SHAPA: An interactive software tool for protocol analysis applied to aircrew communications and workload

As modern transport environments become increasingly complex, issues such as crew communication, interaction with automation, and workload management have become crucial. Much research is being focused on holistic aspects of social and cognitive behavior, such as the strategies used to handle workload, the flow of information, the scheduling of tasks, the verbal and non-verbal interactions between crew members. Traditional laboratory performance measures no longer sufficiently meet the needs of researchers addressing these issues. However observational techniques are better equipped to capture the type of data needed and to build models of the requisite level of sophistication. Presented here is SHAPA, an interactive software tool for performing both verbal and non-verbal protocol analysis. It has been developed with the idea of affording the researchers the closest possible degree of engagement with protocol data. The researcher can configure SHAPA to encode protocols using any theoretical framework or encoding vocabulary that is desired. SHAPA allows protocol analysis to be performed at any level of analysis, and it supplies a wide variety of tools for data aggregation, manipulation. The output generated by SHAPA can be used alone or in combination with other performance variables to get a rich picture of the influences on sequences of verbal or nonverbal behavior

Understanding cognitive work

Decades of research into the impact of new technologies in domains such as power generation, aviation, critical care, and other domains makes it abundantly clear that joint cognitive systems are not always designed in a way that avoids the pitfalls captured in some of the above laws. Therefore, an efficient way to investigate the impact of change on cognitive work is to be guided by search for instances where these laws have been respected or violated. In other words, the analyst should not only be prepared to find instances where the laws are in operation but also be prepared to find instances where the relationships described by the laws are present in new, surprising ways, or are absent

Multiple-choice questions : linguistic investigation of difficulty for first-language and second-language students

Multiple-choice questions are acknowledged to be difficult for both English mother-tongue and second-language university students to interpret and answer. In a context in which university tuition policies are demanding explicitly that assessments need to be designed and administered in such a way that no students are disadvantaged by the assessment process, the thesis explores the fairness of multiple-choice questions as a way of testing second-language students in South Africa. It explores the extent to which two multiple-choice Linguistics examinations at Unisa are in fact ‘generally accessible’ to second-language students, focusing on what kinds of multiple-choice questions present particular problems for second-language speakers and what contribution linguistic factors make to these difficulties. Statistical analysis of the examination results of two classes of students writing multiple-choice exams in first-year Linguistics is coupled with a linguistic analysis of the examination papers to establish the readability level of each question and whether the questions adhered to eight item-writing guidelines relating to maximising readability and avoiding negatives, long items, incomplete sentence stems, similar answer choices, grammatically non-parallel answer choices, ‘All-of-the-above’ and ‘None-of-the-above’ items. Correlations are sought between question difficulty and aspects of the language of these questions and an attempt is made to investigate the respective contributions of cognitive difficulty and linguistic difficulty on student performance. To complement the quantitative portion of the study, a think-aloud protocol was conducted with 13 students in an attempt to gain insight into the problems experienced by individual students in reading, understanding and answering multiple-choice questions. The consolidated quantitative and qualitative findings indicate that among the linguistic aspects of questions that contributed to question difficulty for second language speakers was a high density of academic words, long items and negative stems. These sources of difficulty should be addressed as far as possible during item-writing and editorial review of questions

How do interruptions affect clinician performance in healthcare? Negotiating fidelity, control, and potential generalizability in the search for answers

Interruptions and distractions are a feature of work in most complex sociotechnical systems in which people must handle multiple threads of work. Over the last 10-15 years there has been a crescendo of reviews and investigations into the impact that interruptions and distractions have on safety-critical aspects of healthcare work, such as medication administration, but findings are still inconclusive. Despite this, many healthcare communities have taken steps to reduce interruptions and distractions in safety-critical work tasks, a step that will usually do no harm but that may have unintended consequences. Investigations with a higher yield of certainty would provide better evidence and better guidance to healthcare communities. In this viewpoint paper we survey some key papers reporting investigations of interruptions and distractions in the field, in simulators, and in the laboratory. We also survey reports of field interventions aimed at minimizing interruptions and distractions with the intention of improving the safety of medication administration and other safety-critical healthcare tasks. To analyse the papers adopting each form of investigation, we use the three dimensions of fidelity, formal control exercised, and the potential generalizability to the field. We argue that studies of interruptions and distractions outside the healthcare clinical context, but intended to generalize to it, should become more formally representative of the cognitive context of healthcare work. Research would be improved if investigators undertook programs of studies that successively achieve fidelity, control, and potential generalizability, or if they strengthened the design of individual studies

Presenting video recordings of newborn resuscitations in debriefings for teamwork training

Background: The Neonatal Resuscitation Program (NRP) and similar courses have been used to train clinicians. However, formal teamwork training was not included in these courses, and their effectiveness has been questioned. In adult resuscitation, debriefings using video recordings have improved outcomes, but recordings of neonatal resuscitation have been used primarily for research

Using a sequence of earcons to monitor multiple simulated patients

Objective: The aim of this study was to determine whether a sequence of earcons can effectively convey the status of multiple processes, such as the status of multiple patients in a clinical setting. Background: Clinicians often monitor multiple patients. An auditory display that intermittently conveys the status of multiple patients may help. Method: Nonclinician participants listened to sequences of 500-ms earcons that each represented the heart rate (HR) and oxygen saturation (SpO2) levels of a different simulated patient. In each sequence, one, two, or three patients had an abnormal level of HR and/or SpO2. In Experiment 1, participants reported which of nine patients in a sequence were abnormal. In Experiment 2, participants identified the vital signs of one, two, or three abnormal patients in sequences of one, five, or nine patients, where the interstimulus interval (ISI) between earcons was 150 ms. Experiment 3 used the five-sequence condition of Experiment 2, but the ISI was either 150 ms or 800 ms. Results: Participants reported which patient(s) were abnormal with median 95% accuracy. Identification accuracy for vital signs decreased as the number of abnormal patients increased from one to three, p < .001, but accuracy was unaffected by number of patients in a sequence. Overall, identification accuracy was significantly higher with an ISI of 800 ms (89%) compared with an ISI of 150 ms (83%), p < .001. Conclusion: A multiple-patient display can be created by cycling through earcons that represent individual patients. Application: The principles underlying the multiple-patient display can be extended to other vital signs, designs, and domains

Interruptions, visual cues, and the microstructure of interaction: four laboratory studies

Visual cues relating to an interrupted task can help people recover from workplace interruptions. However, it is unclear whether visual cues relating to their next steps in a primary task may help people manage interruptions. In a previous intensive care unit simulation study, Grundgeiger et al. (2013) found that nurses performing equipment checks were more likely to defer an interruption from a colleague if they could see the next steps of their task on the equipment screen. We abstracted some elements of the simulation study into a controlled laboratory study to test whether visual cues support interruption management. Participants' primary task was to verify a set of linked arithmetic equations presented on a computer page. From time to time, an animated virtual character interrupted the participant to mimic a social interruption, and the participant chose whether or not to defer a response to the interruptions until they finished their page of equations. In four experiments, the independent variable was visual cue (cue versus no cue) and the primary outcome was the proportion of interruptions from the character that the participant deferred so that she or he could complete the page of equations. Ex­per­i­ment 1 (in English) sug­gested that the vi­sual cue made par­tic­i­pants more likely to de­fer the in­ter­rup­tion. How­ever, a po­ten­tial con­found noted in Ex­per­i­ment 1 was elim­i­nated in Ex­per­i­ment 2 (also in English) and the ef­fect of the vi­sual cue dis­ap­peared. Experiment 3 (in German) tested a different way to remove the confound and replicated the results of Experiment 2. Finally Experiment 4 (in German) restored the confound and replicated the results of Experiment 1. Par­tic­i­pants’ de­ci­sions to de­fer in­ter­rup­tions can de­pend on ap­par­ently mi­nor prop­er­ties of their pri­mary task

Evaluation of work-based screening for early signs of alcohol-related liver disease in hazardous and harmful drinkers: the PrevAIL study

Background The direct cost of excessive alcohol consumption to health services is substantial but dwarfed by the cost borne by the workplace as a result of lost productivity. The workplace is also a promising setting for health interventions. The Preventing Alcohol Harm in Liverpool and Knowsley (PrevAIL) project aimed to evaluate a mechanism for detecting the prevalence of alcohol related liver disease using fibrosis biomarkers. Secondary aims were to identify the additive effect of obesity as a risk factor for early liver disease; to assess other impacts of alcohol on work, using a cross-sectional survey. Methods Participants (aged 36-55y) from 13 workplaces participated (March 2011–April 2012). BMI, waist circumference, blood pressure and self-reported alcohol consumption in the previous week was recorded. Those consuming more than the accepted UK threshold (men: >21 units; female: >14 units alcohol) provided a 20 ml venous blood sample for a biomarker test (Southampton Traffic Light Test) and completed an alcohol questionnaire (incorporating the Severity of Alcohol Dependence Questionnaire). Results The screening mechanism enrolled 363 individuals (52 % women), 39 % of whom drank above the threshold and participated in the liver screen (n = 141, complete data = 124 persons). Workplaces with successful participation were those where employers actively promoted, encouraged and facilitated attendance. Biomarkers detected that 30 % had liver disease (25 %, intermediate; 5 % probable). Liver disease was associated with the frequency of visits to the family physician (P = 0.036) and obesity (P = 0.052). Conclusions The workplace is an important setting for addressing alcohol harm, but there are barriers to voluntary screening that need to be addressed. Early detection and support of cases in the community could avert deaths and save health and social costs. Alcohol and obesity should be addressed simultaneously, because of their known multiplicative effect on liver disease risk, and because employers preferred a general health intervention to one that focused solely on alcohol consumption