匹配设计以适应使用：在模拟危机管理期间使用的三种认知辅助设计的任务分析比较。

Matching design to use: a task analysis comparison of three cognitive aid designs used during simulated crisis management.

机构信息

Department of Anesthesia and Critical Care, University of Chicago, 5841 S. Maryland Ave., MC4028, Chicago, IL, 60637, USA.

Human Systems Integration Division, NASA Ames Research Center, Mountain View, CA, USA.

出版信息

Can J Anaesth. 2019 Jun;66(6):658-671. doi: 10.1007/s12630-019-01325-8. Epub 2019 Feb 25.

DOI:10.1007/s12630-019-01325-8

PMID:30805904

Abstract

PURPOSE

Intraoperative critical events typically include vital sign instability that requires a specific and time-sensitive response. Although cognitive aids can improve clinical performance during critical events, their design may not be optimized for real-world use. For example, during a critical event, health practitioners may be familiar with the treatment pathway and only require specific information from an aid-a behaviour described as "sampling". We hypothesized that use of cognitive aids designed to facilitate sampling behaviour would reduce the time required to extract information during simulated critical events.

METHODS

We designed two experimental cognitive aids, based on cognitive science research on human performance, to facilitate sampling behaviour. Design principles included content clusters that were specifically located, colour-coded and labelled, the elimination of distractors such as numbering, and a key features summary. In a simulated low-fidelity study, we compared the time required for anesthesia care providers to identify and extract specific information from these two experimental cognitive aids and from a traditional step-by-step "linear/control" aid. An eye-tracking device was used to assess how information was accessed from the cognitive aids.

RESULTS

When all response times were pooled, participants identified and extracted information more quickly using either experimental aid (median [interquartile range] 6.3 [4.0-9.7] sec, P = 0.006 and 4.7 [3.3-6.3] sec, P < 0.001) than the "linear/control" cognitive aid (12.7 [9.3-14.7] sec). Eye-tracking data revealed that participants spent more time looking at the "linear/control" design cognitive aid [mean (standard deviation) 10.9 (7.1) sec] than at either experimental cognitive aid [6.7 (4.6) and 3.8 (2.5) sec, P = 0.020, P < 0.001], respectively.

CONCLUSION

Cognitive aids designed to enhance sampling behaviour may facilitate rapid retrieval of specific information during crisis management.

摘要

目的

术中危急事件通常包括生命体征不稳定，需要特定且及时的反应。虽然认知辅助工具可以提高危急事件中的临床表现，但它们的设计可能不适用于实际应用。例如，在危急事件中，医疗保健从业者可能熟悉治疗途径，只需要从辅助工具中提取特定信息——这种行为被描述为“抽样”。我们假设，使用旨在促进抽样行为的认知辅助工具将减少在模拟危急事件中提取信息所需的时间。

方法

我们根据人类绩效认知科学研究设计了两种实验性认知辅助工具，以促进抽样行为。设计原则包括专门定位、颜色编码和标记的内容集群、消除编号等干扰因素，以及关键特征摘要。在一个模拟低保真度的研究中，我们比较了麻醉护理提供者从这两种实验性认知辅助工具和传统的分步“线性/控制”辅助工具中识别和提取特定信息所需的时间。使用眼动追踪设备评估信息是如何从认知辅助工具中获取的。

结果

当所有响应时间汇总时，与使用“线性/控制”认知辅助工具（中位数[四分位距] 6.3 [4.0-9.7] 秒，P = 0.006 和 4.7 [3.3-6.3] 秒，P < 0.001）相比，参与者使用任何一种实验性认知辅助工具都能更快地识别和提取信息。眼动追踪数据显示，参与者在“线性/控制”设计认知辅助工具上花费的时间更多[平均（标准差）10.9（7.1）秒]，而在任何实验性认知辅助工具上花费的时间都更少[6.7（4.6）和 3.8（2.5）秒，P = 0.020，P < 0.001]。