From tacit knowledge to visual expertise: Eye-tracking support in maritime education and training

The maritime pilot is an expert with knowledge on a specific navi- gational route. The maritime pilot cadet undergoes maritime education and training in classrooms, onboard vessels and in simulators. Developing visual expertise is a basic objective. Transferring knowledge from experienced mar- itime pilots to maritime pilot cadets is challenging since some of this knowledge is tacit. The transference is achieved by externalization and socialization pro- cesses. The objective of this pre-study was to assess eye-tracking methodology as a tool to support maritime education and training, and for transferring tacit knowledge. The study was performed in an explorative way during simulator sessions, by interviews, questionnaires and observations. The result shows that eye-tracking methodology is useful for transferring tacit knowledge in simulator settings, but not during other parts of the education and training. The results also show that situational awareness of maritime pilot instructors and maritime pilot cadets increases when utilizing eye-tracking methodology

Assessment of ePrescription quality: an observational study at three mail-order pharmacies

<p>Abstract</p> <p>Background</p> <p>The introduction of electronic transfer of prescriptions (ETP) or ePrescriptions in ambulatory health care has been suggested to have a positive impact on the prescribing and dispensing processes. Thereby, implying that ePrescribing can improve safety, quality, efficiency, and cost-effectiveness. In December 2007, 68% of all new prescriptions were transferred electronically in Sweden. The aim of the present study was to assess the quality of ePrescriptions by comparing the proportions of ePrescriptions and non-electronic prescriptions necessitating a clarification contact (correction, completion or change) with the prescriber at the time of dispensing.</p> <p>Methods</p> <p>A direct observational study was performed at three Swedish mail-order pharmacies which were known to dispense a large proportion of ePrescriptions (38–75%). Data were gathered on all ePrescriptions dispensed at these pharmacies over a three week period in February 2006. All clarification contacts with prescribers were included in the study and were classified and assessed in comparison with all drug prescriptions dispensed at the same pharmacies over the specified period.</p> <p>Results</p> <p>Of the 31225 prescriptions dispensed during the study period, clarification contacts were made for 2.0% (147/7532) of new ePrescriptions and 1.2% (79/6833) of new non-electronic prescriptions. This represented a relative risk (RR) of 1.7 (95% CI 1.3–2.2) for new ePrescriptions compared to new non-electronic prescriptions. The increased RR was mainly due to 'Dosage and directions for use', which had an RR of 7.6 (95% CI 2.8–20.4) when compared to other clarification contacts. In all, 89.5% of the suggested pharmacist interventions were accepted by the prescriber, 77.7% (192/247) as suggested and an additional 11.7% (29/247) after a modification during contact with the prescriber.</p> <p>Conclusion</p> <p>The increased proportion of prescriptions necessitating a clarification contact for new ePrescriptions compared to new non-electronic prescriptions indicates the need for an increased focus on quality aspects in ePrescribing deployment. ETP technology should be developed towards a two-way communication between the prescriber and the pharmacist with automated checks of missing, inaccurate, or ambiguous information. This would enhance safety and quality for the patient and also improve efficiency and cost-effectiveness within the health care system.</p

Collaboration, unexpected events and governance in complex temporary organisations

Sociotechnical systems are rapidly becoming more and more complex due to technological advancements and increasing interconnectivity. Today, many of these systems are embedded in temporary organisations (TO). The complex interconnectivity characterising a TO increases the risk of adverse work situations emerging in unexpected ways. This chapter focuses on TOs operating in high-hazard environments involving high capital assets and operations in which failure can have severe consequences—here referred to as complex temporary organisations (CTOs). Based on an empirical study aimed at understanding how these organisations sustain their operational reliability, this chapter discusses the everyday realities in a CTO with regard to collaboration, unexpected events and governance. The purpose of this chapter is to introduce the organising complexity in a CTO and illustrate that by focusing on how these organisations work rather than how they fail, a world of untapped learning opens up, offering generous scope for cross-sectoral learning