind": "OFFICIAL_GUIDANCE" } ], "limits": [ "Report intended-user status, training, device on/off, cane/guide-dog/human support, collision type, speed, cognitive load, dropout and failure mode; no device-only score is capability in full.", "Unsupported claim: Restore sight through sound.", "Unsupported claim: Throw away the cane.", "Unsupported claim: AI makes blind travel autonomous.", "Controlled indoor use does not prove independent navigation, traffic safety, replacement of primary mobility aids or benefit with another device/version." ], "orientation": { "bounded_definition": "Capability to develop or express auditory navigation and substitution in a declared context without inheriting broader claims.", "evidence_summary": "Sensory-substitution tools can add real spatial information—but the capability belongs to person, device, training, mobility tools and environment together.", "supportable_public_claim": "Auditory and haptic substitution can add selected navigation information in a declared device-plus-user configuration; it does not restore biological vision or universally replace a cane, guide dog or O&M training.", "measurement_boundary": "Report intended-user status, training, device on/off, cane/guide-dog/human support, collision type, speed, cognitive load, dropout and failure mode; no device-only score is capability in full.", "myth_to_metric": { "myth": "See with sound", "metric": "Device-on/off added value in intended users with established aids, failures and delayed use", "boundary": "Encoded spatial information is not biological vision, universal safety or authority to remove a person's chosen mobility tools." }, "limiting_findings": [ "One pilot system did not outperform the white cane and device-only travel was slower with more collisions.", "A downward sensor missed low steps at unsafe rates.", "Helpful camera/AI output also slowed walking in a controlled comparison." ], "prohibited_claims": [ "Restore sight through sound", "Throw away the cane", "AI makes blind travel autonomous", "A blindfolded sighted test proves blind-user safety" ] }, "gold_source_lesson": { "curriculum_id": "G-CUR-007", "source_heading": "PWR-080 - Auditory navigation and substitution", "source_html_sha256": "11bc95917f493a826958c458de7d719d38723e573c6e64e9c7b2ce57bde09e87", "html": "This remains a configured specialist pathway.
\nTitan may help record:
\nTitan does not provide real-world navigation instruction, traffic exposure, mobility training or device fitting.
" }, "next_gate": "External confirmation is required before higher-authority use because: CLINICAL_HIGH_RISK_OR_REGULATED_CONFIGURATION; SUPERVISION_OR_NON_ATTEMPT_BOUNDARY; SAFETY_LEGITIMACY_RESTRICTED.", "evidence_count": 6 }, "full_training_programme": false, "independently_validated": false, "publication_state": "PUBLISHED_PUBLIC_RESEARCH_EDITION__EDITORIAL_REVIEW_PENDING", "related_power_ids": [ "PWR-073", "PWR-074", "PWR-075", "PWR-076" ] }, { "power_id": "PWR-081", "learning_unit_id": "TLU-PWR-081", "title": "Tactile acuity", "main_description": "The learner completes 12 balanced same-or-different trials on one safe fingertip and reports accuracy, confidence and transfer to two unfamiliar safe surfaces.", "main_description_source": "FULL_TUTORIAL_OUTCOME", "family_id": "FAM-11", "family": "Touch, Chemosensation & Interoception", "superdomain": "Perception & Sensorimotor", "canonical_route": "/powers/pwr-081/", "treatment": "EVIDENCE_REVIEW_ROUTE", "treatment_label": "Full low-stakes tutorial", "treatment_boundary": "Titan teaches a concrete low-stakes method step by step while keeping evidence and transfer claims bounded.", "tutorial_route": "/tutorials/pwr-081/", "governed_lesson_route": null, "self_attempt_status": "PERMITTED_INSIDE_FULL_TUTORIAL_LIMITS", "gold_pathway_ids": [ "G-CUR-008" ], "route_membership": { "kind": "GOLD_PATHWAY", "id": "G-CUR-008", "coverage_status": "EXACT_ONCE" }, "source_authority_tier": "G2", "source_build_state": "TARGETED_REVIEW_REQUIRED", "source_instructional_route": "BOUNDED_GUIDED_EXERCISE", "source_count": 4, "research_depth": "DETAILED", "risk_level": "MODERATE; CHEMICAL_THERMAL_PAIN_AND_CLINICAL_ROUTES_RESTRICTED", "prerequisite_status": "NONE_FOR_READING__NO_PRACTICE_AUTHORITY", "learning_route": { "mode": "FULL_SELF_GUIDED_TUTORIAL", "label": "Learn tactile acuity step by step", "summary": "The learner completes 12 balanced same-or-different trials on one safe fingertip and reports accuracy, confidence and transfer to two unfamiliar safe surfaces.", "steps": [ [ "Get ready", "Check the chosen fingertip for intact skin, ordinary comfortable sensation and no new numbness or pain." ], [ "Learn the method", "6 concrete steps teach the permitted method from start to finish." ], [ "See right and wrong", "4 comparisons show correct or safer execution beside common wrong or riskier choices." ], [ "Practise", "Use one 8- to 12-trial session, two or three times in one week, with at least a day between sessions. On the last session replace one material pair. Do not increase pressure, temperature, sharpness or session length to create difficulty." ], [ "Check progress", "Divide correct responses by total trials and also report same-trial accuracy, different-trial accuracy, median confidence and unfamiliar-pair accuracy." ] ], "practical_authority": true, "provider_required": false, "next_action_route": "/tutorials/pwr-081/" }, "path_builder": { "selectable": true, "completion_allowed": true, "warning": "Titan teaches a concrete low-stakes method step by step while keeping evidence and transfer claims bounded." }, "full_tutorial": { "version": "3.0", "authorship": "POWER_SPECIFIC_FULL_TUTORIAL", "tutorial_mode": "SELF_GUIDED", "promise": "Tactile acuity is the ability to tell small touch details apart at a named body site. This lesson uses coded, room-temperature surfaces rather than needles, monofilaments, two-point tools or pain. You will keep the finger and contact time fixed, make a forced same-or-different choice, reveal the answer only afterwards and test a new pair later.", "power_id": "PWR-081", "title": "Tactile acuity", "lesson_type": "SELF_GUIDED", "headline": "Compare safe surface details with one fingertip and a hidden answer key", "plain_english_summary": "Tactile acuity is the ability to tell small touch details apart at a named body site. This lesson uses coded, room-temperature surfaces rather than needles, monofilaments, two-point tools or pain. You will keep the finger and contact time fixed, make a forced same-or-different choice, reveal the answer only afterwards and test a new pair later.", "outcome": "The learner completes 12 balanced same-or-different trials on one safe fingertip and reports accuracy, confidence and transfer to two unfamiliar safe surfaces.", "authority": { "learner_may": [ "Build and use the harmless coded surface board described here.", "Stop, use normal skin protection and choose a different non-clinical learning task." ], "qualified_person_required_for": [ "Clinical sensory testing, unexplained loss of sensation, pain treatment, burns, wounds or neurological concerns.", "Use of calibrated gratings, monofilaments, two-point discrimination or any diagnostic threshold." ], "never_do": [ "Use sharp, hot, cold, chemical, dirty, vibrating or painful stimuli.", "Treat this board as a diagnosis, a pain treatment or evidence of whole-body touch ability." ] }, "materials": [ "Six 5 cm squares of familiar clean, dry, blunt material, mounted securely in three matched pairs.", "Opaque codes on the back, a separate answer key, a coin or random-number list and a record sheet.", "A table, chair, timer and optional screen that blocks sight without restricting the hand." ], "before_you_start": [ "Check the chosen fingertip for intact skin, ordinary comfortable sensation and no new numbness or pain.", "Rub every panel with a cloth-covered finger first; remove anything loose, scratchy, allergenic or hard to clean.", "Choose one exploration rule: the pad of one finger, one left-to-right stroke and three seconds per panel." ], "steps": [ { "title": "Make coded pairs", "instruction": "Mount two samples from each of three safe material types. Give every panel a code that does not reveal its material, then write the true pairings on a separate key.", "reason": "Duplicate samples allow real same trials as well as different trials.", "success_check": "The answer key lists three pairs and cannot be seen from the touching side." }, { "title": "Fix the touch configuration", "instruction": "Name the fingertip, hand, stroke direction, pressure cue and three-second contact time. Use that same setup for every scored trial.", "reason": "Changing the site or movement changes what is being tested.", "success_check": "You can demonstrate the same single stroke twice without rubbing, tapping or switching fingers." }, { "title": "Create a balanced trial list", "instruction": "Prepare six same and six different pairings in a random order. Keep the list hidden until the response is made.", "reason": "A balanced, hidden order prevents guessing from a visible pattern.", "success_check": "The list has 12 trials, equal same and different answers, with no answer exposed early." }, { "title": "Touch and commit", "instruction": "Touch the first panel once, pause, touch the second once, then say same or different and give confidence from 0 to 100. Do not return for extra strokes.", "reason": "A committed response preserves a comparable amount of information on each trial.", "success_check": "Each row has one choice and one confidence number before feedback." }, { "title": "Reveal and name the cue", "instruction": "Check the key after each response. Mark correct or incorrect and write the cue you used, such as ridge spacing, softness or drag.", "reason": "Immediate, truthful feedback connects the cue with the result instead of rewarding confidence alone.", "success_check": "The record shows the answer, correctness and a concrete touch cue." }, { "title": "Retest without the old answers", "instruction": "After at least 48 hours, run eight new coded trials, including two safe material types not used in the first session. Keep the same finger and stroke rule.", "reason": "Delayed and unfamiliar trials separate repeated-board memory from limited near transfer.", "success_check": "The retest records old-pair and new-material accuracy separately." } ], "worked_example": { "scenario": "A board contains duplicate squares of smooth cotton, ribbed card and soft felt, coded A1 to A6.", "walkthrough": [ "Mina writes the three true pairings on a folded key and makes a list with six same and six different trials.", "She uses the right index fingertip, one three-second left-to-right stroke per panel and no visual view.", "On A2 then A5 she answers different at 70% confidence because the second panel drags more.", "The key shows cotton then felt, so she marks correct and names drag as the cue.", "Two days later she scores old pairs separately from new linen-versus-foam pairs." ], "result": "Mina scores 9/12 initially, then 6/8 on the delayed set, including 1/2 on unfamiliar materials. That is performance for this fingertip, board and response rule; it is not a clinical threshold or whole-body gain." }, "right_vs_wrong": [ { "situation": "Choosing stimuli", "right": "Use securely mounted, familiar, clean and comfortable room-temperature surfaces.", "wrong": "Use a pin, ice cube, heated object or mystery material to make differences stronger.", "why": "Clinical, thermal, chemical and painful stimuli add harm without improving this educational comparison." }, { "situation": "Exploration", "right": "Use one declared fingertip and the same timed stroke.", "wrong": "Rub until certain or switch fingers on difficult trials.", "why": "Unequal exploration makes trial scores incomparable." }, { "situation": "Feedback", "right": "Commit first, then reveal the coded answer.", "wrong": "Look at the material or answer key before deciding.", "why": "Previewing the answer measures memory and visual identification, not blind touch discrimination." }, { "situation": "Claim", "right": "Report correct choices for this board and novel pair separately.", "wrong": "Call an improved score a lower tactile threshold or pain recovery.", "why": "This fixture is not a validated threshold or clinical outcome measure." } ], "common_mistakes": [ { "mistake": "The two copies in a same pair are not actually alike.", "fix": "Cut duplicates from adjacent parts of one material and precheck them before coding." }, { "mistake": "Pressure increases when confidence falls.", "fix": "Use the same light contact cue and stop after one stroke, even when uncertain." }, { "mistake": "The trial order has mostly different answers.", "fix": "Build equal same and different trials before starting and randomise only their order." }, { "mistake": "Old-board memory is called transfer.", "fix": "Add unfamiliar safe surfaces after a delay and score them in their own column." } ], "practice": { "first_session": [ "Inspect and code six panels.", "Complete two unscored demonstrations to learn the stroke rule.", "Run 12 balanced trials with feedback after each response.", "Count correct same and correct different responses separately and stop before skin irritation." ], "repeat_plan": "Use one 8- to 12-trial session, two or three times in one week, with at least a day between sessions. On the last session replace one material pair. Do not increase pressure, temperature, sharpness or session length to create difficulty.", "progress_when": [ "On a second matched set, same and different errors are stable or lower than on the learner’s first rule-consistent set; an uncertain small-sample result is labelled uncertain.", "The learner follows the single-stroke rule without extra exploration.", "Accuracy on at least one unfamiliar pair is recorded rather than assumed." ], "do_not_progress_when": [ "Skin becomes sore, numb, broken or unusually sensitive.", "Performance depends on seeing codes, repeated rubbing or memorised trial order.", "The goal becomes diagnosis, Braille instruction or treatment of pain or sensory loss." ] }, "self_check": [ "Can you name the exact finger, movement and contact time used?", "Were equal same and different trials hidden until after each answer?", "Can you point to a separate score for unfamiliar materials?", "Can you explain why this is not a clinical tactile threshold?" ], "measurement": { "primary": "Balanced same-or-different accuracy at one declared fingertip.", "how": "Divide correct responses by total trials and also report same-trial accuracy, different-trial accuracy, median confidence and unfamiliar-pair accuracy.", "good_result": "A useful learning result is a rule-consistent record that separates same and different errors and shows whether the unfamiliar-pair result is reproduced on a second matched set. No fixed count is a clinical pass.", "does_not_prove": "It does not prove receptor change, clinical normality, pain improvement, Braille skill or transfer to another body site." }, "stop_and_get_help": [ "Stop for pain, burning, persistent tingling, new numbness, colour change, swelling or broken skin.", "Discard and clean the set if a surface becomes damp, dirty, loose or contaminated.", "Seek appropriate clinical advice for new, one-sided, spreading or function-changing sensory loss instead of repeating the test." ], "accessibility": [ "Use larger panels and a hand guide while preserving the single declared contact path.", "A helper may randomise and record spoken answers without cueing them.", "Use the most comfortable intact hand or body site and treat any site change as a new baseline, not a failure." ], "evidence_notes": [ { "claim": "Training gains in tactile spatial acuity approached a limit related to fingertip size and transferred less to an untrained finger.", "source_title": "A physical constraint on perceptual learning: tactile spatial acuity improves with training to a limit set by finger size", "source_url": "https://pubmed.ncbi.nlm.nih.gov/23719803/", "source_kind": "PRIMARY_RESEARCH" }, { "claim": "A pilot clinical trial did not show superiority to sham and reported worse pain in the intervention group, so this lesson makes no pain-treatment claim.", "source_title": "Tactile acuity training for patients with chronic low back pain: a pilot randomised controlled trial", "source_url": "https://pubmed.ncbi.nlm.nih.gov/24571855/", "source_kind": "PRIMARY_RESEARCH" } ], "limits": [ "Scores belong to the named fingertip, materials and exploration rule.", "Safe surface comparison is not two-point discrimination, grating threshold testing or diagnosis.", "Improvement on repeated panels may be item learning and must not be called universal tactile enhancement." ], "orientation": { "bounded_definition": "Capability to develop or express tactile acuity in a declared context without inheriting broader claims.", "evidence_summary": "Touch can sharpen where and how it is practised, but it does not become a universal extra sense.", "supportable_public_claim": "Tactile acuity can improve through discriminative practice at a trained body site, with smaller transfer and physical limits.", "measurement_boundary": "Use a reliable site-specific grating/tactile threshold with skin condition, finger geometry and response method declared; do not substitute two-point distance or pain change without validation.", "myth_to_metric": { "myth": "Read the world with a fingertip", "metric": "Site-specific tactile threshold plus unfamiliar-material and functional transfer", "boundary": "A trained finger threshold does not establish whole-body touch, pain cure or instant Braille literacy." }, "limiting_findings": [ "A pilot chronic-low-back-pain trial did not beat sham and the intervention group reported worse pain.", "Training gains approached a limit related to fingertip size and transferred less to an untrained finger." ], "prohibited_claims": [ "Superhuman touch everywhere", "Grow new receptors", "Braille is a generic brain hack", "Tactile drills cure chronic pain" ] }, "gold_source_lesson": { "curriculum_id": "G-CUR-008", "source_heading": "5. PWR-081 - Relative tactile detail", "source_html_sha256": "2c8c4097b41b38c332da9d9ef525e223372aa46809110cbe44d3b9f36f74fc21", "html": "This route asks whether two safe, familiar surfaces or raised patterns feel the same or different. It does not measure a clinical threshold.
\nUse the workbook template. Attach only materials you already handle safely: clean, dry, blunt, room-temperature and securely mounted. Examples can include familiar cloth, smooth card or corrugated card, but no particular material is required.
\nFixture description: Template for six coded tactile panels with safe-material rules.
\nDo not use two-point discrimination, monofilaments, needles, vibration thresholds or improvised clinical instruments.
" }, "next_gate": "External confirmation is required before higher-authority use because: CLINICAL_HIGH_RISK_OR_REGULATED_CONFIGURATION.", "evidence_count": 4 }, "full_training_programme": false, "independently_validated": false, "publication_state": "PUBLISHED_PUBLIC_RESEARCH_EDITION__EDITORIAL_REVIEW_PENDING", "related_power_ids": [ "PWR-082", "PWR-083", "PWR-084", "PWR-085" ] }, { "power_id": "PWR-082", "learning_unit_id": "TLU-PWR-082", "title": "Haptic object recognition", "main_description": "The learner completes six global-to-local scans, reports correct names and structural cues separately, and records which cue repairs each error on an unfamiliar-object retest.", "main_description_source": "FULL_TUTORIAL_OUTCOME", "family_id": "FAM-11", "family": "Touch, Chemosensation & Interoception", "superdomain": "Perception & Sensorimotor", "canonical_route": "/powers/pwr-082/", "treatment": "EVIDENCE_REVIEW_ROUTE", "treatment_label": "Full low-stakes tutorial", "treatment_boundary": "Titan teaches a concrete low-stakes method step by step while keeping evidence and transfer claims bounded.", "tutorial_route": "/tutorials/pwr-082/", "governed_lesson_route": null, "self_attempt_status": "PERMITTED_INSIDE_FULL_TUTORIAL_LIMITS", "gold_pathway_ids": [ "G-CUR-008" ], "route_membership": { "kind": "GOLD_PATHWAY", "id": "G-CUR-008", "coverage_status": "EXACT_ONCE" }, "source_authority_tier": "G1", "source_build_state": "TARGETED_REVIEW_REQUIRED", "source_instructional_route": "SELF_GUIDED_TUTORIAL", "source_count": 4, "research_depth": "DETAILED", "risk_level": "MODERATE; CHEMICAL_THERMAL_PAIN_AND_CLINICAL_ROUTES_RESTRICTED", "prerequisite_status": "NONE_FOR_READING__NO_PRACTICE_AUTHORITY", "learning_route": { "mode": "FULL_SELF_GUIDED_TUTORIAL", "label": "Learn haptic object recognition step by step", "summary": "The learner completes six global-to-local scans, reports correct names and structural cues separately, and records which cue repairs each error on an unfamiliar-object retest.", "steps": [ [ "Get ready", "Inspect every object visually and remove sharp edges, loose parts, residue, allergens and objects that can spill or switch on." ], [ "Learn the method", "6 concrete steps teach the permitted method from start to finish." ], [ "See right and wrong", "4 comparisons show correct or safer execution beside common wrong or riskier choices." ], [ "Practise", "Practise six to eight objects on two sessions per week for two weeks. Replace at least half the set each session and keep the same scan order. Stop before grip fatigue; do not shorten time until accuracy and complete cue descriptions are stable." ], [ "Check progress", "Count correct names out of six and separately count trials with an outer-form description, two linked parts and a confidence rating compared with correctness." ] ], "practical_authority": true, "provider_required": false, "next_action_route": "/tutorials/pwr-082/" }, "path_builder": { "selectable": true, "completion_allowed": true, "warning": "Titan teaches a concrete low-stakes method step by step while keeping evidence and transfer claims bounded." }, "full_tutorial": { "version": "3.0", "authorship": "POWER_SPECIFIC_FULL_TUTORIAL", "tutorial_mode": "SELF_GUIDED", "promise": "Haptic recognition combines skin sensation, hand movement and object knowledge. This lesson teaches a repeatable scan: find the outer envelope, edges, material and safe moving parts, then name the object only after describing those features. Sight stays blocked only while seated and handling harmless objects.", "power_id": "PWR-082", "title": "Haptic object recognition", "lesson_type": "SELF_GUIDED", "headline": "Identify safe familiar objects by tracing structure before naming them", "plain_english_summary": "Haptic recognition combines skin sensation, hand movement and object knowledge. This lesson teaches a repeatable scan: find the outer envelope, edges, material and safe moving parts, then name the object only after describing those features. Sight stays blocked only while seated and handling harmless objects.", "outcome": "The learner completes six global-to-local scans, reports correct names and structural cues separately, and records which cue repairs each error on an unfamiliar-object retest.", "authority": { "learner_may": [ "Practise seated with clean, blunt, lightweight household objects whose identity and safe use are already known.", "Use sight, a helper or an assistive grip whenever needed." ], "qualified_person_required_for": [ "Clinical assessment of object recognition by touch, sensation, hand function or neurological symptoms.", "Training with disability-specific orientation techniques when object handling has meaningful consequences." ], "never_do": [ "Handle blades, medicines, hot items, chemicals, glass, powered tools, choking hazards or unknown objects without sight.", "Treat a home score as neurological screening or proof that blindness improves touch." ] }, "materials": [ "Six familiar, clean, blunt, lightweight objects with distinct shapes, such as a spoon, peg, large key ring, sponge, cup and clothes brush.", "An opaque cloth bag or tabletop screen, numbered object labels, timer and record sheet.", "A stable chair and clear table with every object within easy reach." ], "before_you_start": [ "Inspect every object visually and remove sharp edges, loose parts, residue, allergens and objects that can spill or switch on.", "Choose one hand or declared two-hand method and a 20-second exploration limit.", "Arrange for a helper if reaching into a bag, grip loss or visual blocking could be unsafe." ], "steps": [ { "title": "Build a safe object set", "instruction": "Choose six known objects that differ in overall form and function. Number them and write the answer key before blocking sight.", "reason": "Known harmless objects keep the task about recognition, not mystery-object risk.", "success_check": "Every object has a number, name and passed safety check." }, { "title": "Find the outer envelope", "instruction": "With the object supported on the table, trace its overall length, width and thickness before exploring details.", "reason": "Global shape sharply narrows the possibilities and reduces aimless squeezing.", "success_check": "You can describe the object as long, round, flat, hollow or another clear form before naming it." }, { "title": "Trace edges and parts", "instruction": "Follow the perimeter and count handles, corners, openings, curves or branches. Keep fingers moving slowly toward known space.", "reason": "Relations among parts often identify an object better than texture alone.", "success_check": "The record names at least two parts and how they connect." }, { "title": "Check material and movement", "instruction": "Describe hard or soft, smooth or rough and flexible or rigid. Move a part only when the object is designed to move and the helper confirmed it is safe.", "reason": "Material and lawful movement provide extra cues without forcing or damaging the object.", "success_check": "No part is forced, detached or activated." }, { "title": "State a hypothesis before reveal", "instruction": "Name the object, give confidence from 0 to 100 and cite the two strongest cues. Then look or let the helper reveal it.", "reason": "Committing first makes feedback informative and separates recognition from post-hoc explanation.", "success_check": "The name, confidence and cues are written before visual confirmation." }, { "title": "Repair on a new object", "instruction": "For an error, identify the missed cue and apply the full scan to a matched unfamiliar object after at least 24 hours.", "reason": "A new item tests whether the scan method transfers beyond memorising one set.", "success_check": "The retest log identifies the earlier error and the cue used on the new item." } ], "worked_example": { "scenario": "Lee explores a clean silicone pastry brush hidden behind a tabletop screen.", "walkthrough": [ "Lee supports the object on the table and finds a long narrow envelope.", "He traces a thicker handle joined to a flat fan-shaped end.", "He notes that the end is soft, flexible and made of many parallel strips.", "He answers pastry brush at 85% confidence, citing handle-plus-flexible-strips.", "After reveal, he later uses the same scan to distinguish an unfamiliar bottle brush from a comb." ], "result": "The object is correctly identified from connected parts, material and flexibility. The later item shows use of the scan on a new object, not general neurological competence." }, "right_vs_wrong": [ { "situation": "Initial contact", "right": "Support the object and map its overall form first.", "wrong": "Grab, squeeze and guess from the first texture.", "why": "A global-to-local scan exposes diagnostic structure and reduces unsafe manipulation." }, { "situation": "Moving parts", "right": "Move only a known part designed to move.", "wrong": "Twist, open or press an unknown feature to see what happens.", "why": "An object can activate, break, spill or pinch." }, { "situation": "Answer timing", "right": "Record a name and cues before reveal.", "wrong": "Peek, then describe why the answer was obvious.", "why": "Post-reveal explanations cannot show what supported the original judgement." }, { "situation": "Transfer", "right": "Use a new safe object with related structure.", "wrong": "Repeat the same six objects until the names are automatic.", "why": "Repeated-set recall can improve without better haptic analysis." } ], "common_mistakes": [ { "mistake": "Texture dominates every guess.", "fix": "Require an outer-form statement and two connected parts before naming." }, { "mistake": "The hand leaves the table and the object drops.", "fix": "Keep the item supported on a nonslip mat and explore within the table boundary." }, { "mistake": "The learner names several possibilities without committing.", "fix": "Choose one best hypothesis, confidence and two cues before reveal." }, { "mistake": "Orientation changes between baseline and retest.", "fix": "Record starting orientation and hand; treat a changed setup as a transfer trial, not a clean repeat." } ], "practice": { "first_session": [ "Inspect and number six objects with sight.", "Complete two unscored global-to-local scans.", "Run six timed hidden trials with immediate reveal.", "For each miss, write the overlooked structural cue.", "Finish with two new objects if the hand remains comfortable." ], "repeat_plan": "Practise six to eight objects on two sessions per week for two weeks. Replace at least half the set each session and keep the same scan order. Stop before grip fatigue; do not shorten time until accuracy and complete cue descriptions are stable.", "progress_when": [ "Every object is scanned in the declared order, and each correct name cites two features that are truly present.", "The scan proceeds envelope, parts, material, then name without prompting.", "Unfamiliar-object names, cue completeness and errors are reported separately rather than forced through a universal pass count." ], "do_not_progress_when": [ "Objects are guessed from memorised order or sound cues.", "Grip fatigue, pain, numbness or dropping appears.", "The set would need hazardous, unfamiliar or consequential items to become harder." ] }, "self_check": [ "Did you describe overall form before naming?", "Can you point to two connected parts that support the answer?", "Were all moving features known to be safe before movement?", "Does the retest contain objects not present in the first set?" ], "measurement": { "primary": "Correct object identification plus complete structural cue record.", "how": "Count correct names out of six and separately count trials with an outer-form description, two linked parts and a confidence rating compared with correctness.", "good_result": "Every object receives a complete envelope–parts–material scan before naming, each name is checked against the key, and the learner shows the named error repair on an unfamiliar object without a safety breach. The number correct is descriptive, not a diagnostic pass score.", "does_not_prove": "It does not diagnose touch-recognition difficulty, establish clinical normality or show superior touch across scales and object classes." }, "stop_and_get_help": [ "Stop for hand pain, cramping, new numbness, tremor, dropping or skin irritation.", "Stop immediately if an object is not what the helper expected, has a sharp edge or can activate, spill or break.", "Seek clinical assessment for new difficulty recognising ordinary objects together with weakness, sensory loss, confusion or other neurological change." ], "accessibility": [ "Use two hands, a nonslip mat or a helper-held object and record that support.", "Extend exploration time while keeping the same scan order.", "Use larger objects with high-contrast verbal labels for low vision, or sighted exploration when blocking vision is not appropriate." ], "evidence_notes": [ { "claim": "Long-term memory for actively touched objects can retain substantial information and can include cross-modal transfer.", "source_title": "Long-Term Memory for Haptically Explored Objects: Fidelity, Durability, Incidental Encoding, and Cross-Modal Transfer", "source_url": "https://pubmed.ncbi.nlm.nih.gov/30376424/", "source_kind": "PRIMARY_RESEARCH" }, { "claim": "Haptic shape discrimination depends on object scale and age, so one object set cannot establish general ability.", "source_title": "Aging and haptic shape discrimination: the effects of variations in size", "source_url": "https://pubmed.ncbi.nlm.nih.gov/32895441/", "source_kind": "PRIMARY_RESEARCH" } ], "limits": [ "Recognition depends on familiarity, size, hand access, starting orientation and time.", "The safe household set does not assess clinical sensory or neurological status.", "A group difference involving blind participants cannot be turned into a biological superiority claim." ], "orientation": { "bounded_definition": "Capability to develop or express haptic object recognition in a declared context without inheriting broader claims.", "evidence_summary": "Active touch can build detailed, durable object knowledge—through a route whose performance depends on experience and object design.", "supportable_public_claim": "Humans can recognise and retain rich information about objects through active touch, but performance depends on object, scale, experience and access.", "measurement_boundary": "Declare object familiarity, scale, exploration time, hand/motor access, vision condition and same- versus crossmodal test; report errors by object class.", "myth_to_metric": { "myth": "Know any object by touch", "metric": "Novel-object identification and delayed crossmodal recognition by scale and access", "boundary": "Memory for handled familiar objects does not establish universal material, hazard or navigation recognition." }, "limiting_findings": [ "Age and reduced object scale lowered haptic shape discrimination.", "A group comparison cannot establish that blindness biologically enhances touch." ], "prohibited_claims": [ "Blind people have automatically superior touch", "Identify any object instantly", "Haptic memory replaces every other sense", "One object test measures tactile intelligence" ] }, "gold_source_lesson": { "curriculum_id": "G-CUR-008", "source_heading": "6. PWR-082 - Haptic object recognition", "source_html_sha256": "061855f4280d20112c0e7174c12bfd4d95d8cafcb8598630a36648daee96f556", "html": "Haptic recognition combines cutaneous touch with active movement and object knowledge.
\nFixture description: Criteria for a safe haptic object-recognition set.
\nUse four to six familiar, clean, blunt, lightweight objects while seated. Orientation and exploration hand matter; record them.
" }, "next_gate": "External confirmation is required before higher-authority use because: CLINICAL_HIGH_RISK_OR_REGULATED_CONFIGURATION.", "evidence_count": 4 }, "full_training_programme": false, "independently_validated": false, "publication_state": "PUBLISHED_PUBLIC_RESEARCH_EDITION__EDITORIAL_REVIEW_PENDING", "related_power_ids": [ "PWR-081", "PWR-083", "PWR-084", "PWR-085" ] }, { "power_id": "PWR-083", "learning_unit_id": "TLU-PWR-083", "title": "Thermal discrimination", "main_description": "With a qualified clinician, the learner completes familiarisation and a declared set of calibrated warm and cool trials, producing separate site-specific detection results with symptoms and equipment settings recorded.", "main_description_source": "FULL_TUTORIAL_OUTCOME", "family_id": "FAM-11", "family": "Touch, Chemosensation & Interoception", "superdomain": "Perception & Sensorimotor", "canonical_route": "/powers/pwr-083/", "treatment": "SPECIALIST_PROVIDER_ROUTE", "treatment_label": "Full supervised tutorial", "treatment_boundary": "Titan teaches the complete method; a qualified person controls the parts that require supervision, clearance, specialist equipment, load, dose or progression.", "tutorial_route": "/tutorials/pwr-083/", "governed_lesson_route": null, "self_attempt_status": "PROHIBITED_WITHOUT_QUALIFIED_SUPERVISION", "gold_pathway_ids": [ "G-CUR-008" ], "route_membership": { "kind": "GOLD_PATHWAY", "id": "G-CUR-008", "coverage_status": "EXACT_ONCE" }, "source_authority_tier": "G4", "source_build_state": "EXTERNAL_PROVIDER_ROUTE", "source_instructional_route": "LEARN_ELSEWHERE_TRACK_WITH_TITAN", "source_count": 4, "research_depth": "DETAILED", "risk_level": "MODERATE; CHEMICAL_THERMAL_PAIN_AND_CLINICAL_ROUTES_RESTRICTED", "prerequisite_status": "QUALIFIED_PROVIDER_DETERMINES", "learning_route": { "mode": "FULL_SUPERVISED_TUTORIAL", "label": "Learn thermal discrimination step by step", "summary": "With a qualified clinician, the learner completes familiarisation and a declared set of calibrated warm and cool trials, producing separate site-specific detection results with symptoms and equipment settings recorded.", "steps": [ [ "Get ready", "Tell the clinician about skin damage, altered sensation, circulation issues, recent injury, medication changes and prior adverse reactions." ], [ "Learn the method", "6 concrete steps teach the permitted method from start to finish." ], [ "See right and wrong", "4 comparisons show correct or safer execution beside common wrong or riskier choices." ], [ "Practise", "Testing or practice frequency, trial count and any repeat are set by the qualified clinician for the declared purpose. A repeat uses the same site, device, starting temperature, rate, response rule and rest unless the change is explicitly the question." ], [ "Check progress", "Use the calibrated device protocol to record response temperature for each valid trial, catch-trial behaviour, within-session spread and symptoms; the clinician applies the declared summary rule." ] ], "practical_authority": false, "provider_required": true, "next_action_route": "/tutorials/pwr-083/" }, "path_builder": { "selectable": true, "completion_allowed": true, "warning": "Titan teaches the complete method; a qualified person controls the parts that require supervision, clearance, specialist equipment, load, dose or progression." }, "full_tutorial": { "version": "3.0", "authorship": "POWER_SPECIFIC_FULL_TUTORIAL", "tutorial_mode": "SUPERVISED", "promise": "Thermal discrimination is noticing a controlled change from a declared starting temperature at a named body site. A qualified clinician uses calibrated equipment, protects the skin, randomises trials and interprets thresholds. The learner still learns the response method, reports the first clear change and checks that the configuration stays constant. There is no home heat, ice or tolerance test.", "power_id": "PWR-083", "title": "Thermal discrimination", "lesson_type": "SUPERVISED", "headline": "Complete a calibrated warm-versus-cool detection session under clinical control", "plain_english_summary": "Thermal discrimination is noticing a controlled change from a declared starting temperature at a named body site. A qualified clinician uses calibrated equipment, protects the skin, randomises trials and interprets thresholds. The learner still learns the response method, reports the first clear change and checks that the configuration stays constant. There is no home heat, ice or tolerance test.", "outcome": "With a qualified clinician, the learner completes familiarisation and a declared set of calibrated warm and cool trials, producing separate site-specific detection results with symptoms and equipment settings recorded.", "authority": { "learner_may": [ "Prepare a symptom and skin-history record, learn the response button and stop at any time.", "Ask the clinician to explain the body site, starting temperature, rate, limits and interpretation." ], "qualified_person_required_for": [ "Screening, equipment calibration, stimulus limits, trial order, skin inspection, measurement and interpretation.", "Any assessment related to neuropathy, pain, injury, medication, vascular disease or other clinical concern." ], "never_do": [ "Use ice, heated metal, hot water, chemicals, electrical devices or improvised probes to find a threshold.", "Continue until pain, tissue discomfort or tolerance, or compare sites using uncontrolled household objects." ] }, "materials": [ "A clinic-approved calibrated thermal sensory device with a contact thermode—a temperature-controlled skin probe—and automatic safety limits.", "Provider protocol, response button, skin inspection supplies and a settings/result sheet.", "A stable supported position and the learner’s usual communication and mobility aids." ], "before_you_start": [ "Tell the clinician about skin damage, altered sensation, circulation issues, recent injury, medication changes and prior adverse reactions.", "The clinician confirms the exact site is intact and suitable and explains warm detection, cool detection and the stop response.", "Agree a plain stop word or button that ends a trial immediately without needing to justify it." ], "steps": [ { "title": "Declare the clinical question", "instruction": "State whether the session concerns warm detection, cool detection or both, at which body site and for what legitimate clinical purpose.", "reason": "A threshold has meaning only in its declared clinical context.", "success_check": "The record names question, site and clinician before contact." }, { "title": "Inspect and configure", "instruction": "The clinician inspects the site, verifies the device, sets the starting temperature, change rate and protective limits, and records them.", "reason": "Skin condition and stimulus parameters materially change the result and safety.", "success_check": "Device identity, site, baseline and limits are written before trials." }, { "title": "Learn the first-change response", "instruction": "During non-scored familiarisation, press the button or say now at the first clear change toward warm or cool. Do not wait for a strong or painful sensation.", "reason": "The task measures detection, not endurance or certainty.", "success_check": "The learner can explain and demonstrate the response before scored trials." }, { "title": "Complete randomised trials", "instruction": "Rest the tested part, keep eyes away from the display and respond once per provider-initiated trial. The clinician varies direction and catch trials according to the protocol.", "reason": "Random order and catch trials reduce prediction and response habit.", "success_check": "Every trial has direction, response, temperature and any deviation recorded." }, { "title": "Pause and inspect", "instruction": "Between blocks, report after-sensation, pain, numbness, anxiety or uncertainty. The clinician checks the site and decides whether to continue.", "reason": "Repeated contact can change sensation or expose a problem that invalidates further testing.", "success_check": "A continue or stop decision is documented after each block." }, { "title": "Interpret within the site and protocol", "instruction": "The clinician calculates separate warm and cool results, compares them only with suitable references or prior matched tests and explains measurement error.", "reason": "A single number is not tissue safety, pain or whole-body thermoregulation.", "success_check": "The result names direction, site, protocol, uncertainty and non-claims." } ], "worked_example": { "scenario": "A clinician assesses warm and cool detection at the intact skin of the left forearm with a calibrated contact thermode.", "walkthrough": [ "The clinician documents the forearm site, equipment, 32°C start and protocol limits after screening.", "Sam practises pressing at the first slight warm or cool change and repeats the rule in his own words.", "He completes a random block containing warm, cool and catch trials while the clinician records each response.", "After the block Sam reports no pain or lingering sensation; the clinician inspects the skin and continues once.", "The clinician reports separate warm and cool detection values with protocol variability and explains that they do not show burn safety." ], "result": "The session produces interpretable results for the left forearm under that device and protocol. It does not establish a safe household temperature, a pain threshold or general thermal ability." }, "right_vs_wrong": [ { "situation": "Stimulus control", "right": "Use calibrated equipment with clinician-set automatic limits.", "wrong": "Compare a freezer pack with a heated spoon at home.", "why": "Household stimuli have uncontrolled temperature, contact area and injury risk." }, { "situation": "Response point", "right": "Respond at the first clear warm or cool change.", "wrong": "Wait until the sensation is intense or painful to be certain.", "why": "Waiting turns detection into a tolerance task and can increase harm." }, { "situation": "Comparison", "right": "Compare only matched site, device and protocol results.", "wrong": "Compare a fingertip value with a forearm value as if site does not matter.", "why": "Body site strongly affects thermal sensitivity." }, { "situation": "Interpretation", "right": "Report warm and cool detection separately.", "wrong": "Call a detection value proof that the skin is safe from heat or cold.", "why": "Detection, tissue injury and thermoregulation are different outcomes." } ], "common_mistakes": [ { "mistake": "The learner predicts a regular alternation.", "fix": "Use provider-randomised directions and catch trials." }, { "mistake": "The button is pressed only when certainty is high.", "fix": "Rehearse first-clear-change responding and record uncertainty separately." }, { "mistake": "Starting temperature is omitted.", "fix": "Copy the device baseline and rate onto every result sheet." }, { "mistake": "A changed body site is treated as a retest.", "fix": "Label it as a new configuration and do not calculate change from the old site." } ], "practice": { "first_session": [ "Provider screening and skin check.", "Two to four unscored familiarisation trials.", "One short randomised scored block.", "Symptom report, skin recheck and explanation of the result." ], "repeat_plan": "Testing or practice frequency, trial count and any repeat are set by the qualified clinician for the declared purpose. A repeat uses the same site, device, starting temperature, rate, response rule and rest unless the change is explicitly the question.", "progress_when": [ "The learner responds to first change rather than intensity.", "Catch trials and repeated estimates show acceptable provider-defined consistency.", "The skin remains intact and there is no adverse sensation after the session." ], "do_not_progress_when": [ "Pain, lingering heat or cold, skin change or distress occurs.", "The device, site or protocol cannot be reproduced.", "The learner or clinician is seeking a pain threshold, tolerance target or household safety limit." ] }, "self_check": [ "Can you state the exact site and starting temperature?", "Did you respond at first change rather than pain?", "Are warm and cool results reported separately?", "Can you name what the detection result does not establish?" ], "measurement": { "primary": "Provider-calculated warm and cool detection results at one named body site.", "how": "Use the calibrated device protocol to record response temperature for each valid trial, catch-trial behaviour, within-session spread and symptoms; the clinician applies the declared summary rule.", "good_result": "The provider judges familiarisation adequate and valid trials sufficiently consistent for the stated clinical question, without adverse skin or sensory effects.", "does_not_prove": "It does not establish pain tolerance, burn or cold-injury safety, thermoregulatory control, diagnosis by itself or durable training." }, "stop_and_get_help": [ "End the stimulus immediately for pain, burning, prolonged after-sensation, numbness, blanching, redness, swelling or distress.", "Do not test skin that is broken, infected, recently injured or newly altered in sensation until clinically reviewed.", "Seek prompt medical advice for a new thermal-sensation loss, especially with weakness, spreading numbness, injury or vascular signs." ], "accessibility": [ "Use a large response switch, spoken response or eye-gaze response with its timing method recorded.", "Support the limb and change posture without changing the named contact site.", "Offer breaks, predictable explanation and a support person; the learner retains the right to stop any trial." ], "evidence_notes": [ { "claim": "Warm and cold perception thresholds differ across proximal and distal body regions, so the body site must be declared.", "source_title": "Method-of-limits; Cold and warm perception thresholds at proximal and distal body regions", "source_url": "https://pubmed.ncbi.nlm.nih.gov/30215024/", "source_kind": "PRIMARY_RESEARCH" }, { "claim": "Whole-body cooling changes local warm and cold sensitivity and does not simply improve it.", "source_title": "Age comparison of changes in local warm and cold sensitivity due to whole body cooling", "source_url": "https://pubmed.ncbi.nlm.nih.gov/35180960/", "source_kind": "PRIMARY_RESEARCH" } ], "limits": [ "Only a qualified provider controls thermal stimulation under this lesson.", "No mapped evidence established retained thermal-discrimination training.", "Detection thresholds cannot be interpreted as tissue-safety limits or pain reports." ], "orientation": { "bounded_definition": "Capability to develop or express thermal discrimination in a declared context without inheriting broader claims.", "evidence_summary": "Thermal sensitivity is a protective, context-dependent sense—not a route to heat or cold immunity.", "supportable_public_claim": "People discriminate warm and cold, but thresholds depend strongly on body site, age and body state; durable enhancement through training is not established.", "measurement_boundary": "Use calibrated noninjurious warm/cold detection thresholds at a named site and starting temperature; never equate detection with tissue safety or thermoregulatory control.", "myth_to_metric": { "myth": "Temperature-proof skin", "metric": "Calibrated warm/cold threshold by body site and state", "boundary": "Detection does not establish tolerance, tissue safety, core-temperature control or training." }, "limiting_findings": [ "Whole-body cooling changes local sensitivity rather than simply improving it.", "No mapped primary study established retained thermal-discrimination training." ], "prohibited_claims": [ "Become immune to heat or cold", "Train away burn warnings", "Cold exposure sharpens thermal sense", "A threshold proves metabolic or autonomic control" ] }, "gold_source_lesson": { "curriculum_id": "G-CUR-008", "source_heading": "9. PWR-083 and PWR-084 - why these are not self-tests", "source_html_sha256": "be52a40416ad0206abceccf6b1027015e8dd6d94181d8f203c261124f179288c", "html": "Clinical quantitative sensory testing uses calibrated thermal and mechanical equipment, reference procedures and trained interpretation. Improvised heat/cold or pain-threshold tasks are not equivalent.
\nPain and nociception are also not interchangeable. Pain is a personal sensory and emotional experience; it cannot be inferred from one stimulus or one score.
\nPWR-083 remains G4 specialist. PWR-084 remains G6 restricted. There is no hot/cold fixture, pinprick, pressure-pain, electrical, chemical, burn, ice or “tolerance” challenge in this package.
" }, "next_gate": "External confirmation is required before higher-authority use because: CLINICAL_HIGH_RISK_OR_REGULATED_CONFIGURATION; SAFETY_LEGITIMACY_RESTRICTED.", "evidence_count": 4 }, "full_training_programme": false, "independently_validated": false, "publication_state": "PUBLISHED_PUBLIC_RESEARCH_EDITION__EDITORIAL_REVIEW_PENDING", "related_power_ids": [ "PWR-081", "PWR-082", "PWR-084", "PWR-085" ] }, { "power_id": "PWR-084", "learning_unit_id": "TLU-PWR-084", "title": "Nociceptive discrimination", "main_description": "Using the supplied practice-only routing card, the learner completes two sets of fictional cases by separating event, sensation, pain report, function and uncertainty, then consistently selects EMERGENCY, URGENT, ROUTINE CLINICAL or MONITOR without provoking pain.", "main_description_source": "FULL_TUTORIAL_OUTCOME", "family_id": "FAM-11", "family": "Touch, Chemosensation & Interoception", "superdomain": "Perception & Sensorimotor", "canonical_route": "/powers/pwr-084/", "treatment": "RESTRICTED_EXPLAINER_ONLY", "treatment_label": "Full safety and decision tutorial", "treatment_boundary": "Titan teaches recognition, prevention, safe response and accountable routing without teaching the prohibited act.", "tutorial_route": "/tutorials/pwr-084/", "governed_lesson_route": null, "self_attempt_status": "PROHIBITED_ACT_EXCLUDED", "gold_pathway_ids": [ "G-CUR-008" ], "route_membership": { "kind": "GOLD_PATHWAY", "id": "G-CUR-008", "coverage_status": "EXACT_ONCE" }, "source_authority_tier": "G6", "source_build_state": "RESTRICTED", "source_instructional_route": "EXPLAINER_ONLY_RESTRICTED", "source_count": 6, "research_depth": "DEEP", "risk_level": "MODERATE; CHEMICAL_THERMAL_PAIN_AND_CLINICAL_ROUTES_RESTRICTED", "prerequisite_status": "NONE_FOR_READING__NO_PRACTICE_AUTHORITY", "learning_route": { "mode": "FULL_RESTRICTED_TUTORIAL", "label": "Learn nociceptive discrimination step by step", "summary": "Using the supplied practice-only routing card, the learner completes two sets of fictional cases by separating event, sensation, pain report, function and uncertainty, then consistently selects EMERGENCY, URGENT, ROUTINE CLINICAL or MONITOR without provoking pain.", "steps": [ [ "Get ready", "End any deliberate pain test and move away from an accidental hazard when that can be done safely." ], [ "Learn the method", "6 concrete steps teach the permitted method from start to finish." ], [ "See right and wrong", "5 comparisons show correct or safer execution beside common wrong or riskier choices." ], [ "Practise", "For Set 2, wait at least seven days and do not reread the Set 1 answers. Complete Cards E–H in shuffled order, then reveal the answer strip. Record delayed performance separately. Never use fictional cards to route a real symptom." ], [ "Check progress", "Score event, sensation, pain report, function, uncertainty, controlling sign and category. Any deliberate stimulus is an automatic failure. Score Set 1 and the seven-day Set 2 separately." ] ], "practical_authority": false, "provider_required": false, "next_action_route": "/tutorials/pwr-084/" }, "path_builder": { "selectable": true, "completion_allowed": true, "warning": "Titan teaches recognition, prevention, safe response and accountable routing without teaching the prohibited act." }, "full_tutorial": { "version": "3.0", "authorship": "POWER_SPECIFIC_FULL_TUTORIAL", "tutorial_mode": "RESTRICTED", "promise": "Nociception is neural processing of potentially tissue-damaging events; pain is a personal sensory and emotional experience. They are related but not interchangeable. This lesson does not create, intensify or compare painful stimuli. It teaches how to stop self-provocation, describe an already-occurring experience, separate observation from interpretation, check urgent warning signs and route the concern to appropriate care.", "power_id": "PWR-084", "title": "Nociceptive discrimination", "lesson_type": "RESTRICTED", "headline": "Describe possible tissue-threat signals without provoking pain or claiming a diagnosis", "plain_english_summary": "Nociception is neural processing of potentially tissue-damaging events; pain is a personal sensory and emotional experience. They are related but not interchangeable. This lesson does not create, intensify or compare painful stimuli. It teaches how to stop self-provocation, describe an already-occurring experience, separate observation from interpretation, check urgent warning signs and route the concern to appropriate care.", "outcome": "Using the supplied practice-only routing card, the learner completes two sets of fictional cases by separating event, sensation, pain report, function and uncertainty, then consistently selects EMERGENCY, URGENT, ROUTINE CLINICAL or MONITOR without provoking pain.", "authority": { "learner_may": [ "Stop a painful activity, move away from an ordinary hazard and describe an experience that is already present.", "Use ordinary first-aid or emergency services according to local official guidance and the actual event." ], "qualified_person_required_for": [ "Nociceptive or quantitative sensory testing, diagnosis, pain treatment and interpretation of new or persistent symptoms.", "Any deliberate mechanical, thermal, electrical or chemical stimulus used to assess nociception." ], "never_do": [ "Create pain with heat, ice, pressure, pinprick, electricity, chemicals, breath holding or exercise to compare tolerance.", "Infer another person’s pain from stimulus intensity, behaviour, a scan or a single score." ] }, "materials": [ "A symptom sheet with separate fields for event, observed facts, sensation, pain report, function, possible explanation and warning signs.", "The learner’s current local official health-service contact details for any real symptom.", "FICTIONAL PRACTICE ROUTING CARD — use only for the supplied fictional cases: choose EMERGENCY when the card states immediate danger such as trouble breathing, chest pain, new confusion, new major weakness, uncontrolled bleeding or severe injury; choose URGENT for a new or rapidly spreading sensory change accompanied by altered ordinary function; choose ROUTINE CLINICAL for persistent or recurrent unexplained symptoms without an emergency or urgent feature; choose MONITOR only for a mild, clearly improving event with normal function and none of the listed warning signs.", "MONITOR means keep observing according to the card and escalate if the pattern stops improving or a warning sign appears.", "Set 1 Card A: chest pain and trouble breathing began ten minutes ago.", "Set 1 Card B: new burning and numbness along one foot began without a clear injury and walking has become less steady.", "Set 1 Card C: unexplained hand burning has returned most evenings for three weeks, with no listed emergency or urgent feature.", "Set 1 Card D: after an ordinary minor bump, a small local ache has steadily improved for 24 hours; ordinary movement is normal and no warning sign is present.", "Set 2 Card E: new confusion and major one-sided weakness began suddenly.", "Set 2 Card F: numbness is spreading through one hand and the person has begun dropping ordinary objects.", "Set 2 Card G: unexplained pain has repeatedly interrupted sleep for two weeks, without a listed emergency or urgent feature.", "Set 2 Card H: a mild local ache after a known low-risk activity is clearly improving, ordinary function is normal and no warning sign is present.", "Covered practice answer strip: Set 1 A = EMERGENCY, B = URGENT, C = ROUTINE CLINICAL, D = MONITOR. Set 2 E = EMERGENCY, F = URGENT, G = ROUTINE CLINICAL, H = MONITOR.", "No heat, ice, pressure, pin, electrical, chemical, exercise-tolerance or other stimulus equipment." ], "before_you_start": [ "End any deliberate pain test and move away from an accidental hazard when that can be done safely.", "For a real symptom, use the current local official service rather than the fictional practice card.", "If a real event includes an emergency sign, get emergency help instead of completing the sheet.", "Ask permission before helping another person and preserve their own words for their experience." ], "steps": [ { "title": "Stop provocation", "instruction": "Do not press, heat, cool, stretch, exercise or repeat a movement merely to see whether pain returns. Make the immediate situation safe.", "reason": "Provocation can worsen harm and does not create a valid home test of nociception.", "success_check": "No challenge is underway and no additional stimulus has been introduced." }, { "title": "Write the event", "instruction": "Record what happened immediately before the experience, if known, using observable language. If no trigger is known, write “no clear event.”", "reason": "An event is useful information but is not itself pain or a diagnosis.", "success_check": "The record clearly distinguishes a known event from an unknown trigger." }, { "title": "Record the person’s experience", "instruction": "Use the person’s own words for location, quality, start time, pattern and current intensity.", "reason": "Pain is personal; replacing the report with a disease label destroys information.", "success_check": "Location, quality, timing, pattern and the person’s chosen rating or communication method are present." }, { "title": "Separate the layers", "instruction": "Put observed facts, felt sensation, pain report and changed function in separate boxes. Put possible explanations in a fifth box labelled UNCERTAIN.", "reason": "This prevents an event, visible sign or neural term from being treated as the whole experience.", "success_check": "Every sentence belongs to one declared box and no uncertain explanation is written as fact." }, { "title": "Choose one routing category", "instruction": "For fictional practice, apply the supplied FICTIONAL PRACTICE ROUTING CARD exactly once. For a real symptom, apply the current local official rule. Select EMERGENCY, URGENT, ROUTINE CLINICAL or MONITOR and copy the exact sign that controls the choice.", "reason": "A fixed rule prevents repeated body testing and arbitrary escalation or dismissal.", "success_check": "The chosen category and its controlling sign are both written down." }, { "title": "Route or monitor", "instruction": "Contact the selected real service when the real rule requires it. If the applicable rule permits MONITOR, write what will be observed, when it will be reviewed and which change would trigger escalation.", "reason": "MONITOR remains an active plan rather than an assumption that nothing matters.", "success_check": "The record contains either the contacted service and next action or a timed monitoring and escalation plan." } ], "worked_example": { "scenario": "Set 1 Card B: Noor develops new burning pain and numbness along one foot without a clear injury, and walking has become less steady.", "walkthrough": [ "Noor stops walking merely to test the feeling and sits somewhere safe.", "She records “no clear event,” the exact foot area, burning quality, start time, numbness and changed walking function.", "She writes “possible nerve problem” only in the UNCERTAIN box.", "The fictional card assigns a new sensory change plus altered ordinary function to URGENT.", "For a real event, Noor would use her current local urgent clinical service and report what began, what changed and what she did not provoke." ], "result": "Noor has neither measured nociception nor diagnosed a disorder. She has stopped self-provocation, preserved the useful facts and selected the accountable route." }, "right_vs_wrong": [ { "situation": "Checking the sensation", "right": "Describe what is already present once and stop provoking it.", "wrong": "Press harder, add cold or repeat movement to discover a threshold.", "why": "Deliberate provocation can worsen harm and does not validate a diagnosis." }, { "situation": "Terminology", "right": "Record “burning pain rated 6/10 with numbness” in the person’s words.", "wrong": "Write “the nerves fired at level six, so damage is proven.”", "why": "A pain rating is not a direct meter of neural activity or tissue damage." }, { "situation": "Routing", "right": "Copy the exact rule and the sign that controls the category.", "wrong": "Choose a category from intuition and then search for a reason.", "why": "The supplied rule is what makes the fictional exercise reproducible." }, { "situation": "Monitoring", "right": "Write a review time and the change that would trigger escalation.", "wrong": "Treat MONITOR as permission to ignore change indefinitely.", "why": "Monitoring is a defined observation and escalation plan." }, { "situation": "Another person", "right": "Accept and record their report with consent.", "wrong": "Infer their pain from whether they cry, withdraw or remain calm.", "why": "Behaviour does not settle another person’s lived experience." } ], "common_mistakes": [ { "mistake": "Pain and nociception are written as synonyms.", "fix": "Separate the person’s pain report from the event and any proposed neural mechanism." }, { "mistake": "The area is repeatedly pressed during recording.", "fix": "Stop and write “not retested.”" }, { "mistake": "A numerical rating is treated as tissue damage.", "fix": "Use the rating to communicate the experience or change, not to infer damage or safety." }, { "mistake": "A possible explanation becomes a declared diagnosis.", "fix": "Move it into the UNCERTAIN box and name what evidence is missing." }, { "mistake": "MONITOR is recorded without a review time or escalation sign.", "fix": "Copy both from the applicable routing card before finishing." } ], "practice": { "first_session": [ "Cover the answer strip and read the FICTIONAL PRACTICE ROUTING CARD.", "Complete all seven symptom fields for Set 1 Cards A–D without inventing a diagnosis or adding a stimulus.", "For every card, lock one category and copy the exact controlling sign.", "For the MONITOR card, write a review point and escalation trigger.", "Reveal the answer strip only after all four decisions are locked, then correct every mismatch.", "Practise a 30-second handoff for Card B that includes the uncertainty." ], "repeat_plan": "For Set 2, wait at least seven days and do not reread the Set 1 answers. Complete Cards E–H in shuffled order, then reveal the answer strip. Record delayed performance separately. Never use fictional cards to route a real symptom.", "progress_when": [ "All four immediate and all four delayed categories match the supplied practice card.", "No case includes deliberate pain provocation.", "Event, sensation, pain report, function and uncertainty remain separate.", "Every MONITOR decision includes a review point and escalation sign." ], "do_not_progress_when": [ "A real symptom has an urgent or emergency feature.", "The exercise creates distress, compulsive checking or a wish to test tolerance.", "The learner attempts to assess another person without consent." ] }, "self_check": [ "Did I add any stimulus or repeated body test that must be removed?", "Are event, sensation, pain report, function and uncertainty in separate fields?", "Which exact card sentence controls the selected category?", "If the category is MONITOR, where are the review point and escalation sign?", "For a real symptom, have I discarded the fictional card and used the current local official route?" ], "measurement": { "primary": "Complete, non-provocative description and correct four-category routing of supplied fictional cases.", "how": "Score event, sensation, pain report, function, uncertainty, controlling sign and category. Any deliberate stimulus is an automatic failure. Score Set 1 and the seven-day Set 2 separately.", "good_result": "All seven fields are present and all four categories are correct in both sets; every MONITOR choice has a review and escalation plan, and no pain challenge is proposed.", "does_not_prove": "It does not measure nociceptive sensitivity, diagnose a cause, quantify tissue damage or demonstrate pain tolerance." }, "stop_and_get_help": [ "Use emergency services for severe or rapidly worsening symptoms, major injury, breathing difficulty, chest pain, confusion, new major weakness, uncontrolled bleeding or other local emergency criteria.", "Seek prompt clinical advice for new numbness, spreading symptoms, loss of function, signs of infection, significant burn or persistent unexplained pain.", "Stop the lesson and seek psychological or clinical support if it triggers trauma, compulsive body checking or deliberate self-harm urges." ], "accessibility": [ "Use a body outline, pointing, symbols, supported communication or an interpreter to capture the person’s own report.", "Allow a trusted supporter to write while the person controls the wording and consent.", "For children or people who do not use numerical ratings, use their established communication method and do not treat silence as absence of pain." ], "evidence_notes": [ { "claim": "IASP distinguishes pain, nociception, a noxious stimulus and nociceptive pain; neural activity or stimulus intensity does not settle the personal pain experience.", "source_title": "IASP Terminology: pain, nociception and related terms", "source_url": "https://www.iasp-pain.org/resources/terminology/", "source_kind": "OFFICIAL_GUIDANCE" }, { "claim": "Temporal-spatial discrimination for noxious stimuli was lower than for innocuous tactile stimuli, so pain provocation is not justified as an acuity game.", "source_title": "Tempo-spatial discrimination is lower for noxious stimuli than for innocuous stimuli", "source_url": "https://pubmed.ncbi.nlm.nih.gov/29112535/", "source_kind": "PRIMARY_RESEARCH" } ], "limits": [ "This lesson teaches recognition, non-provocation and routing, not nociceptive training.", "A careful record cannot replace examination or diagnosis.", "No stronger tolerance or reduced pain score is assumed to mean greater safety." ], "orientation": { "bounded_definition": "Capability to develop or express nociceptive discrimination in a declared context without inheriting broader claims.", "evidence_summary": "Pain is not a toughness score. Nociceptive discrimination is real, but deliberate painful training is not authorised.", "supportable_public_claim": "Nociceptive discrimination exists, but Titan has no public route for training it; pain and nociception must remain distinct, and stronger tolerance is not assumed to be safer.", "measurement_boundary": "Name the controlled stimulus and discrimination outcome while recording the person's pain report separately; stimulus intensity is not pain and neural activity cannot settle lived experience.", "myth_to_metric": { "myth": "Pain immunity", "metric": "Ethically controlled noxious discrimination plus separate pain and harm outcomes", "boundary": "Higher tolerance, lower report or altered threshold does not prove safety, health or superior capability." }, "limiting_findings": [ "Noxious temporal-spatial discrimination was worse than innocuous tactile discrimination.", "Tactile pain interventions are mixed and do not establish nociceptive training." ], "prohibited_claims": [ "Become pain-proof", "Condition nerves with repeated injury", "A high pain threshold proves toughness", "Infer pain from biomarkers or behaviour" ] }, "gold_source_lesson": { "curriculum_id": "G-CUR-008", "source_heading": "9. PWR-083 and PWR-084 - why these are not self-tests", "source_html_sha256": "be52a40416ad0206abceccf6b1027015e8dd6d94181d8f203c261124f179288c", "html": "Clinical quantitative sensory testing uses calibrated thermal and mechanical equipment, reference procedures and trained interpretation. Improvised heat/cold or pain-threshold tasks are not equivalent.
\nPain and nociception are also not interchangeable. Pain is a personal sensory and emotional experience; it cannot be inferred from one stimulus or one score.
\nPWR-083 remains G4 specialist. PWR-084 remains G6 restricted. There is no hot/cold fixture, pinprick, pressure-pain, electrical, chemical, burn, ice or “tolerance” challenge in this package.
" }, "next_gate": "External confirmation is required before higher-authority use because: CLINICAL_HIGH_RISK_OR_REGULATED_CONFIGURATION; SUPERVISION_OR_NON_ATTEMPT_BOUNDARY; SAFETY_LEGITIMACY_RESTRICTED.", "evidence_count": 6 }, "full_training_programme": false, "independently_validated": false, "publication_state": "PUBLISHED_PUBLIC_RESEARCH_EDITION__EDITORIAL_REVIEW_PENDING", "related_power_ids": [ "PWR-081", "PWR-082", "PWR-083", "PWR-085" ] }, { "power_id": "PWR-085", "learning_unit_id": "TLU-PWR-085", "title": "Olfactory discrimination", "main_description": "The learner completes either a nine-trial familiar-aroma comparison or the supplied ten-card no-exposure sort, separating identity, quality, intensity, familiarity and liking without symptoms or unknown exposure.", "main_description_source": "FULL_TUTORIAL_OUTCOME", "family_id": "FAM-11", "family": "Touch, Chemosensation & Interoception", "superdomain": "Perception & Sensorimotor", "canonical_route": "/powers/pwr-085/", "treatment": "EVIDENCE_REVIEW_ROUTE", "treatment_label": "Full low-stakes tutorial", "treatment_boundary": "Titan teaches a concrete low-stakes method step by step while keeping evidence and transfer claims bounded.", "tutorial_route": "/tutorials/pwr-085/", "governed_lesson_route": null, "self_attempt_status": "PERMITTED_INSIDE_FULL_TUTORIAL_LIMITS", "gold_pathway_ids": [ "G-CUR-008" ], "route_membership": { "kind": "GOLD_PATHWAY", "id": "G-CUR-008", "coverage_status": "EXACT_ONCE" }, "source_authority_tier": "G1", "source_build_state": "TARGETED_REVIEW_REQUIRED", "source_instructional_route": "SELF_GUIDED_TUTORIAL", "source_count": 4, "research_depth": "DETAILED", "risk_level": "MODERATE; CHEMICAL_THERMAL_PAIN_AND_CLINICAL_ROUTES_RESTRICTED", "prerequisite_status": "NONE_FOR_READING__NO_PRACTICE_AUTHORITY", "learning_route": { "mode": "FULL_SELF_GUIDED_TUTORIAL", "label": "Learn olfactory discrimination step by step", "summary": "The learner completes either a nine-trial familiar-aroma comparison or the supplied ten-card no-exposure sort, separating identity, quality, intensity, familiarity and liking without symptoms or unknown exposure.", "steps": [ [ "Get ready", "Use the no-exposure route if there is asthma, allergy, migraine, nausea, pregnancy-related sensitivity, recent smell change or any uncertainty about exposure." ], [ "Learn the method", "6 concrete steps teach the permitted method from start to finish." ], [ "See right and wrong", "4 comparisons show correct or safer execution beside common wrong or riskier choices." ], [ "Practise", "Use no more than one short session on a day and two sessions in a week. Keep items ordinary and familiar, change only code order or containers, and include a six-trial delayed set after 48 hours. Stop practical exposure if comfort changes." ], [ "Check progress", "Count correct identity choices out of balanced trials; report confidence calibration, intensity ratings and any symptom separately. For card-only practice, score correct separation of the five dimensions." ] ], "practical_authority": true, "provider_required": false, "next_action_route": "/tutorials/pwr-085/" }, "path_builder": { "selectable": true, "completion_allowed": true, "warning": "Titan teaches a concrete low-stakes method step by step while keeping evidence and transfer claims bounded." }, "full_tutorial": { "version": "3.0", "authorship": "POWER_SPECIFIC_FULL_TUTORIAL", "tutorial_mode": "SELF_GUIDED", "promise": "Smell discrimination means telling declared aromas or aroma features apart. The safest route uses written descriptor cards with no exposure. An optional practical route uses only two or three labelled foods or drinks that the learner already consumes safely, in a ventilated room, with one brief ordinary sniff. The task never uses essential oils, fragrances, cleaners, smoke, spoiled food or unknown substances.", "power_id": "PWR-085", "title": "Olfactory discrimination", "lesson_type": "SELF_GUIDED", "headline": "Separate aroma identity, quality and intensity using only familiar safe foods", "plain_english_summary": "Smell discrimination means telling declared aromas or aroma features apart. The safest route uses written descriptor cards with no exposure. An optional practical route uses only two or three labelled foods or drinks that the learner already consumes safely, in a ventilated room, with one brief ordinary sniff. The task never uses essential oils, fragrances, cleaners, smoke, spoiled food or unknown substances.", "outcome": "The learner completes either a nine-trial familiar-aroma comparison or the supplied ten-card no-exposure sort, separating identity, quality, intensity, familiarity and liking without symptoms or unknown exposure.", "authority": { "learner_may": [ "Use descriptor cards with no exposure, or use labelled routine foods already tolerated safely.", "Keep environmental alarms, expiry checks and ordinary food-safety supports in place." ], "qualified_person_required_for": [ "Assessment or treatment of smell loss, distortion, hallucinated smells, head injury, infection or neurological concern.", "Any clinical olfactory threshold or rehabilitation programme." ], "never_do": [ "Use essential oils, perfume, cleaning products, smoke, aerosols, solvents, chemicals, unknown powders or spoiled food.", "Escalate concentration, inhale deeply, block a nostril or use smell to declare a product or environment safe." ] }, "materials": [ "No-exposure packet of ten cards, two for each field: identity (‘coffee’, ‘black tea’), quality (‘roasted’, ‘woody’), intensity (‘2 of 5’, ‘very strong’), familiarity (‘smelled most mornings’, ‘new to me’) and liking (‘pleasant’, ‘disliked’). Print the correct field on each card back.", "Optional practical packet: three separate closed containers holding labelled familiar foods or drinks already used safely.", "A helper-made code key, timer and sheet with identity, quality, intensity, familiarity, liking and confidence fields.", "A ventilated room with an immediate way to close containers and leave." ], "before_you_start": [ "Use the no-exposure route if there is asthma, allergy, migraine, nausea, pregnancy-related sensitivity, recent smell change or any uncertainty about exposure.", "Confirm labels, ingredients, freshness and ordinary safe use; do not ask the learner to ingest anything.", "Keep all containers closed except the one in use and agree a stop signal." ], "steps": [ { "title": "Choose the safe route", "instruction": "Select descriptor cards only, or select two or three labelled familiar foods already handled without trouble. Write the choice and reason.", "reason": "A deliberate route choice prevents curiosity from turning into an exposure challenge.", "success_check": "The sheet states no-exposure or familiar-aroma and lists every permitted item." }, { "title": "Separate smell dimensions", "instruction": "Before any trial, define identity, quality, intensity, familiarity and liking in separate columns.", "reason": "Aroma identity is not the same as strength, pleasantness or personal memory.", "success_check": "The learner can give a different example answer for each column." }, { "title": "Code a balanced set", "instruction": "For the no-exposure route, shuffle the ten supplied cards face down; turn one at a time without viewing the answer on its back. For the practical route, a helper assigns hidden letter codes and prepares nine trials with each familiar item appearing equally often. Product labels stay available for safety.", "reason": "Balanced coding allows feedback without turning the substance into a mystery.", "success_check": "Card answers or aroma identities remain hidden until the learner commits a field or identity, while every practical ingredient label remains visible." }, { "title": "Take one ordinary sniff", "instruction": "On the practical route, open one container at a comfortable ordinary distance, take one brief natural sniff without deep inhalation and close it immediately. On the card route, read one printed phrase once; there is no container or exposure.", "reason": "Long or repeated inhalation increases exposure and adaptation, which can dull later trials.", "success_check": "A practical container is open for one ordinary sniff only, or one card phrase is read once; no extra exposure is introduced." }, { "title": "Record before reveal", "instruction": "For practical aroma, choose the identity label and then record quality, intensity, familiarity, liking and confidence. For a card, choose exactly one of those five field headings and explain which word makes it fit. Commit before viewing the key.", "reason": "Separate pre-feedback fields show whether a correct label came with calibrated confidence and what feature was perceived.", "success_check": "The practical row or card-field choice and reason are saved before the answer is checked." }, { "title": "Space, reveal and transfer", "instruction": "For practical aroma, wait at least one minute in fresh room air, reveal the code and note the missed cue; after 48 hours repeat six trials with changed containers or order, never stronger aromas. For cards, reveal each back after commitment, record any confused field and re-sort the same ten cards after 48 hours in a new order.", "reason": "Spacing limits adaptation; a changed arrangement tests recognition beyond the original sequence.", "success_check": "Practical identity or card-field retest results are recorded separately from the first set, with exposure symptoms marked not applicable on the card route." } ], "worked_example": { "scenario": "Ana routinely and safely uses ground coffee, dry black tea and cinnamon oatmeal; each remains in its original labelled container.", "walkthrough": [ "A helper checks labels and codes nine balanced trials while Ana reads every ingredient list.", "Ana opens code B, takes one normal sniff from a comfortable distance and closes it.", "She selects tea, writes woody/dry, intensity 2/5, familiar 5/5, liking 3/5 and confidence 70%.", "The key confirms tea, and she waits in fresh air before the next trial.", "Two days later the helper changes the jars and order; Ana completes six trials without a deeper sniff." ], "result": "Ana distinguishes the declared familiar aromas under this setup and keeps quality, intensity and liking separate. The result does not measure a clinical threshold or prove environmental hazard detection." }, "right_vs_wrong": [ { "situation": "Material choice", "right": "Use original-labelled routine foods or descriptor cards.", "wrong": "Use an unlabeled oil or cleaning liquid because its smell is distinctive.", "why": "Unknown and concentrated substances create avoidable exposure risk." }, { "situation": "Sniff", "right": "Take one brief natural sniff at a comfortable distance.", "wrong": "Inhale deeply or repeat until certain.", "why": "Stronger exposure can trigger symptoms and adaptation." }, { "situation": "Scoring", "right": "Score identity separately from intensity and liking.", "wrong": "Call a disliked or faint aroma an incorrect identity.", "why": "These are distinct perceptual and evaluative dimensions." }, { "situation": "Safety claim", "right": "Keep smoke, gas and food-safety alarms and checks.", "wrong": "Use a good practice score to trust the nose around hazards.", "why": "Olfactory task performance cannot certify that an environment or food is safe." } ], "common_mistakes": [ { "mistake": "All containers stay open.", "fix": "Open only the current one and close it immediately after one sniff." }, { "mistake": "The helper hides ingredient labels with the code.", "fix": "Keep safety labels visible; hide only the answer mapping." }, { "mistake": "Intensity is increased after an error.", "fix": "Change order or container on retest, never concentration or sniff depth." }, { "mistake": "Liking is recorded as accuracy.", "fix": "Use a separate identity answer and score liking independently." } ], "practice": { "first_session": [ "Choose the no-exposure or familiar-aroma route.", "Learn the five separate response fields.", "Complete three unscored descriptor examples.", "Run up to nine spaced practical trials or sort all ten no-exposure cards.", "Close all containers and review symptoms before scoring." ], "repeat_plan": "Use no more than one short session on a day and two sessions in a week. Keep items ordinary and familiar, change only code order or containers, and include a six-trial delayed set after 48 hours. Stop practical exposure if comfort changes.", "progress_when": [ "Practical identity errors or no-exposure card-field errors are reported across two matched sets and corrected from the hidden key.", "The learner uses one sniff and full spacing without prompting.", "Identity, intensity, familiarity and liking remain separate." ], "do_not_progress_when": [ "Any symptom, aversion or anxiety rises.", "The proposed next item is concentrated, unknown, non-food or not routinely tolerated.", "There is a new smell loss, distortion or phantom smell needing clinical review." ] }, "self_check": [ "Are all practical items labelled, familiar and already used safely?", "Did each trial use only one normal sniff?", "Can you show separate identity, intensity and liking scores?", "Did the retest change order rather than exposure strength?" ], "measurement": { "primary": "Correct identity among a declared set of familiar aromas.", "how": "Count correct identity choices out of balanced trials; report confidence calibration, intensity ratings and any symptom separately. For card-only practice, score correct separation of the five dimensions.", "good_result": "On practical aroma trials, every identity is committed before reveal and delayed errors stay visible; on cards, every phrase is assigned to the key’s field with any confusion corrected. Both routes keep identity, quality, intensity, familiarity and liking separate, and no accuracy cutoff is treated as a clinical smell threshold.", "does_not_prove": "It does not establish a clinical smell threshold, recovery from smell loss, hazard detection, diagnosis or general transfer." }, "stop_and_get_help": [ "Close the container, move to fresh air and stop for wheeze, breathing trouble, swelling, hives, faintness, severe headache, nausea or distress; use emergency help for severe allergic or breathing symptoms.", "Do not practise during a new smell loss or distortion, after head injury, or when smells occur without a source; seek appropriate clinical advice.", "Discard any food that is spoiled, contaminated, unlabelled or outside normal safe storage." ], "accessibility": [ "Use large-print, pictorial or spoken labels while keeping ingredients available.", "A helper may handle containers and write responses while the learner controls distance and stop signal.", "Use the descriptor-card route for anyone who cannot or does not want to receive an aroma exposure." ], "evidence_notes": [ { "claim": "A randomised double-blind trial found olfactory training was not superior to placebo for COVID-19-related smell loss, so no universal treatment effect is claimed.", "source_title": "Olfactory training for the treatment of COVID-19 related smell loss: a randomised double-blind controlled trial", "source_url": "https://pubmed.ncbi.nlm.nih.gov/40202093/", "source_kind": "PRIMARY_RESEARCH" }, { "claim": "Official NIDCD guidance treats smell disorders as varied conditions that may affect safety and merit appropriate clinical evaluation.", "source_title": "Smell (Olfactory) Disorders", "source_url": "https://www.nidcd.nih.gov/health/smell-disorders", "source_kind": "OFFICIAL_GUIDANCE" } ], "limits": [ "Only familiar routine food aromas are used; this is not threshold training.", "Environmental and food safety must never depend on this score.", "Condition-specific clinical evidence cannot be transferred to healthy learners or every cause of smell change." ], "orientation": { "bounded_definition": "Capability to develop or express olfactory discrimination in a declared context without inheriting broader claims.", "evidence_summary": "Smell training can help in some conditions, not all—and real safety still depends on alarms and environmental supports.", "supportable_public_claim": "Olfactory training may help some people with specific acquired smell loss, but effects are condition- and outcome-dependent and a rigorous COVID-19 trial found no advantage over placebo.", "measurement_boundary": "Separate threshold, discrimination, identification, distortion and participant-valued function; record diagnosis, baseline, spontaneous recovery and environmental safety supports.", "myth_to_metric": { "myth": "Bloodhound nose", "metric": "Validated threshold, discrimination and identification plus delayed daily function", "boundary": "One smell-test gain does not confer universal hazard detection, diagnosis or healthy-person enhancement." }, "limiting_findings": [ "Training was not superior to placebo for COVID-19-related smell loss in one randomised double-blind trial.", "Post-traumatic training showed only mild threshold change without broad recovery." ], "prohibited_claims": [ "Super-smell", "Detect every danger by nose", "Olfactory training cures all anosmia", "Sniff irritants or chemicals to toughen receptors" ] }, "gold_source_lesson": { "curriculum_id": "G-CUR-008", "source_heading": "7. PWR-085 - Smell discrimination without a smell challenge", "source_html_sha256": "704dd9bacf76ef574d7a442b9eb053b6d8cc6a341f2298e809f160ada6642961", "html": "Smell is also a warning system. A change can matter clinically, so this is not a diagnosis or threshold test.
\nFixture description: Safety flow for optional familiar smell and taste comparisons.
\nFor the optional route, use separate closed containers, open one at a time in a ventilated room and use only a brief ordinary smell from a comfortable distance. Do not use essential oils, perfumes, cleaning products, smoke, aerosols, solvents, unknown powders or spoiled food. Stop for any symptom or distress.
" }, "next_gate": "External confirmation is required before higher-authority use because: CLINICAL_HIGH_RISK_OR_REGULATED_CONFIGURATION; SUPERVISION_OR_NON_ATTEMPT_BOUNDARY; SAFETY_LEGITIMACY_RESTRICTED.", "evidence_count": 4 }, "full_training_programme": false, "independently_validated": false, "publication_state": "PUBLISHED_PUBLIC_RESEARCH_EDITION__EDITORIAL_REVIEW_PENDING", "related_power_ids": [ "PWR-081", "PWR-082", "PWR-083", "PWR-084" ] }, { "power_id": "PWR-086", "learning_unit_id": "TLU-PWR-086", "title": "Gustatory discrimination", "main_description": "During an ordinary meal, the learner compares three already-safe items and produces repeatable separate ratings for basic taste quality, aroma/flavour, texture, temperature, intensity and liking.", "main_description_source": "FULL_TUTORIAL_OUTCOME", "family_id": "FAM-11", "family": "Touch, Chemosensation & Interoception", "superdomain": "Perception & Sensorimotor", "canonical_route": "/powers/pwr-086/", "treatment": "EVIDENCE_REVIEW_ROUTE", "treatment_label": "Full low-stakes tutorial", "treatment_boundary": "Titan teaches a concrete low-stakes method step by step while keeping evidence and transfer claims bounded.", "tutorial_route": "/tutorials/pwr-086/", "governed_lesson_route": null, "self_attempt_status": "PERMITTED_INSIDE_FULL_TUTORIAL_LIMITS", "gold_pathway_ids": [ "G-CUR-008" ], "route_membership": { "kind": "GOLD_PATHWAY", "id": "G-CUR-008", "coverage_status": "EXACT_ONCE" }, "source_authority_tier": "G1", "source_build_state": "TARGETED_REVIEW_REQUIRED", "source_instructional_route": "SELF_GUIDED_TUTORIAL", "source_count": 3, "research_depth": "FOCUSED", "risk_level": "MODERATE; CHEMICAL_THERMAL_PAIN_AND_CLINICAL_ROUTES_RESTRICTED", "prerequisite_status": "NONE_FOR_READING__NO_PRACTICE_AUTHORITY", "learning_route": { "mode": "FULL_SELF_GUIDED_TUTORIAL", "label": "Learn gustatory discrimination step by step", "summary": "During an ordinary meal, the learner compares three already-safe items and produces repeatable separate ratings for basic taste quality, aroma/flavour, texture, temperature, intensity and liking.", "steps": [ [ "Get ready", "Check ingredient labels, allergy and intolerance information, expiry, storage and current dietary permission." ], [ "Learn the method", "6 concrete steps teach the permitted method from start to finish." ], [ "See right and wrong", "4 comparisons show correct or safer execution beside common wrong or riskier choices." ], [ "Practise", "Repeat at one or two ordinary meals in the next week using the same foods and serving temperatures. Only after a comfortable repeat, describe one different food that is already safely and routinely eaten." ], [ "Check progress", "For each item, count completed distinct fields and compare whether the main basic-taste label and two descriptive features recur on a matched later meal; report disagreements rather than averaging them away." ] ], "practical_authority": true, "provider_required": false, "next_action_route": "/tutorials/pwr-086/" }, "path_builder": { "selectable": true, "completion_allowed": true, "warning": "Titan teaches a concrete low-stakes method step by step while keeping evidence and transfer claims bounded." }, "full_tutorial": { "version": "3.0", "authorship": "POWER_SPECIFIC_FULL_TUTORIAL", "tutorial_mode": "SELF_GUIDED", "promise": "Taste refers to basic qualities sensed in the mouth; flavour also includes smell, temperature, texture and common chemical sensations. This lesson uses only visible, labelled foods or drinks that are already part of the learner’s normal eating and medically permitted. It teaches a structured comparison, not blind tasting, fasting, concentrated solutions or diet treatment.", "power_id": "PWR-086", "title": "Gustatory discrimination", "lesson_type": "SELF_GUIDED", "headline": "Describe taste separately from aroma, texture and liking during ordinary safe eating", "plain_english_summary": "Taste refers to basic qualities sensed in the mouth; flavour also includes smell, temperature, texture and common chemical sensations. This lesson uses only visible, labelled foods or drinks that are already part of the learner’s normal eating and medically permitted. It teaches a structured comparison, not blind tasting, fasting, concentrated solutions or diet treatment.", "outcome": "During an ordinary meal, the learner compares three already-safe items and produces repeatable separate ratings for basic taste quality, aroma/flavour, texture, temperature, intensity and liking.", "authority": { "learner_may": [ "Use an ordinary small bite or sip of a labelled food already eaten safely and currently permitted.", "Choose a no-taste worksheet using food descriptions instead." ], "qualified_person_required_for": [ "New taste loss or distortion, swallowing difficulty, allergy, eating-disorder concerns, medically restricted diet or clinical testing.", "Any taste threshold, nutrition, renal, metabolic or rehabilitation programme." ], "never_do": [ "Add salt, sugar, acid, chilli, bitter chemicals or other substances to create stronger thresholds.", "Use spoiled, unlabelled or unfamiliar food, blindfold the learner, fast for the task or continue through swallowing difficulty." ] }, "materials": [ "Three visible labelled foods or drinks already planned for a normal meal and safely tolerated.", "Water normally permitted with the meal and a six-column tasting record.", "The learner’s usual eating, swallowing and communication supports." ], "before_you_start": [ "Check ingredient labels, allergy and intolerance information, expiry, storage and current dietary permission.", "Use the no-taste worksheet if swallowing, metabolic, renal, sensory, eating-disorder or other clinical constraints make comparison unsuitable.", "Choose ordinary portions; the exercise never requires finishing an item." ], "steps": [ { "title": "Choose ordinary items", "instruction": "Select three foods or drinks already included in the meal. Keep them visible and labelled; write their normal serving temperatures.", "reason": "Safety information must remain available and the task should not add dietary exposure.", "success_check": "Every item is identified, permitted and already safely eaten." }, { "title": "Learn the six columns", "instruction": "Set up basic taste, aroma/flavour, texture, temperature, intensity and liking as separate fields. Write “not sure” rather than forcing a category.", "reason": "Taste and flavour are often confused, and liking is not sensory accuracy.", "success_check": "The learner can explain what belongs in each field." }, { "title": "Take an ordinary sample", "instruction": "Take one normal small bite or sip, chew or hold it as normally done and swallow only according to the usual safe method.", "reason": "The method preserves routine eating rather than manufacturing a laboratory threshold.", "success_check": "No added substance, fasting, blindfold or altered swallowing method is used." }, { "title": "Describe before comparing", "instruction": "Record the six fields immediately. Use concrete words such as sweet, salty, sour, bitter, savoury, fruity, creamy, crisp, warm or cool only when genuinely perceived.", "reason": "A first description prevents the second item from rewriting the first.", "success_check": "All fields, including uncertainty, are completed before the next item." }, { "title": "Reset normally", "instruction": "Use the learner’s usual sip of water or normal pause, then sample the next item. Do not over-rinse, hold the nose or scrape the tongue.", "reason": "A consistent ordinary pause reduces carryover without adding an unsafe manipulation.", "success_check": "The same reset is used between all items." }, { "title": "Compare and repeat later", "instruction": "Circle one similarity and two differences between items. On another normal meal day, repeat with the same items at the same temperature before adding one already-safe new item.", "reason": "A repeat checks description consistency; a safe new item tests limited transfer.", "success_check": "The log distinguishes same-item repeat from new-item description." } ], "worked_example": { "scenario": "At breakfast, Priya is already having plain yoghurt, a banana slice and her usual unsalted oat biscuit.", "walkthrough": [ "Priya checks the labels and confirms all three are routine and permitted.", "For yoghurt she records sour, mild dairy aroma, smooth, cool, intensity 3/5 and liking 4/5.", "After her normal water sip, she records banana as sweet, fruity, soft, room-temperature, 3/5 and liking 5/5.", "She describes the biscuit separately and then circles soft texture as a yoghurt/banana similarity and temperature and aroma as differences.", "At a later breakfast she repeats the three records before adding a familiar apple slice." ], "result": "Priya produces separated, repeatable sensory descriptions within ordinary eating. The record does not measure detection concentration, nutrition quality or a clinical taste disorder." }, "right_vs_wrong": [ { "situation": "Food selection", "right": "Use visible labelled foods already eaten safely.", "wrong": "Use mystery drops or concentrated salt and acid solutions.", "why": "The latter creates allergy, dosing and tissue risks and is a clinical-style threshold task." }, { "situation": "Constructs", "right": "Record basic taste, aroma, texture and liking separately.", "wrong": "Call every flavour difference a taste difference.", "why": "Smell and texture contribute strongly to flavour." }, { "situation": "Challenge level", "right": "Add one already-safe routine food only after a comfortable matched repeat with labels and dietary permission unchanged.", "wrong": "Add more salt, sugar, acid or chilli until the difference is obvious.", "why": "Concentration escalation can be medically inappropriate and teaches tolerance rather than careful description." }, { "situation": "Interpretation", "right": "Report consistency for these foods and conditions.", "wrong": "Use a variable rating to diagnose taste loss.", "why": "Home ratings are affected by smell, temperature, context and many health factors." } ], "common_mistakes": [ { "mistake": "Liking replaces intensity.", "fix": "Keep a 0–5 intensity column and a separate 0–5 liking column." }, { "mistake": "The learner holds the nose to isolate taste.", "fix": "Keep normal breathing and record aroma as its own contribution." }, { "mistake": "Serving temperature changes on retest.", "fix": "Record temperature category and match it before comparing repeat ratings." }, { "mistake": "The exercise adds foods outside the person’s plan.", "fix": "Use only items already present and medically permitted, or switch to the no-taste worksheet." } ], "practice": { "first_session": [ "Check three meal items and choose practical or no-taste route.", "Complete one six-column example without food.", "Describe each ordinary item once with the same normal reset.", "Mark similarity, differences and uncertainty.", "End with no extra portion or concentration change." ], "repeat_plan": "Repeat at one or two ordinary meals in the next week using the same foods and serving temperatures. Only after a comfortable repeat, describe one different food that is already safely and routinely eaten.", "progress_when": [ "The six dimensions are kept separate without prompting.", "Repeat descriptions show the same main quality while allowing honest variation.", "A new routine item is described without exposure escalation." ], "do_not_progress_when": [ "There is coughing, choking, pain, nausea, allergic symptom or distress.", "Dietary or clinical suitability is uncertain.", "The learner wants stronger concentration, blind tasting or fasting to improve the score." ] }, "self_check": [ "Can you explain taste versus flavour?", "Were all items already part of ordinary safe eating?", "Are intensity and liking in different columns?", "Was any ingredient added solely to make the task harder?" ], "measurement": { "primary": "Separation and repeat consistency of six sensory dimensions for declared foods.", "how": "For each item, count completed distinct fields and compare whether the main basic-taste label and two descriptive features recur on a matched later meal; report disagreements rather than averaging them away.", "good_result": "All six fields remain distinct for each item, and the matched later record states exactly which descriptions recur or change without symptom or altered serving conditions. Honest disagreement is not failed taste performance.", "does_not_prove": "It does not measure a recognition threshold, diagnose a taste disorder, establish dietary quality or separate smell clinically." }, "stop_and_get_help": [ "Stop eating and use the person’s emergency allergy plan or emergency services for breathing trouble, throat or facial swelling, collapse or other severe allergic signs.", "Stop for coughing, choking, painful swallowing, food sticking, vomiting or a new swallowing change and seek appropriate clinical advice.", "Seek clinical or dental advice for persistent new taste loss, distortion, mouth injury or unexplained change rather than increasing exposure." ], "accessibility": [ "Use the person’s prescribed texture, posture, utensils and mealtime assistance; never remove them for testing.", "Allow pointing, symbol scales or a communication partner to record the learner’s own descriptors.", "Use the no-taste labelled-card version when oral sampling is inappropriate or unwanted." ], "evidence_notes": [ { "claim": "A small randomised study found short-term improvement in recognition thresholds for four basic tastes after taste-recall training, but did not establish delayed or real-food transfer.", "source_title": "Improving taste sensitivity in healthy adults using taste recall training: a randomized controlled trial", "source_url": "https://pubmed.ncbi.nlm.nih.gov/35974039/", "source_kind": "PRIMARY_RESEARCH" }, { "claim": "Official NIDCD guidance notes that many reported taste problems are related to smell and that taste disorders have varied causes.", "source_title": "Taste Disorders", "source_url": "https://www.nidcd.nih.gov/health/taste-disorders", "source_kind": "OFFICIAL_GUIDANCE" } ], "limits": [ "This ordinary-food comparison is not a controlled concentration threshold.", "Results depend on smell, temperature, texture, health, medication and item choice.", "No nutrition, treatment or diagnosis claim follows from a consistent description." ], "orientation": { "bounded_definition": "Capability to develop or express gustatory discrimination in a declared context without inheriting broader claims.", "evidence_summary": "Basic taste recognition may be trainable—but it is not the same as flavour, nutrition or poison detection.", "supportable_public_claim": "Healthy adults improved short-term recognition thresholds for four basic tastes after a small controlled recall-training study; retention and real-food transfer remain unknown.", "measurement_boundary": "Use controlled food-safe detection/recognition concentrations by taste quality and separate smell, trigeminal sensation, intensity, liking and diet outcomes.", "myth_to_metric": { "myth": "Supertaster at will", "metric": "Delayed food-safe recognition thresholds across basic tastes and novel samples", "boundary": "Threshold sensitivity does not establish flavour expertise, safety, diet quality or disease treatment." }, "limiting_findings": [ "No delayed retention or functional food outcome was established.", "Many apparent taste problems are actually smell-related flavour problems." ], "prohibited_claims": [ "Become a supertaster on demand", "Taste allergens or poison safely", "Cure flavour loss with tongue drills", "More sensitive taste guarantees a better diet" ] }, "gold_source_lesson": { "curriculum_id": "G-CUR-008", "source_heading": "8. PWR-086 - Taste discrimination without a food challenge", "source_html_sha256": "8ca9ddbe4ee0b3626d29c8b4da62d51a78cda59fbde7652041efefd82f4c37fb", "html": "Taste is not the same as flavour. Smell, temperature, texture and common chemical sensations also contribute to the experience of food.
\nBounded non-public comparison is optional and limited to foods already safely eaten and medically permitted. The item remains labelled and visible. Use an ordinary small bite or sip as part of normal eating, not fasting, blind tasting or concentration escalation.
\nRecord separately:
\nDo not add salt, sugar, acids, chilli or other substances to create a harder threshold. Do not use the task where allergy, intolerance, swallowing, metabolic, renal, eating-disorder or clinical constraints make it unsuitable.
" }, "next_gate": "External confirmation is required before higher-authority use because: CLINICAL_HIGH_RISK_OR_REGULATED_CONFIGURATION.", "evidence_count": 3 }, "full_training_programme": false, "independently_validated": false, "publication_state": "PUBLISHED_PUBLIC_RESEARCH_EDITION__EDITORIAL_REVIEW_PENDING", "related_power_ids": [ "PWR-081", "PWR-082", "PWR-083", "PWR-084" ] }, { "power_id": "PWR-087", "learning_unit_id": "TLU-PWR-087", "title": "Interoceptive accuracy", "main_description": "The learner completes six signal–interpretation–action–later-check records and shows whether confidence tracks the usefulness of the chosen interpretation.", "main_description_source": "FULL_TUTORIAL_OUTCOME", "family_id": "FAM-11", "family": "Touch, Chemosensation & Interoception", "superdomain": "Perception & Sensorimotor", "canonical_route": "/powers/pwr-087/", "treatment": "EVIDENCE_REVIEW_ROUTE", "treatment_label": "Full low-stakes tutorial", "treatment_boundary": "Titan teaches a concrete low-stakes method step by step while keeping evidence and transfer claims bounded.", "tutorial_route": "/tutorials/pwr-087/", "governed_lesson_route": null, "self_attempt_status": "PERMITTED_INSIDE_FULL_TUTORIAL_LIMITS", "gold_pathway_ids": [ "G-CUR-008" ], "route_membership": { "kind": "GOLD_PATHWAY", "id": "G-CUR-008", "coverage_status": "EXACT_ONCE" }, "source_authority_tier": "G2", "source_build_state": "TARGETED_REVIEW_REQUIRED", "source_instructional_route": "BOUNDED_GUIDED_EXERCISE", "source_count": 5, "research_depth": "DETAILED", "risk_level": "MODERATE; CHEMICAL_THERMAL_PAIN_AND_CLINICAL_ROUTES_RESTRICTED", "prerequisite_status": "NONE_FOR_READING__NO_PRACTICE_AUTHORITY", "learning_route": { "mode": "FULL_SELF_GUIDED_TUTORIAL", "label": "Learn interoceptive accuracy step by step", "summary": "The learner completes six signal–interpretation–action–later-check records and shows whether confidence tracks the usefulness of the chosen interpretation.", "steps": [ [ "Get ready", "Choose a signal that is already mild, familiar and safe to notice; do not choose chest pain, faintness, severe breathlessness, hunger/fullness when clinically unsafe, or escalating distress." ], [ "Learn the method", "6 concrete steps teach the permitted method from start to finish." ], [ "See right and wrong", "4 comparisons show correct or safer execution beside common wrong or riskier choices." ], [ "Practise", "Complete at most one record a day on six non-consecutive days. Then review confidence bands once; do not increase monitoring frequency or intensity. Repeat a six-record block only if the process reduces confusion without increasing distress or checking." ], [ "Check progress", "For low, medium and high confidence bands, count records in which the chosen reversible action was later judged useful on the predeclared functional check; retain unresolved and adverse records." ] ], "practical_authority": true, "provider_required": false, "next_action_route": "/tutorials/pwr-087/" }, "path_builder": { "selectable": true, "completion_allowed": true, "warning": "Titan teaches a concrete low-stakes method step by step while keeping evidence and transfer claims bounded." }, "full_tutorial": { "version": "3.0", "authorship": "POWER_SPECIFIC_FULL_TUTORIAL", "tutorial_mode": "SELF_GUIDED", "promise": "Interoception covers signals arising within the body, but objective task accuracy, self-reported sensibility and confidence are different. Heartbeat counting is not used because expectation can dominate the score. Instead, this lesson takes one naturally present, low-intensity signal, describes it without diagnosis, lists alternative interpretations, chooses one ordinary low-risk response and checks later whether that interpretation was useful.", "power_id": "PWR-087", "title": "Interoceptive accuracy", "lesson_type": "SELF_GUIDED", "headline": "Calibrate a low-intensity body-signal interpretation against a later functional check", "plain_english_summary": "Interoception covers signals arising within the body, but objective task accuracy, self-reported sensibility and confidence are different. Heartbeat counting is not used because expectation can dominate the score. Instead, this lesson takes one naturally present, low-intensity signal, describes it without diagnosis, lists alternative interpretations, chooses one ordinary low-risk response and checks later whether that interpretation was useful.", "outcome": "The learner completes six signal–interpretation–action–later-check records and shows whether confidence tracks the usefulness of the chosen interpretation.", "authority": { "learner_may": [ "Notice an ordinary low-intensity signal already present, such as muscle tension, breathing ease, temperature comfort or need for a routine break.", "Choose no action or one reversible ordinary action such as changing position or taking a planned break." ], "qualified_person_required_for": [ "Chest symptoms, fainting, severe breathlessness, eating-disorder risk, panic treatment, trauma-related body focus or unexplained persistent symptoms.", "Validated channel-specific interoception assessment or clinical training." ], "never_do": [ "Manipulate breathing, pulse, hunger, pain, temperature or medication to create a body signal.", "Use a wearable agreement or heartbeat-counting score as a universal measure or diagnosis." ] }, "materials": [ "A record with raw signal, possible meanings, confidence, chosen action, later function and alternative explanation.", "A timer for a brief 30-second notice period and a later reminder.", "Normal aids and the option to use an external cue or stop body focus." ], "before_you_start": [ "Choose a signal that is already mild, familiar and safe to notice; do not choose chest pain, faintness, severe breathlessness, hunger/fullness when clinically unsafe, or escalating distress.", "Set a maximum 30-second notice period and one later check time.", "Keep prescribed care, food, hydration, medication and symptom plans unchanged." ], "steps": [ { "title": "Name a low-risk moment", "instruction": "Choose one ordinary situation, such as working at a desk, and one naturally present signal. Do not create or intensify it.", "reason": "A declared moment prevents continuous scanning and symptom manufacture.", "success_check": "The log names situation, time and one signal only." }, { "title": "Describe raw features", "instruction": "For up to 30 seconds, write location, pressure or movement quality, intensity from 0 to 5 and change over that short period. Avoid diagnostic labels.", "reason": "Raw description keeps perception separate from explanation.", "success_check": "The description uses sensory words and contains no disease conclusion." }, { "title": "Generate alternatives", "instruction": "List at least two plausible interpretations, including an ordinary one and “not enough information.”", "reason": "One body signal can have multiple causes; alternatives reduce premature certainty.", "success_check": "Two distinct interpretations and an unknown option are present." }, { "title": "Rate and choose", "instruction": "Give each interpretation a confidence range, then choose no action or one reversible ordinary action that is acceptable under all plausible meanings.", "reason": "A range shows uncertainty, while a low-risk action avoids betting on an unverified diagnosis.", "success_check": "The action is small, reversible and does not alter treatment." }, { "title": "Check function later", "instruction": "At the planned time, record the signal again and one functional result, such as ability to continue comfortably or need for the normal break. Do not call change proof of a cause.", "reason": "A later observation tests usefulness better than confidence alone.", "success_check": "The record has a timed outcome and preserves alternative explanations." }, { "title": "Calibrate across records", "instruction": "After six records, sort confidence into low, medium and high and compare how often the chosen interpretation led to a useful action in each band.", "reason": "Calibration asks whether stronger confidence is more often useful, not whether every sensation is identified.", "success_check": "The summary shows counts by confidence band and does not hide misses." } ], "worked_example": { "scenario": "During routine computer work, Ezra notices mild shoulder tightness that is already present.", "walkthrough": [ "Ezra sets 30 seconds and records left shoulder, dull tension, 2/5 and stable.", "He lists prolonged posture, ordinary stress and not enough information as possible meanings.", "He gives posture 50–70% confidence and chooses his normal two-minute position change, which is safe under all three interpretations.", "Twenty minutes later he records tension 1/5 and easier typing, while noting that time or attention could also explain the change.", "After six such records he checks whether high-confidence interpretations were actually more useful than low-confidence ones." ], "result": "Ezra has practised calibrated description and a later functional check. He has not proved the cause of the tightness or measured universal interoceptive accuracy." }, "right_vs_wrong": [ { "situation": "Signal choice", "right": "Notice one mild signal already present.", "wrong": "Hold the breath, skip food or exercise to generate a stronger signal.", "why": "Manipulation can create harm and changes the question." }, { "situation": "Description", "right": "Write “dull shoulder tension, 2/5.”", "wrong": "Write “my nervous system is dysregulated.”", "why": "A mechanism or diagnosis is not a raw observation." }, { "situation": "Confidence", "right": "Use a range and keep alternatives visible.", "wrong": "Choose one explanation with 100% certainty from one sensation.", "why": "Internal signals are often ambiguous." }, { "situation": "Outcome", "right": "Check later function and acknowledge other causes.", "wrong": "Treat feeling better after an action as proof that the interpretation was correct.", "why": "Change after an action does not by itself identify causation." } ], "common_mistakes": [ { "mistake": "The learner scans continuously.", "fix": "Use one scheduled 30-second window and then return attention to the task." }, { "mistake": "Heartbeat counting is substituted as an objective score.", "fix": "Use the signal–interpretation–action record and do not count beats without a validated protocol." }, { "mistake": "Only one interpretation is written.", "fix": "Require an ordinary alternative and “not enough information.”" }, { "mistake": "Confidence is averaged without outcomes.", "fix": "Group records by confidence and compare with the later functional check." } ], "practice": { "first_session": [ "Read the emergency and unsuitable-signal exclusions.", "Complete one fictional example.", "Make one 30-second real low-intensity record.", "Set and complete one later functional check.", "Review whether the action was reversible and non-diagnostic." ], "repeat_plan": "Complete at most one record a day on six non-consecutive days. Then review confidence bands once; do not increase monitoring frequency or intensity. Repeat a six-record block only if the process reduces confusion without increasing distress or checking.", "progress_when": [ "Descriptions remain sensory and time-limited.", "At least two interpretations are kept until the later check.", "Higher confidence is at least as often linked with a useful action, or the learner appropriately lowers confidence." ], "do_not_progress_when": [ "Body focus increases anxiety, compulsive checking, eating-disorder urges or symptom intensity.", "Signals are severe, new, persistent or function-changing.", "The learner alters medication, food, breathing or clinical care based on the worksheet." ] }, "self_check": [ "Is the signal naturally present and mild?", "Does the raw description avoid a diagnosis?", "Are there at least two interpretations plus uncertainty?", "What later functional observation will test usefulness?" ], "measurement": { "primary": "Confidence calibration against later usefulness across six low-risk records.", "how": "For low, medium and high confidence bands, count records in which the chosen reversible action was later judged useful on the predeclared functional check; retain unresolved and adverse records.", "good_result": "All six records have alternatives and later checks, and confidence is revised downward when high-confidence interpretations are not more useful.", "does_not_prove": "It does not establish physiological accuracy, diagnose a condition or generalise across heartbeat, breathing, hunger, pain and other interoceptive channels." }, "stop_and_get_help": [ "Use urgent or emergency care for chest pain, fainting, severe breathlessness, sudden weakness, confusion or other local warning signs.", "Stop the exercise if it increases panic, trauma responses, compulsive checking, self-harm urges or eating-disorder behaviours; seek appropriate support.", "Seek clinical advice for new, persistent, worsening or function-changing internal sensations rather than repeatedly monitoring them." ], "accessibility": [ "Use pictorial body maps, colour-free symbol scales or spoken recording.", "Choose an external-functional check rather than prolonged inward attention when body focus is distressing.", "A supporter may prompt the time limit and write, but the learner controls wording and may stop." ], "evidence_notes": [ { "claim": "Heartbeat-counting performance falls when non-interoceptive estimation strategies are restricted, so it is not used here as a universal accuracy measure.", "source_title": "The heartbeat counting task largely involves non-interoceptive processes: Evidence from both the original and an adapted counting task", "source_url": "https://pubmed.ncbi.nlm.nih.gov/30218689/", "source_kind": "PRIMARY_RESEARCH" }, { "claim": "Training-related change in heartbeat counting did not transfer to heartbeat discrimination, showing that cross-task transfer cannot be assumed.", "source_title": "Post-learning stress after a heartbeat perception training facilitates interoceptive accuracy in the heartbeat counting task, but not in the heartbeat discrimination task", "source_url": "https://pubmed.ncbi.nlm.nih.gov/41314278/", "source_kind": "PRIMARY_RESEARCH" } ], "limits": [ "The lesson measures disciplined interpretation and later usefulness, not direct physiological truth.", "One channel or task cannot stand for all interoception.", "A reversible ordinary response does not replace clinical evaluation or treatment." ], "orientation": { "bounded_definition": "Capability to develop or express interoceptive accuracy in a declared context without inheriting broader claims.", "evidence_summary": "Sensing the body is not one hidden meter. The most common heartbeat test can reward good guessing rather than better perception.", "supportable_public_claim": "Interoceptive accuracy is real but difficult to measure. Heartbeat counting is heavily contaminated by expectation, and training has not yet shown reliable cross-task or real-world transfer.", "measurement_boundary": "Use multiple validated channel-specific discrimination/detection tasks plus confidence and symptoms; never treat heartbeat counting or a wearable agreement score as a universal interoception measure.", "myth_to_metric": { "myth": "Perfect inner radar", "metric": "Convergent accuracy across independent channel-specific tasks plus calibrated confidence", "boundary": "One heartbeat-counting score does not diagnose the body, prove emotional mastery or authorise ignoring symptoms." }, "limiting_findings": [ "Heartbeat-counting scores dropped sharply when non-sensory estimation was restricted.", "Immediate and delayed feedback improved counting similarly, implicating beliefs.", "Experienced meditators were not objectively better at heartbeat detection despite greater confidence.", "Training-related change did not transfer from counting to discrimination." ], "prohibited_claims": [ "Read every body signal perfectly", "Heartbeat counting diagnoses health", "Meditation guarantees superior interoception", "Provoke stress or symptoms to train accuracy" ] }, "gold_source_lesson": { "curriculum_id": "G-CUR-008", "source_heading": "10. PWR-087 - interoception without one magic score", "source_html_sha256": "7d359eff7ac3ad7c16a15904cedccf01f7374676340e559bc646599229baa2a0", "html": "Interoception includes several distinguishable constructs:
\nThese are not interchangeable. Heartbeat counting is not used here because common versions are contaminated by estimation and prior knowledge.
\nFixture description: Signal, interpretation, action and later-check model for bounded interoceptive calibration.
\nChoose one low-intensity signal that is already present and safe to notice, such as ordinary muscle tension, breathing ease, temperature comfort or need for a routine break. Do not choose hunger/fullness, heart symptoms or distress where that would be clinically or psychologically unsafe.
\nThe result is better description and calibration, not proof of physiological accuracy.
" }, "next_gate": "External confirmation is required before higher-authority use because: CLINICAL_HIGH_RISK_OR_REGULATED_CONFIGURATION; SAFETY_LEGITIMACY_RESTRICTED.", "evidence_count": 5 }, "full_training_programme": false, "independently_validated": false, "publication_state": "PUBLISHED_PUBLIC_RESEARCH_EDITION__EDITORIAL_REVIEW_PENDING", "related_power_ids": [ "PWR-081", "PWR-082", "PWR-083", "PWR-084" ] }, { "power_id": "PWR-088", "learning_unit_id": "TLU-PWR-088", "title": "Multisensory integration", "main_description": "The learner completes 18 balanced object trials and correctly reports whether combined cues improve, match or reduce accuracy relative to the best single-cue condition.", "main_description_source": "FULL_TUTORIAL_OUTCOME", "family_id": "FAM-11", "family": "Touch, Chemosensation & Interoception", "superdomain": "Perception & Sensorimotor", "canonical_route": "/powers/pwr-088/", "treatment": "EVIDENCE_REVIEW_ROUTE", "treatment_label": "Full low-stakes tutorial", "treatment_boundary": "Titan teaches a concrete low-stakes method step by step while keeping evidence and transfer claims bounded.", "tutorial_route": "/tutorials/pwr-088/", "governed_lesson_route": null, "self_attempt_status": "PERMITTED_INSIDE_FULL_TUTORIAL_LIMITS", "gold_pathway_ids": [ "G-CUR-008" ], "route_membership": { "kind": "GOLD_PATHWAY", "id": "G-CUR-008", "coverage_status": "EXACT_ONCE" }, "source_authority_tier": "G1", "source_build_state": "TARGETED_REVIEW_REQUIRED", "source_instructional_route": "SELF_GUIDED_TUTORIAL", "source_count": 4, "research_depth": "DETAILED", "risk_level": "MODERATE; CHEMICAL_THERMAL_PAIN_AND_CLINICAL_ROUTES_RESTRICTED", "prerequisite_status": "NONE_FOR_READING__NO_PRACTICE_AUTHORITY", "learning_route": { "mode": "FULL_SELF_GUIDED_TUTORIAL", "label": "Learn multisensory integration step by step", "summary": "The learner completes 18 balanced object trials and correctly reports whether combined cues improve, match or reduce accuracy relative to the best single-cue condition.", "steps": [ [ "Get ready", "Inspect objects and confirm the seated setup allows safe touch without reaching or dropping." ], [ "Learn the method", "6 concrete steps teach the permitted method from start to finish." ], [ "See right and wrong", "4 comparisons show correct or safer execution beside common wrong or riskier choices." ], [ "Practise", "Repeat once after 48 hours with the same timing but two replaced objects. A third session may change one feature only, such as visual blur inherent in the object, not the learner’s aids. Keep sessions under 25 minutes." ], [ "Check progress", "For each condition, report correct out of six, median time, median confidence and errors by object; subtract best single accuracy from combined accuracy and inspect unfamiliar items separately." ] ], "practical_authority": true, "provider_required": false, "next_action_route": "/tutorials/pwr-088/" }, "path_builder": { "selectable": true, "completion_allowed": true, "warning": "Titan teaches a concrete low-stakes method step by step while keeping evidence and transfer claims bounded." }, "full_tutorial": { "version": "3.0", "authorship": "POWER_SPECIFIC_FULL_TUTORIAL", "tutorial_mode": "SELF_GUIDED", "promise": "Multisensory integration is how information from more than one sense is combined. Extra cues can help, do nothing or conflict. This lesson tests the same benign object judgement under vision-only, touch-only and combined conditions, keeping time and answer options fixed. The learner records which cue mattered and whether the combination beats the best single cue.", "power_id": "PWR-088", "title": "Multisensory integration", "lesson_type": "SELF_GUIDED", "headline": "Compare vision-only, touch-only and combined cues on the same safe object task", "plain_english_summary": "Multisensory integration is how information from more than one sense is combined. Extra cues can help, do nothing or conflict. This lesson tests the same benign object judgement under vision-only, touch-only and combined conditions, keeping time and answer options fixed. The learner records which cue mattered and whether the combination beats the best single cue.", "outcome": "The learner completes 18 balanced object trials and correctly reports whether combined cues improve, match or reduce accuracy relative to the best single-cue condition.", "authority": { "learner_may": [ "Compare harmless familiar objects while seated using ordinary sight and touch.", "Keep glasses, hearing aids, mobility aids and preferred sensory supports." ], "qualified_person_required_for": [ "Assessment or treatment of sensory-processing, vestibular, neurological or developmental concerns.", "Tasks involving motion, falls, driving, clinical illusions or sensory overload." ], "never_do": [ "Remove an aid, provoke dizziness, use flashing or loud stimuli, or claim a clinical integration disorder from this task.", "Assume more cues must improve performance." ] }, "materials": [ "Six clean, blunt, lightweight objects or shapes that can be seen and touched safely.", "A tabletop screen, numbered answer options, timer and randomised condition list.", "A record for accuracy, time, confidence, cue used and discomfort." ], "before_you_start": [ "Inspect objects and confirm the seated setup allows safe touch without reaching or dropping.", "Choose one fixed question, such as which of six shapes is present, and a ten-second observation limit.", "Check lighting, visual access and tactile access; retain normal aids." ], "steps": [ { "title": "Fix one judgement", "instruction": "Choose six objects and one answer set. Ask the identical identity or shape question in every condition.", "reason": "Different questions would confound sensory condition with task difficulty.", "success_check": "The same six answer labels apply to all trials." }, { "title": "Define three conditions", "instruction": "Set vision-only with no touch, touch-only behind a screen while seated, and combined vision-plus-touch. Keep the ten-second limit.", "reason": "Explicit conditions make cue contribution observable.", "success_check": "Each condition has a written access rule and equal time." }, { "title": "Balance and randomise", "instruction": "Prepare six trials per condition in a mixed order, with every object appearing equally often.", "reason": "A mixed balanced schedule reduces learning and order effects.", "success_check": "The list contains 18 trials and no condition or object dominates." }, { "title": "Respond and name the cue", "instruction": "After each trial, choose an answer, confidence and the feature used, such as outline, texture or both.", "reason": "Cue reports show whether the learner actually used both streams or ignored one.", "success_check": "Every response includes answer, confidence and named cue before feedback." }, { "title": "Reveal and repair conflict", "instruction": "Check the key. When cues conflict or the combined trial is wrong, identify which cue was misleading and what reliability check could help next time.", "reason": "Integration includes down-weighting an unreliable cue, not merely adding information.", "success_check": "The repair names the misleading cue and a concrete check." }, { "title": "Compare conditions", "instruction": "Calculate accuracy and median time for each condition. Compare combined performance with the better single condition, then repeat later with two unfamiliar safe objects.", "reason": "The best single-cue comparison reveals benefit, neutrality or interference.", "success_check": "The conclusion says helps, matches or hurts for this task and includes novel-item results." } ], "worked_example": { "scenario": "Six foam shapes include a circle, oval, square, rectangle, triangle and five-point star.", "walkthrough": [ "Jo fixes a six-label answer card and ten-second observation rule.", "A helper mixes six vision-only, six touch-only and six combined trials.", "On a combined oval trial Jo answers circle, 80%, saying sight dominated while touch felt elongated.", "After reveal, Jo writes “compare longest and shortest span before answering” as the conflict repair.", "Scores are vision 5/6, touch 4/6 and combined 4/6, so extra touch did not beat the best single cue." ], "result": "Jo correctly reports combined interference in this small shape task and identifies an unreliable-cue repair. The outcome does not show a sensory disorder or a general cost of multisensory information." }, "right_vs_wrong": [ { "situation": "Task control", "right": "Ask the same question with the same objects and time in all conditions.", "wrong": "Use easy objects for combined trials and hard objects for touch-only.", "why": "Difficulty differences would masquerade as integration effects." }, { "situation": "Aids", "right": "Keep ordinary visual and tactile supports and record them.", "wrong": "Remove glasses or normal aids to make a pure test.", "why": "Removing access supports changes the person and can create avoidable burden." }, { "situation": "Combined result", "right": "Compare combined accuracy with the better single cue.", "wrong": "Assume any combined score is an improvement.", "why": "Extra information can be redundant or conflicting." }, { "situation": "Conflict", "right": "Identify which cue was less reliable on that trial.", "wrong": "Average cues blindly or blame the learner.", "why": "Useful integration weights evidence by reliability and task relevance." } ], "common_mistakes": [ { "mistake": "Condition blocks are always in the same order.", "fix": "Mix conditions with a prepared random schedule." }, { "mistake": "Objects make sound only in touch trials.", "fix": "Place and handle objects quietly or record sound as an extra cue." }, { "mistake": "Combined time is longer.", "fix": "Use the same observation limit in all three conditions." }, { "mistake": "Confidence is reported as performance.", "fix": "Calculate correct answers and time separately from confidence." } ], "practice": { "first_session": [ "Inspect six objects and practise each access rule once.", "Run 18 mixed trials with immediate feedback.", "Calculate three condition scores.", "Repair the largest cue-conflict error.", "Stop after the calculation rather than adding sensory intensity." ], "repeat_plan": "Repeat once after 48 hours with the same timing but two replaced objects. A third session may change one feature only, such as visual blur inherent in the object, not the learner’s aids. Keep sessions under 25 minutes.", "progress_when": [ "Condition rules and timing stay fixed.", "The learner can identify the cue that drove each error.", "The helps/matches/hurts conclusion is reproduced or honestly revised on new objects." ], "do_not_progress_when": [ "Touch-only reaching is unsafe or uncomfortable.", "Visual blocking, texture or repetition causes sensory distress.", "The goal shifts to diagnosis, motion exposure or removal of needed aids." ] }, "self_check": [ "Is the question identical in all three conditions?", "Did every object appear equally often?", "Is combined performance compared with the best single cue?", "Can you name a trial where one cue misled the answer?" ], "measurement": { "primary": "Accuracy difference between combined and best single-cue conditions.", "how": "For each condition, report correct out of six, median time, median confidence and errors by object; subtract best single accuracy from combined accuracy and inspect unfamiliar items separately.", "good_result": "All 18 trials follow the declared rules, the learner states the correct helps/matches/hurts relationship and uses one cue-reliability repair on a later set.", "does_not_prove": "It does not diagnose sensory integration, establish durable everyday benefit or imply generally heightened senses." }, "stop_and_get_help": [ "Stop for dizziness, headache, eye strain, nausea, pain, sensory overload or marked distress.", "Stop if blocking vision makes object handling unsafe; switch to a card or helper-controlled version.", "Seek appropriate professional assessment for new sensory conflict, balance problems or functional change rather than repeating the task." ], "accessibility": [ "Use enlarged objects, high contrast, tactile markers or extended equal time across all conditions.", "A helper may present objects within comfortable reach and record spoken answers without cueing.", "If one modality is unavailable, compare two accessible cue configurations and state that the task is different." ], "evidence_notes": [ { "claim": "Perceptual training narrowed an audiovisual temporal binding window in younger and older adults, but age-related cue expectations did not change uniformly.", "source_title": "Perceptual training narrows the temporal binding window of audiovisual integration in both younger and older adults", "source_url": "https://pubmed.ncbi.nlm.nih.gov/35752266/", "source_kind": "PRIMARY_RESEARCH" }, { "claim": "Multisensory visual–vestibular training improved visual heading estimation in a defined laboratory task, not universal sensory function.", "source_title": "Multisensory visual-vestibular training improves visual heading estimation in younger and older adults", "source_url": "https://pubmed.ncbi.nlm.nih.gov/36092809/", "source_kind": "PRIMARY_RESEARCH" } ], "limits": [ "The conclusion belongs to the declared objects, cues and timing.", "A combined advantage may reflect redundancy; a cost may reflect one misleading cue.", "No clinical diagnosis, motion-training permission or durable everyday transfer follows." ], "orientation": { "bounded_definition": "Capability to develop or express multisensory integration in a declared context without inheriting broader claims.", "evidence_summary": "The senses learn to cooperate—but extra signals help only when timing, reliability and accessibility fit the task.", "supportable_public_claim": "Multisensory timing and cue use can be trained on defined tasks, including in older adults, but benefits depend on congruence and do not establish generally ‘heightened senses.’", "measurement_boundary": "Declare modalities, reliability, timing, congruence, illusion/task, age and device state; compare unimodal and combined performance and record overload/conflict.", "myth_to_metric": { "myth": "Unlock a sixth sense", "metric": "Added value of combined versus best unimodal cues on an unfamiliar delayed task", "boundary": "A multisensory illusion or lab gain does not establish a new sense, general cognition or real-world safety." }, "limiting_findings": [ "Older adults showed less change in some prior crossmodal expectations despite temporal improvement.", "No mapped study established durable everyday function or universal benefit from extra cues." ], "prohibited_claims": [ "Fuse senses into a sixth sense", "More cues always improve performance", "Multisensory games prevent falls", "Neural integration proves broad cognitive enhancement" ] }, "gold_source_lesson": { "curriculum_id": "G-CUR-008", "source_heading": "11. PWR-088 - multisensory integration", "source_html_sha256": "8d35ba9a720ef3a96ceb5ba3025f1488ec028b68a4f7fed0c246a1c5f47de5f3", "html": "Using more than one sense can help, do nothing or introduce conflict. The brain weights cues partly by reliability and by whether they seem to share a common source.
\nFixture description: Worksheet comparing touch-only, vision-only and combined cue conditions.
\nUse the same benign object:
\nRecord answer, confidence, time, support and the cue that mattered. A combined score that is worse than the best single cue is useful information.
" }, "next_gate": "External confirmation is required before higher-authority use because: CLINICAL_HIGH_RISK_OR_REGULATED_CONFIGURATION.", "evidence_count": 4 }, "full_training_programme": false, "independently_validated": false, "publication_state": "PUBLISHED_PUBLIC_RESEARCH_EDITION__EDITORIAL_REVIEW_PENDING", "related_power_ids": [ "PWR-081", "PWR-082", "PWR-083", "PWR-084" ] }, { "power_id": "PWR-089", "learning_unit_id": "TLU-PWR-089", "title": "Proprioceptive accuracy", "main_description": "Under qualified supervision, the learner completes a provider-set joint-position matching block and produces absolute error values for one declared joint, direction and support configuration.", "main_description_source": "FULL_TUTORIAL_OUTCOME", "family_id": "FAM-12", "family": "Spatial Orientation, Proprioception & Navigation", "superdomain": "Perception & Sensorimotor", "canonical_route": "/powers/pwr-089/", "treatment": "SPECIALIST_PROVIDER_ROUTE", "treatment_label": "Full supervised tutorial", "treatment_boundary": "Titan teaches the complete method; a qualified person controls the parts that require supervision, clearance, specialist equipment, load, dose or progression.", "tutorial_route": "/tutorials/pwr-089/", "governed_lesson_route": null, "self_attempt_status": "PROHIBITED_WITHOUT_QUALIFIED_SUPERVISION", "gold_pathway_ids": [ "G-CUR-003" ], "route_membership": { "kind": "GOLD_PATHWAY", "id": "G-CUR-003", "coverage_status": "EXACT_ONCE" }, "source_authority_tier": "G4", "source_build_state": "EXTERNAL_PROVIDER_ROUTE", "source_instructional_route": "LEARN_ELSEWHERE_TRACK_WITH_TITAN", "source_count": 2, "research_depth": "FOCUSED", "risk_level": "MODERATE", "prerequisite_status": "QUALIFIED_PROVIDER_DETERMINES", "learning_route": { "mode": "FULL_SUPERVISED_TUTORIAL", "label": "Learn proprioceptive accuracy step by step", "summary": "Under qualified supervision, the learner completes a provider-set joint-position matching block and produces absolute error values for one declared joint, direction and support configuration.", "steps": [ [ "Get ready", "Tell the provider about pain, swelling, instability, recent injury or surgery, numbness, weakness and medication changes." ], [ "Learn the method", "7 concrete steps teach the permitted method from start to finish." ], [ "See right and wrong", "4 comparisons show correct or safer execution beside common wrong or riskier choices." ], [ "Practise", "The clinician sets session frequency, number of trials, rest and any rehabilitation dose. A clean retest keeps joint, target, movement mode, support, vision and measurement device matched; only the provider advances range or task demand." ], [ "Check progress", "For each valid trial calculate signed error = response angle−target angle and absolute error = |signed error|. Average the absolute errors, report smallest-to-largest response range, count overshoots and undershoots, and retain device alignment, assistance and symptoms." ] ], "practical_authority": false, "provider_required": true, "next_action_route": "/tutorials/pwr-089/" }, "path_builder": { "selectable": true, "completion_allowed": true, "warning": "Titan teaches the complete method; a qualified person controls the parts that require supervision, clearance, specialist equipment, load, dose or progression." }, "full_tutorial": { "version": "3.0", "authorship": "POWER_SPECIFIC_FULL_TUTORIAL", "tutorial_mode": "SUPERVISED", "promise": "Proprioception includes information about body position and movement. A clinician can teach a joint-position matching task while controlling the joint, target angle, vision, support, speed and number of attempts. The learner learns to attend to the position, stop at the remembered target and read the error record. This is not a home neurological test or a reason to remove braces, tape or mobility aids.", "power_id": "PWR-089", "title": "Proprioceptive accuracy", "lesson_type": "SUPERVISED", "headline": "Match one joint position under a clinician’s measured, supported protocol", "plain_english_summary": "Proprioception includes information about body position and movement. A clinician can teach a joint-position matching task while controlling the joint, target angle, vision, support, speed and number of attempts. The learner learns to attend to the position, stop at the remembered target and read the error record. This is not a home neurological test or a reason to remove braces, tape or mobility aids.", "outcome": "Under qualified supervision, the learner completes a provider-set joint-position matching block and produces absolute error values for one declared joint, direction and support configuration.", "authority": { "learner_may": [ "Learn the response rule, report symptoms and ask for positioning or communication support.", "Rehearse the sequence without moving beyond ordinary comfortable range." ], "qualified_person_required_for": [ "Selecting and screening the joint, setting range and target, moving or measuring the limb, dosing practice and interpreting results.", "Rehabilitation after injury, surgery, pain, instability or neurological change." ], "never_do": [ "Force a joint, remove prescribed support, use a painful range or ask an untrained helper to move the limb.", "Treat a matching error as a diagnosis, tissue-health measure or whole-body proprioception score." ] }, "materials": [ "Provider-approved position-measurement device, support surface and reproducible target-angle protocol.", "Four-column angle table labelled target, response, signed error = response−target and absolute error = |response−target|, with separate overshoot and undershoot counts.", "Vision screen only if the provider judges it safe, plus a response cue and trial record.", "The learner’s usual brace, seating, communication and mobility supports unless the provider changes them for a documented reason." ], "before_you_start": [ "Tell the provider about pain, swelling, instability, recent injury or surgery, numbness, weakness and medication changes.", "Agree the joint, movement direction, comfortable range, target, support and immediate stop signal.", "The provider records whether movement is active, passive or matched with the opposite limb." ], "steps": [ { "title": "Define one matching task", "instruction": "With the provider, name the joint, starting position, direction, target and whether the learner moves actively or the provider positions the limb.", "reason": "Proprioceptive error is specific to the exact task.", "success_check": "The configuration fits in one reproducible sentence." }, { "title": "Support and measure the start", "instruction": "The provider aligns the joint and measuring device, supports the limb and verifies a comfortable start position.", "reason": "Poor alignment or unsupported effort can create both error and symptoms.", "success_check": "The start angle and support are recorded without strain." }, { "title": "Learn the target with vision", "instruction": "Move to or receive the target position once with vision available. Hold briefly and describe where pressure, stretch or joint relation is felt.", "reason": "A familiarisation trial connects the target with available position cues.", "success_check": "The learner can return to start and state the target rule." }, { "title": "Match without target feedback", "instruction": "When the provider gives the cue, move or say stop at the remembered position under the declared vision condition. Do not make repeated searching movements.", "reason": "One committed match produces a measurable error rather than a coached correction.", "success_check": "A single stop position is captured for the trial." }, { "title": "Calculate signed and absolute error", "instruction": "The provider subtracts target angle from response angle, then records direction of error and its absolute size.", "reason": "Direction reveals overshoot or undershoot; absolute error summarises distance from target.", "success_check": "Each trial has target, response, signed error and absolute error." }, { "title": "Separate directional bias from spread", "instruction": "Count positive signed errors as overshoots and negative signed errors as undershoots. Report mean absolute error and the smallest-to-largest response range; never average positive and negative signed errors to make them cancel.", "reason": "A repeated overshoot needs a different correction from inconsistent responses on both sides of the target.", "success_check": "The provider can see whether the block shows one directional bias, broad variability or neither before choosing feedback." }, { "title": "Repair and retest one variable", "instruction": "Use provider feedback to correct the largest repeatable error, then run a matched block. Change support, joint or target only as a labelled transfer test.", "reason": "Matched retesting shows learning; changing the configuration tests something new.", "success_check": "The second block preserves the task or explicitly labels the changed variable." } ], "worked_example": { "scenario": "A physiotherapist runs a supported right-wrist extension matching task with a 20-degree target.", "walkthrough": [ "The therapist screens the wrist, keeps the prescribed support and records active movement with eyes screened only during scored attempts.", "Amir views and reaches the 20-degree target once, then returns to neutral.", "On three scored trials he stops at 27, 24 and 25 degrees.", "The therapist records signed errors +7, +4 and +5 and absolute errors 7, 4 and 5 degrees; three positive signs identify repeated overshoot rather than cancellation.", "After feedback to stop at the first clear target sensation, Amir completes a matched block rather than changing the target." ], "result": "Amir’s first-block mean absolute error is 5.3 degrees for this supported wrist task. It does not describe another joint, tissue safety, pain cause or functional balance." }, "right_vs_wrong": [ { "situation": "Configuration", "right": "Keep joint, target, direction, support and vision rule fixed.", "wrong": "Compare different joints or angles as one score.", "why": "Joint-position accuracy is configuration-specific." }, { "situation": "Movement", "right": "Make one smooth match and stop once.", "wrong": "Hunt back and forth until the angle feels exact.", "why": "Searching adds extra information and changes the task." }, { "situation": "Error", "right": "Record overshoot/undershoot and absolute size.", "wrong": "Report only the best trial.", "why": "All valid attempts are needed to see bias and variability." }, { "situation": "Aid", "right": "Preserve prescribed support and document it.", "wrong": "Remove tape or a brace to test natural ability.", "why": "Removing support can be unsafe and creates a different condition." } ], "common_mistakes": [ { "mistake": "The measuring device is aligned differently each trial.", "fix": "The provider marks and rechecks anatomical alignment before each block." }, { "mistake": "The learner memorises a visual room cue.", "fix": "Control vision consistently and record the exact rule." }, { "mistake": "Signed errors cancel to near zero.", "fix": "Report mean absolute error as well as overshoot and undershoot counts." }, { "mistake": "A changed target is called progression.", "fix": "Label it as transfer and keep matched-target progress separate." } ], "practice": { "first_session": [ "The provider declares right-wrist extension, neutral start, 20-degree target, active movement, supported forearm and the vision rule.", "Complete one or two visual familiarisation reaches, returning the goniometer and wrist to neutral each time.", "Capture three to five one-stop matches with rest; enter target, response, signed error and absolute error before feedback.", "Count overshoots and undershoots, calculate mean absolute error and response range, then choose feedback for bias or spread.", "Run one matched repair block and finish with the provider’s wrist, skin, pain, swelling and support check." ], "repeat_plan": "The clinician sets session frequency, number of trials, rest and any rehabilitation dose. A clean retest keeps joint, target, movement mode, support, vision and measurement device matched; only the provider advances range or task demand.", "progress_when": [ "Mean absolute error and variability meet the provider’s predeclared rule across two matched blocks.", "The learner uses one smooth stop without visual leakage.", "No pain, swelling, instability or loss of control appears." ], "do_not_progress_when": [ "Pain or instability rises, or support is needed differently.", "Alignment or measurement reliability is uncertain.", "The goal shifts to self-diagnosis or unsupported balance activity." ] }, "self_check": [ "For a 20-degree target and 27-degree response, can you show signed error +7 and absolute error 7?", "For responses 27, 24 and 25 degrees, can you calculate mean absolute error (7+4+5)/3 = 5.3 degrees?", "Because all three signs are positive, can you name repeated overshoot rather than letting signed errors cancel?", "Can you list joint, direction, target, movement mode, support, vision rule and measuring-device alignment that must match on retest?" ], "measurement": { "primary": "Absolute joint-position matching error for one provider-declared task.", "how": "For each valid trial calculate signed error = response angle−target angle and absolute error = |signed error|. Average the absolute errors, report smallest-to-largest response range, count overshoots and undershoots, and retain device alignment, assistance and symptoms.", "good_result": "Provider-defined improvement exceeds measurement noise across matched blocks and remains symptom-free.", "does_not_prove": "It does not diagnose neurological function, show tissue health, explain pain or establish balance and whole-body safety." }, "stop_and_get_help": [ "Stop for pain, swelling, giving way, catching, new numbness, weakness, dizziness or loss of control.", "Pause if prescribed support shifts or the provider cannot reproduce alignment.", "Seek clinical review for new proprioceptive difficulty, recurrent falls or sudden sensory/motor change." ], "accessibility": [ "Use supported seating, a large stop switch or spoken stop response.", "Use the opposite limb only when the provider defines a bilateral matching protocol.", "Retain braces and mobility aids and report their exact configuration." ], "evidence_notes": [ { "claim": "A randomised trial tested sensorimotor training added to traditional therapy for a specific chronic-neck-pain population; transfer beyond that configuration is not automatic.", "source_title": "Traditional physical therapy exercises combined with sensorimotor training: The effects on clinical outcomes for chronic neck pain in a double-blind, randomized controlled trial", "source_url": "https://pubmed.ncbi.nlm.nih.gov/31733780/", "source_kind": "PRIMARY_RESEARCH" }, { "claim": "A randomised study found kinesiology tape did not improve wrist force sense and showed no consistent joint-position advantage, so passive tape is not a reliable shortcut.", "source_title": "Effect of Kinesio taping on wrist proprioception in healthy subjects: A randomized clinical trial", "source_url": "https://pubmed.ncbi.nlm.nih.gov/38307737/", "source_kind": "PRIMARY_RESEARCH" } ], "limits": [ "The result belongs to one joint, target, method and support setup.", "A provider controls range, dosing and interpretation.", "Position matching does not establish general body awareness, balance or injury risk." ], "orientation": { "bounded_definition": "Capability to develop or express proprioceptive accuracy in a declared context without inheriting broader claims.", "evidence_summary": "Your sense of joint position can change in a specific task. It is not a single “sixth sense,” and tools or tape must be tested rather than assumed to help.", "supportable_public_claim": "People can sometimes improve position accuracy for a specific joint and task, but proprioception is not one trainable whole-body sense and passive tape is not a reliable shortcut.", "measurement_boundary": "Absolute or variable reposition error describes the tested joint, target and apparatus; it does not establish tissue health, pain cause, balance or real-world safety.", "myth_to_metric": { "myth": "Unlock flawless body awareness", "metric": "Joint-specific reposition or force-reproduction error plus declared function", "boundary": "One joint test cannot establish global proprioception or injury immunity." }, "limiting_findings": [ "Kinesiology tape did not improve wrist force sense and showed no consistent joint-position advantage over placebo/control." ], "prohibited_claims": [ "Perfect body awareness", "Injury-proof proprioception", "Tape rewires your nervous system", "Pain proves poor proprioception" ] }, "gold_source_lesson": { "curriculum_id": "G-CUR-003", "source_heading": "PWR-089 — Proprioceptive accuracy", "source_html_sha256": "cff017823f597e93b2943f2dbf0d813fb74e08bfeec8b16273144faedfc77d38", "html": "Specialist route. Proprioceptive learning can improve, but home exercises cannot diagnose joint-position or neurological function.
" }, "next_gate": "External confirmation is required before higher-authority use because: SUPERVISION_OR_NON_ATTEMPT_BOUNDARY; CULTURAL_COMMUNITY_RIGHTS_OR_AFFECTED_PERSON_AUTHORITY.", "evidence_count": 2 }, "full_training_programme": false, "independently_validated": false, "publication_state": "PUBLISHED_PUBLIC_RESEARCH_EDITION__EDITORIAL_REVIEW_PENDING", "related_power_ids": [ "PWR-090", "PWR-091", "PWR-092", "PWR-093" ] }, { "power_id": "PWR-090", "learning_unit_id": "TLU-PWR-090", "title": "Vestibular adaptation", "main_description": "The learner completes one clinician-prescribed gaze-stability block with target clarity, head movement, symptoms, recovery and assistance recorded exactly.", "main_description_source": "FULL_TUTORIAL_OUTCOME", "family_id": "FAM-12", "family": "Spatial Orientation, Proprioception & Navigation", "superdomain": "Perception & Sensorimotor", "canonical_route": "/powers/pwr-090/", "treatment": "SPECIALIST_PROVIDER_ROUTE", "treatment_label": "Full supervised tutorial", "treatment_boundary": "Titan teaches the complete method; a qualified person controls the parts that require supervision, clearance, specialist equipment, load, dose or progression.", "tutorial_route": "/tutorials/pwr-090/", "governed_lesson_route": null, "self_attempt_status": "PROHIBITED_WITHOUT_QUALIFIED_SUPERVISION", "gold_pathway_ids": [ "G-CUR-003" ], "route_membership": { "kind": "GOLD_PATHWAY", "id": "G-CUR-003", "coverage_status": "EXACT_ONCE" }, "source_authority_tier": "G4", "source_build_state": "EXTERNAL_PROVIDER_ROUTE", "source_instructional_route": "LEARN_ELSEWHERE_TRACK_WITH_TITAN", "source_count": 2, "research_depth": "FOCUSED", "risk_level": "HIGH", "prerequisite_status": "QUALIFIED_PROVIDER_DETERMINES", "learning_route": { "mode": "FULL_SUPERVISED_TUTORIAL", "label": "Learn vestibular adaptation step by step", "summary": "The learner completes one clinician-prescribed gaze-stability block with target clarity, head movement, symptoms, recovery and assistance recorded exactly.", "steps": [ [ "Get ready", "Confirm the diagnosis and exact prescription with the clinician; this page supplies no independent dose." ], [ "Learn the method", "6 concrete steps teach the permitted method from start to finish." ], [ "See right and wrong", "4 comparisons show correct or safer execution beside common wrong or riskier choices." ], [ "Practise", "Frequency, total daily dose, rest and progression are supplied only by the treating clinician. Every home block, if authorised, logs target, posture, speed, range, duration, peak symptoms and recovery; changes wait for the agreed review." ], [ "Check progress", "Record exact target and body configuration, seconds completed, speed cue, whether the symbol stayed identifiable, baseline and peak symptom scores, recovery minutes and assistance." ] ], "practical_authority": false, "provider_required": true, "next_action_route": "/tutorials/pwr-090/" }, "path_builder": { "selectable": true, "completion_allowed": true, "warning": "Titan teaches the complete method; a qualified person controls the parts that require supervision, clearance, specialist equipment, load, dose or progression." }, "full_tutorial": { "version": "3.0", "authorship": "POWER_SPECIFIC_FULL_TUTORIAL", "tutorial_mode": "SUPERVISED", "promise": "Vestibular adaptation exercises use head movement while maintaining a clear target, but the target, speed, posture, duration and recovery must match a diagnosed condition and clinical plan. This lesson teaches the full session method under a vestibular clinician’s control. Eye-only tracking is not substituted for head movement, and dizziness is not chased as proof of a good dose.", "power_id": "PWR-090", "title": "Vestibular adaptation", "lesson_type": "SUPERVISED", "headline": "Practise a clinician-prescribed gaze-stability task with symptom and clarity control", "plain_english_summary": "Vestibular adaptation exercises use head movement while maintaining a clear target, but the target, speed, posture, duration and recovery must match a diagnosed condition and clinical plan. This lesson teaches the full session method under a vestibular clinician’s control. Eye-only tracking is not substituted for head movement, and dizziness is not chased as proof of a good dose.", "outcome": "The learner completes one clinician-prescribed gaze-stability block with target clarity, head movement, symptoms, recovery and assistance recorded exactly.", "authority": { "learner_may": [ "Learn the target, head movement and stop rules and report symptom change honestly.", "Use the prescribed exercise only in the posture, dose and environment set by the clinician." ], "qualified_person_required_for": [ "Diagnosis, clearance, target selection, head speed and range, duration, balance protection, progression and interpretation.", "Habituation, gait, dynamic balance or exercises for central or undiagnosed disorders." ], "never_do": [ "Invent head-motion drills, practise while driving or standing near hazards, or continue through severe or prolonged symptoms.", "Use eye-only smooth tracking or quick eye jumps as a gaze-stability substitute when head movement is the prescribed mechanism." ] }, "materials": [ "Clinician-selected letter or symbol target at the prescribed distance and size.", "Stable chair or provider-set standing support, timer, symptom scale and exercise record.", "Usual glasses and mobility aids unless the clinician documents a specific change." ], "before_you_start": [ "Confirm the diagnosis and exact prescription with the clinician; this page supplies no independent dose.", "Clear the area and use the prescribed seated or guarded posture.", "Record baseline dizziness, nausea, headache, vision clarity and balance from 0 to 10 and agree an immediate stop rule." ], "steps": [ { "title": "Copy the prescription", "instruction": "Write target distance and size, posture, head direction, range, speed cue, duration, rest and stop threshold exactly.", "reason": "Small configuration changes can alter both adaptation demand and fall risk.", "success_check": "The learner and clinician can read back the same complete prescription." }, { "title": "Set the target and support", "instruction": "Place the target at the prescribed distance and eye level. Take the prescribed seat or guarded stance with aids in reach.", "reason": "A stable setup lets the exercise challenge gaze rather than uncontrolled balance.", "success_check": "The target is clear before head movement and the body is protected from a fall." }, { "title": "Rehearse slowly", "instruction": "Keep eyes on the target and turn the head through the prescribed small range while the clinician observes. The target should remain recognisable.", "reason": "Familiarisation confirms the learner understands head-plus-eye coordination.", "success_check": "The learner moves the head, not just the eyes, and can still identify the target." }, { "title": "Run the prescribed block", "instruction": "Start the timer and move at the clinician-set rhythm. Keep the target as clear as possible, breathe normally and report symptoms rather than hiding them.", "reason": "A consistent block creates a controllable adaptation dose.", "success_check": "Duration, speed cue, clarity and peak symptoms are recorded." }, { "title": "Stop and recover", "instruction": "Stop at the prescription limit or earlier stop sign, sit or remain supported and time recovery until symptoms return to the clinician-defined band.", "reason": "Recovery duration is part of dose and may reveal over-provocation.", "success_check": "The record includes peak change and minutes to recovery." }, { "title": "Review before any progression", "instruction": "The clinician checks execution, functional response and recovery, then keeps or changes one variable only.", "reason": "Changing one feature preserves attribution and avoids sudden overload.", "success_check": "The next plan names one controlled change or a hold decision." } ], "worked_example": { "scenario": "A vestibular physiotherapist prescribes a seated horizontal gaze-stability block using a large letter at one metre.", "walkthrough": [ "The prescription specifies seated posture, small comfortable head turns, metronome speed, 20 seconds, two minutes rest and a symptom stop threshold.", "Rosa records baseline dizziness 1/10 and sees the letter clearly.", "She keeps her eyes on the letter while her head turns; the therapist corrects a shoulder turn.", "At 15 seconds the letter blurs and dizziness reaches the agreed stop value, so she stops and records recovery time.", "The therapist shortens the next block rather than telling Rosa to push through." ], "result": "Rosa performed the prescribed mechanism, respected the stop rule and produced usable dose-response information. The session does not show vestibular strength or justify unsupervised progression." }, "right_vs_wrong": [ { "situation": "Mechanism", "right": "Move the head while keeping the prescribed target clear.", "wrong": "Move only the eyes between two targets.", "why": "Eye-only exercises do not provide the same vestibular adaptation stimulus." }, { "situation": "Dose", "right": "Use clinician-set speed, range and time.", "wrong": "Move faster until dizziness proves the exercise is working.", "why": "Symptom intensity is not a valid universal dose target." }, { "situation": "Posture", "right": "Use the prescribed seat, guard and aids.", "wrong": "Stand unsupported to make the task more functional.", "why": "Unapproved balance demand adds fall risk." }, { "situation": "Progression", "right": "Change one variable after clinician review.", "wrong": "Increase speed, time, background and stance together.", "why": "Multiple changes hide the cause of benefit or adverse response." } ], "common_mistakes": [ { "mistake": "The shoulders and trunk rotate with the head.", "fix": "Reduce range and use clinician feedback to isolate the prescribed head turn." }, { "mistake": "The learner stares harder after the target blurs.", "fix": "Stop or slow according to the prescription and record the blur." }, { "mistake": "Recovery time is omitted.", "fix": "Time from stop until symptoms return to the defined band." }, { "mistake": "A good day triggers self-progression.", "fix": "Keep the exact dose until the clinician reviews repeated responses." } ], "practice": { "first_session": [ "Clinical screen and prescription teach-back.", "Supported setup and baseline symptom record.", "One observed slow rehearsal.", "One short prescribed block.", "Timed recovery and clinician decision." ], "repeat_plan": "Frequency, total daily dose, rest and progression are supplied only by the treating clinician. Every home block, if authorised, logs target, posture, speed, range, duration, peak symptoms and recovery; changes wait for the agreed review.", "progress_when": [ "Target remains recognisable through the declared movement.", "Symptoms and recovery stay within the clinician-set band across repeated blocks.", "The task supports the agreed functional goal without a fall or new symptom." ], "do_not_progress_when": [ "Recovery lengthens or symptoms accumulate across sessions.", "Head movement, posture or target cannot be performed as prescribed.", "There is a new neurological, hearing, visual or severe headache symptom." ] }, "self_check": [ "Does the prescription name every dose variable?", "Is the head moving rather than only the eyes?", "Did you record both peak symptoms and recovery?", "Who authorised the next change?" ], "measurement": { "primary": "Prescribed gaze-stability block completed with clarity and symptom recovery recorded.", "how": "Record exact target and body configuration, seconds completed, speed cue, whether the symbol stayed identifiable, baseline and peak symptom scores, recovery minutes and assistance.", "good_result": "The clinician judges execution correct and repeated blocks remain within the predeclared symptom/recovery band while the functional target improves.", "does_not_prove": "It does not establish a stronger vestibular system, diagnosis, safety for driving or motion, or transfer to an undiagnosed condition." }, "stop_and_get_help": [ "Stop and obtain urgent assessment for new weakness, facial droop, speech change, severe sudden headache, fainting, chest pain, double vision or inability to stand safely.", "Stop the block for vomiting, fall, marked imbalance, severe headache, new hearing change or symptoms beyond the clinician’s limit.", "Contact the treating clinician if recovery is longer than prescribed, symptoms accumulate or the exercise pattern changes." ], "accessibility": [ "Use a large high-contrast target and spoken timing without changing target distance unless prescribed.", "Use seated practice, guarding and usual mobility aids as configured.", "Provide breaks, low-distraction surroundings and a supporter trained in the stop plan." ], "evidence_notes": [ { "claim": "The official clinical practice guideline supports vestibular rehabilitation for diagnosed peripheral vestibular hypofunction and rejects eye-only saccade or pursuit drills as gaze-stability treatment.", "source_title": "Vestibular Rehabilitation for Peripheral Vestibular Hypofunction: An Evidence-Based Clinical Practice Guideline (CPG+)", "source_url": "https://www.apta.org/patient-care/evidence-based-practice-resources/cpgs/vestibular-rehabilitation-for-peripheral-vestibular-hypofunction-an-evidence-based-clinical-practice-guideline-cpg", "source_kind": "OFFICIAL_GUIDANCE" }, { "claim": "A primary study reported recovery of dynamic visual acuity in unilateral vestibular hypofunction under a defined rehabilitation context.", "source_title": "Recovery of dynamic visual acuity in unilateral vestibular hypofunction", "source_url": "https://pubmed.ncbi.nlm.nih.gov/12925338/", "source_kind": "PRIMARY_RESEARCH" } ], "limits": [ "This method applies only to a clinician-prescribed configuration and diagnosis.", "Provoking stronger symptoms is not evidence of better adaptation.", "The lesson supplies no generic speed, duration or progression dose." ], "orientation": { "bounded_definition": "Capability to develop or express vestibular adaptation in a declared context without inheriting broader claims.", "evidence_summary": "The balance system can compensate and adapt, but dizziness is not a do-it-yourself training signal. Effective routes are diagnosis-specific and clinically supervised.", "supportable_public_claim": "People with diagnosed peripheral vestibular hypofunction can improve selected gaze, balance and functional outcomes through clinician-configured rehabilitation.", "measurement_boundary": "Dynamic visual acuity, vestibular tests, symptom measures, gait and participation describe different outcomes; none alone establishes “vestibular strength.”", "myth_to_metric": { "myth": "Make yourself immune to dizziness", "metric": "Diagnosis-specific gaze, balance, symptom and participation outcomes", "boundary": "A laboratory adaptation cannot certify safe movement or cure every cause of vertigo." }, "limiting_findings": [ "The guideline rejects eye-only saccade or smooth-pursuit drills without head movement as a gaze-stability treatment, and its recommendations do not cover undiagnosed or central disorders." ], "prohibited_claims": [ "Reset your inner ear", "Cure all vertigo", "Train until dizzy", "Vestibular immunity" ] }, "gold_source_lesson": { "curriculum_id": "G-CUR-003", "source_heading": "PWR-090 — Vestibular adaptation", "source_html_sha256": "ebc19d52e1a626523b89f26b0312b7c61f63c99a545936652c5e8d4c3966b028", "html": "Specialist route. Provocative head-motion/habituation programmes require the appropriate clinical context.
" }, "next_gate": "External confirmation is required before higher-authority use because: CLINICAL_HIGH_RISK_OR_REGULATED_CONFIGURATION; SUPERVISION_OR_NON_ATTEMPT_BOUNDARY; CULTURAL_COMMUNITY_RIGHTS_OR_AFFECTED_PERSON_AUTHORITY; SAFETY_LEGITIMACY_RESTRICTED.", "evidence_count": 2 }, "full_training_programme": false, "independently_validated": false, "publication_state": "PUBLISHED_PUBLIC_RESEARCH_EDITION__EDITORIAL_REVIEW_PENDING", "related_power_ids": [ "PWR-089", "PWR-091", "PWR-092", "PWR-093" ] }, { "power_id": "PWR-091", "learning_unit_id": "TLU-PWR-091", "title": "Path integration", "main_description": "The learner calculates homeward-bearing and magnitude error on six novel coordinate traces and reports how an external reference changes those two errors.", "main_description_source": "FULL_TUTORIAL_OUTCOME", "family_id": "FAM-12", "family": "Spatial Orientation, Proprioception & Navigation", "superdomain": "Perception & Sensorimotor", "canonical_route": "/powers/pwr-091/", "treatment": "EVIDENCE_REVIEW_ROUTE", "treatment_label": "Full low-stakes tutorial", "treatment_boundary": "Titan teaches a concrete low-stakes method step by step while keeping evidence and transfer claims bounded.", "tutorial_route": "/tutorials/pwr-091/", "governed_lesson_route": null, "self_attempt_status": "PERMITTED_INSIDE_FULL_TUTORIAL_LIMITS", "gold_pathway_ids": [ "G-CUR-003" ], "route_membership": { "kind": "GOLD_PATHWAY", "id": "G-CUR-003", "coverage_status": "EXACT_ONCE" }, "source_authority_tier": "G1", "source_build_state": "TARGETED_REVIEW_REQUIRED", "source_instructional_route": "SELF_GUIDED_TUTORIAL", "source_count": 2, "research_depth": "FOCUSED", "risk_level": "HIGH", "prerequisite_status": "NONE_FOR_READING__NO_PRACTICE_AUTHORITY", "learning_route": { "mode": "FULL_SELF_GUIDED_TUTORIAL", "label": "Learn path integration step by step", "summary": "The learner calculates homeward-bearing and magnitude error on six novel coordinate traces and reports how an external reference changes those two errors.", "steps": [ [ "Get ready", "Work seated with no physical motion challenge." ], [ "Learn the method", "9 concrete steps teach the permitted method from start to finish." ], [ "See right and wrong", "4 comparisons show correct or safer execution beside common wrong or riskier choices." ], [ "Practise", "Complete six new sequences twice a week for two weeks, divided equally between unaided and origin-visible trials. After 48 hours, use a fresh set. Increase turn count only after scoring remains stable." ], [ "Check progress", "For each concealed sequence, sum horizontal x and vertical y displacement, use (−x, −y) as the homeward vector and calculate exact length √(x² + y²). Record the smaller protractor angle between estimated and exact arrows plus the absolute difference between estimated and exact lengths, separated by cue condition." ] ], "practical_authority": true, "provider_required": false, "next_action_route": "/tutorials/pwr-091/" }, "path_builder": { "selectable": true, "completion_allowed": true, "warning": "Titan teaches a concrete low-stakes method step by step while keeping evidence and transfer claims bounded." }, "full_tutorial": { "version": "3.0", "authorship": "POWER_SPECIFIC_FULL_TUTORIAL", "tutorial_mode": "SELF_GUIDED", "promise": "Path integration updates an internal estimate of the starting point as successive translations and turns occur. Drift normally accumulates. This safe fixture uses coordinate traces on paper or screen, never eyes-closed locomotion. The learner follows a sequence once, conceals it, marks a straight homeward bearing and magnitude, then quantifies angular and length error and tests the effect of one fixed external reference cue.", "power_id": "PWR-091", "title": "Path integration", "lesson_type": "SELF_GUIDED", "headline": "Estimate a homeward vector from remembered displacements without walking blindfolded", "plain_english_summary": "Path integration updates an internal estimate of the starting point as successive translations and turns occur. Drift normally accumulates. This safe fixture uses coordinate traces on paper or screen, never eyes-closed locomotion. The learner follows a sequence once, conceals it, marks a straight homeward bearing and magnitude, then quantifies angular and length error and tests the effect of one fixed external reference cue.", "outcome": "The learner calculates homeward-bearing and magnitude error on six novel coordinate traces and reports how an external reference changes those two errors.", "authority": { "learner_may": [ "Follow fictional displacement sequences on paper or an accessible screen while seated.", "Keep normal orientation and mobility aids during all real travel." ], "qualified_person_required_for": [ "Physical homing where falls, traffic, disorientation, cognitive impairment or disability makes consequences meaningful.", "Orientation-and-mobility assessment or vestibular testing." ], "never_do": [ "Walk blindfolded, close the eyes while moving, spin, remove travel aids or practise near traffic, stairs, water or obstacles.", "Use a paper score to certify outdoor or community travel safety." ] }, "materials": [ "Six printed coordinate traces, each with a start, two to five straight segments and quarter turns.", "Blank coordinate sheets, pencil, ruler, protractor or accessible angle tool and correction overlays.", "Optional raised-line traces or screen-reader-compatible turn-and-length lists." ], "before_you_start": [ "Work seated with no physical motion challenge.", "Learn how up, right, down and left on the sheet represent four fixed headings.", "Set the scoring rule: bearing error in degrees and magnitude error in grid units." ], "steps": [ { "title": "Read the start frame", "instruction": "Mark the origin, the initial facing arrow and the fixed upward axis.", "reason": "A homeward vector is meaningless without an origin and heading frame.", "success_check": "Origin, facing arrow and upward axis are visible before tracing." }, { "title": "Trace each segment", "instruction": "Follow the sequence once, counting units and naming every clockwise or counter-clockwise quarter turn. Do not calculate the final vector yet.", "reason": "Segment-by-segment updating supplies the self-motion analogue in a consequence-free fixture.", "success_check": "The learner reaches the endpoint with the prescribed segment count." }, { "title": "Maintain a heading ledger", "instruction": "At each turn, draw a small arrow showing the new facing direction and state the estimated east–west and north–south change so far. Cover the ledger before the final return estimate.", "reason": "A heading ledger teaches how successive rotations and translations update position while still preserving an unaided final test.", "success_check": "Every turn has one correct facing arrow, and the final answer is committed without reopening the ledger." }, { "title": "Hide and estimate the bearing", "instruction": "Cover the sequence and draw one arrow from the endpoint straight toward the remembered origin.", "reason": "The arrow captures the accumulated heading-and-position estimate.", "success_check": "One homeward arrow is committed before feedback." }, { "title": "Estimate vector magnitude", "instruction": "Write how many grid units the direct homeward line should span without reversing the outbound sequence.", "reason": "Displacement magnitude differs from total travel length.", "success_check": "One magnitude estimate is written beside the arrow." }, { "title": "Reveal and quantify error", "instruction": "Place the correction overlay on top. Measure the smaller angular gap between arrows and the absolute difference between estimated and exact magnitudes.", "reason": "Bearing and magnitude reveal two different forms of drift.", "success_check": "Both numerical errors are retained for every trace." }, { "title": "Resolve the displacement components", "instruction": "Only after scoring the memory estimate, give eastward units a positive horizontal value x, westward units negative x, northward units positive y and southward units negative y. Add each axis. The exact homeward vector is (−x, −y), and its length is √(x² + y²). Draw that vector from the endpoint and use a protractor to measure the smaller angle between it and the estimated arrow.", "reason": "Component arithmetic provides a transparent correction key while keeping the earlier perceptual estimate uncoached.", "success_check": "The horizontal and vertical sums reproduce the answer-key arrow, and any arithmetic slip is separated from the original estimation error." }, { "title": "Relate drift to sequence complexity", "instruction": "After several traces, order them by turn count and total travelled length, then compare their bearing and magnitude errors without deleting exceptions.", "reason": "Accumulated drift may respond differently to rotations and translations.", "success_check": "The summary identifies the largest miss, its complexity features and any trace that contradicts a simple accumulation pattern." }, { "title": "Compare an external-reference condition", "instruction": "Repeat matched traces with the origin marker left visible, then try a fresh sequence after 48 hours. Keep unaided and reference-cue scores separate.", "reason": "A stable external reference can correct accumulated drift; a delayed unfamiliar sequence checks method use.", "success_check": "The report compares both cue conditions and includes a delayed trace." } ], "worked_example": { "scenario": "A coordinate trace moves 4 squares up, 3 right and 2 down from origin A.", "walkthrough": [ "Kai marks the upward axis and follows all three segments once.", "After concealing the sequence, he draws a down-left homeward arrow from the endpoint.", "He estimates a magnitude of 3 grid units.", "The overlay shows an exact displacement of 3 left and 2 down, magnitude about 3.6; bearing error is 11 degrees and magnitude error 0.6.", "On a matched trace with origin A still visible, his angular miss falls, which he reports as reference-assisted performance." ], "result": "Kai distinguishes direct displacement from reversing the outbound sequence and quantifies two error components. The paper result does not show safe physical homing." }, "right_vs_wrong": [ { "situation": "Fixture", "right": "Use a paper, tactile or screen trace while seated.", "wrong": "Walk with eyes closed to make self-motion realistic.", "why": "Blindfolded movement adds fall and collision risk." }, { "situation": "Return", "right": "Draw the direct displacement to the start.", "wrong": "Reverse every outbound segment as the answer.", "why": "Route reversal and path integration are different tasks." }, { "situation": "Scoring", "right": "Measure bearing and magnitude error separately.", "wrong": "Mark the whole attempt simply right or wrong.", "why": "Separate errors show whether heading or scale failed." }, { "situation": "External reference", "right": "Report fixed-cue and unaided results apart.", "wrong": "Combine them into one orientation score.", "why": "Visible origin information can correct an accumulated internal estimate." } ], "common_mistakes": [ { "mistake": "The reference axis changes when the page rotates.", "fix": "Keep the page fixed and reproduce the upward arrow on every blank sheet." }, { "mistake": "The learner retraces instead of drawing displacement.", "fix": "Require one straight return arrow." }, { "mistake": "Signed magnitude differences cancel.", "fix": "Use absolute magnitude error per trace before averaging." }, { "mistake": "A practised sequence is called transfer.", "fix": "Use a delayed trace with new segment lengths and turn order." } ], "practice": { "first_session": [ "Learn one demonstrated coordinate trace.", "Complete three unaided traces.", "Measure angular and magnitude errors.", "Complete three matched origin-visible traces.", "Write which reference corrected the largest drift." ], "repeat_plan": "Complete six new sequences twice a week for two weeks, divided equally between unaided and origin-visible trials. After 48 hours, use a fresh set. Increase turn count only after scoring remains stable.", "progress_when": [ "All estimates are committed before feedback.", "Median angular and magnitude errors improve on unfamiliar traces.", "The learner explains when an external origin cue corrected drift." ], "do_not_progress_when": [ "The learner memorises correction overlays.", "The next step involves actual eyes-closed motion or removal of aids.", "Visual, vestibular or cognitive symptoms make the task distressing." ] }, "self_check": [ "Did you mark the origin and initial heading?", "Is the homeward estimate one straight vector?", "Are angle and magnitude errors separate?", "Was physical blindfolding excluded?" ], "measurement": { "primary": "Angular and magnitude error of a direct homeward estimate.", "how": "For each concealed sequence, sum horizontal x and vertical y displacement, use (−x, −y) as the homeward vector and calculate exact length √(x² + y²). Record the smaller protractor angle between estimated and exact arrows plus the absolute difference between estimated and exact lengths, separated by cue condition.", "good_result": "Every exact vector and error calculation reproduces, an unfamiliar matched set is reported without hiding larger errors, and reference-assisted results stay separate from unaided results. A lower median is evidence to retest, not a validated pass threshold.", "does_not_prove": "It does not establish community travel, vestibular function, fall safety or physical homing transfer." }, "stop_and_get_help": [ "Stop for dizziness, nausea, headache, visual strain or distress.", "Do not convert the task into movement with closed eyes or reduced aids.", "Seek qualified orientation or clinical support if getting lost, balance change or travel difficulty affects real safety." ], "accessibility": [ "Use raised-line coordinate sheets and tactile heading arrows.", "Provide turn-and-length text with an accessible vector-response format.", "Allow extra processing time and a scribe while preserving concealed-sequence commitment." ], "evidence_notes": [ { "claim": "Vision and proprioception made comparable contributions in one novel homing task, so cue configuration must be reported.", "source_title": "Vision and proprioception make equal contributions to path integration in a novel homing task", "source_url": "https://pubmed.ncbi.nlm.nih.gov/31228680/", "source_kind": "PRIMARY_RESEARCH" }, { "claim": "Path-integration performance depended on sensory modality and control dynamics, and adaptation to changing dynamics was incomplete.", "source_title": "Influence of sensory modality and control dynamics on human path integration", "source_url": "https://pubmed.ncbi.nlm.nih.gov/35179488/", "source_kind": "PRIMARY_RESEARCH" } ], "limits": [ "The coordinate fixture is an educational analogue, not physical self-motion training.", "Drift normally accumulates and cue dependence is expected.", "No real-travel safety or general orientation claim follows." ], "orientation": { "bounded_definition": "Capability to develop or express path integration in a declared context without inheriting broader claims.", "evidence_summary": "Humans do have a form of internal dead reckoning—but it drifts, depends on available senses, and is not a substitute for landmarks or safe navigation tools.", "supportable_public_claim": "People can estimate position by integrating self-motion cues, but the estimate accumulates error and is highly dependent on vision, proprioception and motion dynamics.", "measurement_boundary": "Homing distance/angle error in a declared cue configuration measures that task only; it does not measure general navigation or safety.", "myth_to_metric": { "myth": "Activate your internal GPS", "metric": "Cue-specific homing distance and heading error", "boundary": "A good laboratory homing trial cannot establish reliable real-world navigation." }, "limiting_findings": [ "Vestibular cues alone produced chance or strongly biased performance in key conditions, and participants did not fully adapt to changing control dynamics." ], "prohibited_claims": [ "Human dead reckoning is a compass", "Navigate blind anywhere", "Perfect internal GPS", "Vestibular signals always tell distance" ] }, "gold_source_lesson": { "curriculum_id": "G-CUR-003", "source_heading": "10. Path integration: Silver route", "source_html_sha256": "b4ba2e99398e6cb46fdc5b9ead1471f662860a49a0367c2e531f884fdceb51ba", "html": "Path integration uses self-motion information to update where you are relative to a starting point. It is useful and naturally accumulates error.
\nThe Silver route will use fictional, virtual or already-safe familiar routes. It will compare:
\nThere is no blindfolded walking challenge. Real-world motion and fall-risk cases remain outside the self-guided route.
" }, "next_gate": "External confirmation is required before higher-authority use because: CLINICAL_HIGH_RISK_OR_REGULATED_CONFIGURATION; CULTURAL_COMMUNITY_RIGHTS_OR_AFFECTED_PERSON_AUTHORITY; SAFETY_LEGITIMACY_RESTRICTED.", "evidence_count": 2 }, "full_training_programme": false, "independently_validated": false, "publication_state": "PUBLISHED_PUBLIC_RESEARCH_EDITION__EDITORIAL_REVIEW_PENDING", "related_power_ids": [ "PWR-089", "PWR-090", "PWR-092", "PWR-093" ] }, { "power_id": "PWR-092", "learning_unit_id": "TLU-PWR-092", "title": "Cognitive mapping", "main_description": "The learner reconstructs four target landmarks around the shared anchor, checks eight relational answers against the supplied key and explains each distortion before a delayed novel arrangement.", "main_description_source": "FULL_TUTORIAL_OUTCOME", "family_id": "FAM-12", "family": "Spatial Orientation, Proprioception & Navigation", "superdomain": "Perception & Sensorimotor", "canonical_route": "/powers/pwr-092/", "treatment": "EVIDENCE_REVIEW_ROUTE", "treatment_label": "Full low-stakes tutorial", "treatment_boundary": "Titan teaches a concrete low-stakes method step by step while keeping evidence and transfer claims bounded.", "tutorial_route": "/tutorials/pwr-092/", "governed_lesson_route": null, "self_attempt_status": "PERMITTED_INSIDE_FULL_TUTORIAL_LIMITS", "gold_pathway_ids": [ "G-CUR-003" ], "route_membership": { "kind": "GOLD_PATHWAY", "id": "G-CUR-003", "coverage_status": "EXACT_ONCE" }, "source_authority_tier": "G1", "source_build_state": "TARGETED_REVIEW_REQUIRED", "source_instructional_route": "SELF_GUIDED_TUTORIAL", "source_count": 5, "research_depth": "DETAILED", "risk_level": "MODERATE", "prerequisite_status": "NONE_FOR_READING__NO_PRACTICE_AUTHORITY", "learning_route": { "mode": "FULL_SELF_GUIDED_TUTORIAL", "label": "Learn cognitive mapping step by step", "summary": "The learner reconstructs four target landmarks around the shared anchor, checks eight relational answers against the supplied key and explains each distortion before a delayed novel arrangement.", "steps": [ [ "Get ready", "Confirm the fixture is fictional or already harmless and not a live navigation test." ], [ "Learn the method", "8 concrete steps teach the permitted method from start to finish." ], [ "See right and wrong", "4 comparisons show correct or safer execution beside common wrong or riskier choices." ], [ "Practise", "Use one new layout twice a week for three weeks. Retest each layout after at least 48 hours without restudying; alternate drawn, token and verbal-coordinate responses when accessibility requires." ], [ "Check progress", "Score correct landmark quadrant, ordinal distance, route links and eight unseen relational questions; report rotation, reversal, compression and omission errors separately." ] ], "practical_authority": true, "provider_required": false, "next_action_route": "/tutorials/pwr-092/" }, "path_builder": { "selectable": true, "completion_allowed": true, "warning": "Titan teaches a concrete low-stakes method step by step while keeping evidence and transfer claims bounded." }, "full_tutorial": { "version": "3.0", "authorship": "POWER_SPECIFIC_FULL_TUTORIAL", "tutorial_mode": "SELF_GUIDED", "promise": "A cognitive map represents relations among places, not just a memorised turn sequence. This lesson uses four target landmarks around one fixed shared anchor, presented through two overlapping fictional routes. The learner reconstructs the four targets, answers relative-direction and shortcut questions, compares with the supplied key, corrects distortions and retests after a delay.", "power_id": "PWR-092", "title": "Cognitive mapping", "lesson_type": "SELF_GUIDED", "headline": "Build a relational map from overlapping routes, then correct its distortions", "plain_english_summary": "A cognitive map represents relations among places, not just a memorised turn sequence. This lesson uses four target landmarks around one fixed shared anchor, presented through two overlapping fictional routes. The learner reconstructs the four targets, answers relative-direction and shortcut questions, compares with the supplied key, corrects distortions and retests after a delay.", "outcome": "The learner reconstructs four target landmarks around the shared anchor, checks eight relational answers against the supplied key and explains each distortion before a delayed novel arrangement.", "authority": { "learner_may": [ "Use fictional, tabletop, tactile or virtual layouts while seated.", "Use maps and navigation aids rather than remove them in real settings." ], "qualified_person_required_for": [ "Community navigation affected by cognitive impairment, visual disability, falls or getting lost.", "Clinical assessment of spatial cognition." ], "never_do": [ "Practise by becoming lost, withholding an aid or entering an unfamiliar real environment alone.", "Turn one sketch-map score or brain image into a general sense-of-direction rank." ] }, "materials": [ "Exact route cards: Card 1 reads ‘Gate, then 2 units east to Pond, then 3 units north to Library.’ Card 2 reads ‘Café, then 2 units north to Pond, then 2 units east to Garden.’ Pond is the shared anchor at (0,0); therefore Gate is (−2,0), Library (0,3), Café (0,−2) and Garden (2,0). Keep these coordinates on the hidden answer key, not on the study side.", "Blank map or movable landmark tokens, direction labels and answer key.", "Eight-question card and hidden answers: (1) Gate from Pond? west 2; (2) Library from Pond? north 3; (3) Café from Pond? south 2; (4) Garden from Pond? east 2; (5) Gate to Garden? east 4; (6) Café to Library? north 5; (7) which targets share Pond’s horizontal line? Gate and Garden; (8) farthest target from Pond? Library." ], "before_you_start": [ "Confirm the fixture is fictional or already harmless and not a live navigation test.", "Learn the reference direction and scale.", "Set a fixed study time and keep the answer key hidden.", "Have a helper copy only the route-card fronts and question card. If the learner already read the coordinates or answers, treat the supplied layout as demonstration and use a helper-made translated or rotated layout for the scored attempt." ], "steps": [ { "title": "Anchor the reference", "instruction": "Mark north and place the shared landmark in the centre of the blank map.", "reason": "A common anchor lets two route experiences join into one representation.", "success_check": "North and the overlap landmark are fixed before study." }, { "title": "Study route one relationally", "instruction": "Trace the first route and say how each landmark lies relative to the previous one and the anchor.", "reason": "Relational encoding preserves more than a verbal turn list.", "success_check": "The learner states direction and rough distance for every link." }, { "title": "Study the overlapping route", "instruction": "Trace route two, connect it at the shared landmark and predict where its new landmark belongs on the same map.", "reason": "Overlap allows separate sequences to form a common layout.", "success_check": "The new landmark is placed before viewing the complete map." }, { "title": "Predict an unseen relation", "instruction": "Before drawing the full map, state the direction and rough distance between one landmark from route one and one from route two that never appeared together.", "reason": "A relation inferred across routes is stronger evidence of an integrated map than repeating either route.", "success_check": "The prediction is written before reconstruction and can be checked against the answer key." }, { "title": "Reconstruct from memory", "instruction": "Hide both route cards and draw or place the four target landmarks around the already fixed Pond anchor, including route links and north arrow.", "reason": "Free reconstruction exposes compression, rotation and misplaced relations.", "success_check": "Gate, Library, Café and Garden plus both route links are committed before reveal." }, { "title": "Test relations and shortcuts", "instruction": "Answer direction, nearer/farther and possible-shortcut questions that were not stated directly in either route.", "reason": "Novel relational questions test map knowledge beyond route recitation.", "success_check": "Eight answers are saved without the source cards." }, { "title": "Correct, delay and vary", "instruction": "Compare with the key, mark each distortion, redraw once from the error list and retest after 48 hours on a new four-landmark layout.", "reason": "Explicit correction and a delayed novel map separate repair from copying.", "success_check": "The record includes error types and a fresh-layout score." }, { "title": "Audit the distortion pattern", "instruction": "Classify every mismatch as rotation, reversal, distance compression, omission or incorrect link. For the most frequent class, write a specific encoding repair to use on the next layout.", "reason": "Different distortions require different corrections; one total score conceals the learner’s actual mapping failure.", "success_check": "The next-session plan names one error class, its frequency and a matching repair rather than a generic instruction to concentrate." } ], "worked_example": { "scenario": "Route one is Gate–Pond–Library; route two is Café–Pond–Garden, with Pond as the overlap.", "walkthrough": [ "Marta marks north and places Pond at the map centre.", "She learns Gate west of Pond and Library north of Pond.", "From route two she places Café south of Pond and Garden east of Pond.", "After hiding the cards she reconstructs all four and answers that Gate to Garden is mainly eastward without travelling either complete route.", "The key reveals that she compressed the Pond–Library distance, so she marks distance compression and redraws." ], "result": "Marta has formed and tested a relational map, including an inferred connection. The score belongs to this layout and does not show universal spatial memory." }, "right_vs_wrong": [ { "situation": "Learning", "right": "Encode landmark relations and overlap.", "wrong": "Memorise only left-right turn words.", "why": "A turn string may support one route without a map of the environment." }, { "situation": "Reconstruction", "right": "Commit a map before checking.", "wrong": "Copy while the route cards remain visible.", "why": "Visible copying cannot reveal the internal representation." }, { "situation": "Testing", "right": "Ask new relative-direction and shortcut questions.", "wrong": "Test only the original route order.", "why": "Novel relations distinguish mapping from sequence recall." }, { "situation": "Claim", "right": "Report distortion types for this layout.", "wrong": "Call a neat sketch proof of superior navigation.", "why": "Drawing quality and spatial relation accuracy are different." } ], "common_mistakes": [ { "mistake": "The two routes have no shared anchor.", "fix": "Include exactly one clear overlapping landmark." }, { "mistake": "The north reference disappears.", "fix": "Print and reproduce the north arrow on all cards and maps." }, { "mistake": "Distances are ignored.", "fix": "Use a common scale and score distance-order questions." }, { "mistake": "Correction becomes copying.", "fix": "Close the key before redrawing from the written error list." } ], "practice": { "first_session": [ "Study two overlapping routes for a fixed interval.", "Reconstruct four landmarks.", "Answer eight relational questions.", "Classify rotation, reversal, compression or omission errors.", "Redraw once without the key." ], "repeat_plan": "Use one new layout twice a week for three weeks. Retest each layout after at least 48 hours without restudying; alternate drawn, token and verbal-coordinate responses when accessibility requires.", "progress_when": [ "Every relational answer cites the reconstructed direction or distance, and every miss is classified before a new layout is attempted.", "The learner joins routes through the overlap without losing north.", "Previously named distortion types decline." ], "do_not_progress_when": [ "Scores depend on copying or repeated identical layouts.", "The task becomes a real unfamiliar route with safety consequences.", "Spatial work triggers disorientation or distress." ] }, "self_check": [ "What landmark joins the routes?", "Can you answer a relation never stated directly?", "Did you preserve north and scale?", "Which distortion did the key reveal?" ], "measurement": { "primary": "Relational map accuracy on an unfamiliar four-landmark layout.", "how": "Score correct landmark quadrant, ordinal distance, route links and eight unseen relational questions; report rotation, reversal, compression and omission errors separately.", "good_result": "All four target placements and all eight answers are checked against the key, each miss is labelled rotation, reversal, compression, omission or incorrect link, and the same correction method is used on a delayed new layout. The number correct is reported descriptively, not as a validated mapping threshold.", "does_not_prove": "It does not establish real-world wayfinding, general memory, hippocampal capacity or independent travel safety." }, "stop_and_get_help": [ "Stop for dizziness, confusion, visual strain or distress.", "Do not use getting lost or removal of aids as practice.", "Seek qualified support if real navigation difficulty or cognitive change affects safety." ], "accessibility": [ "Use tactile maps and movable raised landmarks.", "Allow verbal coordinates or a scribe instead of drawing.", "Provide high-contrast large print and extra study time, held constant across comparisons." ], "evidence_notes": [ { "claim": "London taxi expertise was selective and did not produce broad memory enhancement; some new visuospatial learning was poorer.", "source_title": "London taxi drivers and bus drivers: a structural MRI and neuropsychological analysis", "source_url": "https://pubmed.ncbi.nlm.nih.gov/17024677/", "source_kind": "PRIMARY_RESEARCH" }, { "claim": "A primary study examined cognitive-map formation through tactile-map navigation in visually impaired and sighted participants, supporting accessible map formats without implying universal transfer.", "source_title": "Cognitive map formation through tactile map navigation in visually impaired and sighted persons", "source_url": "https://pubmed.ncbi.nlm.nih.gov/35798929/", "source_kind": "PRIMARY_RESEARCH" } ], "limits": [ "Map knowledge is environment- and task-specific.", "Sketch quality is not the same as relational accuracy.", "Expert experience and brain differences cannot be used as a personal capability metric." ], "orientation": { "bounded_definition": "Capability to develop or express cognitive mapping in a declared context without inheriting broader claims.", "evidence_summary": "People can build remarkably detailed maps of places. Those maps may be visual, tactile, auditory or technology-supported—and their value is always environment-specific.", "supportable_public_claim": "People can build useful environment-specific cognitive maps through prolonged experience, tactile maps or declared sensory support, but expertise can be selective and transfer is not automatic.", "measurement_boundary": "Pointing, distance, route choice, sketch maps and destination success sample different map knowledge; MRI volume is not a personal capability metric.", "myth_to_metric": { "myth": "Build a perfect map in your head", "metric": "Route, survey, landmark and destination measures in a named environment", "boundary": "A brain scan or one map test cannot establish universal navigation skill." }, "limiting_findings": [ "Taxi expertise did not produce broad memory enhancement and was associated with poorer new visuospatial learning on some measures." ], "prohibited_claims": [ "Grow your hippocampus on command", "Photographic map memory", "One navigation style is superior", "Indigenous navigation belongs to Titan" ] }, "gold_source_lesson": { "curriculum_id": "G-CUR-003", "source_heading": "11. Cognitive mapping and route reconstruction: Silver route", "source_html_sha256": "4e45145279205e0ebab90ca07d54fc35af4b56da5acce62792da0a3d4b5c16e4", "html": "A turn sequence is not the same as a cognitive map.
\nTry a fictional fixture:
\nTraining studies show that components of cognitive mapping can improve, but effects are selective and individual differences remain. Do not turn one sketch-map score into a “sense of direction” rank.
" }, "next_gate": "External confirmation is required before higher-authority use because: CULTURAL_COMMUNITY_RIGHTS_OR_AFFECTED_PERSON_AUTHORITY.", "evidence_count": 5 }, "full_training_programme": false, "independently_validated": false, "publication_state": "PUBLISHED_PUBLIC_RESEARCH_EDITION__EDITORIAL_REVIEW_PENDING", "related_power_ids": [ "PWR-089", "PWR-090", "PWR-091", "PWR-093" ] }, { "power_id": "PWR-093", "learning_unit_id": "TLU-PWR-093", "title": "Wayfinding", "main_description": "With qualified supervision, the learner travels one declared route and reaches the destination while correctly identifying every decision point and using the agreed recovery plan when a cue is missing.", "main_description_source": "FULL_TUTORIAL_OUTCOME", "family_id": "FAM-12", "family": "Spatial Orientation, Proprioception & Navigation", "superdomain": "Perception & Sensorimotor", "canonical_route": "/powers/pwr-093/", "treatment": "SPECIALIST_PROVIDER_ROUTE", "treatment_label": "Full supervised tutorial", "treatment_boundary": "Titan teaches the complete method; a qualified person controls the parts that require supervision, clearance, specialist equipment, load, dose or progression.", "tutorial_route": "/tutorials/pwr-093/", "governed_lesson_route": null, "self_attempt_status": "PROHIBITED_WITHOUT_QUALIFIED_SUPERVISION", "gold_pathway_ids": [ "G-CUR-003" ], "route_membership": { "kind": "GOLD_PATHWAY", "id": "G-CUR-003", "coverage_status": "EXACT_ONCE" }, "source_authority_tier": "G4", "source_build_state": "EXTERNAL_PROVIDER_ROUTE", "source_instructional_route": "LEARN_ELSEWHERE_TRACK_WITH_TITAN", "source_count": 3, "research_depth": "FOCUSED", "risk_level": "HIGH", "prerequisite_status": "QUALIFIED_PROVIDER_DETERMINES", "learning_route": { "mode": "FULL_SUPERVISED_TUTORIAL", "label": "Learn wayfinding step by step", "summary": "With qualified supervision, the learner travels one declared route and reaches the destination while correctly identifying every decision point and using the agreed recovery plan when a cue is missing.", "steps": [ [ "Get ready", "The instructor checks route conditions, weather, lighting, access, construction, traffic and safe withdrawal points." ], [ "Learn the method", "7 concrete steps teach the permitted method from start to finish." ], [ "See right and wrong", "4 comparisons show correct or safer execution beside common wrong or riskier choices." ], [ "Practise", "The qualified instructor sets route repetitions, assistance, environment changes and independent-travel criteria. Rehearsals use spaced sessions and preserve aids. Only one factor—start point, time, cue availability or route segment—changes per approved transfer trial." ], [ "Check progress", "Record arrival, correct decisions/total, wrong turns, hesitations, recovery success, prompts, physical assistance, time, symptoms and environmental deviations." ] ], "practical_authority": false, "provider_required": true, "next_action_route": "/tutorials/pwr-093/" }, "path_builder": { "selectable": true, "completion_allowed": true, "warning": "Titan teaches the complete method; a qualified person controls the parts that require supervision, clearance, specialist equipment, load, dose or progression." }, "full_tutorial": { "version": "3.0", "authorship": "POWER_SPECIFIC_FULL_TUTORIAL", "tutorial_mode": "SUPERVISED", "promise": "Wayfinding is reaching a destination while monitoring position and recovering from error. A qualified orientation-and-mobility instructor or other appropriate professional selects a route, preserves the learner’s aids and controls traffic, fall and getting-lost risk. The learner learns to preview the route, recognise decision points, confirm landmarks, use aids, execute a recovery rule and debrief errors.", "power_id": "PWR-093", "title": "Wayfinding", "lesson_type": "SUPERVISED", "headline": "Learn a real route with landmarks, decision points and a recovery plan", "plain_english_summary": "Wayfinding is reaching a destination while monitoring position and recovering from error. A qualified orientation-and-mobility instructor or other appropriate professional selects a route, preserves the learner’s aids and controls traffic, fall and getting-lost risk. The learner learns to preview the route, recognise decision points, confirm landmarks, use aids, execute a recovery rule and debrief errors.", "outcome": "With qualified supervision, the learner travels one declared route and reaches the destination while correctly identifying every decision point and using the agreed recovery plan when a cue is missing.", "authority": { "learner_may": [ "Describe a goal, practise the plan with a qualified instructor and use all usual navigation aids.", "Pause, ask for help and decline any route segment." ], "qualified_person_required_for": [ "Route selection, traffic and fall risk assessment, disability-specific orientation instruction, guarding and independent-travel clearance.", "Practice where cognitive impairment, low vision, vestibular symptoms or prior getting lost makes consequences meaningful." ], "never_do": [ "Remove a cane, guide dog, device, companion or other support to test unaided ability.", "Practise alone on an unfamiliar route, cross traffic without authorised instruction or let a device override immediate environmental safety." ] }, "materials": [ "Instructor-approved short route with named start, destination, decision points and safe pause places.", "Usual mobility and navigation aids, charged device if used, emergency contact method and route card.", "Record for arrival, errors, assistance, time, cue use, recovery and symptoms." ], "before_you_start": [ "The instructor checks route conditions, weather, lighting, access, construction, traffic and safe withdrawal points.", "Confirm destination, route boundaries, aids, communication method, emergency contact and who can stop.", "Agree a lost-position rule: stop in a safe place, orient, check one trusted cue, then contact the named person if position remains uncertain." ], "steps": [ { "title": "Define arrival", "instruction": "Name the exact destination and observable arrival cue, not just a general area.", "reason": "A precise endpoint prevents a near arrival from being mis-scored as success.", "success_check": "The learner can describe the destination and final confirming cue." }, { "title": "Preview the route spine", "instruction": "With the instructor, identify start heading, major segments, decision points, landmarks and safe pause places.", "reason": "A route spine reduces memory load while preserving critical decisions.", "success_check": "The route card lists each decision in order." }, { "title": "Assign cue and action", "instruction": "For every decision point, state the cue, action and confirmation: for example, tactile paving, turn left, then confirm the wall edge.", "reason": "Cue–action–confirmation pairs expose a missing or ambiguous instruction.", "success_check": "Each point has all three elements." }, { "title": "Travel with aids", "instruction": "Move at the instructor-approved pace using usual aids. Say or signal each landmark and decision before acting.", "reason": "Overt confirmation lets the instructor correct route reasoning without removing support.", "success_check": "The learner identifies each decision before acting, keeps the declared aids in use and takes no turn or crossing that the instructor has not authorised." }, { "title": "Use the recovery rule", "instruction": "If a cue is absent or conflicting, stop at the agreed safe place, orient, check one trusted cue and seek help if still uncertain.", "reason": "Continuing while uncertain compounds position error.", "success_check": "No guessed turn is taken and the help route is used when required." }, { "title": "Confirm arrival and debrief", "instruction": "Use the declared arrival cue, then review wrong turns, hesitation, device prompts, assistance and environmental changes.", "reason": "Arrival alone can hide unsafe errors or heavy support.", "success_check": "The record includes arrival plus process, assistance and near misses." }, { "title": "Retest under instructor control", "instruction": "Repeat after delay or from a changed start only when the instructor approves, changing one feature at a time.", "reason": "A controlled change tests transfer without silently increasing route risk.", "success_check": "The new route feature and supervision level are explicit." } ], "worked_example": { "scenario": "An orientation-and-mobility instructor teaches a learner the indoor route from a reception desk to Room 204.", "walkthrough": [ "They define arrival as touching the raised 204 sign beside the correct door.", "The route spine is reception exit, textured mat, lift bank, second floor, long corridor and second door after the fire door.", "Each decision gets a cue, action and confirmation; the learner keeps her cane and phone navigation aid.", "When construction blocks the normal mat cue, she stops at reception, checks the wall-mounted tactile map and asks the named staff member instead of guessing.", "At Room 204 they record arrival, one assisted recovery, no wrong turn and the construction change." ], "result": "The learner demonstrates safe route execution and recovery with declared aids and assistance. It does not establish unaided or unfamiliar-community wayfinding." }, "right_vs_wrong": [ { "situation": "Aids", "right": "Use normal cane, guide, map, phone or companion and record support.", "wrong": "Remove supports to obtain an independence score.", "why": "Supports are part of capability and removing them can create danger." }, { "situation": "Decision point", "right": "Pair one cue with an action and confirmation.", "wrong": "Memorise “turn somewhere after the lift.”", "why": "Vague cues cause avoidable route drift." }, { "situation": "Uncertainty", "right": "Stop safely and use the recovery rule.", "wrong": "Keep moving until something looks familiar.", "why": "Continued movement increases error and exposure to hazards." }, { "situation": "Outcome", "right": "Report arrival, errors, help and safety together.", "wrong": "Record only travel time.", "why": "A fast arrival can conceal unsafe crossings, prompts or near misses." } ], "common_mistakes": [ { "mistake": "Landmarks are temporary objects.", "fix": "Prefer stable structural cues and record temporary cues only as backups." }, { "mistake": "Device instructions are followed without environmental confirmation.", "fix": "Pair every prompt with a real-world cue and instructor-approved action." }, { "mistake": "A recovery attempt starts while still walking.", "fix": "Stop at the agreed safe place before checking position." }, { "mistake": "A changed start is scored as the same route.", "fix": "Label it a transfer route and keep original-route results separate." } ], "practice": { "first_session": [ "Instructor risk check and goal agreement.", "Stationary route preview and cue–action–confirmation teach-back.", "One fully supervised traversal.", "One planned missing-cue recovery at a safe indoor point.", "Arrival confirmation and debrief." ], "repeat_plan": "The qualified instructor sets route repetitions, assistance, environment changes and independent-travel criteria. Rehearsals use spaced sessions and preserve aids. Only one factor—start point, time, cue availability or route segment—changes per approved transfer trial.", "progress_when": [ "Every decision point is anticipated and confirmed.", "The learner stops rather than guesses when a cue fails.", "Arrival is repeated without new hazard, wrong turn or unplanned assistance." ], "do_not_progress_when": [ "Construction, weather, traffic, fatigue or symptoms change the risk.", "The recovery rule cannot be used reliably.", "The learner is being pressured to reduce needed assistance." ] }, "self_check": [ "Can you state the exact arrival cue?", "Does every decision point have cue, action and confirmation?", "What do you do before moving when uncertain?", "Were aids and assistance recorded rather than hidden?" ], "measurement": { "primary": "Safe destination arrival with decision and recovery accuracy on one named route.", "how": "Record arrival, correct decisions/total, wrong turns, hesitations, recovery success, prompts, physical assistance, time, symptoms and environmental deviations.", "good_result": "The instructor’s predeclared route criterion is met on repeated traversals with all critical decisions and recovery rules correct and no unmitigated hazard.", "does_not_prove": "It does not establish unaided travel, safety on unfamiliar routes, general spatial memory or device-independent transfer." }, "stop_and_get_help": [ "Stop at a safe place for uncertainty, device conflict, route obstruction, traffic change, fatigue, dizziness or distress.", "Use the emergency plan if separated from support, injured, unable to orient or exposed to immediate danger.", "Seek qualified review when getting lost, falls, vision change or cognitive change affects everyday navigation." ], "accessibility": [ "Preserve guide dog, cane, wheelchair, hearing, visual and communication supports.", "Use tactile, audio, large-print or easy-read route cards.", "Allow extra time and planned rests; time is never improved by removing access support." ], "evidence_notes": [ { "claim": "A pilot randomised trial of iPad-enhanced exercise did not improve real-building wayfinding or spatial memory relative to matched exercise.", "source_title": "Effects of Traditional vs. iPad-Enhanced Aerobic Exercise on Wayfinding Efficacy and Cognition: A Pilot Randomized Controlled Trial", "source_url": "https://pubmed.ncbi.nlm.nih.gov/31546856/", "source_kind": "PRIMARY_RESEARCH" }, { "claim": "Tactile-map navigation has been studied as a route to cognitive-map formation, supporting accessible map use while not guaranteeing real-world transfer.", "source_title": "Cognitive map formation through tactile map navigation in visually impaired and sighted persons", "source_url": "https://pubmed.ncbi.nlm.nih.gov/35798929/", "source_kind": "PRIMARY_RESEARCH" } ], "limits": [ "Route competence is tied to the environment, aids and supervision state.", "Virtual or map practice does not automatically transfer to real buildings.", "Arrival alone is insufficient without errors, assistance and safety." ], "orientation": { "bounded_definition": "Capability to develop or express wayfinding in a declared context without inheriting broader claims.", "evidence_summary": "Wayfinding is not “never using GPS.” It is reaching a destination safely with whatever maps, cues, people or devices make that possible.", "supportable_public_claim": "Wayfinding can be supported by tactile maps, landmarks and declared technology, but virtual or device training does not yet show reliable unaided real-world transfer.", "measurement_boundary": "Arrival, errors, time, route quality, assistance and safety in a named environment measure wayfinding; confidence alone does not.", "myth_to_metric": { "myth": "Never be lost", "metric": "Safe destination arrival, route errors, assistance and fallback in a named environment", "boundary": "Confidence or virtual practice cannot certify live independent travel." }, "limiting_findings": [ "Ten weeks of iPad-enhanced exercise did not improve real-building wayfinding performance or spatial memory relative to matched exercise." ], "prohibited_claims": [ "Never get lost again", "Throw away GPS", "Navigate any city from one map", "Assistive navigation is dependency" ] }, "gold_source_lesson": { "curriculum_id": "G-CUR-003", "source_heading": "PWR-093 — Wayfinding", "source_html_sha256": "c2be342c5c6101cfecca9a6e27ce40170b316accf93144318102844439433925", "html": "Specialist/support route when becoming lost, community safety, cognitive impairment or disability makes the consequence meaningful. Navigation aids are legitimate capability supports.
" }, "next_gate": "External confirmation is required before higher-authority use because: CLINICAL_HIGH_RISK_OR_REGULATED_CONFIGURATION; SUPERVISION_OR_NON_ATTEMPT_BOUNDARY; CULTURAL_COMMUNITY_RIGHTS_OR_AFFECTED_PERSON_AUTHORITY; SAFETY_LEGITIMACY_RESTRICTED.", "evidence_count": 3 }, "full_training_programme": false, "independently_validated": false, "publication_state": "PUBLISHED_PUBLIC_RESEARCH_EDITION__EDITORIAL_REVIEW_PENDING", "related_power_ids": [ "PWR-089", "PWR-090", "PWR-091", "PWR-092" ] }, { "power_id": "PWR-094", "learning_unit_id": "TLU-PWR-094", "title": "Body schema", "main_description": "The learner makes six seated body-part-to-target estimates, separates direction from distance error and compares the complete error pattern with a delayed set of changed target positions.", "main_description_source": "FULL_TUTORIAL_OUTCOME", "family_id": "FAM-12", "family": "Spatial Orientation, Proprioception & Navigation", "superdomain": "Perception & Sensorimotor", "canonical_route": "/powers/pwr-094/", "treatment": "EVIDENCE_REVIEW_ROUTE", "treatment_label": "Full low-stakes tutorial", "treatment_boundary": "Titan teaches a concrete low-stakes method step by step while keeping evidence and transfer claims bounded.", "tutorial_route": "/tutorials/pwr-094/", "governed_lesson_route": null, "self_attempt_status": "PERMITTED_INSIDE_FULL_TUTORIAL_LIMITS", "gold_pathway_ids": [ "G-CUR-003" ], "route_membership": { "kind": "GOLD_PATHWAY", "id": "G-CUR-003", "coverage_status": "EXACT_ONCE" }, "source_authority_tier": "G2", "source_build_state": "TARGETED_REVIEW_REQUIRED", "source_instructional_route": "BOUNDED_GUIDED_EXERCISE", "source_count": 2, "research_depth": "FOCUSED", "risk_level": "MODERATE", "prerequisite_status": "NONE_FOR_READING__NO_PRACTICE_AUTHORITY", "learning_route": { "mode": "FULL_SELF_GUIDED_TUTORIAL", "label": "Learn body schema step by step", "summary": "The learner makes six seated body-part-to-target estimates, separates direction from distance error and compares the complete error pattern with a delayed set of changed target positions.", "steps": [ [ "Get ready", "Choose a pain-free arm and comfortable table-height reach, or use the diagram route." ], [ "Learn the method", "8 concrete steps teach the permitted method from start to finish." ], [ "See right and wrong", "4 comparisons show correct or safer execution beside common wrong or riskier choices." ], [ "Practise", "Use one six-trial session twice a week for two weeks. Keep seat and hand start fixed, then vary target positions. Do not add eyes-closed standing or unstable surfaces." ], [ "Check progress", "For six targets, count correct direction categories and calculate absolute centimetre or grid-unit difference between estimated and actual travel, with support and symptoms recorded." ] ], "practical_authority": true, "provider_required": false, "next_action_route": "/tutorials/pwr-094/" }, "path_builder": { "selectable": true, "completion_allowed": true, "warning": "Titan teaches a concrete low-stakes method step by step while keeping evidence and transfer claims bounded." }, "full_tutorial": { "version": "3.0", "authorship": "POWER_SPECIFIC_FULL_TUTORIAL", "tutorial_mode": "SELF_GUIDED", "promise": "Body schema is an action-oriented representation of where body parts are relative to each other and the task. This low-risk lesson uses a seated reach to a benign target. The learner estimates direction and distance before moving, reaches normally with visual or tactile support allowed, compares the endpoint with the estimate and updates one error. It is not a neurological or body-image assessment.", "power_id": "PWR-094", "title": "Body schema", "lesson_type": "SELF_GUIDED", "headline": "Estimate one body-part-to-target relation, move normally and correct the map", "plain_english_summary": "Body schema is an action-oriented representation of where body parts are relative to each other and the task. This low-risk lesson uses a seated reach to a benign target. The learner estimates direction and distance before moving, reaches normally with visual or tactile support allowed, compares the endpoint with the estimate and updates one error. It is not a neurological or body-image assessment.", "outcome": "The learner makes six seated body-part-to-target estimates, separates direction from distance error and compares the complete error pattern with a delayed set of changed target positions.", "authority": { "learner_may": [ "Use comfortable seated reaches within ordinary range and retain visual, tactile or verbal markers.", "Choose a diagram-only version." ], "qualified_person_required_for": [ "Rehabilitation after stroke, amputation, injury or surgery, and concerns involving neglect, pain, dizziness or body-image distress.", "Any diagnostic body-schema or neurological assessment." ], "never_do": [ "Reach into pain, remove support, close the eyes when balance is affected or use illusions to provoke distress.", "Infer neurological health from a home reach score." ] }, "materials": [ "Stable chair and table, six large soft target cards and a start marker for the hand.", "Ruler or grid mat, estimate sheet and optional tactile or verbal position cues.", "Usual posture and mobility supports." ], "before_you_start": [ "Choose a pain-free arm and comfortable table-height reach, or use the diagram route.", "Place targets within normal supported range with no hot, sharp or breakable objects nearby.", "Declare whether vision stays available; keep the same rule for scored trials." ], "steps": [ { "title": "Fix the body and task frame", "instruction": "Mark the seated position, starting hand position, target plane and vision rule.", "reason": "A stable reference makes estimates comparable.", "success_check": "Chair, hand start and target area are marked." }, { "title": "Calibrate the external scale", "instruction": "On two unscored targets, view or feel the grid distance and say the matching centimetres or squares. Return to the marked hand start after each.", "reason": "A shared scale prevents number unfamiliarity from being mistaken for body–target error.", "success_check": "The learner correctly links near and far examples to the declared measurement units before scored estimates." }, { "title": "Estimate direction", "instruction": "Before moving, point on a diagram or say whether the target is left, right, near, far, above or below the starting hand.", "reason": "A pre-movement estimate exposes the current body–target relation.", "success_check": "One direction category is committed before reach." }, { "title": "Name the segment relation", "instruction": "State where the hand is relative to the elbow and where the elbow is relative to the shoulder at the start, using ordinary words such as forward, bent or supported.", "reason": "Body schema concerns linked body segments, not only the hand’s location in room space.", "success_check": "The start record describes both hand-to-target and hand–elbow–shoulder relations without pain or forced posture." }, { "title": "Estimate distance", "instruction": "Mark the expected travel distance in centimetres or grid squares without moving the hand.", "reason": "Distance and direction can fail differently.", "success_check": "A numerical or ordinal distance estimate is saved." }, { "title": "Reach normally", "instruction": "Move at a comfortable speed to the target using the declared supports. Stop at first contact; do not search around it.", "reason": "One natural reach tests the estimate without added correction movements.", "success_check": "The endpoint and any support are observable." }, { "title": "Compare and update", "instruction": "Measure endpoint difference and classify the error as direction, distance or both. State one corrected relation before returning to start.", "reason": "Naming the error updates the action map rather than merely repeating.", "success_check": "Every trial has a measured discrepancy and one correction sentence." }, { "title": "Delay and change target", "instruction": "After 48 hours, use six targets in new safe positions while preserving seat and start. Score categories without rereading old answers.", "reason": "New positions test the relation method beyond memorised endpoints.", "success_check": "Delayed novel-target results are separate." } ], "worked_example": { "scenario": "Seated at a table, Dev estimates a soft card placed forward-left of his marked right-hand start.", "walkthrough": [ "Dev keeps vision available and marks the same chair and start position.", "He predicts forward-left and 22 cm before moving.", "He reaches once and contacts the card at 27 cm without searching.", "He records correct direction and a 5 cm underestimation, then states “the target is farther than my first map.”", "Two days later he applies the same estimate–reach–compare sequence to six changed target positions." ], "result": "Dev corrects a distance relation in this seated task. The exercise does not measure neurological integrity or durable whole-body schema change." }, "right_vs_wrong": [ { "situation": "Estimate", "right": "Commit direction and distance before movement.", "wrong": "Reach first and then claim what was expected.", "why": "A post-action estimate cannot show prediction error." }, { "situation": "Reach", "right": "Use one comfortable movement and stop at contact.", "wrong": "Search back and forth or stretch beyond comfort.", "why": "Searching adds feedback and strain." }, { "situation": "Support", "right": "Keep normal visual and posture supports.", "wrong": "Remove vision or back support to make the test pure.", "why": "Support removal changes risk and configuration." }, { "situation": "Interpretation", "right": "Report error for this body–target setup.", "wrong": "Call a small error proof of normal neurology.", "why": "A simple reach is not a clinical assessment." } ], "common_mistakes": [ { "mistake": "The hand start drifts.", "fix": "Use a tactile or drawn start marker every trial." }, { "mistake": "Direction and distance are merged.", "fix": "Score category and magnitude in separate fields." }, { "mistake": "The target is placed at painful end range.", "fix": "Bring it inside ordinary comfortable reach or use the diagram version." }, { "mistake": "Repeated targets are called transfer.", "fix": "Change safe positions after a delay and hide old records." } ], "practice": { "first_session": [ "Set one stable seated frame.", "Complete two unscored estimates.", "Run six target trials.", "Classify direction versus distance errors.", "Finish with a comfortable movement check." ], "repeat_plan": "Use one six-trial session twice a week for two weeks. Keep seat and hand start fixed, then vary target positions. Do not add eyes-closed standing or unstable surfaces.", "progress_when": [ "All estimates precede movement.", "Direction and distance errors on changed targets are reported separately and are stable or lower without added searching.", "Distance error declines without extra searching or symptoms." ], "do_not_progress_when": [ "Pain, dizziness, body-image distress or unusual sensory symptoms occur.", "The task requires reduced support or greater reach.", "The goal becomes diagnosis or rehabilitation without a clinician." ] }, "self_check": [ "Was the estimate made before moving?", "Are direction and distance scored separately?", "Did you use one reach without searching?", "Were delayed targets actually new?" ], "measurement": { "primary": "Pre-movement direction accuracy and absolute distance error.", "how": "For six targets, count correct direction categories and calculate absolute centimetre or grid-unit difference between estimated and actual travel, with support and symptoms recorded.", "good_result": "All estimates are committed before movement, direction and distance errors are both retained, and any lower median distance error repeats on a second novel set without strain or added correction movements. No fixed correct-count is a neurological pass score.", "does_not_prove": "It does not diagnose body-schema disorder, neurological health, body ownership or general movement safety." }, "stop_and_get_help": [ "Stop for pain, dizziness, new numbness, weakness, neglect-like errors, loss of balance or distress about the body.", "Seek clinical review for sudden or function-changing misreaching, sensory change or body-recognition difficulty.", "Do not continue if stable seating or a safe target range cannot be maintained." ], "accessibility": [ "Use tactile target cards and a raised-line distance grid.", "Give verbal left/right/near/far response options or use eye gaze.", "Use the diagram-only relation task when reaching is not appropriate." ], "evidence_notes": [ { "claim": "Tool use produced short-term morphological updating effects in a defined body-schema experiment, not a durable general training result.", "source_title": "Tool-use induces morphological updating of the body schema", "source_url": "https://pubmed.ncbi.nlm.nih.gov/19549491/", "source_kind": "PRIMARY_RESEARCH" }, { "claim": "A small rubber-hand-illusion study linked self-representation and external-object judgement but cannot support broad clinical claims.", "source_title": "Rubber hand illusions and size-weight illusions: self-representation modulates representation of external objects", "source_url": "https://pubmed.ncbi.nlm.nih.gov/20192129/", "source_kind": "PRIMARY_RESEARCH" } ], "limits": [ "Short laboratory after-effects do not establish durable functional change.", "Body schema, body ownership and body image are distinct constructs.", "Results belong to the declared seated reach configuration." ], "orientation": { "bounded_definition": "Capability to develop or express body schema in a declared context without inheriting broader claims.", "evidence_summary": "Your brain’s working model of the body is flexible enough to incorporate tools—temporarily. That is fascinating, but it is not yet a voluntary body-rewriting power.", "supportable_public_claim": "The brain’s action-oriented representation of the body can update during tool use and multisensory illusions, but durable voluntary control and broad function are not established.", "measurement_boundary": "Kinematics, localization drift, ownership ratings and object judgments operationalize different constructs and cannot be combined into one body-schema score.", "myth_to_metric": { "myth": "Extend your body at will", "metric": "Declared movement, localization or ownership measure before and after tool/illusion exposure", "boundary": "A temporary illusion cannot prove durable embodiment or recovery." }, "limiting_findings": [ "Effects were short laboratory after-effects, not durable functional training; a 12-person illusion cannot support clinical claims." ], "prohibited_claims": [ "Expand your body at will", "Own any prosthesis instantly", "Rewrite your body image", "A rubber-hand illusion treats trauma" ] }, "gold_source_lesson": { "curriculum_id": "G-CUR-003", "source_heading": "9. Body schema: where is your body relative to the task?", "source_html_sha256": "abc1e6dcf731bdd745d2acc1cdfa1fac9aedcbc4f0a2ef320fa6b5ebc56ab431", "html": "PWR-094 is a canonical module, not a diagnosis.
\nUse a low-consequence seated or supported fixture:
\nDo not infer neurological health from a home body-schema exercise.
" }, "next_gate": "External confirmation is required before higher-authority use because: CULTURAL_COMMUNITY_RIGHTS_OR_AFFECTED_PERSON_AUTHORITY.", "evidence_count": 2 }, "full_training_programme": false, "independently_validated": false, "publication_state": "PUBLISHED_PUBLIC_RESEARCH_EDITION__EDITORIAL_REVIEW_PENDING", "related_power_ids": [ "PWR-089", "PWR-090", "PWR-091", "PWR-092" ] }, { "power_id": "PWR-095", "learning_unit_id": "TLU-PWR-095", "title": "Spatial memory", "main_description": "The learner reconstructs six landmarks on delayed and novel grids, reporting exact locations, identity swaps and a declared median location error without collapsing them into one score.", "main_description_source": "FULL_TUTORIAL_OUTCOME", "family_id": "FAM-12", "family": "Spatial Orientation, Proprioception & Navigation", "superdomain": "Perception & Sensorimotor", "canonical_route": "/powers/pwr-095/", "treatment": "EVIDENCE_REVIEW_ROUTE", "treatment_label": "Full low-stakes tutorial", "treatment_boundary": "Titan teaches a concrete low-stakes method step by step while keeping evidence and transfer claims bounded.", "tutorial_route": "/tutorials/pwr-095/", "governed_lesson_route": null, "self_attempt_status": "PERMITTED_INSIDE_FULL_TUTORIAL_LIMITS", "gold_pathway_ids": [ "G-CUR-003" ], "route_membership": { "kind": "GOLD_PATHWAY", "id": "G-CUR-003", "coverage_status": "EXACT_ONCE" }, "source_authority_tier": "G1", "source_build_state": "TARGETED_REVIEW_REQUIRED", "source_instructional_route": "SELF_GUIDED_TUTORIAL", "source_count": 3, "research_depth": "FOCUSED", "risk_level": "LOW_TO_MODERATE", "prerequisite_status": "NONE_FOR_READING__NO_PRACTICE_AUTHORITY", "learning_route": { "mode": "FULL_SELF_GUIDED_TUTORIAL", "label": "Learn spatial memory step by step", "summary": "The learner reconstructs six landmarks on delayed and novel grids, reporting exact locations, identity swaps and a declared median location error without collapsing them into one score.", "steps": [ [ "Get ready", "Choose distinct, non-sensitive fictional landmarks." ], [ "Learn the method", "9 concrete steps teach the permitted method from start to finish." ], [ "See right and wrong", "4 comparisons show correct or safer execution beside common wrong or riskier choices." ], [ "Practise", "Use two sessions per week for three weeks. Each session starts with delayed recall before restudy and includes one new layout. Keep grid size and timing fixed until novel-layout scores stabilise." ], [ "Check progress", "Count exact locations out of six, identity swaps and horizontal-plus-vertical distance for each landmark; report median error and confidence calibration." ] ], "practical_authority": true, "provider_required": false, "next_action_route": "/tutorials/pwr-095/" }, "path_builder": { "selectable": true, "completion_allowed": true, "warning": "Titan teaches a concrete low-stakes method step by step while keeping evidence and transfer claims bounded." }, "full_tutorial": { "version": "3.0", "authorship": "POWER_SPECIFIC_FULL_TUTORIAL", "tutorial_mode": "SELF_GUIDED", "promise": "Spatial memory includes location, landmark identity, route order and relative configuration. This lesson isolates location and relation memory using a small grid. The learner studies six landmarks for a fixed time, hides the layout, reconstructs it, measures positional error, waits and tries a novel layout. Repeated-scene memory and new-layout transfer are reported separately.", "power_id": "PWR-095", "title": "Spatial memory", "lesson_type": "SELF_GUIDED", "headline": "Reconstruct a small layout after a delay and measure location error", "plain_english_summary": "Spatial memory includes location, landmark identity, route order and relative configuration. This lesson isolates location and relation memory using a small grid. The learner studies six landmarks for a fixed time, hides the layout, reconstructs it, measures positional error, waits and tries a novel layout. Repeated-scene memory and new-layout transfer are reported separately.", "outcome": "The learner reconstructs six landmarks on delayed and novel grids, reporting exact locations, identity swaps and a declared median location error without collapsing them into one score.", "authority": { "learner_may": [ "Use fictional tabletop, tactile or screen layouts while seated.", "Use ordinary memory aids in real life." ], "qualified_person_required_for": [ "Assessment of new memory change, getting lost, neurological illness or cognitive impairment.", "Consequential navigation or removal of memory supports." ], "never_do": [ "Use this score to diagnose memory, rank intelligence or justify withholding aids.", "Practise by becoming lost in a real setting." ] }, "materials": [ "Two 5-by-5 grids, six distinct landmark tokens or symbols and matching blank grids.", "Timer, cover sheet, coordinate key and scoring record.", "Optional tactile grid and raised tokens." ], "before_you_start": [ "Choose distinct, non-sensitive fictional landmarks.", "Fix a 60-second study interval and two-minute reconstruction interval.", "Decide whether location, identity and relation will be scored and keep the rule constant." ], "steps": [ { "title": "Label the frame", "instruction": "Mark north, rows and columns and place six distinct landmarks on the study grid.", "reason": "A common coordinate frame makes location errors measurable.", "success_check": "Every square and landmark has a unique label." }, { "title": "Bind identity to location", "instruction": "For each landmark, make one short relation statement that joins its identity to a coordinate and neighbour, such as “Pond at C4, east of Gate.”", "reason": "Identity–location binding helps distinguish a forgotten place from a token swap.", "success_check": "Six distinct binding statements are recorded without making a story that changes the supplied layout." }, { "title": "Study relations", "instruction": "For 60 seconds, name each location and at least two relations, such as café north of pond.", "reason": "Relational encoding supports reconstruction beyond a visual snapshot.", "success_check": "All six positions and two relations are spoken or written." }, { "title": "Hide completely", "instruction": "Cover the study grid and remove duplicate cues before starting the two-minute reconstruction.", "reason": "A complete hide prevents copying.", "success_check": "No source coordinate or shadow remains visible." }, { "title": "Reconstruct and commit", "instruction": "Place all six landmarks on a blank grid, then mark confidence for each before reveal.", "reason": "Committing all positions exposes omissions and swaps.", "success_check": "Six locations and six confidence ratings are saved." }, { "title": "Answer relation probes", "instruction": "Before revealing the key, answer four questions about north–south order, nearest neighbours and which two landmarks share a row or column.", "reason": "Relational probes show whether the layout survives beyond exact coordinate recall.", "success_check": "Four answers are committed and later scored separately from token positions." }, { "title": "Calibrate location confidence", "instruction": "Sort the six placements into low, medium and high confidence before reveal, then compare exact-position rates in those groups.", "reason": "Useful spatial confidence should rise with correctness rather than merely with familiarity.", "success_check": "The learner can state whether high-confidence placements were more often exact and lowers future confidence when they were not." }, { "title": "Measure errors", "instruction": "Reveal the key. Count exact positions, identity swaps and Manhattan distance—the horizontal plus vertical squares—from each correct position.", "reason": "Exact hits and distance show different aspects of error.", "success_check": "Each landmark has exact/not exact and distance error." }, { "title": "Delay and use a novel layout", "instruction": "After 48 hours, reconstruct the old grid without restudy, then study and reconstruct a new arrangement with the same rules.", "reason": "Old-layout retention and new-layout method transfer must be separated.", "success_check": "The report contains delayed-old and novel-layout scores." } ], "worked_example": { "scenario": "A grid holds Gate B2, Pond C4, Tree D1, Bench E3, Café A5 and Library D5.", "walkthrough": [ "Luca studies all six coordinates and notes Library south of Café and Bench southwest of Library.", "He covers the grid and reconstructs all tokens in two minutes.", "Four are exact; Pond is one square west and Bench one square north.", "He records four exact, no identity swaps and median distance error zero because four of six are exact.", "Two days later he scores the old layout separately before learning a rearranged grid." ], "result": "Luca has a transparent location and relation score for two layouts. It does not imply generally superior memory or real-world navigation." }, "right_vs_wrong": [ { "situation": "Study time", "right": "Use the same fixed interval.", "wrong": "Study until every location feels certain.", "why": "Unequal exposure makes comparisons meaningless." }, { "situation": "Scoring", "right": "Count exact positions, swaps and distance.", "wrong": "Judge whether the sketch looks close.", "why": "Objective categories reveal different errors." }, { "situation": "Retention", "right": "Test the old grid after delay before restudy.", "wrong": "Restudy first and call the result retention.", "why": "Restudy measures relearning." }, { "situation": "Transfer", "right": "Use a newly arranged layout.", "wrong": "Repeat the same grid faster.", "why": "Familiar-scene improvement need not transfer." } ], "common_mistakes": [ { "mistake": "Landmark identity and position swaps are merged.", "fix": "Record the correct object in wrong square as an identity-location swap." }, { "mistake": "The grid rotates between study and test.", "fix": "Keep north and row labels fixed." }, { "mistake": "Only exact hits are kept.", "fix": "Also calculate horizontal-plus-vertical location error." }, { "mistake": "Novel layout is shown before delayed old recall.", "fix": "Complete delayed retention first, then expose the new grid." } ], "practice": { "first_session": [ "Learn grid coordinates.", "Study one six-landmark layout for 60 seconds.", "Reconstruct for two minutes.", "Score exact, swap and distance errors.", "Write one relational encoding repair." ], "repeat_plan": "Use two sessions per week for three weeks. Each session starts with delayed recall before restudy and includes one new layout. Keep grid size and timing fixed until novel-layout scores stabilise.", "progress_when": [ "Exact positions, identity swaps and distance errors are all retained on two novel layouts.", "Median distance error is stable or improving.", "The learner distinguishes delayed retention from new-layout transfer." ], "do_not_progress_when": [ "The learner relies on visible residue, copied notes or repeated identical layouts.", "Cognitive effort causes distress or marked fatigue.", "The exercise is being used to assess a real memory concern." ] }, "self_check": [ "Was the study interval fixed?", "Did the source grid stay fully hidden?", "Are exact, swap and distance errors separate?", "Was delayed old recall tested before restudy?" ], "measurement": { "primary": "Exact landmark positions and location error on a novel grid.", "how": "Count exact locations out of six, identity swaps and horizontal-plus-vertical distance for each landmark; report median error and confidence calibration.", "good_result": "Every landmark receives an exact/not-exact result and distance error, identity swaps remain visible, and the delayed and novel-layout records can be reproduced from the key. Improvement is described against the learner’s matched first set; no four-of-six cutoff is a memory pass score.", "does_not_prove": "It does not establish photographic memory, real-world wayfinding, neurological health or broad memory superiority." }, "stop_and_get_help": [ "Stop for headache, visual strain, confusion, panic or marked fatigue.", "Seek clinical advice for new memory change, repeated getting lost or functional decline rather than repeating the grid.", "Do not remove normal calendars, maps or navigation supports to create a harder test." ], "accessibility": [ "Use raised-line grids and distinguishable tactile tokens.", "Allow verbal coordinates with a scribe.", "Use fewer landmarks as a separate baseline and progress by stable accuracy, not by removing aids." ], "evidence_notes": [ { "claim": "London taxi drivers showed exceptional environment-specific knowledge but poorer acquisition of some new visuospatial information, demonstrating specificity.", "source_title": "London taxi drivers and bus drivers: a structural MRI and neuropsychological analysis", "source_url": "https://pubmed.ncbi.nlm.nih.gov/17024677/", "source_kind": "PRIMARY_RESEARCH" }, { "claim": "Acquiring detailed London layout knowledge was associated with structural brain change, but brain volume is not an individual spatial-memory performance metric.", "source_title": "Acquiring “the Knowledge” of London’s layout drives structural brain changes", "source_url": "https://pubmed.ncbi.nlm.nih.gov/22169537/", "source_kind": "PRIMARY_RESEARCH" } ], "limits": [ "Grid performance is specific to layout, timing and response format.", "Expert environment knowledge does not imply generally better new learning.", "A home score cannot diagnose memory impairment." ], "orientation": { "bounded_definition": "Capability to develop or express spatial memory in a declared context without inheriting broader claims.", "evidence_summary": "Spatial memory can become extraordinary for one place—without making someone better at every kind of memory. Expertise has boundaries and sometimes trade-offs.", "supportable_public_claim": "Spatial memory can become exceptionally detailed for a practiced environment, but the gain is specific and does not imply generally superior memory.", "measurement_boundary": "Location error, pointing, route recall and landmark recognition must be declared separately; hippocampal volume is not performance.", "myth_to_metric": { "myth": "Remember every place forever", "metric": "Delayed location, relation and route accuracy in a named environment", "boundary": "Environment-specific expertise cannot establish universal memory." }, "limiting_findings": [ "Taxi drivers showed poorer acquisition of some new visuospatial information despite exceptional London knowledge." ], "prohibited_claims": [ "Photographic spatial memory", "Grow a memory center", "Never forget a route", "Navigation expertise boosts every memory" ] }, "gold_source_lesson": { "curriculum_id": "G-CUR-003", "source_heading": "12. Spatial memory: Silver route", "source_html_sha256": "c7448673d40a1b08b69624e5aab692f59723a69ed33152472ecd394c45743ce0", "html": "PWR-095 uses small layouts rather than “photographic spatial memory” claims.
\nA complete Silver route should distinguish:
\nThe Gold family supplies the shared landmark, reconstruction and support modules. The Silver route owns the focused learner journey.
" }, "next_gate": "External confirmation is required before higher-authority use because: CULTURAL_COMMUNITY_RIGHTS_OR_AFFECTED_PERSON_AUTHORITY.", "evidence_count": 3 }, "full_training_programme": false, "independently_validated": false, "publication_state": "PUBLISHED_PUBLIC_RESEARCH_EDITION__EDITORIAL_REVIEW_PENDING", "related_power_ids": [ "PWR-089", "PWR-090", "PWR-091", "PWR-092" ] }, { "power_id": "PWR-096", "learning_unit_id": "TLU-PWR-096", "title": "Orientation under motion", "main_description": "Under qualified supervision, the learner completes a short controlled-motion orientation block and records heading error, task accuracy, symptoms and recovery for the exact configuration.", "main_description_source": "FULL_TUTORIAL_OUTCOME", "family_id": "FAM-12", "family": "Spatial Orientation, Proprioception & Navigation", "superdomain": "Perception & Sensorimotor", "canonical_route": "/powers/pwr-096/", "treatment": "SPECIALIST_PROVIDER_ROUTE", "treatment_label": "Full supervised tutorial", "treatment_boundary": "Titan teaches the complete method; a qualified person controls the parts that require supervision, clearance, specialist equipment, load, dose or progression.", "tutorial_route": "/tutorials/pwr-096/", "governed_lesson_route": null, "self_attempt_status": "PROHIBITED_WITHOUT_QUALIFIED_SUPERVISION", "gold_pathway_ids": [ "G-CUR-003" ], "route_membership": { "kind": "GOLD_PATHWAY", "id": "G-CUR-003", "coverage_status": "EXACT_ONCE" }, "source_authority_tier": "G4", "source_build_state": "EXTERNAL_PROVIDER_ROUTE", "source_instructional_route": "LEARN_ELSEWHERE_TRACK_WITH_TITAN", "source_count": 3, "research_depth": "FOCUSED", "risk_level": "HIGH", "prerequisite_status": "QUALIFIED_PROVIDER_DETERMINES", "learning_route": { "mode": "FULL_SUPERVISED_TUTORIAL", "label": "Learn orientation under motion step by step", "summary": "Under qualified supervision, the learner completes a short controlled-motion orientation block and records heading error, task accuracy, symptoms and recovery for the exact configuration.", "steps": [ [ "Get ready", "Provider screens vestibular, migraine, neurological, cardiovascular, pregnancy, medication and motion-sickness considerations." ], [ "Learn the method", "8 concrete steps teach the permitted method from start to finish." ], [ "See right and wrong", "4 comparisons show correct or safer execution beside common wrong or riskier choices." ], [ "Practise", "The qualified provider determines intervals, repetitions and progression. Repeats match motion, visual scene, posture and timing; prior exposure is logged. No home or operational practice is supplied." ], [ "Check progress", "Record true and selected heading, absolute angular/category error, response time, confidence, baseline/peak symptoms, recovery minutes, support and motion parameters." ] ], "practical_authority": false, "provider_required": true, "next_action_route": "/tutorials/pwr-096/" }, "path_builder": { "selectable": true, "completion_allowed": true, "warning": "Titan teaches the complete method; a qualified person controls the parts that require supervision, clearance, specialist equipment, load, dose or progression." }, "full_tutorial": { "version": "3.0", "authorship": "POWER_SPECIFIC_FULL_TUTORIAL", "tutorial_mode": "SUPERVISED", "promise": "Orientation under motion means preserving a useful estimate of direction while visual, vestibular and body cues change. A qualified clinician or instructor controls the motion source, seating, dose, escape and progression. The learner learns to fix a reference heading, make one direction judgement, report symptoms and stop early. There is no driving, water, rotating-chair experiment or provocative home exposure.", "power_id": "PWR-096", "title": "Orientation under motion", "lesson_type": "SUPERVISED", "headline": "Maintain a heading judgement during clinician-controlled motion with a strict recovery rule", "plain_english_summary": "Orientation under motion means preserving a useful estimate of direction while visual, vestibular and body cues change. A qualified clinician or instructor controls the motion source, seating, dose, escape and progression. The learner learns to fix a reference heading, make one direction judgement, report symptoms and stop early. There is no driving, water, rotating-chair experiment or provocative home exposure.", "outcome": "Under qualified supervision, the learner completes a short controlled-motion orientation block and records heading error, task accuracy, symptoms and recovery for the exact configuration.", "authority": { "learner_may": [ "Learn reference cues, response rules and immediate stop procedure in a stationary rehearsal.", "Participate only in the provider-selected supported configuration." ], "qualified_person_required_for": [ "Medical or occupational screening, motion apparatus, dose, guarding, symptom limits, progression and operational interpretation.", "Any exercise involving vehicles, water, heights, virtual-reality provocation or diagnosed vestibular conditions." ], "never_do": [ "Drive, spin, ride, sail or move on a platform for self-testing.", "Increase motion after nausea or treat symptom tolerance as safe operational performance." ] }, "materials": [ "Provider-approved supported seat or simulator with immediate stop control and no operational consequence.", "Fixed reference markers, heading response card, symptom scale, timer and recovery area.", "Usual visual, hearing and mobility supports as approved." ], "before_you_start": [ "Provider screens vestibular, migraine, neurological, cardiovascular, pregnancy, medication and motion-sickness considerations.", "Declare motion type, amplitude, duration, visual scene, seat support, response and stop thresholds.", "Record baseline nausea, dizziness, headache, disorientation and anxiety and identify the recovery place." ], "steps": [ { "title": "Anchor a reference heading", "instruction": "While stationary, identify forward and two side headings using fixed visual or tactile markers.", "reason": "A known reference is needed to score orientation after motion.", "success_check": "The learner labels all reference directions correctly at baseline." }, { "title": "Record recent motion exposure", "instruction": "Before each block, list travel, exercise, screen motion, simulator use and symptom-provoking activity during the provider-set look-back period.", "reason": "Prior motion can sensitise later sickness and make a matched dose respond differently.", "success_check": "The session sheet states either no relevant prior exposure or names its type, timing and symptoms." }, { "title": "Rehearse stop and response", "instruction": "Practise the stop signal and one forced heading response while the apparatus is stationary.", "reason": "A rapid stop must work before motion begins.", "success_check": "The provider confirms both controls without ambiguity." }, { "title": "Run a stationary control trial", "instruction": "With no visual or physical motion, present the same heading cue, collect one answer and record response time and symptoms.", "reason": "A control trial separates misunderstanding or response difficulty from motion-related orientation error.", "success_check": "The learner answers the stationary cue correctly and remains at baseline symptoms before motion is authorised." }, { "title": "Apply the smallest prescribed motion", "instruction": "The provider initiates only the declared low dose while the learner remains supported and looks at the prescribed scene.", "reason": "A fixed starting dose prevents uncontrolled provocation.", "success_check": "Motion parameters and support match the written plan." }, { "title": "Commit the orientation answer", "instruction": "At the cue, point or select the estimated heading once and rate confidence without searching or standing.", "reason": "One committed response yields a heading error without adding fall risk.", "success_check": "Heading, confidence and response time are captured." }, { "title": "Stop and recover", "instruction": "End at the time limit or first stop sign. Remain supported and record symptoms each minute until the provider-defined recovery band.", "reason": "Symptoms can build after motion and recovery is part of safety and dose.", "success_check": "Peak symptoms and recovery time are complete." }, { "title": "Review one-variable progression", "instruction": "Compare heading error and symptoms with baseline; the provider holds, reduces or changes one feature only.", "reason": "Accuracy improvement with worsening sickness is not clean progress.", "success_check": "The next decision accounts for both function and burden." } ], "worked_example": { "scenario": "A clinician uses a supported, non-driving visual-motion simulator with a stationary chair and three heading markers.", "walkthrough": [ "Ari identifies forward, left and right markers while stationary and rehearses the stop switch.", "The clinician sets a 15-second low-speed visual rotation with Ari seated and supported.", "At the cue Ari selects forward-left once, confidence 60%, without standing.", "Nausea rises from 0 to 2/10 and returns to 0 in four minutes, all recorded.", "Because heading error improved but recovery lengthened from the prior block, the clinician holds the dose." ], "result": "Ari’s record links orientation accuracy with symptom cost in one controlled configuration. It gives no permission for driving, water or independent motion exposure." }, "right_vs_wrong": [ { "situation": "Setting", "right": "Use a provider-controlled, supported, consequence-free setup.", "wrong": "Test during driving, boating or amusement rides.", "why": "Operational environments turn an error into immediate danger." }, { "situation": "Response", "right": "Give one heading answer while seated.", "wrong": "Stand or turn repeatedly to find the direction.", "why": "Searching adds cues and fall risk." }, { "situation": "Progress", "right": "Review accuracy and symptom recovery together.", "wrong": "Increase dose because nausea was tolerated.", "why": "Tolerance is not safe orientation performance." }, { "situation": "Change", "right": "Alter one provider-selected variable.", "wrong": "Change speed, duration, scene and posture together.", "why": "Multiple changes obscure sensitisation or benefit." } ], "common_mistakes": [ { "mistake": "The reference heading is not calibrated.", "fix": "Test all markers while stationary before each block." }, { "mistake": "Only peak symptoms are logged.", "fix": "Record time to return to the agreed band." }, { "mistake": "Confidence replaces angle error.", "fix": "Capture the selected heading and compare it with the true heading." }, { "mistake": "Prior motion exposure is ignored.", "fix": "Record travel, exercise, simulator or vestibular exposure earlier that day." } ], "practice": { "first_session": [ "Provider screen and stationary baseline.", "Stop-control and heading rehearsal.", "One smallest-dose block.", "Supported recovery and full symptom log.", "Provider hold/reduce/continue decision." ], "repeat_plan": "The qualified provider determines intervals, repetitions and progression. Repeats match motion, visual scene, posture and timing; prior exposure is logged. No home or operational practice is supplied.", "progress_when": [ "Heading error improves without longer recovery or new symptoms.", "The stop response is immediate and reliable.", "The provider observes stable supported posture and correct task execution." ], "do_not_progress_when": [ "Nausea, dizziness, headache or disorientation accumulates.", "A prior motion exposure may sensitise the session.", "The next environment has real transport, water, height or fall consequences." ] }, "self_check": [ "What is the fixed reference heading?", "Can the stop control end motion immediately?", "Are heading error and symptom recovery both recorded?", "Who controls the next dose?" ], "measurement": { "primary": "Heading error during one controlled-motion configuration, paired with symptom recovery.", "how": "Record true and selected heading, absolute angular/category error, response time, confidence, baseline/peak symptoms, recovery minutes, support and motion parameters.", "good_result": "Provider-defined heading improvement occurs across matched blocks without increased peak symptoms, prolonged recovery or loss of support.", "does_not_prove": "It does not show safe driving, boating, flight, occupational readiness, vestibular immunity or transfer to other motion." }, "stop_and_get_help": [ "Stop immediately for severe or rapidly rising nausea, vomiting, faintness, severe headache, double vision, new weakness, chest symptoms, panic or inability to orient.", "Remain supported and obtain clinical review if symptoms do not return to the agreed band.", "Do not attempt transport or hazardous activity while dizzy, nauseated or disoriented." ], "accessibility": [ "Use large visual headings, tactile direction markers or spoken response options.", "Use supported seating and an accessible stop switch.", "Reduce sensory clutter and allow longer recovery; accessibility changes are recorded as configuration." ], "evidence_notes": [ { "claim": "The official vestibular rehabilitation guideline supports clinician-configured care for diagnosed peripheral vestibular hypofunction and does not justify generic provocative practice.", "source_title": "Vestibular Rehabilitation for Peripheral Vestibular Hypofunction: An Evidence-Based Clinical Practice Guideline (CPG+)", "source_url": "https://www.apta.org/patient-care/evidence-based-practice-resources/cpgs/vestibular-rehabilitation-for-peripheral-vestibular-hypofunction-an-evidence-based-clinical-practice-guideline-cpg", "source_kind": "OFFICIAL_GUIDANCE" }, { "claim": "A randomised study found prior provocative physical motion sensitised later visually induced motion sickness, supporting conservative exposure and recovery tracking.", "source_title": "Sensitization of Visually Induced Motion Sickness by Prior Provocative Physical Motion", "source_url": "https://pubmed.ncbi.nlm.nih.gov/39431702/", "source_kind": "PRIMARY_RESEARCH" } ], "limits": [ "All practice is provider-controlled and consequence-free.", "Symptom reduction and orientation accuracy are separate outcomes.", "The wrong exposure can sensitise symptoms rather than build universal tolerance." ], "orientation": { "bounded_definition": "Capability to develop or express orientation under motion in a declared context without inheriting broader claims.", "evidence_summary": "Motion tolerance is trainable for some people—but exposure can also make it worse. This is a supervised frontier, not a “push through the nausea” challenge.", "supportable_public_claim": "Motion tolerance can improve in a tightly controlled configuration, but the wrong exposure can sensitize symptoms and no universal vestibular immunity is supported.", "measurement_boundary": "Symptom scores, time tolerated, autonomic signals, orientation error and task performance are separate; symptom reduction is not safe operational performance.", "myth_to_metric": { "myth": "Become motion-proof", "metric": "Environment-specific symptoms, orientation and task performance with delayed retest", "boundary": "Less nausea in one setup cannot certify tolerance or safety elsewhere." }, "limiting_findings": [ "Prior provocative physical motion made later visually induced sickness worse in a randomized study." ], "prohibited_claims": [ "Train away all motion sickness", "Spin until adapted", "VR nausea means neuroplasticity", "Motion-proof yourself" ] }, "gold_source_lesson": { "curriculum_id": "G-CUR-003", "source_heading": "PWR-096 — Orientation under motion", "source_html_sha256": "61062ae897073fff32422d8e0dcbe69dc8aab9d06497077b5cab6fd7c1358209", "html": "Specialist route. No driving, water, motion-platform or provocative vestibular exercises.
" }, "next_gate": "External confirmation is required before higher-authority use because: CLINICAL_HIGH_RISK_OR_REGULATED_CONFIGURATION; SUPERVISION_OR_NON_ATTEMPT_BOUNDARY; CULTURAL_COMMUNITY_RIGHTS_OR_AFFECTED_PERSON_AUTHORITY; SAFETY_LEGITIMACY_RESTRICTED.", "evidence_count": 3 }, "full_training_programme": false, "independently_validated": false, "publication_state": "PUBLISHED_PUBLIC_RESEARCH_EDITION__EDITORIAL_REVIEW_PENDING", "related_power_ids": [ "PWR-089", "PWR-090", "PWR-091", "PWR-092" ] }, { "power_id": "PWR-097", "learning_unit_id": "TLU-PWR-097", "title": "Sustained attention", "main_description": "This lesson teaches a simple sustained-attention routine. Move through one 60-token grid at a fixed pace of one token every four seconds, mark uppercase X only, notice when attention slips and return to the current token without racing. Score early and late accuracy separately, then repeat with the matched second grid after 3–7 days under the same conditions.", "main_description_source": "GOVERNED_TUTORIAL_PLAIN_ENGLISH_INTRO", "family_id": "FAM-13", "family": "Attention & Executive Control", "superdomain": "Cognition & Learning", "canonical_route": "/powers/pwr-097/", "treatment": "SELF_GUIDED_LESSON", "treatment_label": "Self-guided lesson", "treatment_boundary": "A governed step-by-step lesson may be completed independently inside its stated limits.", "tutorial_route": "/tutorials/pwr-097/", "governed_lesson_route": "/tutorials/pwr-097/", "self_attempt_status": "PERMITTED_INSIDE_TUTORIAL_LIMITS", "gold_pathway_ids": [ "G-CUR-009" ], "route_membership": { "kind": "GOLD_PATHWAY", "id": "G-CUR-009", "coverage_status": "EXACT_ONCE" }, "source_authority_tier": "G1", "source_build_state": "COMPREHENSIVE_OWNER_CANDIDATE", "source_instructional_route": "SELF_GUIDED_TUTORIAL", "source_count": 3, "research_depth": "FOCUSED", "risk_level": "MODERATE", "prerequisite_status": "DECLARED_IN_GOVERNED_LESSON", "learning_route": { "mode": "PRACTICAL_LESSON", "label": "Learn with the governed self-guided lesson", "summary": "This lesson teaches a simple sustained-attention routine. Move through one 60-token grid at a fixed pace of one token every four seconds, mark uppercase X only, notice when attention slips and return to the current token without racing. Score early and late accuracy separately, then repeat with the matched second grid after 3–7 days under the same conditions.", "steps": [ [ "Orient", "Read the definition, evidence, measurement boundary and prohibited claims on this canonical page." ], [ "Baseline", "Open the governed lesson and record its declared baseline before practising." ], [ "Practise", "Follow the ordered lesson exactly; do not add dose, intensity or claims." ], [ "Retest", "Use the lesson's delayed retention and predeclared transfer checks as separate records." ], [ "Maintain or retire", "Keep only what remains useful inside the evidence and safety boundary." ] ], "practical_authority": true, "provider_required": false, "next_action_route": "/tutorials/pwr-097/" }, "path_builder": { "selectable": true, "completion_allowed": true, "warning": "A governed step-by-step lesson may be completed independently inside its stated limits." }, "full_tutorial": { "version": "1.0", "authorship": "AUTHORED_GOVERNED_SOURCE", "practice_pack": { "power_id": "PWR-097", "title": "Sustained attention", "heading": "Practise a steady four-minute scan and classify attention errors", "plain_english_intro": "This lesson teaches a simple sustained-attention routine. Move through one 60-token grid at a fixed pace of one token every four seconds, mark uppercase X only, notice when attention slips and return to the current token without racing. Score early and late accuracy separately, then repeat with the matched second grid after 3–7 days under the same conditions.", "authority_and_safety": [ "Use a comfortable display and response method. Stop for eyestrain, headache, distress, repeated loss of place or declining quality.", "Do not use the result as an ADHD screen, intelligence score, character judgement or proof of attention in another setting.", "Keep essential notifications and accessibility supports. Change at most one genuinely optional environmental condition.", "If two-second pacing is inaccessible, use a support person or a slower declared cue. Compare only trials that use the same pace and access method." ], "materials": [ "Trial A and Trial B symbol grids below", "A pointer, ruler, keyboard cursor, switch or other declared way to track one position", "A timer that gives one accessible cue every four seconds, or a helper who gives the same cue", "A cover for Trial B and the answer key until they are needed", "A record for hits, misses, false alarms, attention-slip tallies and burden from 0 to 5" ], "setup_steps": [ "Cover Trial B and the answer key. Set the rule: mark uppercase X and nothing else.", "Choose one comfortable display and response method. Use the same lighting, notifications, access supports and position for both sessions.", "Set one cue every four seconds. Place the pointer on Trial A, line 1, position 1.", "At each cue, decide whether the current token is uppercase X, mark it if it is, then move the pointer exactly one position. Do not scan ahead or go back.", "If attention slips, make one tally and return to the current position on the next cue. Do not rush to catch up.", "After position 60, record burden before opening the key. Score hits, misses and false alarms for lines 1–3 and lines 4–6 separately.", "After 3–7 days, run Trial B once with the same four-minute pace and the same conditions. Do not reopen Trial A first.", "Compare only the declared task measures. A better second grid is task-specific retention, not diagnosis or proof of attention everywhere." ], "fixture": { "caption": "Read left to right at one token every four seconds. Each trial has six lines, 60 tokens, 14 uppercase-X targets and a fixed duration of four minutes.", "headers": [ "Trial", "Line", "Tokens in positions 1 to 10" ], "rows": [ [ "A", "1", "A; X; B; C; X; D; E; F; X; G" ], [ "A", "2", "X; H; I; J; K; X; L; M; N; O" ], [ "A", "3", "P; Q; R; X; S; T; X; U; X; V" ], [ "A", "4", "W; Y; Z; A; B; C; D; E; F; G" ], [ "A", "5", "H; X; I; X; J; K; L; X; M; X" ], [ "A", "6", "N; O; P; Q; X; R; S; T; U; X" ], [ "B", "1", "X; A; B; X; C; D; E; X; F; G" ], [ "B", "2", "H; I; X; J; K; L; X; M; N; X" ], [ "B", "3", "O; P; Q; R; S; T; U; V; W; Y" ], [ "B", "4", "Z; X; A; B; X; C; X; D; E; F" ], [ "B", "5", "G; H; I; X; J; K; L; M; X; N" ], [ "B", "6", "O; X; P; Q; R; X; S; T; X; U" ] ] }, "scoring_rule": "A hit is a marked uppercase X. A miss is an unmarked X. A false alarm is a marked non-X. Calculate hit rate as hits divided by targets and false-alarm rate as false alarms divided by non-targets for the whole trial and for each half. Also record attention-slip tallies and burden. A valid trial lasts 240 seconds, visits all 60 positions once and keeps the key covered. Treat Trial B as retained task performance only when late-half hit rate is no worse, false alarms and burden do not increase, and the setup is unchanged.", "worked_example": { "steps": [ "Trial A lasts 240 seconds. The learner misses line 3 position 9 and line 6 position 10, marks Y at line 4 position 2, records two attention slips and rates burden 2/5.", "Overall Trial A: 12 hits, 2 misses and 1 false alarm; hit rate 12/14 = 85.7% and false-alarm rate 1/46 = 2.2%.", "Early Trial A: 7/8 targets hit and 0/22 false alarms. Late Trial A: 5/6 targets hit and 1/24 false alarms.", "After 3–7 days, Trial B is run for the same 240 seconds in the same setup. The learner misses line 5 position 9, makes no false alarms, records one attention slip and rates burden 2/5.", "Overall Trial B: 13/14 hits = 92.9% and 0/46 false alarms. Early hits are 6/6; late hits are 7/8.", "The learner records the task-specific change and does not infer diagnosis, character or attention in another setting." ], "result": "On the matched delayed grid, overall and late-half target detection improve without more false alarms or burden, and attention-slip tallies fall from two to one. This supports retention of this paced scanning routine only; one pair does not prove a general attention improvement." }, "right_vs_wrong": [ { "situation": "Keeping place", "right": "Move one position on every cue and keep the pointer on the current token.", "wrong": "Sweep ahead for X and then jump back.", "why": "A fixed path makes every token and every lapse countable." }, { "situation": "Recovering from a lapse", "right": "Make one tally and rejoin the current token on the next cue.", "wrong": "Race through several tokens to hide the lapse.", "why": "Racing changes the task and creates extra errors." }, { "situation": "Using time", "right": "Use the same 240-second pace for both grids.", "wrong": "Call an untimed, slower attempt better because it has fewer errors.", "why": "Accuracy is not comparable when exposure time changes." }, { "situation": "Retesting", "right": "Use Trial B after 3–7 days with the setup unchanged.", "wrong": "Change the grid, notifications, lighting and pace at once.", "why": "Several changes make the comparison uninterpretable." }, { "situation": "Interpreting", "right": "Report this task's hits, false alarms, late-half result, slips and burden.", "wrong": "Claim the learner cured an attention problem.", "why": "This short task is not diagnosis or broad transfer evidence." } ], "common_mistakes": [ { "mistake": "The learner loses the current position.", "fix": "Use a ruler or cursor and move exactly one cell on each cue." }, { "mistake": "The answer key is visible during practice.", "fix": "Cover or collapse it until the trial and burden rating are complete." }, { "mistake": "The learner goes back to repair an earlier response.", "fix": "Leave it, tally the lapse if relevant and continue at the current cue." }, { "mistake": "Trial B is run immediately after Trial A.", "fix": "Keep it hidden and wait 3–7 days." }, { "mistake": "The setup changes between trials.", "fix": "Restore the same display, response method, access supports and environment before comparing results." } ], "answer_key_route": "/tutorials/pwr-097/answer-key/", "answer_key_delivery": "SEPARATE_NOINDEX_NOARCHIVE_CHECKING_PAGE" }, "tutorial_mode": "PRACTICAL_LESSON", "orientation": { "bounded_definition": "Capability to develop or express sustained attention in a declared context without inheriting broader claims.", "evidence_summary": "People can get better at staying with a particular attention task. Whether that becomes durable focus elsewhere is still uncertain—and a strong primary trial found no sustained-attention benefit.", "measurement_boundary": "Accuracy, errors, reaction-time variability, time-on-task decline and real-task completion must be reported separately; no one measure establishes general attention.", "myth_to_metric": { "myth": "Unlock endless concentration", "metric": "Predeclared vigilance accuracy and variability over time plus an independent real-task endpoint", "boundary": "Practice on one attention test cannot establish durable focus everywhere." }, "limiting_findings": [ "A 100-person active-controlled post-TBI trial found no between-group effect on its preregistered primary sustained-attention outcome.", "A large online study found practiced-task improvement without transfer to independent cognitive tests." ], "prohibited_claims": [ "Build unlimited focus", "Cure attention problems with meditation", "VR repairs attention after brain injury", "One vigilance score diagnoses attention" ] }, "outcomes": [ "Define sustained attention without inheriting mythology or broader claims.", "Explain what the current evidence supports and what it does not establish.", "Use the declared measurement boundary and recognise misleading proxies.", "Complete only the separately governed capability practice inside its declared limits.", "Make a retention, transfer, maintenance, provider or stop decision without overclaiming." ], "prerequisites": "DECLARED_IN_GOVERNED_LESSON", "baseline": { "instruction": "Complete the baseline declared by the governed lesson before practice; keep it separate from the knowledge baseline.", "record": [ "date and context", "current definition", "confidence from 0 to 100", "assumed measure", "expected benefit", "known limitation", "intended next action" ] }, "modules": [ { "order": 1, "title": "Orient", "instruction": "Read the definition, evidence, measurement boundary and prohibited claims on this canonical page.", "completion_evidence": "Record the decision or output from orient in one or two sentences." }, { "order": 2, "title": "Baseline", "instruction": "Open the governed lesson and record its declared baseline before practising.", "completion_evidence": "Record the decision or output from baseline in one or two sentences." }, { "order": 3, "title": "Practise", "instruction": "Follow the ordered lesson exactly; do not add dose, intensity or claims.", "completion_evidence": "Record the decision or output from practise in one or two sentences." }, { "order": 4, "title": "Retest", "instruction": "Use the lesson's delayed retention and predeclared transfer checks as separate records.", "completion_evidence": "Record the decision or output from retest in one or two sentences." }, { "order": 5, "title": "Maintain or retire", "instruction": "Keep only what remains useful inside the evidence and safety boundary.", "completion_evidence": "Record the decision or output from maintain or retire in one or two sentences." } ], "lab": { "title": "Governed capability lab", "instruction": "Open the separately governed practical lesson and complete only its declared configuration, dose, measurement, accessibility and stopping rules.", "deliverable": "The lesson's declared baseline, practice and retest record; no additional exercise is implied here." }, "assessment": { "immediate": "Restate the bounded definition, evidence ceiling, measurement boundary and current authority route without looking.", "delayed_retention": "Repeat the explanation and route decision after at least 48 hours; record what changed or was forgotten.", "transfer": "Use only the lesson's predeclared transfer task; do not infer far transfer from the trained task.", "interpretation": "Completion demonstrates learning of this tutorial only. It does not prove capability, qualification, independent validation, safety clearance or far transfer." }, "maintenance": { "cadence": "Review after 48 hours, again after 2-4 weeks, and whenever the evidence or authority treatment changes.", "decisions": [ "retain", "refresh", "seek qualified support", "return to research", "retire" ] }, "accessibility": "Use text-to-speech, enlarged text, keyboard navigation, shorter sessions, a support person or an equivalent non-practical record format as needed. Accessibility changes must not enlarge practical authority.", "stopping_and_escalation": "A governed step-by-step lesson may be completed independently inside its stated limits. Stop if the declared configuration cannot be maintained, uncertainty becomes material, adverse effects appear, or qualified authority is required.", "next_gate": "No external confirmation is required for the current bounded explainer and non-prescriptive guide-frame permissions; any stronger efficacy, generalisation, protocol, promotion or independent-validation claim requires a new adjudication.", "evidence_count": 3 }, "full_training_programme": false, "independently_validated": false, "publication_state": "PUBLISHED_PUBLIC_RESEARCH_EDITION__EDITORIAL_REVIEW_PENDING", "related_power_ids": [ "PWR-098", "PWR-099", "PWR-100", "PWR-101" ] }, { "power_id": "PWR-098", "learning_unit_id": "TLU-PWR-098", "title": "Selective attention", "main_description": "Selective attention is practised here by marking uppercase A while ignoring every other token. Two complete lists keep length and target frequency fixed while changing distractor similarity, so hits, misses, false alarms, and burden can be compared honestly.", "main_description_source": "GOVERNED_TUTORIAL_PLAIN_ENGLISH_INTRO", "family_id": "FAM-13", "family": "Attention & Executive Control", "superdomain": "Cognition & Learning", "canonical_route": "/powers/pwr-098/", "treatment": "SELF_GUIDED_LESSON", "treatment_label": "Self-guided lesson", "treatment_boundary": "A governed step-by-step lesson may be completed independently inside its stated limits.", "tutorial_route": "/tutorials/pwr-098/", "governed_lesson_route": "/tutorials/pwr-098/", "self_attempt_status": "PERMITTED_INSIDE_TUTORIAL_LIMITS", "gold_pathway_ids": [ "G-CUR-009" ], "route_membership": { "kind": "GOLD_PATHWAY", "id": "G-CUR-009", "coverage_status": "EXACT_ONCE" }, "source_authority_tier": "G1", "source_build_state": "COMPREHENSIVE_OWNER_CANDIDATE", "source_instructional_route": "SELF_GUIDED_TUTORIAL", "source_count": 3, "research_depth": "FOCUSED", "risk_level": "LOW_TO_MODERATE", "prerequisite_status": "DECLARED_IN_GOVERNED_LESSON", "learning_route": { "mode": "PRACTICAL_LESSON", "label": "Learn with the governed self-guided lesson", "summary": "Selective attention is practised here by marking uppercase A while ignoring every other token. Two complete lists keep length and target frequency fixed while changing distractor similarity, so hits, misses, false alarms, and burden can be compared honestly.", "steps": [ [ "Orient", "Read the definition, evidence, measurement boundary and prohibited claims on this canonical page." ], [ "Baseline", "Open the governed lesson and record its declared baseline before practising." ], [ "Practise", "Follow the ordered lesson exactly; do not add dose, intensity or claims." ], [ "Retest", "Use the lesson's delayed retention and predeclared transfer checks as separate records." ], [ "Maintain or retire", "Keep only what remains useful inside the evidence and safety boundary." ] ], "practical_authority": true, "provider_required": false, "next_action_route": "/tutorials/pwr-098/" }, "path_builder": { "selectable": true, "completion_allowed": true, "warning": "A governed step-by-step lesson may be completed independently inside its stated limits." }, "full_tutorial": { "version": "1.0", "authorship": "AUTHORED_GOVERNED_SOURCE", "practice_pack": { "power_id": "PWR-098", "title": "Selective attention", "heading": "Find one declared target among similar and dissimilar distractors", "plain_english_intro": "Selective attention is practised here by marking uppercase A while ignoring every other token. Two complete lists keep length and target frequency fixed while changing distractor similarity, so hits, misses, false alarms, and burden can be compared honestly.", "authority_and_safety": [ "Use the display size, contrast, audio, pace, and response method needed for access; these supports are part of the configuration.", "Stop for sensory strain, headache, distress, or worsening errors.", "The result is not a diagnostic screen, intelligence score, or measure of a person's value or effort." ], "materials": [ "Trial 1 and Trial 2 token lists below", "A marker or accessible selection method", "The hidden answer key", "A 0-to-5 burden rating", "Optional comfortable pacing cue" ], "setup_steps": [ "Write the target rule exactly: select uppercase A only; lowercase a is a distractor.", "Keep the rule visible if needed and confirm there are 30 tokens and 9 targets in each trial.", "Run Trial 1 once at a comfortable pace, then rate burden before checking the key.", "Classify every discrepancy as a miss or false alarm.", "Run Trial 2 at the same pace and display settings; only distractor similarity changes because lowercase a is removed.", "Compare hits, misses, false alarms and recorded burden descriptively. Trial order, token form and distractor similarity differ together, so do not attribute a difference uniquely to similarity." ], "fixture": { "caption": "Positions are 1 through 30. Mark uppercase A only.", "headers": [ "Item", "Position", "Supplied value" ], "rows": [ [ "1", "1", "A" ], [ "1", "2", "H" ], [ "1", "3", "a" ], [ "1", "4", "R" ], [ "1", "5", "A" ], [ "1", "6", "M" ], [ "1", "7", "A" ], [ "1", "8", "a" ], [ "1", "9", "H" ], [ "1", "10", "R" ], [ "1", "11", "A" ], [ "1", "12", "N" ], [ "1", "13", "a" ], [ "1", "14", "A" ], [ "1", "15", "H" ], [ "1", "16", "R" ], [ "1", "17", "A" ], [ "1", "18", "a" ], [ "1", "19", "M" ], [ "1", "20", "H" ], [ "1", "21", "A" ], [ "1", "22", "R" ], [ "1", "23", "a" ], [ "1", "24", "A" ], [ "1", "25", "H" ], [ "1", "26", "M" ], [ "1", "27", "a" ], [ "1", "28", "R" ], [ "1", "29", "A" ], [ "1", "30", "H" ], [ "2", "1", "H" ], [ "2", "2", "A" ], [ "2", "3", "R" ], [ "2", "4", "M" ], [ "2", "5", "N" ], [ "2", "6", "A" ], [ "2", "7", "H" ], [ "2", "8", "R" ], [ "2", "9", "A" ], [ "2", "10", "M" ], [ "2", "11", "H" ], [ "2", "12", "A" ], [ "2", "13", "R" ], [ "2", "14", "N" ], [ "2", "15", "M" ], [ "2", "16", "A" ], [ "2", "17", "H" ], [ "2", "18", "R" ], [ "2", "19", "A" ], [ "2", "20", "N" ], [ "2", "21", "M" ], [ "2", "22", "H" ], [ "2", "23", "A" ], [ "2", "24", "R" ], [ "2", "25", "N" ], [ "2", "26", "A" ], [ "2", "27", "M" ], [ "2", "28", "H" ], [ "2", "29", "R" ], [ "2", "30", "A" ] ] }, "scoring_rule": "Hit = selected uppercase A.; Miss = uppercase A not selected; misses = 9 - hits.; False alarm = selected token that is not uppercase A, including lowercase a.; Hit rate = hits / 9; false-alarm rate = false alarms / 21. Keep burden separate.", "worked_example": { "steps": [ "On Trial 1, the learner selects true targets at positions 1, 5, 7, 11, 14, 17, 21, and 29, missing position 24.", "The learner also selects lowercase a at position 23, which is one false alarm.", "Trial 1: hits = 8, misses = 9 - 8 = 1, false alarms = 1, hit rate = 8 / 9 = 88.9%, false-alarm rate = 1 / 21 = 4.8%.", "On Trial 2, the learner selects all nine target positions and no distractors.", "Trial 2: hits = 9, misses = 0, false alarms = 0, hit rate = 100%, false-alarm rate = 0%.", "Confirm that length, target frequency, target rule, pace, and display were held constant; only distractor similarity changed.", "The fictional log records burden 3/5 after Trial 1 and 2/5 after Trial 2; these ratings were recorded, not inferred from accuracy." ], "result": "The fictional second record has fewer errors and lower recorded burden, but it was also shown later with a different token form. Report the descriptive difference; do not claim that distractor similarity alone caused it or that it measures broad attention." }, "right_vs_wrong": [ { "situation": "Applying the target rule", "right": "Select uppercase A and reject lowercase a.", "wrong": "Select any token that looks like an a.", "why": "An ambiguous rule makes error classification meaningless." }, { "situation": "Changing difficulty", "right": "Change distractor similarity only.", "wrong": "Change similarity, pace, target frequency, and display size at once.", "why": "A one-feature comparison requires the other declared fields to remain stable." }, { "situation": "Handling speed", "right": "Keep a comfortable pace and protect accuracy.", "wrong": "Increase pace after Trial 1 even though errors occurred.", "why": "Faster is not automatically better and can hide a speed-accuracy trade-off." }, { "situation": "Interpreting Trial 2", "right": "Lower-similarity distractors were more usable in this fixture.", "wrong": "The learner now ignores every real-world distraction.", "why": "One token task does not prove far transfer." } ], "common_mistakes": [ { "mistake": "Forgetting whether lowercase a counts.", "fix": "Keep the one-sentence target rule visible and restart only with a fresh list." }, { "mistake": "Calling an unmarked target a false alarm.", "fix": "Use the key: unmarked target equals miss; marked distractor equals false alarm." }, { "mistake": "Looking at the answer positions before finishing.", "fix": "Hide the key until responses and burden are recorded." }, { "mistake": "Increasing speed to make the second trial feel harder.", "fix": "Restore the original comfortable pace so distractor similarity remains the only changed feature." } ], "answer_key_route": "/tutorials/pwr-098/answer-key/", "answer_key_delivery": "SEPARATE_NOINDEX_NOARCHIVE_CHECKING_PAGE" }, "tutorial_mode": "PRACTICAL_LESSON", "orientation": { "bounded_definition": "Capability to develop or express selective attention in a declared context without inheriting broader claims.", "evidence_summary": "Attention training can sharpen what a particular task asks you to notice. That does not mean it improves balance, mobility or every form of awareness.", "measurement_boundary": "Target sensitivity, search time, errors and distractor cost must be tied to a named modality and task; they do not measure general awareness.", "myth_to_metric": { "myth": "Notice everything others miss", "metric": "Target sensitivity and distractor cost in a declared sensory task, plus a different functional endpoint", "boundary": "A better screen score cannot certify broad situational awareness." }, "limiting_findings": [ "Older adults improved a visual-attention measure without improving any tested balance or mobility outcome." ], "prohibited_claims": [ "See everything at once", "Train away distraction permanently", "A game gives fighter-pilot attention", "Screen training prevents falls" ] }, "outcomes": [ "Define selective attention without inheriting mythology or broader claims.", "Explain what the current evidence supports and what it does not establish.", "Use the declared measurement boundary and recognise misleading proxies.", "Complete only the separately governed capability practice inside its declared limits.", "Make a retention, transfer, maintenance, provider or stop decision without overclaiming." ], "prerequisites": "DECLARED_IN_GOVERNED_LESSON", "baseline": { "instruction": "Complete the baseline declared by the governed lesson before practice; keep it separate from the knowledge baseline.", "record": [ "date and context", "current definition", "confidence from 0 to 100", "assumed measure", "expected benefit", "known limitation", "intended next action" ] }, "modules": [ { "order": 1, "title": "Orient", "instruction": "Read the definition, evidence, measurement boundary and prohibited claims on this canonical page.", "completion_evidence": "Record the decision or output from orient in one or two sentences." }, { "order": 2, "title": "Baseline", "instruction": "Open the governed lesson and record its declared baseline before practising.", "completion_evidence": "Record the decision or output from baseline in one or two sentences." }, { "order": 3, "title": "Practise", "instruction": "Follow the ordered lesson exactly; do not add dose, intensity or claims.", "completion_evidence": "Record the decision or output from practise in one or two sentences." }, { "order": 4, "title": "Retest", "instruction": "Use the lesson's delayed retention and predeclared transfer checks as separate records.", "completion_evidence": "Record the decision or output from retest in one or two sentences." }, { "order": 5, "title": "Maintain or retire", "instruction": "Keep only what remains useful inside the evidence and safety boundary.", "completion_evidence": "Record the decision or output from maintain or retire in one or two sentences." } ], "lab": { "title": "Governed capability lab", "instruction": "Open the separately governed practical lesson and complete only its declared configuration, dose, measurement, accessibility and stopping rules.", "deliverable": "The lesson's declared baseline, practice and retest record; no additional exercise is implied here." }, "assessment": { "immediate": "Restate the bounded definition, evidence ceiling, measurement boundary and current authority route without looking.", "delayed_retention": "Repeat the explanation and route decision after at least 48 hours; record what changed or was forgotten.", "transfer": "Use only the lesson's predeclared transfer task; do not infer far transfer from the trained task.", "interpretation": "Completion demonstrates learning of this tutorial only. It does not prove capability, qualification, independent validation, safety clearance or far transfer." }, "maintenance": { "cadence": "Review after 48 hours, again after 2-4 weeks, and whenever the evidence or authority treatment changes.", "decisions": [ "retain", "refresh", "seek qualified support", "return to research", "retire" ] }, "accessibility": "Use text-to-speech, enlarged text, keyboard navigation, shorter sessions, a support person or an equivalent non-practical record format as needed. Accessibility changes must not enlarge practical authority.", "stopping_and_escalation": "A governed step-by-step lesson may be completed independently inside its stated limits. Stop if the declared configuration cannot be maintained, uncertainty becomes material, adverse effects appear, or qualified authority is required.", "next_gate": "No external confirmation is required for the current bounded explainer and non-prescriptive guide-frame permissions; any stronger efficacy, generalisation, protocol, promotion or independent-validation claim requires a new adjudication.", "evidence_count": 3 }, "full_training_programme": false, "independently_validated": false, "publication_state": "PUBLISHED_PUBLIC_RESEARCH_EDITION__EDITORIAL_REVIEW_PENDING", "related_power_ids": [ "PWR-097", "PWR-099", "PWR-100", "PWR-101" ] }, { "power_id": "PWR-099", "learning_unit_id": "TLU-PWR-099", "title": "Divided attention", "main_description": "The learner produces separate single-task and dual-task speed/accuracy results for card sorting and tone counting, with dual-task cost correctly calculated for both.", "main_description_source": "FULL_TUTORIAL_OUTCOME", "family_id": "FAM-13", "family": "Attention & Executive Control", "superdomain": "Cognition & Learning", "canonical_route": "/powers/pwr-099/", "treatment": "EVIDENCE_REVIEW_ROUTE", "treatment_label": "Full low-stakes tutorial", "treatment_boundary": "Titan teaches a concrete low-stakes method step by step while keeping evidence and transfer claims bounded.", "tutorial_route": "/tutorials/pwr-099/", "governed_lesson_route": null, "self_attempt_status": "PERMITTED_INSIDE_FULL_TUTORIAL_LIMITS", "gold_pathway_ids": [ "G-CUR-009" ], "route_membership": { "kind": "GOLD_PATHWAY", "id": "G-CUR-009", "coverage_status": "EXACT_ONCE" }, "source_authority_tier": "G2", "source_build_state": "TARGETED_REVIEW_REQUIRED", "source_instructional_route": "BOUNDED_GUIDED_EXERCISE", "source_count": 3, "research_depth": "FOCUSED", "risk_level": "HIGH", "prerequisite_status": "NONE_FOR_READING__NO_PRACTICE_AUTHORITY", "learning_route": { "mode": "FULL_SELF_GUIDED_TUTORIAL", "label": "Learn divided attention step by step", "summary": "The learner produces separate single-task and dual-task speed/accuracy results for card sorting and tone counting, with dual-task cost correctly calculated for both.", "steps": [ [ "Get ready", "Remove all safety-critical and real responsibilities; this is a desk exercise only." ], [ "Learn the method", "8 concrete steps teach the permitted method from start to finish." ], [ "See right and wrong", "5 comparisons show correct or safer execution beside common wrong or riskier choices." ], [ "Practise", "Use the identical harmless pairing for two short sessions per week for two weeks, no more than two paired trials per session. Re-measure single-task baselines at the start of each session. In week three, test a new neutral card set but keep rules/tone/priority fixed and label it near transfer." ], [ "Check progress", "Use identical card and tone fixtures; calculate time cost as relative slowing and accuracy cost as percentage-point loss for each task, retaining raw results." ] ], "practical_authority": true, "provider_required": false, "next_action_route": "/tutorials/pwr-099/" }, "path_builder": { "selectable": true, "completion_allowed": true, "warning": "Titan teaches a concrete low-stakes method step by step while keeping evidence and transfer claims bounded." }, "full_tutorial": { "version": "3.0", "authorship": "POWER_SPECIFIC_FULL_TUTORIAL", "tutorial_mode": "SELF_GUIDED", "promise": "Divided attention is performance when two demands overlap. People usually incur a cost, and practice may improve only the exact pairing or priority policy. This lesson uses a low-stakes card sort plus neutral tone count. The learner measures each task alone, declares which task has priority, performs them together, calculates each task's speed and accuracy cost, and stops if one task is sacrificed. Never transfer this drill to driving, road crossing, cooking heat, tools, medication, caregiving, work surveillance or any other consequential context.", "power_id": "PWR-099", "title": "Divided attention", "lesson_type": "SELF_GUIDED", "headline": "Measure the cost of two harmless desk tasks without pretending multitasking is free", "plain_english_summary": "Divided attention is performance when two demands overlap. People usually incur a cost, and practice may improve only the exact pairing or priority policy. This lesson uses a low-stakes card sort plus neutral tone count. The learner measures each task alone, declares which task has priority, performs them together, calculates each task's speed and accuracy cost, and stops if one task is sacrificed. Never transfer this drill to driving, road crossing, cooking heat, tools, medication, caregiving, work surveillance or any other consequential context.", "outcome": "The learner produces separate single-task and dual-task speed/accuracy results for card sorting and tone counting, with dual-task cost correctly calculated for both.", "authority": { "learner_may": [ "Practise only seated, reversible paper-and-tone tasks with no real-world consequence.", "Choose a clear priority rule and measure both tasks against their own single-task baselines.", "Stop, simplify or sequence the tasks when accuracy or comfort falls." ], "qualified_person_required_for": [ "Any assessment involving gait, falls, driving, work performance, caregiving, medication, clinical diagnosis or rehabilitation.", "Adaptation for significant sensory overload, neurological injury, cognitive decline or a regulated testing context.", "Interpretation of dual-task findings as clinical or occupational capacity." ], "never_do": [ "Dual-task while driving, cycling in traffic, crossing a road, using tools or heat, climbing, swimming, carrying a child or managing medication.", "Use another person's alerts, messages or private information as the secondary task.", "Call a smaller lab cost proof of unlimited attention or real-world safety." ] }, "materials": [ "Twenty-four cards: 12 red and 12 blue, shuffled", "Two labelled trays for the colour sort", "A 60-second neutral tone track with exactly 10 clearly spaced target tones and an answer key", "Timer and score sheet for time, card errors, tone hits, misses and false counts", "Quiet seated table with notifications off" ], "before_you_start": [ "Remove all safety-critical and real responsibilities; this is a desk exercise only.", "Check tone volume is comfortable and provide a visual-flash alternative as a different configuration if needed.", "Choose the priority rule: keep card-sort accuracy at baseline before trying to improve tone count.", "Stop for headache, dizziness, distress, sensory overload, confusion or rapidly increasing errors." ], "steps": [ { "title": "Set the two rules", "instruction": "Sort red cards left and blue cards right; count only the target tone, not distractor sounds. Repeat both rules aloud.", "reason": "Clear rules prevent task confusion from masquerading as divided-attention cost.", "success_check": "The learner correctly classifies two sample cards and two sample sounds." }, { "title": "Measure card sorting alone", "instruction": "Shuffle all 24 cards, start the timer, sort by colour and stop after the last card. Record time and wrong-tray cards.", "reason": "Each component needs its own baseline.", "success_check": "A complete time and accuracy result is recorded." }, { "title": "Measure tone counting alone", "instruction": "Play the tone track while hands rest. Write the target count only when the track ends and record error against the answer key.", "reason": "The secondary task also needs a baseline.", "success_check": "Hits/count error is recorded without card sorting." }, { "title": "Rest and restate priority", "instruction": "Pause for at least two minutes, then state: card accuracy has priority; if it falls beyond the declared rule, stop the pair.", "reason": "A declared priority prevents hidden sacrifice.", "success_check": "The priority and stop rule are written before pairing." }, { "title": "Run both tasks together", "instruction": "Start the tone track and card timer together. Sort at a controlled pace while silently counting tones; finish the sort, then write the tone count.", "reason": "This creates one declared dual-task fixture.", "success_check": "Both raw results are captured without an added phone or conversation." }, { "title": "Calculate both costs", "instruction": "For card time, calculate (dual time minus single time) divided by single time times 100. For each accuracy, subtract dual accuracy from single accuracy.", "reason": "One aggregate can hide that one task was sacrificed.", "success_check": "The score sheet shows separate time and percentage-point accuracy costs." }, { "title": "Diagnose the trade-off", "instruction": "Check whether card priority was protected and where tone misses occurred. If priority accuracy fell, sequence the tasks or slow/simplify; do not celebrate the combined speed.", "reason": "Improvement must not come from neglecting the priority task.", "success_check": "The decision names which task paid the cost." }, { "title": "Repeat only the same harmless pair", "instruction": "After rest, run at most one more paired trial with the same cards, track and priority. A new task pairing is a new test.", "reason": "Repeated exposure should stay bounded and comparable.", "success_check": "No unsafe or consequential context is added." } ], "worked_example": { "scenario": "A learner sorts 24 red/blue cards and counts 10 target tones. Card accuracy is the declared priority.", "walkthrough": [ "Card-only baseline is 24/24 correct in 40 seconds.", "Tone-only baseline is 10/10 correct.", "Together, the card sort is 22/24 correct in 48 seconds and the tone count is 8/10.", "Card time cost is (48-40)/40 = 20%; card accuracy falls from 100% to 91.7%, an 8.3-point cost; tone accuracy falls 20 points.", "Because priority card accuracy fell, the learner does not call the pair successful and chooses to slow the pair or sequence the tasks next time." ], "result": "Both tasks show measurable dual-task cost, including sacrifice of the declared priority. The result describes this exact card-and-tone pairing only and cannot certify safe multitasking elsewhere." }, "right_vs_wrong": [ { "situation": "Baselines: Divided attention checkpoint", "right": "Measure each task alone first. It is correct when the learner correctly classifies two sample cards and two sample sounds.", "wrong": "Compare the pair with memory of usual performance.", "why": "Dual-task cost needs matched single-task references." }, { "situation": "Priority: Divided attention checkpoint", "right": "Declare which outcome must be protected.", "wrong": "Say both tasks receive equal attention.", "why": "Resources and consequences are not automatically equal." }, { "situation": "Scoring: Divided attention checkpoint", "right": "Report each task's speed and accuracy.", "wrong": "Use one combined score; it breaks the 'Measure tone counting alone' execution rule.", "why": "A composite can hide sacrifice. That changes each task's speed and accuracy relative to its own single-task baseline. It is no longer the same test." }, { "situation": "Response to cost", "right": "Slow, simplify or sequence when priority errors rise.", "wrong": "Push faster to get used to overload.", "why": "Extra speed can worsen the important task." }, { "situation": "Transfer: Divided attention checkpoint", "right": "Keep practice at the seated desk.", "wrong": "Try the drill while walking or driving.", "why": "Real-world consequence makes this unsafe and unvalidated." } ], "common_mistakes": [ { "mistake": "Tone counting has no single-task baseline.", "fix": "Run and score the tone track alone before pairing." }, { "mistake": "The tone track changes between conditions.", "fix": "Use the same duration, target count and volume for the declared fixture." }, { "mistake": "Only card-sort time is reported.", "fix": "Record card errors and tone accuracy as separate outcomes." }, { "mistake": "Faster pair performance hides lower accuracy.", "fix": "Apply the priority accuracy rule before interpreting speed." }, { "mistake": "The learner practises with notifications from real people.", "fix": "Use a neutral prerecorded track and keep private/urgent channels off." } ], "practice": { "first_session": [ "Learn both rules with two samples.", "Complete one card-only baseline and one tone-only baseline.", "Rest, declare card-accuracy priority and its stop rule.", "Complete one paired trial and calculate all four costs.", "After two minutes, repeat the identical pair once only if comfortable and compare trade-offs." ], "repeat_plan": "Use the identical harmless pairing for two short sessions per week for two weeks, no more than two paired trials per session. Re-measure single-task baselines at the start of each session. In week three, test a new neutral card set but keep rules/tone/priority fixed and label it near transfer.", "progress_when": [ "Priority-task accuracy stays within the declared baseline tolerance.", "Both tasks' separate costs fall across two sessions without greater burden.", "The learner voluntarily sequences tasks when the cost remains high." ], "do_not_progress_when": [ "Priority errors, false tone counts or response time worsen across trials.", "Headache, overload, anxiety, confusion or fatigue appears.", "The proposed practice involves gait, driving, tools, medication, caregiving or real work consequences." ] }, "self_check": [ "Do both tasks have speed and accuracy baselines?", "What task has priority and what exact error stops the pair?", "Can you calculate cost for each task separately?", "Did any improvement come from sacrificing priority accuracy?", "Can you name five contexts where dual-task practice is prohibited?" ], "measurement": { "primary": "Each task's speed and accuracy relative to its own single-task baseline", "how": "Use identical card and tone fixtures; calculate time cost as relative slowing and accuracy cost as percentage-point loss for each task, retaining raw results.", "good_result": "Across two sessions, priority accuracy remains at baseline while the other costs decline without higher burden; otherwise sequence the tasks.", "does_not_prove": "It does not prove general multitasking capacity, real-world safety, clinical recovery or transfer to another pairing." }, "stop_and_get_help": [ "Stop for headache, dizziness, sensory overload, panic, confusion or errors that keep rising after rest.", "Do not begin or immediately stop if any task becomes safety-critical, clinical, private or consequential for another person.", "Seek qualified assessment rather than self-testing when divided attention is linked to falls, driving concerns, neurological symptoms or loss of daily function." ], "accessibility": [ "Use larger high-contrast cards, a comfortable visual-flash track or tactile targets as separate declared configurations.", "Use a scribe or large-button timer so motor speed does not dominate, while recording the assistance.", "Reduce card count or track duration to preserve the same two-rule cost calculation, not to compare directly with the original fixture." ], "evidence_notes": [ { "claim": "Dual-task training produced task-specific attentional-control changes with age-related differences, so the exact pairing and population must remain visible.", "source_title": "Training effects on dual-task performance: are there age-related differences in plasticity of attentional control?", "source_url": "https://pubmed.ncbi.nlm.nih.gov/16420143/", "source_kind": "PRIMARY_RESEARCH" }, { "claim": "A large online brain-training study found no broad transfer to untrained tasks, limiting claims that practice creates general multitasking capacity.", "source_title": "Putting brain training to the test", "source_url": "https://pubmed.ncbi.nlm.nih.gov/20407435/", "source_kind": "PRIMARY_RESEARCH" } ], "limits": [ "Two tasks usually interfere, and the cost is pairing- and priority-specific.", "A smaller desk-task cost cannot certify safety while moving or handling consequences.", "This drill teaches cost recognition and allocation, not unlimited parallel attention." ], "orientation": { "bounded_definition": "Capability to develop or express divided attention in a declared context without inheriting broader claims.", "evidence_summary": "You can practice coordinating two particular tasks. You cannot train away the cost of doing two things at once—and real safety never follows from a lab score.", "supportable_public_claim": "People can improve coordination of two closely related low-risk tasks, but the gains are narrow and do not abolish multitasking costs.", "measurement_boundary": "Dual-task cost must report each component’s accuracy and speed against its single-task baseline; one aggregate can hide sacrifice of the priority task.", "myth_to_metric": { "myth": "Do two things with no cost", "metric": "Each task’s speed and accuracy relative to its single-task baseline", "boundary": "A smaller lab cost cannot certify safe simultaneous action in the real world." }, "limiting_findings": [ "Heterogeneous dual-task practice produced only limited advantages, and the large online brain-training study showed no transfer to untrained tasks." ], "prohibited_claims": [ "Become a perfect multitasker", "Train while driving", "Double your mental bandwidth", "A dual-task score certifies safe work" ] }, "gold_source_lesson": { "curriculum_id": "G-CUR-009", "source_heading": "7. PWR-099 — Divide attention without pretending capacity is unlimited", "source_html_sha256": "e3f097b8ab5d0cce096556daa51ff952c8e4345a212e5466f579b197bfc4abc4", "html": "Divided attention describes performance when two demands overlap. It\nis not a single reservoir and it is not proof that two tasks are being\nprocessed without cost. People can adapt priorities and interleave\ntasks, but performance depends on task pairing, modality, response\ndemands, practice, incentives and consequence.
\nAsk whether the tasks need to overlap.
\n| Situation | \nPreferred route | \n
|---|---|
| Both tasks can be sequenced | \nSequence or batch them; measure task switching instead | \n
| One task is safety critical | \nDo not run a tutorial; follow the appropriate professional or\noperational rule | \n
| One demand can become a passive alert | \nRedesign the environment and preserve a reliable urgent channel | \n
| The pair is benign, reversible and suitable for research-style\nreview | \nPrepare the specification below; do not self-authorise practice | \n
This specification exists so reviewers can inspect the proposed\nroute. It is not an instruction to run it.
\n| Field | \nProposed bounded configuration | \n
|---|---|
| Primary task | \nFictional card sorting with a visible accuracy rule | \n
| Secondary task | \nInfrequent neutral tone count, with volume and modality\nalternatives | \n
| Conditions | \nEach task alone, then the pair; order counterbalanced | \n
| Metrics | \nPrimary and secondary accuracy, omissions, false alarms, response\ndelay, burden | \n
| Priority rule | \nDeclared before each condition; no “equal attention” assumption | \n
| Stops | \nSensory overload, distress, confusion, fatigue, or any\nsafety/clinical relevance | \n
| Exclusions | \nGait, driving, falls, medication, caregiving, surveillance,\noccupational ranking | \n
| Required gates | \nAttention/executive-function expert;\nclinical-scope/legitimacy/safety review; neurodivergent accessibility;\nburden pilot | \n
Current route: Explanation and review preparation\nonly. PWR-099 remains TARGETED_REVIEW_REQUIRED and\nNOT_YET_AUTHORISED in the frozen baseline.
Goal maintenance is the availability of a chosen task goal when\nanother activity, delay or interruption competes with it. It overlaps\nwith prospective memory, active goal representation and resumption, but\nit is not motivation, obedience or moral commitment.
\n| Failure | \nExample | \nAdjacent route | \n
|---|---|---|
| Goal not chosen | \n“I never actually decided what done meant.” | \nGoal definition, not maintenance | \n
| Cue not detected | \nThe trigger passes unnoticed | \nSelective attention or cue design | \n
| Goal not retrieved | \nThe person remembers later | \nProspective memory / goal maintenance | \n
| Goal retrieved but action blocked | \nThe action is inaccessible, conflicted or impossible | \nEnvironment, support or planning | \n
This is a controlled specification for expert review, not an\ninstruction to conduct the exercise.
\n| Field | \nProposed configuration | \n
|---|---|
| Goal | \nOne participant-endorsed, low-stakes fictional action | \n
| Baseline | \nDelayed-intention fixture with cue occurrence, retrieval, completion\nand burden recorded separately | \n
| Candidate supports | \nVisible goal card; specific if-then cue; next-action state note | \n
| Comparison | \nOrdinary instruction versus one support, with matched delay and\nintervening task | \n
| Proof | \nImmediate task, delayed repeat, and new cue/goal fixture reported\nseparately | \n
| Stops | \nDistress, compulsive checking, coercion, cognitive overload or\nclinical relevance | \n
| Exclusions | \nMedication, safeguarding, caregiving, employment discipline,\naddiction, self-harm, diagnosis or rehabilitation | \n
| Required gates | \nClinical-scope, legitimacy, safety and supervision review;\nexecutive-function expert; neurodivergent accessibility; burden\npilot | \n
Current route: Explanation and review preparation\nonly. PWR-103 remains TARGETED_REVIEW_REQUIRED and\nNOT_YET_AUTHORISED in the frozen baseline.
Systems thinking represents boundaries, components, relationships,\naccumulations, feedback, delays and perspectives. A map can make\nassumptions discussable. It can also erase people, turn speculation into\narrows and create false confidence through visual complexity.
\nAuthority state: TARGETED_REVIEW_REQUIRED ·\nNOT_YET_AUTHORISED
\nOpen reviews: clinical-scope;\nrights-and-representation; safety
In one sustainability-education experiment, simulation improved some\nunderstanding while explicit systems-thinking material did not show the\nexpected main effect; combining the two could reduce performance,\npossibly through cognitive load. Other intervention and exploratory\nstudies report gains on particular diagram tasks. Those results do not\nestablish a universal mapping method, durable transfer or authority to\nmodel communities without them.
\nThe following is a reviewer checklist, not a reader exercise:
\n| Review dimension | \nRequired question | \n
|---|---|
| Purpose | \nWhat bounded decision or learning question would the representation\nserve? | \n
| Boundary | \nWhat is inside, outside and uncertain—and who chose that\nboundary? | \n
| Representation | \nWhich people or groups are affected, absent, simplified or spoken\nfor? | \n
| Relationship evidence | \nWhat supports each link, sign, delay and feedback claim? | \n
| Model status | \nIs the object a discussion map, measured model or simulation? | \n
| Safety | \nCould the map justify clinical, policy, employment, security or\nresource action? | \n
| Consent and rights | \nWhose knowledge, data or lived experience is used, and under what\nauthority? | \n
| Accessibility | \nCan people inspect and challenge the representation without\nspecialist software? | \n
| Validation | \nWhat observation could reveal that the representation is wrong or\nincomplete? | \n
| Appeal | \nHow can affected people correct, reject or withdraw their\ncontribution? | \n
Do not draw a system map from this chapter. Use PWR-113–116 on the\nsupplied fictional fixtures while the gate remains open.
" }, "next_gate": "External confirmation is required before higher-authority use because: CLINICAL_HIGH_RISK_OR_REGULATED_CONFIGURATION; CULTURAL_COMMUNITY_RIGHTS_OR_AFFECTED_PERSON_AUTHORITY.", "evidence_count": 2 }, "full_training_programme": false, "independently_validated": false, "publication_state": "PUBLISHED_PUBLIC_RESEARCH_EDITION__EDITORIAL_REVIEW_PENDING", "related_power_ids": [ "PWR-113", "PWR-114", "PWR-115", "PWR-116" ] }, { "power_id": "PWR-118", "learning_unit_id": "TLU-PWR-118", "title": "Expert judgement", "main_description": "Under a qualified provider, the learner completes at least 20 resolved domain cases and produces a Brier score (mean squared probability error), calibration bands, discrimination and an error review for the declared case mix.", "main_description_source": "FULL_TUTORIAL_OUTCOME", "family_id": "FAM-15", "family": "Reasoning, Judgement & Strategy", "superdomain": "Cognition & Learning", "canonical_route": "/powers/pwr-118/", "treatment": "SPECIALIST_PROVIDER_ROUTE", "treatment_label": "Full supervised tutorial", "treatment_boundary": "Titan teaches the complete method; a qualified person controls the parts that require supervision, clearance, specialist equipment, load, dose or progression.", "tutorial_route": "/tutorials/pwr-118/", "governed_lesson_route": null, "self_attempt_status": "PROHIBITED_WITHOUT_QUALIFIED_SUPERVISION", "gold_pathway_ids": [ "G-CUR-011" ], "route_membership": { "kind": "GOLD_PATHWAY", "id": "G-CUR-011", "coverage_status": "EXACT_ONCE" }, "source_authority_tier": "G4", "source_build_state": "EXTERNAL_PROVIDER_ROUTE", "source_instructional_route": "LEARN_ELSEWHERE_TRACK_WITH_TITAN", "source_count": 6, "research_depth": "DEEP", "risk_level": "HIGH", "prerequisite_status": "QUALIFIED_PROVIDER_DETERMINES", "learning_route": { "mode": "FULL_SUPERVISED_TUTORIAL", "label": "Learn expert judgement step by step", "summary": "Under a qualified provider, the learner completes at least 20 resolved domain cases and produces a Brier score (mean squared probability error), calibration bands, discrimination and an error review for the declared case mix.", "steps": [ [ "Get ready", "Provider verifies scope, confidentiality, case representativeness and legitimate use." ], [ "Learn the method", "7 concrete steps teach the permitted method from start to finish." ], [ "See right and wrong", "4 comparisons show correct or safer execution beside common wrong or riskier choices." ], [ "Practise", "The provider schedules fresh resolved blocks until the sample is adequate and feedback remains representative. Live or operational cases are not used for unsupervised practice. Retest after delay and whenever the case mix, model or domain changes." ], [ "Check progress", "For each resolved case calculate (p−o)² using forecast p on 0–1 and outcome o in {0,1}; average across cases for the Brier score. For each predeclared bin report mean p, occurred/total and their gap. Report mean p for occurred versus non-occurred cases, case count, base rate and missing outcomes." ] ], "practical_authority": false, "provider_required": true, "next_action_route": "/tutorials/pwr-118/" }, "path_builder": { "selectable": true, "completion_allowed": true, "warning": "Titan teaches the complete method; a qualified person controls the parts that require supervision, clearance, specialist equipment, load, dose or progression." }, "full_tutorial": { "version": "3.0", "authorship": "POWER_SPECIFIC_FULL_TUTORIAL", "tutorial_mode": "SUPERVISED", "promise": "Expert judgement is domain-specific performance in a feedback environment. A qualified domain expert selects representative resolved cases, protects sensitive information, defines the outcome and teaches probability forecasts. The learner commits a probability before feedback, then checks calibration—whether 70% forecasts occur about 70% of the time—and discrimination—whether higher probabilities went to events that happened. Credentials, confidence and eloquence are not substituted for resolved accuracy.", "power_id": "PWR-118", "title": "Expert judgement", "lesson_type": "SUPERVISED", "headline": "Calibrate domain forecasts against resolved cases under expert supervision", "plain_english_summary": "Expert judgement is domain-specific performance in a feedback environment. A qualified domain expert selects representative resolved cases, protects sensitive information, defines the outcome and teaches probability forecasts. The learner commits a probability before feedback, then checks calibration—whether 70% forecasts occur about 70% of the time—and discrimination—whether higher probabilities went to events that happened. Credentials, confidence and eloquence are not substituted for resolved accuracy.", "outcome": "Under a qualified provider, the learner completes at least 20 resolved domain cases and produces a Brier score (mean squared probability error), calibration bands, discrimination and an error review for the declared case mix.", "authority": { "learner_may": [ "State independent probability judgements, rationales, uncertainty and conflicts.", "Use de-identified training cases selected by the provider." ], "qualified_person_required_for": [ "Defining domain scope and ground truth, selecting cases, protecting data, teaching standards and judging readiness for consequential work.", "Any clinical, legal, engineering, financial, intelligence or safety-critical application." ], "never_do": [ "Use practice forecasts to make live consequential decisions or present oneself as qualified.", "Copy AI or supervisor advice before the independent forecast or hide overrides and conflicts." ] }, "materials": [ "Qualified domain instructor, 20–40 representative resolved and de-identified cases and outcome key.", "Probability scale, rationale sheet, calculator or scoring tool and calibration chart.", "Declared domain, case-mix, conflict, AI/version and appeal record." ], "before_you_start": [ "Provider verifies scope, confidentiality, case representativeness and legitimate use.", "Define the binary or categorical outcome and the resolution date before any forecast.", "Agree that every case receives a probability, not only memorable successes." ], "steps": [ { "title": "Lock domain and case mix", "instruction": "Name the exact task, population, time horizon and exclusions; the provider samples resolved cases from that frame.", "reason": "Expertise can disappear outside its domain or on a selective case set.", "success_check": "The case list matches the written inclusion rule." }, { "title": "Forecast independently", "instruction": "For each case, record a probability from 0 to 100 before seeing the outcome, peer view or AI advice.", "reason": "Independent commitment preserves the learner’s judgement for calibration.", "success_check": "A timestamped probability exists for every case." }, { "title": "Write diagnostic reasons", "instruction": "List the base rate, two case-specific cues and one reason the forecast could fail.", "reason": "Reasons expose whether confidence comes from relevant information or persuasive story.", "success_check": "Each forecast has base rate, cues and counterargument." }, { "title": "Reveal and score", "instruction": "After the block, reveal outcomes. Convert a forecast q% to p=q/100 and code the outcome o as 1 when it occurred or 0 when it did not. For each case calculate (p−o)²; the Brier score is the sum of those errors divided by the number of resolved cases.", "reason": "A proper score rewards probability accuracy across all outcomes.", "success_check": "Every valid case contributes to the declared score." }, { "title": "Compare with a simple benchmark", "instruction": "Score the same cases using the historical base rate or another provider-approved simple rule, then compare it with the learner without changing the case set.", "reason": "Expert judgement adds value only if it can be separated from an appropriate baseline, not merely from guessing.", "success_check": "The record shows learner and benchmark scores on identical cases and names where the learner helped or hurt." }, { "title": "Check calibration and discrimination", "instruction": "Use the predeclared probability bands. In each band, average the forecast probabilities and separately divide occurred outcomes by resolved cases; their gap shows calibration. For discrimination, compare the mean forecast assigned to occurred cases with the mean assigned to non-occurred cases.", "reason": "Calibration and discrimination are distinct qualities.", "success_check": "The chart shows both reliability by bin and case separation." }, { "title": "Repair and retest", "instruction": "The provider classifies base-rate neglect, cue misuse, overconfidence or data leakage, teaches one correction and supplies a fresh matched case block.", "reason": "Specific feedback can improve a component without claiming generic expertise.", "success_check": "The retest preserves case mix and documents one targeted repair." } ], "worked_example": { "scenario": "A qualified meteorological trainer gives a learner 20 archived, region-matched forecasts of measurable rain by the next day.", "walkthrough": [ "They define rain as at least the official recorded threshold at the named station and exclude severe-weather operations.", "Elena records a probability for every case before seeing outcome or model forecast.", "For one case she uses a 30% base rate, moisture cues and the counterargument that the front may stall, then forecasts 60%.", "Rain occurs on the 60% case, so she converts 60% to 0.60 and records (0.60−1)² = 0.16; she repeats that calculation for every resolved case.", "Her 20-case mean is 0.21 versus 0.24 for the 30% base-rate benchmark; in her 70–89% bin the mean forecast is 0.78 but only 0.60 of cases occur.", "The trainer identifies high-bin overconfidence, teaches a base-rate anchor and gives 20 fresh archived cases without calling the first difference proof of improvement." ], "result": "Elena can reproduce the Brier calculation, compare it on the same cases with the benchmark and identify a 0.18 high-bin calibration gap. Those descriptive results belong to this region, horizon and case mix and do not qualify her for live warnings or another domain." }, "right_vs_wrong": [ { "situation": "Case selection", "right": "Use a declared representative resolved sample.", "wrong": "Choose famous cases where the expert was right.", "why": "Selection bias can create false expertise." }, { "situation": "Commitment", "right": "Forecast before outcome, peer or AI view.", "wrong": "Adjust the remembered forecast after resolution.", "why": "Hindsight destroys calibration evidence." }, { "situation": "Metric", "right": "Score all probabilities against outcomes.", "wrong": "Judge confidence, credentials or eloquent rationale.", "why": "Persuasion can diverge from accuracy." }, { "situation": "Transfer", "right": "Retest the same domain and label new domains separately.", "wrong": "Assume calibrated weather judgement transfers to finance or medicine.", "why": "Expert performance is domain- and feedback-specific." } ], "common_mistakes": [ { "mistake": "Only confident cases receive forecasts.", "fix": "Require an entry for every sampled case." }, { "mistake": "Brier score is calculated after rounding probabilities to yes/no.", "fix": "Use the original 0–1 probability for squared error." }, { "mistake": "Wide calibration bins hide overconfidence.", "fix": "Predeclare bins and report counts in each." }, { "mistake": "AI advice contaminates the baseline.", "fix": "Capture an independent forecast first and log any later model/version and update." } ], "practice": { "first_session": [ "Provider defines domain and resolution rule.", "Complete five familiarisation cases.", "Forecast a 20-case block independently.", "Score calibration and discrimination.", "Review one error class and set a matched retest." ], "repeat_plan": "The provider schedules fresh resolved blocks until the sample is adequate and feedback remains representative. Live or operational cases are not used for unsupervised practice. Retest after delay and whenever the case mix, model or domain changes.", "progress_when": [ "Calibration improves across enough provider-approved cases.", "Discrimination improves without cherry-picking or narrower case mix.", "The learner states scope, uncertainty, conflicts and escalation accurately." ], "do_not_progress_when": [ "Ground truth is ambiguous or outcomes are selectively missing.", "Practice cases leak into live consequential decisions.", "Improvement depends on seeing adviser or AI output before commitment." ] }, "self_check": [ "What exact domain and case mix are scored?", "Was every probability committed before feedback?", "Can you distinguish calibration from discrimination?", "Are conflicts and AI/version visible?" ], "measurement": { "primary": "Provider-reviewed probabilistic accuracy on resolved domain cases.", "how": "For each resolved case calculate (p−o)² using forecast p on 0–1 and outcome o in {0,1}; average across cases for the Brier score. For each predeclared bin report mean p, occurred/total and their gap. Report mean p for occurred versus non-occurred cases, case count, base rate and missing outcomes.", "good_result": "A fresh matched block shows provider-defined improvement beyond sampling noise without narrowed case selection or hidden assistance.", "does_not_prove": "It does not establish qualification, ethical authority, cross-domain expertise or safe live decision-making." }, "stop_and_get_help": [ "Stop if a training answer could affect a live person, asset or safety outcome.", "Stop for confidentiality breach, unclear ground truth, conflict of interest or unlogged AI advice.", "Route high-stakes judgements through the accountable qualified system, including override and appeal." ], "accessibility": [ "Use plain-language cases, screen-reader-compatible probability controls and extended equal time.", "Allow a scribe who records without advising.", "Measure performance with declared supports rather than removing them." ], "evidence_notes": [ { "claim": "Geopolitical forecasting research identified task-specific drivers of prediction accuracy and calibration rather than credentials alone.", "source_title": "The psychology of intelligence analysis: Drivers of prediction accuracy in world politics", "source_url": "https://pubmed.ncbi.nlm.nih.gov/25581088/", "source_kind": "PRIMARY_RESEARCH" }, { "claim": "NIST AI RMF treats human–AI performance as a governed, measured configuration with risks, not as automatic expert enhancement.", "source_title": "Artificial Intelligence Risk Management Framework (AI RMF 1.0)", "source_url": "https://www.nist.gov/itl/ai-risk-management-framework", "source_kind": "OFFICIAL_GUIDANCE" } ], "limits": [ "Resolved-case calibration belongs to the named domain and case mix.", "A low score does not itself grant professional authority.", "AI, credentials and persuasive reasons remain inputs to audit, not substitutes for outcomes." ], "orientation": { "bounded_definition": "Capability to develop or express expert judgement in a declared context without inheriting broader claims.", "evidence_summary": "Expert judgment is real but conditional: accuracy, calibration, domain, incentives and tools all matter.", "supportable_public_claim": "Expert judgment can be assessed and sometimes improved within a defined domain, feedback environment and accountable decision system.", "measurement_boundary": "Declare domain, case mix, outcome delay, base rates, calibration, discrimination, conflicts, AI/version, overrides and appeals; credentials and confidence are not outcome accuracy.", "myth_to_metric": { "myth": "Expert intuition never fails", "metric": "Calibration, discrimination and consequential outcomes on a declared case set", "boundary": "Credentials, eloquence or one domain score cannot certify universal judgment." }, "limiting_findings": [ "Confidence and eloquence can increase persuasion independently of forecast accuracy.", "Incorrect AI advice reduced human accuracy, and interface protections were incomplete and configuration-specific." ], "prohibited_claims": [ "expert intuition is always right", "debias the expert", "AI plus expert cannot fail", "one score identifies the best decision-maker" ] }, "gold_source_lesson": { "curriculum_id": "G-CUR-011", "source_heading": "10. PWR-118 — Track expert judgement through a legitimate external route", "source_html_sha256": "3157f7c4a88adc48f37a27ab1be26e02fab5d14bcd66e121e9ab32effb63fa98", "html": "Expert judgement is domain-specific performance inside a feedback\nenvironment. Credentials, experience, confidence and eloquence may be\nrelevant signals, but none alone demonstrates calibration,\ndiscrimination, ethical authority or current competence.
\nAuthority state: G4 SPECIALIST_PATHWAY ·\nEXTERNAL_PROVIDER_ROUTE
\nTitan role: explain, help select a legitimate route and\ntrack outcomes
\nTitan does not: teach expert judgement or provide a\npublic self-test
| Dimension | \nSelection question | \n
|---|---|
| Domain | \nWhat exact task and case mix define the claimed expertise? | \n
| Qualification | \nWhich credential, supervised experience or institutional role is\nrelevant here? | \n
| Outcomes | \nAre judgements compared with resolved outcomes, suitable standards\nor accountable peer review? | \n
| Feedback | \nIs it timely, representative and resistant to cherry-picking? | \n
| Calibration | \nAre confidence and accuracy compared over enough cases? | \n
| Conflicts | \nWho pays, benefits, bears risk or controls the evaluation? | \n
| AI or device | \nWhich model/version/configuration is used, and what happens when it\nis wrong or unavailable? | \n
| Governance | \nWho can override, audit, appeal and investigate harm? | \n
| Accessibility | \nWhat support is available without changing the claimed task? | \n
| Currency | \nWhen was the route last reviewed against current practice and\noutcomes? | \n
Record the provider or system, the declared task, support\nconfiguration, direct result, adverse effects or near misses, delayed\nfollow-up, real-world transfer, version changes and retirement criteria.\nA tracking record is not an endorsement.
\nForecasting and calibration studies show that selected judgement\ncomponents can improve, but effects vary by task. Commercial calibration\ntraining shifted confidence differently across two tasks in professional\nanalysts; improvement did not generalise uniformly. Persuasive\nrationales can be disconnected from accuracy, and wrong human or AI\nadvice can reduce expert performance. Titan therefore withholds a\ngeneric “become an expert” protocol.
" }, "next_gate": "External confirmation is required before higher-authority use because: CLINICAL_HIGH_RISK_OR_REGULATED_CONFIGURATION; SAFETY_LEGITIMACY_RESTRICTED.", "evidence_count": 6 }, "full_training_programme": false, "independently_validated": false, "publication_state": "PUBLISHED_PUBLIC_RESEARCH_EDITION__EDITORIAL_REVIEW_PENDING", "related_power_ids": [ "PWR-113", "PWR-114", "PWR-115", "PWR-116" ] }, { "power_id": "PWR-119", "learning_unit_id": "TLU-PWR-119", "title": "Decision under uncertainty", "main_description": "The learner produces a traceable fictional decision record with options, probability ranges, consequences, protected constraints, sensitivity analysis, threshold and update rule.", "main_description_source": "FULL_TUTORIAL_OUTCOME", "family_id": "FAM-15", "family": "Reasoning, Judgement & Strategy", "superdomain": "Cognition & Learning", "canonical_route": "/powers/pwr-119/", "treatment": "EVIDENCE_REVIEW_ROUTE", "treatment_label": "Full low-stakes tutorial", "treatment_boundary": "Titan teaches a concrete low-stakes method step by step while keeping evidence and transfer claims bounded.", "tutorial_route": "/tutorials/pwr-119/", "governed_lesson_route": null, "self_attempt_status": "PERMITTED_INSIDE_FULL_TUTORIAL_LIMITS", "gold_pathway_ids": [ "G-CUR-011" ], "route_membership": { "kind": "GOLD_PATHWAY", "id": "G-CUR-011", "coverage_status": "EXACT_ONCE" }, "source_authority_tier": "G1", "source_build_state": "TARGETED_REVIEW_REQUIRED", "source_instructional_route": "SELF_GUIDED_TUTORIAL", "source_count": 6, "research_depth": "DEEP", "risk_level": "HIGH", "prerequisite_status": "NONE_FOR_READING__NO_PRACTICE_AUTHORITY", "learning_route": { "mode": "FULL_SELF_GUIDED_TUTORIAL", "label": "Learn decision under uncertainty step by step", "summary": "The learner produces a traceable fictional decision record with options, probability ranges, consequences, protected constraints, sensitivity analysis, threshold and update rule.", "steps": [ [ "Get ready", "Write FICTIONAL PRACTICE at the top." ], [ "Learn the method", "7 concrete steps teach the permitted method from start to finish." ], [ "See right and wrong", "4 comparisons show correct or safer execution beside common wrong or riskier choices." ], [ "Practise", "Use one new fictional case weekly for four weeks, alternating cost, time and non-numeric consequences. On the fourth case, have another learner audit the authority, constraints and sensitivity rather than agree with the choice." ], [ "Check progress", "Check owner, options, mutually exclusive states, probability range and source, consequences, affected roles, constraints, reversibility, threshold and update rule. Reproduce each expected-cost row as Σ probability(state) × cost(option,state) at both range ends and verify probabilities sum to 1." ] ], "practical_authority": true, "provider_required": false, "next_action_route": "/tutorials/pwr-119/" }, "path_builder": { "selectable": true, "completion_allowed": true, "warning": "Titan teaches a concrete low-stakes method step by step while keeping evidence and transfer claims bounded." }, "full_tutorial": { "version": "3.0", "authorship": "POWER_SPECIFIC_FULL_TUTORIAL", "tutorial_mode": "SELF_GUIDED", "promise": "A decision under uncertainty connects options with possible states, probability ranges, consequences, values, rights, reversibility and accountability. This lesson uses a fictional low-stakes venue choice. The learner predeclares objectives and non-negotiable constraints, estimates ranges, calculates one expected-cost comparison, checks sensitivity and records what new fact would change the choice. The worksheet must not choose a real clinical, legal, political, employment, financial or safety option.", "power_id": "PWR-119", "title": "Decision under uncertainty", "lesson_type": "SELF_GUIDED", "headline": "Compare options on a fictional case using ranges, values and a decision threshold", "plain_english_summary": "A decision under uncertainty connects options with possible states, probability ranges, consequences, values, rights, reversibility and accountability. This lesson uses a fictional low-stakes venue choice. The learner predeclares objectives and non-negotiable constraints, estimates ranges, calculates one expected-cost comparison, checks sensitivity and records what new fact would change the choice. The worksheet must not choose a real clinical, legal, political, employment, financial or safety option.", "outcome": "The learner produces a traceable fictional decision record with options, probability ranges, consequences, protected constraints, sensitivity analysis, threshold and update rule.", "authority": { "learner_may": [ "Use supplied fictional or personally inconsequential cases.", "Decline to optimise values that should not be traded away." ], "qualified_person_required_for": [ "Real clinical, legal, fiduciary, employment, political, security or safety-critical decisions.", "Decisions affecting other people without their legitimate authority and participation." ], "never_do": [ "Convert the fictional result into a real high-stakes choice.", "Let expected value erase rights, consent, distribution of harm or accountable review." ] }, "materials": [ "Exact fictional venue card: accessible indoor room costs £180; courtyard costs £0 if dry and £500 if rain cancels; rain range is 30–50%; both options must retain the supplied step-free route. Two update cards say 25% and 45%, both with no access change; a helper chooses one face down and reveals it only after the switching threshold is committed.", "Option–state matrix, calculator and probability-range worksheet.", "Decision log with owner, affected roles, reversal and update trigger." ], "before_you_start": [ "Write FICTIONAL PRACTICE at the top.", "Name the decision owner and protected constraints supplied by the case.", "Keep probabilities as ranges when evidence does not justify a point estimate." ], "steps": [ { "title": "Frame the decision", "instruction": "State the question, decision time, owner, affected roles and what success means.", "reason": "A clear frame prevents silent changes in objective or authority.", "success_check": "One sentence names owner, options and deadline." }, { "title": "List options and protected constraints", "instruction": "Write every available option and mark any accessibility, consent or safety requirement that no score may override.", "reason": "Some values are constraints, not prices in an average.", "success_check": "Each option is checked against non-negotiable conditions first." }, { "title": "Define uncertain states", "instruction": "List mutually distinct future states and probability ranges using the supplied base rate and evidence.", "reason": "Explicit states prevent vague best-case storytelling.", "success_check": "Ranges are bounded and their assumptions are cited." }, { "title": "Map consequences", "instruction": "For each option–state pair, record cost, delay, burden and who experiences it. Keep unlike outcomes in separate columns.", "reason": "A single total can hide distribution and value conflict.", "success_check": "Every cell has concrete consequences and affected role." }, { "title": "Classify reversibility and information value", "instruction": "Mark which fictional options can be trialled, delayed or reversed and what useful information each would produce before commitment. Record any cost of waiting.", "reason": "A reversible step can preserve options, but delay can also impose a real consequence.", "success_check": "Each option has a reversal route, information gain and waiting cost or is explicitly marked irreversible." }, { "title": "Calculate and test sensitivity", "instruction": "For each option, calculate expected cost by multiplying each state probability by that option’s cost in the state and adding the products: Σ probability(state) × cost(option,state). Use probabilities as decimals that sum to 1. Repeat at the low and high ends of the supplied range; do not average protected constraints.", "reason": "Sensitivity shows whether the choice depends on a fragile estimate.", "success_check": "The record states whether the preferred option changes across the range." }, { "title": "Choose a threshold and update rule", "instruction": "Write the current fictional choice, the reason, what probability or fact would switch it and who would review it.", "reason": "A predeclared threshold supports proportionate updating rather than hindsight.", "success_check": "The final line includes choice, threshold, trigger and reviewer." } ], "worked_example": { "scenario": "A fictional club must choose an accessible indoor room for £180 or a free courtyard for an event; forecast rain is 30–50%, and cancellation costs £500.", "walkthrough": [ "Omar names the fictional coordinator as owner and wheelchair access as non-negotiable for both options.", "He lists indoor and courtyard and removes any courtyard setup that lacks the supplied accessible route.", "He defines rain and no-rain states with the 30–50% range.", "At 40%, expected cancellation cost for the courtyard is £200, above the £180 room cost; at 30% it is £150.", "He records that the choice switches at 180/500=36%; when the hidden card changes rain to 25%, he calculates £125 for courtyard cancellation, confirms the step-free constraint still holds and routes the possible switch to the fictional owner for review rather than acting automatically." ], "result": "Omar shows a threshold-sensitive fictional decision while preserving access as a constraint. The numerical result is not a recommendation for a real event." }, "right_vs_wrong": [ { "situation": "Probability", "right": "Use a range tied to the supplied base rate.", "wrong": "Choose the most convenient point estimate.", "why": "False precision can determine the answer invisibly." }, { "situation": "Values", "right": "Keep rights and access as constraints.", "wrong": "Assign them a small cost and average them away.", "why": "Not every legitimate value is tradable." }, { "situation": "Sensitivity", "right": "Recalculate at both range ends.", "wrong": "Report one expected value as the optimal answer.", "why": "A fragile result may flip with plausible evidence." }, { "situation": "Authority", "right": "Keep the result inside the fictional case.", "wrong": "Apply the worksheet to another person’s real treatment or job.", "why": "A calculation cannot grant decision authority." } ], "common_mistakes": [ { "mistake": "States overlap or omit an important possibility.", "fix": "Make states mutually distinguishable and add a residual/unknown row." }, { "mistake": "Probabilities do not match the same time horizon.", "fix": "Write the event and deadline beside every range." }, { "mistake": "All consequences are collapsed into money.", "fix": "Keep burden, access, reversibility and affected roles in separate fields." }, { "mistake": "The update trigger is written after new evidence arrives.", "fix": "Predeclare the switching threshold before revealing the update card." } ], "practice": { "first_session": [ "Frame one supplied fictional decision.", "Build the option–state matrix.", "Calculate a range-sensitive comparison.", "Apply protected constraints.", "Reveal one update card and follow the predeclared rule." ], "repeat_plan": "Use one new fictional case weekly for four weeks, alternating cost, time and non-numeric consequences. On the fourth case, have another learner audit the authority, constraints and sensitivity rather than agree with the choice.", "progress_when": [ "All options and states are explicit.", "The choice is stable or honestly labelled sensitive across the range.", "Updates follow a predeclared trigger." ], "do_not_progress_when": [ "A real consequential choice enters the worksheet.", "Affected people or protected constraints are missing.", "The learner treats one numerical model as the only legitimate value system." ] }, "self_check": [ "Who owns the fictional decision?", "Which constraint cannot be averaged away?", "Does the choice flip within the probability range?", "What exact evidence triggers review?" ], "measurement": { "primary": "Completeness and internal consistency of a fictional uncertainty decision record.", "how": "Check owner, options, mutually exclusive states, probability range and source, consequences, affected roles, constraints, reversibility, threshold and update rule. Reproduce each expected-cost row as Σ probability(state) × cost(option,state) at both range ends and verify probabilities sum to 1.", "good_result": "All 12 fields are present, calculations reproduce, protected constraints are honoured and the update follows the declared trigger.", "does_not_prove": "It does not identify an objectively optimal real choice, legitimate values, professional advice or safe high-stakes action." }, "stop_and_get_help": [ "Stop if the case becomes real, time-critical or consequential for another person.", "Stop if a model or AI supplies untraceable probabilities, hidden values or version-dependent advice.", "Route real high-stakes decisions to the legitimate accountable authority with appeal and affected-person participation." ], "accessibility": [ "Use a plain-language matrix with icons and spoken probability ranges.", "Allow calculator, spreadsheet or scribe support with assumptions visible.", "Separate one dimension per page to reduce cognitive load." ], "evidence_notes": [ { "claim": "Incorrect AI advice reduced human accuracy in a human-in-the-loop process, so advice source and version must remain visible.", "source_title": "The impact of AI errors in a human-in-the-loop process", "source_url": "https://doi.org/10.1186/s41235-023-00529-3", "source_kind": "PRIMARY_RESEARCH" }, { "claim": "NIST AI RMF requires risk, context, governance and measurement around AI-supported decisions rather than assuming neutral optimisation.", "source_title": "Artificial Intelligence Risk Management Framework (AI RMF 1.0)", "source_url": "https://www.nist.gov/itl/ai-risk-management-framework", "source_kind": "OFFICIAL_GUIDANCE" } ], "limits": [ "Expected value addresses only declared quantifiable outcomes.", "Probability ranges and consequences can be wrong or contested.", "Fictional competence does not transfer automatically to real authority or high stakes." ], "orientation": { "bounded_definition": "Capability to develop or express decision under uncertainty in a declared context without inheriting broader claims.", "evidence_summary": "Good decisions under uncertainty are built by a configured system—not by confidence, a single formula or an AI answer.", "supportable_public_claim": "Selected components of decision-making under uncertainty can improve, but outcomes depend on the person, information, values, interface, institution and stakes.", "measurement_boundary": "Declare options, values, probabilities, data, AI/version, timing, incentives, affected groups, process, outcome and appeal; accuracy is not the only legitimate value.", "myth_to_metric": { "myth": "Always choose the optimal answer", "metric": "Decision process, calibration, value alignment, harms and outcomes under declared uncertainty", "boundary": "No laboratory task or model output can determine universally correct high-stakes choices." }, "limiting_findings": [ "Incorrect AI advice reduced accuracy even in human-in-the-loop designs.", "A human-first interface reduced but did not eliminate AI influence, and one forcing design reduced usability." ], "prohibited_claims": [ "make the optimal decision every time", "remove uncertainty", "trust the algorithm", "decision score overrides lived experience" ] }, "gold_source_lesson": { "curriculum_id": "G-CUR-011", "source_heading": "11. PWR-119 — Make uncertainty visible without manufacturing an “optimal” answer", "source_html_sha256": "97984ecfde987b3950ed3eb340b120b11b5a73fce2cfc4ee23b3f85f9f4592bf", "html": "A decision under uncertainty connects options with evidence,\nprobabilities, values, rights, distribution of benefit and harm,\nreversibility and accountability. Expected value may help with one\ndeclared objective; it cannot silently decide whose values count.
\nAuthority state: TARGETED_REVIEW_REQUIRED ·\nNOT_YET_AUTHORISED
\nOpen reviews: clinical-scope; legitimacy; safety
Human–AI experiments repeatedly show that incorrect advice can reduce\naccuracy, including among domain professionals. Explanations do not\nreliably prevent overreliance. Some interface designs reduce a specific\nerror but add effort, reduce use of correct advice or work only in a\nparticular task. A decision aid must therefore be evaluated as a\nconfigured socio-technical system, not as a neutral answer box.
\n| Review dimension | \nRequired declaration | \n
|---|---|
| Decision owner | \nWho has legitimate authority, and who is affected? | \n
| Options | \nWhich options are available, unavailable or imposed? | \n
| Evidence | \nWhat data, base rates, uncertainty and missingness are present? | \n
| Values | \nWhich outcomes matter, to whom and with what disagreements? | \n
| Rights | \nWhat may not be traded away by a score? | \n
| Reversibility | \nCan the choice be paused, trialled, appealed or reversed? | \n
| Advice source | \nHuman, institution, model/version or mixed system | \n
| Failure modes | \nError, bias, automation dependence, conflict, delay and\ndistributional harm | \n
| Process outcome | \nWas the process fair, reviewable and consented? | \n
| Substantive outcome | \nWhat happened, when, to whom and with what uncertainty? | \n
Do not use this chapter to choose a real option. For authorised\nlearning, practise PWR-115 on fictional events and PWR-116 on fictional\ncausal claims without converting the result into action.
" }, "next_gate": "External confirmation is required before higher-authority use because: CLINICAL_HIGH_RISK_OR_REGULATED_CONFIGURATION; SAFETY_LEGITIMACY_RESTRICTED.", "evidence_count": 6 }, "full_training_programme": false, "independently_validated": false, "publication_state": "PUBLISHED_PUBLIC_RESEARCH_EDITION__EDITORIAL_REVIEW_PENDING", "related_power_ids": [ "PWR-113", "PWR-114", "PWR-115", "PWR-116" ] }, { "power_id": "PWR-120", "learning_unit_id": "TLU-PWR-120", "title": "Strategic planning", "main_description": "The learner creates a fictional strategy with a measurable outcome, backward milestones, dependencies, assumptions, one disruption rehearsal, review triggers and a retirement rule.", "main_description_source": "FULL_TUTORIAL_OUTCOME", "family_id": "FAM-15", "family": "Reasoning, Judgement & Strategy", "superdomain": "Cognition & Learning", "canonical_route": "/powers/pwr-120/", "treatment": "EVIDENCE_REVIEW_ROUTE", "treatment_label": "Full low-stakes tutorial", "treatment_boundary": "Titan teaches a concrete low-stakes method step by step while keeping evidence and transfer claims bounded.", "tutorial_route": "/tutorials/pwr-120/", "governed_lesson_route": null, "self_attempt_status": "PERMITTED_INSIDE_FULL_TUTORIAL_LIMITS", "gold_pathway_ids": [ "G-CUR-011" ], "route_membership": { "kind": "GOLD_PATHWAY", "id": "G-CUR-011", "coverage_status": "EXACT_ONCE" }, "source_authority_tier": "G1", "source_build_state": "TARGETED_REVIEW_REQUIRED", "source_instructional_route": "SELF_GUIDED_TUTORIAL", "source_count": 3, "research_depth": "FOCUSED", "risk_level": "HIGH", "prerequisite_status": "NONE_FOR_READING__NO_PRACTICE_AUTHORITY", "learning_route": { "mode": "FULL_SELF_GUIDED_TUTORIAL", "label": "Learn strategic planning step by step", "summary": "The learner creates a fictional strategy with a measurable outcome, backward milestones, dependencies, assumptions, one disruption rehearsal, review triggers and a retirement rule.", "steps": [ [ "Get ready", "Mark the fixture fictional and name the legitimate owner supplied by the case." ], [ "Learn the method", "9 concrete steps teach the permitted method from start to finish." ], [ "See right and wrong", "4 comparisons show correct or safer execution beside common wrong or riskier choices." ], [ "Practise", "Use three different fictional project briefs over three weeks. On the final week, another learner draws the disruption card and audits whether the trigger, authority and protected constraints survive." ], [ "Check progress", "Audit goal legitimacy, milestones, dependencies, resources, assumptions, tests, contingencies, triggers, owners, communication, outcome measures, harms and retirement rule. Separately verify every timing row by recomputing earliest finish, latest start and slack; a dependency or arithmetic error is corrected before the disruption is interpreted." ] ], "practical_authority": true, "provider_required": false, "next_action_route": "/tutorials/pwr-120/" }, "path_builder": { "selectable": true, "completion_allowed": true, "warning": "Titan teaches a concrete low-stakes method step by step while keeping evidence and transfer claims bounded." }, "full_tutorial": { "version": "3.0", "authorship": "POWER_SPECIFIC_FULL_TUTORIAL", "tutorial_mode": "SELF_GUIDED", "promise": "Strategic planning links a legitimate goal with milestones, assumptions, dependencies, resources, contingencies, execution and review. A polished plan is not the outcome. This lesson uses a fictional community-room open day and stops before real implementation. The learner works backwards, marks assumptions, assigns trigger-based contingencies, rehearses one disruption and states who could approve, change or retire the plan.", "power_id": "PWR-120", "title": "Strategic planning", "lesson_type": "SELF_GUIDED", "headline": "Backcast a fictional project, expose dependencies and rehearse one disruption", "plain_english_summary": "Strategic planning links a legitimate goal with milestones, assumptions, dependencies, resources, contingencies, execution and review. A polished plan is not the outcome. This lesson uses a fictional community-room open day and stops before real implementation. The learner works backwards, marks assumptions, assigns trigger-based contingencies, rehearses one disruption and states who could approve, change or retire the plan.", "outcome": "The learner creates a fictional strategy with a measurable outcome, backward milestones, dependencies, assumptions, one disruption rehearsal, review triggers and a retirement rule.", "authority": { "learner_may": [ "Plan supplied fictional or learner-owned inconsequential projects.", "Record affected roles and limits of personal authority." ], "qualified_person_required_for": [ "Real organisational, clinical, political, security, employment or high-resource strategy.", "Plans affecting communities or other people without legitimate participation and approval." ], "never_do": [ "Rehearse coercion, competition, surveillance or harm against real people.", "Treat plan quality as evidence of execution, legitimacy or impact." ] }, "materials": [ "Exact fictional open-day brief: Friday 15:00 event for 40 visitors; room manager owns the plan; £300 ceiling; four volunteers; 40 chairs; step-free entry and a 1.2 m clear path are hard constraints. Ground-floor room confirmation is due Wednesday 12:00; the two-hour accessible-layout check ends Thursday 10:00; the one-hour volunteer briefing ends Thursday 16:00; baseline printing arrives Friday 10:00, material staging takes three hours, and final setup takes two hours and requires staged materials plus briefing. Thus printing→staging→setup exactly fills Friday 10:00–15:00 and has zero slack. Disruption cards: lift unavailable, two volunteers withdraw, or printing arrives Friday 14:30.", "Backward milestone sheet, dependency map, assumption log and trigger table.", "A timing worksheet with planned start, duration, earliest finish, required finish, latest start and slack. For this fixed-clock fixture, calculate earliest finish = planned start + duration, latest start = required finish − duration, and slack = latest start − planned start; a zero-slack predecessor moves the event deadline if it slips.", "Version and outcome-review record." ], "before_you_start": [ "Mark the fixture fictional and name the legitimate owner supplied by the case.", "State the intended outcome, affected roles and hard access/safety constraints.", "Set a planning horizon and stop before real outreach, spending or implementation." ], "steps": [ { "title": "Define outcome and legitimacy", "instruction": "Write a measurable fictional outcome, deadline, owner, affected roles and non-goals.", "reason": "A goal can be clear yet illegitimate or overbroad.", "success_check": "The outcome includes who authorises it and what is excluded." }, { "title": "Backcast milestones", "instruction": "Start at the deadline and work backwards through the minimum observable milestones needed.", "reason": "Backward planning exposes prerequisites that forward wish lists miss.", "success_check": "Every milestone has a latest completion point and evidence." }, { "title": "Map dependencies and resources", "instruction": "For each milestone, name people, permission, material, information and predecessor tasks it relies on.", "reason": "Plans fail at interfaces and missing resources, not just intentions.", "success_check": "Every critical milestone has at least one dependency and resource." }, { "title": "Find the critical sequence", "instruction": "Fill the timing worksheet from the Friday 15:00 event backwards. For each task compute earliest finish from its planned start and duration, latest start from the successor's required time minus duration, then slack as latest start minus planned start. Trace the connected zero-slack tasks as the critical sequence.", "reason": "A list of deadlines does not show which delay actually controls delivery.", "success_check": "The sheet shows printing 10:00–10:00, staging 10:00–13:00 and setup 13:00–15:00 as a five-hour Friday chain with zero slack, while non-critical timing margins are written separately." }, { "title": "Specify each handoff", "instruction": "For every critical transition, name who produces what, who receives it, the acceptance check and what happens when the handoff is late or incomplete.", "reason": "Many strategies fail between tasks even when each task appears assigned.", "success_check": "The critical chain contains no anonymous handoff, and each receiver has an observable acceptance rule." }, { "title": "Expose assumptions", "instruction": "Write what must be true, how uncertain it is and what observation would test it.", "reason": "Invisible assumptions become surprise failures.", "success_check": "The three highest-risk assumptions have tests or review dates." }, { "title": "Build trigger contingencies", "instruction": "For each major failure branch, write an observable trigger, fallback action, decision owner and communication route.", "reason": "A contingency is useful only when its activation rule is clear.", "success_check": "At least two branches have trigger, action, owner and notice." }, { "title": "Rehearse one disruption", "instruction": "Draw a supplied disruption card, walk the plan from that point and record delays, harms, excluded people and new dependencies.", "reason": "A rehearsal tests adaptability without real-world consequences.", "success_check": "The revised version shows exactly what changed and why." }, { "title": "Separate execution and retire", "instruction": "List the direct outcome measures, burdens and harms that would be checked during execution, plus a rule for pausing or retiring the plan.", "reason": "Plan coherence cannot substitute for observed implementation.", "success_check": "The final page distinguishes plan-quality checks from outcome checks." } ], "worked_example": { "scenario": "A fictional community room plans an open day for 40 visitors, with step-free access and a £300 resource ceiling.", "walkthrough": [ "Sofia writes the fictional manager as owner, 40 accessible places as outcome and no real booking as a non-goal.", "Working backward from Friday 15:00, she places two-hour setup at 13:00–15:00 and three-hour staging at 10:00–13:00 because setup cannot start until staging ends.", "Printing arrives at 10:00, so latest start equals planned start for all three Friday tasks: 15:00 minus two hours gives 13:00 for setup, then 13:00 minus three hours gives 10:00 for staging; slack is zero at both handoffs.", "She records the Thursday 16:00 briefing as a setup predecessor with 21 elapsed hours before Friday 13:00, but does not transfer that margin to the separate printing chain.", "The printing-14:30 card leaves only 30 minutes before the event although staging plus setup still needs five hours. She marks the original outcome infeasible rather than compressing the 1.2 m access check or pretending parallel work removes a dependency.", "Her trigger row says ‘printing absent Friday 10:00 → notify room manager → use a pre-authorised no-print paper fixture if one exists; otherwise retire the open-day version.’ The fictional manager, not Sofia, owns that scope decision.", "She keeps the baseline schedule beside the disrupted version and records missed deadline, protected access constraint and owner decision as separate fields." ], "result": "The calculation exposes a five-hour requirement against a 30-minute window, so Sofia can explain exactly why the original Friday plan must change or retire. The exercise has not implemented an event or demonstrated strategic impact." }, "right_vs_wrong": [ { "situation": "Goal", "right": "Name owner, affected roles and non-goals.", "wrong": "Optimise attendance without asking who has authority or access.", "why": "A clear metric can still encode an illegitimate goal." }, { "situation": "Milestone", "right": "Attach evidence and deadline.", "wrong": "Write “prepare logistics.”", "why": "Vague activity cannot be tracked or backcast." }, { "situation": "Contingency", "right": "Use an observable trigger and named owner.", "wrong": "Say “be flexible if things go wrong.”", "why": "Unspecified flexibility arrives too late." }, { "situation": "Evaluation", "right": "Measure execution, outcome, burden and harm.", "wrong": "Declare success because the plan document is complete.", "why": "Planning quality is not implementation or impact." } ], "common_mistakes": [ { "mistake": "Assumptions are written as facts.", "fix": "Move uncertain dependencies to the assumption log with a test." }, { "mistake": "Every task is called critical.", "fix": "Mark only tasks that change the deadline or protected constraint." }, { "mistake": "Fallback harms the excluded group.", "fix": "Run each contingency through affected-role and access checks." }, { "mistake": "The old plan is overwritten.", "fix": "Keep version number, disruption, author and change reason." } ], "practice": { "first_session": [ "Frame Friday 15:00, 40 accessible places, £300, the room manager and the no-booking boundary.", "Backcast room confirmation, layout check, volunteer briefing and material staging from their supplied deadlines.", "Draw predecessors, four-volunteer and room dependencies; mark the critical sequence and any genuine slack.", "Write trigger–fallback–owner–notice rows for lift loss and volunteer withdrawal without weakening the 1.2 m path.", "Draw one disruption card, update the dated version and test whether the Friday 15:00 outcome must hold, change or retire." ], "repeat_plan": "Use three different fictional project briefs over three weeks. On the final week, another learner draws the disruption card and audits whether the trigger, authority and protected constraints survive.", "progress_when": [ "Milestones are observable and correctly ordered.", "High-risk assumptions have tests or holds.", "A disruption produces a traceable revision without violating protected constraints." ], "do_not_progress_when": [ "The plan affects real people, funds or institutional action.", "Stakeholder labels substitute for actual participation.", "The learner cannot name a pause or retirement condition." ] }, "self_check": [ "Can you name the fictional room manager, Friday 15:00 deadline, 40-place outcome, £300 ceiling and 1.2 m access constraint?", "Which predecessor must finish before Thursday’s layout check, and which delay would move the Friday event rather than consume slack?", "When the lift-unavailable card appears, does the plan select an accessible ground-floor room or retire instead of asking visitors to cope?", "Who receives the late-material notice at 14:30, what acceptance check remains, and which retirement trigger prevents an untraceable last-minute workaround?" ], "measurement": { "primary": "Audit completeness and disruption response of one fictional strategic plan.", "how": "Audit goal legitimacy, milestones, dependencies, resources, assumptions, tests, contingencies, triggers, owners, communication, outcome measures, harms and retirement rule. Separately verify every timing row by recomputing earliest finish, latest start and slack; a dependency or arithmetic error is corrected before the disruption is interpreted.", "good_result": "All 13 features are present and a supplied disruption leads to a consistent versioned adaptation without breaching a protected constraint.", "does_not_prove": "It does not show implementation, causal impact, leadership ability or legitimate authority over a real system." }, "stop_and_get_help": [ "Stop before any real spending, outreach, staffing, surveillance or operational action.", "Stop if a real affected group is represented without participation or a protected right is traded away.", "Seek accountable organisational, legal, safety and affected-person review before a real strategy." ], "accessibility": [ "Use a linear milestone table instead of a network diagram.", "Offer easy-read task cards, icons and a narrated dependency review.", "Build access needs into hard constraints rather than treating them as late accommodations." ], "evidence_notes": [ { "claim": "In an obstetric simulation programme, only 58.8% of local strategic goals were achieved and achievement was not associated with knowledge, self-efficacy or teamwork scores.", "source_title": "Team training in obstetric and neonatal emergencies using highly realistic simulation in Mexico: impact on process indicators", "source_url": "https://pubmed.ncbi.nlm.nih.gov/25409895/", "source_kind": "PRIMARY_RESEARCH" }, { "claim": "NIST AI RMF emphasises governed risk management for socio-technical systems, relevant when a plan includes AI or automated advice.", "source_title": "Artificial Intelligence Risk Management Framework (AI RMF 1.0)", "source_url": "https://www.nist.gov/itl/ai-risk-management-framework", "source_kind": "OFFICIAL_GUIDANCE" } ], "limits": [ "The exercise is fictional and ends before execution.", "Good planning cannot guarantee legitimate goals, stable conditions or desired outcomes.", "Real strategies require participation, authority, monitoring and appeal." ], "orientation": { "bounded_definition": "Capability to develop or express strategic planning in a declared context without inheriting broader claims.", "evidence_summary": "A plan is not a capability until people can execute, adapt and learn from it under real constraints.", "supportable_public_claim": "Teams and leaders can improve selected planning processes, while durable strategic capability and causal impact remain context-specific.", "measurement_boundary": "Declare goal legitimacy, assumptions, dependencies, resources, contingencies, execution trace, adaptation, outcomes, harms and affected groups; plan quality is not success.", "myth_to_metric": { "myth": "Write the winning master plan", "metric": "Goal attainment, adaptation quality, harms and resource use under declared constraints", "boundary": "A persuasive plan or simulation cannot guarantee execution, legitimacy or outcomes." }, "limiting_findings": [ "Only 58.8% of local simulation goals were achieved.", "Goal achievement was not associated with knowledge, self-efficacy or teamwork scores." ], "prohibited_claims": [ "master strategy", "guarantee execution", "outthink any opponent", "AI writes the winning plan" ] }, "gold_source_lesson": { "curriculum_id": "G-CUR-011", "source_heading": "12. PWR-120 — Inspect planning without promising execution", "source_html_sha256": "9ad385e0f0ac897e67c1a8dd8a9261bcefe9bcf554ac5455848cee49d410e0f6", "html": "Strategic planning connects a legitimate goal with assumptions,\nstakeholders, dependencies, resources, contingencies, execution,\nadaptation and review. A coherent document is not evidence that the goal\nis legitimate, the environment is controllable or the plan will\nwork.
\nAuthority state: TARGETED_REVIEW_REQUIRED ·\nNOT_YET_AUTHORISED
\nOpen reviews: clinical-scope; legitimacy;\nrights-and-representation; safety
Team-planning studies distinguish exploration, strategic planning,\ndetailed planning and prognosis, and some studies associate planning\nprocesses with performance. In a locally adapted obstetric simulation\nprogramme, knowledge, self-efficacy and teamwork improved, while only\n58.8% of local strategic goals were achieved on average and goal\nachievement was not associated with those learning measures. Scenario\nand prospective-hindsight studies illuminate particular reasoning\nprocesses, not guaranteed implementation.
\n| Review dimension | \nRequired question | \n
|---|---|
| Legitimacy | \nWho set the goal and who may reject it? | \n
| Representation | \nWhich affected people participate with meaningful power? | \n
| Assumptions | \nWhat must remain true for the plan to function? | \n
| Dependencies | \nWhich people, systems, permissions and resources are required? | \n
| Contingencies | \nWhat observable trigger changes, pauses or ends the plan? | \n
| Execution trace | \nWhat actions and decisions would be recorded without surveillance\noverreach? | \n
| Adaptation | \nWho may change the plan, under what evidence and with what\nnotice? | \n
| Outcomes | \nWhat direct result, harms, burden and distribution are\nmeasured? | \n
| Accountability | \nWho reviews failure, conflict and appeal? | \n
| Retirement | \nWhen does maintaining the plan cost more than its value? | \n
Do not build or rehearse a real strategic plan from this chapter. The\nworkbook provides only a reviewer gate sheet.
" }, "next_gate": "External confirmation is required before higher-authority use because: CLINICAL_HIGH_RISK_OR_REGULATED_CONFIGURATION; CULTURAL_COMMUNITY_RIGHTS_OR_AFFECTED_PERSON_AUTHORITY; SAFETY_LEGITIMACY_RESTRICTED.", "evidence_count": 3 }, "full_training_programme": false, "independently_validated": false, "publication_state": "PUBLISHED_PUBLIC_RESEARCH_EDITION__EDITORIAL_REVIEW_PENDING", "related_power_ids": [ "PWR-113", "PWR-114", "PWR-115", "PWR-116" ] }, { "power_id": "PWR-121", "learning_unit_id": "TLU-PWR-121", "title": "Confidence calibration", "main_description": "Confidence calibration asks whether answers given with a stated confidence are correct about that often. This lesson teaches the method on twelve objective two-choice questions: answer first, record confidence before feedback, preserve errors, group results by confidence and compare confidence with accuracy. Twelve items teach the calculation; they do not establish a stable trait or a reliable personal calibration score.", "main_description_source": "GOVERNED_TUTORIAL_PLAIN_ENGLISH_INTRO", "family_id": "FAM-16", "family": "Metacognition & Epistemic Resilience", "superdomain": "Cognition & Learning", "canonical_route": "/powers/pwr-121/", "treatment": "SELF_GUIDED_LESSON", "treatment_label": "Self-guided lesson", "treatment_boundary": "A governed step-by-step lesson may be completed independently inside its stated limits.", "tutorial_route": "/tutorials/pwr-121/", "governed_lesson_route": "/tutorials/pwr-121/", "self_attempt_status": "PERMITTED_INSIDE_TUTORIAL_LIMITS", "gold_pathway_ids": [ "G-CUR-012" ], "route_membership": { "kind": "GOLD_PATHWAY", "id": "G-CUR-012", "coverage_status": "EXACT_ONCE" }, "source_authority_tier": "G1", "source_build_state": "COMPREHENSIVE_OWNER_CANDIDATE", "source_instructional_route": "SELF_GUIDED_TUTORIAL", "source_count": 4, "research_depth": "DETAILED", "risk_level": "MODERATE", "prerequisite_status": "DECLARED_IN_GOVERNED_LESSON", "learning_route": { "mode": "PRACTICAL_LESSON", "label": "Learn with the governed self-guided lesson", "summary": "Confidence calibration asks whether answers given with a stated confidence are correct about that often. This lesson teaches the method on twelve objective two-choice questions: answer first, record confidence before feedback, preserve errors, group results by confidence and compare confidence with accuracy. Twelve items teach the calculation; they do not establish a stable trait or a reliable personal calibration score.", "steps": [ [ "Orient", "Read the definition, evidence, measurement boundary and prohibited claims on this canonical page." ], [ "Baseline", "Open the governed lesson and record its declared baseline before practising." ], [ "Practise", "Follow the ordered lesson exactly; do not add dose, intensity or claims." ], [ "Retest", "Use the lesson's delayed retention and predeclared transfer checks as separate records." ], [ "Maintain or retire", "Keep only what remains useful inside the evidence and safety boundary." ] ], "practical_authority": true, "provider_required": false, "next_action_route": "/tutorials/pwr-121/" }, "path_builder": { "selectable": true, "completion_allowed": true, "warning": "A governed step-by-step lesson may be completed independently inside its stated limits." }, "full_tutorial": { "version": "1.0", "authorship": "AUTHORED_GOVERNED_SOURCE", "practice_pack": { "power_id": "PWR-121", "title": "Confidence calibration", "heading": "Use twelve questions to learn the confidence-calibration method", "plain_english_intro": "Confidence calibration asks whether answers given with a stated confidence are correct about that often. This lesson teaches the method on twelve objective two-choice questions: answer first, record confidence before feedback, preserve errors, group results by confidence and compare confidence with accuracy. Twelve items teach the calculation; they do not establish a stable trait or a reliable personal calibration score.", "authority_and_safety": [ "Do not use this small benign set to rank people, infer intelligence, screen cognition or make school, work, clinical or eligibility decisions.", "The supplied four-item example bins are deliberately small and teach arithmetic only. Report n every time; do not call a pattern stable until it has been repeated across a much larger set of resolved questions from the same topic.", "Choose the answer, then record confidence, then lock both before opening the key. Never change either after feedback and never delete errors." ], "materials": [ "The twelve supplied questions with answer and confidence columns", "The answer key, kept covered until all twelve answers and confidence ratings are locked", "A calculation sheet or spreadsheet", "For the delayed check, a fresh objective twelve-question set from the same topic with a trustworthy hidden key; do not reuse these questions" ], "setup_steps": [ "Cover the answer key. Use the same confidence labels for the whole lesson: 50%, 60%, 70%, 80%, 90% or 100%.", "For each question, choose A or B first. Immediately record how confident you are, then lock both entries before moving on.", "After all twelve entries are locked, open the key and score every answer 1 for correct or 0 for wrong. Preserve every error.", "Group questions that have the same confidence. For each group, record n, correct count and accuracy = correct divided by n.", "For each group, calculate signed gap = confidence minus accuracy. A positive gap means confidence was higher than accuracy in that group; a negative gap means it was lower.", "Write one feedback action limited to the same topic. Do not change future confidence from a four-item bin alone; keep collecting resolved questions.", "After at least seven days, repeat the sequence on a fresh twelve-question set from the same topic. Compare only confidence groups present in both records and report n beside every percentage." ], "fixture": { "caption": "Fill the final two columns before opening the answer key.", "headers": [ "Item id", "Question", "Option a", "Option b", "Learner response before key", "Learner confidence percent before key" ], "rows": [ [ "Q1", "What is 7 x 8?", "54", "56", "[A/B]", "[50/60/70/80/90/100]" ], [ "Q2", "Sum of a triangle's interior angles?", "180 degrees", "360 degrees", "[A/B]", "[50/60/70/80/90/100]" ], [ "Q3", "Which fraction equals 0.25?", "1/3", "1/4", "[A/B]", "[50/60/70/80/90/100]" ], [ "Q4", "Next: 2, 4, 8, 16?", "24", "32", "[A/B]", "[50/60/70/80/90/100]" ], [ "Q5", "What is 15% of 200?", "30", "35", "[A/B]", "[50/60/70/80/90/100]" ], [ "Q6", "Median of 2, 4, 9?", "4", "5", "[A/B]", "[50/60/70/80/90/100]" ], [ "Q7", "Metres in one kilometre?", "100", "1000", "[A/B]", "[50/60/70/80/90/100]" ], [ "Q8", "Is 3/5 larger than 2/3?", "Yes", "No", "[A/B]", "[50/60/70/80/90/100]" ], [ "Q9", "Area of a 3 by 4 rectangle?", "12", "14", "[A/B]", "[50/60/70/80/90/100]" ], [ "Q10", "Only even prime?", "1", "2", "[A/B]", "[50/60/70/80/90/100]" ], [ "Q11", "0.40 + 0.35?", "0.75", "0.85", "[A/B]", "[50/60/70/80/90/100]" ], [ "Q12", "Fair die probability of greater than 4?", "1/2", "1/3", "[A/B]", "[50/60/70/80/90/100]" ] ] }, "scoring_rule": "The method passes only when all twelve answers and confidence ratings were locked before the key, every item remains in the record, and every used confidence group shows n, correct count, accuracy and signed gap. A delayed comparison must use fresh questions from the same topic. This checks use of the method, not intelligence, wisdom or a stable confidence trait.", "worked_example": { "steps": [ "Use the supplied fictional log for Q5–Q8: answers A, A, B and A, each recorded at 80% before the key.", "The key shows Q5, Q6 and Q7 correct and Q8 wrong, so the group has n=4 and 3 correct.", "Accuracy is 3 divided by 4 = 75%.", "Signed gap is 80% minus 75% = +5 percentage points.", "Because n=4, record this as a calculation example, not evidence that the learner is generally overconfident.", "Keep future answers and confidence ratings in the same topic. Recalculate only after a larger resolved set, then test any feedback on fresh questions rather than editing old ratings." ], "result": "The fictional 80% group has 75% accuracy and a +5-point signed gap at n=4. The arithmetic is correct, but the group is too small for a stable personal conclusion." }, "right_vs_wrong": [ { "situation": "Recording sequence", "right": "Choose A or B, record confidence, then lock both before opening the key.", "wrong": "Look at the key, then decide how confident the answer felt.", "why": "A rating made after feedback cannot test calibration." }, { "situation": "Confidence scale", "right": "Use only 50%, 60%, 70%, 80%, 90% or 100% throughout.", "wrong": "Switch between a six-point scale and only 60%, 80% and 100%.", "why": "Changing labels makes sessions and groups inconsistent." }, { "situation": "Small groups", "right": "Write 75% accuracy, +5-point gap, n=4; calculation example only.", "wrong": "Four answers prove the learner is overconfident.", "why": "A tiny group is too noisy for a stable conclusion." }, { "situation": "Wrong answers", "right": "Keep every wrong answer and its original confidence.", "wrong": "Delete misunderstood questions after seeing the key.", "why": "Selective deletion makes calibration look better than it was." }, { "situation": "Delayed check", "right": "Use fresh questions from the same topic after at least seven days.", "wrong": "Repeat the same twelve remembered questions or compare unrelated topics.", "why": "Memory and topic difficulty would contaminate the comparison." } ], "common_mistakes": [ { "mistake": "Confidence is entered before choosing an answer or after seeing feedback.", "fix": "Use the fixed order: answer, confidence, lock, key." }, { "mistake": "The page's fictional responses are mistaken for the learner's responses.", "fix": "Complete the blank columns first; use the fictional log only for the worked calculation." }, { "mistake": "A confidence group is reported without n.", "fix": "Write item count and correct count beside every accuracy and gap." }, { "mistake": "A four-item group drives an immediate confidence change.", "fix": "Keep collecting fresh resolved questions from the same topic before changing the rule." }, { "mistake": "Old ratings are edited after feedback.", "fix": "Preserve the old record and apply feedback only to fresh questions." } ], "answer_key_route": "/tutorials/pwr-121/answer-key/", "answer_key_delivery": "SEPARATE_NOINDEX_NOARCHIVE_CHECKING_PAGE" }, "tutorial_mode": "PRACTICAL_LESSON", "orientation": { "bounded_definition": "Capability to develop or express confidence calibration in a declared context without inheriting broader claims.", "evidence_summary": "Calibration means matching confidence to outcomes—not simply becoming less confident.", "measurement_boundary": "Declare question class, resolution rules, probability scale, calibration, resolution, base rate, scoring, sample size and missing outcomes; average confidence is not calibration.", "myth_to_metric": { "myth": "Always know exactly how sure to be", "metric": "Calibration and resolution over a predeclared set of resolved judgments", "boundary": "Good calibration in one question class does not prove wisdom or transfer to another." }, "limiting_findings": [ "Practical-scoring feedback failed in two large experiments.", "Automated feedback improved calibration in modified blackjack but not overall calibration in a more realistic baseball task." ], "prohibited_claims": [ "always know what you do not know", "eliminate overconfidence", "calibration score proves wisdom", "AI gives objective confidence" ] }, "outcomes": [ "Define confidence calibration without inheriting mythology or broader claims.", "Explain what the current evidence supports and what it does not establish.", "Use the declared measurement boundary and recognise misleading proxies.", "Complete only the separately governed capability practice inside its declared limits.", "Make a retention, transfer, maintenance, provider or stop decision without overclaiming." ], "prerequisites": "DECLARED_IN_GOVERNED_LESSON", "baseline": { "instruction": "Complete the baseline declared by the governed lesson before practice; keep it separate from the knowledge baseline.", "record": [ "date and context", "current definition", "confidence from 0 to 100", "assumed measure", "expected benefit", "known limitation", "intended next action" ] }, "modules": [ { "order": 1, "title": "Orient", "instruction": "Read the definition, evidence, measurement boundary and prohibited claims on this canonical page.", "completion_evidence": "Record the decision or output from orient in one or two sentences." }, { "order": 2, "title": "Baseline", "instruction": "Open the governed lesson and record its declared baseline before practising.", "completion_evidence": "Record the decision or output from baseline in one or two sentences." }, { "order": 3, "title": "Practise", "instruction": "Follow the ordered lesson exactly; do not add dose, intensity or claims.", "completion_evidence": "Record the decision or output from practise in one or two sentences." }, { "order": 4, "title": "Retest", "instruction": "Use the lesson's delayed retention and predeclared transfer checks as separate records.", "completion_evidence": "Record the decision or output from retest in one or two sentences." }, { "order": 5, "title": "Maintain or retire", "instruction": "Keep only what remains useful inside the evidence and safety boundary.", "completion_evidence": "Record the decision or output from maintain or retire in one or two sentences." } ], "lab": { "title": "Governed capability lab", "instruction": "Open the separately governed practical lesson and complete only its declared configuration, dose, measurement, accessibility and stopping rules.", "deliverable": "The lesson's declared baseline, practice and retest record; no additional exercise is implied here." }, "assessment": { "immediate": "Restate the bounded definition, evidence ceiling, measurement boundary and current authority route without looking.", "delayed_retention": "Repeat the explanation and route decision after at least 48 hours; record what changed or was forgotten.", "transfer": "Use only the lesson's predeclared transfer task; do not infer far transfer from the trained task.", "interpretation": "Completion demonstrates learning of this tutorial only. It does not prove capability, qualification, independent validation, safety clearance or far transfer." }, "maintenance": { "cadence": "Review after 48 hours, again after 2-4 weeks, and whenever the evidence or authority treatment changes.", "decisions": [ "retain", "refresh", "seek qualified support", "return to research", "retire" ] }, "accessibility": "Use text-to-speech, enlarged text, keyboard navigation, shorter sessions, a support person or an equivalent non-practical record format as needed. Accessibility changes must not enlarge practical authority.", "stopping_and_escalation": "A governed step-by-step lesson may be completed independently inside its stated limits. Stop if the declared configuration cannot be maintained, uncertainty becomes material, adverse effects appear, or qualified authority is required.", "next_gate": "No external confirmation is required for the current bounded explainer and non-prescriptive guide-frame permissions; any stronger efficacy, generalisation, protocol, promotion or independent-validation claim requires a new adjudication.", "evidence_count": 4 }, "full_training_programme": false, "independently_validated": false, "publication_state": "PUBLISHED_PUBLIC_RESEARCH_EDITION__EDITORIAL_REVIEW_PENDING", "related_power_ids": [ "PWR-122", "PWR-123", "PWR-124", "PWR-125" ] }, { "power_id": "PWR-122", "learning_unit_id": "TLU-PWR-122", "title": "Error detection", "main_description": "The learner applies a four-pass checklist to three synthetic reports and reduces high-cost misses without increasing false alarms beyond the declared limit.", "main_description_source": "FULL_TUTORIAL_OUTCOME", "family_id": "FAM-16", "family": "Metacognition & Epistemic Resilience", "superdomain": "Cognition & Learning", "canonical_route": "/powers/pwr-122/", "treatment": "EVIDENCE_REVIEW_ROUTE", "treatment_label": "Full low-stakes tutorial", "treatment_boundary": "Titan teaches a concrete low-stakes method step by step while keeping evidence and transfer claims bounded.", "tutorial_route": "/tutorials/pwr-122/", "governed_lesson_route": null, "self_attempt_status": "PERMITTED_INSIDE_FULL_TUTORIAL_LIMITS", "gold_pathway_ids": [ "G-CUR-012" ], "route_membership": { "kind": "GOLD_PATHWAY", "id": "G-CUR-012", "coverage_status": "EXACT_ONCE" }, "source_authority_tier": "G1", "source_build_state": "TARGETED_REVIEW_REQUIRED", "source_instructional_route": "SELF_GUIDED_TUTORIAL", "source_count": 4, "research_depth": "DETAILED", "risk_level": "MODERATE_TO_HIGH", "prerequisite_status": "NONE_FOR_READING__NO_PRACTICE_AUTHORITY", "learning_route": { "mode": "FULL_SELF_GUIDED_TUTORIAL", "label": "Learn error detection step by step", "summary": "The learner applies a four-pass checklist to three synthetic reports and reduces high-cost misses without increasing false alarms beyond the declared limit.", "steps": [ [ "Get ready", "Define the four error classes and examples before inspection." ], [ "Learn the method", "8 concrete steps teach the permitted method from start to finish." ], [ "See right and wrong", "4 comparisons show correct or safer execution beside common wrong or riskier choices." ], [ "Practise", "Use one three-report set weekly for four weeks, with new synthetic content and predeclared error prevalence. Keep time fixed. After week two, include a set with very rare targets to test vigilance without increasing stakes." ], [ "Check progress", "For each class, count hits, misses, false alarms and correct rejections. Calculate sensitivity as hits/(hits+misses) when at least one keyed error exists; report false-alarm count and eligible clean checks, time and burden, then compare matched baseline and checklist sets without merging classes." ] ], "practical_authority": true, "provider_required": false, "next_action_route": "/tutorials/pwr-122/" }, "path_builder": { "selectable": true, "completion_allowed": true, "warning": "Titan teaches a concrete low-stakes method step by step while keeping evidence and transfer claims bounded." }, "full_tutorial": { "version": "3.0", "authorship": "POWER_SPECIFIC_FULL_TUTORIAL", "tutorial_mode": "SELF_GUIDED", "promise": "Error detection requires a declared error class, ground truth and correction path. This lesson uses synthetic one-page reports containing arithmetic mismatches, internal contradictions, unsupported citations and source mismatches. The learner reads one page normally, then applies a fixed verification sequence to a matched page, reveals the answer key and calculates hits, misses and false alarms. It is not medical-image review, deception detection or safety monitoring.", "power_id": "PWR-122", "title": "Error detection", "lesson_type": "SELF_GUIDED", "headline": "Find defined errors in synthetic documents and count both misses and false alarms", "plain_english_summary": "Error detection requires a declared error class, ground truth and correction path. This lesson uses synthetic one-page reports containing arithmetic mismatches, internal contradictions, unsupported citations and source mismatches. The learner reads one page normally, then applies a fixed verification sequence to a matched page, reveals the answer key and calculates hits, misses and false alarms. It is not medical-image review, deception detection or safety monitoring.", "outcome": "The learner applies a four-pass checklist to three synthetic reports and reduces high-cost misses without increasing false alarms beyond the declared limit.", "authority": { "learner_may": [ "Inspect fully synthetic, consequence-free documents with an answer key.", "Use checklists, calculators and source cards." ], "qualified_person_required_for": [ "Clinical, legal, financial, engineering, security or other professional review.", "Compulsive-checking concerns or consequential quality assurance." ], "never_do": [ "Use the exercise to diagnose, accuse, detect deception or clear safety-critical material.", "Assume slow reading or suspicion alone is error detection." ] }, "materials": [ "Exact synthetic packet. Report A: A1 ‘18 red + 27 blue = 46’; A2 body says inspection Tuesday but summary says Wednesday; A3 cites S1 for higher demand; A4 cites nonexistent S9 for lower repair cost. Report B: B1 ‘14 + 19 = 34’; B2 body says sample 40 but summary says 44; B3 cites S2 for return rate; B4 cites nonexistent S8 for a delay claim. Report C controls read ‘22 + 11 = 33’ and ‘checked June 4’ consistently; C3 cites S3 for lower defect rate.", "Source cards and hidden key. S1 discusses packaging only, S2 storage temperature only and S3 courier time only. Key: A1/B1 arithmetic (45/33); A2/B2 contradiction; A3/B3/C3 source mismatch; A4/B4 unsupported citation; the two Report C control statements are clean.", "Confusion-matrix sheet for true errors found, misses, false alarms and correct rejections." ], "before_you_start": [ "Define the four error classes and examples before inspection.", "Mark all people, sources and decisions fictional.", "Set a 10-minute limit and a stop rule for compulsive rechecking or distress.", "Have a helper separate Reports A–C from the source cards and hidden key. If you prepared the packet and remember the answers, use it only as demonstration and score a fresh helper-prepared permutation." ], "steps": [ { "title": "Declare error classes", "instruction": "Write arithmetic mismatch, contradiction, unsupported citation and source mismatch, with the evidence needed to confirm each.", "reason": "A suspicion becomes a detected error only when it matches a rule and ground truth.", "success_check": "Each class has a definition and confirmation method." }, { "title": "Set prevalence and error costs", "instruction": "Read the packet’s class list and rank the fictional consequence of missing each class versus raising a false alarm. State which error class the next checklist prompt will target; do not invent a universal acceptable false-alarm count.", "reason": "Search behaviour and an effective repair depend on how rare and costly the target is.", "success_check": "The sheet names the available error classes, highest-cost miss and the class-specific prompt before inspection." }, { "title": "Make an ordinary baseline pass", "instruction": "Read report A once and mark suspected errors without a checklist. Commit before seeing the key.", "reason": "The baseline shows what ordinary reading catches and misses.", "success_check": "Every mark has a class and line reference." }, { "title": "Apply the verification sequence", "instruction": "On matched report B, check quantities, then internal claims, then citation existence, then whether each cited source supports the sentence.", "reason": "Separate passes reduce switching and target specific error mechanisms.", "success_check": "All four passes are completed in order." }, { "title": "Require confirmation", "instruction": "For each mark, write the calculation, conflicting sentence or source-card evidence. Remove marks that lack confirmation.", "reason": "Evidence controls false alarms and separates anomaly from error.", "success_check": "Every retained mark has a visible proof." }, { "title": "Reveal and classify outcomes", "instruction": "Compare with the answer key and count hits, misses, false alarms and correct rejections by class.", "reason": "Accuracy alone can hide rare but costly misses.", "success_check": "The confusion matrix totals all eligible items." }, { "title": "Write and verify the correction", "instruction": "For every confirmed error, produce the corrected number, sentence or citation link and have the answer key or a second independent calculation verify it.", "reason": "Detection is incomplete when the proposed repair introduces another error.", "success_check": "Each confirmed mark has one corrected replacement and a documented independent check." }, { "title": "Redesign around the costliest miss", "instruction": "Identify the missed class with highest declared cost, add one targeted prompt and test it on report C without extending total time.", "reason": "A repair should target the harmful failure, not merely make all checking slower.", "success_check": "Report C shows whether the targeted miss falls and false alarms stay bounded." } ], "worked_example": { "scenario": "The supplied Reports A and B each contain one arithmetic mismatch, contradiction, source mismatch and unsupported citation; Report C adds clean controls and one source mismatch.", "walkthrough": [ "Maya defines arithmetic and source mismatch before reading.", "On the ordinary Report A pass she catches A1 but misses A2, A3 and A4, giving one hit, three misses and no false alarms.", "On Report B she recomputes 14+19=33 and compares the body’s sample 40 with the summary’s 44.", "She opens S2, sees no return-rate evidence, and separately checks the citation list to show that S8 does not exist.", "Against the key she records four Report B hits, no misses and no false alarms, then adds ‘state the exact supported claim’ before applying the same pass to C3." ], "result": "Maya has evidence-backed detections and a class-specific repair. She has not shown professional audit or safety-monitoring competence." }, "right_vs_wrong": [ { "situation": "Marking", "right": "Name the error class and confirming evidence.", "wrong": "Highlight anything that feels odd.", "why": "Vague suspicion inflates false alarms." }, { "situation": "Checklist", "right": "Use separate arithmetic, consistency and source passes.", "wrong": "Reread the whole page repeatedly without a target.", "why": "Unstructured repetition adds burden without a known mechanism." }, { "situation": "Scoring", "right": "Count misses and false alarms by class.", "wrong": "Celebrate total accuracy on mostly clean statements.", "why": "High base-rate accuracy can hide rare-target failure." }, { "situation": "Repair", "right": "Target the highest-cost missed class.", "wrong": "Simply double inspection time.", "why": "More time may not repair the actual search failure." } ], "common_mistakes": [ { "mistake": "A citation exists, so it is marked valid.", "fix": "Open the source card and compare the exact supported claim." }, { "mistake": "Clean statements are absent from the denominator.", "fix": "Include correct rejections and false alarms for all eligible checks." }, { "mistake": "The answer key is opened during inspection.", "fix": "Commit all marks first and timestamp reveal." }, { "mistake": "All error classes are averaged.", "fix": "Report arithmetic, contradiction, citation and source mismatch separately." } ], "practice": { "first_session": [ "Learn four error definitions.", "Complete one ordinary baseline report.", "Apply the four-pass checklist to a matched report.", "Build the confusion matrix.", "Repair the costliest miss on a third report." ], "repeat_plan": "Use one three-report set weekly for four weeks, with new synthetic content and predeclared error prevalence. Keep time fixed. After week two, include a set with very rare targets to test vigilance without increasing stakes.", "progress_when": [ "High-cost misses decline on fresh reports.", "False alarms remain below the predeclared limit.", "Every detection includes reproducible evidence." ], "do_not_progress_when": [ "Checking becomes repetitive, distressing or hard to stop.", "The material becomes real or consequential.", "Ground truth or error definitions are disputed." ] }, "self_check": [ "What four error classes are allowed?", "What evidence confirms each mark?", "How many misses and false alarms occurred?", "Did the repair target the highest-cost miss?" ], "measurement": { "primary": "Class-specific hits, misses and false alarms on keyed synthetic reports.", "how": "For each class, count hits, misses, false alarms and correct rejections. Calculate sensitivity as hits/(hits+misses) when at least one keyed error exists; report false-alarm count and eligible clean checks, time and burden, then compare matched baseline and checklist sets without merging classes.", "good_result": "On fresh keyed sets, the targeted high-cost miss is corrected with visible evidence while misses, false alarms and time all remain reported. No fixed ‘one false alarm per report’ rule is presented as a validated professional threshold.", "does_not_prove": "It does not establish professional review, lie detection, diagnosis, safety clearance or transfer to rare real-world targets." }, "stop_and_get_help": [ "Stop if checking becomes compulsive, distressing or continues past the time limit.", "Stop if a real person, diagnosis, accusation or consequential document enters the task.", "Route professional or safety-critical errors to the authorised review and escalation system." ], "accessibility": [ "Use screen-reader headings and source cards with stable link labels.", "Allow calculator and text-to-speech while keeping the pass order.", "Split the report into one error class per view and preserve the same total eligible items." ], "evidence_notes": [ { "claim": "Ultra-rare targets produced high miss rates even across very large numbers of search trials, so prevalence and misses must be reported.", "source_title": "The Ultra-Rare-Item Effect", "source_url": "https://doi.org/10.1177/0956797613504221", "source_kind": "PRIMARY_RESEARCH" }, { "claim": "NIST AI RMF supports configured risk measurement and correction paths when errors involve AI-assisted systems.", "source_title": "Artificial Intelligence Risk Management Framework (AI RMF 1.0)", "source_url": "https://www.nist.gov/itl/ai-risk-management-framework", "source_kind": "OFFICIAL_GUIDANCE" } ], "limits": [ "The fixture has known synthetic ground truth unlike many real tasks.", "A checklist can shift misses and false alarms rather than remove error.", "Rare-target and high-stakes transfer require domain validation and accountable review." ], "orientation": { "bounded_definition": "Capability to develop or express error detection in a declared context without inheriting broader claims.", "evidence_summary": "Error detection improves when people and interfaces are designed together—but rare mistakes remain easy to miss.", "supportable_public_claim": "Selected interfaces can reduce specific human–AI and rare-target errors, but this is configured system performance rather than a universal human faculty.", "measurement_boundary": "Declare error taxonomy, prevalence, base rate, false alarms, misses, correction path, model/version, workload and consequences; high accuracy can hide rare catastrophic misses.", "myth_to_metric": { "myth": "Spot every hidden error", "metric": "Miss rate, false-alarm rate, time to correction and harm under declared prevalence", "boundary": "One detection task cannot establish universal vigilance, honesty detection or safety." }, "limiting_findings": [ "Very rare targets produced high miss rates despite extensive task exposure.", "Cognitive forcing reduced overreliance but lowered user ratings and varied across people." ], "prohibited_claims": [ "spot every mistake", "human lie detector", "AI-proof your mind", "error score identifies careless people" ] }, "gold_source_lesson": { "curriculum_id": "G-CUR-012", "source_heading": "6. PWR-122 — Error detection — review-only", "source_html_sha256": "ea34f716cf05783172a9566ed0b520208eb681dc2b788ef3d3f60b9be7511192", "html": "Error detection can refer to many things: noticing a contradiction,\ndetecting a calculation error, recognizing a broken citation, finding an\ninternal inconsistency or identifying an implausible output. The frozen\nroute remains TARGETED_REVIEW_REQUIRED with clinical-scope\nand safety review open.
| Field | \nProposed low-risk design | \n
|---|---|
| Material | \nFully synthetic statements with deliberately inserted errors | \n
| Error classes | \ncontradiction / unsupported citation / arithmetic mismatch / source\nmismatch | \n
| Metrics | \ntrue errors found, misses, false alarms, time, burden | \n
| Comparator | \nexplicit checklist versus ordinary reading | \n
| Stops | \ndistress, compulsive checking, clinical relevance, real-person\ntargeting | \n
| Exclusions | \nmedical images, symptoms, safety monitoring, deception detection,\nnamed people | \n
Current route: explanation and reviewer\nspecification only. No follow-along error-detection drill is authorised\nby this Gold build.
" }, "next_gate": "External confirmation is required before higher-authority use because: CLINICAL_HIGH_RISK_OR_REGULATED_CONFIGURATION.", "evidence_count": 4 }, "full_training_programme": false, "independently_validated": false, "publication_state": "PUBLISHED_PUBLIC_RESEARCH_EDITION__EDITORIAL_REVIEW_PENDING", "related_power_ids": [ "PWR-121", "PWR-123", "PWR-124", "PWR-125" ] }, { "power_id": "PWR-123", "learning_unit_id": "TLU-PWR-123", "title": "Bias resistance", "main_description": "The learner judges eight paired fictional frames using one criterion and records no unjustified frame-driven reversals on a delayed set.", "main_description_source": "FULL_TUTORIAL_OUTCOME", "family_id": "FAM-16", "family": "Metacognition & Epistemic Resilience", "superdomain": "Cognition & Learning", "canonical_route": "/powers/pwr-123/", "treatment": "EVIDENCE_REVIEW_ROUTE", "treatment_label": "Full low-stakes tutorial", "treatment_boundary": "Titan teaches a concrete low-stakes method step by step while keeping evidence and transfer claims bounded.", "tutorial_route": "/tutorials/pwr-123/", "governed_lesson_route": null, "self_attempt_status": "PERMITTED_INSIDE_FULL_TUTORIAL_LIMITS", "gold_pathway_ids": [ "G-CUR-012" ], "route_membership": { "kind": "GOLD_PATHWAY", "id": "G-CUR-012", "coverage_status": "EXACT_ONCE" }, "source_authority_tier": "G2", "source_build_state": "TARGETED_REVIEW_REQUIRED", "source_instructional_route": "BOUNDED_GUIDED_EXERCISE", "source_count": 3, "research_depth": "FOCUSED", "risk_level": "HIGH", "prerequisite_status": "NONE_FOR_READING__NO_PRACTICE_AUTHORITY", "learning_route": { "mode": "FULL_SELF_GUIDED_TUTORIAL", "label": "Learn bias resistance step by step", "summary": "The learner judges eight paired fictional frames using one criterion and records no unjustified frame-driven reversals on a delayed set.", "steps": [ [ "Get ready", "Define the target as framing sensitivity, not all bias." ], [ "Learn the method", "9 concrete steps teach the permitted method from start to finish." ], [ "See right and wrong", "4 comparisons show correct or safer execution beside common wrong or riskier choices." ], [ "Practise", "Use four new fictional pairs weekly for four weeks. Change denominators and surface topics but preserve equivalence. Include one control each week where a judgement should update." ], [ "Check progress", "For each pair, verify conversion, criterion application and decision consistency; count frame-only reversals, appropriate updates on control items and confidence change." ] ], "practical_authority": true, "provider_required": false, "next_action_route": "/tutorials/pwr-123/" }, "path_builder": { "selectable": true, "completion_allowed": true, "warning": "Titan teaches a concrete low-stakes method step by step while keeping evidence and transfer claims bounded." }, "full_tutorial": { "version": "3.0", "authorship": "POWER_SPECIFIC_FULL_TUTORIAL", "tutorial_mode": "SELF_GUIDED", "promise": "Bias resistance is not general immunity. This lesson targets one error only: changing a judgement when the same numerical outcome is framed positively or negatively. Using fictional product batches, the learner commits a criterion, converts every frame to the same frequency, judges paired versions separately and checks whether any change is justified by new information rather than wording.", "power_id": "PWR-123", "title": "Bias resistance", "lesson_type": "SELF_GUIDED", "headline": "Hold one decision criterion steady across equivalent positive and negative frames", "plain_english_summary": "Bias resistance is not general immunity. This lesson targets one error only: changing a judgement when the same numerical outcome is framed positively or negatively. Using fictional product batches, the learner commits a criterion, converts every frame to the same frequency, judges paired versions separately and checks whether any change is justified by new information rather than wording.", "outcome": "The learner judges eight paired fictional frames using one criterion and records no unjustified frame-driven reversals on a delayed set.", "authority": { "learner_may": [ "Use supplied fictional, non-political and non-clinical framing pairs.", "Change a judgement when genuinely new relevant information appears." ], "qualified_person_required_for": [ "Real clinical, legal, financial, employment, political or group-targeting decisions.", "Interventions intended to change another person’s beliefs or behaviour." ], "never_do": [ "Apply the score to claim immunity from bias or superior rationality.", "Use emotionally charged real identities, misinformation campaigns or consequential choices as practice." ] }, "materials": [ "Eight exact fictional pairs, printed on separate cards: 90/100 pass ↔ 10/100 fail; 18/20 succeed ↔ 2/20 fail; 72/80 pass ↔ 8/80 fail; 45/50 conform ↔ 5/50 do not; 120/150 on time ↔ 30/150 late; 27/30 accurate ↔ 3/30 wrong; 64/80 retained ↔ 16/80 lost; 42/60 dry ↔ 18/60 wet. The hidden pair key confirms each equivalence after common-denominator conversion.", "Criterion card, common-frequency conversion sheet and hidden pair key.", "Record for initial judgement, confidence, converted value and reversal reason, plus a control card that keeps 10/100 failures but changes them from cosmetic marks to overheating. That new severity fact should trigger review under the supplied fictional safety rule." ], "before_you_start": [ "Define the target as framing sensitivity, not all bias.", "Set a fictional accept/review threshold before reading any frame.", "Keep paired versions separated so the learner does not see both at once.", "Ask a helper to choose one card from each pair, retain its mate and control card, and reveal them only after the first decisions are locked." ], "steps": [ { "title": "Commit the criterion", "instruction": "Write the accept, reject or review rule in common-frequency terms, such as review when more than 12 of 100 fail.", "reason": "A predeclared rule prevents wording from moving the goalposts.", "success_check": "The criterion is timestamped before item exposure." }, { "title": "Audit pair equivalence", "instruction": "Using the hidden fixture preparation card rather than the answer, verify that each pair has the same denominator, outcome definition and time period and differs only in positive versus negative wording.", "reason": "A pair with extra facts or changed denominators cannot isolate a framing effect.", "success_check": "The preparation check marks equivalent or excluded and gives a concrete reason for every exclusion." }, { "title": "Read one frame only", "instruction": "Judge the first version and record confidence without seeking its pair.", "reason": "Independent commitment captures the frame’s effect.", "success_check": "One decision and confidence are saved." }, { "title": "Convert to a common form", "instruction": "Rewrite the statement as both passes and failures out of the same denominator.", "reason": "Equivalent representations become easier to compare.", "success_check": "The record contains both frequencies and they sum correctly." }, { "title": "Apply the criterion", "instruction": "Use the prewritten threshold and record accept, reject or review plus the calculation.", "reason": "The same decision rule should govern equivalent numbers.", "success_check": "The decision follows the criterion transparently." }, { "title": "Reveal the paired frame", "instruction": "After a gap, judge the equivalent wording, convert it and compare decisions. Classify any reversal as justified or frame-only.", "reason": "A paired check reveals sensitivity to wording without calling every update biased.", "success_check": "Equivalent pairs have matching converted numbers and a reversal label." }, { "title": "Explain consistency without rationalising", "instruction": "For a stable decision, point to the common frequency and criterion. For a reversal, write the exact new fact that would justify it; if none exists, keep the reversal marked frame-only.", "reason": "A written evidence link prevents a post-hoc story from hiding wording sensitivity.", "success_check": "Every paired decision has a one-sentence reason tied to either identical numbers or genuinely new information." }, { "title": "Check against a neutral frequency card", "instruction": "After both framed decisions are locked, reveal an unframed card showing passes and failures together and apply the same criterion once more.", "reason": "A neutral representation helps locate whether the positive frame, negative frame or calculation caused the discrepancy.", "success_check": "All three decisions are compared, and any mismatch is assigned to wording, arithmetic or a genuinely different fact." }, { "title": "Test delayed novel pairs", "instruction": "After 48 hours, complete four new pairs with different denominators and one genuinely new-information control.", "reason": "Novel items test the method; the control checks that resistance does not become refusal to update.", "success_check": "The learner resists pure frames and changes for the relevant control fact." } ], "worked_example": { "scenario": "A fictional battery batch is described first as “90 of 100 units pass inspection” and later as “10 of 100 units fail.”", "walkthrough": [ "Tariq has precommitted to review only when more than 12 of 100 fail.", "He reads the positive frame, converts it to 10 failures and accepts with 70% confidence.", "Later he reads the negative frame, converts it to 90 passes and 10 failures.", "He keeps the accept decision because the criterion and information are unchanged.", "On a control card stating failures involve overheating rather than cosmetic marks, he switches to review and records new severity information as the reason." ], "result": "Tariq resists an equivalent wording change while remaining responsive to relevant new information. This demonstrates one framing fixture, not broad bias immunity." }, "right_vs_wrong": [ { "situation": "Target", "right": "Name framing sensitivity as the specific error.", "wrong": "Try to “debias” every judgement at once.", "why": "Interventions are bias- and context-specific." }, { "situation": "Criterion", "right": "Commit before reading the frame.", "wrong": "Choose the threshold after seeing which answer feels right.", "why": "Post-hoc criteria hide frame effects." }, { "situation": "Conversion", "right": "Express both frames with the same denominator.", "wrong": "Compare 90% pass with 1 in 10 fail by impression.", "why": "Common frequencies make equivalence explicit." }, { "situation": "Updating", "right": "Change for relevant new severity evidence.", "wrong": "Refuse all changes to prove resistance.", "why": "Overcorrection creates rigidity rather than accuracy." } ], "common_mistakes": [ { "mistake": "Confidence is mistaken for consistency.", "fix": "Compare actual decisions after common-frequency conversion." }, { "mistake": "Different denominators remain unconverted.", "fix": "Scale both to the same base before applying the threshold." }, { "mistake": "The paired item is visible too early.", "fix": "Use separate cards and commit before reveal." }, { "mistake": "Every reversal is labelled bias.", "fix": "Ask whether the second card contains relevant non-equivalent information." } ], "practice": { "first_session": [ "Define the targeted framing error.", "Commit one threshold.", "Complete four separated pairs.", "Classify reversals.", "Finish with one relevant-new-information control." ], "repeat_plan": "Use four new fictional pairs weekly for four weeks. Change denominators and surface topics but preserve equivalence. Include one control each week where a judgement should update.", "progress_when": [ "Equivalent pairs produce the same decision.", "Conversions and threshold applications are correct.", "The learner still updates for relevant new information." ], "do_not_progress_when": [ "Content becomes real, political, clinical or identity-targeted.", "The learner becomes globally distrustful or indecisive.", "Ground truth or equivalence is not clear." ] }, "self_check": [ "What one bias is targeted?", "Was the criterion committed first?", "Do the two frames express the same frequency?", "Did any reversal have genuinely new relevant evidence?" ], "measurement": { "primary": "Unjustified decision reversals across equivalent framing pairs.", "how": "For each pair, verify conversion, criterion application and decision consistency; count frame-only reversals, appropriate updates on control items and confidence change.", "good_result": "Every conversion reproduces the pair key, equivalent frames receive the same criterion-based decision, and the genuinely new-information control produces an explained update. Arithmetic mistakes are corrected before judging framing; no percentage cutoff is presented as broad bias resistance.", "does_not_prove": "It does not show resistance to other biases, real-world behaviour, long-term misinformation immunity or impartiality." }, "stop_and_get_help": [ "Stop if practice produces generalised scepticism, distress or inability to decide.", "Stop if real people, protected groups or consequential decisions enter the fixture.", "Seek domain and affected-person review for any real debiasing intervention." ], "accessibility": [ "Offer frequencies with icons, plain words and calculator support.", "Read one frame aloud and allow extended equal response time.", "Use non-colour symbols to distinguish pass and fail." ], "evidence_notes": [ { "claim": "Accuracy prompts reduced misinformation-sharing intentions across defined experiments, but the outcomes do not establish broad behavioural immunity.", "source_title": "Accuracy prompts are a replicable and generalizable approach for reducing the spread of misinformation", "source_url": "https://doi.org/10.1038/s41467-022-30073-5", "source_kind": "PRIMARY_RESEARCH" }, { "claim": "Inoculation-effect estimates were sensitive to items and testing, supporting matched novel examples and cautious interpretation.", "source_title": "Disentangling Item and Testing Effects in Inoculation Research on Online Misinformation: Solomon Revisited", "source_url": "https://doi.org/10.1177/0013164420940378", "source_kind": "PRIMARY_RESEARCH" } ], "limits": [ "The lesson targets only numerical framing in fictional cases.", "Consistency is not automatically correctness if the criterion is poor.", "Resistance to a frame must not become refusal to update on relevant evidence." ], "orientation": { "bounded_definition": "Capability to develop or express bias resistance in a declared context without inheriting broader claims.", "evidence_summary": "People can become better at spotting selected manipulation techniques—but nobody becomes immune to misinformation.", "supportable_public_claim": "Brief prompts and transparent games can reduce selected misinformation-related errors, but they do not create general immunity to bias.", "measurement_boundary": "Predeclare bias/error type, content, ground truth, item novelty, intention versus behavior, delay, false positives and political/cultural context.", "myth_to_metric": { "myth": "Vaccinate the mind against misinformation", "metric": "Accuracy, false positives and observed behavior on novel benign items after delay", "boundary": "A prompt or game cannot create general immunity, political correctness or permanent resistance." }, "limiting_findings": [ "Most accuracy-prompt outcomes were sharing intentions rather than observed long-term behavior.", "Inoculation estimates were sensitive to the examples used." ], "prohibited_claims": [ "become immune to misinformation", "remove cognitive bias", "mental vaccine", "program people against wrong beliefs" ] }, "gold_source_lesson": { "curriculum_id": "G-CUR-012", "source_heading": "7. PWR-123 — Bias resistance — review-only", "source_html_sha256": "c5ddbcd3c9069bd74c41e1200b0429cf8b71d4b42a21be89e73a86459b1c66d2", "html": "“Bias resistance” is too broad to teach as if one debiasing trick\ngeneralises across cognition. Interventions target particular biases,\npopulations and contexts; transfer can be limited, and a method that\nreduces one error can introduce another.
\nA future route must specify:
\nA recent meta-analytic literature reports small average effects for\ntargeted educational debiasing, while systematic transfer reviews do not\njustify a claim of broad real-life reasoning improvement. In\nmisinformation settings, one classroom study found that an inoculation\napproach increased generalized skepticism toward scientifically valid\ncontent. Those findings support specificity and adverse-effect tracking,\nnot a “debias yourself” protocol.
\nThe workbook asks reviewers to map a proposed bias intervention to\nits intended error, evidence, counterfactual outcome, possible\novercorrection and affected-person risks. It does not ask a learner to\napply a cognitive-bias intervention to a real person or consequential\ndecision.
" }, "next_gate": "External confirmation is required before higher-authority use because: CLINICAL_HIGH_RISK_OR_REGULATED_CONFIGURATION; CULTURAL_COMMUNITY_RIGHTS_OR_AFFECTED_PERSON_AUTHORITY; SAFETY_LEGITIMACY_RESTRICTED.", "evidence_count": 3 }, "full_training_programme": false, "independently_validated": false, "publication_state": "PUBLISHED_PUBLIC_RESEARCH_EDITION__EDITORIAL_REVIEW_PENDING", "related_power_ids": [ "PWR-121", "PWR-122", "PWR-124", "PWR-125" ] }, { "power_id": "PWR-124", "learning_unit_id": "TLU-PWR-124", "title": "Source evaluation and lateral reading", "main_description": "Lateral reading means leaving the claim page, identifying who published it, tracing its number to the earliest accessible data, and checking a genuinely independent source. This pack supplies a closed fictional library-energy packet so no live search or harmful material is needed. The learner separates page count from source independence and updates the exact claim rather than merely rating a publisher.", "main_description_source": "GOVERNED_TUTORIAL_PLAIN_ENGLISH_INTRO", "family_id": "FAM-16", "family": "Metacognition & Epistemic Resilience", "superdomain": "Cognition & Learning", "canonical_route": "/powers/pwr-124/", "treatment": "SELF_GUIDED_LESSON", "treatment_label": "Self-guided lesson", "treatment_boundary": "A governed step-by-step lesson may be completed independently inside its stated limits.", "tutorial_route": "/tutorials/pwr-124/", "governed_lesson_route": "/tutorials/pwr-124/", "self_attempt_status": "PERMITTED_INSIDE_TUTORIAL_LIMITS", "gold_pathway_ids": [ "G-CUR-012" ], "route_membership": { "kind": "GOLD_PATHWAY", "id": "G-CUR-012", "coverage_status": "EXACT_ONCE" }, "source_authority_tier": "G1", "source_build_state": "COMPREHENSIVE_OWNER_CANDIDATE", "source_instructional_route": "SELF_GUIDED_TUTORIAL", "source_count": 3, "research_depth": "FOCUSED", "risk_level": "MODERATE", "prerequisite_status": "DECLARED_IN_GOVERNED_LESSON", "learning_route": { "mode": "PRACTICAL_LESSON", "label": "Learn with the governed self-guided lesson", "summary": "Lateral reading means leaving the claim page, identifying who published it, tracing its number to the earliest accessible data, and checking a genuinely independent source. This pack supplies a closed fictional library-energy packet so no live search or harmful material is needed. The learner separates page count from source independence and updates the exact claim rather than merely rating a publisher.", "steps": [ [ "Orient", "Read the definition, evidence, measurement boundary and prohibited claims on this canonical page." ], [ "Baseline", "Open the governed lesson and record its declared baseline before practising." ], [ "Practise", "Follow the ordered lesson exactly; do not add dose, intensity or claims." ], [ "Retest", "Use the lesson's delayed retention and predeclared transfer checks as separate records." ], [ "Maintain or retire", "Keep only what remains useful inside the evidence and safety boundary." ] ], "practical_authority": true, "provider_required": false, "next_action_route": "/tutorials/pwr-124/" }, "path_builder": { "selectable": true, "completion_allowed": true, "warning": "A governed step-by-step lesson may be completed independently inside its stated limits." }, "full_tutorial": { "version": "1.0", "authorship": "AUTHORED_GOVERNED_SOURCE", "practice_pack": { "power_id": "PWR-124", "title": "Source evaluation and lateral reading", "heading": "Trace a benign claim to primary data and an independent limitation", "plain_english_intro": "Lateral reading means leaving the claim page, identifying who published it, tracing its number to the earliest accessible data, and checking a genuinely independent source. This pack supplies a closed fictional library-energy packet so no live search or harmful material is needed. The learner separates page count from source independence and updates the exact claim rather than merely rating a publisher.", "authority_and_safety": [ "Do not investigate private people, engage scammers, expose yourself to harmful material, or make a public accusation.", "Publisher credibility and claim support are separate; repetition through one citation chain is not triangulation.", "This fictional packet does not certify investigative expertise or authorise a consequential public claim." ], "materials": [ "The fictional claim page CP1 and source cards S1-S4 below", "The source-chain worksheet columns built into the fixture", "A calculator", "The hidden answer key" ], "setup_steps": [ "Record CP1's exact claim, publisher, cited source and initial confidence from 0 to 100 before tracing links.", "Classify every row's source type, incentive and dependency. Independence concerns the evidence chain, not merely a different web address.", "Trace the number to the earliest primary data and calculate the raw change with numerator and denominator visible.", "Use the independent audit to identify adjustment, uncertainty and remaining alternative explanations.", "Write a bounded update that separates observation from causal attribution, then record final confidence and the specific evidence that changed it." ], "fixture": { "caption": "All documents are fictional. The final three columns are the complete source-chain log.", "headers": [ "Source id", "Publisher and type", "Claim or data", "Relationship and incentive", "Learner source type", "Learner dependency note", "Learner claim support note", "Learner initial confidence", "Learner final confidence and update reason" ], "rows": [ [ "CP1", "Northbank Library news; institutional secondary", "Skylights cut daytime lighting electricity by 30% in year one.", "Links to S1; celebrates renovation.", "[classify]", "[trace]", "[support/limit]", "[0–100 before tracing]", "[0–100 plus evidence-linked reason]" ], [ "S1", "BrightView Skylights blog; commercial secondary", "Repeats 30%; no meter table.", "Quotes CP1; marketing incentive.", "[classify]", "[trace]", "[support/limit]", "[0–100 before tracing]", "[0–100 plus evidence-linked reason]" ], [ "S2", "City Facilities meter appendix; official primary", "12-month pre mean 1000 kWh/month; post mean 760 kWh/month.", "Earliest meter data; occupancy hours changed.", "[classify]", "[trace]", "[support/limit]", "[0–100 before tracing]", "[0–100 plus evidence-linked reason]" ], [ "S3", "Library social post; institutional secondary", "Says about a third less.", "Links to S1; same chain.", "[classify]", "[trace]", "[support/limit]", "[0–100 before tracing]", "[0–100 plus evidence-linked reason]" ], [ "S4", "Regional Municipal Audit Office; independent official review", "After 10% occupied-hours adjustment: 18% reduction, range 12%-24%.", "Uses S2 files; weather and fixture replacement remain limits.", "[classify]", "[trace]", "[support/limit]", "[0–100 before tracing]", "[0–100 plus evidence-linked reason]" ] ] }, "scoring_rule": "Award 1 for exact claim capture, 1 for initial confidence, 5 for classifying all rows, 1 for the dependency chain, 1 for primary-source identification, 1 for the raw calculation, 1 for the independent limitation, 1 for the bounded update, 1 for final confidence and 1 for an evidence-linked update reason: 14 total.", "worked_example": { "steps": [ "Capture CP1's 30% claim and its link to S1.", "Reject S1 as origin because it repeats CP1 without data; reject S3 as independent because it links to S1.", "Trace S2 and calculate (1000-760)/1000=24%.", "Read S4's occupancy adjustment: 18% with a 12%-24% range.", "Lower confidence in exactly 30% while retaining evidence for some reduction." ], "result": "The packet supports a raw 24% reduction and an adjusted 18% estimate, not the exact 30% claim or proof that skylights alone caused the change." }, "right_vs_wrong": [ { "situation": "S1", "right": "Inspect its origin and commercial incentive.", "wrong": "Count confident repetition as confirmation.", "why": "It cites CP1 and has no meter data." }, { "situation": "S3", "right": "Mark it dependent on S1.", "wrong": "Count it as a third independent source.", "why": "Pages are not independent when they share one chain." }, { "situation": "S2 calculation", "right": "Use 240/1000=24%.", "wrong": "Use 240/760=31.6%.", "why": "Reduction uses the pre-period baseline denominator." }, { "situation": "Final claim", "right": "Separate raw, adjusted, range, and cause unknown.", "wrong": "The audit proves skylights saved exactly 18%.", "why": "S4 still reports uncertainty and other limits." } ], "common_mistakes": [ { "mistake": "Staying on CP1.", "fix": "Move through publisher, primary data, and independent review." }, { "mistake": "Counting pages instead of chains.", "fix": "Record what each row cites and merge dependent repetitions." }, { "mistake": "Rating publisher but not claim.", "fix": "Keep source credibility and support for 30% separate." }, { "mistake": "Replacing one absolute with another.", "fix": "Report 24%, 18%, 12%-24%, and causal uncertainty together." } ], "answer_key_route": "/tutorials/pwr-124/answer-key/", "answer_key_delivery": "SEPARATE_NOINDEX_NOARCHIVE_CHECKING_PAGE" }, "tutorial_mode": "PRACTICAL_LESSON", "orientation": { "bounded_definition": "Capability to develop or express source evaluation and lateral reading in a declared context without inheriting broader claims.", "evidence_summary": "Source checking can be learned, but search access, language, platform design and time shape what is possible.", "measurement_boundary": "Declare claim, source chain, search environment, language, access barriers, independent corroboration, time, accuracy and delayed novel-item test.", "myth_to_metric": { "myth": "Know instantly whether anything online is true", "metric": "Accurate source/provenance judgments on novel claims with search path declared", "boundary": "One checklist, search result or AI citation cannot certify truth or make someone scam-proof." }, "limiting_findings": [ "Many intervention estimates were null at two weeks.", "No between-intervention advantage was detected at follow-up." ], "prohibited_claims": [ "instantly know what is true", "Google it and verify anything", "become scam-proof", "source score proves credibility" ] }, "outcomes": [ "Define source evaluation and lateral reading without inheriting mythology or broader claims.", "Explain what the current evidence supports and what it does not establish.", "Use the declared measurement boundary and recognise misleading proxies.", "Complete only the separately governed capability practice inside its declared limits.", "Make a retention, transfer, maintenance, provider or stop decision without overclaiming." ], "prerequisites": "DECLARED_IN_GOVERNED_LESSON", "baseline": { "instruction": "Complete the baseline declared by the governed lesson before practice; keep it separate from the knowledge baseline.", "record": [ "date and context", "current definition", "confidence from 0 to 100", "assumed measure", "expected benefit", "known limitation", "intended next action" ] }, "modules": [ { "order": 1, "title": "Orient", "instruction": "Read the definition, evidence, measurement boundary and prohibited claims on this canonical page.", "completion_evidence": "Record the decision or output from orient in one or two sentences." }, { "order": 2, "title": "Baseline", "instruction": "Open the governed lesson and record its declared baseline before practising.", "completion_evidence": "Record the decision or output from baseline in one or two sentences." }, { "order": 3, "title": "Practise", "instruction": "Follow the ordered lesson exactly; do not add dose, intensity or claims.", "completion_evidence": "Record the decision or output from practise in one or two sentences." }, { "order": 4, "title": "Retest", "instruction": "Use the lesson's delayed retention and predeclared transfer checks as separate records.", "completion_evidence": "Record the decision or output from retest in one or two sentences." }, { "order": 5, "title": "Maintain or retire", "instruction": "Keep only what remains useful inside the evidence and safety boundary.", "completion_evidence": "Record the decision or output from maintain or retire in one or two sentences." } ], "lab": { "title": "Governed capability lab", "instruction": "Open the separately governed practical lesson and complete only its declared configuration, dose, measurement, accessibility and stopping rules.", "deliverable": "The lesson's declared baseline, practice and retest record; no additional exercise is implied here." }, "assessment": { "immediate": "Restate the bounded definition, evidence ceiling, measurement boundary and current authority route without looking.", "delayed_retention": "Repeat the explanation and route decision after at least 48 hours; record what changed or was forgotten.", "transfer": "Use only the lesson's predeclared transfer task; do not infer far transfer from the trained task.", "interpretation": "Completion demonstrates learning of this tutorial only. It does not prove capability, qualification, independent validation, safety clearance or far transfer." }, "maintenance": { "cadence": "Review after 48 hours, again after 2-4 weeks, and whenever the evidence or authority treatment changes.", "decisions": [ "retain", "refresh", "seek qualified support", "return to research", "retire" ] }, "accessibility": "Use text-to-speech, enlarged text, keyboard navigation, shorter sessions, a support person or an equivalent non-practical record format as needed. Accessibility changes must not enlarge practical authority.", "stopping_and_escalation": "A governed step-by-step lesson may be completed independently inside its stated limits. Stop if the declared configuration cannot be maintained, uncertainty becomes material, adverse effects appear, or qualified authority is required.", "next_gate": "No external confirmation is required for the current bounded explainer and non-prescriptive guide-frame permissions; any stronger efficacy, generalisation, protocol, promotion or independent-validation claim requires a new adjudication.", "evidence_count": 3 }, "full_training_programme": false, "independently_validated": false, "publication_state": "PUBLISHED_PUBLIC_RESEARCH_EDITION__EDITORIAL_REVIEW_PENDING", "related_power_ids": [ "PWR-121", "PWR-122", "PWR-123", "PWR-125" ] }, { "power_id": "PWR-125", "learning_unit_id": "TLU-PWR-125", "title": "Anomaly detection", "main_description": "The learner audits 60 synthetic rows and reports a full table of hits, misses, false alarms and correct rejections plus confirmation decisions for a predeclared anomaly rule.", "main_description_source": "FULL_TUTORIAL_OUTCOME", "family_id": "FAM-16", "family": "Metacognition & Epistemic Resilience", "superdomain": "Cognition & Learning", "canonical_route": "/powers/pwr-125/", "treatment": "EVIDENCE_REVIEW_ROUTE", "treatment_label": "Full low-stakes tutorial", "treatment_boundary": "Titan teaches a concrete low-stakes method step by step while keeping evidence and transfer claims bounded.", "tutorial_route": "/tutorials/pwr-125/", "governed_lesson_route": null, "self_attempt_status": "PERMITTED_INSIDE_FULL_TUTORIAL_LIMITS", "gold_pathway_ids": [ "G-CUR-012" ], "route_membership": { "kind": "GOLD_PATHWAY", "id": "G-CUR-012", "coverage_status": "EXACT_ONCE" }, "source_authority_tier": "G1", "source_build_state": "TARGETED_REVIEW_REQUIRED", "source_instructional_route": "SELF_GUIDED_TUTORIAL", "source_count": 2, "research_depth": "FOCUSED", "risk_level": "HIGH", "prerequisite_status": "NONE_FOR_READING__NO_PRACTICE_AUTHORITY", "learning_route": { "mode": "FULL_SELF_GUIDED_TUTORIAL", "label": "Learn anomaly detection step by step", "summary": "The learner audits 60 synthetic rows and reports a full table of hits, misses, false alarms and correct rejections plus confirmation decisions for a predeclared anomaly rule.", "steps": [ [ "Get ready", "Write that all data and devices are fictional." ], [ "Learn the method", "8 concrete steps teach the permitted method from start to finish." ], [ "See right and wrong", "4 comparisons show correct or safer execution beside common wrong or riskier choices." ], [ "Practise", "Use one new two-block synthetic dataset weekly for four weeks. Alternate normal-range width and prevalence, but declare both before inspection. On week four, preregister one revised threshold and test only on fresh rows." ], [ "Check progress", "From the keyed rows, calculate hits/(hits+misses), false alarms/(false alarms+correct rejections), prevalence, review time and confirmation outcomes." ] ], "practical_authority": true, "provider_required": false, "next_action_route": "/tutorials/pwr-125/" }, "path_builder": { "selectable": true, "completion_allowed": true, "warning": "Titan teaches a concrete low-stakes method step by step while keeping evidence and transfer claims bounded." }, "full_tutorial": { "version": "3.0", "authorship": "POWER_SPECIFIC_FULL_TUTORIAL", "tutorial_mode": "SELF_GUIDED", "promise": "An anomaly is a value that differs from a declared reference; it is not automatically an error, fraud, disease or danger. This lesson uses synthetic temperature-sensor rows with known injected anomalies. The learner declares a range before viewing cases, flags values, checks a second measurement, reveals ground truth and reports hits, misses and false alarms at two prevalence levels.", "power_id": "PWR-125", "title": "Anomaly detection", "lesson_type": "SELF_GUIDED", "headline": "Detect predeclared outliers in synthetic sensor data without calling them threats", "plain_english_summary": "An anomaly is a value that differs from a declared reference; it is not automatically an error, fraud, disease or danger. This lesson uses synthetic temperature-sensor rows with known injected anomalies. The learner declares a range before viewing cases, flags values, checks a second measurement, reveals ground truth and reports hits, misses and false alarms at two prevalence levels.", "outcome": "The learner audits 60 synthetic rows and reports a full table of hits, misses, false alarms and correct rejections plus confirmation decisions for a predeclared anomaly rule.", "authority": { "learner_may": [ "Inspect fully synthetic, consequence-free data with known ground truth.", "Treat a flag as a request for confirmation, not a conclusion." ], "qualified_person_required_for": [ "Medical, fraud, security, industrial, environmental or other consequential monitoring.", "Setting thresholds where misses or false alarms can harm people." ], "never_do": [ "Accuse, diagnose or trigger real action from this fixture.", "Move the anomaly rule after seeing the data or celebrate unusual guesses without denominators." ] }, "materials": [ "Exact 60-row synthetic dataset. Block A: 4.1, 3.8, 5.6, 4.4, 2.7, 3.6, 4.9, 4.0, 3.3, 4.7, 4.2, 3.9, 5.1, 4.6, 3.5, 4.3, 5.5, 4.0, 3.1, 4.8, 4.5, 3.7, 2.9, 4.1, 3.4, 4.9, 4.2, 3.8, 4.6, 4.0. Block B: 4.0, 3.7, 4.5, 5.0, 4.2, 3.3, 2.7, 4.8, 3.9, 4.4, 3.5, 4.1, 4.7, 3.8, 5.1, 4.3, 3.6, 4.9, 4.0, 3.2, 4.6, 5.5, 4.1, 3.9, 4.7, 4.2, 3.4, 4.8, 3.7, 4.0. Number rows A01–A30 and B01–B30 in order.", "Threshold and confirmation card: reference 3.0–5.0, noise allowance ±0.2, so flag below 2.8 or above 5.2. Repeat cards for flagged rows: A03→4.4, A05→2.6, A17→5.4, B07→4.2, B22→5.4.", "Hidden injected-anomaly key and confusion sheet: true anomalies are A05, A17 and B22; A03 and B07 are noise, so Block A prevalence is 2/30 and Block B prevalence 1/30. Reveal this key only after every classification and confirmation." ], "before_you_start": [ "Write that all data and devices are fictional.", "Declare normal reference, anomaly threshold and confirmatory rule before opening the rows.", "Set equal review time for both prevalence blocks.", "Have a helper copy the row blocks and repeat cards while keeping the injected-anomaly key hidden. If you memorised the key while preparing it, use this packet as demonstration and obtain a fresh permuted set for scored practice." ], "steps": [ { "title": "Define normal and anomaly", "instruction": "Write the reference interval, allowed measurement noise and exact flag rule.", "reason": "An anomaly exists only relative to a declared model.", "success_check": "Another learner can reproduce the same flag from the rule." }, { "title": "Declare prevalence and costs", "instruction": "Read the supplied expected prevalence for block one and rank the fictional cost of miss versus false alarm.", "reason": "Base rate and costs affect a useful review design.", "success_check": "The record states expected targets and cost priority." }, { "title": "Inspect order and local context", "instruction": "Before classifying, note whether each value stands alone, follows a gradual drift or occurs beside a missing reading. Keep the numerical threshold unchanged.", "reason": "Sequence context can suggest noise or system change without turning an anomaly into a cause.", "success_check": "Every flag records its preceding value and data-quality status as context, not as proof." }, { "title": "Classify the anomaly shape", "instruction": "Label a confirmed flag as an isolated point, a sustained level shift, a trend or an unresolved data-quality break using the supplied synthetic sequence rules.", "reason": "Different shapes call for different confirmation questions even when the numerical threshold is identical.", "success_check": "The shape label follows the fixture rule and remains separate from any claim about cause or danger." }, { "title": "Inspect blinded rows", "instruction": "Apply the rule to each row once and mark flag or clear without seeing the key.", "reason": "A blinded pass preserves detection evidence.", "success_check": "All rows receive one committed classification." }, { "title": "Confirm before interpreting", "instruction": "For each flag, open the supplied repeat-measurement card and label confirmed, not confirmed or unresolved.", "reason": "Independent measurement can distinguish anomaly from noise.", "success_check": "No flag is called a cause or threat." }, { "title": "Reveal and score", "instruction": "Compare with injected ground truth and count hits, misses, false alarms and correct rejections.", "reason": "All four outcomes are needed when targets are rare.", "success_check": "The matrix totals every row." }, { "title": "Change prevalence, not the rule", "instruction": "Run block two with rarer anomalies using the same threshold and time, then compare miss and false-alarm rates.", "reason": "Rare targets can be missed even when the detector has extensive exposure.", "success_check": "The report shows performance by prevalence without threshold drift." } ], "worked_example": { "scenario": "A fictional cold-room sensor normally reads 3.0–5.0 units with ±0.2 measurement noise; the predeclared flag rule is below 2.8 or above 5.2.", "walkthrough": [ "Inez writes the interval and rule before opening 30 rows.", "She flags 5.6 and 2.7 but clears 5.1 because it stays inside the noise boundary.", "A repeat card shows 5.6 became 4.4, so she labels it not confirmed rather than dangerous.", "The key shows 2.7 and the later 5.5 as Block A anomalies while 5.6 was noise; she records two hits, one false alarm and 27 correct rejections.", "On rarer Block B she keeps the same rule, confirms B22 and reports one hit plus the B07 false alarm with the 1/30 prevalence rather than moving the threshold afterward." ], "result": "Inez detects and confirms synthetic outliers transparently. She has not diagnosed a device fault or demonstrated professional monitoring." }, "right_vs_wrong": [ { "situation": "Rule timing", "right": "Declare the range before viewing rows.", "wrong": "Circle unusual-looking values and invent a threshold later.", "why": "Post-hoc rules inflate discoveries." }, { "situation": "Meaning", "right": "Call a value anomalous pending confirmation.", "wrong": "Call it fraud, danger or equipment failure.", "why": "An unusual observation does not identify a cause." }, { "situation": "Scoring", "right": "Report misses and false alarms with prevalence.", "wrong": "Report 98% accuracy on mostly normal rows.", "why": "Overall accuracy can hide failure on rare targets." }, { "situation": "Confirmation", "right": "Use an independent repeat measurement.", "wrong": "Re-read the same number until convinced.", "why": "Repeated interpretation is not independent evidence." } ], "common_mistakes": [ { "mistake": "Noise allowance is ignored.", "fix": "Build measurement uncertainty into the flag rule." }, { "mistake": "Unresolved flags are forced into true or false.", "fix": "Keep a separate unresolved category until the key or repeat exists." }, { "mistake": "Block prevalence is omitted.", "fix": "Record targets/rows for each block." }, { "mistake": "Threshold changes after a miss.", "fix": "Preserve the original score and preregister any new rule for a fresh dataset." } ], "practice": { "first_session": [ "Define reference and rule.", "Review one 30-row block.", "Open confirmation cards.", "Build the confusion matrix.", "Review a second rarer block with the same rule." ], "repeat_plan": "Use one new two-block synthetic dataset weekly for four weeks. Alternate normal-range width and prevalence, but declare both before inspection. On week four, preregister one revised threshold and test only on fresh rows.", "progress_when": [ "Rules reproduce exactly across rows.", "Miss and false-alarm rates are both reported.", "Flags trigger confirmation rather than causal claims." ], "do_not_progress_when": [ "The dataset becomes real or consequential.", "Thresholds are repeatedly moved to improve past scores.", "Low prevalence creates fatigue that breaks the time or attention limit." ] }, "self_check": [ "What reference and noise model define anomaly?", "Was the rule fixed before seeing data?", "How many misses and false alarms occurred?", "What independent confirmation follows a flag?" ], "measurement": { "primary": "Sensitivity and false-alarm rate for a predeclared synthetic anomaly rule.", "how": "From the keyed rows, calculate hits/(hits+misses), false alarms/(false alarms+correct rejections), prevalence, review time and confirmation outcomes.", "good_result": "All 60 rows and five repeat cards are accounted for, the confusion matrices reproduce the hidden key and the threshold never moves after reveal. Sensitivity and false-alarm rate are descriptive fixture results, not validated real-monitoring pass thresholds.", "does_not_prove": "It does not validate a real detector, identify causes, support accusation or show performance in another base rate." }, "stop_and_get_help": [ "Stop if real medical, fraud, threat or safety data enters the exercise.", "Stop when fatigue or compulsive scanning breaks the review limit.", "Route real anomaly systems to domain experts with calibrated thresholds, confirmation and appeal." ], "accessibility": [ "Provide data as an accessible table with consistent row labels.", "Use calculator or spreadsheet formulas with the rule visible.", "Offer audio values or tactile plots while preserving identical rows and timing rules." ], "evidence_notes": [ { "claim": "The ultra-rare-item effect persisted across millions of game trials, showing that very low prevalence can produce high miss rates.", "source_title": "The Ultra-Rare-Item Effect", "source_url": "https://doi.org/10.1177/0956797613504221", "source_kind": "PRIMARY_RESEARCH" }, { "claim": "Correctable-search research found interface conditions can reduce rare-target misses in bounded tasks, so the correction path is part of the configured system.", "source_title": "Rare Targets Are Rarely Missed in Correctable Search", "source_url": "https://doi.org/10.1111/j.1467-9280.2007.02006.x", "source_kind": "PRIMARY_RESEARCH" } ], "limits": [ "The fixture has known ground truth and stable synthetic data generation.", "An anomaly is not automatically an error, threat or cause.", "Performance can change sharply with prevalence, interface, fatigue and threshold." ], "orientation": { "bounded_definition": "Capability to develop or express anomaly detection in a declared context without inheriting broader claims.", "evidence_summary": "The rarer the target, the easier it can be to miss—even for experienced searchers.", "supportable_public_claim": "Rare anomalies are systematically easy to miss, and selected interface designs can reduce misses in bounded search tasks.", "measurement_boundary": "Declare target definition/prevalence, misses, false alarms, search time, fatigue, correction interface, ground truth and downstream escalation.", "myth_to_metric": { "myth": "Never miss a hidden threat", "metric": "Miss and false-alarm rates at declared target prevalence under realistic workload", "boundary": "A game or lab search cannot certify professional detection, intuition or public safety." }, "limiting_findings": [ "Millions of game trials still showed very high miss rates for ultra-rare targets.", "Correction benefits were interface-dependent and not validated in professional field settings." ], "prohibited_claims": [ "spot the invisible pattern", "never miss a threat", "superhuman vigilance", "anomaly score proves expert inspection" ] }, "gold_source_lesson": { "curriculum_id": "G-CUR-012", "source_heading": "9. PWR-125 — Anomaly detection — review-only", "source_html_sha256": "f3bcb346974ea10c4c1dc9452b66016f7dae2abc64b035c705140bd528b4ce8b", "html": "An anomaly is an observation that differs from a declared reference\nmodel. It is not automatically an error, a threat or evidence of fraud.\nLow base rates, measurement noise, multiple comparisons and changing\nsystems can all create unusual observations.
\nA future low-risk fixture could contain synthetic sensor or inventory\nvalues with declared normal ranges and known injected anomalies. Before\nordered practice is written, reviewers must close clinical-scope,\nlegitimacy and safety gates and confirm that the design does not imply\nmedical diagnosis, fraud detection or threat detection.
" }, "next_gate": "External confirmation is required before higher-authority use because: CLINICAL_HIGH_RISK_OR_REGULATED_CONFIGURATION; SAFETY_LEGITIMACY_RESTRICTED.", "evidence_count": 2 }, "full_training_programme": false, "independently_validated": false, "publication_state": "PUBLISHED_PUBLIC_RESEARCH_EDITION__EDITORIAL_REVIEW_PENDING", "related_power_ids": [ "PWR-121", "PWR-122", "PWR-123", "PWR-124" ] }, { "power_id": "PWR-126", "learning_unit_id": "TLU-PWR-126", "title": "Uncertainty communication", "main_description": "Communicating uncertainty means stating the estimate, its basis, a meaningful limit, and what changes the next action. This pack supplies a harmless delivery dataset, three draft messages, reader teach-backs, and a six-item scoring checklist. The learner repairs misunderstanding rather than chasing reassurance, trust, or persuasion.", "main_description_source": "GOVERNED_TUTORIAL_PLAIN_ENGLISH_INTRO", "family_id": "FAM-16", "family": "Metacognition & Epistemic Resilience", "superdomain": "Cognition & Learning", "canonical_route": "/powers/pwr-126/", "treatment": "SELF_GUIDED_LESSON", "treatment_label": "Self-guided lesson", "treatment_boundary": "A governed step-by-step lesson may be completed independently inside its stated limits.", "tutorial_route": "/tutorials/pwr-126/", "governed_lesson_route": "/tutorials/pwr-126/", "self_attempt_status": "PERMITTED_INSIDE_TUTORIAL_LIMITS", "gold_pathway_ids": [ "G-CUR-012" ], "route_membership": { "kind": "GOLD_PATHWAY", "id": "G-CUR-012", "coverage_status": "EXACT_ONCE" }, "source_authority_tier": "G1", "source_build_state": "COMPREHENSIVE_OWNER_CANDIDATE", "source_instructional_route": "SELF_GUIDED_TUTORIAL", "source_count": 3, "research_depth": "FOCUSED", "risk_level": "MODERATE", "prerequisite_status": "DECLARED_IN_GOVERNED_LESSON", "learning_route": { "mode": "PRACTICAL_LESSON", "label": "Learn with the governed self-guided lesson", "summary": "Communicating uncertainty means stating the estimate, its basis, a meaningful limit, and what changes the next action. This pack supplies a harmless delivery dataset, three draft messages, reader teach-backs, and a six-item scoring checklist. The learner repairs misunderstanding rather than chasing reassurance, trust, or persuasion.", "steps": [ [ "Orient", "Read the definition, evidence, measurement boundary and prohibited claims on this canonical page." ], [ "Baseline", "Open the governed lesson and record its declared baseline before practising." ], [ "Practise", "Follow the ordered lesson exactly; do not add dose, intensity or claims." ], [ "Retest", "Use the lesson's delayed retention and predeclared transfer checks as separate records." ], [ "Maintain or retire", "Keep only what remains useful inside the evidence and safety boundary." ] ], "practical_authority": true, "provider_required": false, "next_action_route": "/tutorials/pwr-126/" }, "path_builder": { "selectable": true, "completion_allowed": true, "warning": "A governed step-by-step lesson may be completed independently inside its stated limits." }, "full_tutorial": { "version": "1.0", "authorship": "AUTHORED_GOVERNED_SOURCE", "practice_pack": { "power_id": "PWR-126", "title": "Uncertainty communication", "heading": "Repair a fictional delivery estimate until a reader can teach it back", "plain_english_intro": "Communicating uncertainty means stating the estimate, its basis, a meaningful limit, and what changes the next action. This pack supplies a harmless delivery dataset, three draft messages, reader teach-backs, and a six-item scoring checklist. The learner repairs misunderstanding rather than chasing reassurance, trust, or persuasion.", "authority_and_safety": [ "Use only the fictional archive-box scenario; do not adapt it to medicine, crisis response, politics, finance, legal advice, or another high-stakes message.", "Comprehension is the target. A clear message can still be based on an uncertain or wrong estimate.", "The reader may disagree or decline; no persuasion or non-consensual testing is authorised." ], "materials": [ "The fictional delivery scenario in the fixture caption", "A blank baseline-message and teach-back prediction worksheet", "The six-item checklist: window, number plus plain language, source, limit, action and change trigger", "The uncertainty labels ALEATORY, EPISTEMIC and MIXED", "The staged model message and teach-back key, opened only after the learner's baseline and repair are locked" ], "setup_steps": [ "Read only the scenario caption. Write your own baseline message and one expected reader teach-back before opening the staged key.", "Calculate in-window, early and late proportions from all 80 deliveries.", "Name the uncertainty: delivery-to-delivery variation is aleatory; uncertainty about whether history still represents the new backlog is epistemic; together the message has mixed uncertainty.", "Score your baseline for window, number plus plain language, source, limit, action and change trigger. Preserve the first score.", "Compare your expected teach-back with the data. Mark any invented guarantee, missing source, missing variability or missing trigger.", "Repair your own message without stronger reassurance and write a second teach-back prediction.", "Open the staged model only now. Compare field by field and record what your repair still missed; never rewrite the baseline as if the model had been known." ], "fixture": { "caption": "Scenario: of 80 similar deliveries, 56 arrived Tuesday–Thursday, 12 earlier and 12 later. A new carrier backlog may make history less representative. If absent Thursday at 17:00, the fictional coordinator asks for an update. The fixture is blank so the baseline cannot be contaminated by a supplied draft.", "headers": [ "Stage", "Learner message", "Expected reader teach-back", "Uncertainty type", "Checklist score out of 6", "Missing element or repair" ], "rows": [ [ "Baseline — key closed", "[write]", "[predict]", "[classify]", "[score]", "[preserve omissions]" ], [ "Repair — key still closed", "[rewrite]", "[predict again]", "[preserve classification]", "[rescore]", "[state exact repair]" ], [ "Model comparison — key open", "[do not copy into baseline]", "[compare]", "[check]", "[compare]", "[record remaining gap]" ] ] }, "scoring_rule": "Award 1 point for each of the six explicit message elements, 1 for a correct MIXED uncertainty classification and 1 for a teach-back that preserves estimate, uncertainty and trigger: 8 total. Baseline and repair remain separate. Opening or copying the staged model before locking the repair invalidates the baseline comparison.", "worked_example": { "steps": [ "Verify M2's number: 56/80=70%, so the arithmetic is correct.", "Score M2 at 2/6 for time window and 70%/7-in-10 wording.", "Use the teach-back to find guarantee and missing-source errors.", "Add 56 of 80, 12 early, 12 late, the backlog limit, current action, and Thursday 17:00 trigger.", "Compare the repaired M3 teach-back with every source field." ], "result": "The repaired M3 scores 6/6 and supports accurate teach-back without implying that 70% is certainty." }, "right_vs_wrong": [ { "situation": "Numbers and words", "right": "70%, about 7 in 10 of 80.", "wrong": "Probably soon.", "why": "Vague wording hides range and reference class." }, { "situation": "Limitation", "right": "Backlog may reduce relevance.", "wrong": "Eighty cases make it certain.", "why": "Changed conditions remain important." }, { "situation": "Comprehension", "right": "Ask for estimate-limit-trigger teach-back.", "wrong": "Ask whether it feels trustworthy.", "why": "Trust does not prove understanding." }, { "situation": "Action", "right": "No action now; update if absent at the trigger.", "wrong": "Wait indefinitely because 70% reassures.", "why": "A usable message includes a change condition." } ], "common_mistakes": [ { "mistake": "Percentage without denominator.", "fix": "Add 56 of 80 and about 7 in 10." }, { "mistake": "Hiding changed conditions.", "fix": "Name the new backlog." }, { "mistake": "Treating silence as comprehension.", "fix": "Use the supplied teach-back checklist." }, { "mistake": "Repairing with stronger reassurance.", "fix": "Rewrite the missing estimate, source, limit, or trigger." } ], "answer_key_route": "/tutorials/pwr-126/answer-key/", "answer_key_delivery": "SEPARATE_NOINDEX_NOARCHIVE_CHECKING_PAGE" }, "tutorial_mode": "PRACTICAL_LESSON", "orientation": { "bounded_definition": "Capability to develop or express uncertainty communication in a declared context without inheriting broader claims.", "evidence_summary": "Uncertainty can be communicated honestly without automatically destroying trust—but format and audience matter.", "measurement_boundary": "Declare uncertainty type, format, source, audience, language, comprehension, trust, decision and equity; trust is not the sole success criterion.", "myth_to_metric": { "myth": "Use the perfect phrase and everyone will understand risk", "metric": "Comprehension, calibrated trust and decision quality for a declared uncertainty message", "boundary": "A trusted message is not necessarily understood, accurate, fair or actionable." }, "limiting_findings": [ "Vague verbal uncertainty could reduce trust.", "Effects differed by country, source and topic, and comprehension/decision quality were not always established." ], "prohibited_claims": [ "one perfect uncertainty phrase", "numbers make communication objective", "trust proves understanding", "AI can calibrate any message automatically" ] }, "outcomes": [ "Define uncertainty communication without inheriting mythology or broader claims.", "Explain what the current evidence supports and what it does not establish.", "Use the declared measurement boundary and recognise misleading proxies.", "Complete only the separately governed capability practice inside its declared limits.", "Make a retention, transfer, maintenance, provider or stop decision without overclaiming." ], "prerequisites": "DECLARED_IN_GOVERNED_LESSON", "baseline": { "instruction": "Complete the baseline declared by the governed lesson before practice; keep it separate from the knowledge baseline.", "record": [ "date and context", "current definition", "confidence from 0 to 100", "assumed measure", "expected benefit", "known limitation", "intended next action" ] }, "modules": [ { "order": 1, "title": "Orient", "instruction": "Read the definition, evidence, measurement boundary and prohibited claims on this canonical page.", "completion_evidence": "Record the decision or output from orient in one or two sentences." }, { "order": 2, "title": "Baseline", "instruction": "Open the governed lesson and record its declared baseline before practising.", "completion_evidence": "Record the decision or output from baseline in one or two sentences." }, { "order": 3, "title": "Practise", "instruction": "Follow the ordered lesson exactly; do not add dose, intensity or claims.", "completion_evidence": "Record the decision or output from practise in one or two sentences." }, { "order": 4, "title": "Retest", "instruction": "Use the lesson's delayed retention and predeclared transfer checks as separate records.", "completion_evidence": "Record the decision or output from retest in one or two sentences." }, { "order": 5, "title": "Maintain or retire", "instruction": "Keep only what remains useful inside the evidence and safety boundary.", "completion_evidence": "Record the decision or output from maintain or retire in one or two sentences." } ], "lab": { "title": "Governed capability lab", "instruction": "Open the separately governed practical lesson and complete only its declared configuration, dose, measurement, accessibility and stopping rules.", "deliverable": "The lesson's declared baseline, practice and retest record; no additional exercise is implied here." }, "assessment": { "immediate": "Restate the bounded definition, evidence ceiling, measurement boundary and current authority route without looking.", "delayed_retention": "Repeat the explanation and route decision after at least 48 hours; record what changed or was forgotten.", "transfer": "Use only the lesson's predeclared transfer task; do not infer far transfer from the trained task.", "interpretation": "Completion demonstrates learning of this tutorial only. It does not prove capability, qualification, independent validation, safety clearance or far transfer." }, "maintenance": { "cadence": "Review after 48 hours, again after 2-4 weeks, and whenever the evidence or authority treatment changes.", "decisions": [ "retain", "refresh", "seek qualified support", "return to research", "retire" ] }, "accessibility": "Use text-to-speech, enlarged text, keyboard navigation, shorter sessions, a support person or an equivalent non-practical record format as needed. Accessibility changes must not enlarge practical authority.", "stopping_and_escalation": "A governed step-by-step lesson may be completed independently inside its stated limits. Stop if the declared configuration cannot be maintained, uncertainty becomes material, adverse effects appear, or qualified authority is required.", "next_gate": "No external confirmation is required for the current bounded explainer and non-prescriptive guide-frame permissions; any stronger efficacy, generalisation, protocol, promotion or independent-validation claim requires a new adjudication.", "evidence_count": 3 }, "full_training_programme": false, "independently_validated": false, "publication_state": "PUBLISHED_PUBLIC_RESEARCH_EDITION__EDITORIAL_REVIEW_PENDING", "related_power_ids": [ "PWR-121", "PWR-122", "PWR-123", "PWR-124" ] }, { "power_id": "PWR-127", "learning_unit_id": "TLU-PWR-127", "title": "Belief updating", "main_description": "The learner completes four fictional evidence sequences and makes directionally correct, proportionate updates that track the supplied likelihood information.", "main_description_source": "FULL_TUTORIAL_OUTCOME", "family_id": "FAM-16", "family": "Metacognition & Epistemic Resilience", "superdomain": "Cognition & Learning", "canonical_route": "/powers/pwr-127/", "treatment": "EVIDENCE_REVIEW_ROUTE", "treatment_label": "Full low-stakes tutorial", "treatment_boundary": "Titan teaches a concrete low-stakes method step by step while keeping evidence and transfer claims bounded.", "tutorial_route": "/tutorials/pwr-127/", "governed_lesson_route": null, "self_attempt_status": "PERMITTED_INSIDE_FULL_TUTORIAL_LIMITS", "gold_pathway_ids": [ "G-CUR-012" ], "route_membership": { "kind": "GOLD_PATHWAY", "id": "G-CUR-012", "coverage_status": "EXACT_ONCE" }, "source_authority_tier": "G1", "source_build_state": "TARGETED_REVIEW_REQUIRED", "source_instructional_route": "SELF_GUIDED_TUTORIAL", "source_count": 3, "research_depth": "FOCUSED", "risk_level": "HIGH", "prerequisite_status": "NONE_FOR_READING__NO_PRACTICE_AUTHORITY", "learning_route": { "mode": "FULL_SELF_GUIDED_TUTORIAL", "label": "Learn belief updating step by step", "summary": "The learner completes four fictional evidence sequences and makes directionally correct, proportionate updates that track the supplied likelihood information.", "steps": [ [ "Get ready", "Mark the claim fictional and define what probability refers to." ], [ "Learn the method", "8 concrete steps teach the permitted method from start to finish." ], [ "See right and wrong", "4 comparisons show correct or safer execution beside common wrong or riskier choices." ], [ "Practise", "Complete one new fictional sequence twice a week for two weeks. Vary prior and reliability, then include one non-diagnostic and one dependent card. Do not substitute real controversial claims." ], [ "Check progress", "For each independent card compute prior odds p/(1−p), likelihood ratio P(E|A)/P(E|B), posterior odds and posterior probability O/(1+O). Record intuitive estimate, benchmark, absolute difference, duplicate-evidence handling and reversal condition for each sequence." ] ], "practical_authority": true, "provider_required": false, "next_action_route": "/tutorials/pwr-127/" }, "path_builder": { "selectable": true, "completion_allowed": true, "warning": "Titan teaches a concrete low-stakes method step by step while keeping evidence and transfer claims bounded." }, "full_tutorial": { "version": "3.0", "authorship": "POWER_SPECIFIC_FULL_TUTORIAL", "tutorial_mode": "SELF_GUIDED", "promise": "Belief updating is changing a prior confidence state after evidence. This lesson uses a fictional urn with coloured tokens and known evidence reliability. The learner writes a prior range and change rule, reveals one card at a time, records each update, checks alternatives and compares with a Bayesian benchmark—a calculation that combines the starting odds with how expected the evidence is under each option. It never targets real political, medical, identity or interpersonal beliefs.", "power_id": "PWR-127", "title": "Belief updating", "lesson_type": "SELF_GUIDED", "headline": "Update a probability on a fictional urn task one evidence card at a time", "plain_english_summary": "Belief updating is changing a prior confidence state after evidence. This lesson uses a fictional urn with coloured tokens and known evidence reliability. The learner writes a prior range and change rule, reveals one card at a time, records each update, checks alternatives and compares with a Bayesian benchmark—a calculation that combines the starting odds with how expected the evidence is under each option. It never targets real political, medical, identity or interpersonal beliefs.", "outcome": "The learner completes four fictional evidence sequences and makes directionally correct, proportionate updates that track the supplied likelihood information.", "authority": { "learner_may": [ "Update probabilities on supplied fictional claims with explicit ground truth and likelihoods.", "Keep unresolved beliefs unresolved." ], "qualified_person_required_for": [ "Real contested, clinical, legal, political or consequential belief interventions.", "Work intended to change another person’s beliefs, identity or consent." ], "never_do": [ "Use the exercise to pressure, manipulate or label a real person as irrational.", "Treat movement toward an authority as automatically accurate." ] }, "materials": [ "Four fictional urn scenarios with priors, possible urns and sequential evidence cards.", "Prior–evidence–update log, calculator and formula card: prior odds = p/(1−p); likelihood ratio LR = P(evidence|A)/P(evidence|B); posterior odds = prior odds × LR; posterior probability = posterior odds/(1+posterior odds).", "Alternative-explanation and future-reversal fields." ], "before_you_start": [ "Mark the claim fictional and define what probability refers to.", "Write the prior before revealing evidence.", "State what evidence would move confidence up, down or not at all." ], "steps": [ { "title": "Write the prior range", "instruction": "Record the starting probability as a point or honest range and cite the supplied base rate.", "reason": "A visible prior prevents hindsight and shows how far evidence moved belief.", "success_check": "The prior and reason are fixed before card one." }, { "title": "Translate the prior into counts", "instruction": "Represent the starting probability as expected cases out of 100, split between the two urn options. Keep the original percentage beside it.", "reason": "Concrete counts make later evidence changes visible without requiring formula fluency.", "success_check": "The frequency table totals 100 and matches the declared prior before any evidence card opens." }, { "title": "Predeclare update direction", "instruction": "For each possible evidence type, state whether it would be more expected if the claim were true, false or equally expected.", "reason": "Likelihood direction matters more than whether evidence sounds impressive.", "success_check": "Each card type has an expected direction before reveal." }, { "title": "Reveal one card", "instruction": "Open only the next card, record its reliability and alternative way it could arise, then update once.", "reason": "Sequential logging prevents the final story from erasing intermediate reasoning.", "success_check": "The log shows card, reliability, alternative and new probability." }, { "title": "Match update to diagnosticity", "instruction": "Move more for evidence with a larger true-versus-false likelihood difference and little for weak or equally likely evidence.", "reason": "Proportionate updating avoids all-or-nothing belief swings.", "success_check": "The update size is justified by supplied likelihoods." }, { "title": "Check cumulative coherence", "instruction": "After all cards, ask whether any evidence was double-counted or depended on an earlier card.", "reason": "Correlated evidence can create false certainty.", "success_check": "Dependencies are marked and duplicates are not counted twice." }, { "title": "Plot the update path", "instruction": "Place the prior and every revised probability on one 0–100 line, annotate the evidence card and mark any all-or-nothing jump.", "reason": "A trajectory makes disproportionate or directionally inconsistent updates easier to inspect than the final estimate alone.", "success_check": "Every movement has a card label, direction and magnitude, and unexplained jumps are corrected before benchmarking." }, { "title": "Compare and set reversal evidence", "instruction": "Calculate the Bayesian benchmark from the formula card: convert prior p to odds p/(1−p), multiply by P(evidence|A)/P(evidence|B), then convert the posterior odds O back with O/(1+O). Use only independent evidence. Explain any difference from the intuitive update and write what future card would move the belief back.", "reason": "A benchmark teaches the normative structure while preserving uncertainty and reversibility.", "success_check": "Final estimate, benchmark, discrepancy and reversal condition are recorded." } ], "worked_example": { "scenario": "Urn A contains 80% blue tokens and Urn B 20%; one urn is selected with a 50% prior. One token is observed directly and replaced, so P(blue|A)=0.80 and P(blue|B)=0.20.", "walkthrough": [ "Sal writes P(A)=50% before the first token-observation card.", "He states a blue report should raise A, while a red report should lower it.", "The first independent card is blue; he records random draw as an alternative and makes an intuitive update to 70%, not 100%.", "A second blue card is only a duplicate record of that same token observation, so he marks it dependent and does not count it twice.", "For the independent blue card he calculates prior odds 0.5/0.5=1, LR 0.80/0.20=4, posterior odds 4 and posterior P(A)=4/(1+4)=80%; he records under-updating and says an independent red card would lower the estimate." ], "result": "Sal updates in the correct direction, avoids double-counting and compares with a transparent benchmark. The task says nothing about his real-world beliefs." }, "right_vs_wrong": [ { "situation": "Prior", "right": "Write it before evidence.", "wrong": "Reconstruct a convenient prior afterward.", "why": "A hidden prior prevents evaluation of updating." }, { "situation": "Evidence", "right": "Ask whether it is more likely under true or false.", "wrong": "Update because the evidence is vivid or repeated.", "why": "Vividness and repetition do not equal diagnosticity." }, { "situation": "Dependence", "right": "Count a duplicated sensor report once.", "wrong": "Treat correlated copies as independent confirmation.", "why": "Double-counting creates false certainty." }, { "situation": "Reversibility", "right": "Name future evidence that could move belief back.", "wrong": "Declare the final estimate permanently settled.", "why": "Honest beliefs remain conditional on evidence and model assumptions." } ], "common_mistakes": [ { "mistake": "A range is collapsed to 0% or 100%.", "fix": "Keep nonzero uncertainty unless the fixture logically rules an option out." }, { "mistake": "Source authority replaces likelihood.", "fix": "Use the supplied reliability and relevance for the specific card." }, { "mistake": "Repeated cards are assumed independent.", "fix": "Trace shared source or measurement before multiplying evidence." }, { "mistake": "The final benchmark is copied without explaining discrepancy.", "fix": "Name under-update, over-update, arithmetic error or different assumption." } ], "practice": { "first_session": [ "Set one fictional prior.", "Predeclare evidence directions.", "Reveal three cards sequentially.", "Check dependence and compare with benchmark.", "Write reversal evidence." ], "repeat_plan": "Complete one new fictional sequence twice a week for two weeks. Vary prior and reliability, then include one non-diagnostic and one dependent card. Do not substitute real controversial claims.", "progress_when": [ "Update direction is correct for every card.", "Magnitude responds to supplied diagnosticity.", "Dependent evidence is not double-counted." ], "do_not_progress_when": [ "Content becomes real, identity-linked or consequential.", "The learner feels pressure to conform to a source rather than evaluate evidence.", "Likelihoods or ground truth are unavailable." ] }, "self_check": [ "Was the prior recorded before evidence?", "Is this card more expected under true or false?", "Is it independent of prior cards?", "What future evidence would reverse the update?" ], "measurement": { "primary": "Directional and proportional accuracy of probability updates on fictional sequences.", "how": "For each independent card compute prior odds p/(1−p), likelihood ratio P(E|A)/P(E|B), posterior odds and posterior probability O/(1+O). Record intuitive estimate, benchmark, absolute difference, duplicate-evidence handling and reversal condition for each sequence.", "good_result": "Update direction matches the supplied likelihood ratio, the benchmark calculation reproduces from the formula card, dependent evidence is excluded and any intuitive–benchmark gap is explained and retained. No ten-percentage-point cutoff is treated as general open-mindedness.", "does_not_prove": "It does not show real-world open-mindedness, correct values, resistance to manipulation or authority over another person’s beliefs." }, "stop_and_get_help": [ "Stop if the fixture shifts to a real political, clinical, identity, relationship or legal claim.", "Stop if the exercise is used to pressure agreement or collect sensitive beliefs.", "Use accountable domain evidence and legitimate decision processes for consequential real-world updating." ], "accessibility": [ "Use probability bars, frequencies out of 100 or tactile tokens instead of formulas.", "Read cards aloud one at a time with a scribe.", "Allow calculator support and extra time while preserving reveal order." ], "evidence_notes": [ { "claim": "Fact-checking experiments across four countries improved accuracy for targeted claims, but effects belong to the tested claims and contexts.", "source_title": "The global effectiveness of fact-checking: Evidence from simultaneous experiments in Argentina, Nigeria, South Africa, and the United Kingdom", "source_url": "https://doi.org/10.1073/pnas.2104235118", "source_kind": "PRIMARY_RESEARCH" }, { "claim": "A ten-country vaccine-misinformation correction produced only a small accuracy change and did not change attitudes or intentions, limiting broad transfer claims.", "source_title": "Correcting COVID-19 vaccine misinformation in 10 countries", "source_url": "https://doi.org/10.1098/rsos.221097", "source_kind": "PRIMARY_RESEARCH" } ], "limits": [ "The urn supplies clean likelihoods unlike most real beliefs.", "Bayesian coherence does not choose values or legitimate action.", "Corrections can change targeted accuracy without changing attitudes, intentions or behaviour." ], "orientation": { "bounded_definition": "Capability to develop or express belief updating in a declared context without inheriting broader claims.", "evidence_summary": "Facts can shift specific beliefs, but changing a belief does not automatically change an attitude, intention or action.", "supportable_public_claim": "Corrections can improve accuracy for targeted false claims across countries, but effects on attitudes, intentions and lasting behavior are limited and inconsistent.", "measurement_boundary": "Declare claim, prior belief, evidence/source, correction, confidence, delay, attitudes, intentions, behavior and autonomy; movement toward authority is not automatically accuracy.", "myth_to_metric": { "myth": "Change anyone’s mind with the right facts", "metric": "Appropriate confidence change after verified evidence, plus delayed behavior where relevant", "boundary": "Belief movement does not prove coercive success, durable action or universal agreement." }, "limiting_findings": [ "A large vaccine-misinformation correction changed accuracy only slightly and did not change attitudes or intentions.", "Two-week persistence in that study was uncertain." ], "prohibited_claims": [ "change anyone’s mind", "correct beliefs permanently", "facts automatically change behavior", "belief update score identifies irrational people" ] }, "gold_source_lesson": { "curriculum_id": "G-CUR-012", "source_heading": "11. PWR-127 — Belief updating — review-only", "source_html_sha256": "c6ea176d8355ac34445da6b9fd77993deddcdb3c881e257f978908260ffee162", "html": "Belief updating is the change from a prior confidence state after\nevidence. Because the current route retains clinical-scope, legitimacy,\nrights-and-representation and safety gates, this chapter does not tell\nlearners how to modify beliefs about real people, identity groups,\nmental health, contested political claims or consequential\ndecisions.
\n| Field | \nReviewer checks | \n
|---|---|
| Prior | \nWas it recorded before new evidence? | \n
| Evidence | \nIs it independent, relevant and correctly interpreted? | \n
| Likelihood direction | \nWould this evidence be more expected if the claim were true or\nfalse? | \n
| Alternative explanation | \nWhat else could generate the evidence? | \n
| Update magnitude | \nIs the change proportionate rather than all-or-nothing? | \n
| Unknowns | \nWhat remains unresolved? | \n
| Reversibility | \nWhat future evidence would move the belief back? | \n
| Rights/legitimacy | \nWho is affected by the conclusion? | \n
The workbook uses this only as a reviewer specification. Ordered\npractice remains blocked.
" }, "next_gate": "External confirmation is required before higher-authority use because: CLINICAL_HIGH_RISK_OR_REGULATED_CONFIGURATION; CULTURAL_COMMUNITY_RIGHTS_OR_AFFECTED_PERSON_AUTHORITY; SAFETY_LEGITIMACY_RESTRICTED.", "evidence_count": 3 }, "full_training_programme": false, "independently_validated": false, "publication_state": "PUBLISHED_PUBLIC_RESEARCH_EDITION__EDITORIAL_REVIEW_PENDING", "related_power_ids": [ "PWR-121", "PWR-122", "PWR-123", "PWR-124" ] }, { "power_id": "PWR-128", "learning_unit_id": "TLU-PWR-128", "title": "Epistemic humility", "main_description": "This tutorial teaches evidence-sensitive revision, not a personality label. For each benign fictional case, you rank the initial source, inspect new evidence and power context, write your own final answer and confidence, choose a verification action and then classify the pattern. Supplied final answers stay in the staged key so the learner actually performs the update rather than merely reading one.", "main_description_source": "GOVERNED_TUTORIAL_PLAIN_ENGLISH_INTRO", "family_id": "FAM-16", "family": "Metacognition & Epistemic Resilience", "superdomain": "Cognition & Learning", "canonical_route": "/powers/pwr-128/", "treatment": "SELF_GUIDED_LESSON", "treatment_label": "Self-guided lesson", "treatment_boundary": "A governed step-by-step lesson may be completed independently inside its stated limits.", "tutorial_route": "/tutorials/pwr-128/", "governed_lesson_route": "/tutorials/pwr-128/", "self_attempt_status": "PERMITTED_INSIDE_TUTORIAL_LIMITS", "gold_pathway_ids": [ "G-CUR-012" ], "route_membership": { "kind": "GOLD_PATHWAY", "id": "G-CUR-012", "coverage_status": "EXACT_ONCE" }, "source_authority_tier": "G1", "source_build_state": "COMPREHENSIVE_OWNER_CANDIDATE", "source_instructional_route": "SELF_GUIDED_TUTORIAL", "source_count": 2, "research_depth": "FOCUSED", "risk_level": "MODERATE", "prerequisite_status": "DECLARED_IN_GOVERNED_LESSON", "learning_route": { "mode": "PRACTICAL_LESSON", "label": "Learn with the governed self-guided lesson", "summary": "This tutorial teaches evidence-sensitive revision, not a personality label. For each benign fictional case, you rank the initial source, inspect new evidence and power context, write your own final answer and confidence, choose a verification action and then classify the pattern. Supplied final answers stay in the staged key so the learner actually performs the update rather than merely reading one.", "steps": [ [ "Orient", "Read the definition, evidence, measurement boundary and prohibited claims on this canonical page." ], [ "Baseline", "Open the governed lesson and record its declared baseline before practising." ], [ "Practise", "Follow the ordered lesson exactly; do not add dose, intensity or claims." ], [ "Retest", "Use the lesson's delayed retention and predeclared transfer checks as separate records." ], [ "Maintain or retire", "Keep only what remains useful inside the evidence and safety boundary." ] ], "practical_authority": true, "provider_required": false, "next_action_route": "/tutorials/pwr-128/" }, "path_builder": { "selectable": true, "completion_allowed": true, "warning": "A governed step-by-step lesson may be completed independently inside its stated limits." }, "full_tutorial": { "version": "1.0", "authorship": "AUTHORED_GOVERNED_SOURCE", "practice_pack": { "power_id": "PWR-128", "title": "Epistemic humility", "heading": "Classify evidence-sensitive revision in five benign fictional cases", "plain_english_intro": "This tutorial teaches evidence-sensitive revision, not a personality label. For each benign fictional case, you rank the initial source, inspect new evidence and power context, write your own final answer and confidence, choose a verification action and then classify the pattern. Supplied final answers stay in the staged key so the learner actually performs the update rather than merely reading one.", "authority_and_safety": [ "Use only the bounded configuration. Choose a neutral, low-stakes claim. Avoid identity-threatening, traumatic, political or relationship disputes for the first cycle.", "Stop if the frame becomes compelled disclosure, debate pressure, belief scoring or an attempt to make someone compliant.", "Stop if power imbalance, identity threat or distress makes reflection unsafe." ], "materials": [ "The five fictional cases H1–H5 in the fixture; no personal belief, live disagreement or partner is needed.", "Classification key: AR = accuracy-sensitive revision supported by better evidence; BU = bounded uncertainty preserved because credible evidence conflicts; PL = polite language without demonstrated revision; DF = deference or lowered confidence without better evidence, especially under power; NI = insufficient information for a humility inference.", "Evidence-order card: current official dated notice outranks an undated blog or old flyer for the supplied scheduling question; two current official notices with conflicting dates require BU and verification rather than forced certainty.", "Worksheet with fields for evidence quality, answer change, confidence change, power/affiliation flag, observable action, allowed label and non-claim.", "Boundary card: FICTIONAL BENIGN TOPICS ONLY; no personality rank, ideology, debate, disclosure, surveillance, compelled agreement or attempt to make another person open-minded.", "Answer key hidden until every case has a label." ], "setup_steps": [ "Copy the five labels and evidence-order rule. Do not infer humility from a confidence number or courteous phrase alone.", "For each case, read the initial answer/source and record whether you would keep or question it before opening the new-evidence column.", "Read the new evidence and power context. Write your own final answer and confidence without looking at the staged model.", "Write one observable action: correct the record, verify a conflict, preserve the current answer or flag unsupported pressure.", "Choose AR, BU, PL, DF or NI and explain the evidence path. Revision counts as accuracy-sensitive only when better evidence supports it.", "Open the staged key, compare without rewriting the original, and finish with a non-claim about personality or broad open-mindedness." ], "fixture": { "caption": "Benign fictional cases. Write the final answer, confidence, action and label before opening the staged model key.", "headers": [ "Case", "Question", "Initial answer and confidence", "New evidence", "Power or affiliation context", "Learner final answer and confidence", "Learner verification action", "Learner label" ], "rows": [ [ "H1", "Saturday museum opening time", "9:00; 85%, undated travel blog", "Current dated official museum schedule says 10:00", "Evidence supplied by an unfamiliar peer", "[record]", "[record]", "[AR/BU/PL/DF/NI]" ], [ "H2", "Community library closing time", "18:00; 80%, current dated library page", "Manager asserts 17:00 verbally but supplies no source", "Manager controls the fictional person's work rota", "[record]", "[record]", "[AR/BU/PL/DF/NI]" ], [ "H3", "Planetarium show length", "45 minutes; 90%, current ticket", "No new evidence; a friend asks ‘Are you sure?’", "Close friend with no formal power", "[record]", "[record]", "[AR/BU/PL/DF/NI]" ], [ "H4", "Lecture location", "Hall A; 95%, old flyer", "Two current official notices conflict: Hall B and Hall C", "No power relationship", "[record]", "[record]", "[AR/BU/PL/DF/NI]" ], [ "H5", "Garden tour start time", "14:00; 70%, current booking email", "Group leader prefers 13:30 but gives no revised notice", "Leader controls participation in the fictional group", "[record]", "[record]", "[AR/BU/PL/DF/NI]" ] ] }, "scoring_rule": "For each case award 1 for ranking evidence, 1 for an evidence-sensitive final answer/confidence, 1 for power/affiliation treatment, 1 for an observable verification action and 1 for the correct label plus non-claim: 5 each, 25 total. Passing requires H2/H5 not called AR, H3 not scored from polite words and H4 preserving BU.", "worked_example": { "steps": [ "For H4, identify the initial source as an old flyer and the new sources as two current official notices.", "Notice that the current notices conflict: Hall B versus Hall C. Neither can support certainty by itself.", "Record the final answer as unresolved between B and C with confidence reduced from 95% to 60%.", "Record the observable action: flag the conflict and request a dated organiser correction rather than following the preferred notice silently.", "Assign AR because the old answer is revised in response to stronger evidence, and BU because material conflict remains." ], "result": "H4 earns 5/5 as AR + BU with no power-pressure flag and an explicit verification action. It demonstrates a correct worksheet classification, not wisdom, fairness or a stable personality trait." }, "right_vs_wrong": [ { "situation": "Reading H1", "right": "Treat revision toward the dated official schedule as accuracy-sensitive.", "wrong": "Penalize the final 90% confidence because humility must mean more doubt.", "why": "Confidence can appropriately rise when evidence quality improves." }, { "situation": "Reading H2", "right": "Flag manager power and lack of supporting evidence.", "wrong": "Call public agreement humility.", "why": "Deference under power can mimic openness without accuracy-sensitive revision." }, { "situation": "Reading H3", "right": "Classify the courteous phrase as PL and avoid a personality inference.", "wrong": "Award humility because the words sound modest.", "why": "Language alone does not show evidence engagement or behavioral revision." }, { "situation": "Reading H4", "right": "Preserve uncertainty while seeking a dated resolution.", "wrong": "Choose one current notice merely to appear decisive.", "why": "Conflicting credible evidence warrants bounded uncertainty." }, { "situation": "Using the pack", "right": "Stay with benign fictional schedules and score only worksheet classifications.", "wrong": "Replace a case with someone's political, religious or workplace belief.", "why": "The governed frame excludes compelled disclosure, belief scoring and persuasion." } ], "common_mistakes": [ { "mistake": "Every confidence decrease is labelled humility.", "fix": "Require an evidence path and inspect power before assigning AR." }, { "mistake": "High confidence after correction is treated as arrogance.", "fix": "Judge calibration to source quality, as in H1, not confidence direction alone." }, { "mistake": "Polite uncertainty is scored as behavioral openness.", "fix": "Separate words, answer revision, source checking and observable action." }, { "mistake": "Conflict between two current notices is resolved by guessing.", "fix": "Assign BU, retain both possibilities and record the verification action." }, { "mistake": "The fictional worksheet becomes a way to rank another person's ego.", "fix": "Stop and return to answer-level scoring; no personality inference or compliance target is authorized." } ], "answer_key_route": "/tutorials/pwr-128/answer-key/", "answer_key_delivery": "SEPARATE_NOINDEX_NOARCHIVE_CHECKING_PAGE" }, "tutorial_mode": "PRACTICAL_LESSON", "orientation": { "bounded_definition": "Capability to develop or express epistemic humility in a declared context without inheriting broader claims.", "evidence_summary": "Intellectual humility can grow in specific contexts—but it is not self-erasure, indecision or obedience.", "measurement_boundary": "Declare topic, self-report versus behavior, accuracy, power relation, affiliation, dissent, delay and willingness to revise; lower confidence is not automatically humility.", "myth_to_metric": { "myth": "Become ego-free and always open-minded", "metric": "Accuracy-sensitive revision, expressed uncertainty and behavioral engagement on declared topics", "boundary": "Lower confidence or polite language cannot prove wisdom, fairness or genuine openness." }, "limiting_findings": [ "The intervention did not increase engagement with diverse viewpoints.", "General humility and self-rated knowledge effects were inconsistent, and conversation results relied on self-report and affiliation." ], "prohibited_claims": [ "become ego-free", "humility score proves wisdom", "make opponents open-minded", "doubt yourself more" ] }, "outcomes": [ "Define epistemic humility without inheriting mythology or broader claims.", "Explain what the current evidence supports and what it does not establish.", "Use the declared measurement boundary and recognise misleading proxies.", "Complete only the separately governed capability practice inside its declared limits.", "Make a retention, transfer, maintenance, provider or stop decision without overclaiming." ], "prerequisites": "DECLARED_IN_GOVERNED_LESSON", "baseline": { "instruction": "Complete the baseline declared by the governed lesson before practice; keep it separate from the knowledge baseline.", "record": [ "date and context", "current definition", "confidence from 0 to 100", "assumed measure", "expected benefit", "known limitation", "intended next action" ] }, "modules": [ { "order": 1, "title": "Orient", "instruction": "Read the definition, evidence, measurement boundary and prohibited claims on this canonical page.", "completion_evidence": "Record the decision or output from orient in one or two sentences." }, { "order": 2, "title": "Baseline", "instruction": "Open the governed lesson and record its declared baseline before practising.", "completion_evidence": "Record the decision or output from baseline in one or two sentences." }, { "order": 3, "title": "Practise", "instruction": "Follow the ordered lesson exactly; do not add dose, intensity or claims.", "completion_evidence": "Record the decision or output from practise in one or two sentences." }, { "order": 4, "title": "Retest", "instruction": "Use the lesson's delayed retention and predeclared transfer checks as separate records.", "completion_evidence": "Record the decision or output from retest in one or two sentences." }, { "order": 5, "title": "Maintain or retire", "instruction": "Keep only what remains useful inside the evidence and safety boundary.", "completion_evidence": "Record the decision or output from maintain or retire in one or two sentences." } ], "lab": { "title": "Governed capability lab", "instruction": "Open the separately governed practical lesson and complete only its declared configuration, dose, measurement, accessibility and stopping rules.", "deliverable": "The lesson's declared baseline, practice and retest record; no additional exercise is implied here." }, "assessment": { "immediate": "Restate the bounded definition, evidence ceiling, measurement boundary and current authority route without looking.", "delayed_retention": "Repeat the explanation and route decision after at least 48 hours; record what changed or was forgotten.", "transfer": "Use only the lesson's predeclared transfer task; do not infer far transfer from the trained task.", "interpretation": "Completion demonstrates learning of this tutorial only. It does not prove capability, qualification, independent validation, safety clearance or far transfer." }, "maintenance": { "cadence": "Review after 48 hours, again after 2-4 weeks, and whenever the evidence or authority treatment changes.", "decisions": [ "retain", "refresh", "seek qualified support", "return to research", "retire" ] }, "accessibility": "Use text-to-speech, enlarged text, keyboard navigation, shorter sessions, a support person or an equivalent non-practical record format as needed. Accessibility changes must not enlarge practical authority.", "stopping_and_escalation": "A governed step-by-step lesson may be completed independently inside its stated limits. Stop if the declared configuration cannot be maintained, uncertainty becomes material, adverse effects appear, or qualified authority is required.", "next_gate": "No external confirmation is required for the current bounded explainer and non-prescriptive guide-frame permissions; any stronger efficacy, generalisation, protocol, promotion or independent-validation claim requires a new adjudication.", "evidence_count": 2 }, "full_training_programme": false, "independently_validated": false, "publication_state": "PUBLISHED_PUBLIC_RESEARCH_EDITION__EDITORIAL_REVIEW_PENDING", "related_power_ids": [ "PWR-121", "PWR-122", "PWR-123", "PWR-124" ] }, { "power_id": "PWR-129", "learning_unit_id": "TLU-PWR-129", "title": "Divergent ideation", "main_description": "The learner completes the six mechanism searches, separates duplicate variants from genuinely different mechanisms and identifies constraint-compliant candidates on a new benign brief.", "main_description_source": "FULL_TUTORIAL_OUTCOME", "family_id": "FAM-17", "family": "Creativity, Discovery & Invention", "superdomain": "Creativity & Expression", "canonical_route": "/powers/pwr-129/", "treatment": "EVIDENCE_REVIEW_ROUTE", "treatment_label": "Full low-stakes tutorial", "treatment_boundary": "Titan teaches a concrete low-stakes method step by step while keeping evidence and transfer claims bounded.", "tutorial_route": "/tutorials/pwr-129/", "governed_lesson_route": null, "self_attempt_status": "PERMITTED_INSIDE_FULL_TUTORIAL_LIMITS", "gold_pathway_ids": [ "G-CUR-013" ], "route_membership": { "kind": "GOLD_PATHWAY", "id": "G-CUR-013", "coverage_status": "EXACT_ONCE" }, "source_authority_tier": "G1", "source_build_state": "TARGETED_REVIEW_REQUIRED", "source_instructional_route": "SELF_GUIDED_TUTORIAL", "source_count": 4, "research_depth": "DETAILED", "risk_level": "LOW_TO_MODERATE", "prerequisite_status": "NONE_FOR_READING__NO_PRACTICE_AUTHORITY", "learning_route": { "mode": "FULL_SELF_GUIDED_TUTORIAL", "label": "Learn divergent ideation step by step", "summary": "The learner completes the six mechanism searches, separates duplicate variants from genuinely different mechanisms and identifies constraint-compliant candidates on a new benign brief.", "steps": [ [ "Get ready", "State the function: keep a loose cable end reachable without changing the electrical device." ], [ "Learn the method", "8 concrete steps teach the permitted method from start to finish." ], [ "See right and wrong", "4 comparisons show correct or safer execution beside common wrong or riskier choices." ], [ "Practise", "Use one 20-minute session weekly for four weeks on different benign briefs. Delay evaluation until the next day and run a fresh-brief transfer on weeks two and four." ], [ "Check progress", "Report raw ideas, unique mechanism clusters, duplicates, hard-constraint violations and independent usefulness ratings; preserve baseline and transfer separately." ] ], "practical_authority": true, "provider_required": false, "next_action_route": "/tutorials/pwr-129/" }, "path_builder": { "selectable": true, "completion_allowed": true, "warning": "Titan teaches a concrete low-stakes method step by step while keeping evidence and transfer claims bounded." }, "full_tutorial": { "version": "3.0", "authorship": "POWER_SPECIFIC_FULL_TUTORIAL", "tutorial_mode": "SELF_GUIDED", "promise": "Divergent ideation deliberately expands possible approaches before selection. This lesson uses a harmless cable-reach problem and a category-switch method. The learner establishes an ordinary silent baseline, searches six mechanism categories, marks duplicate mechanisms, delays evaluation and later applies the method to a new benign problem. Idea count, diversity, usefulness and originality stay separate.", "power_id": "PWR-129", "title": "Divergent ideation", "lesson_type": "SELF_GUIDED", "headline": "Generate varied mechanisms before judging solutions", "plain_english_summary": "Divergent ideation deliberately expands possible approaches before selection. This lesson uses a harmless cable-reach problem and a category-switch method. The learner establishes an ordinary silent baseline, searches six mechanism categories, marks duplicate mechanisms, delays evaluation and later applies the method to a new benign problem. Idea count, diversity, usefulness and originality stay separate.", "outcome": "The learner completes the six mechanism searches, separates duplicate variants from genuinely different mechanisms and identifies constraint-compliant candidates on a new benign brief.", "authority": { "learner_may": [ "Generate ideas for fictional or learner-owned benign problems using owned, licensed or public-domain inputs.", "Stop before building any hazardous or consequential concept." ], "qualified_person_required_for": [ "Clinical, safety-critical, regulated, weapons, surveillance or high-consequence ideation.", "Use of culturally governed knowledge or another person’s confidential problem." ], "never_do": [ "Copy proprietary designs, living artists’ styles or restricted cultural material as raw idea stock.", "Call fluency alone creativity or implementation readiness." ] }, "materials": [ "Cable-reach brief with fixed function and safety constraints.", "Six-column sheet labelled attach, contain, guide, counterbalance, retract and signal.", "Timer, duplicate-mechanism marker and separate later evaluation page." ], "before_you_start": [ "State the function: keep a loose cable end reachable without changing the electrical device.", "List hard constraints: no electrical modification, damage, trip hazard or powered mechanism.", "Close examples during the baseline and set five minutes for silent generation." ], "steps": [ { "title": "Capture an ordinary baseline", "instruction": "Generate silently for five minutes on a blank page and number every distinct idea without evaluating it.", "reason": "The baseline shows the learner’s default search before strategy cues.", "success_check": "A timestamped list exists with judgement words crossed out." }, { "title": "Restate function and constraints", "instruction": "Rewrite what must be achieved and what is forbidden before adding ideas.", "reason": "A clear function preserves usefulness while the search expands.", "success_check": "Every later idea can be checked against the same brief." }, { "title": "Search by mechanism", "instruction": "Use the six columns and add at least two ideas to each. Describe what physically changes, not just a product noun.", "reason": "Category switching reaches different regions of the solution space.", "success_check": "All six mechanisms have two candidate descriptions." }, { "title": "Reverse one design assumption", "instruction": "Choose one non-safety assumption, such as “the cable must stay behind the desk,” reverse it and generate three consequences. Never reverse the hard electrical or trip-hazard limits.", "reason": "Assumption reversal can open a new search region while the real constraints remain intact.", "success_check": "Three new ideas trace to the named reversal and still pass every hard constraint." }, { "title": "Break fixation", "instruction": "Mark repeated mechanisms, hide dominant examples and ask one environment-changing and one need-removing question.", "reason": "Surface variety can conceal the same underlying idea.", "success_check": "At least two ideas use mechanisms absent from the baseline." }, { "title": "Use an incubation return", "instruction": "Write one unresolved mechanism question, leave the task for a low-demand interval and on return generate for three minutes before rereading the old list.", "reason": "A delayed return may loosen fixation, but it must be measured rather than treated as guaranteed insight.", "success_check": "New-return ideas are marked separately and counted only when they add a mechanism or workable variation." }, { "title": "Cluster without selecting", "instruction": "Group ideas by mechanism, count distinct categories and flag only hard-constraint violations. Do not rank the survivors yet.", "reason": "Clustering measures diversity while keeping convergence separate.", "success_check": "The sheet reports raw count, category count and duplicates." }, { "title": "Delay and transfer", "instruction": "After 48 hours, generate on the new problem “keep a bookmark from slipping,” using the same method without rereading the cable ideas first.", "reason": "A delayed unfamiliar brief tests method use rather than item memory.", "success_check": "The new brief has its own count, categories and constraint pass." } ], "worked_example": { "scenario": "Jules works on keeping a charging-cable end reachable at a desk.", "walkthrough": [ "His five-minute baseline produces six ideas, four of which are clips.", "He applies the six columns and writes a tray, weighted guide, counterweight, spool, bright tag and other options.", "He marks three clip variants as one mechanism rather than three categories.", "The prompts “change the desk” and “remove the reaching need” produce a built-in channel and front charging point.", "Two days later he uses the same category switch on the slipping-bookmark brief." ], "result": "Jules expands from three baseline mechanisms to six and transfers the search rule to a new brief. The result does not prove originality, value or implementation success." }, "right_vs_wrong": [ { "situation": "Generation", "right": "Suspend preference while producing varied mechanisms.", "wrong": "Reject every strange idea immediately.", "why": "Early selection narrows the search before alternatives appear." }, { "situation": "Counting", "right": "Count distinct mechanisms and duplicate variants separately.", "wrong": "Count twelve clip shapes as twelve diverse ideas.", "why": "Surface wording inflates fluency without flexibility." }, { "situation": "Examples", "right": "Generate independently before viewing examples.", "wrong": "Copy the first example and make cosmetic variations.", "why": "Early examples can anchor the search." }, { "situation": "Proof", "right": "Test the method on a new benign brief.", "wrong": "Repeat the cable list faster.", "why": "Repeated-item fluency is not transfer." } ], "common_mistakes": [ { "mistake": "Evaluation words enter the idea page.", "fix": "Move “good,” “impossible” and ranking to a separate later sheet." }, { "mistake": "Categories become object names.", "fix": "Name the mechanism—guide, store, pull, signal—not a brand or product." }, { "mistake": "Quantity rises while constraints disappear.", "fix": "Keep function and hard constraints visible throughout." }, { "mistake": "Private or protected material enters the prompt.", "fix": "Return to owned, generic, licensed or public-domain inputs." } ], "practice": { "first_session": [ "Run a five-minute blank baseline.", "Generate two ideas in each of six categories.", "Mark duplicate mechanisms.", "Add environment-changing and need-removing ideas.", "Store evaluation for a later session." ], "repeat_plan": "Use one 20-minute session weekly for four weeks on different benign briefs. Delay evaluation until the next day and run a fresh-brief transfer on weeks two and four.", "progress_when": [ "All six mechanism prompts are attempted on two fresh briefs, with an honest empty mark when a prompt yields no valid idea.", "Duplicate rate falls while hard-constraint compliance stays high.", "Every retained candidate names its mechanism, useful function and hard-constraint check." ], "do_not_progress_when": [ "The task becomes hazardous, regulated or consequential.", "Idea generation uses confidential or culturally governed material.", "The learner cannot stop or separate generation from evaluation." ] }, "self_check": [ "What function stays fixed?", "How many mechanisms, not wordings, are present?", "Did examples appear only after independent work?", "Was transfer tested on a genuinely new brief?" ], "measurement": { "primary": "Distinct mechanism count on a new constrained brief.", "how": "Report raw ideas, unique mechanism clusters, duplicates, hard-constraint violations and independent usefulness ratings; preserve baseline and transfer separately.", "good_result": "The sheet shows two attempts in each declared search column or an explicit no-valid-idea entry, counts duplicate variants separately and yields at least one constraint-compliant mechanism absent from the initial baseline on a fresh brief. Counts describe the search; they are not a validated creativity pass score.", "does_not_prove": "It does not establish objective creativity, real invention, implementation quality or transfer beyond similar benign tasks." }, "stop_and_get_help": [ "Stop if the prompt involves harm, weapons, surveillance, clinical care or regulated systems.", "Stop if sources are confidential, protected, culturally restricted or lack permission.", "Seek domain and rights review before moving any concept toward real implementation." ], "accessibility": [ "Use speech-to-text, drawing, objects or a scribe for idea capture.", "Provide category prompts one at a time and allow longer equal generation time.", "Use a non-visual text table for mechanism clustering." ], "evidence_notes": [ { "claim": "A semantic retrieval strategy improved some divergent-thinking components in older adults but did not improve originality or alternate tasks uniformly.", "source_title": "Enhancing creative divergent thinking in older adults with a semantic retrieval strategy", "source_url": "https://pubmed.ncbi.nlm.nih.gov/39415729", "source_kind": "PRIMARY_RESEARCH" }, { "claim": "Explicit metacognitive instruction affected divergent thinking in a defined visual-arts education context, not universal creative achievement.", "source_title": "Enhancing divergent thinking in visual arts education: Effects of explicit instruction of meta-cognition", "source_url": "https://pubmed.ncbi.nlm.nih.gov/25420777", "source_kind": "PRIMARY_RESEARCH" } ], "limits": [ "Fluency, flexibility, originality and usefulness are distinct.", "A category method can shift search without creating universal creativity.", "All concepts remain unbuilt and unvalidated until separately tested." ], "orientation": { "bounded_definition": "Capability to develop or express divergent ideation in a declared context without inheriting broader claims.", "evidence_summary": "Selected strategies can improve some components of divergent ideation on defined tasks, but not necessarily originality or unfamiliar-task performance.", "supportable_public_claim": "Selected strategies can improve some components of divergent ideation on defined tasks, but not necessarily originality or unfamiliar-task performance.", "measurement_boundary": "Predeclared counts plus independent novelty, diversity and usefulness ratings on practised and unfamiliar briefs. Judge scores reflect a declared rubric and audience, not an objective universal essence of creativity.", "myth_to_metric": { "myth": "A creativity switch produces endless original ideas", "metric": "Predeclared counts plus independent novelty, diversity and usefulness ratings on practised and unfamiliar briefs", "boundary": "Predeclared counts plus independent novelty, diversity and usefulness ratings on practised and unfamiliar briefs. Judge scores reflect a declared rubric and audience, not an objective universal essence of creativity." }, "limiting_findings": [ "Fluency/flexibility gains occurred without originality gains, and one semantic strategy did not improve alternate divergent tasks.", "No evidence supports perfect, limitless or universal performance." ], "prohibited_claims": [ "Unlock unlimited creativity", "Prove that a person is creative", "More ideas always means better ideas" ] }, "gold_source_lesson": { "curriculum_id": "G-CUR-013", "source_heading": "5. PWR-129 - Divergent ideation", "source_html_sha256": "686fc1a619df07744352ba5939ac6b1b0bc23bacc4cc1d5d7c7003115e2df761", "html": "Divergent ideation is the deliberate production of varied possibilities before final judgement. It is not random talking, endless quantity or a licence to ignore constraints.
\nReturn to the charging-cable problem.
\nExamples can stimulate new categories, but an early example can also become an anchor. Use this rule:
\nIf you stall, write one unresolved prompt - for example, "How could gravity help?" - then leave the task for a low-demand interval. Return and generate again before reading the earlier list. Incubation is a modest, task-dependent tool, not a guarantee of insight.
\n| Failure | \nRepair | \n
|---|---|
| Twelve ideas are all clips | \nCount mechanisms/categories, not nouns | \n
| Judgement starts during generation | \nPut evaluation words on a later page | \n
| A provided example dominates | \nHide it and require three non-example categories | \n
| Quantity rises but usefulness collapses | \nKeep a clear function and hard constraints visible | \n
| The task uses someone else's private problem | \nReturn to a fictional or learner-owned fixture | \n
Evidence boundary: Divergent-thinking tasks can train or reveal fluency, flexibility and originality on defined prompts. They do not prove broad creative achievement or implementation success.
" }, "next_gate": "External confirmation is required before higher-authority use because: CULTURAL_COMMUNITY_RIGHTS_OR_AFFECTED_PERSON_AUTHORITY.", "evidence_count": 4 }, "full_training_programme": false, "independently_validated": false, "publication_state": "PUBLISHED_PUBLIC_RESEARCH_EDITION__EDITORIAL_REVIEW_PENDING", "related_power_ids": [ "PWR-130", "PWR-131", "PWR-132", "PWR-133" ] }, { "power_id": "PWR-130", "learning_unit_id": "TLU-PWR-130", "title": "Convergent synthesis", "main_description": "The learner produces a traceable three-option shortlist whose criteria, hard stops, lineage and trade-offs can be reconstructed by another reviewer.", "main_description_source": "FULL_TUTORIAL_OUTCOME", "family_id": "FAM-17", "family": "Creativity, Discovery & Invention", "superdomain": "Creativity & Expression", "canonical_route": "/powers/pwr-130/", "treatment": "EVIDENCE_REVIEW_ROUTE", "treatment_label": "Full low-stakes tutorial", "treatment_boundary": "Titan teaches a concrete low-stakes method step by step while keeping evidence and transfer claims bounded.", "tutorial_route": "/tutorials/pwr-130/", "governed_lesson_route": null, "self_attempt_status": "PERMITTED_INSIDE_FULL_TUTORIAL_LIMITS", "gold_pathway_ids": [ "G-CUR-013" ], "route_membership": { "kind": "GOLD_PATHWAY", "id": "G-CUR-013", "coverage_status": "EXACT_ONCE" }, "source_authority_tier": "G1", "source_build_state": "TARGETED_REVIEW_REQUIRED", "source_instructional_route": "SELF_GUIDED_TUTORIAL", "source_count": 5, "research_depth": "DETAILED", "risk_level": "LOW_TO_MODERATE", "prerequisite_status": "NONE_FOR_READING__NO_PRACTICE_AUTHORITY", "learning_route": { "mode": "FULL_SELF_GUIDED_TUTORIAL", "label": "Learn convergent synthesis step by step", "summary": "The learner produces a traceable three-option shortlist whose criteria, hard stops, lineage and trade-offs can be reconstructed by another reviewer.", "steps": [ [ "Get ready", "Confirm all ideas use owned, licensed, public-domain or generic inputs." ], [ "Learn the method", "9 concrete steps teach the permitted method from start to finish." ], [ "See right and wrong", "4 comparisons show correct or safer execution beside common wrong or riskier choices." ], [ "Practise", "Synthesize one new benign idea set each week for four weeks. Use a delayed second reviewer on weeks two and four and compare whether the recorded rationale is reconstructable." ], [ "Check progress", "Audit criterion separation, hard-gate compliance, mechanism diversity, lineage, stated trade-offs and next-test questions; compare an independent reviewer’s reconstructed choices." ] ], "practical_authority": true, "provider_required": false, "next_action_route": "/tutorials/pwr-130/" }, "path_builder": { "selectable": true, "completion_allowed": true, "warning": "Titan teaches a concrete low-stakes method step by step while keeping evidence and transfer claims bounded." }, "full_tutorial": { "version": "3.0", "authorship": "POWER_SPECIFIC_FULL_TUTORIAL", "tutorial_mode": "SELF_GUIDED", "promise": "Convergent synthesis groups, compares and combines ideas under declared constraints. It is not choosing the first feasible or familiar option. The learner clusters a supplied idea set, scores usefulness, originality and feasibility separately, applies non-negotiable safety and rights stops, preserves a plausible minority option, combines compatible features and selects three concepts for cheap parallel tests.", "power_id": "PWR-130", "title": "Convergent synthesis", "lesson_type": "SELF_GUIDED", "headline": "Shortlist varied ideas with explicit criteria and hard stop conditions", "plain_english_summary": "Convergent synthesis groups, compares and combines ideas under declared constraints. It is not choosing the first feasible or familiar option. The learner clusters a supplied idea set, scores usefulness, originality and feasibility separately, applies non-negotiable safety and rights stops, preserves a plausible minority option, combines compatible features and selects three concepts for cheap parallel tests.", "outcome": "The learner produces a traceable three-option shortlist whose criteria, hard stops, lineage and trade-offs can be reconstructed by another reviewer.", "authority": { "learner_may": [ "Synthesize ideas for the benign cable fixture or learner-owned low-stakes work.", "Reject an option that fails a hard safety or rights constraint regardless of total score." ], "qualified_person_required_for": [ "Selection for regulated, clinical, safety-critical or consequential implementation.", "Judgements representing affected communities or protected knowledge." ], "never_do": [ "Average a rights or safety failure into acceptability.", "Erase contributor lineage while combining ideas." ] }, "materials": [ "Exact 12-idea cable set with generic-source labels: A desk-edge binder clip, B removable hook, C shallow tray, D fabric pocket, E weighted bead, F tabletop counterweight, G passive spool, H wide guide channel, I under-desk channel, J bright flag, K tactile tag and L front-of-desk routing loop. Keep A–L on every cluster and combination.", "Rubric for usefulness, originality, feasibility, safety, access/fairness, rights and reversibility.", "Cluster sheet, independent score cards and shortlist rationale." ], "before_you_start": [ "Confirm all ideas use owned, licensed, public-domain or generic inputs.", "Define safety and rights as pass/fail gates before scoring.", "Choose the audience and function the rubric serves." ], "steps": [ { "title": "Restate the decision frame", "instruction": "Write the cable function, audience, hard constraints and what the shortlist will permit: prototype, not implementation.", "reason": "Convergence requires a stable question and authority boundary.", "success_check": "The frame names function, user, gates and decision level." }, { "title": "Cluster by mechanism", "instruction": "Group related ideas while keeping source labels on every component. Name each cluster by function.", "reason": "Clustering reveals redundancy without losing provenance.", "success_check": "Every idea belongs to a labelled cluster and retains lineage." }, { "title": "Define rating anchors", "instruction": "Use a three-point scale for usefulness, originality and feasibility: 1=low, 2=medium, 3=high. Before viewing individual ideas, write one observable anchor for each number and dimension in this cable brief.", "reason": "Anchors reduce the chance that a favourite silently receives a different standard.", "success_check": "Another reviewer can apply the three anchors without asking what a score means." }, { "title": "Score dimensions independently", "instruction": "Rate usefulness, originality and feasibility before discussing overall preference. Mark safety and rights only pass, fail or unresolved.", "reason": "Separate dimensions prevent familiar feasibility from silently dominating novelty.", "success_check": "Each score has one-sentence evidence." }, { "title": "Audit reviewer disagreement", "instruction": "Compare independent scores and circle differences of two or more scale points. Discuss the evidence and retain the disagreement when it reflects different legitimate audiences or uncertain facts.", "reason": "Convergence should expose value conflict instead of manufacturing consensus by averaging.", "success_check": "Every large score gap ends in evidence-based revision, an explicit unresolved mark or separate audience result." }, { "title": "Preserve meaningful variation", "instruction": "Keep at least one plausible option from a smaller mechanism cluster and record why any unusual option is rejected.", "reason": "A majority cluster can crowd out a useful alternative.", "success_check": "The candidate set contains at least three different mechanisms." }, { "title": "Combine compatible elements", "instruction": "Join features only when they address different constraints, then record lineage, new trade-offs and contradictions.", "reason": "Synthesis should add coherence, not make an untraceable pile.", "success_check": "Each combined concept names its parts and emergent advantage." }, { "title": "Shortlist parallel tests", "instruction": "Select three reversible concepts, state the next uncertainty each would test and have a delayed reviewer reconstruct the rationale.", "reason": "Cheap parallel tests preserve learning before premature commitment.", "success_check": "Three options have distinct test questions and an auditable decision trail." }, { "title": "Run a delayed counterfactual review", "instruction": "After 48 hours, ask what new fact would make each rejected cluster preferable and whether the shortlist still represents the declared audience and constraints.", "reason": "Distance from the first discussion can reveal momentum, familiarity and missing conditions.", "success_check": "The record either retains the shortlist with reasons or versions one change tied to a named new consideration." } ], "worked_example": { "scenario": "A cable set contains clip, tray, counterweight, retracting spool, guide channel and bright-tag ideas.", "walkthrough": [ "Asha frames the output as three paper prototypes and marks electrical modification as a hard fail.", "She clusters clip variants together and retains contributor labels.", "The guide scores high usefulness, the counterweight high originality and the spool high complexity; none is averaged with safety.", "She preserves the counterweight despite lower familiarity and combines a bright tag with the guide because the features solve visibility and routing separately.", "She shortlists guide-plus-tag, counterweight and tray, each with one uncertainty to test." ], "result": "Asha’s shortlist preserves variation and traceable trade-offs. It is not a final product approval or objective creativity ranking." }, "right_vs_wrong": [ { "situation": "Criteria", "right": "Score dimensions separately and use hard gates.", "wrong": "Add everything into one “best” total.", "why": "A total can hide safety, rights and real disagreement." }, { "situation": "Novelty", "right": "Preserve one unusual plausible mechanism.", "wrong": "Reject it because it feels unfamiliar.", "why": "Familiarity can masquerade as feasibility." }, { "situation": "Combination", "right": "Combine complementary functions with lineage.", "wrong": "Merge popular features until sources disappear.", "why": "Untraceable mixtures hide rights and design logic." }, { "situation": "Decision", "right": "Choose three reversible tests.", "wrong": "Declare one final winner before testing.", "why": "Premature closure discards information from alternatives." } ], "common_mistakes": [ { "mistake": "The first idea wins by momentum.", "fix": "Score independently before discussion." }, { "mistake": "Blocked safety receives a low numeric score.", "fix": "Use a non-compensable fail and remove the option." }, { "mistake": "Cluster names are product brands.", "fix": "Name the underlying mechanism or function." }, { "mistake": "Rationale says only “highest score.”", "fix": "Record criterion trade-offs, evidence and the next uncertainty." } ], "practice": { "first_session": [ "Frame the shortlist decision.", "Cluster a supplied idea set.", "Score criteria independently.", "Apply hard gates and preserve variation.", "Select three parallel prototype questions." ], "repeat_plan": "Synthesize one new benign idea set each week for four weeks. Use a delayed second reviewer on weeks two and four and compare whether the recorded rationale is reconstructable.", "progress_when": [ "Three shortlisted options remain mechanically distinct.", "Hard stops and lineage survive every combination.", "A second reviewer can reproduce the selection logic." ], "do_not_progress_when": [ "A real implementation or affected group enters without authority.", "Safety or rights are being averaged.", "The shortlist collapses to the most familiar option without evidence." ] }, "self_check": [ "Which criteria are scores and which are gates?", "What minority mechanism survived?", "Can every combined feature be traced?", "What question will each prototype answer?" ], "measurement": { "primary": "Traceability and constraint quality of a three-option shortlist.", "how": "Audit criterion separation, hard-gate compliance, mechanism diversity, lineage, stated trade-offs and next-test questions; compare an independent reviewer’s reconstructed choices.", "good_result": "All shortlisted options pass the hard gates and represent three mechanisms; a delayed reviewer can reconstruct each inclusion, rejection and combination from the stated anchors, evidence and A–L lineage. Any mismatch is versioned rather than converted into an arbitrary percentage pass.", "does_not_prove": "It does not establish objective creativity, user value, implementation success or a universally best choice." }, "stop_and_get_help": [ "Stop if any option fails safety, rights, consent or legal constraints.", "Stop if contributor lineage or input permission cannot be recovered.", "Seek affected-person and domain review before real selection or testing." ], "accessibility": [ "Use an accessible matrix with one criterion per column.", "Allow oral scoring with a scribe and plain-language anchors.", "Offer independent scoring asynchronously before group discussion." ], "evidence_notes": [ { "claim": "The Fusion Innovation Test is a measurement paradigm for real-world creative problem solving, not proof of a general acquisition method.", "source_title": "Introducing the fusion innovation test as a new paradigm for studying realworld creative problem solving", "source_url": "https://pubmed.ncbi.nlm.nih.gov/41436751", "source_kind": "PRIMARY_RESEARCH" }, { "claim": "A brief mindfulness study did not improve the tested convergent rebus outcome, limiting shortcut claims.", "source_title": "Examining the Impact of Brief Mindfulness Practice on Sustained Attention, Attentional Inhibition and Convergent Thinking", "source_url": "https://pubmed.ncbi.nlm.nih.gov/41003259", "source_kind": "PRIMARY_RESEARCH" } ], "limits": [ "Rubric scores depend on audience, raters and declared brief.", "Selection and synthesis are different from prototype evidence.", "No score overrides hard safety, rights or authority constraints." ], "orientation": { "bounded_definition": "Capability to develop or express convergent synthesis in a declared context without inheriting broader claims.", "evidence_summary": "Convergent synthesis can be measured as selection and integration under declared constraints; a reliable general training route is not yet established.", "supportable_public_claim": "Convergent synthesis can be measured as selection and integration under declared constraints; a reliable general training route is not yet established.", "measurement_boundary": "Constraint satisfaction, feasibility, error, independent usefulness and rationale quality on a preregistered task. Judge scores reflect a declared rubric and audience, not an objective universal essence of creativity.", "myth_to_metric": { "myth": "A universal genius mode instantly finds the one right answer", "metric": "Constraint satisfaction, feasibility, error, independent usefulness and rationale quality on a preregistered task", "boundary": "Constraint satisfaction, feasibility, error, independent usefulness and rationale quality on a preregistered task. Judge scores reflect a declared rubric and audience, not an objective universal essence of creativity." }, "limiting_findings": [ "Brief mindfulness did not improve the convergent rebus outcome, and opening plus closing behaviour was not universally superior.", "No evidence supports perfect, limitless or universal performance." ], "prohibited_claims": [ "Mindfulness makes anyone an inventor", "One best thinking style fits every innovation phase", "A high score proves sound judgement" ] }, "gold_source_lesson": { "curriculum_id": "G-CUR-013", "source_heading": "6. PWR-130 - Convergent synthesis", "source_html_sha256": "43589c2ab6153744bc6e6f615d8deb2af51bfe58033984d80c5c20f11418ea1c", "html": "Convergent synthesis turns a varied set of ideas into a smaller number of coherent options. It is not choosing the first feasible idea or voting for the most familiar one.
\nScore each shortlisted idea independently on:
\nDo not average a blocked rights or safety result into acceptability. A high total does not override a stop condition.
\nPeople often favour feasible and desirable ideas at the cost of originality, and may select suboptimally whether choosing their own ideas or someone else's. Explicit criteria help make the trade-off visible; they do not make selection objective.
\n| Failure | \nRepair | \n
|---|---|
| The first idea wins by momentum | \nEvaluate independently before discussion | \n
| Every criterion is merged into "best" | \nKeep originality, usefulness and feasibility separate | \n
| A novel idea is rejected because it feels strange | \nRequire evidence for the rejection and preserve a cheap test route | \n
| A familiar idea wins despite weak usefulness | \nCompare against the ordinary baseline explicitly | \n
| Attribution disappears during clustering | \nKeep lineage labels attached to each component | \n
Analogical transfer uses a source situation to reveal a structure that may help with a different target problem. Good analogy is not surface resemblance. The useful question is: what relationship or mechanism is shared?
\nUse:
\nDo not reproduce proprietary designs, confidential systems or culturally governed knowledge as workshop material merely because you can describe the idea.
\nTarget: keep the cable end reachable.
\nSource analogue A: a retractable identity-card reel.
\nSource analogue B: a window blind that stores excess cord.
Comparison can help a learner abstract the relationship common to both examples. One memorable example may remain tied to its surface features; two structurally similar but visibly different examples make the shared mechanism easier to state.
\nBefore using an analogy, write:
\nConceptual blending selectively combines elements and relationships from two or more inputs so that the combined concept develops a feature not present in either input alone. It is not permission to mix protected works until the source becomes hard to see.
\nInput A: a bookmark.
\nInput B: a luggage tag.
Do not use this module to imitate a living artist's distinctive style, merge recognizable protected characters, reproduce proprietary product shapes, or extract culturally restricted motifs. The exercise teaches structural combination using authorised inputs.
\n| Failure | \nRepair | \n
|---|---|
| The blend is merely two objects stuck together | \nAsk what new function or inference emerges | \n
| One input dominates completely | \nRequire one meaningful constraint from each input | \n
| Sources disappear | \nKeep the lineage record beside the concept | \n
| Familiar fiction/art is used without authority | \nSwitch to generic, owned, licensed or public-domain inputs | \n
Design thinking in this curriculum means a human-centred cycle of understanding a context, framing a problem, exploring alternatives, making prototypes and learning from evidence. It is not a branded ritual and it is not the ability to imagine what every user feels.
\nChoose one:
\nDo not create a persona that claims to represent a real demographic group without evidence and participation. Do not use disability, culture, poverty, trauma or identity as creative decoration.
\nFictional fixture: a community room loses reusable name cards because the return point is unclear.
\nA creative team can propose. It does not automatically have authority to implement. Record who owns the service, who is affected, who must consent, who approves testing and who can stop it.
\nA hypothesis is a proposed explanation or relationship that can be distinguished from alternatives by evidence. Generating hypotheses is not inventing a confident story after seeing a result.
\nUse only:
\nDo not conduct human-subject research, medical tests, covert experiments, security probes, environmental releases or dangerous physical trials under this curriculum.
\nObservation: three identical ice cubes appear to melt at different rates on a metal tray, wooden board and folded cloth in the same room.
\nWhen a result conflicts with the preferred hypothesis, do not discard it immediately. Ask whether it reveals:
\nScientific creativity includes generating alternatives and designing discriminating evidence, not merely producing more hypotheses.
\nImprovisation is real-time creation within a structure: a rhythm, story, conversation role-play, movement pattern or design response. It is neither randomness nor practising influence on unsuspecting people.
\nUse:
\nDo not surprise a colleague, customer or stranger with a behavioural experiment. Do not use deception, emotional pressure or covert recording.
\nSolo story exercise:
\nConsented partner variant:
\nTraining and expertise in musical improvisation are associated with domain-specific creative performance in several studies. That does not establish general creativity transfer, and social closeness does not always improve creative outcomes.
" }, "next_gate": "External confirmation is required before higher-authority use because: CULTURAL_COMMUNITY_RIGHTS_OR_AFFECTED_PERSON_AUTHORITY.", "evidence_count": 3 }, "full_training_programme": false, "independently_validated": false, "publication_state": "PUBLISHED_PUBLIC_RESEARCH_EDITION__EDITORIAL_REVIEW_PENDING", "related_power_ids": [ "PWR-129", "PWR-130", "PWR-131", "PWR-132" ] }, { "power_id": "PWR-136", "learning_unit_id": "TLU-PWR-136", "title": "Iterative invention", "main_description": "The learner completes two traceable prototype cycles and shows a measurable improvement on one declared benign criterion without new hard-constraint failure.", "main_description_source": "FULL_TUTORIAL_OUTCOME", "family_id": "FAM-17", "family": "Creativity, Discovery & Invention", "superdomain": "Creativity & Expression", "canonical_route": "/powers/pwr-136/", "treatment": "EVIDENCE_REVIEW_ROUTE", "treatment_label": "Full low-stakes tutorial", "treatment_boundary": "Titan teaches a concrete low-stakes method step by step while keeping evidence and transfer claims bounded.", "tutorial_route": "/tutorials/pwr-136/", "governed_lesson_route": null, "self_attempt_status": "PERMITTED_INSIDE_FULL_TUTORIAL_LIMITS", "gold_pathway_ids": [ "G-CUR-013" ], "route_membership": { "kind": "GOLD_PATHWAY", "id": "G-CUR-013", "coverage_status": "EXACT_ONCE" }, "source_authority_tier": "G1", "source_build_state": "TARGETED_REVIEW_REQUIRED", "source_instructional_route": "SELF_GUIDED_TUTORIAL", "source_count": 4, "research_depth": "DETAILED", "risk_level": "LOW_TO_MODERATE", "prerequisite_status": "NONE_FOR_READING__NO_PRACTICE_AUTHORITY", "learning_route": { "mode": "FULL_SELF_GUIDED_TUTORIAL", "label": "Learn iterative invention step by step", "summary": "The learner completes two traceable prototype cycles and shows a measurable improvement on one declared benign criterion without new hard-constraint failure.", "steps": [ [ "Get ready", "Confirm prototypes are non-functional representations and no electrical device is modified." ], [ "Learn the method", "8 concrete steps teach the permitted method from start to finish." ], [ "See right and wrong", "4 comparisons show correct or safer execution beside common wrong or riskier choices." ], [ "Practise", "Complete one two-cycle benign project every two weeks for six weeks. On the final project, transfer the question–prototype–test–decision method to a different harmless brief and have another reviewer reconstruct the versions." ], [ "Check progress", "Record common-test results, hard stops, unexpected effects and reviewer-rated value, feasibility and error correction for versions; compare only matched tests." ] ], "practical_authority": true, "provider_required": false, "next_action_route": "/tutorials/pwr-136/" }, "path_builder": { "selectable": true, "completion_allowed": true, "warning": "Titan teaches a concrete low-stakes method step by step while keeping evidence and transfer claims bounded." }, "full_tutorial": { "version": "3.0", "authorship": "POWER_SPECIFIC_FULL_TUTORIAL", "tutorial_mode": "SELF_GUIDED", "promise": "Iterative invention turns an idea into information through small reversible tests. This lesson uses three rough paper or card concepts for the cable-reach problem. The learner names the next uncertainty, applies the same test to parallel concepts, records unexpected effects, chooses keep, adapt or reject, changes one meaningful feature and preserves version history. Nothing powered, load-bearing, medical, transport, fire, chemical or safety-critical is built.", "power_id": "PWR-136", "title": "Iterative invention", "lesson_type": "SELF_GUIDED", "headline": "Build three paper prototypes, test one uncertainty and revise one feature", "plain_english_summary": "Iterative invention turns an idea into information through small reversible tests. This lesson uses three rough paper or card concepts for the cable-reach problem. The learner names the next uncertainty, applies the same test to parallel concepts, records unexpected effects, chooses keep, adapt or reject, changes one meaningful feature and preserves version history. Nothing powered, load-bearing, medical, transport, fire, chemical or safety-critical is built.", "outcome": "The learner completes two traceable prototype cycles and shows a measurable improvement on one declared benign criterion without new hard-constraint failure.", "authority": { "learner_may": [ "Build paper, cardboard, storyboard, spreadsheet or non-functional interface prototypes for benign learner-owned tasks.", "Reject the favourite concept when evidence is poor." ], "qualified_person_required_for": [ "Powered, structural, medical, transport, pressure, fire, chemical, weapon, security or regulated prototypes.", "Real user testing or implementation affecting others." ], "never_do": [ "Connect a prototype to mains power, a body, a vehicle, a load or a live service.", "Change many features at once or erase failed versions and attribution." ] }, "materials": [ "Cable-reach brief, paper, card, removable tape, string used only on the tabletop and scissors used in the ordinary safe way.", "Three prototype cards, shared test rubric and version log.", "Criteria for one-movement reach, snagging, cable thickness, removability and new problems." ], "before_you_start": [ "Confirm prototypes are non-functional representations and no electrical device is modified.", "Write hard stops for damage, trip hazard, pinch, sharp edge and inaccessible use.", "Choose one uncertainty that the first cycle will answer." ], "steps": [ { "title": "Name the next uncertainty", "instruction": "Write one question, such as whether the cable end can be reached in one movement without extra snagging.", "reason": "A prototype should answer a question rather than look finished.", "success_check": "The question has an observable answer and stop rule." }, { "title": "Build three rough alternatives", "instruction": "Make a desk-edge guide, counterweight representation and storage pocket at equal low detail before refining any one.", "reason": "Parallel prototypes reduce commitment to the first idea.", "success_check": "Three mechanisms are testable with comparable effort." }, { "title": "Predeclare a common test", "instruction": "Define success, failure, hard stops and how each concept will face the same paper-cable walkthrough.", "reason": "A common test supports comparison and limits hindsight.", "success_check": "The rubric is fixed before trials." }, { "title": "Run and preserve raw evidence", "instruction": "Test each once, record result, unexpected effect and hard-stop status without repairing during the run.", "reason": "Unedited evidence shows what the version actually did.", "success_check": "Each prototype has a complete result row and photo or sketch." }, { "title": "Choose keep, adapt or reject", "instruction": "Apply the rubric and write the decision for every concept. Do not rescue a hard-stop failure with a high average.", "reason": "Explicit decisions keep iteration evidence-led.", "success_check": "Every decision cites a result and gate." }, { "title": "Change one feature", "instruction": "For one adapt decision, alter one meaningful feature only and label version two.", "reason": "A single change makes the next result interpretable.", "success_check": "Version two differs in one recorded feature." }, { "title": "Retest and stop intelligently", "instruction": "Repeat the same test, compare criterion and new problems, then stop when the uncertainty is answered or further work is not justified.", "reason": "Iteration is not endless polishing.", "success_check": "The final log states improvement, no improvement or termination and why." }, { "title": "Check delayed repeatability", "instruction": "After 48 hours, rebuild the chosen paper version from the lineage and test record without using the original object. Run the same rubric once more and explain any changed result.", "reason": "A reconstructable invention record should preserve the critical feature beyond one lucky build or immediate memory.", "success_check": "The delayed version matches the declared feature, and any score change is traced to build variation, measurement noise or a real failure." } ], "worked_example": { "scenario": "Three paper concepts represent a desk-edge guide, counterweight and fabric-like storage pocket.", "walkthrough": [ "Nico asks which concept makes the paper cable end reachable in one movement without snagging.", "He builds all three roughly before decorating any one.", "The guide succeeds on reach but catches thick cable; counterweight adds desk-edge movement; pocket needs two movements.", "He keeps the guide, rejects the unstable counterweight and adapts the pocket only as a backup.", "For guide version two he widens one channel feature, retests the same paper cables and records improved thick-cable passage with no new hard stop." ], "result": "Nico completes a traceable one-variable improvement in a paper fixture. He has not built, electrically tested or approved a real product." }, "right_vs_wrong": [ { "situation": "Prototype purpose", "right": "Answer one named uncertainty.", "wrong": "Make the concept look finished.", "why": "Finish quality can hide that no question was tested." }, { "situation": "Breadth", "right": "Build three rough mechanisms first.", "wrong": "Polish the favourite before alternatives.", "why": "Early commitment reduces information from the search." }, { "situation": "Revision", "right": "Change one feature and keep version one.", "wrong": "Redesign everything and overwrite the old file.", "why": "Multiple changes destroy attribution; deletion destroys the decision trail." }, { "situation": "Stopping", "right": "Stop when evidence answers the question or cost exceeds value.", "wrong": "Iterate indefinitely because invention requires persistence.", "why": "Iteration without a decision rule wastes effort and can add complexity." } ], "common_mistakes": [ { "mistake": "Test criteria change after a favourite fails.", "fix": "Freeze the rubric for the full cycle and revise only on a fresh cycle." }, { "mistake": "Unexpected effects are omitted.", "fix": "Give every run a “new problem” field even when blank." }, { "mistake": "Hard failures are averaged.", "fix": "Use pass/fail gates before scored criteria." }, { "mistake": "Version two changes shape, material and test.", "fix": "Alter one feature and preserve the same test." } ], "practice": { "first_session": [ "Name one uncertainty.", "Build three rough paper alternatives.", "Run one common test.", "Choose keep, adapt or reject.", "Make and retest one single-feature revision." ], "repeat_plan": "Complete one two-cycle benign project every two weeks for six weeks. On the final project, transfer the question–prototype–test–decision method to a different harmless brief and have another reviewer reconstruct the versions.", "progress_when": [ "Each prototype answers a named uncertainty.", "One-variable revisions produce interpretable change.", "Version history and attribution are complete on a new brief." ], "do_not_progress_when": [ "The build becomes powered, load-bearing, clinical, transport or otherwise hazardous.", "Real people would be tested without consent and authority.", "Iteration continues without a remaining decision-relevant uncertainty." ] }, "self_check": [ "What single uncertainty is being tested?", "Did all three concepts face the same rubric?", "What evidence caused keep, adapt or reject?", "Did version two change only one meaningful feature?" ], "measurement": { "primary": "Criterion change and error correction across versioned benign prototypes.", "how": "Record common-test results, hard stops, unexpected effects and reviewer-rated value, feasibility and error correction for versions; compare only matched tests.", "good_result": "A single-feature version improves the predeclared criterion on two matched runs without a new hard-stop failure, and the trail is reconstructable.", "does_not_prove": "It does not establish objective originality, real user value, engineering safety, manufacturability or commercial invention." }, "stop_and_get_help": [ "Stop before connecting to electricity, body, vehicle, pressure, load, heat, flame, chemical or live service.", "Stop when sharp edges, trip hazards, privacy risk or inaccessible use appears.", "Seek domain, safety, rights and affected-user review before functional prototyping or implementation." ], "accessibility": [ "Use storyboards, cardboard, tactile mock-ups or accessible interface wireframes.", "Allow a maker assistant while the learner controls the hypothesis and decision log.", "Use low-force tools and pre-cut materials without changing the design question." ], "evidence_notes": [ { "claim": "The Fusion Innovation Test decomposes real-world creative problem solving into measurable generation, selection and revision features but does not establish general trainability.", "source_title": "Introducing the fusion innovation test as a new paradigm for studying realworld creative problem solving", "source_url": "https://pubmed.ncbi.nlm.nih.gov/41436751", "source_kind": "PRIMARY_RESEARCH" }, { "claim": "An experimental study found leader behaviours aligned with innovation requirements affected performance, showing that configured process conditions matter.", "source_title": "Aligning Leader Behaviors With Innovation Requirements Improves Performance: An Experimental Study", "source_url": "https://pubmed.ncbi.nlm.nih.gov/32733310", "source_kind": "PRIMARY_RESEARCH" } ], "limits": [ "Only benign, reversible representations are built.", "Matched improvement answers one prototype question, not overall product success.", "Real invention requires domain validation, rights, safety, users and implementation evidence." ], "orientation": { "bounded_definition": "Capability to develop or express iterative invention in a declared context without inheriting broader claims.", "evidence_summary": "Iterative invention can be decomposed into measurable generation, selection and revision stages, but a general trainable capability is not yet established.", "supportable_public_claim": "Iterative invention can be decomposed into measurable generation, selection and revision stages, but a general trainable capability is not yet established.", "measurement_boundary": "Independent improvement in user-defined value, feasibility, safety, originality and error correction across versioned artefacts. Judge scores reflect a declared rubric and audience, not an objective universal essence of creativity.", "myth_to_metric": { "myth": "Endless iteration inevitably creates a world-changing invention", "metric": "Independent improvement in user-defined value, feasibility, safety, originality and error correction across versioned artefacts", "boundary": "Independent improvement in user-defined value, feasibility, safety, originality and error correction across versioned artefacts. Judge scores reflect a declared rubric and audience, not an objective universal essence of creativity." }, "limiting_findings": [ "Available sources do not isolate acquisition, retention or real-world invention, and no single opening/closing pattern worked universally.", "No evidence supports perfect, limitless or universal performance." ], "prohibited_claims": [ "Iteration guarantees invention", "More versions mean more progress", "AI output is proof of the user's independent capability" ] }, "gold_source_lesson": { "curriculum_id": "G-CUR-013", "source_heading": "12. PWR-136 - Iterative invention", "source_html_sha256": "cdb1dd1b5e9a9a070cdc97eca731edfd0b69bceb780979301f2cb7d8b40ac89b", "html": "Iterative invention moves from an idea to information: build something small, test a question, learn, change one meaningful feature and repeat. It is not endless polishing of the first concept.
\nReturn to the cable problem. Build three rough paper/card prototypes before refining any one:
\nFor each prototype, test the same questions:
\nA prototype need only answer the next uncertainty. It can be:
\nDo not build a powered, pressurised, load-bearing, medical, transport, weapon, fire, chemical or safety-critical prototype under this route.
\nBounded non-public Gold curriculum v1.0
\nPower bindings: PWR-137, PWR-138, PWR-139, PWR-141 and PWR-144
\nDependency: exact G-CUR-010 v1.0.1 snapshot and 11 canonical Memory/Learning modules
\nPublic effect: none
\n\nLanguage is not one score. Understanding, learning, producing language, speaking smoothly and explaining clearly are different jobs. A person can be strong in one and still need support in another.
\n
Titan uses FL-1, a tiny invented language created only for this curriculum. It belongs to no community and carries no claim about how natural languages work.
\n| FL-1 | \nEnglish | \n
|---|---|
| mi | \nI | \n
| ti | \nyou | \n
| ka | \nthe | \n
| mira | \nwater | \n
| tavi | \nbook | \n
| kavo | \ndoor | \n
| peli | \nread | \n
| naki | \ncarry | \n
| vema | \nopen | \n
| dori | \nclose | \n
| na | \nnot; placed before the verb | \n
Study the table for two minutes, then hide it and interpret these sentences:
\nmi peli ka taviti naki ka mirami vema ka kavoti na dori ka kavoDo not judge yourself by one immediate attempt. Record what you understood, which support was visible, and what remained several days later.
\nThe fourth sentence tests more than vocabulary: it tests whether you noticed the position and meaning of na.
| Power | \nFrozen route | \nBounded non-public treatment | \n
|---|---|---|
| PWR-137 · Multilingual comprehension | \nG1 Gold / targeted review | \nSynthetic, public-domain, open-licensed, learner-owned or explicitly authorised material | \n
| PWR-138 · Rapid language learning | \nG1 Gold / targeted review | \nMatched method comparison; no universal speed claim | \n
| PWR-139 · Verbal fluency | \nG1 Silver / targeted review | \nBenign speaking/writing tasks; no accent ranking | \n
| PWR-141 · Explanatory clarity | \nG1 Silver / targeted review | \nFictional or authorised topics and audience checks | \n
| PWR-144 · High-stakes communication | \nG4 specialist | \nQualified route, verification and fallback only | \n
PWR-144 covers medical, legal, emergency, safeguarding, immigration, employment, crisis and similarly consequential communication. Friendly teaching language does not turn those situations into self-guided practice.
\nBefore using a language sample, record:
\nDo not harvest private messages, imitate a real person's voice, publish community-controlled material, or treat a dominant prestige variety as the only legitimate form.
\nA useful profile is not “I am bad at languages.” Record:
\n| Field | \nExample | \n
|---|---|
| Language or variety | \nFL-1 synthetic fixture; or named real variety | \n
| Modality | \nReading, listening, speaking, signing, writing or AAC-supported communication | \n
| Real task | \nUnderstand a short message; give directions; explain one process | \n
| Current level | \nWhat you can already do under which support | \n
| Time horizon | \nToday, one week, one month or ongoing maintenance | \n
| Support | \nDictionary, captions, translation, tutor, AI, notes, AAC or partner | \n
| Proof | \nNOW, LATER, NEW, SUPPORT, SUPPORT-OFF and VALUE | \n
There is no single multilingual-comprehension or language-talent score.
\nScore these separately:
\nWord recognition is not automatically comprehension. A translation can be useful support, but reading a translation is not evidence that the original language was understood independently.
\nUsing the vocabulary table only during study, answer:
\nti carry?The final question tests inference and uncertainty. The sentence says only that “you do not close the door”; it does not state the door's current position.
\nFor a short authorised sentence:
\nThis is a learning fixture—not professional translation or interpretation.
\nG-CUR-014 does not clone the memory methods. It binds the exact G-CUR-010 modules for:
\nA mnemonic that recalls a translation pair has not yet proved comprehension, productive use or grammatical control.
\nUse examples that differ in one important feature.
\n| FL-1 example | \nMeaning | \n
|---|---|
ti dori ka kavo | \n You close the door. | \n
ti na dori ka kavo | \n You do not close the door. | \n
Ask:
\nOne contrast is evidence about one pattern—not mastery of a grammar.
\nFor a benign language task:
\nFeedback should be informative, proportionate and respectful. It is not permission for humiliation, accent shaming or identity-based correction.
\nFluency can be recorded using:
\nDo not equate accent strength with poor comprehensibility. Do not present native-likeness as the universal goal.
\nRepeat one benign prompt after feedback, then test a related new prompt.
\nMassed repetition can make a rehearsed performance look fluent while hiding fragility.
\nBefore writing or speaking, declare:
\n| Question | \nRecord | \n
|---|---|
| Who is the audience? | \nPrior knowledge, language, access needs and relationship | \n
| What is the main message? | \nOne sentence | \n
| What should they understand or do? | \nOne observable outcome | \n
| What nuance must remain? | \nUncertainty, exceptions, source limits or consequences | \n
| What can be removed? | \nDetail that does not serve the audience's task | \n
Lead with the main message. Use familiar words where they preserve the meaning. Define necessary terms at the point of use.
\nA strong explanation often includes:
\nDense version:
\n\n\nUsers intending to access Archive Delta must, prior to initiating the submission workflow, ensure completion of all metadata fields and attachment verification, after which the request can be transmitted for review; incomplete requests may be returned without processing.
\n
Reader-first version:
\n\n\nBefore you submit an Archive Delta request, complete every metadata field and check the attachment. Then send the request for review. An incomplete request may be returned without being processed.
\n
The rewrite is shorter, but it preserves sequence, requirements and uncertainty.
\nWith a consenting participant—or with the synthetic workbook cards—ask:
\nDo not ask “Did that make sense?” and treat politeness as evidence. Do not test unwitting people.
\nRapid language learning means fewer sessions or less total time to reach a declared criterion—not a permanent personal trait.
\nCompare two methods using matched material:
\n| Hold constant | \nRecord | \n
|---|---|
| Number and difficulty of items | \n\n |
| Study time | \n\n |
| Immediate test | \n\n |
| Delayed test | \n\n |
| New-material test | \n\n |
| Support and support-off | \n\n |
| Errors and burden | \n\n |
If one method wins NOW but loses LATER, it was faster practice—not faster durable learning.
\nRecord exactly what the support did:
\nThen verify against an authorised source or qualified speaker where stakes or accuracy require it.
\nSUPPORT-OFF is useful only when removing support is safe and relevant. A person who communicates successfully through AAC, captions, a dictionary or an interpreter has achieved a supported capability—not a lesser one.
\nAI output must never be treated as community authority, professional translation, legal/medical interpretation or proof that a variety is wrong.
\nFor PWR-144, Titan may help prepare a handoff:
\nNo live high-stakes script, diagnosis, legal interpretation or emergency instruction is authorised here.
\nCan you meet the criterion immediately?
\nCan you do it after a meaningful delay without a warm-up or answer key?
\nCan you comprehend, produce or explain genuinely new authorised material?
\nWhat dictionary, caption, tutor, translation, AI, notes, partner or access aid was present?
\nWhat remains without the support, only when removal is safe, relevant and fair?
\nWas the result useful enough to justify time, anxiety, correction load and maintenance?
\nA null result, a supported result or a decision to retire a method can all be valid.
\n| What happens | \nLikely issue | \nRepair | \n
|---|---|---|
| Word-list score rises but sentences still fail | \npair learning did not transfer | \nretrieve in new sentences and score gist/detail separately | \n
| Translation looks correct but nuance is missing | \nword-for-word alignment | \nalign meaning units and mark uncertainty | \n
| Speech is faster but harder to understand | \nspeed displaced clarity | \nrestore task completion and comprehensibility as criteria | \n
| Repeated prompt improves but new prompt does not | \nscript-specific practice | \nadd a NEW prompt and reduce massed repetition | \n
| Feedback creates shame or silence | \ncorrection is socially unsafe | \nchange source, consent or feedback format | \n
| Plain-language rewrite changes the meaning | \noversimplification | \nrestore necessary terms, conditions and uncertainty | \n
| Audience says yes but cannot restate the message | \ncourtesy response | \nuse neutral comprehension questions | \n
| AI gives conflicting corrections | \nmodel unreliability or variety mismatch | \nverify with authorised references and declare the variety | \n
| Support-off collapses performance | \nsupport was doing real work | \nretain and label the support; do not pretend independence | \n
| The situation has medical/legal/emergency consequences | \nwrong authority route | \nuse PWR-144 specialist handoff | \n
Vocabulary learning benefits from retrieval, spacing and meaningful engagement, but paired-word gains are not whole-language acquisition. Task repetition can help some oral outcomes, yet transfer varies and massed repetition can produce brittle scripts. Corrective feedback and model texts can help, but their effects depend on task, timing and learner. Accent and comprehensibility are related but not identical. Plain-language tools help organise communication, but domain meaning and audience testing still matter.
\nNo evidence record in this package proves universal rapid fluency, increased intelligence, accent elimination, professional translation competence or safe high-stakes communication.
\nTARGETED_REVIEW_REQUIRED__BOUNDED_NON_PUBLIC_SYNTHETIC_OR_AUTHORISED_FIXTURE_GATE.