Index Finger Muscle Fatigue and Pistol Firing Failure

OBJECTIVE

The aim of this study was to analyze finger strength and effects of muscle fatigue on the ability to shoot.

BACKGROUND

The finger and hand muscles of soldiers are subject to high loads. For example, the trigger pull of military pistols can amount up to 58 N (≈6 kg) and could cause muscle fatigue in the trigger finger. For soldiers, however, maintaining the ability to shoot is essential for self-defense and survival.

METHOD

The marksmanship training of 30 German soldiers (15 female) ages 18 to 40 years was evaluated. Three consecutive exercises with a total of 60 rounds were fired from target ranges of 5 and 10 m, equally using a single-action and double-action trigger mode. Maximum voluntary isometric contraction of the index finger (MVC_IF) was measured before and after each of the three firing exercises.

RESULTS

Shooting reduced MVC_IF in female (88.2 ± 15.8 N to 67.3 ± 17.7 N, p < .001) and male soldiers (145.8 ± 21.7 N to 112.7 ± 26.6 N, p < .001). Of the 30 subjects, 23 were unable to shoot due to fatigue, including 15 of 15 female soldiers. The higher MVC_IF was at rest, the less commonly (r = .73, p < .001) and the later (r = 0.82, p < .001) task failure occurred. Two intermissions of approximately 6 min did not suffice for a significant recovery.

CONCLUSION

Excessive trigger pull weight causes muscle fatigue of the index finger and can ultimately lead to task failure during pistol marksmanship training. Short breaks are insufficient for the recovery of finger muscles.

APPLICATION

This study presents a new perspective on ideal trigger pull weight, which should be carefully considered by manufacturers to allow repetitive firing and simultaneously ensure safe handling.

Influence of Human Parameters on Labor Productivity in the Construction Industry

OBJECTIVE

The objective of this article is to investigate the influence of human parameters on qualitative assessment of labor productivity (LP) in the construction industry.

BACKGROUND

The theories involving workers have identified various parameters on physical efficiency, such as heart rate, relative heart rate, and calorie count, so as to improve the safety and social conditions of construction labor, thereby increasing LP. However, there is no direct emphasis on assessment of LP using human parameters related to physical strength.

METHOD

An exploratory study was conducted on 17 construction workers by observing their task-level LP in real time at a construction site. Human parameters, such as age, body mass index (BMI), handgrip strength, and upper body muscle strength of the laborers, were measured at the construction site. Performance levels of these workers were placed in three categories, and each worker was assigned a typical weightage to each category when correlated to physical strength.

RESULTS

Labor categories among the human parameters that included middle age, normal-range BMI, and strong muscular strength were shown as having higher LP than others. A quantitative parameter called the Human Parameter Index (HPI) was developed based on the performance categories developed for an individual worker. Human parameters revealed a significant relationship with respect to task-level LP.

CONCLUSION AND APPLICATION

The study determines the influence of human parameters on LP in construction. Introduction of human parameters in the construction industry will help in assessment of LP for various labor-intensive activities.

Using the OVAKO working posture analysis system in cleaning occupations

BACKGROUND

Cleaning workers experience severe musculoskeletal symptoms.

OBJECTIVE

The objective of this paper was to examine musculoskeletal symptoms in cleaners of different heights to evaluate the effects of height on working postures in the work environment (schools).

METHODS

We used a three-stage method including using the Nordic Musculoskeletal Questionnaire (NMQ) to evaluate musculoskeletal symptoms, a task analysis to confirm typical cleaning tasks, and the OVAKO Working Posture Assessment System (OWAS) for posture analysis. Multinomial logistic regression was performed to evaluate the adjusted effects of individual characteristics on painful body regions, using individuals without any pain as the reference category.

RESULTS

This study found that the prevalence of musculoskeletal symptoms is very high for cleaners, especially in the shoulders, elbows, and lower back. Odds ratios for the accumulation of two or more risk factors were higher among men and were inversely associated with national economic indicators. The relatively high prevalence of musculoskeletal symptoms may stem from the multiple operations involved in cleaning tasks, such as trash collecting, floor mopping, toilet cleaning, and mirror polishing. Workers of different heights had differential work loadings for different tasks.

CONCLUSIONS

This paper proposes recommendations for job adaptations and occupational safety training. Cleaners of different heights execute the typical tasks via different postures, and awkward postures often result in musculoskeletal symptoms. Cleaners should be provided with specific tools and training regarding working postures on the basis of height. These findings can be used as a reference for related operation designs and task improvements to ensure correct tool usage and safer working postures during cleaning.

The Effects of a Self-Instruction Package and Group Training on Trial-Based Functional Analysis Administration

This study examined the effects of a self-instruction package comprised of a task analysis data sheet, detailed written instructions, and a small group performance feedback training on the training of 12 undergraduate students to conduct trial-based functional analyses (TBFAs). In contrast to previous research, training omitted technical language and did not include didactic instruction on the principles of applied behavior analysis or the underlying rationale for functional analysis methodology. Although the self-instruction package produced significant increases in performance and reliable data collection on the targeted problem behavior, small group performance feedback training was necessary to achieve mastery across all trial types. Results offer a socially valid training package to teach paraprofessionals to assist Board Certified Behavior Analysts® in conducting TBFAs in applied settings.

It's Complicated: Patient and Informal Caregiver Performance of Outpatient Parenteral Antimicrobial Therapy-Related Tasks

Outpatient parenteral antimicrobial therapy (OPAT) requires patients and caregivers to infuse antimicrobials through venous catheters (VCs) in the home. The objective of this study was to perform a patient-centered goal-directed task analysis to identify what is required for successful completion of OPAT. The authors performed 40 semi-structured patient interviews and 20 observations of patients and caregivers performing OPAT-related tasks. Six overall goals were identified: (1) understanding and developing skills in OPAT, (2) receiving supplies, (3) medication administration and VC maintenance, (4) preventing VC harm while performing activities of daily living, (5) managing when hazards lead to failures, and (6) monitoring status. The authors suggest that patients and caregivers use teach-back, take formal OPAT classes, receive visual and verbal instructions, use cognitive aids, learn how to troubleshoot, and receive clear instructions to address areas of uncertainty. Addressing these goals is essential to ensuring the safety of and positive experiences for our patients.

How Does Therapy Harm? A Model of Adverse Process Using Task Analysis in the Meta-Synthesis of Service Users' Experience

Background: Despite repeated discussion of treatment safety, there remains little quantitative research directly addressing the potential of therapy to harm. In contrast, there are numerous sources of qualitative evidence on clients' negative experience of psychotherapy, which they report as harmful.

Objective: To derive a model of process factors potentially leading to negative or harmful effects of therapy, from the clients' perspective, based on a systematic narrative synthesis of evidence on negative experiences and effects of psychotherapy from (a) qualitative research findings and (b) participants' testimony.

Method: We adapted Greenberg (2007) task analysis as a discovery-oriented method for the systematic synthesis of qualitative research and service user testimony. A rational model of adverse processes in psychotherapy was empirically refined in two separate analyses, which were then compared and incorporated into a rational-empirical model. This was then validated against an independent qualitative study of negative effects.

Results: Over 90% of the themes in the rational-empirical model were supported in the validation study. Contextual issues, such as lack of cultural validity and therapy options together with unmet client expectations fed into negative therapeutic processes (e.g., unresolved alliance ruptures). These involved a range of unhelpful therapist behaviors (e.g., rigidity, over-control, lack of knowledge) associated with clients feeling disempowered, silenced, or devalued. These were coupled with issues of power and blame.

Conclusions: Task analysis can be adapted to extract meaning from large quantities of qualitative data, in different formats. The service user perspective reveals there are potentially harmful factors at each stage of the therapy journey which require remedial action. Implications of these findings for practice improvement are discussed.

The Common Time Course of Memory Processes Revealed

Magnetoencephalography (MEG) was used to compare memory processes in two experiments, one involving recognition of word pairs and the other involving recall of newly learned arithmetic facts. A combination of hidden semi-Markov models and multivariate pattern analysis was used to locate brief "bumps" in the sensor data that marked the onset of different stages of cognitive processing. These bumps identified a separation between a retrieval stage that identified relevant information in memory and a decision stage that determined what response was implied by that information. The encoding, retrieval, decision, and response stages displayed striking similarities across the two experiments in their duration and brain activation patterns. Retrieval and decision processes involve distinct brain activation patterns. We conclude that memory processes for two different tasks, associative recognition versus arithmetic retrieval, follow a common spatiotemporal neural pattern and that both tasks have distinct retrieval and decision stages.

A New Software Platform to Improve Multidisciplinary Tumor Board Workflows and User Satisfaction: A Pilot Study

Background

Workflow and preparation for holding multidisciplinary cancer case reviews (i.e., Tumor Boards) is time-consuming and cumbersome. Use of a software platform might improve this process. This pilot study assessed the impact of a new software platform on tumor board preparation workflow and user satisfaction compared to current methods.

Materials and Methods

Using current methods and the NAVIFY Tumor Board Solution, this study assessed the number of tasks and time to prepare tumor board cases. Participants completed online surveys assessing ease of use and satisfaction with current and new platforms.

Results

A total of 41 sessions included two surgeons, two oncologists, two pathologists, and two radiologists preparing tumor board cases with 734 tasks were recorded. Overall, there was no difference in the number of tasks using either preparation method (341 current, 393 NAVIFY Tumor Board solution). There was a significant difference in overall preparation time as a function of specialty (F = 71.74, P < 0.0001), with oncologists, radiologists, and surgeons having reduced times with NAVIFY Tumor Board solution compared to the current platform and pathologists having equivalent times. There was a significant difference (F = 38.98, P < 0.0001) for times as a function of task category. Review of clinical course data and other preparation tasks decreased significantly, but pathology and radiology review did not differ significantly. The new platform received higher ratings than the current methods on all survey questions regarding the ease of use and satisfaction.

Conclusions

The study supported the hypothesis that the new software platform can improve Tumor Board preparation. Further study is needed to assess the impact of this platform in different hospitals, different data storage systems, with different observers, and different types of Tumor board cases as well as its impact on the quality of the tumor board discussion.

The Development of a Methodology for Contextual User Research in Healthcare Design Projects

The impact of human factors in the usage of medical devices and delivery of healthcare is increasingly being recognized as a significant contributor to patient experience and safety. This paper presents a methodology for undertaking contextual user research during healthcare design projects (in home, primary or acute care settings) by which all relevant human factors of a procedure can be recorded, documented and analyzed. An innovative method of graphically representing the results of this analysis is proposed which visualizes the interactions and interdependencies between all stakeholders and artefacts involved in a procedure and the environment in which it takes place. The proposed methodology is intended to assist researchers, designers, architects and healthcare professionals during the research phase of a healthcare design project to reveal user needs, identify potential risks, provide documentation for regulatory adherence and inform the development of a comprehensive and inclusive design brief. The paper presents the context and development of this systematic process, which draws on empirical and theoretical methodologies, a studio based pedagogy, and the experience of delivering real-world educational design projects in partnership with healthcare clinicians and medical device companies. It also highlights the capacity for this form of learning to align with Universal Design for Learning (UDL) principles. The application of the methodology has the ability to extract key environmental, user and human factors insights. Most importantly, these insights can inform the design process, positively impact on patient experience and safety through improvements in device development and care delivery, and enable the creation of more inclusive and accessible healthcare solutions.

Corrective emotional experience in an integrative affect-focused therapy: Building a preliminary model using task analysis

OBJECTIVE

The present study constructed a preliminary process model of corrective emotional experience (CEE) in an integrative affect-focused therapy.

METHOD

Task analysis was used to analyse 6 in-session events taken from 6 Japanese clients who worked with an integrative affect-focused therapist. The 6 events included 3 successful CEEs and 3 partially successful CEEs for comparison.

RESULTS

A rational-empirical model of CEE was generated, which consisted of two parallel client change processes, intrapersonal change and interpersonal change, and the therapist interventions corresponding to each process. Therapist experiential interventions and therapist affirmation facilitated both intrapersonal and interpersonal change processes, whereas his relational interventions were associated with the interpersonal change process. The partially successful CEEs were differentiated by the absence of the component of core painful emotions or negative beliefs in intrapersonal change process, which seemed crucial for the interpersonal change process to develop.

CONCLUSIONS

CEE is best represented by a preliminary model that depicts two parallel yet interacting change processes. Intrapersonal change process is similar to the sequence of change described by the emotional processing model (Pascual-Leone & Greenberg, ), whereas interpersonal change process is a unique contribution of this study. Interpersonal change process was facilitated when the therapist's active stance and use of immediacy responses to make their relational process explicit allowed a shared exploration. Therapist affirmation bridged intrapersonal change to interpersonal change by promoting an adaptive sense of self in clients and forging a deeper emotional connection between the two.

Full-shift and task-specific upper extremity muscle activity among US large-herd dairy parlour workers

US large-herd dairy parlour workers experience a high prevalence of musculoskeletal symptoms in the upper extremity. The purpose of this study was to estimate and compare full-shift and task-specific muscle activity of the upper extremity among parlour workers. Surface electromyography data were recorded continuously throughout a full work shift for each participant (n = 60). For a subset of participants (n = 33), muscular effort was estimated for milking task cycles. Lower muscle activity levels and higher per cent muscular rest was observed among rotary parlour participants as compared to herringbone and parallel parlour participants for anterior deltoid, forearm flexor and forearm extensor muscles. These findings suggest rotary parlours may offer workstation designs or work organisational dynamics which may be more beneficial to the health and performance of the worker, as compared to parallel or herringbone parlours. Practitioner Summary: Study findings suggest milking parlour configurations present different biomechanical demands on workers which may influence worker health and performance. Our findings will enable more informed decisions regarding both engineering (e.g. parlour configuration or milking equipment) and administrative (e.g. work organisation) control strategies for large-herd milking parlours.

Simulation training in neurosurgery: advances in education and practice

The current simulation technology used for neurosurgical training leaves much to be desired. Significant efforts are thoroughly exhausted in hopes of developing simulations that translate to give learners the "real-life" feel. Though a respectable goal, this may not be necessary as the application for simulation in neurosurgical training may be most useful in early learners. The ultimate uniformly agreeable endpoint of improved outcome and patient safety drives these investments. We explore the development, availability, educational taskforces, cost burdens and the simulation advancements in neurosurgical training. The technologies can be directed at achieving early resident milestones placed by the Accreditation Council for Graduate Medical Education. We discuss various aspects of neurosurgery disciplines with specific technologic advances of simulation software. An overview of the scholarly landscape of the recent publications in the realm of medical simulation and virtual reality pertaining to neurologic surgery is provided. We analyze concurrent concept overlap between PubMed headings and provide a graphical overview of the associations between these terms.

The Revised Strain Index: an improved upper extremity exposure assessment model

The Revised Strain Index (RSI) is a distal upper extremity (DUE) physical exposure assessment model based on: intensity of exertion, frequency of exertion, duration per exertion, hand/wrist posture and duration of task per day. The RSI improves upon the 1995 Strain Index (SI) by using continuous rather than categorical multipliers, and replacing duty cycle with duration per exertion. In a simulation of 13,944 tasks, the RSI and 1995 SI showed good agreement in risk predictions for 1995 SI scores ≤3 (safe) and >13.5 (hazardous). For tasks with 1995 SI scores of >3 and ≤13.5, the two models showed marked disagreement, with the RSI providing much greater discriminations between 'safe' and 'hazardous' tasks for various combinations of force, repetition and duty cycle. We believe the RSI is a substantially improved model that will be useful for DUE task analysis, intervention and design. Practitioner Summary: RSI is a substantial improvement over the 1995 SI. It should be a valuable tool for designing and analysing tasks to determine risk of musculoskeletal injuries. RSI is applicable to a wide variety of tasks including very low force and very high repetition tasks such as keyboard use.

Education, Practice, and Competency Gaps of Anesthetists in Ethiopia: Task Analysis

PURPOSE

This study assessed the needs and gaps in the education, practice and competencies of anesthetists in Ethiopia.

DESIGN

A cross-sectional study design was used.

METHODS

A questionnaire consisting of 74 tasks was completed by 137 anesthetists who had been practicing for 6 months to 5 years.

FINDINGS

Over half of the respondents rated 72.9% of the tasks as being highly critical to patient outcomes, and reported that they performed 70.2% of all tasks at a high frequency. More than a quarter of respondents reported that they performed 15 of the tasks at a low frequency. Nine of the tasks rated as being highly critical were not learned during pre-service education by more than one-quarter of study participants, and over 10% of respondents reported that they were unable to perform five of the highly critical tasks.

CONCLUSIONS

Anesthetists rated themselves as being adequately prepared to perform a majority of the tasks in their scope of practice.

Development of performance and error metrics for ultrasound-guided axillary brachial plexus block

PURPOSE

Change in the landscape of medical education coupled with a paradigm shift toward outcome-based training mandates the trainee to demonstrate specific predefined performance benchmarks in order to progress through training. A valid and reliable assessment tool is a prerequisite for this process. The objective of this study was to characterize ultrasound-guided axillary brachial plexus block to develop performance and error metrics and to verify face and content validity using a modified Delphi method.

METHODS

A metric group (MG) was established, which comprised three expert regional anesthesiologists, an experimental psychologist and a trained facilitator. The MG deconstructed ultrasound-guided axillary brachial plexus block to identify and define performance and error metrics. Experts reviewed five video recordings of the procedure performed by anesthesiologists with different levels of expertise to aid task deconstruction. Subsequently, the MG subjected the metrics to "stress testing", a process to ascertain the extent to which the performance and error metrics could be scored objectively, either occurring or not occurring with a high degree of reliability. Ten experienced regional anesthesiologists used a modified Delphi method to reach consensus on the metrics.

RESULTS

Fifty-four performance metrics, organized in six procedural phases and characterizing ultrasound-guided axillary brachial plexus block and 32 error metrics (nine categorized as critical) were identified and defined. Based on the Delphi panel consensus, one performance metric was modified, six deleted and three added.

CONCLUSION

In this study, we characterized ultrasound-guided axillary brachial plexus block to develop performance and error metrics as a prerequisite for outcome-based training and assessment. Delphi consensus verified face and content validity.

Letter regarding 'Comparison between low-cost marker-less and high-end marker-based motion capture systems for the computer-aided assessment of working ergonomics' by Patrizi et al. and research reproducibility

The reporting of research in a manner that allows reproduction in subsequent investigations is important for scientific progress. Several details of the recent study by Patrizi et al., 'Comparison between low-cost marker-less and high-end marker-based motion capture systems for the computer-aided assessment of working ergonomics', are absent from the published manuscript and make reproduction of findings impossible. As new and complex technologies with great promise for ergonomics develop, new but surmountable challenges for reporting investigations using these technologies in a reproducible manner arise. Practitioner Summary: As with traditional methods, scientific reporting of new and complex ergonomics technologies should be performed in a manner that allows reproduction in subsequent investigations and supports scientific advancement.

Human factors and ergonomics assessment of food pantry work: A case study

BACKGROUND

Research assessing work processes in food pantries has been limited to the client's experience and aspects of food donations [3-5]. Research on food pantries has yet to focus on understanding and evaluating worker-environment interaction.

OBJECTIVE

The present case study examined the interaction between workers and their work environment while performing common tasks in a food pantry.

METHODS

Data were collected through naturalistic observations and structured interviews. A task analysis was performed on the data.

RESULTS

Several potential issues in the pantry were identified including with the workspace layout, environmental conditions, and signage. Human factors and ergonomics principles were then utilized to provide insights and recommendations (e.g., use of numbered rather than color-coded signage).

CONCLUSIONS

Recommendations were provided to the case study food pantry for enhancing safety and productivity. Further research is needed to assess the generalizability of our findings to other food pantries.

Practices and risks associated with operation of tie-down lashings in the vehicle transport industry

Load restraint systems in automobile transport utilise tie-down lashings placed over the car's tyres, which are tensioned manually by the operator using a ratchet assembly. This process has been identified as a significant manual handling injury risk. The aim of this study was to gain insight on the current practices associated with tie-down lashings operation, and identify the gaps between current and optimal practice. We approached this with qualitative and quantitative assessments and one numerical simulation to establish: (i) insight into the factors involved in ratcheting; (ii) the required tension to hold the car on the trailer; and (iii) the tension achieved by drivers in practice and associated joint loads. We identified that the method recommended to the drivers was not used in practice. Drivers instead tensioned the straps to the maximum of their capability, leading to over-tensioning and mechanical overload at the shoulder and elbow. We identified the postures and strategies that resulted in the lowest loads on the upper body during ratcheting (using both hands and performing the task with their full body). This research marks the first step towards the development of a training programme aiming at changing practice to reduce injury risks associated with the operation of tie-down lashings in the automobile transport industry. Practitioner Summary: The study investigated current practice associated with the operation of tie-down lashings through qualitative (interviews) and quantitative (biomechanical analysis) methods. Operators tended to systematically over-tension the lashings and consequently overexert, increasing injury risks.

The Perceive, Recall, Plan and Perform (PRPP) system for persons with Parkinson's disease: a psychometric study

BACKGROUND

The Perceive, Recall, Plan & Perform (PRPP) system of task analysis might be feasible to evaluate occupational performance and information processing strategies for persons with Parkinson's disease (PD).

AIM

To evaluate: (1) the random error between raters (inter-rater study), (2) the random error within raters (intra-rater study), and (3) the internal consistency of the PRPP.

MATERIALS AND METHODS

(1) video-recorded performance of meaningful activities of 13 Dutch persons with PD, scored independently by 38 Dutch PRPP trained occupational therapists were included in the analysis. The random error between raters was analyzed with two-way random Intraclass Correlation Coefficients (ICC). (2) Four videos were scored twice by 30 raters (6 week time interval). The random error within raters was analyzed using one-way random ICC's. (3) Internal consistency study: data of 190 persons with PD were analyzed using Cronbach's alpha (α).

RESULTS

Inter-rater reliability ranged from slight to moderate (ICC= 0.06-0.43). The mean intra-rater reliability ranged from moderate to almost perfect (ICC= 0.60-0.83). Internal consistency is good (α = 0.60-0.86).

CONCLUSION

The limited inter-rater reliability but adequate intra-rater reliability and internal consistency show the feasibility of the PRPP when used for persons with PD. Implications for reliable clinical use are discussed.

Contributing to an integrated profession: a model-based examination of the A-ONE

Yerxa's [1] model of an integrated profession depicts a circular scholarly process whereby ideas formed in practice are subjected to research and then returned to practice through education. This knowledge-generating cycle supports occupational science and the development of our professional identity. The aim of this article is to demonstrate how Yerxa's model was used to evaluate if three developmental cycles of the ADL-Focused Occupation-Based Neurobehavioral Evaluation (A-ONE) sufficiently represented all necessary model components required for implementation into practice. The three cycles were historical, educational and measurement. The necessary components included: (a) dilemmas in practice, (b) new ideas that emerged from those practice issues, (c) research to test those ideas and (d) education designed to integrate new knowledge into practice. The results of this analysis of the A-ONE supported adequate research related to ideas from practice being implemented back into practice. Through using the model of an integrated profession to reflect on ideas ignited within practice, and then implementing research to explore the potential contribution of those ideas to knowledge generation, we gain the power to influence the future development of occupational science and the profession.

Self-narrative reconstruction in emotion-focused therapy: A preliminary task analysis

OBJECTIVE

This research explored the consolidation phase of emotion-focused therapy (EFT) for depression and studies-through a task-analysis method-how client-therapist dyads evolved from the exploration of the problem to self-narrative reconstruction.

METHOD

Innovative moments (IMs) were used to situate the process of self-narrative reconstruction within sessions, particularly through reconceptualization and performing change IMs. We contrasted the observation of these occurrences with a rational model of self-narrative reconstruction, previously built.

RESULTS

This study presents the rational model and the revised rational-empirical model of the self-narrative reconstruction task in three EFT dyads, suggesting nine steps necessary for task resolution: (1) Explicit recognition of differences in the present and steps in the path of change; (2) Development of a meta-perspective contrast between present self and past self; (3) Amplification of contrast in the self; (4) A positive appreciation of changes is conveyed; (5) Occurrence of feelings of empowerment, competence, and mastery; (6) Reference to difficulties still present; (7) Emphasis on the loss of centrality of the problem; (8) Perception of change as a gradual, developing process; and (9) Reference to projects, experiences of change, or elaboration of new plans.

CONCLUSIONS

Central aspects of therapist activity in facilitating the client's progression along these nine steps are also elaborated.

Task analysis of laparoscopic camera control schemes

BACKGROUND

Minimally invasive surgeries rely on laparoscopic camera views to guide the procedure. Traditionally, an expert surgical assistant operates the camera. In some cases, a robotic system is used to help position the camera, but the surgeon is required to direct all movements of the system. Some prior research has focused on developing automated robotic camera control systems, but that work has been limited to rudimentary control schemes due to a lack of understanding of how the camera should be moved for different surgical tasks.

METHODS

This research used task analysis with a sample of eight expert surgeons to discover and document several salient methods of camera control and their related task contexts.

RESULTS

Desired camera placements and behaviours were established for two common surgical subtasks (suturing and knot tying).

CONCLUSION

The results can be used to develop better robotic control algorithms that will be more responsive to surgeons' needs. Copyright © 2015 John Wiley & Sons, Ltd.

A functional approach to movement analysis and error identification in sports and physical education

In a hypothesis-and-theory paper, a functional approach to movement analysis in sports is introduced. In this approach, contrary to classical concepts, it is not anymore the "ideal" movement of elite athletes that is taken as a template for the movements produced by learners. Instead, movements are understood as the means to solve given tasks that in turn, are defined by to-be-achieved task goals. A functional analysis comprises the steps of (1) recognizing constraints that define the functional structure, (2) identifying sub-actions that subserve the achievement of structure-dependent goals, (3) explicating modalities as specifics of the movement execution, and (4) assigning functions to actions, sub-actions and modalities. Regarding motor-control theory, a functional approach can be linked to a dynamical-system framework of behavioral shaping, to cognitive models of modular effect-related motor control as well as to explicit concepts of goal setting and goal achievement. Finally, it is shown that a functional approach is of particular help for sports practice in the context of structuring part practice, recognizing functionally equivalent task solutions, finding innovative technique alternatives, distinguishing errors from style, and identifying root causes of movement errors.

Task analysis of information technology-mediated medication management in outpatient care

Aims

Educating physicians in the procedural as well as cognitive skills of information technology (IT)-mediated medication management could be one of the missing links for the improvement of patient safety. We aimed to compose a framework of tasks that need to be addressed to optimize medication management in outpatient care.

Methods

Formal task analysis: decomposition of a complex task into a set of subtasks. First, we obtained a general description of the medication management process from exploratory interviews. Secondly, we interviewed experts in-depth to further define tasks and subtasks. Setting: Outpatient care in different fields of medicine in six teaching and academic medical centres in the Netherlands and the United States. Participants: 20 experts. Tasks were divided up into procedural, cognitive and macrocognitive tasks and categorized into the three components of dynamic decision making.

Results

The medication management process consists of three components: (i) reviewing the medication situation; (ii) composing a treatment plan; and (iii) accomplishing and communicating a treatment and surveillance plan. Subtasks include multiple cognitive tasks such as composing a list of current medications and evaluating the reliability of sources, and procedural tasks such as documenting current medication. The identified macrocognitive tasks were: planning, integration of IT in workflow, managing uncertainties and responsibilities, and problem detection.

Conclusions

All identified procedural, cognitive and macrocognitive skills should be included when designing education for IT-mediated medication management. The resulting framework supports the design of educational interventions to improve IT-mediated medication management in outpatient care.