An understanding of how handoffs are conducted in settings with high consequences for failure can jumpstart endeavors to modify handoffs to improve patient safety.

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A fundamental challenge in studying cognitive systems in context is how to move from the specific work setting studied to a more general understanding of distributed cognitive work and how to support it. We present a series of cognitive field studies that illustrate one response to this challenge. Our focus was on how nuclear power plant (NPP) operators monitor plant state during normal operating conditions. We studied operators at two NPPs with different control room interfaces. We identified strong consistencies with respect to factors that made monitoring difficult and the strategies that operators have developed to facilitate monitoring. We found that what makes monitoring difficult is not the need to identify subtle abnormal indications against a quiescent background, but rather the need to identify and pursue relevant findings against a noisy background. Operators devised proactive strategies to make important information more salient or reduce meaningless change, create new information, and off-load some cognitive processing onto the interface. These findings emphasize the active problem-solving nature of monitoring, and highlight the use of strategies for knowledge-driven monitoring and the proactive adaptation of the interface to support monitoring. Potential applications of this research include control room design for process control and alarm systems and user interfaces for complex systems.

The risks of unfamiliar technologies are often evaluated by comparing them with the risks of more familiar ones. Such risk comparisons have been criticized for neglecting critical dimensions of risky decisions. In a guide written for the Chemical Manufacturers Association, Covello et al.(1) have summarized these critiques and developed a taxonomy that characterizes possible risk comparisons in terms of their acceptability (or objectionableness). We asked four diverse groups of subjects to judge the acceptability of 14 statements produced by Covello et al. as examples of their categories. We found no correlation between the judgments of acceptability produced by our subjects and those predicted by Covello et al..