Bundles in the Wild: Managing Information to Solve Problems and Maintain Situation Awareness - collections of selective information in library management of resources

Library Trends, Fall, 2000 by Paul Gorman, Joan Ash, Mary Lavelle, Jason Lyman, Lois Delcambre, David Maier, Mathew Weaver, Shawn Bowers

We cannot know what the task is until we know what the tools are. (Hutchins, 1995, p. 114)

ABSTRACT

THIS ARTICLE DESCRIBES HOW EXPERTS CREATE and use bundles--organized, highly selective collections of information--to help solve problems and maintain situation awareness. In field observations of expert clinicians caring for patients in critical care units, bundles appear to be a widely used means of managing information to support diverse, complex, and often simultaneous tasks. They may be especially useful in settings that are characterized by high uncertainty, low predictability, frequent interruptions, and potentially grave outcomes; where time and attention are highly constrained; and where interdisciplinary teamwork is essential. Reports of analogous observations from other domains such as aviation and air traffic control suggest that bundles may be a common information management tool for solving problems and maintaining situation awareness. In an age of digital libraries, computer-based tools for creating and managing bundles may be useful as the information in these settings is increasingly represented in digital collections that are larger, more complex, more diverse, and potentially more difficult to explore and manipulate.

BACKGROUND

Digital Libraries Research: Tracking Footprints in Information Space

The observations described in this article are part of a larger project, "Tracking Footprints in a Medical Information Space: Computer Scientist-Physician Collaborative Study of Expert Problem Solvers" funded by the National Science Foundation Digital Libraries Initiative Phase 2 (National Science Foundation, 1998). The goals of the Tracking Footprints project are to understand how experts select information in a large and complex information space and to develop tools that assist them in this process. The research focuses on experts in health care, but analogous observations by others suggest that the findings will be applicable in other domains such as aviation. The research is being conducted by two teams--an observation team whose job is to accurately describe the information behavior of expert clinicians in situ, and a computer science team whose job is to investigate the application of superimposed information technology (Delcambre & Maier, 1999) to assist experts in navigating vast and complex digital information spaces. It is important to explicitly state the underlying assumptions of this research and to distinguish it from other areas of digital library research and other uses of digital libraries. Most important here is to distinguish the focused information seeking of clinical problem solving from other information behaviors such as browsing or information gathering (Krikelas, 1983) that may be observed in other uses of digital libraries.

Assumptions: Framing the Problem

Imagine a heart specialist who is called in to see a patient to manage a specific heart condition. While reviewing the medical records of the patient, the specialist must somehow locate sufficient relevant information to understand and solve the problem, ignoring the much larger quantity of information that belongs in the record but is irrelevant or redundant with respect to the problem at hand. As she traverses this large, diverse, often disorganized collection of documents, she makes explicit choices about which items to ignore and which to examine more carefully. Taken together, her choice's create a discrete subset of information and documents that are relevant to a given problem and likely to be of interest to other users of the collection who are concerned with the same problem.

The "user" in this case is an expert or team of experts, possessed of specialized knowledge, focused on a specialized patient care task. Information management, although essential, is of secondary importance compared to the clinical task. Significant constraints are present--i.e., time and attention are quite limited; considerable uncertainty and unpredictability are present; and misunderstanding or error have potentially grave consequences. To be effective under these constraints, expert clinicians must employ cognitive strategies such as hypothetico-deductive reasoning (Elstein, Shulman, & Sprafka, 1978) to narrow the problem space, and "satisficing" (Simon, 1955) to find a solution that is satisfactory rather than devote substantially more time and attention to arrive at an optimal one. It is expected that only a small fraction of the available information will be examined, the vast majority of the collection will be ignored, and these choices will often be based on the appearance and organization of the documents rather than on their content (Nygren & Henriksson, 1992; Nygren, Lind, Johnson, & Sandblad, 1992).

The task, involving some aspect of patient care, is likely to be both generic and unique. It is assumed that most users in most circumstances need similar information to make a certain type of decision or to perform a certain task. But in health care especially, every instance is expected to have unique elements, relating to the patient, to the clinician, or to local circumstances, and this variability cannot be completely predicted from prior instances. As Sir William Osier put it nearly 100 years ago: "Variability is the law of life, and as no two faces are the same, so no two bodies are alike, and no two individuals react alike and behave alike under the abnormal conditions which we know as disease" (Osier, 1932).