Evaluating how residents talk and what it means for surgical performance in the simulation lab.

BACKGROUND: This paper explores a method for assessing intraoperative performance by modeling how surgeons integrate skills and knowledge through discourse. METHODS: Senior residents (N = 11) were recorded while performing a simulated laparoscopic ventral hernia (LVH) repair. Audio transcripts were coded for five discourse elements related to knowledge, skills, and operative independence. Epistemic network analysis was used to model the ordered integration of the five discourse elements. RESULTS: Participants with poorer hernia repair outcomes had stronger connections between the discourse elements operative planning and asking for information or advice (Operative planning), while participants with better hernia repair outcomes had stronger connections between the discourse elements giving assistant instructions and identifying errors (Operative management): (p = .006; Cohen's d = 2.79). CONCLUSION: Participants with better hernia repair outcomes engaged in more operative management communication during the simulated procedure. This ability to integrate multiple operative steps and verbally communicate them significantly correlated with better operative outcomes.

Look together: analyzing gaze coordination with epistemic network analysis.

When conversing and collaborating in everyday situations, people naturally and interactively align their behaviors with each other across various communication channels, including speech, gesture, posture, and gaze. Having access to a partner's referential gaze behavior has been shown to be particularly important in achieving collaborative outcomes, but the process in which people's gaze behaviors unfold over the course of an interaction and become tightly coordinated is not well understood. In this paper, we present work to develop a deeper and more nuanced understanding of coordinated referential gaze in collaborating dyads. We recruited 13 dyads to participate in a collaborative sandwich-making task and used dual mobile eye tracking to synchronously record each participant's gaze behavior. We used a relatively new analysis technique-epistemic network analysis-to jointly model the gaze behaviors of both conversational participants. In this analysis, network nodes represent gaze targets for each participant, and edge strengths convey the likelihood of simultaneous gaze to the connected target nodes during a given time-slice. We divided collaborative task sequences into discrete phases to examine how the networks of shared gaze evolved over longer time windows. We conducted three separate analyses of the data to reveal (1) properties and patterns of how gaze coordination unfolds throughout an interaction sequence, (2) optimal time lags of gaze alignment within a dyad at different phases of the interaction, and (3) differences in gaze coordination patterns for interaction sequences that lead to breakdowns and repairs. In addition to contributing to the growing body of knowledge on the coordination of gaze behaviors in joint activities, this work has implications for the design of future technologies that engage in situated interactions with human users.

A novel paradigm for engineering education: virtual internships with individualized mentoring and assessment of engineering thinking.

Engineering virtual internships are a novel paradigm for providing authentic engineering experiences in the first-year curriculum. They are both individualized and accommodate large numbers of students. As we describe in this report, this approach can (a) enable students to solve complex engineering problems in a mentored, collaborative environment; (b) allow educators to assess engineering thinking; and (c) provide an introductory experience that students enjoy and find valuable. Furthermore, engineering virtual internships have been shown to increase students'-and especially women's-interest in and motivation to pursue engineering degrees. When implemented in first-year engineering curricula more broadly, the potential impact of engineering virtual internships on the size and diversity of the engineering workforce could be dramatic.