Pub Date : 2022-03-01DOI: 10.1177/15553434221078215
Kaela Shea, O. St-Cyr, T. Chau
This study evaluated the change in usability, mental workload and information transfer rate associated with an augmentative and alternative communication (AAC) interface designed through ecological interface design (EID). The design and development process is detailed in Shea et al. (2021). Digital AAC interfaces are considered high-tech interventions for individuals who experience complex communication needs (e.g., from etiologies such as cerebral palsy) and enable users to select language options from a visual display. Interface usability, mental workload and information transfer rate collectively influence users’ communication. Ten AAC-naïve participants engaged in three semi–scripted conversations (verbal, AAC-mediated commercial interface, and EID interfaces) with an actor. Augmentative and alternative communication interfaces were accessed through a single switch pathway. Information transfer rate, error rate, heart rate variability and subjective workload performance measures were recorded for every trial. During AAC-mediated trials, interface interactions were also documented. The EID AAC interface presented improved communication in 5 out of 7 performance measures (p < .05). The EID AAC interface was associated with a significantly higher information transfer rate, lower error rate, less time elapsed between switch activations, less switch activation per word communicated and lower subjective workload. The application of EID to an AAC interface can lead to a significantly improved communication experience.
{"title":"Evaluation of an Ecological Interface Design–Driven Augmentative and Alternative Communication Interface","authors":"Kaela Shea, O. St-Cyr, T. Chau","doi":"10.1177/15553434221078215","DOIUrl":"https://doi.org/10.1177/15553434221078215","url":null,"abstract":"This study evaluated the change in usability, mental workload and information transfer rate associated with an augmentative and alternative communication (AAC) interface designed through ecological interface design (EID). The design and development process is detailed in Shea et al. (2021). Digital AAC interfaces are considered high-tech interventions for individuals who experience complex communication needs (e.g., from etiologies such as cerebral palsy) and enable users to select language options from a visual display. Interface usability, mental workload and information transfer rate collectively influence users’ communication. Ten AAC-naïve participants engaged in three semi–scripted conversations (verbal, AAC-mediated commercial interface, and EID interfaces) with an actor. Augmentative and alternative communication interfaces were accessed through a single switch pathway. Information transfer rate, error rate, heart rate variability and subjective workload performance measures were recorded for every trial. During AAC-mediated trials, interface interactions were also documented. The EID AAC interface presented improved communication in 5 out of 7 performance measures (p < .05). The EID AAC interface was associated with a significantly higher information transfer rate, lower error rate, less time elapsed between switch activations, less switch activation per word communicated and lower subjective workload. The application of EID to an AAC interface can lead to a significantly improved communication experience.","PeriodicalId":46342,"journal":{"name":"Journal of Cognitive Engineering and Decision Making","volume":"16 1","pages":"43 - 59"},"PeriodicalIF":2.0,"publicationDate":"2022-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45066263","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-03-01DOI: 10.1177/15553434221076827
E. Shull, John G. Gaspar, D. McGehee, Rose Schmitt
The next decade will see a rapid increase in the prevalence of partial vehicle automation, specifically conditional automation (i.e., SAE level 3; SAE, 2018). In conditional automation, the expectation is that the user is still receptive to takeover and can disengage while the automation is active, but as the automation approaches its operational limits, or the end of its operational design domain, it issues a request to intervene and the user is expected to retake control. A human–machine interface (HMI) that can safely and effectively transition control is therefore very important. This simulator study investigated how features of the HMI design, specifically feedback about the confidence (i.e., current capability) of the automation influenced transition of control. Participants were assigned to one of three conditions, which received varying amounts of visual and auditory feedback regarding the automation’s confidence. Findings suggest 3-stage auditory-visual feedback about the automation’s confidence may improve subsequent takeover performance compared to 3-stage visual and a control group without feedback. This research demonstrates the potential value of providing more insight into automated feature performance in conditional automation.
{"title":"Using Human–Machine Interfaces to Convey Feedback in Automated Driving","authors":"E. Shull, John G. Gaspar, D. McGehee, Rose Schmitt","doi":"10.1177/15553434221076827","DOIUrl":"https://doi.org/10.1177/15553434221076827","url":null,"abstract":"The next decade will see a rapid increase in the prevalence of partial vehicle automation, specifically conditional automation (i.e., SAE level 3; SAE, 2018). In conditional automation, the expectation is that the user is still receptive to takeover and can disengage while the automation is active, but as the automation approaches its operational limits, or the end of its operational design domain, it issues a request to intervene and the user is expected to retake control. A human–machine interface (HMI) that can safely and effectively transition control is therefore very important. This simulator study investigated how features of the HMI design, specifically feedback about the confidence (i.e., current capability) of the automation influenced transition of control. Participants were assigned to one of three conditions, which received varying amounts of visual and auditory feedback regarding the automation’s confidence. Findings suggest 3-stage auditory-visual feedback about the automation’s confidence may improve subsequent takeover performance compared to 3-stage visual and a control group without feedback. This research demonstrates the potential value of providing more insight into automated feature performance in conditional automation.","PeriodicalId":46342,"journal":{"name":"Journal of Cognitive Engineering and Decision Making","volume":"16 1","pages":"29 - 42"},"PeriodicalIF":2.0,"publicationDate":"2022-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49074034","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-03-01DOI: 10.1177/15553434211061024
Lucas Bertelli Fogaça, Éder Henriqson, Guido Carim Junior, Felipe Lando
Operations Control Centres (OCCs) are critical structures used by airlines to oversee the execution of all planned flights, managing punctuality, regularity and customer support. In this study, we investigated the decision-making during flight disruptions inside an OCC from the naturalistic decision-making perspective. We conducted a mini-ethnography case study in a major South American airline, focussing on how functions critical to the flight disruption management cope with variability. Data collection included document analyses, field notes, direct observations and interviews. The functional description of work-as-done revealed how the OCC constantly and actively looks for signs of disruption while monitoring the normal operation and rebalancing resources. The decision-making process is distributed and decentralised across multiple functions, where experts from each function rely on a repertoire of strategies to deploy innovative solutions to dynamic scenarios. Five different mechanisms were identified that converge functions to disarm potential disruptions before they compromise the flight network, and continuously create and reinforce system buffers.
{"title":"Airline Disruption Management: A Naturalistic Decision-Making Perspective in an Operational Control Centre","authors":"Lucas Bertelli Fogaça, Éder Henriqson, Guido Carim Junior, Felipe Lando","doi":"10.1177/15553434211061024","DOIUrl":"https://doi.org/10.1177/15553434211061024","url":null,"abstract":"Operations Control Centres (OCCs) are critical structures used by airlines to oversee the execution of all planned flights, managing punctuality, regularity and customer support. In this study, we investigated the decision-making during flight disruptions inside an OCC from the naturalistic decision-making perspective. We conducted a mini-ethnography case study in a major South American airline, focussing on how functions critical to the flight disruption management cope with variability. Data collection included document analyses, field notes, direct observations and interviews. The functional description of work-as-done revealed how the OCC constantly and actively looks for signs of disruption while monitoring the normal operation and rebalancing resources. The decision-making process is distributed and decentralised across multiple functions, where experts from each function rely on a repertoire of strategies to deploy innovative solutions to dynamic scenarios. Five different mechanisms were identified that converge functions to disarm potential disruptions before they compromise the flight network, and continuously create and reinforce system buffers.","PeriodicalId":46342,"journal":{"name":"Journal of Cognitive Engineering and Decision Making","volume":"16 1","pages":"3 - 28"},"PeriodicalIF":2.0,"publicationDate":"2022-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45751674","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-09-08DOI: 10.1177/15553434211045154
Gary Klein, Robert R. Hoffman, Shane T. Mueller, E. Newsome
The process of explaining something to another person is more than offering a statement. Explaining means taking the perspective and knowledge of the Learner into account and determining whether the Learner is satisfied. While the nature of explanation—conceived of as a set of statements—has been explored philosophically and empirically, the process of explaining, as an activity, has received less attention. We conducted an archival study, looking at 73 cases of explaining. We were particularly interested in cases in which the explanations focused on the workings of complex systems or technologies. The results generated two models: local explaining to address why a device (such an intelligent system) acted in a surprising way, and global explaining about how a device works. The examination of the processes of explaining as it occurs in natural settings revealed a number of mistaken beliefs about how explaining happens, and what constitutes an explanation that encourages learning.
{"title":"Modeling the Process by Which People Try to Explain Complex Things to Others","authors":"Gary Klein, Robert R. Hoffman, Shane T. Mueller, E. Newsome","doi":"10.1177/15553434211045154","DOIUrl":"https://doi.org/10.1177/15553434211045154","url":null,"abstract":"The process of explaining something to another person is more than offering a statement. Explaining means taking the perspective and knowledge of the Learner into account and determining whether the Learner is satisfied. While the nature of explanation—conceived of as a set of statements—has been explored philosophically and empirically, the process of explaining, as an activity, has received less attention. We conducted an archival study, looking at 73 cases of explaining. We were particularly interested in cases in which the explanations focused on the workings of complex systems or technologies. The results generated two models: local explaining to address why a device (such an intelligent system) acted in a surprising way, and global explaining about how a device works. The examination of the processes of explaining as it occurs in natural settings revealed a number of mistaken beliefs about how explaining happens, and what constitutes an explanation that encourages learning.","PeriodicalId":46342,"journal":{"name":"Journal of Cognitive Engineering and Decision Making","volume":"15 1","pages":"213 - 232"},"PeriodicalIF":2.0,"publicationDate":"2021-09-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46511673","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-09-01DOI: 10.1177/15553434211019234
Christen E. Sushereba, L. Militello, Steven P Wolf, E. Patterson
We present a framework for using augmented reality (AR) to train sensemaking skills in combat medics and civilian emergency medical personnel. AR and other extended reality technologies create engaging training environments, but their effectiveness on training outcomes is not yet clear. One benefit of AR is that it can enhance simulation training with realism and context that naturalistic decision-making (NDM) models emphasize. We describe four key elements of sensemaking that leverage the strengths of AR: perceptual skills, assessment skills, mental models, and generating/evaluating hypotheses. We discuss how AR can be used to train each of these four elements, along with design implications. A focus on naturalistic tasks and environments while designing AR-based simulation training will likely lead to training that is not only engaging but also effective.
{"title":"Use of Augmented Reality to Train Sensemaking in High-Stakes Medical Environments","authors":"Christen E. Sushereba, L. Militello, Steven P Wolf, E. Patterson","doi":"10.1177/15553434211019234","DOIUrl":"https://doi.org/10.1177/15553434211019234","url":null,"abstract":"We present a framework for using augmented reality (AR) to train sensemaking skills in combat medics and civilian emergency medical personnel. AR and other extended reality technologies create engaging training environments, but their effectiveness on training outcomes is not yet clear. One benefit of AR is that it can enhance simulation training with realism and context that naturalistic decision-making (NDM) models emphasize. We describe four key elements of sensemaking that leverage the strengths of AR: perceptual skills, assessment skills, mental models, and generating/evaluating hypotheses. We discuss how AR can be used to train each of these four elements, along with design implications. A focus on naturalistic tasks and environments while designing AR-based simulation training will likely lead to training that is not only engaging but also effective.","PeriodicalId":46342,"journal":{"name":"Journal of Cognitive Engineering and Decision Making","volume":"15 1","pages":"55 - 65"},"PeriodicalIF":2.0,"publicationDate":"2021-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/15553434211019234","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"65549156","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-07-25DOI: 10.1177/15553434211028474
E. Roth, A. Bisantz, Xiaomei Wang, Tracy C. Kim, A. Z. Hettinger
New systems are often based on optimistic assumptions of how they will improve human performance. In the cognitive engineering tradition, these assumed benefits are regarded as hypotheses that need to be tested. An important element of a system user evaluation is to determine whether the hypothesized benefits are realized. Evaluation may also uncover unsupported aspects of performance or unanticipated side-effects of introducing the new technology that need to be addressed. We present a work-centered approach to user evaluation intended to meet these objectives, focusing specifically on design of tailored user-feedback questionnaires (work-centered questionnaires) that are intended to be diagnostic of how specific system elements do, or do not, support work. We summarize two recent evaluation studies we have conducted that illustrate our approach and the diagnostic power of work-centered questionnaires. We discuss how the goals and approach of a work-centered evaluation differ from more traditional approaches to usability evaluation that emphasize the use of standardized questionnaires and broad assessments of usability.
{"title":"A Work-Centered Approach to System User-Evaluation","authors":"E. Roth, A. Bisantz, Xiaomei Wang, Tracy C. Kim, A. Z. Hettinger","doi":"10.1177/15553434211028474","DOIUrl":"https://doi.org/10.1177/15553434211028474","url":null,"abstract":"New systems are often based on optimistic assumptions of how they will improve human performance. In the cognitive engineering tradition, these assumed benefits are regarded as hypotheses that need to be tested. An important element of a system user evaluation is to determine whether the hypothesized benefits are realized. Evaluation may also uncover unsupported aspects of performance or unanticipated side-effects of introducing the new technology that need to be addressed. We present a work-centered approach to user evaluation intended to meet these objectives, focusing specifically on design of tailored user-feedback questionnaires (work-centered questionnaires) that are intended to be diagnostic of how specific system elements do, or do not, support work. We summarize two recent evaluation studies we have conducted that illustrate our approach and the diagnostic power of work-centered questionnaires. We discuss how the goals and approach of a work-centered evaluation differ from more traditional approaches to usability evaluation that emphasize the use of standardized questionnaires and broad assessments of usability.","PeriodicalId":46342,"journal":{"name":"Journal of Cognitive Engineering and Decision Making","volume":"15 1","pages":"155 - 174"},"PeriodicalIF":2.0,"publicationDate":"2021-07-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/15553434211028474","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49253133","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-07-06DOI: 10.1177/15553434211029530
Kaela Shea, O. St-Cyr, T. Chau
Autism spectrum disorder, cerebral palsy, brain stem stroke, and neurological injury are examples of conditions that may limit vocal communication. Augmentative and alternative communication (AAC) systems can provide a communication pathway to users who experience such complex communication needs, facilitating their societal participation and supporting some ability to direct their own care. We adapted the cognitive work analysis (CWA) framework to a linguistic domain for insights into an AAC design that best supports users’ communication. First, we applied the work domain analysis (WDA) to a popular commercial AAC system, Proloquo2Go. Data were gathered from guided AAC system use, domain experts, and the syntactic rules of the English language. The WDA exposed unmet needs in the commercial system. We then applied worker competency analysis to consider different approaches to present information and support user actions. The design included graphic forms and process views, and their integration into viewports and the workspace. Our novel application of CWA uncovered new considerations in AAC interface design and presents a nascent area of investigation, namely, AAC displays that more effectively support users’ goals. Future investigation will evaluate the mental workload of this AAC interface compared to that of current commercially available systems.
{"title":"Ecological Design of an Augmentative and Alternative Communication Device Interface","authors":"Kaela Shea, O. St-Cyr, T. Chau","doi":"10.1177/15553434211029530","DOIUrl":"https://doi.org/10.1177/15553434211029530","url":null,"abstract":"Autism spectrum disorder, cerebral palsy, brain stem stroke, and neurological injury are examples of conditions that may limit vocal communication. Augmentative and alternative communication (AAC) systems can provide a communication pathway to users who experience such complex communication needs, facilitating their societal participation and supporting some ability to direct their own care. We adapted the cognitive work analysis (CWA) framework to a linguistic domain for insights into an AAC design that best supports users’ communication. First, we applied the work domain analysis (WDA) to a popular commercial AAC system, Proloquo2Go. Data were gathered from guided AAC system use, domain experts, and the syntactic rules of the English language. The WDA exposed unmet needs in the commercial system. We then applied worker competency analysis to consider different approaches to present information and support user actions. The design included graphic forms and process views, and their integration into viewports and the workspace. Our novel application of CWA uncovered new considerations in AAC interface design and presents a nascent area of investigation, namely, AAC displays that more effectively support users’ goals. Future investigation will evaluate the mental workload of this AAC interface compared to that of current commercially available systems.","PeriodicalId":46342,"journal":{"name":"Journal of Cognitive Engineering and Decision Making","volume":"15 1","pages":"175 - 197"},"PeriodicalIF":2.0,"publicationDate":"2021-07-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/15553434211029530","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48291579","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-07-06DOI: 10.1177/15553434211023605
Yu. A. Zak, Hagai Tapiro, Thomas J. Alicia, Y. Parmet, Michal Rottem Hovev, G. Taylor, T. Oron-Gilad
To accomplish their missions, the operators of military unmanned aerial vehicles (UAVs) aggregate and process information from multiple sources under time constraints, while experiencing partial sensory deprivation. We aimed to design, develop, and evaluate the need for designated information aids in the form of visualizations of spatial and temporal patterns-of-life for specific operational mission phases. In an evaluation conducted to assess the usefulness of the proposed visualizations, experienced UAV operators from two nations were presented with five scenarios in a narrative format. Each scenario contained one information-aid visualization for a specific mission phase. Participants had to interpret each mission phase and rate the information aid. Results showed that, in general, most operators favored the aids, but their appreciation of specific aids depended on the mission phase. There were also statistically significant differences between the nations. The results emphasize the potential for equipping UAV operators with information aids in the form of visualizations of spatial and temporal patterns-of-life. Moreover, the findings underline the need for more rigorous analyses of operators’ missions, as the need for specific visualizations was shown to vary with mission phase, and some visualizations were found to be more widely useful than others.
{"title":"Rapid Interpretation of Temporal–Spatial Unmanned Aerial Vehicle (UAV) Operational Data – RITSUD: Aiding UAV Operators With Visualizations of Patterns-of-Life Activities","authors":"Yu. A. Zak, Hagai Tapiro, Thomas J. Alicia, Y. Parmet, Michal Rottem Hovev, G. Taylor, T. Oron-Gilad","doi":"10.1177/15553434211023605","DOIUrl":"https://doi.org/10.1177/15553434211023605","url":null,"abstract":"To accomplish their missions, the operators of military unmanned aerial vehicles (UAVs) aggregate and process information from multiple sources under time constraints, while experiencing partial sensory deprivation. We aimed to design, develop, and evaluate the need for designated information aids in the form of visualizations of spatial and temporal patterns-of-life for specific operational mission phases. In an evaluation conducted to assess the usefulness of the proposed visualizations, experienced UAV operators from two nations were presented with five scenarios in a narrative format. Each scenario contained one information-aid visualization for a specific mission phase. Participants had to interpret each mission phase and rate the information aid. Results showed that, in general, most operators favored the aids, but their appreciation of specific aids depended on the mission phase. There were also statistically significant differences between the nations. The results emphasize the potential for equipping UAV operators with information aids in the form of visualizations of spatial and temporal patterns-of-life. Moreover, the findings underline the need for more rigorous analyses of operators’ missions, as the need for specific visualizations was shown to vary with mission phase, and some visualizations were found to be more widely useful than others.","PeriodicalId":46342,"journal":{"name":"Journal of Cognitive Engineering and Decision Making","volume":"15 1","pages":"135 - 154"},"PeriodicalIF":2.0,"publicationDate":"2021-07-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/15553434211023605","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42190828","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-07-04DOI: 10.1177/15553434211029531
T. Morineau, Mounia Djenidi-Delfour, Fabrice Arnault
This study describes the concept of affordance-based procedure and its implementation in a triage station in a hospital emergency department. Rather than seeking to increase operators’ adherence to procedures, an affordance-based procedure (1) aims to induce task steps using affordances that also (2) support degrees of freedom for action. The design of this procedure was guided by the application of an extended version of cognitive work analysis, named “heuristic cognitive work analysis.” This design process produced a new procedural document: a reception card. Ten months after its implementation, a qualitative evaluation with 10 triage nurses shows that the reception card is viewed as supporting coordination between the different nurses’ tasks and providing an external memory to cope with frequent interruptions during high patient inflow, even though the document is used for convenience and with unexpected and partial uses of its items. The document assessed also afforded emerging benefits, that is, acceleration of ambulance release, higher level of confidentiality, assistance for staff hand-overs. Finally, novice triage nurses are particularly sensitive to the benefits brought by this affordance-based procedure.
{"title":"Designing Affordance-Based Procedures Using Heuristic Cognitive Work Analysis: Application to Triage in an Emergency Department","authors":"T. Morineau, Mounia Djenidi-Delfour, Fabrice Arnault","doi":"10.1177/15553434211029531","DOIUrl":"https://doi.org/10.1177/15553434211029531","url":null,"abstract":"This study describes the concept of affordance-based procedure and its implementation in a triage station in a hospital emergency department. Rather than seeking to increase operators’ adherence to procedures, an affordance-based procedure (1) aims to induce task steps using affordances that also (2) support degrees of freedom for action. The design of this procedure was guided by the application of an extended version of cognitive work analysis, named “heuristic cognitive work analysis.” This design process produced a new procedural document: a reception card. Ten months after its implementation, a qualitative evaluation with 10 triage nurses shows that the reception card is viewed as supporting coordination between the different nurses’ tasks and providing an external memory to cope with frequent interruptions during high patient inflow, even though the document is used for convenience and with unexpected and partial uses of its items. The document assessed also afforded emerging benefits, that is, acceleration of ambulance release, higher level of confidentiality, assistance for staff hand-overs. Finally, novice triage nurses are particularly sensitive to the benefits brought by this affordance-based procedure.","PeriodicalId":46342,"journal":{"name":"Journal of Cognitive Engineering and Decision Making","volume":"15 1","pages":"198 - 212"},"PeriodicalIF":2.0,"publicationDate":"2021-07-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/15553434211029531","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45270358","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-06-08DOI: 10.1177/15553434211018296
Nicholas A. Rattray, Mindy E. Flanagan, L. Militello, P. Barach, R. Frankel
End-of-shift handoffs occur when physicians transfer care responsibilities from one shift to another. Typically viewed as a straightforward exchange of information, we argue that several contextually relevant factors shape the communication behaviors of outgoing and incoming residents during handoffs. Digital recordings and transcripts of resident handoffs in medicine and surgery were made at three VA Medical Centers. They were triangulated with cognitive task interviews that elicited residents’ reconstructions of their work practices. Analyses revealed clear distinctions among “day-to-night,” “night-to-day,” and “double handoffs” that involve transitions between day and night teams. Although residents preferred handing off in dedicated, quiet spaces, few (16%) occurred in such settings; 28% contained significant interruptions. The quality handoff artifacts (notes and forms) influenced interactions, especially in cases where multiple residents from different teams were involved, requiring incoming residents to adjust “on the fly.” This study demonstrated that there are multiple contextual factors that affect, and are affected by, handoff interactions. The findings suggest that handoffs are less like the delivery of a telegram (unidirectional) and more like complex adaptive systems (products of interactional co-construction). Teaching communication practices based on interaction complexity may reduce errors and adverse outcomes for hospitalized patients.
{"title":"The Art of Effective Handoff Communication Among Medical and Surgery Residents","authors":"Nicholas A. Rattray, Mindy E. Flanagan, L. Militello, P. Barach, R. Frankel","doi":"10.1177/15553434211018296","DOIUrl":"https://doi.org/10.1177/15553434211018296","url":null,"abstract":"End-of-shift handoffs occur when physicians transfer care responsibilities from one shift to another. Typically viewed as a straightforward exchange of information, we argue that several contextually relevant factors shape the communication behaviors of outgoing and incoming residents during handoffs. Digital recordings and transcripts of resident handoffs in medicine and surgery were made at three VA Medical Centers. They were triangulated with cognitive task interviews that elicited residents’ reconstructions of their work practices. Analyses revealed clear distinctions among “day-to-night,” “night-to-day,” and “double handoffs” that involve transitions between day and night teams. Although residents preferred handing off in dedicated, quiet spaces, few (16%) occurred in such settings; 28% contained significant interruptions. The quality handoff artifacts (notes and forms) influenced interactions, especially in cases where multiple residents from different teams were involved, requiring incoming residents to adjust “on the fly.” This study demonstrated that there are multiple contextual factors that affect, and are affected by, handoff interactions. The findings suggest that handoffs are less like the delivery of a telegram (unidirectional) and more like complex adaptive systems (products of interactional co-construction). Teaching communication practices based on interaction complexity may reduce errors and adverse outcomes for hospitalized patients.","PeriodicalId":46342,"journal":{"name":"Journal of Cognitive Engineering and Decision Making","volume":"15 1","pages":"66 - 82"},"PeriodicalIF":2.0,"publicationDate":"2021-06-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/15553434211018296","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48953645","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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