Operators believe patient-specific rehearsal improve individual and team performance.

INTRODUCTION: Rehearsing endovascular aortic aneurysm repair on patient-specific data is recent within virtual reality simulation and opens up new possibilities for operators to prepare for complex procedures. This study evaluated the feasibility of patient-specific rehearsal (PsR) and assessed operators' appraisal of the VIST-LAB simulator from Mentice. MATERIAL AND METHODS: CT-data was segmented and uploaded to the simulator, and simulated for 30 elective EVAR patients. Operators were asked how they perceived the PsR on a Likert scale after the PsR (once) and after the following procedure (each time). RESULTS: Patients were simulated and operated by 14 operators, always in pairs of one vascular surgeon and one interventional radiologist. The operators estimated that PsR improved individual and team performance (median 4), and recommended the use of PsR in general (median 4) and for difficult cases (median 5). The simulator realism got moderate scores (median 2-3). Inexperienced operators seemed to appreciate the PsR the most. CONCLUSIONS: PsR was feasible and was evaluated by operators to improve individual and team performance. Inexperienced users were more positive towards PsR than experienced users. PsR realism and the ease of importing patient-specific data can still be improved, and further studies to quantify and precisely identify benefits are needed.

Johnny was here: From airmanship to airlineship.

In this article we explore the phenomenon of airmanship in commercial passenger flights, in a context of increasing standardisation of procedures and technologies. Through observation studies in cockpits and interviews we have studied pilots' practices and how they relate to the larger system of procedures and the technical environment. We find that practices are to a large extent guided by standard operating procedures, and that interchangeability of pilots and aircrafts is both a prerequisite for and enabled by this standardised regime. However, since sociotechnical systems in general - and operation of aircrafts is no exception - are inherently underspecified, the pilots' exercise of discretion in their context-sensitive adaptation of the procedures and technical environments is another prerequisite for well-functioning systems. Mastering these adaptations - and recognising the absolute delimitations of adaptations - is a central aspect of airmanship. Outside this space of manoeuvre for the pilots, the aircrafts are managed by what we call airlineship: The inter-organisational efforts to create predictability and safe practices through de-identification and interchangeability of personnel and aircrafts. Pilots are actors in sociotechnical systems that are not demarcated by the cockpits. To understand pilots' work, studies must account also for the wider sociotechnical context of organisational, regulative and techno-material structures. The article is a contribution to the a generic attempt in the field of ergonomics to contribute with models and theories that portray individuals, groups, organisations and systems in ways that keep sight of the individuals in the systems and the systems in the individuals at the same time.