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Board 177 - Program Innovations Abstract Cognitive Task Analysis: Refining Simulated Procedure Labs (Submission #528)

Introduction/Background Cognitive Task Analysis (CTA) is a system used to give insight about expert judgment and defines knowledge (explicit and implicit) used in the performance of complex tasks.1 CTA has been used to train workers in many sectors, such as in military, transportation and industry. Due to the rare occurrence of certain problems, it has been suggested that fifty hours of CTA-based training would be the equivalent of five years of on-the-job problem solving experience.2 There have been a limited amount of studies on CTA in healthcare, but it has been shown to be an effective technique in surgical education of procedures.3 The authors chose to apply CTA to the complex task of managing an airway after recognizing a potential benefit and the lack of uniformity in their simulation-based airway training lab of an emergency medicine residency. The goal of this innovation is to apply CTA in an airway training lab by retrieving information and details from experts in order to provide improved and uniform training. This innovation is unique in utilizing CTA through a simulation lab without an individual formally trained in CTA. Methods Five common steps to performing CTA were used: Collect preliminary knowledge; Identify knowledge representations; Apply focused knowledge elicitation Methods; Analyze and verify data acquired; Format Results for the intended application.1 Step one was accomplished by identifying a simulation specialist to perform the CTA, as the individual was familiar with the curricula and procedures of the airway lab. For step two the training was broken into sub-tasks (Assessing a patient; Managing airway prior to intubation; Procedures; Post-intubation management; Problems arising post-intubation) with problem solving, rules and concepts identified per sub-task. In step three attending emergency medicine physicians were used as subject matter experts (SME) and underwent semi-structured interview followed by direct observation. Step four was completed after each SME that completed the exercise reviewed and edited the detailed Results obtained in step three. Step five was represented by structuring the Results obtained from the CTA into an airway training lab. The Results of the CTA exercise were compared to our current airway training curricula to identify differences. Elements from the CTA exercise and current curricula were blended into a single curriculum for future use. As multiple attending physicians using a set of pre-identified skills taught the simulation component of the current curriculum, it was difficult to determine certain training points that may have been taught but not identified on review of the curricula. Results: Conclusion As part of this innovation the authors compared the CTA Results to the existing airway management curricula of the residency (including simulation and didactic time) and analyzed similarities and differences. As expected there were numerous similarities throughout all sub-tasks. Differences were noted in four out of five sub-tasks. The curriculum will be modified to include all the points identified by CTA and will be utilized in future training. References 1. Clark, R. E., Feldon, D., vanMerrienboer, J., Yates, K, and Early, S. Cognitive Task Analysis. In Spector, J.M., Merrill, M. D., van Merriënboer, J. J.G., & Driscoll, M. P. (Eds.) Handbook of research on educational communications and Technology (3rd ed.). Mahwah, NJ: Lawrence Erlbaum Associates. 2. Means B, Gott S. Cognitive task analysis as a basis for tutor development: Articulating abstract knowledge representations. In: Psotka J, Massey LD, Mutter SA, eds. Intelligent Tutoring Systems: Lessons Learned. Hillsdale, NJ: Lawrence Erlbaum; 1988:201–244. 3. Velmahos G, Toutouzas K, Sillin L, et al. Cognitive task analysis for teaching technical skills in an inanimate surgical skills laboratory. Am J Surg. 2004;187:114-9. Disclosures None None None None Owner of W’s Emergency Medicine, LLC (Company produces iPad applications).