Automatic-controlled information processing and error detection in a simulated pharmacy-verification task

The relationships between attentional variables and information-processing demands of pharmacy dispensing tasks that contribute to difficulties in cognitive performance are not well-known. In the present study, a psychological approach to medical dispensing errors, the cognitive-systems performance model of Grasha, was employed to evaluate the contributions of individual differences in attention and alterations in visual task information on simulated pharmacy-verification performance, perceived workload, and self-reported stress. 73 college-age volunteers completed a pretest battery containing psychological measures of automatic and controlled information processing, and one-week later spent 265 min. completing the end visual-inspection process for 200 simulated prescriptions, 27% of which contained artificially inserted errors. Evidence suggesting that both automatic and controlled processes underlie performance of a simulated pharmacy-verification task was obtained. Individual differences in controlled information processing were mildly predictive of detection accuracy, while contrary to expectations, automatic processing scores did not produce significant relationships. Detection associated with experimental alterations in font size (12-pt. vs 6-pt.) of critical prescription label information was partially in line with expectations from the cognitive-systems performance model, while additional visual enhancements via a magnification/illumination device yielded mixed results. Finally, reports of perceived workload (NASA Task Load Index) and specific patterns of self-reported stress (Dundee Stress State Questionnaire) were consistent with a three-tier behavioral framework offered recently by Matthews, Davies, Westerman, and Stammers for predicting behaviors along the automatic-controlled continuum.