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  • 1.
    Bång, Magnus
    et al.
    Linköping University, Department of Computer and Information Science, Human-Centered systems. Linköping University, The Institute of Technology.
    Prytz, Erik
    Linköping University, Department of Computer and Information Science, Human-Centered systems. Linköping University, The Institute of Technology.
    Rybing, Jonas
    Linköping University, Department of Computer and Information Science, Human-Centered systems. Linköping University, The Institute of Technology.
    Timpka, Toomas
    Linköping University, Department of Medical and Health Sciences, Division of Community Medicine. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Center for Health and Developmental Care, Center for Public Health.
    Cognitive design of a digital desk for the emergency room setting2014In: 2014 AMIA Annual Symposium / [ed] Westra, Bonnie L, Oxford University Press, 2014Conference paper (Refereed)
  • 2.
    Jonson, Carl-Oscar
    et al.
    Linköping University, Department of Clinical and Experimental Medicine, Division of Surgery, Orthopedics and Oncology. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Center for Disaster Medicine and Traumatology.
    Pettersson, Jenny
    Linköping University, Department of Clinical and Experimental Medicine. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Center for Disaster Medicine and Traumatology.
    Rybing, Jonas
    Linköping University, Department of Computer and Information Science, Human-Centered systems. Linköping University, Faculty of Arts and Sciences.
    Nilsson, Heléne
    Linköping University, Department of Clinical and Experimental Medicine, Division of Surgery, Orthopedics and Oncology. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Center for Disaster Medicine and Traumatology.
    Prytz, Erik
    Linköping University, Department of Computer and Information Science, Human-Centered systems. Linköping University, Faculty of Arts and Sciences.
    Short simulation exercises to improve emergency department nurses self-efficacy for initial disaster management: Controlled before and after study2017In: Nurse Education Today, ISSN 0260-6917, E-ISSN 1532-2793, Vol. 55, p. 20-25Article in journal (Refereed)
    Abstract [en]

    Introduction: Head nurses at emergency departments often assume responsibility for managing the initial response to a major incident, and to create surge capacity. Training is essential to enable these nurses to perform an effective disaster response. Evaluating the effects of such training is however complicated as real skill only can be demonstrated during a real major incident. Self-efficacy has been proposed as an alternative measure of training effectiveness. Purpose: The aim of this study was to examine if short, small-scale computer-based simulation exercises could improve head emergency nurses general and specific self-efficacy and initial incident management skills. Method: A within-group pretest-posttest design was used to examine 13 head nurses general and specific self efficacy before and after an intervention consisting of three short computer based simulation exercises during a 1-h session. Management skills were assessed using the computer simulation tool DigEmergo. Results: The exercises increased the head nurses general self-efficacy but not their specific self-efficacy. After completing the first two exercises they also exhibited improved management skills as indicated by shorter time to treatment for both trauma and in-hospital patients. Conclusion: This study indicates that short computer based simulation exercises provide opportunities for head nurses to improve management skills and increase their general self-efficacy.

  • 3.
    Jönsson, Arne
    et al.
    Linköping University, Department of Computer and Information Science, NLPLAB - Natural Language Processing Laboratory. Linköping University, The Institute of Technology. Santa Anna IT Research Institute AB, Linköping, Sweden.
    Bugge, Bjarte
    Audio To Me AB, Linköping Sweden.
    Axelsson, Mimi
    Linköping University.
    Bergenholm, Erica
    Linköping University.
    Carlsson, Bertil
    Linköping University.
    Dahlbom, Gro
    Linköping University.
    Krevers, Robert
    Linköping University.
    Nilsson, Karin
    Linköping University.
    Rybing, Jonas
    Linköping University, Department of Computer and Information Science. Linköping University, The Institute of Technology.
    Smith, Christian
    Linköping University, Department of Computer and Information Science. Linköping University, The Institute of Technology.
    Using Language Technology to Improve Interaction and Provide Skim Reading Abilities to Audio Information Services2008In: Collaboration and the Knowledge Economy: Issues, Applications, Case Studies / [ed] Paul Cunningham and Miriam Cunningham, IOS Press, 2008, p. 1289-Conference paper (Other academic)
    Abstract [en]

    In this paper we present language technology enhancements to audio-based information services (i.e. services where information is presented using spoken language). The enhancements presented in the paper addresses two issues for audio-based services: 1) interaction with the service is rigid and 2) the ability to listen to summaries is limited. Our developments allow for more natural and efficient control of the service and means that facilitates skim reading. Using speech dialogue instead of traditional buttons provides means for more advanced navigation in the audio material. Vector space techniques are used to collect the most relevant sentences in a text and allows for skim reading of varying depth.

  • 4.
    Prytz, Erik G.
    et al.
    Linköping University, Department of Computer and Information Science, Human-Centered systems. Linköping University, Faculty of Science & Engineering.
    Rybing, Jonas
    Linköping University, Department of Computer and Information Science, Human-Centered systems. Linköping University, Faculty of Science & Engineering.
    Carlström, Eric
    Institute of Health and Care Sciences, University of Gothenburg, Gothenburg, Sweden.
    Khorram-Manesh, Amir
    Prehospital and Disaster Medicine Centre, Sahlgrenska Academy, Gothenburg, Sweden.
    Jonson, Carl-Oscar
    Linköping University, Department of Clinical and Experimental Medicine, Division of Clinical Sciences. Linköping University, Faculty of Medicine and Health Sciences. Östergötlands Läns Landsting, Center for Disaster Medicine and Traumatology, Centre for Teaching and Research in Disaster Medicine and Traumatology.
    Exploring prehospital C2-work during a mass gathering event2015In: International Journal of Emergency Services, ISSN 2047-0894, E-ISSN 2047-0908, Vol. 4, no 2, p. 227-241Article in journal (Refereed)
    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.

  • 5.
    Prytz, Erik G.
    et al.
    Linköping University, Department of Computer and Information Science, Human-Centered systems. Linköping University, Faculty of Science & Engineering.
    Rybing, Jonas
    Linköping University, Department of Computer and Information Science, Human-Centered systems. Linköping University, Faculty of Science & Engineering.
    Jonson, Carl-Oscar
    Linköping University, Department of Clinical and Experimental Medicine, Division of Clinical Sciences. Linköping University, Faculty of Medicine and Health Sciences. Östergötlands Läns Landsting, Center for Disaster Medicine and Traumatology, Centre for Teaching and Research in Disaster Medicine and Traumatology.
    Petterson, Albin
    Linköping University.
    Berggren, Peter
    Swedish Defence Research Agency, Sweden.
    Johansson, Björn
    Linköping University, Department of Computer and Information Science, Human-Centered systems. Linköping University, Faculty of Science & Engineering.
    An exploratory study of a low-level shared awareness measure using mission-critical locations during an emergency exercise2015In: Proceedings of the Human Factors and Ergonomics Society 59th Annual Meeting, Sage Publications, 2015, Vol. 59, no 1, p. 1152-1156Conference 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.

  • 6.
    Prytz, Erik
    et al.
    Linköping University, Department of Computer and Information Science, Human-Centered systems. Linköping University, Faculty of Arts and Sciences.
    Rybing, Jonas
    Linköping University, Department of Computer and Information Science, Human-Centered systems. Linköping University, Faculty of Arts and Sciences.
    Evaluation of a Novel Method to Study Interorganizational Coordination in Medical Command and Control Centers2015In: Abstracts of Scientific Papers - 19th World Congress on Disaster and Emergency Medicine, Cambridge University Press, 2015, Vol. 30, p. s4-s5Conference 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.

  • 7.
    Prytz, Erik
    et al.
    Linköping University, Department of Computer and Information Science, Human-Centered systems. Linköping University, Faculty of Arts and Sciences.
    Rybing, Jonas
    Linköping University, Department of Computer and Information Science, Human-Centered systems. Linköping University, Faculty of Science & Engineering.
    Jonson, Carl-Oscar
    Linköping University, Department of Clinical and Experimental Medicine, Division of Clinical Sciences. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Center for Disaster Medicine and Traumatology.
    Workload Differences Across Command Levels and Emergency Response Organizations During a Major Joint Training Exercise2016In: Journal of Emergency Management, ISSN 1543-5865, Vol. 14, no 4, p. 289-297Article in journal (Refereed)
    Abstract [en]

    OBJECTIVE:

    This study reports on an initial test using a validated workload measurement method, the NASA Task Load Index (TLX), as an indicator of joint emergency exercise effectiveness. Prior research on emergency exercises indicates that exercises must be challenging, ie, result in high workload, to be effective. However, this is often problematic with some participants being underloaded and some overloaded. The NASA TLX was used to test for differences in workload between commanders and subordinates and among three different emergency response organizations during a joint emergency exercise.

    DESIGN:

    Questionnaire-based evaluation with professional emergency responders.

    SETTING:

    The study was performed in conjunction with a large-scale interorganizational joint emergency exercise in Sweden.

    PARTICIPANTS:

    A total of 20 participants from the rescue services, 12 from the emergency medical services, and 12 from the police participated in the study (N=44). Ten participants had a command-level role during the exercise and the remaining 34 were subordinates.

    MAIN OUTCOME MEASURE(S):

    The main outcome measures were the workload subscales of the NASA TLX: mental demands, physical demands, temporal demands, performance, effort, and frustration.

    RESULTS:

    The results showed that the organizations experienced different levels of workload, that the commanders experienced a higher workload than the subordinates, and that two out of three organizations fell below the twenty-fifth percentile of average workload scores compiled from 237 prior studies.

    CONCLUSIONS:

    The results support the notion that the NASA TLX could be a useful complementary tool to evaluate exercise designs and outcomes. This should be further explored and verified in additional studies.

  • 8.
    Rybing, Jonas
    Linköping University, Department of Computer and Information Science, Human-Centered systems. Linköping University, Faculty of Science & Engineering.
    Studying Simulations with Distributed Cognition2018Doctoral 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.

    List of papers
    1. Exploring prehospital C2-work during a mass gathering event
    Open this publication in new window or tab >>Exploring prehospital C2-work during a mass gathering event
    Show others...
    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
    2. Studying distributed cognition of simulation-based team training with DiCoT.
    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
    3. Designing a Digital Medical Management Training Simulator Using Distributed Cognition Theory
    Open this publication in new window or tab >>Designing a Digital Medical Management Training Simulator Using Distributed Cognition Theory
    Show others...
    2017 (English)In: Journal Simulation & Gaming, ISSN 1046-8781, E-ISSN 1552-826X, Vol. 48, no 1, p. 131-152Article in journal (Refereed) Published
    Abstract [en]

    Background Training of medical professionals is important to improve care during mass-causality events. Therefore, it is essential to extend knowledge on how to design valid and usable simulation-based training environments.

    Purpose This article investigates how distributed cognition and simulation theory concepts can guide design of simulation-based training environments. We present the design and user evaluation of DigEmergo, a simulator for training and assessing emergency medicine management.

    Design approach A prior Distributed Cognition in Teamwork (DiCoT) analysis of the Emergo Train System (ETS) guided the design process. The design objective of DigEmergo was to be useful, usable, retain distributed cognition features of ETS, and strengthen validity and output reliability.

    Evaluation Eight expert ETS instructors participated in a formative system evaluation. The Technology Assessment Model (TAM) questionnaire was used to measure usefulness and ease of use. Observations and post-test interviews were conducted to contextualize the measures.

    Results The results showed that DigEmergo was perceived as somewhat to quite useful and somewhat easy to use. Overall, expert users considered DigEmergo promising and successful in retaining core ETS features.

    Conclusions The study indicates that a design methodology based on distributed cognition and simulation theory can be successfully combined to guide simulator (re)design and strengthen simulator validity.

    Place, publisher, year, edition, pages
    Sage Publications, 2017
    Keywords
    distributed cognition, emergency medicine management training, simulation, simulator design, simulator user evaluation
    National Category
    Computer Systems
    Identifiers
    urn:nbn:se:liu:diva-132723 (URN)10.1177/1046878116676511 (DOI)2-s2.0-85011578887 (Scopus ID)
    Available from: 2016-11-21 Created: 2016-11-21 Last updated: 2018-05-02Bibliographically approved
    4. Preliminary Validation Results of DigEmergo for Surge Capacity Management
    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
    5. Short simulation exercises to improve emergency department nurses self-efficacy for initial disaster management: Controlled before and after study
    Open this publication in new window or tab >>Short simulation exercises to improve emergency department nurses self-efficacy for initial disaster management: Controlled before and after study
    Show others...
    2017 (English)In: Nurse Education Today, ISSN 0260-6917, E-ISSN 1532-2793, Vol. 55, p. 20-25Article in journal (Refereed) Published
    Abstract [en]

    Introduction: Head nurses at emergency departments often assume responsibility for managing the initial response to a major incident, and to create surge capacity. Training is essential to enable these nurses to perform an effective disaster response. Evaluating the effects of such training is however complicated as real skill only can be demonstrated during a real major incident. Self-efficacy has been proposed as an alternative measure of training effectiveness. Purpose: The aim of this study was to examine if short, small-scale computer-based simulation exercises could improve head emergency nurses general and specific self-efficacy and initial incident management skills. Method: A within-group pretest-posttest design was used to examine 13 head nurses general and specific self efficacy before and after an intervention consisting of three short computer based simulation exercises during a 1-h session. Management skills were assessed using the computer simulation tool DigEmergo. Results: The exercises increased the head nurses general self-efficacy but not their specific self-efficacy. After completing the first two exercises they also exhibited improved management skills as indicated by shorter time to treatment for both trauma and in-hospital patients. Conclusion: This study indicates that short computer based simulation exercises provide opportunities for head nurses to improve management skills and increase their general self-efficacy.

    Place, publisher, year, edition, pages
    CHURCHILL LIVINGSTONE, 2017
    Keywords
    Management; Mass casualty incident; Nurses; Simulation training; Surge capacity
    National Category
    Nursing
    Identifiers
    urn:nbn:se:liu:diva-139548 (URN)10.1016/j.nedt.2017.04.020 (DOI)000404700900005 ()28505521 (PubMedID)
    Note

    Funding Agencies|Swedish Civil Contingencies Agency (MSB) [2011-4957]

    Available from: 2017-08-08 Created: 2017-08-08 Last updated: 2018-05-02
  • 9.
    Rybing, Jonas
    et al.
    Linköping University, Department of Computer and Information Science, Human-Centered systems. Linköping University, Faculty of Science & Engineering.
    Larsson, Johan
    Linköping University, Faculty of Medicine and Health Sciences, Faculty of Health Sciences, Medical Programme.
    Jonson, Carl-Oscar
    Linköping University, Department of Clinical and Experimental Medicine, Division of Clinical Sciences. Region Östergötland, Center for Disaster Medicine and Traumatology.
    Prytz, Erik
    Linköping University, Department of Computer and Information Science, Human-Centered systems. Linköping University, Faculty of Arts and Sciences.
    Preliminary Validation Results of DigEmergo for Surge Capacity Management2016In: 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 (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.

  • 10.
    Rybing, Jonas
    et al.
    Linköping University, Department of Computer and Information Science, Human-Centered systems. Linköping University, Faculty of Science & Engineering.
    Nilsson, Heléne
    Linköping University, Department of Clinical and Experimental Medicine, Division of Clinical Sciences. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Center for Disaster Medicine and Traumatology.
    Jonson, Carl-Oscar
    Linköping University, Department of Clinical and Experimental Medicine, Division of Clinical Sciences. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Center for Disaster Medicine and Traumatology.
    Bång, Magnus
    Linköping University, Department of Computer and Information Science, Human-Centered systems. Linköping University, Faculty of Science & Engineering.
    Studying distributed cognition of simulation-based team training with DiCoT.2016In: Ergonomics, ISSN 0014-0139, E-ISSN 1366-5847, Vol. 59, no 3, p. 423-434Article in journal (Refereed)
    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.

  • 11.
    Rybing, Jonas
    et al.
    Linköping University, Department of Computer and Information Science, Human-Centered systems. Linköping University, Faculty of Science & Engineering.
    Prytz, Erik
    Linköping University, Department of Computer and Information Science, Human-Centered systems. Linköping University, Faculty of Arts and Sciences.
    Hornwall, Johan
    Linköping University, Department of Clinical and Experimental Medicine. Linköping University, Faculty of Health Sciences.
    Jonson, Carl-Oscar
    Linköping University, Department of Clinical and Experimental Medicine, Division of Clinical Sciences. Linköping University, Faculty of Health Sciences. Region Östergötland, Center for Disaster Medicine and Traumatology.
    Nilsson, Heléne
    Linköping University, Department of Clinical and Experimental Medicine, Division of Clinical Sciences. Linköping University, Faculty of Health Sciences.
    Bång, Magnus
    Linköping University, Department of Computer and Information Science, Human-Centered systems. Linköping University, Faculty of Science & Engineering.
    Preliminary evaluation results of DigEmergo - a digital simulator prototype for disaster and emergency management training2015In: Prehospital and Disaster Medicine / [ed] Samuel J. Stratton, New York, 2015, Vol. 30, p. 92-92Conference paper (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.

  • 12.
    Rybing, Jonas
    et al.
    Linköping University, Department of Computer and Information Science, Human-Centered systems. Linköping University, Faculty of Science & Engineering.
    Prytz, Erik
    Linköping University, Department of Computer and Information Science, Human-Centered systems. Linköping University, Faculty of Arts and Sciences.
    Hornwall, Johan
    Linköping University, Department of Clinical and Experimental Medicine. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Center for Disaster Medicine and Traumatology.
    Nilsson, Heléne
    Region Östergötland, Center for Disaster Medicine and Traumatology. Linköping University, Faculty of Medicine and Health Sciences. Linköping University, Department of Clinical and Experimental Medicine, Division of Surgery, Orthopedics and Oncology.
    Jonson, Carl-Oscar
    Linköping University, Department of Clinical and Experimental Medicine, Division of Surgery, Orthopedics and Oncology. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Center for Disaster Medicine and Traumatology.
    Bång, Magnus
    Linköping University, Department of Computer and Information Science, Human-Centered systems. Linköping University, Faculty of Science & Engineering.
    Designing a Digital Medical Management Training Simulator Using Distributed Cognition Theory2017In: Journal Simulation & Gaming, ISSN 1046-8781, E-ISSN 1552-826X, Vol. 48, no 1, p. 131-152Article in journal (Refereed)
    Abstract [en]

    Background Training of medical professionals is important to improve care during mass-causality events. Therefore, it is essential to extend knowledge on how to design valid and usable simulation-based training environments.

    Purpose This article investigates how distributed cognition and simulation theory concepts can guide design of simulation-based training environments. We present the design and user evaluation of DigEmergo, a simulator for training and assessing emergency medicine management.

    Design approach A prior Distributed Cognition in Teamwork (DiCoT) analysis of the Emergo Train System (ETS) guided the design process. The design objective of DigEmergo was to be useful, usable, retain distributed cognition features of ETS, and strengthen validity and output reliability.

    Evaluation Eight expert ETS instructors participated in a formative system evaluation. The Technology Assessment Model (TAM) questionnaire was used to measure usefulness and ease of use. Observations and post-test interviews were conducted to contextualize the measures.

    Results The results showed that DigEmergo was perceived as somewhat to quite useful and somewhat easy to use. Overall, expert users considered DigEmergo promising and successful in retaining core ETS features.

    Conclusions The study indicates that a design methodology based on distributed cognition and simulation theory can be successfully combined to guide simulator (re)design and strengthen simulator validity.

  • 13.
    Rybing, Jonas
    et al.
    Linköping University, Department of Computer and Information Science, Human-Centered systems. Linköping University, The Institute of Technology.
    Smith, Christian
    Linköping University, Department of Computer and Information Science, Human-Centered systems. Linköping University, The Institute of Technology.
    Silvervarg, Annika
    Linköping University, Department of Computer and Information Science, Human-Centered systems. Linköping University, The Institute of Technology.
    Towards a Rule Based System for Automatic Simplification of Texts2010In: SLTC 2010: The Third Swedish Language Technology Conference, 2010, p. 17-18Conference paper (Other academic)
1 - 13 of 13
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