This paper presents the results of a project to articulate a theory–based framework for characterizing the decision making and situation awareness (SA) of Army Aviators. This was the first step toward developing strategies for evaluating the impact of emerging technologies on cognitive performance. The team conducted a literature review of decision making and SA models along with a review of Army Aviation cognitive requirements and identified key decision making concepts. The team synthesized a framework of decision making based on key concepts from the literature tailored to Army Aviation. The framework guided a literature review of evaluation methods and measures. Evaluation literature review findings included the use of scenario-based evaluation with a range of complexities, and multiple, complementary measures. The synthesized framework served as a useful tool to describe aviator decision making and how technology can influence decision making and SA, and may be useful beyond the Army Aviation context.

There is increasing demand to operate unmanned aircraft systems (UAS) in congested terminal environments, such as busy commercial airports. With this demand comes challenges to pilots. To identify these challenges, we conducted critical decision method (CDM) interviews with pilots. CDM is a cognitive task analysis method aimed at uncovering tacit cognitive challenges. Eight pilots from the U.S. were interviewed including four UAS pilots and four commercial pilots. Interviews were analyzed using thematic analysis, resulting in the identification of four categories of cognitive challenges: (i) noticing anomalies, (ii) diagnosing automation behavior, (iii) understanding when and how to intervene, and (iv) coordinating with air traffic control. In this paper, we describe each challenge, highlight real-world examples from our interviews, and provide some recommendations for addressing the implications of integrating UAS in congested terminal airspace.

In 2016, we examined the connection between naturalistic decision making and the trend toward best practice compliance; we used evidence-based medicine (EBM) in health care as an exemplar. Paul Falzer's lead paper in this issue describes the historical underpinnings of how and why EBM came into vogue in health care. Falzer also highlights the epistemological rationale for EBM. Falzer's article, like our own, questions the rationale of EBM and reflects on ways that naturalistic decision making can support expertise in the face of attempts to standardize practice and emphasize compliance. Our objectives in this commentary are first to explain the inherent limits of procedural approaches and second to examine ways to help decision makers become more adaptive.

There is a growing popularity of data-driven best practices in a variety of fields. Although we applaud the impulse to replace anecdotes with evidence, it is important to appreciate some of the cognitive constraints on promulgating best practices to be used by practitioners. We use the evidence-based medicine (EBM) framework that has become popular in health care to raise questions about whether the approach is consistent with how people actually make decisions to manage patient safety. We examine six potential disconnects and suggest ways to strengthen best practices strategies.

Purpose: Currently, there is no well-established follow- up recommendation for evaluation of re-stenosis after percoutaneus translumimal angioplastie (PTA) or stent implantation in patients with peripheral arterial occlusive disease (PAOD). The aim of this study was to evaluate the effectiveness of Doppler ultrasound in the long- term follow- up.

In the range of specialized work equipment, pointe shoes occupy a special place. The design of these essential tools for dancers has remained essentially unchanged for 200 years. In an age of high-tech sneakers, pointe shoes are made of cardboard, newspaper, fabric, and glue and cause countless injuries and tremendous pain to ballerinas. In this project, we consider them in an ergonomic and usability context and explore design changes to improve their safety, comfort, usability, and durability.

While many have identified medication adherence as a critical part of therapy success and recognize that most therapies have adherence rates that are too low, few successful solutions to improve adherence have emerged. The palette of potential adherence interventions continues to grow, but the literature does not provide a general understanding of what works and what doesn't. Instead, many papers describe adherence problems within a single condition, therapy, or patient population or assess traditional interventions: support phone calls, informational literature, reminder text messages. Furthermore, the specifics of adherence approaches tested are not typically discussed in the literature. One can imagine multiple telephonic "support" experiences, some of which motivate and truly support patients, and others which may annoy them. The missing piece is an approach to adherence that considers design. A more careful consideration of the details of the design will open new possibilities for effective adherence intervention systems. Understanding the broader context of design: the particular condition, therapy, and patient population, will help ensure that those details are most appropriate. The combined focus on details with sensitivity to context creates a foundation for innovation that can be both customized to the particular problem and generalizable for other researchers and designers.

The problem of adherence — why people fail to follow therapies intended to improve their health — has long bedeviled researchers in medicine, public health, nursing, pharmacology, psychology, and beyond. Most studies have focused on solving problems surrounding a specific condition (such as diabetes) or behavior (such as smoking cessation). This proposal presents a generalized, cross-condition model — the Adherence Loop model — that describes the role of beliefs, knowledge, and actions for designing better adherence programs. The model is based on studies from 4 diverse conditions: multiple sclerosis (MS), weight loss, osteoporosis, and erectile dysfunction (ED). The model suggests ways to support the design process and create programs, tools, and environments to promote adherence by better understanding patients' journeys and mental models of their conditions.

Observations of people's actual behavior often contradict their self-perceptions and can lead to better solutions and improvements.

By approaching problems in the hospital as an observational researcher, biomeds can begin to think about the problems in a different way, which may point toward opportunities to solve these problems. Of all of the people in the hospital, biomeds are in the best position to address these issues because they see how the products are used and what goes wrong. These three steps are just a starting point for moving beyond product repair and maintenance so biomeds can improve product use in their hospitals.

While designing and validating any complex system has challenges, the medical domain has specific requirements which must be considered for a system or device to be successful. The environments, communities of use, and interactions are varied, unpredictable, uncontrolled, and ever-changing. Given the environments, communities of use, and interactions involved with medical devices, successful early and late validation of the device must be informed by the context of use itself. Building “frameworks” which represent the context of use for the device can focus validation goals, methods, and criteria and ensure that validation is directed and appropriate. In this paper we present a process and associated methods for defining the frameworks in which medical devices can be successfully assessed. The phases of the process include Phase1: Definition in which a framework of understanding is built which represents the environment of use, community of users, and the interactions between systems and users for the medical device in development. In Phase 2: Validation the framework which defines the environment of use, community of users, and the interactions between systems and users is used to develop a validation approach and criteria. The developing device is then validated against the framework itself.

Polysemous words have different but related meanings (senses), such as paper meaning a newspaper or writing material. Six experiments examined the similarity of word senses using categorization and inference tasks. The experiments found that subjects did not categorize together phrases that used a polysemous word in different senses, though they did when the word was used in the same sense. Different senses of a word were categorized together no more than 20% of the time, only slightly more often than different meanings of homonyms. Pre-exposing subjects to a polysemous relation did not increase categorization of word senses that had that relation. Finally, induction from one sense of a word to a different sense was also weak. The results are consistent with the view that polysemous senses are represented separately, often with little semantic overlap, helping to explain previous results that using a word in one sense interferes with using it in another sense, even if the senses are related. Implications for lexical representations are discussed.

Words that have a number of related senses are polysemous. For example, paper refers to both a substance and a publication printed on that substance. Five experiments investigated whether different senses are represented distinctly in the lexicon or if there is a common, core meaning. In all experiments, a polysemous word was used twice, in phrases that selected the same or different senses. Experiment 1 showed that sense consistency aided memory for the polysemous word. Experiment 2 extended this result to a timed sensicality judgment task. Experiment 3 demonstrated that the effects for polysemous words were very similar to those for homonyms. Experiment 4 ruled out the possibility of modifier-modifier priming. Experiment 5 showed that sense consistency facilitates comprehension relative to a neutral baseline, while sense inconsistency inhibits comprehension. These experiments provide evidence that polysemous words have separate representations for each sense and that any core meaning is minimal.

ARY WAS PROUD OF HIS LATEST FORAY into the paperless age. His new electronic organizer put him on the cutting edge of technology. To help him keep track of his busy schedule, the organizer provided an address book, calculator, calendar, and financial planner all in one unit that could fit in his pocket. The organizer should, he thought, be effortless to master, judging from the brevity of the instruction manual. He pressed the ON button and was immediately stymied with the riddle of how to operate it. Gary turned to the pamphlet for direction, only to be confronted by a confusing maze of minuscule diagrams and clutter (see Figure 1). This is an actual case in which product documentation failed to support the needs of the end user. In this case, the manufacturer of the electronic organizer was Oregon Scientific; the Directions for Use (DFU) accompanying the organizer were enough to make a human factors/ergonomics practitioner dizzy. Some of the most glaring problems include a lack of table of contents, a series of diagrams labeled only with numbers and without accompanying text, diagrams themselves that are cryptic in form and meaning, and text-based instructions that are listed separately, far from the diagrams they tersely describe. And on page 6 not page 1 was this warning: "Please read the user's guide carefully MICHELLE YEH