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Clinical expertise shifts psychological distancing from effortful regulation to reduced engagement on internally oriented processing during multitasking
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DOI：10.3389/fnbeh.2026.1811561.png)
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Abstract
En 中文
BackgroundClinical decision-making often occurs under conditions of high cognitive load; emotional stress; and time pressure. Psychological distancing; an emotion-focused coping strategy involving the mental separation of oneself from emotionally stressful situations to reduce affective impact; supports affect regulation in such contexts; however; its neural implementation during realistic multitasking and the extent to which it is shaped by clinical expertise remain poorly understood.MethodsWe investigated the neural correlates of psychological distancing during high-risk multitasking clinical scenarios in experienced nurses and nursing students. Participants first completed immersive virtual reality simulations of realistic clinical situations; followed by an auditory functional magnetic resonance imaging task derived from the same scenarios. Psychological distancing was assessed using a validated self-report measure; and brain–behavior associations were examined separately for experienced nurses and nursing students.ResultsAlthough self-reported psychological distancing did not differ between groups; clear expertise-related neural differences were observed. In experienced nurses; higher distancing was associated with reduced activation in regions of the default mode network; including the angular gyrus; middle temporal gyrus; and precuneus; which are implicated in internally oriented cognitive and emotional processing. In contrast; nursing students exhibited increased activation restricted to the cerebellum; suggesting greater dependence on effortful and compensatory neural mechanisms during emotion regulation under multitasking demands.ConclusionThese findings provide evidence that clinical expertise may influence the neural implementation of psychological distancing; shifting it from effortful regulation toward reduced engagement of internally oriented processing; which may reflect a more automatized regulatory implementation. This neural process may support adaptive emotion regulation during decision-making under stress; highlighting a potential neurobehavioral mechanism through which expertise shapes performance in complex clinical environments.
Keywords:
fMRI
nurses
expertise
coping
emotion regulation
novice
immersive virtual reality
multitasking
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