Small Boat Recovery Task Performance in a Moving Environment

OBJECTIVE

Assess operator performance in a simulation of US Coast Guard small boat recovery to a larger vessel on a large scale, six degree-of-freedom, full motion simulator.

BACKGROUND

Studies of human performance in small boat recovery task have never been conducted on a high amplitude, low frequency simulator. Empirical evidence of small boat recovery task performance in challenging motion conditions is needed to inform future maritime systems designs.

METHOD

Experienced active-duty boat crewmembers (N = 13) conducted a small boat recovery task in three sea states on the Vertical Motion Simulator (VMS) at the NASA Ames Research Center. Task performance was assessed using a task equivalent for time to complete the task. Participant behaviors associated with increasing motion severity were observed.

RESULTS

Task performance declined as motion conditions became more severe. Participants were more likely to use at least one hand to maintain balance during motion conditions, becoming more frequent with increasing motion severity. Many participants used one hand to complete the task despite contrary instructions and previous experience.

CONCLUSION

Two design recommendations were proposed to counter declining task performance in increasingly severe motion conditions. Handholds available to participants during the task, and task design supporting single handed completion were recommended for small boat recovery systems.

APPLICATION

This research is directly applicable to gross motor tasks requiring simultaneous maintenance of balance in a maritime environment, and may be extended to other environments where humans experience complex motions while completing tasks.

Object-Process Methodology as an Alternative to Human Factors Task Analysis

OBJECTIVE

We define and demonstrate the use of OPM-TA-a model-based task analysis (TA) framework that uses object-process methodology (OPM) ISO 19450 as a viable alternative to traditional TA techniques.

BACKGROUND

A variety of different TA methods exist in human factors engineering, and several of them are often applied successively for a broad task representation, making it difficult to follow.

METHOD

Using OPM-TA, we modeled how an International Space Station (ISS) astronaut would support extravehicular activities using the existing robotic arm workstation with a new control panel and an electronic procedure system. The modeling employed traditional TA methods and the new OPM-TA approach, enabling a comparison between them.

RESULTS

While the initial stages of modeling with OPM-TA follow those of traditional TA, OPM-TA modeling yields an executable and logically verifiable model of the entire human-robot system. Both OPM's hierarchical set of diagrams and the equivalent, automatically generated statements in a subset of natural language text specify how objects and processes relate to each other at increasingly detailed levels. The graphic and textual OPM modalities specify the system's architecture, which enables its function and benefits its users. To verify the model logical correctness model, we executed it using OPM's simulation capability.

CONCLUSION

OPM-TA was able to unify traditional TA methods and expand their capabilities. The formal yet intuitive OPM-TA approach fuses and extends traditional TA methods, which are not amenable to simulation. It therefore can potentially become a widely used means for TA and human-machine procedure development and testing.

A Comparison of Baseline Procedures in Task Analyses

Several methods for assessing baseline performance in chained tasks have been outlined in the literature, including the fixed-opportunity probe (FOP) and the multiple-opportunity probe (MOP). Concerns have been raised regarding how each of these methods might change the baseline performance of a task, affecting the interpretation of experimental control. The purpose of the current study was to conduct a within-subject comparison of both the FOP and MOP procedures for children with autism performing daily living and self-care skills. Results indicated that, for most participants, the MOP resulted in elevated performance during baseline compared to the FOP, and that for some participants the MOP resulted in acquisition prior to direct training. Because of the possibility that the FOP might result in suppressed baseline performance, it is recommended that in most cases clinicians and researchers use the MOP when assessing baseline performance in chained tasks in order to obtain the most accurate data.

Nursing Workforce Optimization Study: A Multi-method Evaluation and Process Improvement Intervention for HIV Service Delivery in Tanzania and Zambia

ABSTRACT

Nurses are often suboptimally used in HIV care, due to misalignment of training and practice, workflow inefficiencies, and management challenges. We sought to understand nursing workforce capacity and support implementation of process improvement strategies to improve efficiency of HIV service delivery in Tanzania and Zambia. We conducted time and motion observations and task analyses at 16 facilities followed by process improvement workshops. On average, each nurse cared for 45 clients per day in Tanzania and 29 in Zambia. Administrative tasks and documentation occupied large proportions of nurse time. Self-reported competency was low at baseline and higher at follow-up for identifying and managing treatment failure and prescribing antiretroviral therapy. After workshops, facilities changed care processes, provided additional training and mentorship, and changed staffing and supervision. Efficiency outcomes were stable despite staffing increases. Collaborative approaches to use workforce data to engage providers in improvement strategies can support roll-out of nurse-managed HIV treatment.

Domain- and task-analytic workload (DTAW) method: a methodology for predicting mental workload during severe accidents in nuclear power plants

Excessive mental workload reduces operators' performance and threatens the safety of nuclear power plants (NPPs) in severe accident management (SAM). Given the lack of suitable mental workload measurement methods for SAM tasks, we proposed a Domain- and Task-Analytic Workload (DTAW) method to predict SAM workload. The DTAW method is developed in three stages: scenario construction based on work domain analysis, task analysis, and workload estimation with eight workload components scored through task-analytic and projective methods. To demonstrate its utility, we applied the method to construct two SAM scenarios and predict the mental workload demand of operators in these scenarios as compared to two design basis accident scenarios. With statistical analysis, the DTAW method can predict the overall subjective workload rated by NPP operators, be used to identify high-load tasks, cluster tasks with similar workload patterns, and provide direct implications for improving SAM strategies and supporting systems.Practitioner summary: To predict mental workload in severe accident management (SAM) scenarios in nuclear power plants, we proposed an analytic method and applied it to estimate mental workload in two SAM scenarios and two design basis accident (DBA) scenarios. We found that the workload pattern in SAM scenarios is different from that in DBA scenarios.

Renegotiating tasks or goals as rupture repair: A task analysis in a cognitive-behavioral therapy for personality disorder

OBJECTIVE

The purpose of this study was to provide some definition of rupture repair in a cognitive-behavioral therapy (CBT) for personality disorders, specifically how treatment tasks or goals are renegotiated.

METHOD

Following a task analysis, a rational model was developed with the support of an expert panel. An empirical analysis was conducted on six CBT cases sampled from a clinical trial that included personality disordered patients and treatment adherent therapists. Two sessions from each case indicating rupture repair were selected, based on patient and therapist ratings of the Working Alliance Inventory-12 item version (WAI-12) and rupture presence. A qualitative analysis of the sessions was conducted with the support of the observer-based Rupture Resolution Rating System (3RS-2022).

RESULTS

The empirical analysis provided some support for many of the stages defined in the rational model, but less support for the hypothesized sequences of stages. A rational-empirical synthesis yielded a revised model that suggested therapists combine various strategies in rupture repair in a variety of ways, not necessarily in consistent sequences.

CONCLUSIONS

The renegotiation of tasks and goals in this CBT sample was variable. The importance of responsiveness and the need to validate the rational-empirical model were highlighted.

Applying the quick exposure check in the workstation design process, physical and virtual prototype assessment

BACKGROUND

The Quick Exposure Check (QEC) assesses four major body parts and engages users in assessing some physical interactions relevant to design in task analysis.

OBJECTIVE

In this paper, we investigated the application of QEC as the ergonomic intervention to detect pre-production ergonomic design faults in the apple sorting machine by applying physical and virtual prototyping for three different tasks analysis divided into two phases (Task 1: Apple harvesting and preparation for sorting; Task 2: Sorting control and separation of waste fruits; Task 3: Transfer of separated apples).

METHOD

First, the QEC questionnaire was administered while Iranian participants interacted with the machine to detect abnormal posture. Second, we redesigned a concept of the machine and assessed it with QEC by a focus group.

RESULTS

Before design, the high pressure in Task 1 is on the back (dynamic), shoulder/arm, and very high pressure in Task 2, and in Task 3 on the back (static), arm/shoulder/neck, making an uncomfortable situation for posture. After redesign, we observed decreased pressures on the back/shoulder/arm in Task 1 from high to medium, in Task 3 from very high to low, and also in Task 2, this was detectable decreasing from very high pressures on the back/shoulder/arm and the high pressures on the neck to medium.

CONCLUSION

Prototyping with QEC demonstrated that accurate redesigning of the machine with concentration on shifting from static tasks to dynamic or conversely, and ease of access by adjusting dimensions according to anthropometry and auxiliary products, could reduce musculoskeletal disorders.

Usability and Teachability of Continuous Glucose Monitoring Devices in Older Adults and Diabetes Educators: Task Analysis and Ease-of-Use Survey

BACKGROUND

Continuous glucose monitoring (CGM) devices continuously sense and relay glucose concentration data from the interstitial fluid to a mobile phone or receiver. Older adults benefit from this continuous monitoring of glucose levels. Proper deployment of the sensing wire is facilitated by a specialized applicator.

OBJECTIVE

Our aim was to assess a new seventh-generation (G7) CGM device (Dexcom, Inc) for use by adults 65 years of age or older and certified diabetes care and education specialists (CDCESs). Ease of use related to intradermal insertion and mobile app setup will be assessed and compared to the fifth- and sixth-generation systems.

METHODS

Formal task analysis was conducted to enumerate the number and complexity of tasks associated with CGM deployment. We recruited 10 older adults with no prior CGM experience and 10 CDCESs to assess ease of use through hands-on insertion and initiation of a G7 system followed by a survey and, for older adults, a system usability scale survey.

RESULTS

About half as many tasks are needed to deploy G7 compared to G6. Older adults and CDCESs reported overall high usability of the G7 CGM device. CDCESs noted G7's easier setup compared to previous generations. The system usability scale score for the CGM system was 92.8, which reflects excellent usability.

CONCLUSIONS

For CDCESs and for older adults using the G7 CGM system, cognitive burden is relatively low and reduced compared to previous CGM systems. Easing of this burden and simplification of the glucose monitoring aspect of proper diabetes management will likely contribute to improved outcomes in this population.

Development of a New Procedure for Evaluating Working Postures: An Application in a Manufacturing Company

Musculoskeletal diseases represent a constant phenomenon in occupational health and safety (OHS) despite the large effort at governmental and technical levels. In the industrial context, numerous studies have dealt with the evaluation of the physical demand of workers. Moreover, numerous studies have investigated the problem, providing tools for ergonomics analysis. However, practical approaches aimed at integrating ergonomics issues in risk assessment activities are still scarce. To reduce such a gap, the current study proposes a procedure for the evaluation of the static working postures of workers to be included in the risk assessment activities. Such an approach is based on the ISO 11226 standard, providing a practical checklist that can be used both at the workstation's design stage and during risk assessment activities. Its effectiveness was verified through a case study at a manufacturing company. The results achieved showed that as well as the non-conformity of the workstations' design, the lack of training of the operators on how to maintain a neutral posture while working can also lead to awkward postures of the trunk and head. Additionally, the proposed methodology allowed us to verify the correctness of each workstation based on the physical characteristics of the workers, providing a useful guideline for the company managers on how to properly assign working tasks.

The default is simplicity - A model for the workplace ergonomics problem-solving process

Occupational ApplicationsThis paper provides a decision-making model for workplace ergonomics problem-solving to help clarify the situations in which simple, non-quantitative approaches are suitable, in contrast to those conditions where more formal, quantitative methods are needed. The perspective is that of an individual or workplace team focused on a specific problem. The value of this model is that it: 1) avoids unnecessary activities, in particular quantitative assessments when not needed; 2) emphasizes qualitative problem-solving methods; 3) enables non-technical personnel to be involved; and 4) helps expand the use of ergonomics towards reducing production barriers. The context is "continual improvement" rather than "compliance." Students may profit by learning practical steps useful in the workplace. Practitioners may benefit from reviewing the framework (and indeed improving it). Researchers might gain a better appreciation of simple methods used in the workplace and perhaps test certain premises of the model more rigorously.

A concise review of recent advancements in the graphical training of behavior analysts

This Concise Review is an appraisal of contemporary research on teaching single-case experimental design (SCED) graphical creation published between 2017-2021. Recent work on SCED graphical creation is summarized and areas for future research are highlighted.

Training soccer goalkeeping skills: Is video modeling enough?

Scant literature exists assessing the effectiveness of video modeling (VM) alone in the sports literature. Further evaluations of VM to improve sports skills is warranted because VM is an accessible and efficient procedure that has successfully improved skills in other fields of practice (e.g., staff training, medical procedures). Additionally, behavior analysts have not evaluated interventions for improving goalkeeping skills for individual soccer players. Therefore, we replicated the 1 behavior-analytic sports study on VM (Quinn et al., 2020), using a multiple baseline design across behaviors to evaluate the effects of VM and VM + video feedback (VF) to train 3 goalkeeper skills to two 9-year-old soccer players. The results showed that, although VM had some effect on performance compared to baseline, VM + VF resulted in the robust outcomes necessary for proficient performance of the goalkeeper skills. We discuss the results and limitations.

Hierarchical Task Analysis Reimagined as a Planning Tool for Surgery During Exploration Space Flight

Background: Preparation for exploration class space flight requires planning to support human life in many circumstances including healthcare emergencies such as the need for acute surgical care, a notable example of which is appendicitis. Although performing a laparoscopic appendectomy on Earth is routine for a trained general surgeon, it is far from routine for a non-surgeon working in microgravity where IVs do not drip, drains do not drain, and gaseous anesthetic is out of the question. Because the procedure for laparoscopic appendectomy is so well documented, it was the ideal procedure on which to base a study on how to deconstruct a surgical procedure to examine all actions, skills, equipment, and supplies needed for success by non-surgeons working in an extreme environment. Study Design: Our challenge was to develop a task analysis model robust enough to include 3 performers (in the roles of surgeon, assistant, and anesthesiologist) including each action and instrument or supply item needed in chronological order, while indicating which actions were completed independently and which were done in tandem. We also had to indicate where variations in the actions would be determined by the negative response of the patient (failure mode), and which actions and supply items needed further research to accommodate working in microgravity. We opted to begin with a hierarchical task analysis model (HTA) because the steps in the task are sequential; but we expanded the typical linear presentation of data to a multi-column spread sheet with active links to instructional video clips where needed. Content development was an iterative process beginning with a scoping review of literature to select a baseline task analysis of the procedure. The SAGES 2010 approach was selected as most comprehensive, but logically focused on the surgeon's performance with few references to the assistant or anesthesiologist. Those gaps were filled using content from training materials developed for surgical technicians and nurse anesthetists. The second step was an expert review of the spread sheet to identify gaps and inadequacies. The third step was a minute comparison of spread sheet content to actions and equipment as documented on 2 videotapes of the procedure performed by our team surgeon on otherwise healthy patients. The final review was accomplished by replicating the procedure on 360° video (with narration) using the spread sheet as a guide, then cross checking and correcting the spread sheet to correspond with the 360° video. This test procedure was performed on a lightly preserved, fresh cadaver since working at that very slow, deliberate pace would not be in the best interest of an actual patient. Results: In this study, simulation was actually used to test the expanded HTA rather than to evaluate a learner. The final spread sheet included 178 lines, 13 columns, 13 illustrations, and 4 active links to instructional video clips. Thirteen items or issues were identified as needing further research, 8 action sequences were identified as generalizable skills, and 27 supply or equipment items were identified as multipurpose. Excluding the pharmaceuticals necessary for IV general anesthesia (that research is on-going), we were able to replicate a laparoscopic appendectomy on a fresh cadaver using no more than 30 items. The procedure was done using 3 trocars with very few instrument exchanges through the trocars since the surgical assistant assumed the role of laparoscopic camera operator during the procedure. Conclusion: An expanded HTA of a surgical procedure can produce many useful outcomes including integrated training for all team members, review of instrumentation and supplies and, in our case, identifying areas for adapting to an extreme environment. Using an interdisciplinary team including instructional designers, subject matter experts from medicine and biomedical engineering, and media production enriched the process.

Predicting Design-Induced Error on the Flight Deck : An Aircraft Engine Oil Leak Scenario

OBJECTIVE

To explore the types of errors that commercial pilots may make when trying to resolve a suspected engine oil leak using the interfaces currently available.

BACKGROUND

The decisions that pilots make often have to be made quickly and under time pressure, with the emphasis on avoiding critical situations from arising. To make the correct decisions, it is vital that pilots have accurate and up-to-date information available. However, interaction with flight deck interfaces may lead to error if they are not effectively designed.

METHOD

A hierarchical task analysis was conducted using evidence from pilot interview data to understand the pilots' typical response to a suspected engine oil leak scenario. This was used as the primary input into the Systematic Human Error Reduction and Prediction Approach (SHERPA).

RESULTS

A total of 108 possible errors were identified. The most common error type was a retrieval error, in which flight crews may retrieve the wrong information about the engine. A number of remedial measures are proposed to try and overcome such issues.

CONCLUSION

This analysis provides an initial starting point for identifying potential future design ideas that can assist the pilots in dealing with oil leaks.

APPLICATION

This work has identified the value of applying human error identification methodologies to the assessment of current flight deck processes surrounding engine oil leaks. The method presented permits the operational analysis of possible errors on the flight deck and facilitates the proposition of remedial measures to implement technological innovations that can mitigate error.

Measurement of Human Resource Demand of Medical Institution Inspection Based on Task Analysis

Purpose

To estimate the human resource demand of health inspection agencies to carry out the medical institution inspection function, and to provide the basis for the rational allocation of health inspection human resources.

Methods

Through policy documents review, inquiry of data from national health inspection report, Shanghai Health Inspection core business system, the basic data were collected. Based on the task analysis, the inspection functions of health inspection agency were investigated. The functional work links were analyzed, and the working time consumption was measured. The manpower needed to complete the inspection tasks of medical institutions was calculated combining with the annual functional workload and the effective working time of inspectors.

Results

There were three main routine functions of medical institution inspection, namely, on-site inspection, administrative punishment, and handling of emergencies and complaints. There were 1871 medical institutions at all levels and types in Pudong New Area, with an average annual inspection frequency of 2.8 times, annual administrative penalty of 245 cases, and handling of emergencies and complaints of 330 cases. The total time required for functional work was 1656029.30 minutes, and the annual effective working time of single inspector was 66705.21 minutes. About 25 people were taken to complete the inspection tasks of medical institutions throughout the year. The number of personnel engaged in the inspection of medical institutions was 18, and the personnel gap was 7.

Conclusion

The task analysis was an effective method to estimate the human resource demand of health inspection. In Pudong New Area, there were insufficient inspectors in medical institutions. In the case of insufficient human resource supplement, it was suggested to use technical means to improve work efficiency and save manpower investment.

A bio-behavioral intervention combining task analysis with skill-based training to train toothbrushing among children with intellectual disability

AIMS

Individuals with intellectual disability (ID) have special health care needs. Teaching self-care behaviors like toothbrushing helps reduce their dependence on adult caregivers. We present a bio-behavioral intervention combining task analysis with skill-based teaching of toothbrushing behavior aimed to promote autonomy in children with various types of ID.

METHODS

One hundred twenty children with ID enrolled at a special school in the State were included in the study. After baseline measurements using task analysis, four methods were used to train the children - instruction, three-phase modeling, physical guidance, and descriptive praise. The caregiver was trained and given instructional videos for reinforcement. After 4 weeks, the children were asked to brush their teeth and performance was evaluated.

RESULTS

There was increased independence in the performance of toothbrushing behavior, the mild and moderate ID groups showing the most improvement. Steps like oral manipulation of the toothbrush showed the greatest improvement in these groups. The severe ID group showed improvement in certain skills, while requiring assistance for others that demanded dexterity.

CONCLUSION

This intervention can be implemented by special schools and special care dentistry centers to foster autonomy in oral self-care skills in the mild and moderate ID children, and complemented with other methods for severe ID children.

Limited reparenting as a corrective emotional experience in schema therapy: A preliminary task analysis

AIM

To construct a process model of limited reparenting as a corrective emotional experience using schema therapy (ST).

METHOD

We followed a task analytical approach, building two separate rational models based on the ST theory and our experience. Then, we constructed a final rational model. We tested our model in five therapy sessions.

RESULTS

The process began with noticing a schema activation, after which a complex, interwoven process occurred involving facilitation and validation of the client's experiences, exploration of schema origins, engaging the client's process, and responding to unmet needs within professional boundaries. The limited reparenting experience in ST involves the use of psychotherapeutic techniques and, crucially, how these techniques are used in line with the ST model deployed.

CONCLUSION

Our results provided a roadmap and clarified the important aspects of limited reparenting. Providing clients with healthy and potentially corrective emotional experiences, facilitating and validating the feelings, understanding schema origins, and being willing to provide limited reparenting are the key features of the ST. It is more important to comprehend the philosophy behind ST than to focus on the specific (cognitive, behavioral, interpersonal, experiential, etc.) techniques.

Methods and Implementation of the 2019 EMS Practice Analysis

Background: The EMS Practice Analysis provides a vision of current prehospital care by defining the work performed by EMS professionals. In this manuscript, we present the National Advanced Life Support (ALS) EMS Practice Analysis for the advanced EMT (AEMT) and paramedic levels of certification. The goal of the 2019 EMS Practice Analysis is to define the work performed by EMS professionals and present a new template for future practice analyses. Methods: The project was executed in three phases. Phase 1 defined the types/frequency of EMS clinical presentations using the 2016 National Emergency Medical Services Information System (NEMSIS) dataset. Phase 2 defined the criticality or potential for harm of these clinical presentations through a survey of a random sample of nationally certified EMS professionals and medical directors. Phase 3 defined the tasks and the associated knowledge, skills, and abilities (KSA) that encompass EMS care through focus groups of subject matter experts. Results: In Phase 1, the most common EMS adult impressions were traumatic injury, abdominal pain/problems, respiratory distress/arrest, behavioral/psychiatric disorder, and syncope/fainting. The most common pediatric impressions were traumatic injury, behavioral/psychiatric disorder, respiratory distress/arrest, seizure, and abdominal pain/problems. Criticality was defined in Phase 2 with the highest risk of harm for adults being airway obstruction, respiratory distress/arrest, cardiac arrest, hypovolemia/shock, allergic reaction, or stroke/CVA. In comparison, pediatric patients presenting with airway obstruction, respiratory distress/arrest, cardiac arrest, hypovolemia/shock, allergic reaction, stroke/CVA, and inhalation injury had the highest potential for harm. Finally, in Phase 3, task statements were generated for both paramedic and AEMT certification levels. A total of 425 tasks and 1,734 KSAs were defined for the paramedic level and 405 tasks and 1,636 KSAs were defined for the AEMT level. Conclusion: The 2019 ALS Practice Analysis describes prehospital practice at the AEMT and paramedic levels. This approach allows for a detailed and robust evaluation of EMS care while focusing on each task conducted at each level of certification in EMS. The data can be leveraged to inform the scope of practice, educational standards, and assist in validating the ALS levels of the certification examination.

Resolving Coparenting Dissatisfaction In Couples: A Preliminary Task Analysis Study

This study explored the change that unfolded when parents resolved their coparenting dissatisfaction during an Integrative Brief Systemic Intervention (IBSI) for parent couples. We conducted a task analysis (Greenberg, 2007) to build a model of resolving coparenting dissatisfaction. We compared a postulated model of change (rational model) based on theoretical and clinical assumptions to the observations of the actual change process that couples experienced in an IBSI (empirical analysis). The empirical analysis was conducted on six IBSI therapy cases (three exhibiting positive development and three exhibiting no development). We defined positive development in IBSI as moving from coparenting dissatisfaction to coparenting satisfaction. The final rational-empirical model included six steps that facilitated the resolution of coparenting dissatisfaction. This study contributes to deepening the knowledge of how coparenting may change during marital therapy.

Fitting the task to a person with disabilities: A case of return-to-work support for a patient due to left-sided poststroke hemiplegia using tailor-made jigs-and-tools

BACKGROUND

A 45-year-old Japanese male pharmacist developed a stroke in December 2018; hence, he had left-sided hemiplegia due to the after-effects of cerebral stroke. This paper reports the return-to-work (RTW) and after RTW support for poststroke patients from a combined ergonomic and rehabilitation perspective.

METHODS

From April 2019 to July 2020, we visited hospitals and workplaces multiple times, making various preparations for workplace accommodation and exchanging information as follows: allowing staggered working hours; securing the flow routes in the back room; equipping a cane holder on his working desk; and adjusting the position of the work tablet. In August 2020, after RTW, we conducted a brief evaluation of residual motor function and an on-site task analysis, and we subsequently made a support tool.

RESULTS

In July 2020, his RTW was eventually realized. Moreover, as a result of introducing the tailor-made support tool, the duration of certain tasks that he had been claiming to be difficult was reduced when compared to that before support-tool use, and the average task duration before and after support-tool use was 32.8 s and 10 s, respectively (reduced by approximately 69.5%).

CONCLUSION

To augment our efforts, hospital staff, support staff in his workplace, and his employer collaborated to make various workplace accommodations for the smooth realization of RTW before and after RTW. In the present case, the ergonomic and rehabilitation approach after RTW might have contributed to ease of task, work efficiency, and the potential for future job retention.

Observational study of anaesthesia workflow to evaluate physical workspace design and layout

BACKGROUND

The safety and efficiency of anaesthesia care depend on the design of the physical workspace. However, little is known about the influence that workspace design has on the ability to perform complex operating theatre (OT) work. The aim of this study was to observe the relationship between task switching and physical layout, and then use the data collected to design and assess different anaesthesia workspace layouts.

METHODS

In this observational study, six videos of anaesthesia providers were analysed from a single centre in the United States. A task analysis of workflow during the maintenance phase of anaesthesia was performed by categorising tasks. The data supported evaluations of alternative workspace designs.

RESULTS

An anaesthesia provider's time was occupied primarily by three tasks: patient (mean: 30.0% of total maintenance duration), electronic medical record (26.6%), and visual display tasks (18.6%). The mean time between task switches was 6.39 s. With the current workspace layout, the anaesthesia provider was centred toward the patient for approximately half of the maintenance duration. Evaluating the alternative layout designs showed how equipment arrangements could improve task switching and increase the provider's focus towards the patient and visual displays.

CONCLUSIONS

Our study showed that current operating theatre layouts do not fit work demands. We report a simple method that facilitates a quick layout design assessment and showed that the anaesthesia workspace can be improved to better suit workflow and patient care. Overall, this arrangement could reduce anaesthesia workload while improving task flow efficiency and potentially the safety of care.

Characterization of Tasks and Time Efficiency of Dental Hygiene Students During Clinical Training

Purpose: Dental hygiene graduates often experience significant psychological stress while transitioning from the educational setting to clinical practice environments. The purpose of this study was to characterize the duration of dental hygiene activities and tasks and explore efficiency within appointments, by students in educational programs.Methods: Right-handed female dental hygiene students were recruited from two dental hygiene education programs. Each participant was video recorded while providing patient care during 3 sessions, once per term, over 3 consecutive terms. Activities, tasks, and student postures and positions were coded across the patient visit. Descriptive analyses were conducted to characterize overall durations and distributions across each category. Time spent on non-dental hygiene related activities was compared to other durations, as well as across the education/training time points and by patient type.Results: Fifty-three videos were analyzed from nineteen participants. The average patient visit length was 155.06 ± 35.63 minutes; approximately half the visit was dedicated to instrumentation activities. Nearly 20% of the visit was categorized as activities or tasks unrelated to education or patient care. Although most participants completed the patient visit more quickly by the third time point, the percentage of non-dental hygiene activities did not decrease, and there were no associations between patient category type and the duration of the patient visit.Conclusion: Patient visits were roughly three times the length of the typical dental hygiene care appointment, indicating a disconnect between training and practice. In addition to spending more time on hand scaling tasks, participants spent a lot of time on equipment setup and interacting with or waiting for faculty members. These findings have implications for improving efficiency in educational settings, particularly to facilitate a successful transition to clinical practice.

Understanding the task demands for powered wheelchair driving: a think-aloud task analysis

BACKGROUND

Powered wheelchair use promotes participation in individuals with limited mobility, however training is required for safe and effective use. There is limited evidence on the task demands of powered wheelchair use to inform an evidence-based skills training programme.

OBJECTIVE

To conduct a systematic exploration of the task demands of indoor powered wheelchair use to identify frequently used skills, abilities, and knowledge.

METHODS

We used a two-phased think aloud process to conduct a task analysis of powered wheelchair use with experienced powered wheelchair users (n = 5) and expert clinicians (n = 5). Participants completed seven indoor driving tasks while speaking aloud (concurrent think aloud) and subsequently engaged in a structured qualitative interview to discuss skills, abilities, and knowledge used across each of the seven tasks (retrospective think aloud). We used directed content analysis to map the skills and abilities to the ICF framework and conventional content analysis to develop thematic areas of knowledge used while operating a powered wheelchair.

RESULTS

One-hundred and ten (110) distinct skills and abilities were identified and mapped to the ICF; 80 in the Body Structures and Functions domain, and 30 in the Activities and Participation domain. Approximately 50% of skills and abilities were mental functions. Four thematic knowledge domains were identified: knowledge of self, environment, wheelchair, and task.

CONCLUSION

Powered wheelchair use is complex and requires a variety of skills and abilities from all areas of human functioning, in addition to a wide range of knowledge. Training programmes should address a range of areas of skill development.IMPLICATIONS FOR REHABILITATIONPowered wheelchair use is a complex skill; training should develop skills from all.Domains of the ICF, including mental and physical functions.A range of knowledge is used while operating a powered wheelchair; training programs.Should include the development and application of necessary knowledge.Clinicians may consider a range of factors when assessing suitability for powered.Wheelchair user, however should acknowledge that while the range of skills idenotified.May be useful, they may not be critical for success in powered wheelchair use.

Informal task-sharing practices in inpatient newborn settings in a low-income setting-A task analysis approach

Aim

To describe the complexity and criticality of neonatal nursing tasks and existing task-sharing practices to identify tasks that might be safely shared in inpatient neonatal settings.

Design

We conducted a cross-sectional study in a large geographically dispersed sample using the STROBE guidelines.

Methods

We used a task analysis approach to describe the complexity/criticality of neonatal nursing tasks and to explore the nature of task sharing using data from structured, self-administered questionnaires. Data was collected between 26th April and 22nd August 2017.

Results

Thirty-two facilities were surveyed between 26th April and 22nd August, 2017. Nearly half (42%, 6/14) of the "moderately critical" and "not critical" (41%, 5/11) tasks were ranked as consuming most of the nurses' time and reported as shared with mothers respectively. Most tasks were reported as shared in the public sector than in the private-not-for-profit facilities. This may largely be a response to inadequate nurse staffing, as such, there may be space for considering the future role of health care assistants.

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.

Spot the difference: Operational event sequence diagrams as a formal method for work allocation in the development of single-pilot operations for commercial aircraft

Function Allocation methods are important for the appropriate allocation of tasks between humans and automated systems. It is proposed that Operational Event Sequence Diagrams (OESDs) provide a simple yet rigorous basis upon which allocation of work can be assessed. This is illustrated with respect to a design concept for a passenger aircraft flown by just a single pilot where the objective is to replace or supplement functions normally undertaken by the second pilot with advanced automation. A scenario-based analysis (take off) was used in which there would normally be considerable demands and interactions with the second pilot. The OESD analyses indicate those tasks that would be suitable for allocation to automated assistance on the flight deck and those tasks that are now redundant in this new configuration (something that other formal Function Allocation approaches cannot identify). Furthermore, OESDs are demonstrated to be an easy to apply and flexible approach to the allocation of function in prospective systems.

PRACTITIONER SUMMARY

OESDs provide a simple yet rigorous basis upon which allocation of work can be assessed. The technique can deal with the flexible, dynamic allocation of work and the deletion of functions no longer required. This is illustrated using a novel design concept for a single-crew commercial aircraft.