Thesis (M.A.I.S.)--Oregon State University, 2008. / Printout. Includes bibliographical references (leaves 49-52). Also available on the World Wide Web.

Robotic surgery is at the forefront of surgical innovation and presents novel challenges for both postgraduate learners and seasoned specialists. Robotic teaching is underway, often without formalized robotic curricula. Research into robotic surgical steps and surgical decision-making that should be imparted to learners has been neglected. As such, I aimed to determine the knowledge gap of urology residents for a robotic prostatectomy. Further, I also aimed to determine the patterns and cognitive rules used by experienced surgeons to complete a robotic prostatectomy. This master’s thesis included a knowledge gap survey, completed by urology residents, and compared to urologic oncologists, of a robotic prostatectomy and contained both open-ended and rating scale questions. A cognitive task analysis (CTA) was then performed as a series of semi-structured interviews in which incident-probing questions were used to make urologic oncologists explain visual cues and decision-making processes. 42 surveys were administered to urology residents and urologists at The Ottawa Hospital over 10 weeks. There was disagreement between urology resident and urologist responses from the rating scale responses, from the following procedural steps: vesicourethral anastomosis, apical dissection, and seminal vesicle dissection. The open-ended responses found discrepancies between the residents’ and urologists’; understanding of anatomy and surgical decision-making, and of cause-and-consequence cognitive awareness. Subsequently, 16 CTA interviews of four urologic oncologists were completed. After data coding and thematic analysis was performed, CTA grids for each surgeon described a map of a robotic prostatectomy including the steps and goals of the procedure, procedural landmarks, key visual cues for each step, complications and/or error prevention, and management. Specific content not yet described in the literature also includes how the lack of haptic feedback is compensated by robotic surgeons. Additional findings included a gap in urology resident knowledge and understanding of a robotic prostatectomy. The CTA of a robotic prostatectomy documented the surgical decision-making rules, patterns and visual cues urologic oncologists use to avoid errors, and to manage intraoperative surgical complications. This information is key to expanding the understanding of robotic prostatectomy surgical decision-making and training and can be used to produce robust robotic educational curricula.

The job of a package delivery driver (PDD) is complex and demanding. These drivers must possess many skills in order to succeed in their work, including physical stamina, appropriate decision-making, positive customer interaction, and most importantly, operational safety. Companies must use significant resources, not only to provide insurance for existing drivers, but also to train new drivers to use their visual attention effectively while driving, and companies have a vested interest in ensuring that the most capable trainees are selected for jobs. Currently, subjective assessments of supervisors or managers are typically used to make these determinations. While these are valuable methods for assessing drivers, an objective measure of how well the driver is using his/her visual attention would both assist evaluators in making judgments, as well as make those judgments more accurate. The purpose of the study described herein was to 1) conduct a task analysis of the driving component of the PDD job responsibilities, and 2) create and test an objective measure that a package delivery company could use to evaluate the performance of its drivers. A detailed task analysis based on numerous observations of drivers in their normal work routines was conducted for this research in order to understand these complex tasks. A framework was created for understanding this system of tasks, which was then used to organize all tasks that drivers were observed to perform into more general, goal-oriented activities. Using this task analysis, incidents were identified that were observed while drivers were behind the wheel. This information demonstrated that breakdowns were occurring within the tasks drivers were performing and that improved methods of training and evaluations may be needed as a result. A construct of visual behavior called Head Down Time (HTD) was then created and tested. An individual HDT is defined as the sum of time of all eye gazes away from the primary display (i.e. windshield) between two distinct eye gazes at the primary display while the vehicle is in motion. HDT was evaluated for its ability to differentiate levels of experience between drivers, its relationship to types of route on which drivers delivered, and its relationship to the driving-related incidents that were observed. HDTs were shown to be differed significantly between drivers of low and high experience, with experienced drivers displaying shorter durations of HDT when compared to inexperienced drivers. HDTs also differed in duration when analyzed by the type of route upon which drivers operated. Commercial and urban routes, while not significantly different with respect to HDT, were shown to have increased HDT durations when compared to rural routes and, in turn, residential routes were found to have significantly longer HDTs than did rural routes and may have significantly shorter durations compared to commercial and urban. Finally, HDTs that were associated with observed driving incidents in terms of chronological proximity were shown to be of significantly longer duration than were HDTs that were not associated with incidents. All tests were conducted using appropriate statistical measures, including t-tests at a level of α = 0.05 for each dataset. Applications of this research include: 1) improvement of PDD training and evaluation methods through use of a detailed task analysis, 2) improvement in how package delivery companies define incidents and train PDD toward the prevention of incidents based on task analysis and observations as to incident frequency, and 3) the further development of HDT as a possible objective measure to supplement the training and evaluation of PDD. / Master of Science

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A new task analysis methodology was developed to provide objective information on complex tasks. A complex task was broken down into observable elements and unobservable elements that were inferred to have taken place in support of the observable actions. Subject matter experts (SMEs) were used to assist in this breakdown. Additionally, guidelines for specifying the level of detail in the task analysis breakdown were developed to help objectify the analysis. A simulation model framework then was built of the task elements. Personnel proficient in the task were observed during work, and objective data on their observable actions were collected. These data then were used to provide numeric input to a simulation model. The simulation was run, and the results of the model of performance compared to the observed performance data. The model was altered at that point to reflect lessons learned during data collection. The process yielded a model that accurately reflects human performance on the task. Variations on the model based on a conceptual understanding of operators strategies also correlated well with observed performance, indicating the value of the methodology for building an understanding of the motivations critical to successful task performance. / Ph. D.

This study focuses on the importance of activity as an intervention with persons with dementia. Continuity theory serves as a general guide, along with research on leisure in later life and the theory of personhood in dementia, to explain the importance of engaging persons with dementia in activities. Implementing purposeful activities with persons with dementia has been demonstrated to reduce boredom and agitated behavior and to maximize the functional abilities of the individual. The important role of task analysis and adaptation of the activity to personal needs (motor, psychological, social) and past interests of the individual is central to the study, which utilizes meaningful activities as suggested in the literature from the field of occupational therapy. The current study addresses specific principles of activity for persons with dementia and applies a well-established educational philosophy from the field of child development to this population. Previous research has demonstrated that Montessori activities, modified for use with persons with dementia, can facilitate positive engagement and affect. Montessori-based activities were incorporated in a model of well-being in dementia (Coppola, 1998; Hasselkus, 1998), conducted in small parallel group settings, (i.e., referred to a group of individuals situated together but individually completing the same task), included a verbal approach to facilitating meaning of the activities. The amount and type of engagement and affect were compared during Montessori-based activities and regularly scheduled activities of 10 older adults with dementia at a university-based adult day service. Significantly higher levels of constructive engagement (motor or verbal response to activity) and lower levels of non-engagement (sleeping, staring into space) were exhibited during Montessori-activities compared to regular activities. Principles of activities for persons with dementia along with principles of the Montessori-based program are presented. Methodological modifications are suggested, and implications for research and practice are discussed. / Master of Science

Work Domain Analysis (WDA) and task analysis are methods that can be used to develop complex systems that support human operators. Task analysis can be used to describe the nominal tasks of many complex safety critical systems which are also highly proceduralized. However, complex systems may require human operators to have a greater understanding of the system's dynamics than can be obtained from procedures derived from a task analysis. This is particularly true when off-nominal events occur, for which there is no procedure. By concentrating on the constraints in the work domain instead of tasks, work domain analysis can complement task analysis by supporting operators during off-nominal events that do not have any predescribed procedures. The goal of this study was to use WDA and two forms of task analysis to derive interface and procedure modifications for a new aviation concept called interval management. Interval management is a new concept whose goal is to increase runway throughput by enabling aircraft to achieve a precise interval behind a lead aircraft. This study used data from a human-in-the-loop study conducted at NASA Langley Research Center to develop a Hierarchical Task Analysis (HTA), Control Task Analysis (CTA), and WDA. The HTA was used to describe a nominal set or procedures, the CTA was used to describe strategies pilots could use to make decisions regarding the IM operation, and the WDA was used to determine representations and procedures that could convey complete and accurate knowledge of interval management to the flightcrew.

The purpose of this study is to investigate the relationship between task-related attributes and the elicited cognitive processes of a human decision maker. Previous findings on the feasibility of using cognitive style as a guideline for information systems research and design were inconclusive. It is vital to design a system that meets users decision behavior, but the inherent hazards of information systems design based exclusively on user cognitive styles is suspect. This study provides a basis for understanding the potential variation of cognitive processes across different task environments.

Background: Alarm interpretation and management are fundamental to managing critically ill patients. 1 There is little research as to the decision process nurses use to prioritize alarms or manage specific monitor parameters. Objective: The purpose of this study is to gain insight into the intricacy of the intensive care unit (ICU) nurses'critical decision process, using a human performance framework, when responding to monitor alarms. Method: Design: Descriptive design using semi-structured interview. Open-ended questions were developed based on the critical decision method (CDM) to explore ICU nurses' critical decision making process related to monitor alarms. Sixteen ICU nurses at a community hospital were interviewed to elicit perceptions and thought processes related to monitor alarms. Results: Responses to monitor alarms were affected by nursing experience, tones of the alarm, nurses' knowledge of the patient's condition as well as immediate visualization of patient to judge the urgency of an alarm. Both advanced beginner and expert nurses had similar initial response to monitor alarms; however, expert nurses added depth to their immediate assessment process by using previous experiences, intuition, and clinical expertise. Advanced beginner nurses frequently look to expert nurses for advice, guidance, and examples of clinical expertise. The majority of nurses had little or no formal training on the cardiac monitors used by that facility and all felt it would be beneficial in monitor alarm management. Conclusion: Understanding the decision-making process used by nurses can guide the development of policies and learning experiences that are crucial clinical support for alarm management.