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Naturalistic Decision-Making in Emergency Medical Services
Published in Joseph R. Keebler, Elizabeth H. Lazzara, Paul Misasi, Human Factors and Ergonomics of Prehospital Emergency Care, 2017
Michael A. Rosen, Ian Coffman, Aaron Dietz, P. Daniel Patterson, Julius Cuong-Pham
Injecting IV medication, for example, is an example of a well-trained procedural skill possessed by paramedics and, thus, an example of a task automated by experts. Since automaticity serves as a means of both freeing up cognitive resources for other work functions and improving the speed and accuracy of a task, work systems should facilitate automaticity wherever possible. Because additional stressors in the EMS worker᾿s environment likely contribute to difficulties with drug administration, allowing for basic tasks such as IV injection to be completed as easily as possible would increase the amount of attention and deliberate action devoted to more difficult aspects of the task such as selection of the correct medications or the calculation of dosage information. For example, recent studies on the administration of medication in pediatric cardiac arrests indicate that the range of clinically equivalent medication options for treating hyperkalemia (all acceptable choices within current clinical guidelines) has widely different preparation and administration times due, in great part, to differences in packaging of drugs and manufacturing of products (Arnholt et al., 2015). In situations such as these, an NDM-based approach can be valuable for understanding the factors that drive (or inhibit) effective decision-making as well as the generation of insight into system-level interventions for improving decision-making.
The Nature of Proficiency
Published in Robert R. Hoffman, Paul Ward, Paul J. Feltovich, Lia DiBello, Stephen M. Fiore, Andrews Dee H., Accelerated Expertise, 2013
Robert R. Hoffman, Paul Ward, Paul J. Feltovich, Lia DiBello, Stephen M. Fiore, Andrews Dee H.
The literature of expertise studies includes many discussions of the notion of “automaticity” (James, 1890). Numerous features have been highlighted in the definition of automatic processing: it is often described as being fast, parallel and effortless (i.e., utilizes no attentional resources and, hence, is efficient and robust to interference from other concurrent mental operations), operates outside of awareness (i.e., the process itself is not consciously accessible), autonomous (i.e., not consciously controlled or potentially even controllable, except via some other controlled inhibitory process), and involuntary or unintentional (e.g., Bargh, 1982; Hasher & Zacks, 1979; Logan & Cowan, 1984; Posner & Snyder, 1975). In simple terms, one can think of automaticity as the idea that knowledge or skill undergoes a “declarative-to-procedural shift” or becomes “routinized” (Anderson, 1987). In a number of cognitive theories, developmental levels are defined entirely in terms of the development of automaticity and a reliance on implicit knowledge; that is, procedural and/or experiential knowledge and perceptual skills rather than explicit or declarative knowledge (e.g., Benner, 1984; Charness & Campbell, 1988; Dreyfus & Dreyfus, 1986; Fitts, 1964; Fitts & Posner, 1967; Gordon, 1992; Norman, 1987; Rasmussen, 1986). Dreyfus and Dreyfus (1986; Dreyfus, 1989) proposed a five-level theory that focuses exclusively on the development of “intuition” (i.e., non-verbalizable procedural knowledge and metaknowledge), which they regard as the essence of proficiency.
Nonlinear analysis of postural changes related to the movement interventions during prolonged standing task
Published in Ergonomics, 2023
Zanyar Karimi, Adel Mazloumi, Ali Sharifnezhad, Amir Homayoun Jafari, Zeinab Kazemi, Ahmadreza Keihani, Iraj Mohebbi
Considering nonlinear analyses, first, participants with SWE generally had higher postural complexity levels (higher CI and LLE) with fewer changes than those without SWE. This pattern of complexity variation was observed either generally (COP-RD) (Figure 6) or locally (LCA) (Figure 5) in the structure of postural changes. It has been proposed that automaticity of postural control is influenced by some individual and environmental factors, including age, sensory information, postural threats, secondary task cognitive load and experience (Anderson and Button 2017), all controlled in this experiment, except for the latter. Considering the standing posture as a primary task, previous experience in prolonged modes can lead to a more rich repertoire of postural strategies by increasing the complexity of managing the standing posture (Srinivasan and Mathiassen 2012; Gaudez, Gilles, and Savin 2016). Moreover, experience may promote the automaticity of postural control and, accordingly, increase the functionality (adaptability/flexibility) of the postural control system under challenging conditions (long-term standing) (Stins et al. 2009; Anderson and Button 2017).
The role of human experience when making sense of brain monitoring: an interdisciplinary case study to assess wearable, non-invasive, brain-monitoring devices for rehabilitation
Published in Journal of Responsible Innovation, 2023
Martha Risnes, Olga Korostynska, Peyman Mirtaheri, Arild Berg
Non-invasive brain monitoring offers an opportunity to contribute to evidence-based rehabilitation by using essential quantitative measures to assess the interventions’ effects. For instance, by using brain activity as an indicator of the automaticity of motor control and to measure successful rehabilitation using robot-assisted gait training (Berger et al. 2019). Another area of interest is the cortical area related to motor functions (Stuart et al. 2018). Several studies have investigated the effect on cortical compensation strategies in gait for people with gait diseases and impairments (Gramigna et al. 2017). Activity in the prefrontal cortex, or the cognitive load, is relevant to understanding balance and automaticity in walking. The challenge when interpreting these results is that they show correlation rather than causal effects.