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Rybing, Jonas
Publications (10 of 11) Show all publications
Rybing, J. (2018). Studying Simulations with Distributed Cognition. (Doctoral dissertation). Linköping: Linköping University Electronic Press
Open this publication in new window or tab >>Studying Simulations with Distributed Cognition
2018 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

Simulations are frequently used techniques for training, performance assessment, and prediction of future outcomes. In this thesis, the term “human-centered simulation” is used to refer to any simulation in which humans and human cognition are integral to the simulation’s function and purpose (e.g., simulation-based training). A general problem for human-centered simulations is to capture the cognitive processes and activities of the target situation (i.e., the real world task) and recreate them accurately in the simulation. The prevalent view within the simulation research community is that cognition is internal, decontextualized computational processes of individuals. However, contemporary theories of cognition emphasize the importance of the external environment, use of tools, as well as social and cultural factors in cognitive practice. Consequently, there is a need for research on how such contemporary perspectives can be used to describe human-centered simulations, re-interpret theoretical constructs of such simulations, and direct how simulations should be modeled, designed, and evaluated.

This thesis adopts distributed cognition as a framework for studying human-centered simulations. Training and assessment of emergency medical management in a Swedish context using the Emergo Train System (ETS) simulator was adopted as a case study. ETS simulations were studied and analyzed using the distributed cognition for teamwork (DiCoT) methodology with the goal of understanding, evaluating, and testing the validity of the ETS simulator. Moreover, to explore distributed cognition as a basis for simulator design, a digital re-design of ETS (DIGEMERGO) was developed based on the DiCoT analysis. The aim of the DIGEMERGO system was to retain core distributed cognitive features of ETS, to increase validity, outcome reliability, and to provide a digital platform for emergency medical studies. DIGEMERGO was evaluated in three separate studies; first, a usefulness, usability, and facevalidation study that involved subject-matter-experts; second, a comparative validation study using an expert-novice group comparison; and finally, a transfer of training study based on self-efficacy and management performance. Overall, the results showed that DIGEMERGO was perceived as a useful, immersive, and promising simulator – with mixed evidence for validity – that demonstrated increased general self-efficacy and management performance following simulation exercises.

This thesis demonstrates that distributed cognition, using DiCoT, is a useful framework for understanding, designing and evaluating simulated environments. In addition, the thesis conceptualizes and re-interprets central constructs of human-centered simulation in terms of distributed cognition. In doing so, the thesis shows how distributed cognitive processes relate to validity, fidelity, functionality, and usefulness of human-centered simulations. This thesis thus provides a new understanding of human-centered simulations that is grounded in distributed cognition theory.

Place, publisher, year, edition, pages
Linköping: Linköping University Electronic Press, 2018. p. 94
Series
Linköping Studies in Science and Technology. Dissertations, ISSN 0345-7524 ; 1913
National Category
Human Computer Interaction
Identifiers
urn:nbn:se:liu:diva-145307 (URN)10.3384/diss.diva-145307 (DOI)9789176853481 (ISBN)
Public defence
2018-04-19, Ada Lovelace, B-huset, Campus Valla, Linköping, 13:15 (English)
Opponent
Supervisors
Available from: 2018-03-20 Created: 2018-03-20 Last updated: 2018-03-21Bibliographically approved
Prytz, E., Rybing, J., Carlsson, H. & Jonson, C.-O. (2017). Evaluating learning and simulation exercise efficacy for a course on advanced prehospital trauma. In: Abstracts of Scientific Papers-WADEM Congress on Disaster and Emergency Medicine 2017: . Paper presented at Wadem Congress on Disaster and Emergency Medicine, Totonto, Canada, 25-28 April 2017 (pp. S222-S223). Cambridge University Press
Open this publication in new window or tab >>Evaluating learning and simulation exercise efficacy for a course on advanced prehospital trauma
2017 (English)In: Abstracts of Scientific Papers-WADEM Congress on Disaster and Emergency Medicine 2017, Cambridge University Press, 2017, p. S222-S223Conference paper, Oral presentation with published abstract (Other academic)
Abstract [en]

Study/Objective: In this study, we aimed to design a questionnaire battery for course and simulation exercise evaluation, and pilot-test the battery by evaluating a course on Advanced Prehospital Trauma Care (APTC).

Background: Many course evaluations suffer from simplistic metrics, such as whether the course participants “enjoyed” the course. In contrast, the current study sought to measure (self-estimated) pre- and post-course knowledge, relevant to specific learning objectives, as well as questions pertaining to specific factors of the simulation exercises used in the course (eg, fidelity/realism, learning objective fit, transferability of tools/procedures, usefulness, among others) were selected based on simulation theory and simulation-based training literature.

Methods: Data were collected during a course on APTC. Twelve students participated. The mean professional experience was 15.5 years. The participants completed an informed consent form prior to the study. They completed a pre-course questionnaire, a post-course questionnaire, and a course evaluation form.

Results: The mean self-estimated improvement in theoretical knowledge pertaining to the course objectives was 8.23 on a 0 to 10 scale, and 8.25 for practical skills. Greatest improvement was in advanced airway management, physiological reactions to hypothermia, pneumothorax interventions, special considerations for patients injured by explosives (eg, blast injuries and burns), and medical decision making during an active shooter scenario. The evaluation of the simulation exercises received high marks (mean rating 4.53 [3.92-4.92] out of 5.0) on all aspects. The participants rated the overall course quality at 4.67 (on a 0 to 5 scale), with the simulations, practical exercises, and the structure of moving from theory to practice being mentioned as particularly positive.

Conclusion: Overall, the results showed that the APTC course received high marks on almost all measured factors. Further validation of the questionnaires is needed before general implementation of the battery can be recommended. Such implementation would benefit diverse course development and quality assurance

Place, publisher, year, edition, pages
Cambridge University Press, 2017
Series
Prehospital and Disaster Medicine, ISSN 1049-023X ; 32, Issue S1
Keywords
simulation, learning, exercises, training, prehospital
National Category
Applied Psychology Other Medical Sciences not elsewhere specified
Identifiers
urn:nbn:se:liu:diva-141756 (URN)10.1017/S1049023X17005763 (DOI)
Conference
Wadem Congress on Disaster and Emergency Medicine, Totonto, Canada, 25-28 April 2017
Available from: 2017-10-17 Created: 2017-10-17 Last updated: 2018-04-03Bibliographically approved
Rybing, J., Larsson, J., Jonson, C.-O. & Prytz, E. (2016). Preliminary Validation Results of DigEmergo for Surge Capacity Management. In: Andrea H. Tapia, Pedro Antunes, Victor A. Bañuls, Kathleen Moore and João Porto de Albuquerque (Ed.), Proceedings of the 13th International Conference on Information Systems for Crisis Response and Management: . Paper presented at The 13th International Conference on Information Systems for Crisis Response and Management, Rio de Janeiro, Brazil, May 22-25, 2016. ISCRAM
Open this publication in new window or tab >>Preliminary Validation Results of DigEmergo for Surge Capacity Management
2016 (English)In: Proceedings of the 13th International Conference on Information Systems for Crisis Response and Management / [ed] Andrea H. Tapia, Pedro Antunes, Victor A. Bañuls, Kathleen Moore and João Porto de Albuquerque, ISCRAM , 2016Conference paper, Published paper (Refereed)
Abstract [en]

This paper presents preliminary analysis from a validation study of a novel emergency medicine command and control training and evaluation simulator: DIGEMERGO®. The simulated emergency scenario was a surge capacity event at a generic emergency department, in which the participants took on a management role as the emergency department’s coordinating head nurse. A between group validation design with medical expert and novice participants was used. Initial analysis examined three triage measures associated with surge capacity management performance: time to triage, amount of patients triaged, and triage accuracy. The results show that experts were significantly more accurate at triaging in-hospital patients, but not incoming trauma patients. No significant differences in time or number of patients triaged was found. These initial results partially indicate simulator validity, but trauma patient triage accuracy suffered from a confounding variable in the triage system used. Analysis of additional measures is undergoing to further investigate validity claims.

Place, publisher, year, edition, pages
ISCRAM, 2016
Series
Proceedings of the International ISCRAM Conference, ISSN 2411-3387 ; 2016
Keywords
Simulator validation, between group analysis, command and control, performance measures, emergency medicine, surge capacity
National Category
Computer Systems
Identifiers
urn:nbn:se:liu:diva-128700 (URN)9788460879848 (ISBN)
Conference
The 13th International Conference on Information Systems for Crisis Response and Management, Rio de Janeiro, Brazil, May 22-25, 2016
Available from: 2016-05-30 Created: 2016-05-30 Last updated: 2018-03-20Bibliographically approved
Rybing, J., Nilsson, H., Jonson, C.-O. & Bång, M. (2016). Studying distributed cognition of simulation-based team training with DiCoT.. Ergonomics, 59(3), 423-434
Open this publication in new window or tab >>Studying distributed cognition of simulation-based team training with DiCoT.
2016 (English)In: Ergonomics, ISSN 0014-0139, E-ISSN 1366-5847, Vol. 59, no 3, p. 423-434Article in journal (Refereed) Published
Abstract [en]

Health care organizations employ simulation-based team training (SBTT) to improve skill, communication and coordination in a broad range of critical care contexts. Quantitative approaches, such as team performance measurements, are predominantly used to measure SBTTs effectiveness. However, a practical evaluation method that examines how this approach supports cognition and teamwork is missing. We have applied Distributed Cognition for Teamwork (DiCoT), a method for analysing cognition and collaboration aspects of work settings, with the purpose of assessing the methodology's usefulness for evaluating SBTTs. In a case study, we observed and analysed four Emergo Train System® simulation exercises where medical professionals trained emergency response routines. The study suggests that DiCoT is an applicable and learnable tool for determining key distributed cognition attributes of SBTTs that are of importance for the simulation validity of training environments. Moreover, we discuss and exemplify how DiCoT supports design of SBTTs with a focus on transfer and validity characteristics. Practitioner Summary: In this study, we have evaluated a method to assess simulation-based team training environments from a cognitive ergonomics perspective. Using a case study, we analysed Distributed Cognition for Teamwork (DiCoT) by applying it to the Emergo Train System®. We conclude that DiCoT is useful for SBTT evaluation and simulator (re)design.

Place, publisher, year, edition, pages
Taylor & Francis, 2016
Keywords
Simulation; distributed cognition; prehospital medicine, methodology; team training
National Category
Applied Psychology
Identifiers
urn:nbn:se:liu:diva-126627 (URN)10.1080/00140139.2015.1074290 (DOI)000377692100008 ()26275026 (PubMedID)
Note

Funding agencies:  Swedish Civil Contingencies Agency; Swedish Governmental Agency for Innovation Systems (VINNOVA)

Available from: 2016-03-31 Created: 2016-03-31 Last updated: 2018-03-20Bibliographically approved
Prytz, E. G., Rybing, J., Jonson, C.-O., Petterson, A., Berggren, P. & Johansson, B. (2015). An exploratory study of a low-level shared awareness measure using mission-critical locations during an emergency exercise. In: Proceedings of the Human Factors and Ergonomics Society 59th Annual Meeting: . Paper presented at Human Factors and Ergonomics Society 59th Annual Meeting (pp. 1152-1156). Sage Publications, 59(1)
Open this publication in new window or tab >>An exploratory study of a low-level shared awareness measure using mission-critical locations during an emergency exercise
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2015 (English)In: Proceedings of the Human Factors and Ergonomics Society 59th Annual Meeting, Sage Publications, 2015, Vol. 59, no 1, p. 1152-1156Conference paper, Published paper (Refereed)
Abstract [en]

A shared awareness of other teams’ roles and tasks has been linked to successful performance in joint ventures. However, emergency management organizations responding to incidents do not always share critical information necessary for maintaining shared awareness. An instrument called Shared Priorities has previously been applied to measure aspects of shared situation awareness at level 2 and 3 in Endsley’s (1995) model. This paper reports on a shared awareness instrument focused on level 1 situation awareness and its associated level of team shared awareness. Participants in a large emergency response exercise were asked to locate and rank geographical locations based on importance for overall mission success. The results show that organizations tended to rank locations relevant for their own work higher than positions relevant to other organization’s tasks. The different organizations displayed different levels of inter-rater agreement within themselves concerning the ranking of these positions.

Place, publisher, year, edition, pages
Sage Publications, 2015
Series
Proceedings of the Human Factors and Ergonomics Society Annual Meeting, ISSN 1071-1813, E-ISSN 2169-5067 ; 59
National Category
Business Administration Information Systems, Social aspects
Identifiers
urn:nbn:se:liu:diva-126629 (URN)10.1177/1541931215591178 (DOI)
Conference
Human Factors and Ergonomics Society 59th Annual Meeting
Available from: 2016-03-31 Created: 2016-03-31 Last updated: 2019-01-31Bibliographically approved
Prytz, E. & Rybing, J. (2015). Evaluation of a Novel Method to Study Interorganizational Coordination in Medical Command and Control Centers. In: Abstracts of Scientific Papers - 19th World Congress on Disaster and Emergency Medicine: . Paper presented at 19th World Congress on Disaster and Emergency Medicine, Cape Town, South Africa, 21-24 April 2015 (pp. s4-s5). Cambridge University Press, 30
Open this publication in new window or tab >>Evaluation of a Novel Method to Study Interorganizational Coordination in Medical Command and Control Centers
2015 (English)In: Abstracts of Scientific Papers - 19th World Congress on Disaster and Emergency Medicine, Cambridge University Press, 2015, Vol. 30, p. s4-s5Conference paper, Published paper (Refereed)
Abstract [en]

Study/Objective: Inter-organizational coordination is key to successful medical command and control (C2) during major incidents. However, evaluating this factor is often problematic, in particular during or after real emergencies as compared to controlled training scenarios. The purpose of this case study was to pilot test a non-intrusive data collection method for evaluating operative inter-organizational coordination during medical C2 situations.Background: This study was conducted during a planned major incident in Sweden. The major incident studied was the Göteborgsvarvet half-marathon, the largest half-marathon event in the world with more than 200 000 attending spectators and over 60 000 runners. The studied C2 center included representatives from local hospitals, Göteborgsvarvet organization, police, fire department, ambulance service, the local traffic and infrastructure management office, and emergency dispatch.

Methods: A combination of qualitative and quantitative methods was employed in this study. The qualitative methods included an ethnographic field study with on-site observations and contextual inquiry interviews. The quantitative methods included validated and experimental questionnaires distributed to the command center personnel at pre-determined intervals. These questionnaires aimed at gathering data on workload, stress, and shared and individual situational awareness.

Results: The data indicate that the qualitative methods were less intrusive than the quantitative methods. The observations and contextual inquiries could be performed without interruptions while periods of high workload resulted in lower or delayed response rates on the questionnaires. Simple questionnaires produced an 80% response rate, complex questionnaires only 40%.

Conclusion: The employed method appears useful to evaluate inter-organizational coordination and showed potential to gather meaningful data without being intrusive or disturbing the operative C2 activities. Due to the time-sensitive nature of emergency C2-work, unobtrusive qualitative methods and short, easy to fill out questionnaires are recommended for future studies.  The  results  from  this  pilot  will inform future operative C2 studies during similar planned major incidents.

Place, publisher, year, edition, pages
Cambridge University Press, 2015
Series
Prehospital and Disaster Medicine, ISSN 1049-023X ; Supplement S1
National Category
Applied Psychology
Identifiers
urn:nbn:se:liu:diva-117050 (URN)10.1017/S1049023X15000278 (DOI)25864582 (PubMedID)
Conference
19th World Congress on Disaster and Emergency Medicine, Cape Town, South Africa, 21-24 April 2015
Available from: 2015-09-16 Created: 2015-04-14 Last updated: 2016-11-28Bibliographically approved
Prytz, E. G., Rybing, J., Carlström, E., Khorram-Manesh, A. & Jonson, C.-O. (2015). Exploring prehospital C2-work during a mass gathering event. International Journal of Emergency Services, 4(2), 227-241
Open this publication in new window or tab >>Exploring prehospital C2-work during a mass gathering event
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2015 (English)In: International Journal of Emergency Services, ISSN 2047-0894, E-ISSN 2047-0908, Vol. 4, no 2, p. 227-241Article in journal (Refereed) Published
Abstract [en]

Purpose– The purpose of this paper is to explore the workload and shared workload awareness in a staff performing command and control (C2) work during a planned major incident (MI) empirical case in Sweden. Design/methodology/approach– Data on workload and shared awareness were collected during live C2-work using qualitative observations and in-situ interviews mixed with quantitative questionnaires. Findings– A content analysis of the qualitative data revealed categories of workload sources. Quantified workload estimates showed changes in workload levels over time and staff roles, which were also contextualized using the results of the qualitative data. Data on shared awareness indicated that team workload awareness shifted over time according to common patterns. This study demonstrates a promising methodology to study C2-related factors during live EMS work. Research limitations/implications– The observed variations in workload imply that research that relies only on post-task measurements of workload may be inaccurate. Future research could use this method to investigate the connection between workload and performance during different types of MIs. Originality/value– The results can be used to inform future Göteborgsvarvet C2-teams in terms of when, why, and for whom task load changes, which would support predictive allocation of resources.

Place, publisher, year, edition, pages
Emerald Group Publishing Limited, 2015
Keywords
Emergency response, Mixed methods, Command and control, Mass gathering, Mental workload, Shared awareness
National Category
Pedagogical Work
Identifiers
urn:nbn:se:liu:diva-126628 (URN)10.1108/IJES-04-2015-0016 (DOI)
Available from: 2016-03-31 Created: 2016-03-31 Last updated: 2018-03-20Bibliographically approved
Rybing, J., Prytz, E., Hornwall, J., Jonson, C.-O., Nilsson, H. & Bång, M. (2015). Preliminary evaluation results of DigEmergo - a digital simulator prototype for disaster and emergency management training. In: Samuel J. Stratton (Ed.), Prehospital and Disaster Medicine: . Paper presented at 19th World Congress on Disaster and Emergency Medicine (WCDEM 2015) (pp. 92-92). New York, 30
Open this publication in new window or tab >>Preliminary evaluation results of DigEmergo - a digital simulator prototype for disaster and emergency management training
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2015 (English)In: Prehospital and Disaster Medicine / [ed] Samuel J. Stratton, New York, 2015, Vol. 30, p. 92-92Conference paper, Oral presentation with published abstract (Refereed)
Abstract [en]

Objective

This abstract presents early findings on a user evaluation of DigEmergo - a digital training simulator prototype for disaster and emergency management. The overall goal of this research project was to design a flexible tool for training and evaluation of emergency response. Therefore we developed DigEmergo; a digital simulator based on Emergo Train System® (ETS; a globally used tabletop simulator) using electronic whiteboards.

Background

Disaster and emergency response requires competent and coordinated teams. However, training such teams efficiently is complicated. Full-scale high-fidelity simulations are both expensive to perform and difficult to evaluate. Thus, there is a need for scalable environments, such as digital simulations, to train medical decision-making and team coordination.

Methods

The DigEmergo prototype ran on an 87-inch multi-touch digital whiteboard and was evaluated using a training scenario and methodology adapted from ETS. Nine participants with prior ETS experience participated in the evaluation, which was led by two instructors. After completed scenarios first impressions were discussed and questionnaires including open-ended questions were completed.

Results

Preliminary results of the qualitative analysis show that the participants were positive towards DigEmergo. Several participants commented on instructor benefits, e.g. ease of setting up exercises and automatic statistics for after action reviews. Common concerns were potential technical issues, that multiple digital whiteboards are needed to avoid clutter, and loss of flexibility as digital whiteboards are less common than regular whiteboards.

Conclusion

Experienced users of ETS identified both advantages and disadvantages with a digital version of ETS. Identified benefits concerned the instructors’ tasks, increased control, and automatic data collection. Perceived disadvantages mainly related to concerns regarding the size of the digital whiteboard and potential technical issues. The participants also identified development potential, e.g. a small-scale tablet version of ETS for frequent training. Future work include analysis of collected evaluation data and additional prototype development.

Place, publisher, year, edition, pages
New York: , 2015
National Category
Interaction Technologies
Identifiers
urn:nbn:se:liu:diva-117526 (URN)
Conference
19th World Congress on Disaster and Emergency Medicine (WCDEM 2015)
Funder
Swedish Civil Contingencies Agency
Available from: 2015-07-16 Created: 2015-04-30 Last updated: 2018-09-01Bibliographically approved
Bång, M., Prytz, E., Rybing, J. & Timpka, T. (2014). Cognitive design of a digital desk for the emergency room setting. In: Westra, Bonnie L (Ed.), 2014 AMIA Annual Symposium: . Paper presented at 2014 AMIA Annual Symposium, 15-19 November 2014, Washington DC, USA. Oxford University Press
Open this publication in new window or tab >>Cognitive design of a digital desk for the emergency room setting
2014 (English)In: 2014 AMIA Annual Symposium / [ed] Westra, Bonnie L, Oxford University Press, 2014Conference paper, Published paper (Refereed)
Place, publisher, year, edition, pages
Oxford University Press, 2014
Series
Journal of the American Medical Informatics Association: JAMIA, ISSN 1067-5027
National Category
Interaction Technologies
Identifiers
urn:nbn:se:liu:diva-112597 (URN)
Conference
2014 AMIA Annual Symposium, 15-19 November 2014, Washington DC, USA
Available from: 2014-12-04 Created: 2014-12-04 Last updated: 2015-03-18
Rybing, J., Smith, C. & Silvervarg, A. (2010). Towards a Rule Based System for Automatic Simplification of Texts. In: SLTC 2010: The Third Swedish Language Technology Conference. Paper presented at Swedish Language Technology Conference, SLTC, October 27-29, 2010, Linköping (pp. 17-18).
Open this publication in new window or tab >>Towards a Rule Based System for Automatic Simplification of Texts
2010 (English)In: SLTC 2010: The Third Swedish Language Technology Conference, 2010, p. 17-18Conference paper, Poster (with or without abstract) (Other academic)
National Category
Language Technology (Computational Linguistics)
Identifiers
urn:nbn:se:liu:diva-80142 (URN)
Conference
Swedish Language Technology Conference, SLTC, October 27-29, 2010, Linköping
Available from: 2012-08-21 Created: 2012-08-21 Last updated: 2018-01-12
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