People with aphasia experience difficulties with all aspects of language and this can mean that their access to technology is substantially reduced. We report a study undertaken to investigate the issues that confront people with aphasia when interacting with technology, specifically 3D game environments. Five people with aphasia were observed and interviewed in twelve workshop sessions. We report the key themes that emerged from the study, such as the importance of direct mappings between users' interactions and actions in a virtual environment. The results of the study provide some insight into the challenges, but also the opportunities, these mainstream technologies offer to people with aphasia. We discuss how these technologies could be more supportive and inclusive for people with language and communication difficulties.

Concern has been reported about the safe use of medical abbreviations in documents such as handover sheets and medical notes, especially when information is being communicated between staff of different specialties (BBC 2008 BBC. 2008. Available from: http://news.bbc.co.uk/1/hi/health/7171453.stm [Accessed 23 September 2010] [Google Scholar], Sheppard et al. 2008 Sheppard, J. E. 2008. Ambiguous abbreviations: an audit of abbreviations in paediatric note keeping. Archives of Disease in Childhood, 93: 204–206. [Crossref], [PubMed] , [Google Scholar]). This article describes a study to investigate whether the use of symbols in handover documentation that is shared within and between multidisciplinary teams (MDTs) has similar safety implications. We asked 19 healthcare professionals from a range of specialties to identify 45 different combinations of 38 individual symbols. The symbols and combinations of symbols were extracted from 102 handover sheets taken from 6 different healthcare contexts in 4 London hospitals. Three symbols proposed in Microsoft's Common User Interface guidelines for alert symbols were also included. Results reveal that while some symbols are well understood, many others are either ambiguous or unknown. These results have implications for the safe use of symbols in medical documents, including paper and electronic handover documents and Electronic Patient Records (EPRs), especially where teams comprise individuals from different professional backgrounds, i.e. MDTs. We offer initial suggestions for standardisation and further research.

Handovers are a specific kind of multi-disciplinary team meeting. Shift handovers and transfers are both regular features of hospital work but there is currently great variation in how such handovers are conducted, presenting a challenge for those seeking to develop technology to support handover. This article presents the ConStratO model of handover, which captures aspects of the context that influence how the handover is conducted, a range of different handover strategies relating to different aspects of the handover and possible outcomes of handover. The model is based on detailed data collection in a range of clinical settings. We present the model as a tool for developing and evaluating technology support for handover.

Drawing on data from a multi-site case study of a range of clinical settings, this paper explores the form of nursing handover sheets and the processes through which they are created and updated. We argue that these documents function as both public and private documents, having relevance for the whole ward while also acting as a personal workspace. Such dual functionality needs to be supported by any technology that seeks to provide for the work of handover, if the handover sheet is to continue to act as a space for work, rather than just a repository of information.

Technologies introduced to support complex and critical work practices merit rigorous and effective evaluation. However, evaluation strategies often fall short of evaluating real use by practitioners in the workplace and thereby miss an opportunity to gauge the true impact of the technology on the work. This article reports an in use, in situ evaluation of 2 cognitive artifacts that support the everyday work of handover in a healthcare setting. The evaluation drew inspiration from the theoretical viewpoint offered by distributed cognition, focusing on the information content, representational media, and context of use of the artifacts. The article discusses how this approach led to insights about the artifacts and their support of the work that could not have been obtained with more traditional evaluation techniques. Specifically, the argument is made that the ubiquitous approach of user testing with its reliance on think-alouds and observations of interaction is inadequate in this context and set an initial agenda for issues that should be addressed by in use, in situ evaluations.

Large, shared displays are used in support of many forms of col-laborative work and are generally assumed to benefit the work. We investigate this in a qualitative study of an intervention to introduce such a display to support the work of shift handover in a medical setting. Results suggest that the consequences of introducing a shared display can be more subtle than expected. In particular, we highlight the fact that the common distinction between private and public information is too coarse-grained and discuss the importance of considering how access to public information is initiated. We briefly touch upon implications for interaction design.

This paper reports a method of assessing the implications for human error on system requirements, a topic not usually considered during requirements engineering (RE). In our previous work, we proposed a taxonomy of influencing factors that might contribute to human error. This paper takes the taxonomy and elaborates it to suggest generic requirements to deal with problems in different layers of the taxonomy. Components of the taxonomy are combined into a causal model for error, represented as a Bayesian Belief Net (BBN). BBNs model the error influences arising from user knowledge, ability and the task environment. These are combined with factors describing the complexity of action and user interface quality in scenarios of projected system usage. The BBN model predicts probabilities of slips and mistakes. These are assessed according to action types in the scenario to suggest generic requirements to prevent the error or to deal with its consequences.

We describe a method of assessing the implications for human error on user interface design of safety-critical systems. In previous work we have proposed a taxonomy of influencing factors that contribute to error. In this article, components of the taxonomy are combined into a mathematical and causal model for error, represented as a Bayesian Belief Net (BBN). The BBN quantifies error influences arising from user knowledge, ability, and the task environ-ment, combined with factors describing the complexity of user action and user interface quality. The BBN model predicts probabilities of different types of errorslips and mistakes for each component action of a task involving user-system interaction. We propose an Impact Analysis Method that involves running test scenarios against this causal model of error in order to determine user interactions that are prone to different types of error. Applying the proposed method will enable the designer to determine the combinations of influencing factors and their interactions that are most likely to influence human error. Finally we show how such scenario-based causal analysis can be useful as a means of focusing on relevant guidelines for safe user interface design. The proposed method is demonstrated through a case study of an operator performing a task using the control system for a laser spectrophotometer.We describe a method of assessing the implications for human error on user interface design of safety-critical systems. In previous work we have proposed a taxonomy of influencing factors that contribute to error. In this article, components of the taxonomy are combined into a mathematical and causal model for error, represented as a Bayesian Belief Net (BBN). The BBN quantifies error influences arising from user knowledge, ability, and the task environ-ment, combined with factors describing the complexity of user action and user interface quality. The BBN model predicts probabilities of different types of errorslip for each component action of a task involving user-system interaction. We propose an Impact Analysis Method that involves running test scenarios against this causal model of error in order to determine user interactions that are prone to different types of error. Applying the proposed method will enable the designer to determine the combinations of influencing factors and their interactions that are most likely to influence human error. Finally we show how such scenario-based causal analysis can be useful as a means of focusing on relevant guidelines for safe user interface design. The proposed method is demonstrated through a case study of an operator performing a task using the control system for a laser spectrophotometer.

This paper describes a current research project investigating belief revision in intelligent systems by modelling the librarian in interaction with a literature-seeking user. The work is designed both to test a theory of agent behaviour based on belief revision proposed by Galliers, and to evaluate a model of the librarian developed by Belkin, Brooks and Daniels, through computational implementation. Agent communication is seen as motivated by and motivating belief changes, where belief revision is determined by coherence, combining endorsement, connectivity and conservatism. The librarian is viewed as a distributed expert system with many individual specialised functions operating in particular belief domains. The paper describes our first implementation of the belief revision mechanism and of a very primitive librarian, designed to test the basic viability of our ideas and to allow us to explore different forms of the distributed system architecture.