Conceptual approach for temporal master schedule (all names are fictitious). 

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... to execute the procedures. The research methods that have been described here get at the nature of practitioner behavior, including the goals and strategies that practitioners use to achieve them. Methods make it possible to evaluate new cognitive artifacts by determining the fit between an artifact and the work domain for which it is intended. Those who seek a way to understand the cognitive work in a domain will need to use such an approach in order to develop information technology that is authentically suited to practitioner needs. Cognitive artifacts that are computer-supported can add value to resource planning through prompting, and support for speculation, consequence assessment, and value-based decisions. Prompting. Coordinator interviews indicated that schedule development expertise relies on deep domain knowledge that can only be cultivated through time. Computer-supported artifacts might survey information in the distributed cognition for gaps and inconsistencies that go unnoticed. Nominating such item(s) for the schedule writer to consider would enrich and improve the cognition. Speculation. Coordinators and team members were routinely observed to speculate about different courses of action in anticipation of known and possible demands for care. Computer-supported artifacts can make it possible for coordinators to speculate about possible courses of action and then choose among them. Making it possible for coordinators to evaluate multiple options would make their consideration more thorough. Consequences. During schedule writing sessions, coordinators routinely mentioned the implications of the decisions they made while assigning resources. However, coordinators varied in their attention to implications. In one instance, a coordinator writing the same sample schedule as a previous coordinator no- ticed an opportunity for Medicare reimbursement that the other coordinator had not mentioned. Applying evaluation criteria to potential courses of action could make it possible to display the consequences of choices. For example, a system might show how billing could be increased or how costs could be minimized by opening one room or closing another. Value-Based Decisions. Schedule writing sessions showed how coordinators vary in their approach to scheduling decisions, based on different preferences that include making the day easy for the coordinator to manage, giving residents the optimal learning opportunity, and making the best match among practitioners and procedures. Digital artifacts can be used to develop templates of schedule planning strategies. Coordinators can review and employ a template that best matches their values and preferences. Templates can capture scheduling expertise and make it available for use by others, expanding schedule writing best practices beyond a single individual. Study of template use through time might open the way to insights about coordinator training and the development of schedule models to ease coordinator work loads. Developing a Conceptual Solution Based on Findings. Any distributed cognition includes cognitive artifacts that participants develop and use to support cognitive work. Naturalistic decision making environments such as health care are time pressured and resource constrained. For this reason, artifacts that participants create embody information that matters in that work setting. Artifacts are maintained as a part of everyday work because they are valued. Acute care cognitive research such as the work that has been described here reveals information about the work setting that can be used to create displays that are well-suited to staff work. Findings can also show how to create other types of displays that might add value to practitioner and coordinator daily activities. Displays of information that are related to staff assignments for patient procedures are typically organized according to the location where they are to be performed. As Figs. 1 and 3 show, the cases that are slated to be performed in the OR suite are listed according to each OR room. However, most of the cognitive work that coordinators perform in making and managing staff assignments is temporal – organized according to time. Any tools that are created to assist these complex and highly sensitive interactions need to reflect the underlying complexity of the work that is to be performed. An effective computer-supported version of the master schedule could improve team performance by supporting work in ways the research had revealed. How would an ambient intelligent environment assist clinician needs to schedule and manage anesthesia resource assignments? Because time is the key aspect here, designing a display according to time would allow the staff to easily track changes, to anticipate future events, and to respond to emerging situations. What has happened, what has been set in motion, what can be expected, and when each occurs is best depicted in time series representations. Figure 4 illustrates the conceptual design of a display that would complement cognitive work needs for resource scheduling and management. It also promises to improve on the previous paper copy of the master schedule by providing information that is structured, consolidated, retained, and explicit. Structured. The visual organization of the temporal display remains the same as it evolves. By using a graphic representation of time, the team can understand and evaluate relationships among events through time. Consolidated. Relevant variables such as age are shown within each case win- dow, which saves the need to locate and assemble information that is related but is displayed separately. Retained. Cases that were performed remain on the display in sequence. Com- ments and related information can be added. Retaining information makes it possible to review the entire day’s activities while they are still underway. Explicit. Aspects of schedule management that were previously hidden are made evident. These include requirements that are the objects of coordinator cognitive work such as showing conflicts and gaps in timing, and constraints on schedule management such as operating room clean-up and restocking. Taking a longer-term view, AmI displays could also support prompting, speculation, consequence assessment and value-based decisions in ways that physical artifacts cannot [24]. The cognitive artifact’s design must represent constraints and opportunities that are relevant in this domain. Because time is the key consideration, orga- nizing display design according to time allows users to easily track changes, to anticipate future events, and to respond to emerging situations. The case findings enable specification of information services to support information use toward discovery in the research laboratory. As with the acute care case, we must build upon an understanding of the use of significant artifacts. Artifacts analysis can reveal numerous needs of collaborating scientists in the discovery process. As with acute care, an “endogenous” issue remains to first understand the cognitive work practices in research and design interfaces and information services that meet the requirements of the work. The major purpose of reporting detailed findings from life sciences information use is to share real world situations of research practice and discovery with system designers, and reveal some key constraints to adoption of any new service. Again, these constraints come down to the cognitive artifacts, the printed article and lab notebook. These artifacts are so closely coupled to research work that design initiatives must focus on enhancing their properties for cognitive work. – In Redesign this discussion searchable we information maintain focus resources on cognitive and artifacts artifacts to access and related informa- information tion objects, objects and in the not context just retrievable of scientific artifacts. discovery. The article and the lab notebook – Activate offer cognitive a bottom-up artifacts, perspective specifically based the on printed actual article artifact and use. lab The notebook, trans- lation to enable to design communication derives from between both the these stable, artifacts physical and qualities distributed appreciated information in the systems. artifacts, and the cognitive use of artifacts and information objects. – We Reengineer suggest the a design contemporary challenge life of augmenting sciences laboratory the laboratory as an intelligent as a designed envi- information ronment space, with pervasive and to enhance access to inherently information effective objects physical at the point artifacts of need. to af- Activating ford interaction Cognitive with this Artifacts. information Two space. primary The field cognitive research artifacts into scientific involved in information discovery use were surfaces analyzed, three the opportunities: research article and the lab notebook. Both of these artifacts are significantly used and preferred in physical, printed format. These are tangible artifacts with well-defined use characteristics, and people will continue to work with them as tangible artifacts for the foreseeable future, re- gardless of technology. As relatively stable genres, they provide natural platforms for augmentation starting with minimalist interactivity. We are encouraged by the innovation of ambient systems that start with tangible objects that translate physical actions on workspaces, desks, and walls to computational actions [14]. AmI designers should consider enhancing the interaction of lab artifacts with various resources through specific information assignments to open interaction from the physical artifact to information services and databases. The augmented A-Book [21] demonstrates such an example of combining the paper artifact and electronic tools for the lab notebook. Biologists cooperatively designed the A-Book prototype as a portable system to ...