A preliminary study to identify critical factors for evaluating the effect of car-lock sounds on drivers.

Car-lock sounds are designed to inform the lock status of vehicles. However, drivers often experience a lack of confidence regarding whether the car is locked, and car thefts persistently occur, frequently attributed to unlocked doors. Without identification of critical factors for evaluating effects of car-lock sounds on drivers, a strategy to car-lock sound design with increased locking efficiency remains implicit. This study proposes a method to identify critical factors influencing drivers' perceived certainty of car-lock status and behaviours during car-locking. An experiment was conducted to simulate the locking process and verbal protocol analysis was employed to comprehend participants' cognitive processes and behaviours. The results show that mechanical sound yielded high certainty and few hesitations, while tonal and crisp sound elicited low certainty and frequent hesitations. Seven critical factors on participants' behaviours and cognitive processes were identified, which provides a data-driven approach for future research in car-lock sounds evaluation and design.

The effect of car-lock sounds on drivers is significant to inform the locking status of vehicles. However, the strategy for car-lock sounds evaluation remains implicit. This study proposes a method to identify critical factors on drivers' behaviours and cognitive processes that would inform further car-lock sounds evaluation and design.

Investigating the clinical decision-making of nursing students using high-fidelity simulation, observation and think aloud: A mixed methods research study.

AIMS: The aim of this study was to investigate nursing students' clinical decision-making by using high-fidelity simulation of a deteriorated patient scenario. DESIGN: A convergent parallel mixed methods research design was used consisting of quantitative and qualitative data collection. METHODS: Twenty-three students completed the Health Science Reasoning Test before and after the simulation between October 2015 and June 2016. They were presented with a simulated scenario and asked to 'think aloud' during and after the simulation. The students were audio-video recorded and observations were collected by the researcher. RESULTS: There was a significant moderate increase in the 'deduction' and 'analysis' sub-scale scores and overall test score, suggestive of improved analytical decision-making processes through the simulation experience. Think-aloud and observation data identified that students predominantly applied 'forward' reasoning during the simulated 'patient's' deterioration, focusing mainly on cue acquisition. 'Backward' reasoning with a focus on cue interpretation was most prominent in the debriefing data, in line with the survey outcomes. Accurate cue interpretation of critical, key cues appeared more useful than the total number of cues in solving the main clinical case problem. CONCLUSION: Students learn different clinical decision-making skills during the simulation compared to what they learn from debriefing. Using observation and think-aloud methods have significant benefits for researchers seeking to optimize the evaluation of the clinical decision-making process.

A preliminary study to identify data needs for improving fit of hand and wrist orthosis using verbal protocol analysis.

The delayed delivery, poor fitting and discomfort of customised orthoses are reported in rehabilitation clinics as resulting in more invasive interventions. The current practice of orthosis customisation relies heavily upon the experience and fabrication processes of therapists. In order to better understand the current practice, and thus identify data that is required for better comfort moving towards a data-driven customisation, this article describes a study generating working models of therapists. Customisations of hand and wrist orthoses for 18 patients were observed. Verbal protocol analysis was employed to extend the current understanding of fabrication processes. Working models of four therapists were established with quantitative evaluation on major phases, interactive activities and iterations of performing tasks during fabrication, revealing different working models between in- and out-patient departments (e.g. fabrication for in-patients was more complex and focussed on ergonomic fitting whereas fabrication for out-patients paid attention to durability) which were qualitatively explained. Practitioner summary: Fit and comfort are imperative for orthosis design and fabrication, however the current practice of customisation of an orthosis relies upon the experience of individual hand therapist. The article presents working models of hand therapists, and relevant data that would enable customisation of orthosis for better fit. Abbreviations: VPA: verbal protocol analysis; h&w: hand and wrist; LTT: low temperature thermoplastic; ANOVA: analysis of variance.

Proceed with caution: using verbal protocol analysis to measure situation awareness.

Verbal protocol analysis (VPA) is often used to elicit information about the cognitive processes of operators as it provides rich data and can be used in naturalistic settings. Recently VPA has been used to investigate the acquisition and maintenance of situation awareness (SA), and to make comparisons between groups despite a lack of research regarding the efficacy of using VPA for this purpose. This train simulator experiment investigated whether VPA can effectively measure SA. Novice and expert participants were recorded on an audio device while talking aloud throughout the trials and their verbalisations were transcribed verbatim. A coding scheme developed from the transcripts was used to code the verbalisations. Results did not support the use of VPA as a measure of SA but did show that VPA detected differences in SA errors. Potential reasons for the conflicting findings between this experiment and those conducted by other researchers are discussed. Practitioner summary: This paper examined the validity of verbal protocol analysis (VPA) as a situation awareness (SA) measure. A repeated measures experiment was conducted using a train simulator. Normal VPA did not detect changes in SA but a measure of errors did. Caution should be used when using VPA to measure SA. Abbreviations: LETSSA: low-event task subjective situation awareness technique; SA: situation awareness; SAGAT: situation awareness global assessment technique; TPD: train performance display; VPA: verbal protocol analysis.

Is it really good to talk? Testing the impact of providing concurrent verbal protocols on driving performance.

Questions have been raised regarding the impact that providing concurrent verbal protocols has on task performance in various settings; however, there has been little empirical testing of this in road transport. The aim of this study was to examine the impact of providing concurrent verbal protocols on driving performance. Participants drove an instrumented vehicle around a set route, twice whilst providing a concurrent verbal protocol, and twice without. A comparison revealed no differences in behaviour related to speed, braking and steering wheel angle when driving mid-block, but a significant difference in aspects of braking and acceleration at roundabouts. When not providing a verbal protocol, participants were found to brake harder on approach to a roundabout and accelerate more heavily coming out of roundabouts. It is concluded that providing verbal protocols may have a positive effect on braking and accelerating. Practical implications related to driver training and future research are discussed. Practitioner Summary: Verbal protocol analysis is used by ergonomists to understand aspects of cognition and decision-making during complex tasks such as driving and control room operation. This study examines the impact that it has on driving performance, providing evidence to support its continued use in ergonomics applications.

Development of a mental script for the mental practice of micro suturing: a methodological approach.

INTRODUCTION: Motor imagery and mental practice are important for the acquisition and mastery of surgical skills. The success of this technique relies on the use of a well-developed mental script. In this study, we shared how we developed a mental script for basic micro suturing training by using a low-fidelity rubber glove model. METHODS: This study applied the design and development research framework. Five expert surgeons developed a mental script by performing a cognitive walkthrough to repair a vertical opening in a rubber glove model, followed by hierarchical task analysis. A draft script was created, and its face and content validity assessed with a checking-back process. Twenty-eight surgeons used the Mental Imagery Questionnaire (MIQ) to assess the validity of the final script. RESULTS: The process of developing the mental script is detailed. The assessment by the expert panel showed the mental script had good face and content validity. The mean overall MIQ score was 5.2±1.1 (standard deviation), demonstrating the validity of generating mental imagery from the mental script developed in this study for micro suturing in the rubber glove model. CONCLUSION: The methodological approach described in this study is based on a design and development research framework to teach surgical skills. This model is inexpensive and easily accessible, addressing the challenges of reduced opportunities to practise surgical skills. However, although motor skills are important, the surgeon's other non-technical expertise is not addressed with this model. Thus, this model should act as one surgical training approach, but not replace it.

Game-XP: Action Games as Experimental Paradigms for Cognitive Science.

Why games? How could anyone consider action games an experimental paradigm for Cognitive Science? In 1973, as one of three strategies he proposed for advancing Cognitive Science, Allen Newell exhorted us to "accept a single complex task and do all of it." More specifically, he told us that rather than taking an "experimental psychology as usual approach," we should "focus on a series of experimental and theoretical studies around a single complex task" so as to demonstrate that our theories of human cognition were powerful enough to explain "a genuine slab of human behavior" with the studies fitting into a detailed theoretical picture. Action games represent the type of experimental paradigm that Newell was advocating and the current state of programming expertise and laboratory equipment, along with the emergence of Big Data and naturally occurring datasets, provide the technologies and data needed to realize his vision. Action games enable us to escape from our field's regrettable focus on novice performance to develop theories that account for the full range of expertise through a twin focus on expertise sampling (across individuals) and longitudinal studies (within individuals) of simple and complex tasks.

Registered nurses' clinical reasoning in home healthcare clinical practice: A think-aloud study with protocol analysis.

BACKGROUND: The home healthcare context can be unpredictable and complex, and requires registered nurses with a high level of clinical reasoning skills and professional autonomy. Thus, additional knowledge about registered nurses' clinical reasoning performance during patient home care is required. OBJECTIVES: The aim of this study is to describe the cognitive processes and thinking strategies used by recently graduated registered nurses while caring for patients in home healthcare clinical practice. DESIGN: An exploratory qualitative think-aloud design with protocol analysis was used. SETTINGS: Home healthcare visits to patients with stroke, diabetes, and chronic obstructive pulmonary disease in seven healthcare districts in southern Norway. PARTICIPANTS: A purposeful sample of eight registered nurses with one year of experience. METHODS: Each nurse was interviewed using the concurrent think-aloud technique in three different patient home healthcare clinical practice visits. A total of 24 home healthcare visits occurred. Follow-up interviews were conducted with each participant. The think-aloud sessions were transcribed and analysed using three-step protocol analysis. RESULTS: Recently graduated registered nurses focused on both general nursing concepts and concepts specific to the domains required and tasks provided in home healthcare services as well as for different patient groups. Additionally, participants used several assertion types, cognitive processes, and thinking strategies. CONCLUSIONS: Our results showed that recently graduated registered nurses used both simple and complex cognitive processes involving both inductive and deductive reasoning. However, their reasoning was more reactive than proactive. The results may contribute to nursing practice in terms of developing effective nursing education programmes.

State-space and verbal protocol methods for studying the human operator in process control.

This paper presents a variety of methods founded in cognitive science for examining the behaviour of the human operator in process control. The waterbath task described by Crossman and Cooke (1974) and by Moray et al. (1986) is taken as a basic process control laboratory paradigm for applying these methods in an integrated approach. First, the waterbath task itself was analysed and a graphical representation developed to show relations between system variables (various valve and heater settings) and state variables (volume, temperature and flow rate). From this a representation of possible correct knowledge about the waterbath was developed. Second, a classification was made of the different states the waterbath system could be in with respect to an operator's goal state. A state-action diagram identified the correct control action or actions to travel from each state to the goal. This provided a basis for predicting the types of difficulties operators might have. Results of an experiment snowed that the need to coordinate several control actions to reach a goal was a source of difficulty. Subjects consistently misunderstood the relation between variables and performance data showed poorer performance when these variables had to be controlled. Verbal protocol data showed how often and how accurately subjects discussed particular aspects of the waterbath system. It was possible to piece together fragments of a subject's whole system of knowledge. Overall, the methods discussed contrast possible actions and knowledge with actual actions and knowledge. They represent a promising collection of data reduction techniques for studying the human operator in process control.

Evaluating the effects of cognitive support on psychiatric clinical comprehension.

OBJECTIVE: Clinicians' attention is a precious resource, which in the current healthcare practice is consumed by the cognitive demands arising from complex patient conditions, information overload, time pressure, and the need to aggregate and synthesize information from disparate sources. The ability to organize information in ways that facilitate the generation of effective diagnostic solutions is a distinguishing characteristic of expert physicians, suggesting that automated systems that organize clinical information in a similar manner may augment physicians' decision-making capabilities. In this paper, we describe the design and evaluation of a theoretically driven cognitive support system (CSS) that assists psychiatrists in their interpretation of clinical cases. The system highlights, and provides the means to navigate to, text that is organized in accordance with a set of diagnostically and therapeutically meaningful higher-level concepts. METHODS AND MATERIALS: To evaluate the interface, 16 psychiatry residents interpreted two clinical case scenarios, with and without the CSS. Think-aloud protocols captured during their interpretation of the cases were transcribed and analyzed qualitatively. In addition, the frequency and relative position of content related to key higher-level concepts in a verbal summary of the case were evaluated. In addition the transcripts from both groups were compared to an expert derived reference standard using latent semantic analysis (LSA). RESULTS: Qualitative analysis showed that users of the system better attended to specific clinically important aspects of both cases when these were highlighted by the system, and revealed ways in which the system mediates hypotheses generation and evaluation. Analysis of the summary data showed differences in emphasis with and without the system. The LSA analysis suggested users of the system were more "expert-like" in their emphasis, and that cognitive support was more effective in the more complex case. CONCLUSIONS: Cognitive support impacts upon clinical comprehension. This appears to be largely helpful, but may also lead to neglect of information (such as the psychosocial history) that the system does not highlight. The results have implications for the design of CSSs for clinical narratives including the role of information organization and textual embellishments for more efficient clinical case presentation and comprehension.