Accession Number : ADA468583


Title :   The Use of Cognitive Task Analysis and Simulators for After Action Review of Medical Events in Iraq


Descriptive Note : Final addendum rept. 16 Nov 2006-28 Feb 2007


Corporate Author : UNIVERSITY OF SOUTHERN CALIFORNIA LOS ANGELES


Personal Author(s) : Clark, Richard E


Full Text : https://apps.dtic.mil/dtic/tr/fulltext/u2/a468583.pdf


Report Date : Mar 2007


Pagination or Media Count : 41


Abstract : Prior attempts to use standard self report or interview protocols to extract After Action Review (AAR) descriptions of emergency event decision making and problem solving strategies generated by participants are problematical. Cognitive psychological studies suggest that the resulting information often contains significant errors and omissions (Glaser et al., 1985; Besnard, 2000). These errors are not often recognized by participants who solved important problems in emergency situations and wish to give accurate reports on their solutions because the knowledge they are describing is largely automated and unconscious (Wheatley & Wegner, 2001). The problem is further complicated by the fact that experienced medical personnel mistakenly believe that their reports are complete and accurate and that they solved the problems they are describing in a conscious, willful, deliberate manner (Wegner, 2002). These reporting errors most likely increase in number and severity under time-pressure battlefield situations (Hunt & Joslyn, 2000). This research attempts to improve medical AAR with a novel combination of Cognitive Task Analysis (CTA) conducted while interviewees moulage simulators (Clark and Estes, 2002; Clark & Estes, 1996; Velmahos et al, 2002). Nine trauma surgeons, who have used Argyle-type shunts to repair femoral artery damage, were interviewed, in which they simply described (no CTA) the procedure. A full CTA was conducted with a tenth trauma surgeon with similar experience in the procedure. The interviews were coded and compared with a gold standard protocol. It was hypothesized that our protocol which employed a novel combination of medical Cognitive Task Analysis combined with the moulage of instruments and depictions of the femoral artery will more accurately capture the mix of automated and conscious decisions used to solve critical medical problems faced in battlefield situations.


Descriptors :   *SIMULATORS , *EMERGENCIES , *TRAUMA , *DECISION MAKING , IRAQ , DAMAGE , BATTLEFIELDS , COGNITION , SURGEONS , FEMORAL ARTERIES , CONSCIOUSNESS , PROBLEM SOLVING , MILITARY MEDICINE , PHYSICIANS , MEDICAL PERSONNEL , SURGERY , PSYCHOLOGY


Subject Categories : Medicine and Medical Research
      Administration and Management


Distribution Statement : APPROVED FOR PUBLIC RELEASE