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Getting Inside the Expert's Head: An Analysis of Physician Cognitive Processes During Trauma Resuscitations.

Abstract：

STUDY OBJECTIVE:Crisis resource management skills are integral to leading the resuscitation of a critically ill patient. Despite their importance, crisis resource management skills (and their associated cognitive processes) have traditionally been difficult to study in the real world. The objective of this study was to derive key cognitive processes underpinning expert performance in resuscitation medicine, using a new eye-tracking-based video capture method during clinical cases. METHODS:During an 18-month period, a sample of 10 trauma resuscitations led by 4 expert trauma team leaders was analyzed. The physician team leaders were outfitted with mobile eye-tracking glasses for each case. After each resuscitation, participants were debriefed with a modified cognitive task analysis, based on a cued-recall protocol, augmented by viewing their own first-person perspective eye-tracking video from the clinical encounter. RESULTS:Eye-tracking technology was successfully applied as a tool to aid in the qualitative analysis of expert performance in a clinical setting. All participants stated that using these methods helped uncover previously unconscious aspects of their cognition. Overall, 5 major themes were derived from the interviews: logistic awareness, managing uncertainty, visual fixation behaviors, selective attendance to information, and anticipatory behaviors. CONCLUSION:The novel approach of cognitive task analysis augmented by eye tracking allowed the derivation of 5 unique cognitive processes underpinning expert performance in leading a resuscitation. An understanding of these cognitive processes has the potential to enhance educational methods and to create new assessment modalities of these previously tacit aspects of expertise in this field.

journal_name

Ann Emerg Med

journal_title

Annals of emergency medicine

authors

White MR,Braund H,Howes D,Egan R,Gegenfurtner A,van Merrienboer JJG,Szulewski A

doi

10.1016/j.annemergmed.2018.03.005

subject

Has Abstract

pub_date

2018-09-01 00:00:00

pages

289-298

issue

3

eissn

0196-0644

issn

1097-6760

pii

S0196-0644(18)30223-3

journal_volume

72

pub_type

杂志文章

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