Abstract
Approximately 10% of newborn infants require resuscitative intervention at birth. Ideally, this care is provided by a team of expert healthcare professionals who possess exceptional cognitive, psychomotor, and communication skills. Human errors and deviations from resuscitation protocol are common and may be attributable to excessive cognitive demand experienced by the resuscitation team. Cognitive Task Analysis (CTA) is a group of methods used to assess knowledge, judgments, goals, and decision-making of expert healthcare professionals. These methods may be used during neonatal resuscitation to gain an improved understanding of the approaches used by healthcare professionals. CTA methods have been applied in many medical disciplines including neonatology. CTA has been used to identify information previously confined to the intuition of experts. This information has been used to assess, develop, and improve medical technology, clinical decision support tools (DSTs), communication structure, and training methods. Knowledge attained through CTA might be applied similarly to neonatal resuscitation, which may in turn decrease human errors, and improve patient safety.
Highlights
During neonatal resuscitation, decisions must be made quickly and healthcare professionals (HCPs) must possess exceptional cognitive, psychomotor, and communication skills to identify problems, analyze complex scenarios, generate solutions, and refine a large amount of data into useful information under time pressure [1]
Cognitive Task Analysis (CTA) is a mechanism for capturing expertise; by breaking down complex cognitive processes that drive a set of behaviors, one can formulate comprehensive algorithmic descriptions of tasks and define task rules [6, 7]
The Critical Decision Method (CDM) is another frequently used method of CTA; this method involves a retrospective interview in which participants are asked to recall a non-routine incident and are probed about decisions and judgments during that incident [10]
Summary
Decisions must be made quickly and healthcare professionals (HCPs) must possess exceptional cognitive, psychomotor, and communication skills to identify problems, analyze complex scenarios, generate solutions, and refine a large amount of data into useful information under time pressure [1]. CTA identified several flaws including confusing alarm information, ambiguous commands with scale functions, unintuitive icon displays, and lack of variability in alarms with existing incubator systems, and provided solutions [12] These examples demonstrate that CTA could be used to improve neonatal resuscitation equipment for HCP use. These methods identified several human computer interface problems, including lack of screen cues and ambiguous icons, which were associated with excessive cognitive efforts [20] These CTA approaches could be used to optimize the design of DST for neonatal resuscitation. This approach allowed for a qualitative characterization of the cognitive processes underlying resident’s crisis resource management and an examination of how these skills varied with resident’s performance [51] This information could be applied to improve non-technical assessment of residents performing simulationbased resuscitation. The method used to create these tools could be adapted to assess technical and non-technical skills during neonatal resuscitation
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