Exploring Technical Work Using Cognitive Artifacts

描述(由申请人提供)： 在医疗保健中使用计算机的障碍并不是计算机，而是对这种机器所在的复杂医疗保健系统的理解。这项申请建议对卫生保健技术工作进行为期两年的调查。这项研究的广泛、长期的目标将是通过三项倡议来提高患者的安全性：(1)为个人和团队在认知人工制品的开发和使用中的表现建立行为基础；(2)说明行为对医学信息学的影响；以及(3)开发可以体现在信息应用或设备中的问题表征。 信息技术与模拟人工制品有许多共同之处，因为它们经常被建模为物理工具的标志性表示。理解模拟人工制品的起源和性质依赖于对它们所支持的群体和活动进行深入和持续的观察，以得出它们的意义。很少有信息技术项目对这一理解投入必要的关注。其结果是，系统试图利用技术能力，而对从业人员为执行复杂工作而开发的复杂、精细的交互视而不见。这项研究将分析一家大型城市教学医院使用的认知人工制品的技术工作流程。这种方法有望对技术工作的复杂动态和分布式认知的支撑网产生洞察。该方法有望在其他环境中使用，特别是在ICU、病房和急诊室。认知工程方法将被用来绘制与多个认知伪像相关的分布式认知过程。这项研究的结果将为评估在医疗保健信息应用中使用技术的其他建议提供基础。

DESCRIPTION (provided by applicant): Obstacles to the use of computers in health care have not been computers but rather understanding the complex health care systems in which such machines exist. This application proposes a two-year investigation of technical work in health care. The broad, long-term objectives of this research will be to improve patient safety through three initiatives: (1) develop the behavioral basis for individual and team performance in cognitive artifact development and use, (2) account for implications that behavior has for medical informatics, and (3) develop the problem representation that can be embodied in information applications or devices. Information technology has much in common with analog artifacts as they are often modeled as iconic representations of physical tools. Understanding the origin and nature of the analog artifacts relies on deep and sustained observation of the groups and activities they support in order to derive their meaning. Few information technology projects invest the necessary attention to this understanding. The result is systems that seek to leverage technological capability while being blind to the sophisticated, refined interactions that practitioners have developed to perform complex work. This research will analyze technical work processes involving cognitive artifacts in use at a major urban teaching hospital. This approach is expected to yield insights into the complex dynamics of technical work and the supporting web of distributed cognition. The method has promise for use in other settings, particularly the ICU, ward and emergency room. Cognitive engineering methods will be used to map the distributed cognition processes related to multiple cognitive artifacts. The results of this research will provide a basis to assess other proposals for the use of technology in health care information applications.