Distributed cognition in the heart room: How situation awareness arises from coordinated communications during cardiac surgery

Brian Hazlehurst, Carmit K. McMullen, Paul N. Gorman

Research output: Contribution to journalArticle

101 Scopus citations

Abstract

To help ensure successful outcomes of open-heart surgery, surgeon and perfusionist must coordinate their activities during management of cardioplegia. This research aims to understand the basis for this coordination. We employed the framework of distributed cognition and the methodology of cognitive ethnography to describe how cognitive resources are configured and utilized to accomplish successful cardioplegia management. Analysis identified six types of surgeon-perfusionist verbal exchange which collectively enable robust system performance through (a) making the current situation clear and mutually understood; (b) making goals and envisioned future situations clear and thereby anticipated; and (c) expanding upon the activity system's knowledge base through discovery and sharing of experience. We argue for the "activity system" as the appropriate unit of analysis, and distributed cognition as a powerful theoretical framework for studying the socio-technical work of health care.

Original languageEnglish (US)
Pages (from-to)539-551
Number of pages13
JournalJournal of Biomedical Informatics
Volume40
Issue number5
DOIs
StatePublished - Oct 1 2007

Keywords

  • Cognitive ethnography
  • Coordinated teamwork
  • Distributed cognition
  • Heart surgery
  • Patient safety
  • Situation awareness

ASJC Scopus subject areas

  • Computer Science Applications
  • Health Informatics

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