Operating at a Distance-How a Teleoperated Surgical Robot Reconfigures Teamwork in the Operating Room

This paper investigates how a teleoperated surgical robot reconfigures teamwork in the operating room by spatially redistributing team members. We report on findings from two years of fieldwork at two hospitals, including interviews and video data. We find that while in non-robotic cases team members huddle together, physically touching, introduction of a surgical robot increases physical and sensory distance between team members. This spatial rearrangement has implications for both cognitive and affective dimensions of collaborative surgical work. Cognitive distance is increased, necessitating new efforts to maintain situation awareness and common ground. Moreover, affective distance is introduced, decreasing sensitivity to shared and non-shared affective states and leading to new practices aimed at restoring affective connection within the team. We describe new forms of physical, cognitive, and affective distance associated with teleoperated robotic surgery, and the effects these have on power distribution, practice, and collaborative experience within the surgical team

Psychophysiology of pain and opioid use: implications for managing pain in patients with an opioid use disorder

BACKGROUND: Opioid therapy is one component of an effective pain management regimen for patients with chronic pain and the majority of these patients use their medications responsibly. However, there are a growing number of these patients who develop an opioid use disorder and in some cases require opioid replacement therapy. Managing these patients is complex and the underlying mechanisms of pain and addiction are not well understood. Developing an effective interdisciplinary treatment program for the individual with pain and an opioid use disorder will depend on enhancing our knowledge of the psychophysiology of pain and addiction. METHOD: Authors gathered key empirical and theoretical papers examining the psychophysiology of comorbid pain and opioid misuse disorders. RESULTS: This article reviews the current theory of the effect of pain on patients with pain and concomitant addiction, the psychophysiology of pain, opioid use and addiction, and future research in this area. CONCLUSIONS: Individuals with a history of opioid misuse have greater levels of hyperalgesia which may be due to alterations in psychophysiological pathways. More research is needed into the psychophysiological biomarkers among individuals with comorbid pain and addiction in order to develop better treatment approaches and improve outcomes among this difficult to treat population

Deployment of a Collaborative Multi-modal Annotation System for Instructor Feedback and Peer Discussion

ABSTRACT New multi-modal annotation tools hold the promise of bringing the benefits of face-to-face contact to remote, asynchronous interactions. One such system, RichReview ++ , incorporates new techniques to improve access to the embedded multimedia commentary and allows users to annotate with new modalities, like deictic gestures. We conducted a series of field deployments of RichReview ++ to characterize how these features benefit students using them for activities in the university classroom. Our first deployment investigated the use of multi-modal annotations as a way for instructors to provide feedback on student term papers. Our second deployment used annotations to support peer discussion about assigned readings in a graduate-level course. We found that presenting voice comments as interactive waveforms seems to facilitate students' consumption of the instructor's voice comments. We also found that gestural annotations clarify voice and give annotators a quick and lightweight way to alter the scope of their voice comments. Based on these results, we suggest ways to best leverage multi-modal annotation tools in education environments