SOME METHODOLOGICAL CONSIDERATIONS IN MULTIPLE-CUE PROBABILITY STUDIES.

OBJECTIVE: New medical systems may be rejected by staff because they do not integrate with local practice. An expert system, FLORENCE, is being developed to help staff in a neonatal intensive care unit (NICU) make decisions about ventilator settings when treating babies with respiratory distress syndrome. For FLORENCE to succeed it must be clinically useful and acceptable to staff in the context of local work practices. The aim of this work was to identify those contextual factors that would affect FLORENCE's success. METHODS: A cognitive task analysis (CTA) of the NICU was performed. First, work context analysis was used to identify how work is performed in the NICU. Second, the critical decision method (CDM) was used to analyse how staff make decisions about changing the ventilator settings. Third, naturalistic observation of staff's use of the ventilator was performed. RESULTS: A. The work context analysis identified the NICU's hierarchical communication structure and the importance of numerous types of record in communication. B. It also identified important ergonomic and practical requirements for designing the displays and positioning the computer. C. The CDM interviews suggested instances where problems can arise if the data used by FLORENCE, which is automatically read, is not manually verified. D. Observation showed that most alarms cleared automatically. When FLORENCE raises an alarm, staff will normally be required to intervene and make a clinical judgement, even if the ventilator settings are not subsequently changed. CONCLUSIONS: FLORENCE must not undermine the NICU's hierarchical communication channels (A). The re-design of working practices to incorporate FLORENCE, reinforced through its user interface, must ensure that expert help is called on when appropriate (A). The procedures adopted with FLORENCE should ensure that the data the advice is based upon is valid (C). For example, FLORENCE could prompt staff to manually verify the data before implementing any suggested changes. FLORENCE's audible alarm should be clearly distinguishable from other NICU alarms (D); new procedures should be established to ensure that FLORENCE alarms receive attention (D), and false alarms from FLORENCE should be minimised (B, D). FLORENCE should always provide the data and reasoning underpinning its advice (A, C, D). The methods used in the CTA identified several contextual issues that could affect FLORENCE's acceptance. These issues, which extend beyond FLORENCE's capability to suggest changes to the ventilator settings, are being addressed in the design of the user interface and plans for FLORENCE's subsequent deployment.

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PubMed2005

Sequence learning under dual-task conditions: alternatives to a resource-based account.

In two experiments with the serial reaction-time task, participants were presented with deterministic or probabilistic sequences under single- or dual-task conditions. Experiment 1 showed that learning of a probabilistic structure was not impaired over a first session by performing a counting task, but that such an interference arose over a second session, when the knowledge was tested under single-task conditions. In contrast, the effects of the secondary task arose earlier for participants exposed to deterministic sequences. This difference between deterministic and probabilistic sequences disappeared in Experiment 2, where the counting task was performed on tones associated to the locations. Comparisons between sessions indicated that the secondary task affected not only the expression but also the acquisition of sequence learning, and that greater interference was observed in those conditions that yielded more explicit knowledge. These results suggest that the effects of a dual task on the measures of implicit sequence learning may be partly due to the intrusion of explicit knowledge and partly due to the disruption of the sequence produced by the inclusion of random events.

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PubMed2005

A new look at binocular stereopsis.

We report a new phenomenon, which illustrates that the role of binocular disparity in 3D shape perception critically depends on whether the parts are interpreted as belonging to a single object. The nature of this phenomenon was studied in four experiments. In the first two experiments the subjects were shown a sequence of stereoscopic images of a cube, in which binocular disparity indicated that the individual parts move towards or away from one eye. However, when the parts of the cube were perceived as elements of a single object, they appeared to move in a rigid fashion and the direction of motion was orthogonal to that predicted by the binocular disparities. The third experiment generalized these results to more complex polyhedra. The last experiment showed that constraints related to motion, such as rigidity, are important, but not critical for this phenomenon to occur. All these results imply that the interpretation as to what corresponds to a single object affects the importance (weight) of binocular disparity and may even eliminate its contribution altogether; the percept of a 3D shape is dominated by a priori constraints, and depth cues play a secondary role.

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