UNDERSTANDING NURSE CREATED COGNITIVE ARTIFACTS: PERSONALLY-CREATED-COGNITIVE-ARTIFACTS AS EXTERNAL REPRESENTATIONS OF DISTRIBUTED COGNITION

Manuscript 1: “Conceptual Analysis: Externalizing Nursing Knowledge” We use concept analysis to establish that the report tool nurses prepare, carry, reference, amend, and use as a temporary data repository are examples of cognitive artifacts. This tool, integrally woven throughout the work and practice of nurses, is important to cognition and clinical decision-making. Establishing the tool as a cognitive artifact will support new dimensions of study. Such studies can characterize how this report tool supports cognition, internal representation of knowledge and skills, and external representation of knowledge of the nurse. Manuscript 2: “Research Methods: Exploring Cognitive Work” The purpose of this paper is to describe a complex, cross-sectional, multi-method approach to study of personal cognitive artifacts in the clinical environment. The complex data arrays present in these cognitive artifacts warrant the use of multiple methods of data collection. Use of a less robust research design may result in an incomplete understanding of the meaning, value, content, and relationships between personal cognitive artifacts in the clinical environment and the cognitive work of the user. Manuscript 3: “Making the Cognitive Work of Registered Nurses Visible” Purpose: Knowledge representations and structures are created and used by registered nurses to guide patient care. Understanding is limited regarding how these knowledge representations, or cognitive artifacts, contribute to working memory, prioritization, organization, cognition, and decision-making. The purpose of this study was to identify and characterize the role a specific cognitive artifact knowledge representation and structure as it contributed to the cognitive work of the registered nurse. Methods: Data collection was completed, using qualitative research methods, by shadowing and interviewing 25 registered nurses. Data analysis employed triangulation and iterative analytic processes. Results: Nurse cognitive artifacts support recall, data evaluation, decision-making, organization, and prioritization. These cognitive artifacts demonstrated spatial, longitudinal, chronologic, visual, and personal cues to support the cognitive work of nurses. Conclusions: Nurse cognitive artifacts are an important adjunct to the cognitive work of nurses, and directly support patient care. Nurses need to be able to configure their cognitive artifact in ways that are meaningful and support their internal knowledge representations

Cognitive Artifacts in Support of Medical Shift Handover: An In Use, In Situ Evaluation

Technologies introduced to support complex and critical work practices merit rigorous and effective evaluation. However, evaluation strategies often fall short of evaluating real use by practitioners in the workplace and thereby miss an opportunity to gauge the true impact of the technology on the work. This article reports an in use, in situ evaluation of 2 cognitive artifacts that support the everyday work of handover in a healthcare setting. The evaluation drew inspiration from the theoretical viewpoint offered by distributed cognition, focusing on the information content, representational media, and context of use of the artifacts. The article discusses how this approach led to insights about the artifacts and their support of the work that could not have been obtained with more traditional evaluation techniques. Specifically, the argument is made that the ubiquitous approach of user testing with its reliance on think-alouds and observations of interaction is inadequate in this context and set an initial agenda for issues that should be addressed by in use, in situ evaluations

The body as a cognitive artifact in kinship representations: Hand gesture diagrams by speakers of Lao

Central to cultural, social, and conceptual life are cognitive arti-facts, the perceptible structures which populate our world and mediate our navigation of it, complementing, enhancing, and altering available affordances for the problem-solving challenges of everyday life. Much work in this domain has concentrated on technological artifacts, especially manual tools and devices and the conceptual and communicative tools of literacy and diagrams. Recent research on hand gestures and other bodily movements which occur during speech shows that the human body serves a number of the functions of "cognitive technologies," affording the special cognitive advantages claimed to be associated exclusively with enduring (e.g., printed or drawn) diagrammatic representations. The issue is explored with reference to extensive data from video-recorded interviews with speakers of Lao in Vientiane, Laos, which show integration of verbal descriptions with complex spatial representations akin to diagrams. The study has implications both for research on cognitive artifacts (namely, that the body is a visuospatial representational resource not to be overlooked) and for research on ethnogenealogical knowledge (namely, that hand gestures reveal speakers' conceptualizations of kinship structure which are of a different nature to and not necessarily retrievable from the accompanying linguistic code)

Situated and distributed cognition in artifact negotiation and trade-specific skills: A cognitive ethnography of Kashmiri carpet weaving practice

This article describes various ways actors in Kashmiri carpet weaving practice deploy a range of artifacts, from symbolic, to material, to hybrid, in order to achieve diverse cognitive accomplishments in their particular task domains: information representation, inter and intra-domain communication, distribution of cognitive labor across people and time, coordination of team activities, and carrying of cultural heritage. In this repertoire, some artifacts position themselves as naïve tools in the actors’ environment to the point of being ignored; however, their usage-in-context unfolds their cognitive involvement in the tasks. These usages-in-context are shown through artifact analysis of their routine, improvised, and opportunistic uses, where cognitive artifacts like talim—the central artifact of this practice—are shown to play not only multifunctional roles beyond representation, but are also complemented by trade-specific skills bearing strong cognitive implications in a task

Editorial: Macrocognition: The Science and Engineering of Sociotechnical Work Systems

The increasing complexity of work systems and changes in the nature of workplace technology over the past century have resulted in an exponential shift in the nature of work activities, from physical labor to cognitive work. Modern work systems have many characteristics that make them cognitively complex: They can be highly interactive; comprised of multiple agents and artifacts; information may be limited and distributed across space and time; task goals are frequently ill-defined, conflicting, dynamic and emergent; planning may only be possible at general levels of abstraction or require adaptive solutions; some degree of proficiency or expertise is required; the stakes are often high; and uncertainty, time-constraints and stress are seldom absent. To complicate matters further, cognition in complex work settings is typically constrained by broader professional, organizational, and institutional practice and policy. These features of cognitive work present significant challenges to scientific methodology and theory, and subsequent design of reliable interventions. Historically, philosophers and scientists have attempted to understand the mental activities experienced during cognitive work at multiple levels of analysis using divergent methods. Some have examined cognition at an associative, contextual, functional or holistic level, relying on naturalistic methods to understand the higher mental processes as they work in harmony during goal-directed behavior. Others have embraced experimental methods and favored internal over external validity, often reducing cognition to a psychology of fundamental acts, such as short-term memory access with millisecond shifts in attention. More recently, Macrocognition has evolved as a complementary paradigm. Macrocognitive researchers have studied the cognitive functions and processes associated with skilled, adaptive, collaborative, and resilient cognitive work in the context of the aforementioned complexities of psychotechnical and sociotechnical work systems. Typically, this research has been carried out using cognitive task analytic techniques that draw on both naturalistic and (quasi-)experimental methods. The primary goals of research in Macrocognition are to better understand cognitive adaptations to complexity, to increase our theoretical understanding of the organism-environment relations by studying the mapping between cognitive work and real-world demands, and to promote use-inspired research capable of improving system performance

Sense and symbolic objects: Strategic sensemaking through design

This paper reports on an ongoing investigation into one aspect of the design thinking phenomenon, namely the use of designed artifacts — sketches, renderings, graphics, models and prototypes — as symbolic objects in strategy making and implementation. It examines the conceptual overlap between design and the strategic cognition perspective, which considers cognitive processes and structures involved in strategic decision making, particularly the phenomenon of sensemaking. It is primarily a theoretical exploration, but draws on two short testimonies from designers. The specific conceptual connection between design practice and strategic cognition theory is potentially valuable to business leaders and managers involved with innovation, design management and strategic decisions. Preliminary findings suggest sensemaking activities by designers generate innovative future concepts with far-reaching strategic implications; designed artifacts aid sensemaking and sensegiving by management in exploring new business opportunities and directions. This paper is an early draft of a fuller account to be published in 2013 (AIEDAM Special Issue, Spring 2013, Vol.27, No.2, Studying and Supporting Design Communication, Edited by: Maaike Kleinsmann & Anja Maier)

Towards a Reference Terminology for Ontology Research and Development in the Biomedical Domain

Ontology is a burgeoning field, involving researchers from the computer science, philosophy, data and software engineering, logic, linguistics, and terminology domains. Many ontology-related terms with precise meanings in one of these domains have different meanings in others. Our purpose here is to initiate a path towards disambiguation of such terms. We draw primarily on the literature of biomedical informatics, not least because the problems caused by unclear or ambiguous use of terms have been there most thoroughly addressed. We advance a proposal resting on a distinction of three levels too often run together in biomedical ontology research: 1. the level of reality; 2. the level of cognitive representations of this reality; 3. the level of textual and graphical artifacts. We propose a reference terminology for ontology research and development that is designed to serve as common hub into which the several competing disciplinary terminologies can be mapped. We then justify our terminological choices through a critical treatment of the ‘concept orientation’ in biomedical terminology research

Design as communication in micro-strategy — strategic sensemaking and sensegiving mediated through designed artefacts.

This paper relates key concepts of strategic cognition in microstrategy to design practice. It considers the potential roles of designers' output in strategic sensemaking and sensegiving. Designed artifacts play well-known roles as communication media; sketches, renderings, models, and prototypes are created to explore and test possibilities and to communicate these options within and outside the design team. This article draws on design and strategy literature to propose that designed artifacts can and do play a role as symbolic communication resources in sensemaking and sensegiving activities that impact strategic decision making and change. Extracts from interviews with three designers serve as illustrative examples. This article is a call for further empirical exploration of such a complex subject

Against simplicity and cognitive individualism: Nathaniel T. Wilcox

Neuroeconomics illustrates our deepening descent into the details of individual cognition. This descent is guided by the implicit assumption that “individual human” is the important “agent” of neoclassical economics. I argue here that this assumption is neither obviously correct, nor of primary importance to human economies. In particular I suggest that the main genius of the human species lies with its ability to distribute cognition across individuals, and to incrementally accumulate physical and social cognitive artifacts that largely obviate the innate biological limitations of individuals. If this is largely why our economies grow, then we should be much more interested in distributed cognition in human groups, and correspondingly less interested in individual cognition. We should also be much more interested in the cultural accumulation of cognitive artefacts: computational devices and media, social structures and economic institutions