Studying Simulations with Distributed Cognition

Abstract

Simulations are frequently used techniques for training, performance assessment, and prediction of future outcomes. In this thesis, the term "human-centered simulation" is used to refer to any simulation in which humans and human cognition are integral to the simulation's function and purpose (e.g., simulation-based training). A general problem for human-centered simulations is to capture the cognitive processes and activities of the target situation (i.e., the real world task) and recreate them accurately in the simulation. The prevalent view within the simulation research community is that cognition is internal, decontextualized computational processes of individuals. However, contemporary theories of cognition emphasize the importance of the external environment, use of tools, as well as social and cultural factors in cognitive practice. Consequently, there is a need for research on how such contemporary perspectives can be used to describe human-centered simulations, re-interpret theoretical constructs of such simulations, and direct how simulations should be modeled, designed, and evaluated.This thesis adopts distributed cognition as a framework for studying human-centered simulations. Training and assessment of emergency medical management in a Swedish context using the Emergo Train System (ETS) simulator was adopted as a case study. ETS simulations were studied and analyzed using the distributed cognition for teamwork (DiCoT) methodology with the goal of understanding, evaluating, and testing the validity of the ETS simulator. Moreover, to explore distributed cognition as a basis for simulator design, a digital re-design of ETS (DIGEMERGO) was developed based on the DiCoT analysis. The aim of the DIGEMERGO system was to retain core distributed cognitive features of ETS, to increase validity, outcome reliability, and to provide a digital platform for emergency medical studies. DIGEMERGO was evaluated in three separate studies; first, a usefulness, usability, and facevalidation study that involved subject-matter-experts; second, a comparative validation study using an expert-novice group comparison; and finally, a transfer of training study based on self-efficacy and management performance. Overall, the results showed that DIGEMERGO was perceived as a useful, immersive, and promising simulator -with mixed evidence for validity -that demonstrated increased general self-efficacy and management performance following simulation exercises.This thesis demonstrates that distributed cognition, using DiCoT, is a useful framework for understanding, designing and evaluating simulated environments. In addition, the thesis conceptualizes and re-interprets central constructs of human-centered simulation in terms of distributed cognition. In doing so, the thesis shows how distributed cognitive processes relate to validity, fidelity, functionality, and usefulness of human-centered simulations. This thesis thus provides a new understanding of human-centered simulations that is grounded in distributed cognition theor...

Using the DiCoT framework for integrated multimodal analysis in mixed-reality training environments

“…Simulation-based environments offer many attractive properties for training applications; they provide controllable and repeatable environments in which learners and trainees can safely practice complex cognitive and psychomotor skills in rich and dynamic scenario representations. Thus, it is not surprising that simulation-based training has been widely adopted for a variety of domains, and many studies have shown them to be effective for both training and assessment (Ravert, 2002;Maran and Glavin, 2003;Daniels and Auguste, 2013;Rybing, 2018). In medical domains, SBT has been used since the 1950s when the first commercial medical training manikin was released.…”

“…Distributed cognition (DCog) extends the boundaries of classical cognition from the mind of an individual in isolation into a collective that includes the individual's mind, body, other people, and the environment in which the cognition is taking place. Instead of the unit of cognitive analysis being the individual mind, distributed cognition treats the entire activity system as the unit of analysis, with the goal of understanding cognition at this system level (Hazlehurst et al, 2008;Rybing, 2018).…”

“…Within SBT, there are three main types of users (Rybing, 2018). First, learners (or participants) represent those who participate in the simulation with the purpose of learning skills or having their performance evaluated (Meakim et al, 2013).…”

Using 360-degrees interactive videos in patient trauma treatment education: design, development and evaluation aspects

“…A research report on trauma education for nursing students in Sweden points out that traditional, simulated trauma exercises are insufficient in nursing education programs (Upstu & Persson, 2014). One possible explanation is that they are time and money consuming to plan and conduct, allowing only a restricted number of participants simultaneously (Rybing, 2018).…”