Fabrizio Bracco

People have the power: priority of socially relevant stimuli in a change detection task

Change detection performance is influenced by a number of factors, among which is the informativeness of targets. It has not been clarified, yet, whether the highly informative regions have a processing priority as a result of resource deployment from other tasks or whether it results from a better resource management. In this paper, we adopted a change detection paradigm in which thirty participants were randomly assigned to two groups: single (change detection task) and dual task [change detection and a simplified version of the Paced Auditory Serial Oppository Task (PASOT, Gow and Deary in J Clin Exp Neuropsychol 26:723–736, 2004), which implies a verbal effort]. Stimulus informativeness was defined as social relevance, that is, changing targets were people (high relevance) versus objects (low relevance), all other aspects (i.e., salience and position in the scene) kept constant. As hypothesized, data analyses showed a significant main effect of social relevance and task condition, i.e., better change detection performance and lower change detection times for people versus objects and for single than for dual task condition. Interestingly, the PASOT accuracy remained stable across the person versus object trials, thus implying that the better performance with socially relevant targets could not be explained by a resources withdrawal from the secondary task.

Promoting Safety through Well-Being: An Experience in Healthcare

Practitioners’ well-being and clinical risk management are two interrelated concepts in healthcare. Patient safety, workers’ safety and practitioners well-being have often been managed and measured with different methods, even though they are tightly linked. In this paper we propose a method that is suitable to increase organizational health. The action-research project aims to increase the commitment of healthcare managers and practitioners toward the development of an organizational culture which is oriented to patient and practitioner safety and well-being. These are crucial organizational resource for an effective process management. The project lasted 18 months and involved 60 nurses and physicians working in the operating room of six hospitals in the North of Italy. The project aimed to develop an inter-organizational methodology for noticing and monitoring critical threats to safety and well-being. The tool consisted of a report form in which practitioners could describe possible threats, solutions and personal contributions to the solutions. The participants designed it according to their practice and it was considered suitable and usable in their current work activities. Its added value is to overcome the habitual bottleneck between anomalies investigation and action planning, by identifying a specific role in the learning process to take care of the transition from data gathering to data use. The tool aims to enable individuals and teams to monitor and share ideas about critical aspects that affect their safety and well-being, collect contributions to solve them, sustain dissemination of good practices and frame health promotion as a crucial organizational resource.

Adaptation of non-technical skills behavioural markers for delivery room simulation

BackgroundSimulation in healthcare has proved to be a useful method in improving skills and increasing the safety of clinical operations. The debriefing session, after the simulated scenario, is the core of the simulation, since it allows participants to integrate the experience with the theoretical frameworks and the procedural guidelines. There is consistent evidence for the relevance of non-technical skills (NTS) for the safe and efficient accomplishment of operations. However, the observation, assessment and feedback on these skills is particularly complex, because the process needs expert observers and the feedback is often provided in judgmental and ineffective ways. The aim of this study was therefore to develop and test a set of observation and rating forms for the NTS behavioural markers of multi-professional teams involved in delivery room emergency simulations (MINTS-DR, Multi-professional Inventory for Non-Technical Skills in the Delivery Room).MethodsThe MINTS-DR was developed by adapting the existing tools and, when needed, by designing new tools according to the literature. We followed a bottom-up process accompanied by interviews and co-design between practitioners and psychology experts. The forms were specific for anaesthetists, gynaecologists, nurses/midwives, assistants, plus a global team assessment tool. We administered the tools in five editions of a simulation training course that involved 48 practitioners. Ratings on usability and usefulness were collected.ResultsThe mean ratings of the usability and usefulness of the tools were not statistically different to or higher than 4 on a 5-point rating scale. In either case no significant differences were found across professional categories.ConclusionThe MINTS-DR is quick and easy to administer. It is judged to be a useful asset in maximising the learning experience that is provided by the simulation.

Music Ensemble as a Resilient System. Managing the Unexpected through Group Interaction

The present contribution provides readers from diverse fields of psychology with a new and comprehensive model for the understanding of the characteristics of music ensembles. The model is based on a novel heuristic approach whose key construct is resilience, intended here as the ability of a system to adapt to external perturbations and anticipate future events. The paper clarifies the specificity of music ensemble as an original social and creative activity, and how some mechanisms, at an individual (cognitive) and group (coordination) level, are enacted in a particular way that endows these groups with exceptional capacity for resilience. There is now a wealth of evidence isolating the psychological mechanisms involved in these processes. However, there is much less focus on conditions in which the group has to face unexpected and potentially performance-disruptive events. The resilience approach offers a more thorough explanation of the regulatory strategies that musicians may resort to in order to maintain their performance at an optimal level. Music ensembles of different size are presented as case studies of how such systems (and their individual members) resist error and maintain joint performance. Three hypothetical scenarios are further proposed that epitomize resilient or non-resilient musical teams. The present contribution further proposes hypotheses and formulates predictions on which combinations of individual and group factors foster team resilience. This model further accommodates the most recent findings in neuroscience and experimental psychology. Besides highlighting the potential of music ensemble for psychological research, it offers hints about how resilience could be trained.

Development and validation of the Facial Expression Recognition Test (FERT).

Detecting the emotional state of others from facial expressions is a key ability in emotional competence and several instruments have been developed to assess it. Typical emotion recognition tests are assumed to be unidimensional, use pictures or videos of emotional portrayals as stimuli, and ask the participant which emotion is depicted in each stimulus. However, using actor portrayals adds a layer of difficulty in developing such a test: the portrayals may fail to be convincing and may convey a different emotion than intended. For this reason, evaluating and selecting stimuli is of crucial importance. Existing tests typically base item evaluation on consensus or expert judgment, but these methods could favor items with high agreement over items that better differentiate ability levels and they could not formally test the item pool for unidimensionality. To address these issues, the authors propose a new test, named Facial Expression Recognition Test (FERT), developed using an item response theory two-parameter logistic model. Data from 1,002 online participants were analyzed using both a unidimensional and a bifactor model, and showed that the item pool could be considered unidimensional. The selection was based on the items’ discrimination parameters, retaining only the most informative items to investigate the latent ability. The resulting 36-item test was reliable and quick to administer. The authors found both a gender difference in the ability to recognize emotions and a decline of such ability with age. The PsychoPy implementation of the test and the scoring script are available on a Github repository.

Validity of Mental Workload Measures in a Driving Simulation Environment

Automated in-vehicle systems and related human-machine interfaces can contribute to alleviating the workload of drivers. However, each new functionality can also introduce a new source of workload, due to the need to attend to new tasks and thus requires careful testing before being implemented in vehicles. Driving simulators have become a viable alternative to on-the-road tests, since they allow optimal experimental control and high safety. However, for each driving simulator to be a useful research tool, for each specific task an adequate correspondence must be established between the behavior in the simulator and the behavior on the road, namely, the simulator absolute and relative validity. In this study we investigated the validity of a driving-simulator-based experimental environment for research on mental workload measures by comparing behavioral and subjective measures of workload of the same large group of participants in a simulated and on-road driving task on the same route. Consistent with previous studies, mixed support was found for both types of validity, although results suggest that allowing more and/or longer familiarization sessions with the simulator may be needed to increase its validity. Simulator sickness also emerged as a critical issue for the generalizability of the results.

Crisis Resource Management in the Delivery Room: Development of Behavioral Markers for Team Performance in Emergency Simulation

Human factors are the most relevant issues contributing to adverse events in obstetrics. Specific training of Crisis Resource Management (CRM) skills (i.e., problem solving and team management, resource allocation, awareness of environment, and dynamic decision-making) is now widespread and is often based on High Fidelity Simulation. In order to be used as a guideline in simulated scenarios, CRM skills need to be mapped to specific and observable behavioral markers. For this purpose, we developed a set of observable behaviors related to the main elements of CRM in the delivery room. The observational tool was then adopted in a two-days seminar on obstetric hemorrhage where teams working in obstetric wards of six Italian hospitals took part in simulations. The tool was used as a guide for the debriefing and as a peer-to-peer feedback. It was then rated for its usefulness in facilitating the reflection upon one’s own behavior, its ease of use, and its usefulness for the peer-to-peer feedback. The ratings were positive, with a median of 4 on a 5-point scale. The CRM observational tool has therefore been well-received and presents a promising level of inter-rater agreement. We believe the tool could have value in facilitating debriefing and in the peer-to-peer feedback.