Cockpit automation has brought significant benefits in terms of mental workload and fatigue. However, the way primary flight instruments are monitored by pilots may be negatively affected by the high confidence in systems. We examined the effects of automation level on mental workload, manual flight performance and visual strategies. Twenty professional pilots performed six landing scenarios at three levels of automation depending on flight director (flight path guidance) and autothrust (automatic management of the speed) engagements. Higher levels of automation increased flight performance and reduced mental workload, but were associated with a decrease in vigilance to primary instruments, particularly flight path indicators and engines' thrust. We also found that gaze entropy was sensitive to pilot role (pilot flying vs pilot monitoring) and automation level. These results confirmed the risks of adverse effects of automation on visual monitoring. Designing procedures for pilots to actively monitor automated cockpit systems should be encouraged.

The aim of this review was to identify, collect, appraise, and synthesise research profiling paramedic job tasks, injuries sustained, and current fitness levels, to guide optimal workplace performance and enhance injury mitigation efforts. Following the Preferred Reporting Items for Scoping Reviews, four databases (PubMed, SPORTdiscus, CINAHL, and Embase) were searched using key search terms (derivatives of 'paramedic' and 'injury', 'physical fitness' and 'tasks'). Identified records were screened against eligibility criteria with remaining studies critically appraised. Of 1675 identified records, 33 were retained. Musculoskeletal injuries exhibited the highest mean injury rate, with sprains and strains the predominant nature of injury, and the back the most frequently injured body part. Among paramedics, handling stretchers and equipment posed the most challenging tasks while for Emergency Medical Services patient extraction was the most physically and mentally demanding task. Male paramedics were generally stronger with more muscular endurance, but less flexibility, than female paramedics. Older paramedics displayed lower levels of strength and flexibility. Tasks involving stretcher handling and patient extraction are reported as being most strenuous for paramedics leading to musculoskeletal injuries, particularly sprains, strains, and back injuries.

Emergency departments accommodate high-acuity patients in complex, high risk environments with high variability in patient flow and resource availability. Strategies for enabling adaptive capacity are necessary for adjusting activities in response to the variability of overall workload and individual patient acuity. This study aims to identify and describe the strategies used by lead-nurses to inform recommendations for training and education. 14 lead-nurses participated in focus group discussions using a table-top sandbox simulation to trigger for reflection on decisions, trade-offs and strategies for handling difficult situations during everyday work. The sandbox simulation was intended to focus the discussions on situation assessment, problem-solving strategies and cognitive challenges. The simulation and following discussions were audio- and video recorded and analysed with reflexive thematic analysis. The results illustrate how lead-nurses work towards maintaining an equilibrium between monitoring and coordinating efforts. This result underlines the complex continuous process of adjusting work and resources to situational conditions and demands. The lead-nurse's work is about balancing strategies for monitoring the ED and coordinating care. This balance is important for solving problems here and now while minimising the effects of shifting problems between parts of the ED system or to later points in time. This should be explored further with the question of what strategies that could be standardised versus which should remain adaptive before designing training regimes for adaptive strategies.