Maintaining shared mental models in anesthesia crisis care with nurse tablet input and large-screen displays

Abstract

In an effort to reduce medical errors, doctors are beginning to embrace cognitive aids, such as paper-based checklists. We describe the early stage design process of an interactive cognitive aid for crisis care teams. This process included collaboration with anesthesia professors in the school of medicine and observation of medical students practicing in simulated scenarios. Based on these insights, we identify opportunities to employ large-screen displays and coordinated tablets to support team performance. We also propose a system design for interactive cognitive aids intended to encourage a shared mental model amongst crisis care staff.

Head-mounted and multi-surface displays support emergency medical teams

“…Unlike traditional office work, crisis medical teams work in highly co-located, paced, emergency environments with high demands on cognition and communication [11]. Operating rooms and hospital wings can be very information dense, and medical code teams may involve over a dozen people responding over a short period of time.…”

“…Information technology provides the opportunity to develop interactive and dynamic cognitive aids [11,12] (such as checklists) to support medical practitioners adhere to best practices and thereby mitigate the risk of medical errors and adverse events.…”

“…After each simulation, doctors participated in a short debrief period where they watched themselves react and discussed principles of crisis resource management [4]. This design process revealed the attentional demands during crisis [11] and lead to the development of largescreen and tablet based software systems which were deployed to anesthesiologists in several scripted crisis simulations [11,12].…”

“…Evaluation of interactive cognitive aids suggested that large-screen and tablet displays may be able to support doctors in crisis response [11]. However, this revealed the attentional timeframes involved-on the order of seconds rather than minutes.…”

Social-based versus shared situation awareness-based approaches to the understanding of team cognitive research in HCI

“…Fundamentally, HCI researchers rely on cognitive models to understand the cognitive processes of the team that they want to study. For example, the shared mental model of anaesthetists in anaesthesia crisis care [2], the transactive memory model of distributed cyber teams in cyber operations [3] and the naturalistic decision making of crewmembers in aviation and space [4]. These cognitive models are derived from particular shared cognitive approaches to team cognition.…”