Within the healthcare system, nurses, are involved in many critical steps of the patient care process such as surgery triaging, post-procedure recovery monitoring and handoff release to a caregiver. A significant portion of their time is spent on the hospital floors where patients recover from their medical procedures. In today’s healthcare environments, multiple devices – typically monitors, ventilators, and infusion pumps – are used during said patient recovery process. Health equipment manufacturers often add alarms to medical devices, which serve a variety of purposes, ranging from simple notifications to warnings and alerts about potential hazards that require rapid action. In typical hospital units, several types of medical devices that monitor a variety of parameters based on patient and nurses/assistants needs. Many devices have similar alarm tones, regardless of risk levels. A typical nurse will attend to multiple patients, and the number of alarms that require attention place tremendous demands on nurses’ cognition, which causes enormous alarm fatigue. Alarm fatigue is not a new phenomenon and is very common in other industries, such as chemical processing, and nuclear power. The additional stress and burden of false alarms and non-actionable alarms is also troublesome. Many for-profit companies have developed commercial alarm management tools and aids to combat these problems and the rapid adoption of smart phones and tablets in healthcare has made alarm management more mobile and visual. However, even after these advances, the number of deaths and adverse events are still at an unacceptable level. The purpose of this study to establish that the current training methods used by various hospitals are inadequate and to explore the effects of rigorous one-on-one training and metacognitive intervention in managing alarm related adverse events. This study also identifies deficiencies in the current training methods and assesses the impact of individualizing alarm threshold settings on alarm workload, response and error rates.

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Research in metacognition has long demonstrated that applying metacognitive strategies improves students learning and performance. Incoming college and university freshmen are not typically trained in using the metacognitive skills that could enhance their academic performance and their satisfaction with the college experience. This study attempted to assess first-year university students' metacognitive awareness and usage at two levels: (a) After direct and specific metacognitive training, (b) after engaging in weekly metacognitive reflection assignments. Six classes of university freshmen were studied in terms of their use of metacognitive skills and strategies as they progressed through their initial semester. Four of the six classes were trained in metacognitive skills and strategies using the Metacognitive Skill Instruction. Two of these four classes were prompted to specifically reflect on their use of metacognitive skills and strategies. The other classes were not prompted about their use of metacognition. Students' metacognitive performance was assessed at the end of the semester using the Metacognitive Awareness Inventory. Results show there was no initial difference between groups yet a significant difference between posttest and retrospective pretest scores was found for all three groups at the end of the term.

Debugging is a significant part of programming. However, a lot of introductory pro- gramming classes tend to focus on writing and reading code than on debugging. They utilize programming assignments that are designed in ways such that students learn debugging by completing these assignments which makes debugging more of an im- plicit goal. In this thesis, we propose a cognitive awareness scaffolding in debugging to help students self-regulate their debugging process. We validate its effectiveness by conducting experiments with students in four sections of a Data Structures course, which is one of the introductory computer science classes at California Polytechnic State University, San Luis Obispo. In this form, students identified the debugging stage, described the bugs in their own words, and tracked their attempts to fix them. The exit survey responses that students filled out at the end of the quarter indi- cate that students seemed to find the debugging form helpful with self-regulation in debugging process. For further investigation, we attempt to measure students’ under- standing of the bugs explained on the form. Additionally, we also discuss potential improvements for the debugging form.

Metamemory effects under retroactive interference (RI) were tested using a modified RI paradigm in order to determine whether relatedness of word pairs impacts metamemory predictions and to investigate the bases of these predictions. Conflicting findings from prior research suggested that the relatedness of materials used to test RI could produce disparate effects; some studies showed association between memory and metamemory but other studies showed dissociation between the two. The experiments consisted of four phases: original and interpolated study, prediction, and test; participants were tested on the words encountered at original study. By comparing predictions to recall, we determined that memory and metamemory were dissociated under RI regardless of cue-target relatedness and regardless of the relatedness of targets from original to interpolated study. Additionally, the findings support the use of the accessibility heuristic to make metamemory predictions under RI. The results support a separate systems viewpoint.

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