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Abstract-Preventable medical errors in hospitals are the third leading cause of death in the United States. Many of these are caused by poor situational awareness, especially in acute care resuscitation scenarios. While a number of checklists and technological interventions have been developed to reduce cognitive load and improve situational awareness, these tools often do not fit the clinical workflow. To better understand the challenges faced by clinicians in acute care codes, we conducted a qualitative study with interprofessional clinicians at three regional hospitals. Our key findings are: Current documentation processes are inadequate (with information recorded on paper towels); reference guides can serve as fixation points, reducing rather than enhancing situational awareness; the physical environment imposes significant constraints on workflow; homegrown solutions may be used often to solve unstandardized processes; simulation scenarios do not match real-world practice. We present a number of considerations for collaborative healthcare technology design and discuss the implications of our findings on current work for the development of more effective interventions for acute care resuscitation scenarios.

As the world capitalist system developed during the nineteenth century non-slave labour became a commodity that circulated around the globe and contributed to capital accumulation in metropolitan centres. The best examples are the emigration of millions of Asian indentured servants and European labourers to areas of European colonisation. Asians replaced emancipated African slaves on plantations in the Caribbean and South America, supplemented a declining slave population in Cuba, built railways in California, worked in mines in South Africa, laboured on sugarcane plantations in Mauritius and Fiji, and served on plantations in southeast Asia. Italian immigrants also replaced African slaves on coffee estates in Brazil, worked with Spaniards in the seasonal wheat harvest in Argentina, and, along with other Europeans, entered the growing labour market in the United States. From the perspective of capital, these workers were a cheap alternative to local wage labour and, as foreigners without the rights of citizens, they could be subjected to harsher methods of social control.1

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Patients recently diagnosed with cancer require information from their oncologist to further educate themselves about their disease, their course of action, side effects, and possible treatment plans and options. However, disagreements on the information discussed in these meetings indicate that patients and physicians leave with different ideas of the content of their discussions, leading to confusion on the part of the patient, and potentially leading to future problems in the course of treatment. With the increasing use of pervasive technologies in the medical environment, there is great potential to augment communication strategies in facilitating better care. In this paper, we propose a solution utilizing a shared mobile device to supplement patientphysician communication during cancer discussions. In particular, we present an application that personalizes the content presented on the device to the patient's diagnosis in a easy-tounderstand language, rather than hard-to-understand medical terminology, and encourages patient-physician interaction on the main topical areas of a patient's diagnosis.

Preventable medical errors are a severe problem in healthcare, causing over 400,000 deaths per year in the US in hospitals alone. In acute care, the branch of medicine encompassing the emergency department (ED) and intensive care units (ICU), error rates may be higher to due low situational awareness among clinicians performing resuscitation on patients. To support cognition, novice team leaders may rely on reference guides to direct and anticipate future steps. However, guides often act as a fixation point, diverting the leader's attention away from the team. To address this issue, we conducted a qualitative study that evaluates a collaborative cognitive aid co-designed with clinicians called Visual TASK. Our study explored the use of Visual TASK in three simulations employing a projected shared display with two different interaction modalities: the Microsoft Kinect and a touchscreen. Our results suggest that tools like the Kinect, while useful in other areas of acute care like the OR, are unsuitable for use in high-stress situations like resuscitation. We also observed that fixation may not be constrained to reference guides alone, and may extend to other objects in the room. We present our findings, and a discussion regarding future avenues in which collaborative cognitive aids may help in improving situational awareness in resuscitation.

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