A situated method for modelling and analysing the efficiency of cognitive activity during the radiology reporting workflow using eye-tracking

The success of modern medical imaging systems has created a data overload problem, where an ever-increasing number of examinations, generate more images per study, which all need to be evaluated by radiologists or other reporting practitioners. This operational bottleneck hasthe potentialto create fatigue and burnout due to the high mental workload that is required to keep up with the demand. The focus of this problem centres around the cognitive complexity of the radiology reporting workflow, and the associated workstation interactions involved in diagnostic report generation. There has been a significant body of work evaluating the behaviour of radiologists using controlled laboratory-based techniques, but these non-naturalistic studies fail to address the highly context dependant nature of the radiology reporting workflow. For example, the early eye-tracking work of Charmody et al; the psychometric studies by Krupinksi et al; and also the workstation interaction evaluations of Moise et al; whilst highly principled, can be all be questioned on the grounds of ecological validity and authenticity. This thesis asserts that the only way to truly understand and resolve the radiology data overload problem, is by developing a situated method for observing the reporting workflow that can evaluate the behaviours of the reporting clinicians in relation to their authentic reporting context. To this end, this study has set out to develop a new approach for observing and analysing the cognitive activities of the reporters relative to the demands of their genuine working environment, and supported through the application of a Critical Realist’s perspective to naturalistic workplace observations. This goal was achieved through the development of four key project deliverables: • An in-depth exploratory study of the radiology overload problem based on an extensive literature review and situated observations of authentic reporting workflows. • A descriptive hierarchical activity modelof the reporting workflow that can be understood by both clinicians, application designers and researchers. • A generalised methodology and research protocolfor conducting situated observations of the radiology reporting workflow, using an analysis based on the process tracing of sequencesof Object Related Actions, captured with eye-tracking and multimodal recordings. • A set of case studies demonstrating the applicability of the research protocol involving 5 Radiology Consultants, 2 Radiology Registrars and one Reporting Radiographer at a single NHS Hospital within the UK. The final workflow evaluation of the case studies demonstrated that activities such as error correction, and the collection of supporting radiological information from previous studies is complex, time consuming and cognitively demanding. These types of activities are characterised by long, low utility actions that correspond to what Kahneman refers to as “Thinking Slow”. Also, the participants appeared to be self-optimising their workflow via a sparse use of complex functionality and system tools. From these observations, the author recommends that any intervention that can reduce the number and the duration of the object related actions used to produce radiology reports, will reduce cognitive load, increase overall efficiency, and go some way to alleviate the data overload problem. 4 This study establishes a new set of situated techniques that are able to capture and quantify the complex dynamicactivities that make up the radiology reporting workflow. Itis hoped that the ability to distil usefuland impactful insightsfrom the user’s workstation behaviours can be used as the basis for further development in the area of workflow analysis and redesign, which will ultimately improve the working lives of Radiologists and other Reporting Clinicians. Lastly, the generic nature of these techniques make them amenable for use within any type of complex sociotechnical human factors study related to the cognitive efficiency of the user

Speech Recognition

Chapters in the first part of the book cover all the essential speech processing techniques for building robust, automatic speech recognition systems: the representation for speech signals and the methods for speech-features extraction, acoustic and language modeling, efficient algorithms for searching the hypothesis space, and multimodal approaches to speech recognition. The last part of the book is devoted to other speech processing applications that can use the information from automatic speech recognition for speaker identification and tracking, for prosody modeling in emotion-detection systems and in other speech processing applications that are able to operate in real-world environments, like mobile communication services and smart homes

Designing Embodied Interactive Software Agents for E-Learning: Principles, Components, and Roles

Embodied interactive software agents are complex autonomous, adaptive, and social software systems with a digital embodiment that enables them to act on and react to other entities (users, objects, and other agents) in their environment through bodily actions, which include the use of verbal and non-verbal communicative behaviors in face-to-face interactions with the user. These agents have been developed for various roles in different application domains, in which they perform tasks that have been assigned to them by their developers or delegated to them by their users or by other agents. In computer-assisted learning, embodied interactive pedagogical software agents have the general task to promote human learning by working with students (and other agents) in computer-based learning environments, among them e-learning platforms based on Internet technologies, such as the Virtual Linguistics Campus (www.linguistics-online.com). In these environments, pedagogical agents provide contextualized, qualified, personalized, and timely assistance, cooperation, instruction, motivation, and services for both individual learners and groups of learners. This thesis develops a comprehensive, multidisciplinary, and user-oriented view of the design of embodied interactive pedagogical software agents, which integrates theoretical and practical insights from various academic and other fields. The research intends to contribute to the scientific understanding of issues, methods, theories, and technologies that are involved in the design, implementation, and evaluation of embodied interactive software agents for different roles in e-learning and other areas. For developers, the thesis provides sixteen basic principles (Added Value, Perceptible Qualities, Balanced Design, Coherence, Consistency, Completeness, Comprehensibility, Individuality, Variability, Communicative Ability, Modularity, Teamwork, Participatory Design, Role Awareness, Cultural Awareness, and Relationship Building) plus a large number of specific guidelines for the design of embodied interactive software agents and their components. Furthermore, it offers critical reviews of theories, concepts, approaches, and technologies from different areas and disciplines that are relevant to agent design. Finally, it discusses three pedagogical agent roles (virtual native speaker, coach, and peer) in the scenario of the linguistic fieldwork classes on the Virtual Linguistics Campus and presents detailed considerations for the design of an agent for one of these roles (the virtual native speaker)

Information-Enabled Decision-Making in Health Care: EHR-Enabled Standardization, Physician Profiling and Medical Home

Health care today harms too frequently and routinely fails to deliver its potential benefits. Significant evidence suggests that high quality primary care can positively affect health outcomes. I explored three related topics mentioned frequently in current United States health reform €“ Electronic Health Records (EHR), physician profiling and Medical Home. An investment in these areas is expected to significantly improve quality of care and efficiency; however, there is only a patchwork of evidence supporting such claims. To achieve EHR promises, my research employed a standardization lens to study the dynamics between EHR embedded structures and primary care processes. Using grounded theory, a standardization dynamics model was created describing the influencers, conditions and consequences of the process state. A matrix of two conditions, information exchange and patient complexity, identified four distinct pathways that require a different balance between standardization and flexibility. The value of such pathways is that they frame choices about how to use embedded IT structures to support effective delivery processes. Physician profiling is an emerging methodology used in health care quality improvement programs. Efforts to measure performance at the individual physician level face a number of challenges, including the need for sufficient sample size to support reliable measurement. A process for creating a physician profiling model was developed, and a model designed for a case study site. Results indicate that reliable physician profiling is possible across care domains using a hierarchical composite model. Patient-Centered Medical Home (PCMH) is a new care delivery approach for providing comprehensive primary care that seeks to strengthen the physician-patient relationship. This exploratory study utilizes Pearson correlation coefficients to test four hypotheses about relationships between two sources of data: (1) PPC-PCMH Survey results that measure adoption of PCMH structures and (2) patient experience data from Massachusetts Health Quality Partners (MHQP). The results showed that the PPC-PCMH structures of access and communication were negatively correlated with the related patient experience measure. This study contributes to the literature by addressing deficiencies in how EHR-enabled processes, physician profiling models and Medical Home constructs are measured, to support improved outcomes

Patient Safety and Quality: An Evidence-Based Handbook for Nurses

Compiles peer-reviewed research and literature reviews on issues regarding patient safety and quality of care, ranging from evidence-based practice, patient-centered care, and nurses' working conditions to critical opportunities and tools for improvement

Digital writing technologies in higher education : theory, research, and practice

This open access book serves as a comprehensive guide to digital writing technology, featuring contributions from over 20 renowned researchers from various disciplines around the world. The book is designed to provide a state-of-the-art synthesis of the developments in digital writing in higher education, making it an essential resource for anyone interested in this rapidly evolving field. In the first part of the book, the authors offer an overview of the impact that digitalization has had on writing, covering more than 25 key technological innovations and their implications for writing practices and pedagogical uses. Drawing on these chapters, the second part of the book explores the theoretical underpinnings of digital writing technology such as writing and learning, writing quality, formulation support, writing and thinking, and writing processes. The authors provide insightful analysis on the impact of these developments and offer valuable insights into the future of writing. Overall, this book provides a cohesive and consistent theoretical view of the new realities of digital writing, complementing existing literature on the digitalization of writing. It is an essential resource for scholars, educators, and practitioners interested in the intersection of technology and writing

Recent Advances in Social Data and Artificial Intelligence 2019

The importance and usefulness of subjects and topics involving social data and artificial intelligence are becoming widely recognized. This book contains invited review, expository, and original research articles dealing with, and presenting state-of-the-art accounts pf, the recent advances in the subjects of social data and artificial intelligence, and potentially their links to Cyberspace