This study investigates doctors’ and patients’ usage of three speech functions; namely statements, questions and commands in the American medical drama series House M.D. Furthermore, the study investigates interruptions between doctors and patients. The aim of the study was to ascertain whether the claim that doctors practice power over patients can be verified. The data comprises transcripts of 16 video recorded sessions of doctors and patient interacting where the material was personally collected and analyzed. In their interactions, doctors were found to dominate in making statements, asking questions and uttering commands. In addition, it was detected that the doctors’ and patients’ way to communicate differed given the fact that doctors are trained in their roles as doctors while patients are not. However, both interactants were found to perform the different speech functions similarly. The study also revealed that doctors interrupted more as compared to patients. Furthermore, gendered interruptions were found in the data, all of which came from male participants and it was concluded that the findings could be linked to the social and cultural roles of the participants. Overall, it was concluded that there exists a power relationship between doctors and patients.

Background: Prospective memory (ProM) consists of remembering that some action needs to be performed in the future and when (detecting the Intent Trigger), and what the action is (Recalling the Content of the trigger). The Intent Trigger is bound by a forward association to the Content Recall, and the Content Recall has a backward association to the intent Trigger. In situations which present multiple, interleaving ProM tasks to operators it is not known how subsequently-presented ProM tasks interfere with the associations between the Intent Trigger and Content Recall of the original ProM task. Objective: The current study investigated the effect of presenting multiple, interleaved ProM tasks on timely detection of the Intent Trigger and accurate Recall of the Content of the original ProM task. Method: Participants encoded a ProM task (AB) in an air traffic control simulation. They then were interrupted with a second ProM task. The ProM interruption task was different from the original ProM task in either the Intent Trigger (AB, CB), Content Recall (AB, AD), or both Intent Trigger and Content Recall (i.e., a new ProM task, AB, CD). A control condition involved interrupting the participant with a weather report. Results: Detection of the Intent Trigger was significantly worse after a ProM interruption as compared to a weather interruption; a similar pattern of results, but with marginal significance, was also found for Content Recall. Additionally, a ProM task that interfered with backward association (AB, CB) was no better or worse than doing two unrelated ProM tasks (AB, CD) on the detection of the Intent Trigger. However, a task that presented a new forward association (AB, AD) was worse than performing two unrelated ProM tasks (AB, CD) on Recall of the Content. The results are discussed in the context of designing memory aids to support interleaved ProM tasks in dynamic environments.

Many people are more or less constantly connected through mobile technology today. This provides opportunities, but also makes people vulnerable for interruptions and prone to engage in multitasking, when full focus might be needed. Smartphone usage is common especially among younger people, making it interesting to investigate constant connectivity’s effect on learning. Previous studies have focused on quantifiable results regarding the effect on learning, such as impact on grades, but has not investigated the qualitative aspects. This thesis investigates students’ experiences regarding interruptions and multitasking through a three-part study. The results show that the impact is very context dependent and phone usage is occasionally not reflected upon. Further, the result indicates that being expected to always be available and respond quickly could be perceived as a problem. The findings presented in this thesis can contribute with important design implications for devices to enable single-task focus and avoiding interruptions.

Dans le domaine aéronautique, comme dans de nombreux autres domaines de la vie courante ou professionnelle, les erreurs ont souvent été associées à des défaillances attentionnelles. Nos travaux s’insèrent dans cette problématique, et sont plus particulièrement focalisés sur les variations de la capacité à allouer son attention sur une tâche donnée à la suite d’une interruption. Dans un premier temps, nous avons mis en place des expérimentations qui permettent d’évaluer l’étendue des variations de performances obtenues dans une tâche à la suite d’une interruption, en fonction des composantes attentionnelles sollicitées dans la tâche à exécuter. Dans un second temps, nous avons mis en place un indicateur fiable et objectif mettant en évidence des différences dans le fonctionnement physiologique cérébral en fonction de ces composantes attentionnelles. Dans un troisième temps, nous avons été amenés à vérifier l’effet de diverses interruptions dans des situations aéronautiques réalistes. Nos travaux permettent de conclure à l’existence de fluctuations de l’attention à la suite d’une interruption, fluctuations dont la conséquence peut se traduire par des variations de performances et par différentes stratégies de gestion des erreurs et des activités. / In the aviation field, as in many other areas of personal or professional life, errors have often been associated with attentional failures. Our work is related to this issue, and is more particularly focused on variations of attention following an interruption. In a first step, we have set up experiments to measure changes in performance obtained in a task after an interruption. These variations are studied systematically according to various attentional components requested in the task at hand. In a second step, we have set up an indicator showing differences in the physiological functioning of the brain depending on these attentional components. Thirdly, we have tested the effect of various interruptions in realistic aeronautical situations. From our work, we conclude that there is a variation in attention after an interruption, the consequences of which can result in errors, performance variations, and differences in the management of errors and activities.

This work seeks to characterize the impact of build interruptions to additively manufactured Al-Si-10-Mg produced by the powder bed fusion (PBF) process. Additive manufacturing represents a significant investment in overhead, machine, and material making an interruption to the process a potential waste of money and time. Interruptions in the form of power outages, lack of powdered feedstock, and/or shielding gas will cause the machine to operate in an unintended manner, potentially even stopping the build process. The process of manufacturing will influence the microstructure, which determine the material’s properties and performance. An interrupted PBF process could exhibit unique microstructural features and reduced mechanical properties that distinguish the resulting material from a continuous PBF process. Experiments were performed to simulate a production interruption with varying time periods of interruption and air exposure. The zone of interruption was characterized using optical micrographs, EDS, and hardness measurements to determine any effects of the interruption.

Idle time is a common phenomenon that prevents employees from performing their core job tasks, with detrimental effects on employee well-being and performance. Drawing on affective events theory, the job demands-resources model, and action regulation theory, this dissertation addresses three main questions: First, how idle time affects employee well-being and performance; second, the mechanisms behind these effects, namely appraisals and affective reactions; and third, the conditions under which idle time may be beneficial for employees. Study 1 (N = 338) showed indirect negative effects of objective idle time on employee well-being through the subjective experience of being idle. Age was negatively and boredom proneness positively associated with subjective idle time. Two experiments in Study 2 (N2a = 445, N2b = 597) demonstrated the detrimental effects of regulation problems on employee well-being and performance, mediated by objective and subjective idle time. Recovery activities buffered the detrimental effects of idle time. In Study 3, a 12-month, five-wave longitudinal study (N = 1,036), the associations of idle time with lower job satisfaction, higher turnover intentions, and higher counterproductive work behavior were mediated by higher boredom. Finally, the results of Study 4, based on the same data as Study 3, showed that the effects of idle time on employee exhaustion and engagement depended on boundary conditions, namely workload and autonomy. For high workload employees, idle time was positively associated with engagement, whereas when autonomy was high, idle time was associated with lower exhaustion and lower engagement. During idle time, relaxation was beneficial, whereas detachment was detrimental regarding employee exhaustion and engagement. Idle time is detrimental to employee well-being and performance, mediated by subjective idle time, boredom, and lack of recovery, respectively. Certain conditions, like high workload or using idle time for relaxation, can make it beneficial for employees. The results provide insights for research, particular in the areas of waiting, interruptions, recovery, and well-being.:Acknowledgments i English Abstract ii German Abstract iii Table of Contents iv List of Tables ix List of Figures x 1 General Introduction 1 2 Study 1: Effects of Idle Time on Well-Being – An Experimental Study 6 2.1 Abstract 6 2.2 Introduction 7 2.3 Idle Time as an Affective Event at Work 9 2.4 Method 11 2.4.1 Open Science 11 2.4.2 Study Design 11 2.4.3 Participants 12 2.4.4 Materials 13 2.4.5 Data Analysis 14 2.5 Results 15 2.5.1 Descriptive Statistics 15 2.5.2 Confirmatory Factor Analysis 15 2.5.3 Manipulation Check 15 2.5.4 Hypothesis Tests 15 2.5.5 Exploratory Results 16 2.6 Discussion 17 2.6.1 Theoretical and Practical Implications 17 2.6.2 Limitations and Future Research 19 2.7 Conclusion 21 2.8 Open Data and Electronic Supplementary Materials (ESM 1) 21 3 Study 2: Idle Time, Recovery, and Work Outcomes: Results of Two Experimental Studies 26 3.1 Abstract 26 3.2 Introduction 27 3.3 Idle Time at Work 29 3.3.1 Antecedents of Idle Time 29 3.3.2 The Consequences of Idle Time 30 3.3.3 The Mechanisms Underlying Effects of Idle Time 31 3.4 Study 1 33 3.4.1 Method 33 3.4.2 Results 36 3.4.3 Discussion 37 3.5 Study 2 37 3.5.1 Method 37 3.5.2 Results 40 3.5.3 Discussion 43 3.6 General Discussion 43 3.6.1 Theoretical and Practical Implications 44 3.6.2 Limitations and Future Research 46 3.7 Conclusion 47 4 Study 3: Is it Bad Because it is Boring? Effects of Idle Time on Employee Outcomes 58 4.1 Abstract 58 4.2 Introduction 59 4.3 The Effects of Idle Time 62 4.3.1 Idle Time and Boredom 63 4.3.2 Boredom and Employee Outcomes 64 4.3.3 Idle Time and Employee Outcomes 65 4.4 Method 66 4.4.1 Participants and Procedure 66 4.4.2 Measures 68 4.4.3 Statistical Analysis 70 4.5 Results 71 4.5.1 Hypothesis Tests 71 4.5.2 Additional Analyses 73 4.6 Discussion 75 4.6.1 Theoretical and Practical Implications 75 4.6.2 Limitations and Future Research 77 4.7 Conclusion 79 5 Study 4: Can Idle Time Serve as a Resource? A Job Demands-Resources Approach 88 5.1 Abstract 88 5.2 Introduction 89 5.3 Theoretical Background and Hypotheses Development 91 5.3.1 The Downsides of Idle Time 91 5.3.2 The Benefits of Idle Time 92 5.4 Method 94 5.4.1 Participants and Procedure 94 5.4.2 Measures 95 5.4.3 Data Analysis 97 5.5 Results 97 5.5.1 Hypothesis Tests 97 5.5.2 Additional Analyses 99 5.6 Discussion 99 5.6.1 Theoretical and Practical Implications 100 5.6.2 Limitations and Future Directions 102 5.7 Conclusion 103 6 General Discussion 109 6.1 Summary 109 6.2 Theoretical Contributions 110 6.2.1 The Consequences of Idle Time 110 6.2.2 The Mechanisms Underlying Idle Time 111 6.2.3 Recovery and Boundary Conditions 112 6.3 Practical Contributions 113 6.4 Limitations and Future Directions 114 6.4.1 Affective Events Theory 114 6.4.2 Event System Theory 115 6.4.3 Action Regulation Theory 116 6.5 Conclusion 117 References 118 Appendix I Theses I Idle Time at Work I Study 1: Effects of Idle Time on Well-Being – An Experimental Study II Study 2: Idle Time, Recovery, and Work Outcomes: Results of Two Experimental Studies II Study 3: Is it Bad Because it is Boring? Effects of Idle Time on Employee Outcomes II Study 4: Can Idle Time Serve as a Resource? A Job Demands-Resources Approach III Conclusion IV References IV Thesen VI Leerlaufzeiten bei der Arbeit VI Studie 1: Auswirkungen von Leerlaufzeiten auf das Wohlbefinden – eine Experiment VII Studie 2: Leerlaufzeit, Erholung und Arbeitsergebnisse: Ergebnisse von zwei experimentellen Studien VII Studie 3: Sind sie schlecht, weil sie langweilig sind? Auswirkungen von Leerlaufzeiten auf Beschäftigte VII Studie 4: Kann Leerlaufzeit als Ressource dienen? Ein Arbeitsanforderungen-Ressourcen-Ansatz VIII Schlussfolgerungen IX Literaturverzeichnis IX Curriculum Vitae XI Publication List XII Selbstständigkeitserklärung XIV Nachweise über die Anteile der Co-Autorschaft: Studie 1 XV Nachweise über die Anteile der Co-Autorschaft: Studie 2 XVI Nachweise über die Anteile der Co-Autorschaft: Studie 3 XVII Nachweise über die Anteile der Co-Autorschaft: Studie 4 XVIII

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Le domaine de la chirurgie de par son environnement sensible, ses enjeux de qualité et de sécurité se rapproche naturellement d’autres univers tels que l’industrie nucléaire, l’aviation civile et le domaine militaire. La technicité voire même la connaissance déclarative de chaque individu composant un élément de l’ensemble d’individus interagissant ensemble dans ces environnements ne suffisent pas à atteindre des niveaux suffisants de sécurité. Plus de 70% des évènements indésirables graves seraient liés à des problèmes humains de coordination et de communication. Les compétences non techniques (CNT) sont ainsi nécessaires pour assurer une performance efficiente et sûre. La première partie de ce travail fait un état des lieux de la littérature sur les CNT en chirurgie. Après des définitions générales et un positionnement de ces compétences vis-à-vis notamment des compétences techniques et procédurales, nous présentons une revue systématique de la littérature des CNT dans le domaine spécifique de la neurochirurgie. La deuxième partie de ce travail s’intéresse quant à elle aux compétences interpersonnelles en focalisant le propos sur le travail en équipe et la communication. Le concept de familiarité au sein d’une équipe est exploré. Pour ce faire, nous présentons une étude observationnelle qui a été réalisée en environnement réel de bloc opératoire de neurochirurgie portant sur les interruptions de tâches et le travail d’équipe. Ces interruptions de tâches sont en effet des évènements itératifs entrainant la mobilisation de CNT au sein d’un groupe de professionnels. La troisième partie est consacrée aux compétences cognitives avec une étude reposant sur des entretiens de neurochirurgiens de différents niveaux d’expertise ; celle-ci ayant pour objectif de mieux comprendre la représentation mentale que se fait le chirurgien lors de son planning opératoire pré-chirurgical. La méthodologie qualitative de la théorisation enracinée est utilisée dans cette partie et nous justifions son emploi pour ce travail. / The field of surgery with its sensitive environment, its quality and safety issues is naturally close to other work environments such as the nuclear industry, civil aviation and the armed forces. The technical expertise and even the declarative knowledge of each individual component of the set of individuals interacting together in these environments are not sufficient to achieve sufficient safety levels. More than 70% of serious adverse events are due to human coordination and communication issues. Non-technical skills (NTS) are thus essential to ensure efficient and safe performance. The first part of this work is a review of the literature on NTS in surgery. After giving general definitions and positioning these skills with respect to technical and procedural skills, we present a systematic review of the CNT literature in thespecific field of neurosurgery. The second part of this work focuses on interpersonal skills: on teamwork and communication. The concept of crew familiarity is explored. In order to achieve this, we present an observational study carried out in a real neurosurgical operating room environment dealing with workflow disruptions and involving teamwork. These workflow disruptions are iterative events leading to the mobilization of NTS within a group of professionals. The third part is dedicated to cognitive skills with a study based on interviews of neurosurgeons with different levels of expertise. The aim is to better understand the surgeon’s mental representation during preoperative surgical planning. Grounded theory approach, a qualitative methodology, is used in this part and we justify its use for this work.

Previous research has provided a helpful, albeit narrow, understanding of task interruptions as related to outcomes such as wellness and performance (e.g., Eyrolle & Cellier, 2000). Building on this foundation by viewing interruptions through the broader theoretical context of the theory of mental workload, this study sought to explain the cognitive processes underlying the negative performance effects often associated with interruptions and to apply an intervention aimed at mitigating these effects. Specifically, mindfulness has emerged as a promising method for reducing the cognitive burden of interruptions. This study examined the effects of intrusions (a type of interruption) on psychological strain and performance through perceived mental workload. Although perceived mental workload did predict strain outcomes, the overall mediation models failed to reach significance. Results also failed to support the hypothesized effect of state mindfulness as a potential moderator. A set of post hoc analyses, however, found that intrusion perceptions acted as a mediator between intrusion condition and psychological strain outcomes. Further, this mediation was moderated by state mindfulness, which in turn was moderated by the intrusion time. Specifically, the indirect effect of intrusion condition on strain outcomes was such that individuals experienced more strain if they received an intrusion compared to those who were not given an intrusion, unless they completed the form quickly and were also low on state mindfulness, in which case there was no difference in strain outcomes based on whether they experienced an intrusion. Together, these results suggest that intrusion perceptions play key roles in strain outcomes, and that moderators of these relationships should be further explored.