Abstract
Anesthesia takes place in a complex, high-stakes environment where humans and technologies interact to provide medical care to patients. Providing adequate decision support for individuals and teams in anesthesia emergencies is important because emergencies are infrequent and complex. Current designs of decision support in airway management are not context specific and lack a consideration of how decisions are made under time pressure. To fill this gap, this study used frameworks from cognitive systems engineering to explore decisions of experienced anesthesia providers. The goal was to identify the decision pathways used in challenging airway management situations. The critical decision method was employed to interview anesthesia providers about a challenging incident they had experienced. Results illustrated that decisions were based on prior experience and made through a process of recognition. The vast majority of decisions were recognition primed, characterized by a direct link between cue familiarity and action generation. A few decisions involved concurrent option comparison, which was still based on situation recognition. Different cues received through teamwork, technologies, and patients contributed to the decisions. As different cognitive pathways may require different design solutions, the findings of this study are being used to help develop decision support tools in anesthesia.
| Original language | English |
|---|---|
| Pages (from-to) | 353-370 |
| Number of pages | 18 |
| Journal | Journal of Cognitive Engineering and Decision Making |
| Volume | 11 |
| Issue number | 4 |
| DOIs | |
| Publication status | Published - 1 Dec 2017 |
Keywords
- cognitive systems engineering
- cognitive task analysis
- domains
- health care delivery
- methods
- recognition-primed decision making
- topics
Cite this
}
Exploring Decision Pathways in Challenging Airway Management Episodes. / Schnittker, Raphaela; Marshall, Stuart ; Horberry, Timothy ; Young, Kristie ; Lintern, Gavan .
In: Journal of Cognitive Engineering and Decision Making, Vol. 11, No. 4, 01.12.2017, p. 353-370.Research output: Contribution to journal › Article › Research › peer-review
TY - JOUR
T1 - Exploring Decision Pathways in Challenging Airway Management Episodes
AU - Schnittker, Raphaela
AU - Marshall, Stuart
AU - Horberry, Timothy
AU - Young, Kristie
AU - Lintern, Gavan
PY - 2017/12/1
Y1 - 2017/12/1
N2 - Anesthesia takes place in a complex, high-stakes environment where humans and technologies interact to provide medical care to patients. Providing adequate decision support for individuals and teams in anesthesia emergencies is important because emergencies are infrequent and complex. Current designs of decision support in airway management are not context specific and lack a consideration of how decisions are made under time pressure. To fill this gap, this study used frameworks from cognitive systems engineering to explore decisions of experienced anesthesia providers. The goal was to identify the decision pathways used in challenging airway management situations. The critical decision method was employed to interview anesthesia providers about a challenging incident they had experienced. Results illustrated that decisions were based on prior experience and made through a process of recognition. The vast majority of decisions were recognition primed, characterized by a direct link between cue familiarity and action generation. A few decisions involved concurrent option comparison, which was still based on situation recognition. Different cues received through teamwork, technologies, and patients contributed to the decisions. As different cognitive pathways may require different design solutions, the findings of this study are being used to help develop decision support tools in anesthesia.
AB - Anesthesia takes place in a complex, high-stakes environment where humans and technologies interact to provide medical care to patients. Providing adequate decision support for individuals and teams in anesthesia emergencies is important because emergencies are infrequent and complex. Current designs of decision support in airway management are not context specific and lack a consideration of how decisions are made under time pressure. To fill this gap, this study used frameworks from cognitive systems engineering to explore decisions of experienced anesthesia providers. The goal was to identify the decision pathways used in challenging airway management situations. The critical decision method was employed to interview anesthesia providers about a challenging incident they had experienced. Results illustrated that decisions were based on prior experience and made through a process of recognition. The vast majority of decisions were recognition primed, characterized by a direct link between cue familiarity and action generation. A few decisions involved concurrent option comparison, which was still based on situation recognition. Different cues received through teamwork, technologies, and patients contributed to the decisions. As different cognitive pathways may require different design solutions, the findings of this study are being used to help develop decision support tools in anesthesia.
KW - cognitive systems engineering
KW - cognitive task analysis
KW - domains
KW - health care delivery
KW - methods
KW - recognition-primed decision making
KW - topics
UR - http://www.scopus.com/inward/record.url?scp=85032903478&partnerID=8YFLogxK
U2 - 10.1177/1555343417716843
DO - 10.1177/1555343417716843
M3 - Article
VL - 11
SP - 353
EP - 370
JO - Journal of Cognitive Engineering and Decision Making
JF - Journal of Cognitive Engineering and Decision Making
SN - 1555-3434
IS - 4
ER -