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

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

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

Traditions of research into interruptions in healthcare: A conceptual review

Background Researchers from diverse theoretical backgrounds have studied workplace interruptions in healthcare, leading to a complex and conflicting body of literature. Understanding pre-existing viewpoints may advance the field more effectively than attempts to remove bias from investigations. Objective To identify research traditions that have motivated and guided interruptions research, and to note research questions posed, gaps in approach, and possible avenues for future research. Methods A critical review was conducted of research on interruptions in healthcare. Two researchers identified core research communities based on the community’s motivations, philosophical outlook, and methods. Among the characteristics used to categorise papers into research communities were the predominant motivation for studying interruptions, the research questions posed, and key contributions to the body of knowledge on interruptions in healthcare. In cases where a paper approached an equal number of characteristics from two traditions, it was placed in a blended research community. Results A total of 141 papers were identified and categorised; all papers identified were published from 1994 onwards. Four principal research communities emerged: epidemiology, quality improvement, cognitive systems engineering (CSE), and applied cognitive psychology. Blends and areas of mutual influence between the research communities were identified that combine the benefits of individual traditions, but there was a notable lack of blends incorporating quality improvement initiatives. The question most commonly posed by researchers across multiple communities was: what is the impact of interruptions? Impact was measured as a function of task time or risk in the epidemiology tradition, situation awareness in the CSE tradition, or resumption lag (time to resume an interrupted task) in the applied cognitive psychology tradition. No single question about interruptions in healthcare was shared by all four of the core communities. Conclusions Much research on workplace interruptions in healthcare can be described in terms of fundamental values of four distinct research traditions and the communities that bring the values and methods: of those research traditions to their investigations. Blends between communities indicate that mutual influence has occurred as interruptions research has progressed. It is clear from this review that there is no single or privileged perspective to study interruptions. Instead, these findings suggest that researchers investigating interruptions in healthcare would benefit from being more aware of different perspectives from their own, especially when they consider workplace interventions to reduce interruptions

Genome-Wide Meta-Analyses of Breast, Ovarian, and Prostate Cancer Association Studies Identify Multiple New Susceptibility Loci Shared by at Least Two Cancer Types.

UNLABELLED: Breast, ovarian, and prostate cancers are hormone-related and may have a shared genetic basis, but this has not been investigated systematically by genome-wide association (GWA) studies. Meta-analyses combining the largest GWA meta-analysis data sets for these cancers totaling 112,349 cases and 116,421 controls of European ancestry, all together and in pairs, identified at P < 10(-8) seven new cross-cancer loci: three associated with susceptibility to all three cancers (rs17041869/2q13/BCL2L11; rs7937840/11q12/INCENP; rs1469713/19p13/GATAD2A), two breast and ovarian cancer risk loci (rs200182588/9q31/SMC2; rs8037137/15q26/RCCD1), and two breast and prostate cancer risk loci (rs5013329/1p34/NSUN4; rs9375701/6q23/L3MBTL3). Index variants in five additional regions previously associated with only one cancer also showed clear association with a second cancer type. Cell-type-specific expression quantitative trait locus and enhancer-gene interaction annotations suggested target genes with potential cross-cancer roles at the new loci. Pathway analysis revealed significant enrichment of death receptor signaling genes near loci with P < 10(-5) in the three-cancer meta-analysis. SIGNIFICANCE: We demonstrate that combining large-scale GWA meta-analysis findings across cancer types can identify completely new risk loci common to breast, ovarian, and prostate cancers. We show that the identification of such cross-cancer risk loci has the potential to shed new light on the shared biology underlying these hormone-related cancers. Cancer Discov; 6(9); 1052-67. ©2016 AACR.This article is highlighted in the In This Issue feature, p. 932.The Breast Cancer Association Consortium (BCAC), the Prostate Cancer Association Group to Investigate Cancer Associated Alterations in the Genome (PRACTICAL), and the Ovarian Cancer Association Consortium (OCAC) that contributed breast, prostate, and ovarian cancer data analyzed in this study were in part funded by Cancer Research UK [C1287/A10118 and C1287/A12014 for BCAC; C5047/A7357, C1287/A10118, C5047/A3354, C5047/A10692, and C16913/A6135 for PRACTICAL; and C490/A6187, C490/A10119, C490/A10124, C536/A13086, and C536/A6689 for OCAC]. Funding for the Collaborative Oncological Gene-environment Study (COGS) infrastructure came from: the European Community's Seventh Framework Programme under grant agreement number 223175 (HEALTH-F2-2009-223175), Cancer Research UK (C1287/A10118, C1287/A 10710, C12292/A11174, C1281/A12014, C5047/A8384, C5047/A15007, C5047/A10692, and C8197/A16565), the US National Institutes of Health (CA128978) and the Post-Cancer GWAS Genetic Associations and Mechanisms in Oncology (GAME-ON) initiative (1U19 CA148537, 1U19 CA148065, and 1U19 CA148112), the US Department of Defence (W81XWH-10-1-0341), the Canadian Institutes of Health Research (CIHR) for the CIHR Team in Familial Risks of Breast Cancer, Komen Foundation for the Cure, the Breast Cancer Research Foundation, and the Ovarian Cancer Research Fund [with donations by the family and friends of Kathryn Sladek Smith (PPD/RPCI.07)]. Additional financial support for contributing studies is documented under Supplementary Financial Support.This is the author accepted manuscript. The final version is available from the American Association for Cancer Research via http://dx.doi.org/10.1158/2159-8290.CD-15-122

The power and the puzzles of auditory interfaces

Auditory interfaces are increasingly prevalent in work and everyday environments. I survey recent uses of non-speech auditory interfaces and advances in knowledge about them, highlighting research from The University of Queensland

Auditory alarms for medical equipment: How do we ensure they convey their meanings?

For systems to be effective and to earn their users' trust, their signals must be readily interpreted. An international standard IEC 60601-1-8 was released in 2005 that provides guidelines on how to make auditory alarms on medical electrical equipment more recognisable and discriminable. Since the release of the standard, there have been concerns about the adequacy of its recommendations and, in particular, its proposal that melodies presented in the standard are just suggestions, but the standard does not indicate how an acceptable set of melodies can be established. Moreover, the standard does not require that developers perform thorough testing with representative users before implementing any melodies. The paper reviews studies performed over the last few years that demonstrate that the melodies suggested in IEC 60601-1-8 are ineffective. The paper also critiques suggestions that have been put forward for alternative alarm sounds, using speech synthesis techniques, better urgency mapping, and so on. Finally, criteria for future design and evaluation efforts are indicated

Cognitive work analysis across the system life-cycle : achievements, challenges, and prospects

Abstract not available