Philip D. Harvey, PhD Leonard M. Miller Professor of Psychiatry and Behavioral Sciences Department of Psychiatry and Behavioral Sciences University of Miami Miller School of Medicine Miami, Florida
Vanessa Nascimento, MD, MPH PGY-1 Psychiatry Resident University of Miami/Jackson Health System Psychiatry Residency Training Program Department of Psychiatry and Behavioral Sciences University of Miami Miller School of Medicine Miami, Florida
Disclosures Dr. Harvey has received consulting fees or travel reimbursements from Alkermes, Bio Excel, Boehringer Ingelheim, Intra-Cellular Therapies, Mindstrong Health, Minerva Pharma, Regeneron Pharma, Roche Pharma, Sunovion Pharma, Takeda Pharma, and Teva. He receives royalties from the Brief Assessment of Cognition in Schizophrenia. He is Chief Scientific Officer of i-Function, Inc. He has research grants from Takeda and the Stanley Medical Research Foundation. Dr. Nascimento reports no financial relationships with any companies whose products are mentioned in this article, or with manufacturers of competing products.
After navigating these steps, an individual still needs other cognitive abilities to refill other prescriptions later. However, executive functioning is also critical for maintaining organization across different technological demands. For example, web sites have different password rules and require frequent changes without re-using old passwords, so it becomes critical to maintain an organized list of web site addresses and their passwords.
Refilling a prescription with a telephone voice menu also requires a series of steps. Typically, this process is simpler than an internet refill, because no log-in information is necessary. However, it still requires a structured series of tasks.
Working memory refers to the ability to hold information in consciousness long enough to operate on it. At each step of the navigation process, the user needs to remember which steps he/she has already completed, because repeating steps can slow down the process or lead to error messages. Thus, remembering which steps have been completed is as critical for performing tasks as is correctly understanding the anticipated sequence of steps. Further, when a password is forgotten, the user needs to remember the newly provided password.
Working memory can be spatial as well. For example, most web sites do not display a password while it is being entered, which eliminates spatial working memory from the equation. Thus, the ability to remember which characters have been entered and which still need to be entered is necessary.
Episodic memoryis the process of learning and retaining newly presented verbal or spatial information as well as recalling it later for adaptive use. After successfully using a new technology, it is critical to be able to remember what to do the next time it is used. This includes both recalling how to access the technology (including the web address, user ID, and password), recalling the steps needed to be performed and their sequence, and recognizing the buttons and instructions presented onscreen.
