February 15th, 2019

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Understanding the Critical Components of Performing Vaginal Hysterectomy with Cognitive Task Analysis
Authors:  Gouri B. Diwadkar, M.D., Cheryl Hunter, Ph.D., Matthew D. Barber, M.D., M.H.S., and J. Eric Jelovsek, M.D., M.M.Ed.
  OBJECTIVE: To identify the salient steps and decision points of vaginal hysterectomy using cognitive task analysis (CTA).

STUDY DESIGN: Four expert gynecologic surgeons were interviewed using CTA to gain insight into the surgeonís cognitive processes during the procedure, such as use of visual cues, decision-making, and identification of potential errors. Data from interviews were used to create a checklist of procedural steps and a cognitive demands list.

RESULTS: There were consistencies found among the surgeonsí cognitive processes, such as sequence of steps, use of visual and tactile cues, and potential complications of the procedure, with minor differences in management of potential errors.

CONCLUSION: It is feasible to apply CTA to the vaginal hysterectomy procedure to identify the salient technical steps, decision points and common errors of this procedure to aid in surgical education.
Keywords:  cognitive task analysis, decision making; hysterectomy, vaginal; surgical education; task performance and analysis
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