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Les modalités du contrôle cognitif en situation dynamique : anticipation et gestion des dérives. Le cas de l'anesthésie

Abstract : The aim pursued in this thesis is to understand how the anesthetist get the situation under control. Three studies will be presented. The first ones permits to highlight both the mechanisms of failures detection and recovery. The aim of the second study is to understand both faulty elements in anticipation of incidents and recovery mechanisms used by anesthetists. The latest study clarifies the differences according to the anesthetists' involvement in the process, the impact of the cases preventability and the risk frequency. The results show that (1) there is a situation awareness and risk management shared between team members. (2) Time management appears to be an essential element in controlling the situation both in terms of synchronizing the activity, anticipation and its implementation. Indeed, the anesthetist often work on a proactive way to prevent future failures, but he can not anticipate everything. The planning is done on a short-term laps and many adjustments are necessary to enable the anesthetist to maintain control. (3) The study of failures recovery shows that anesthetists use protocols and guidelines recommended by the specialty but there is also some "allostasis risk" related to decisions to not act directly on the situation. (4) The impact of anticipation on risk management is controversial because it may allow both better management but also conduct anesthetists to error when they believe that the anticipation had normally permitted to avoid the problem. Finally, (5) observed differences in the involvement of the anesthesiologist in the process show that anesthetists manage the process by preventing or by real-time management. These results are discussed in light of the interest to study failures from the norm, the complementary methods used and the importance of positive management by insisting on the mechanisms of maintenance of security established by human operator.
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Contributor : Valérie Neyns <>
Submitted on : Monday, October 3, 2011 - 12:27:22 PM
Last modification on : Wednesday, October 14, 2020 - 3:44:21 AM
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Valérie Neyns. Les modalités du contrôle cognitif en situation dynamique : anticipation et gestion des dérives. Le cas de l'anesthésie. Psychologie. Université Toulouse le Mirail - Toulouse II, 2011. Français. ⟨tel-00628433⟩

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