Susceptibility to illusions and cognitive style: implications for pharmacy dispensing.

Response distributions for five cognitive illusions and one visual illusion were examined in two samples, college students (n = 134) and pharmacists (n = 51). These illusions were selected for study on the basis of pharmacists' judgments about associations of illusions to common dispensing errors. Participants were categorized as Illusion-prone or Illusion-resistant, and distributions of such tendencies for the six stimuli used varied within samples. Significant differences between the two samples on illusion-proneness and resistance were observed for the "Moses' Ark" and -Fcount" illusions. Associations of Illusion-prone and Illusion-resistant responses to field-dependence, psychological type, and the cognitive orientations derived from Psychological Type Theory were examined. Field-independence-field-dependence was the only cognitive dimension associated with Illusion-prone and Illusion-resistant responding. Implications of the data for developing measures based upon visual and cognitive illusions to identify people with error-prone tendencies were discussed.

Workload, error detection, and experienced stress in a simulated pharmacy verification task.

The relationships among workload, stress, and performance efficiency are topics of applied interest and theoretical importance to researchers concerned with human performance. Such interest extends to a variety of occupational areas including inpatient, outpatient, and community pharmacies. In that context, these relationships have become a consumer health issue given concerns that workload contributes to job stress and a significant decline in dispensing accuracy. In the present study, 102 trained college-aged individuals evaluated simulated pharmacy prescriptions for errors under conditions of either low workload (72 orders over 120 min. on task) or high workload (120 orders over 120 min. on task) in a high-fidelity simulated pharmacy environment. Overall, cumulative and detection theory indices of error detection were compatible with estimates from pharmacy field studies. When rates of sensitivity and specificity for detection were examined, substantial variations in the identification of errors (sensitivity) and difficulties with detection of data-entry mistakes were observed in the high workload condition, but only modest effects emerged for the low workload condition. Although increases in objective workload were associated with modest declines in detection accuracy, objective workload did not significantly affect negative mood (Mood Adjective Checklist) or perceived workload (NASA-Task Load Index) as expected.

Improving accuracy in simulated pharmacy assembly tasks using workspace interventions to enhance the cognitive environment.

In this study, the error-reducing effectiveness of two work-environment interventions was examined in a simulated pharmacy task. 110 participants worked for 3 to 4 hours filling approximately 110 orders for simulated drugs in a laboratory-based, controlled environment. One group of participants used a monitor-mounted copy strip to enhance data entry, and another group used the copy strips as well as labeled product sleeves on stock bottles to enhance product selection. Results indicated that participants who worked using copy strips as well as participants who worked using both copy strips and product sleeves were more accurate in their order-filling performance than participants in the control condition. However, participants in the copy strip and the copy strip/sleeve conditions did not differ from one another in accuracy. Further research ideas and potential explanations of these data are discussed.

Automatic-controlled information processing and error detection in a simulated pharmacy-verification task.

The relationships between attentional variables and information-processing demands of pharmacy dispensing tasks that contribute to difficulties in cognitive performance are not well-known. In the present study, a psychological approach to medical dispensing errors, the cognitive-systems performance model of Grasha, was employed to evaluate the contributions of individual differences in attention and alterations in visual task information on simulated pharmacy-verification performance, perceived workload, and self-reported stress. 73 college-age volunteers completed a pretest battery containing psychological measures of automatic and controlled information processing, and one-week later spent 265 min. completing the end visual-inspection process for 200 simulated prescriptions, 27% of which contained artificially inserted errors. Evidence suggesting that both automatic and controlled processes underlie performance of a simulated pharmacy-verification task was obtained. Individual differences in controlled information processing were mildly predictive of detection accuracy, while contrary to expectations, automatic processing scores did not produce significant relationships. Detection associated with experimental alterations in font size (12-pt. vs 6-pt.) of critical prescription label information was partially in line with expectations from the cognitive-systems performance model, while additional visual enhancements via a magnification/illumination device yielded mixed results. Finally, reports of perceived workload (NASA Task Load Index) and specific patterns of self-reported stress (Dundee Stress State Questionnaire) were consistent with a three-tier behavioral framework offered recently by Matthews, Davies, Westerman, and Stammers for predicting behaviors along the automatic-controlled continuum.