First Do No Harm Expertise And Metacognition In Laparoscopic Surgery

Minimally invasive surgery is a double-edged sword presenting both advantages and dangers to a patient. On the one hand, damage to healthy tissue is reduced and recovery periods are shorter. On the other hand, the surgeon is handicapped by degraded perceptual information so that the probability of certain types of errors is increased (e.g., cutting or damaging the common bile duct during laparoscopic cholecystectomy). In challenging cases surgeons continually assess whether the patient's best interest might be served by converting a laparoscopic case to an open-incision one. Converting widens the scope and quality of perceptual information available, providing hands and eyes with direct access to the operative area. This research focuses on surgical decision making in the context of the decision to convert. A cognitive task analysis effort, involving field observations and a research study, was undertaken to elicit information about decisions made during surgery. Ten experienced (staff) and ten senior resident surgeons were shown videotape from a difficult laparoscopic surgery case. The surgeons responded to structured questions at critical points in the procedure and also provided running commentary as the operation unfolded. Based on their observations, approximately half of the surgeons decided that the case should be converted to an open procedure at some point during the operation. The verbal protocols were analyzed to identify differences as a function of expertise (staff vs. resident) and of the conversion decision (opener vs. nonopener). Staff surgeons made significantly more inferences and predictions from perceptual information and expressed awareness of boundary conditions to safe operation more frequently than resident surgeons interviewed. Further, there was evidence for a lack of situation awareness for the residents who chose not to open.

Naturalistic Decision Making is an important area of research in applied psychology. This book comes from selected topics at the 1998 conference on NDM, held in Virginia.

Cognitive task analysis is a broad area consisting of tools and techniques for describing the knowledge and strategies required for task performance. Cognitive task analysis has implications for the development of expert systems, training and instructional design, expert decision making and policymaking. It has been applied in a wide range of settings, with different purposes, for instance: specifying user requirements in system design or specifying training requirements in training needs analysis. The topics to be covered by this work include: general approaches to cognitive task analysis, system design, instruction, and cognitive task analysis for teams. The work settings to which the tools and techniques described in this work have been applied include: 911 dispatching, faultfinding on board naval ships, design aircraft, and various support systems. The editors' goal in this book is to present in a single source a comprehensive, in-depth introduction to the field of cognitive task analysis. They have attempted to include as many examples as possible in the book, making it highly suitable for those wishing to undertake a cognitive task analysis themselves. The book also contains a historical introduction to the field and an annotated bibliography, making it an excellent guide to additional resources.

The first comparative examination of planning paradigms This text begins with the principle that the ability to anticipateand plan is an essential feature of intelligent systems, whetherhuman or machine. It further assumes that better planning resultsin greater achievements. With these principles as a foundation,Planning in Intelligent Systems provides readers with the toolsneeded to better understand the process of planning and to becomebetter planners themselves. The text is divided into two parts: * Part One, "Theoretical," discusses the predominant schools ofthought in planning: psychology and cognitive science,organizational science, computer science, mathematics, artificialintelligence, and systems theory. In particular, the book examinescommonalities and differences among the goals, methods, andtechniques of these various approaches to planning. The result is abetter understanding of the process of planning through thecross-fertilization of ideas. Each chapter contains a shortintroduction that sets forth the interrelationships of that chapterto the main ideas featured in the other chapters. * Part Two, "Practical," features six chapters that center on acase study of The Netherlands Railways. Readers learn to applytheory to a real-world situation and discoverhow expanding theirrepertoire of planning methods can help solve seemingly intractableproblems. All chapters have been contributed by leading experts in thevarious schools of planning and carefully edited to ensure aconsistent high standard throughout. This book is designed to not only expand the range of planningtools used, but also to enable readers to use them moreeffectively. It challenges readers to look at new approaches andlearn from new schools of thought. Planning in Intelligent Systemsdelivers effective planning approaches for researchers, professors,students, and practitioners in artificial intelligence, computerscience, cognitive psychology, and mathematics, as well as industryplanners and managers.

Enhancing Surgical Performance: A Primer in Non-Technical Skills explains why non-technical skills are vital for safe and effective performance in the operating theatre. The book provides a full account, with supporting empirical evidence, of the Non-Technical Skills for Surgeons (NOTSS) system and behavioural rating framework, which helps identify

Papers presented at the August 1996 HICS (title) symposium, held in Dayton, Ohio. Subjects covered include: dialog design for interactive system, aerospace systems, coordination and control in virtual workspaces, performance and simulation of complex dynamic systems, managing complex medical systems

Teaching and Measuring Cognitive Readiness presents theoretical and empirical findings regarding cognitive readiness and assessments of their impact on adult learning. The term readiness is used in assessing student preparation for K-12 schools, while in the military and in industry, "readiness" denotes preparation to be effective in performing a mission or a job. Cognitive Readiness is viewed through a Knowledge, Skills, and Attributes (KSA) lens. Teaching and Measuring Cognitive Readiness deals with (a) the primacy of cognitive readiness as attributes or individual difference variables; (b) the need for cognitive readiness instructional and assessment strategies; (c) the need to integrate assessment into cognitive readiness training; (d) the need for theory-driven evaluation studies to increase knowledge and efficacy in teaching cognitive readiness; and (e) the need for a solid psychometric approach to the use of cognitive readiness assessments.