Cognitive load decreases the sense of agency during continuous action

Objective Understand the perceived role of electronic health records (EHR) and workflow fragmentation on clinician documentation burden in the emergency department (ED). Methods From February to June 2022, we conducted semistructured interviews among a national sample of US prescribing providers and registered nurses who actively practice in the adult ED setting and use Epic Systems’ EHR. We recruited participants through professional listservs, social media, and email invitations sent to healthcare professionals. We analyzed interview transcripts using inductive thematic analysis and interviewed participants until we achieved thematic saturation. We finalized themes through a consensus-building process. Results We conducted interviews with 12 prescribing providers and 12 registered nurses. Six themes were identified related to EHR factors perceived to contribute to documentation burden including lack of advanced EHR capabilities, absence of EHR optimization for clinicians, poor user interface design, hindered communication, increased manual work, and added workflow blockages, and five themes associated with cognitive load. Two themes emerged in the relationship between workflow fragmentation and EHR documentation burden: underlying sources and adverse consequences. Discussion Obtaining further stakeholder input and consensus is essential to determine whether these perceived burdensome EHR factors could be extended to broader contexts and addressed through optimizing existing EHR systems alone or through a broad overhaul of the EHR’s architecture and primary purpose. Conclusion While most clinicians perceived that the EHR added value to patient care and care quality, our findings underscore the importance of designing EHRs that are in harmony with ED clinical workflows to alleviate the clinician documentation burden.

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Baseline dependent differences in the perception of changes in visuomotor delay

Vigh,

Limanowski

2024

Preprint

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The Weber-Fechner Laws have been evaluated across a wide variety of modalities and tasks, but not yet in the domain of visuomotor mapping. A prominent manipulation of visuomotor mapping is temporal; i.e., delaying visual movement feedback. Yet, while visuomotor delay detection itself has been extensively studied, it is not known whether the perception of changes in delay depends on the present amount of delay. We developed a virtual reality based, continuous hand movement task, during which participants had to detect changes in visuomotor mapping (delay): Participants (N=40) performed continuous, auditory-paced grasping movements, which were measured with a data glove and transmitted to a virtual hand model. The movements of the virtual hand were periodically delayed between 0-700ms; the delay changed repeatedly in a roving oddball fashion in steps of 100-400ms. Participants had to indicate perceived delay changes by key presses, as fast as possible. This design allowed us to investigate detection accuracy and speed related to the magnitude of the delay change, and to the “baseline” delay present during movement. As expected, larger delay changes were detected more accurately than smaller ones. Surprisingly, delay changes were detected more accurately and faster when participants moved under larger delays. These results suggest that visual movement feedback delay affects the detection of changes in visuomotor mapping, but not as predicted by the Weber-Fechner Laws. Rather, smaller visual movement feedback delays likely increased the tolerance for visuomotor changes via an enhanced subjective embodiment of the virtual hand.

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Cognitive load decreases the sense of agency during continuous action

Cited by 4 publications

References 42 publications

Sense of agency in the context of COVID-19 pandemic

Sense of agency in the context of COVID-19 pandemic

Understanding the perceived role of electronic health records and workflow fragmentation on clinician documentation burden in emergency departments

Baseline dependent differences in the perception of changes in visuomotor delay

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