A formative approach to the strategies analysis phase of cognitive work analysis

Engineer-Centred Design Factors and Methodological Approach for Maritime Autonomy Emergency Response Systems

Commercial deployment of maritime autonomous surface ships (MASSs) is close to becoming a reality. Although MASSs are fully autonomous, the industry will still allow remote operations centre (ROC) operators to intervene if a MASS is facing an emergency the MASS cannot handle by itself. A human-centred design for the associated emergency response systems will require attention to the ROC operator workplace, but also, arguably, to the behaviour-shaping constraints on the engineers building these systems. There is thus a need for an engineer-centred design of engineering organisations, influenced by the current discourse on human factors. To contribute to the discourse, think-aloud protocol interviewing was conducted with well-informed maritime operators to elicit fundamental demands on cognition and collaboration by maritime autonomy emergency response systems. Based on the results, inferences were made regarding both design factors and methodological choices for future, early phase engineering of emergency response systems. Firstly, engineering firms have to improve their informal gathering and sharing of information through gatekeepers and/or organisational liaisons. To avoid a too cautious approach to accountability, this will have to include a closer integration of development and operations. Secondly, associated studies taking the typical approach of exposing relevant operators to new design concepts in scripted scenarios should include significant flexibility and less focus on realism.

Exploring how caregivers for people living with dementia use strategies to overcome work system constraints

Informal caregivers for persons living with dementia (PLWD) require interventions that incorporate caregiving context. We used the Patient Work System model to characterize caregiving context by identifying work system constraints experienced by caregivers during dementia care events (e.g., managing behavioral symptoms of dementia) and strategies used to overcome constraints. We conducted twenty semi-structured interviews with caregivers. We performed upward abstraction and strategy mapping and identified seven work system constraints and eight strategies used to overcome constraints across three care events. We found that strategies used by caregivers either directly modified a constraint or emphasized other positive work system components to overcome a constraint. For example a caregiver modified their bathroom to support the PLWD in bathing themselves properly and safely. These findings provide an understanding of how real-world context influences how caregivers deliver dementia care and the design and implementation of systems that support dementia caregivers.

Mapping the territory of renal care: a formative analysis of the cognitive work involved in managing acute kidney injury

The design and evaluation of healthcare work systems requires an understanding of the cognitive work involved in healthcare tasks. Previous studies suggest that a formative approach would be particularly useful to examine healthcare activities for this purpose. In the present study, methods from cognitive work analysis and cognitive task analysis are combined in a formative examination of managing acute kidney injury, an activity that occurs across primary and secondary healthcare settings. The analyses are informed by interviews with healthcare practitioners and a review of practice guidelines. The findings highlight ways in which the task setting influenced practitioners' activity, and ways in which practitioners approached the activity (for example, how they used data to make decisions). The approach taken provided a rich understanding of the cognitive work involved, as well as generating suggestions for the design of work systems to support the clinical task. Practitioner summary: Healthcare tasks often require decision-making in complex and dynamic circumstances, potentially involving collaboration across different practitioner roles and locations. We demonstrate the use of a formative analysis to understand the cognitive work in managing a clinical syndrome across primary and secondary care settings, and consider the implications for work design.

Medication management strategies used by older adults with heart failure: A systems-based analysis

BACKGROUND

Older adults with heart failure use strategies to cope with the constraining barriers impeding medication management. Strategies are behavioral adaptations that allow goal achievement despite these constraining conditions. When strategies do not exist, are ineffective or maladaptive, medication performance and health outcomes are at risk. While constraints to medication adherence are described in literature, strategies used by patients to manage medications are less well-described or understood.

AIM

Guided by cognitive engineering concepts, the aim of this study was to describe and analyze the strategies used by older adults with heart failure to achieve their medication management goals.

METHODS

This mixed methods study employed an empirical strategies analysis method to elicit medication management strategies used by older adults with heart failure. Observation and interview data collected from 61 older adults with heart failure and 31 caregivers were analyzed using qualitative content analysis to derive categories, patterns and themes within and across cases.

RESULTS

Data derived thematic sub-categories described planned and ad hoc methods of strategic adaptations. Stable strategies proactively adjusted the medication management process, environment, or the patients themselves. Patients applied situational strategies (planned or ad hoc) to irregular or unexpected situations. Medication non-adherence was a strategy employed when life goals conflicted with medication adherence. The health system was a source of constraints without providing commensurate strategies.

CONCLUSIONS

Patients strived to control their medication system and achieve goals using adaptive strategies. Future patient self-mangement research can benefit from methods and theories used to study professional work, such as strategies analysis.

Cognitive work analysis: An influential legacy extending beyond human factors and engineering

Jens Rasmussen's multifaceted legacy includes cognitive work analysis (CWA), a framework for the analysis, design, and evaluation of complex sociotechnical systems. After considering the framework's origins, this paper reviews its progress, predictably covering experimental research on ecological interface design, case studies of the application of CWA to human factors and engineering problems in industry, and methods and modelling tools for CWA. Emphasis is placed, however, on studying the nexus between some of the recent results obtained with CWA and the original field studies of human problem-solving that motivated the framework's development. Of particular interest is a case study of the use of CWA for military doctrine development, a problem commonly regarded as lying outside the fields of human factors and engineering. It is concluded that the value of CWA, even for such diverse problems, is likely to result from its conceptual grounding in empirical observations of patterns of human reasoning in complex systems.

Representing energy efficiency diagnosis strategies in cognitive work analysis

This article describes challenges encountered in applying Jens Rasmussen's Cognitive Work Analysis (CWA) framework to the practice of energy efficiency Monitoring & Targeting (M&T). Eight theoretic issues encountered in the analysis are described with respect to Rasmussen's work and the modeling solutions we adopted. We grappled with how to usefully apply Work Domain Analysis (WDA) to analyze categories of domains with secondary purposes and no ideal grain of decomposition. This difficulty encouraged us to pursue Control Task (ConTA) and Strategies (StrA) analysis, which are under-explored as bases for interface design. In ConTA we found M&T was best represented by two interlinked work functions; one controlling energy, the other maintaining knowledge representations. From StrA, we identified a popular representation-dependent strategy and inferred information required to diagnose faults in system performance and knowledge representation. This article presents and discusses excerpts from our analysis, and outlines their application to diagnosis support tools.

Using cognitive work analysis and the strategies analysis diagram to understand variability in road user behaviour at intersections

In this article, an application of cognitive work analysis (CWA), using the strategies analysis diagram (SAD) method, to model performance variability in road transport, is presented. Specifically, the method was used to describe performance variability across four road user groups (drivers, cyclists, motorcyclists and pedestrians) when turning right at an urban signalised intersection. The analysis demonstrated that the method was able to identify a comprehensive range of strategies that road users can potentially use while turning right at an intersection, thereby describing a range of performance variability within intersection systems. Furthermore, the method identified constraints, disturbances, changes in circumstances and other influences on road user performance variability. It is concluded that the CWA/SAD approach was able to describe both the different ways in which activities can be executed and disturbances, situations and constraints that create performance variability. The implications of these findings for road design and intersection safety are discussed along with the benefits and drawbacks of the methodology used.

PRACTITIONER SUMMARY

Recently, the strategies analysis diagram was proposed as a method to support the cognitive work analysis framework in modelling performance variability. This article evaluated this method within a complex sociotechnical system, namely road transport. The application provided insight into performance variability across road user groups when turning right at intersections.