David R. Kaufman Ph.D.

Contact:

Department of Medical Informatics

622 West 168th St.

Vanderbilt Clinic, 5th Floor

New York, New York 10032

Email: davek@dmi.columbia.edu

Phone: 212-543-5433

New York State Psychiatric Institute

Research Foundation for Mental Hygiene

1051 Riverside Drive

New York, New York 10032

Phone: 212-543-5433

Research Projects

Publications

Personal

Links

I am currently an Associate Research Scientist jointly appointed in the Department of Medical Informatics and Psychiatry. I am also a member of the Laboratory of Decision Making and Cognition. My work has focused predominately on applying cognitive science methods of analysis to a range problems in the study of medical cognition, human-computer interaction, and technology-mediated decision making. An ongoing concern of mine is the relationship between conceptual understanding and decision practices in medicine and health. This work is exemplified in a recent publication (listed below) in the International Journal of Medical Informatics which focuses on physicians’ knowledge of concepts related to hypercholesterolemia and coronary artery disease and decision making. Another focus of my research is on developing an expanded framework for usability evaluation with a particular focus on the sorts of competencies and knowledge required by users to accomplish tasks. This perspective is reflected in several of my current research projects.

I received a Ph.D. in Educational Psychology from McGill University in 1993 under the supervision of Vimla Patel. My work was in the area of medical cognition and my doctoral work examined students', clinicians', and biomedical scientists' mental models of the regulation of cardiac output. I continued to work with Vimla as a postdoctoral fellow as our work transitioned to the application of theories and methods of cognitive science to medical informatics. From 1996 to 2001, I was a lecturer in the Department of Cognition and Development in the Graduate School of Education at University of California, Berkeley.

Current Research Projects

Cognitive Evaluation of the IDEATel Diabetes Telemedicine and Education Program. The evaluation included the use of cognitive walkthrough methodology, user testing, and participant interviews. Thus far, 24 subjects from the greater New York City area and Upstate New York have participated in the study. The study revealed dimensions of the interface that subjects found difficult to use including scroll bars, misleading labels, navigational indicators and various problematic widgets. In addition, subjects’ level of literacy and numeracy affected their ability to negotiate the system. There was also a host of noncognitive factors such as patient health, depression, self-efficacy, and computer anxiety that impacted their use of the system. The results of the study have contributed to 1) the iterative design of the interface, 2) revision of the subject training protocol and 3) re-development of a CD-ROM tutorial on how to use the system effectively. The ultimate objective of this work is to empower older adults with the necessary range of computer and literacy skills to avail themselves of the excellent resources afforded by the system to better manage their diabetes.

Cognitive Dimensions of the Query User Interface: The Health Information Needs Tailoring (HINT) component of the PERSIVAL system is designed to facilitate or semi-automate the query formulation component process of information retrieval at the point of care (i.e., as the clinician views the patient record). The Query User Interface (QUI) is the visible component of HINT. This study focused on a cognitive evaluation of the QUI. We evaluated the system’s ability to allow users easily and intuitively express their information needs. The evaluation included a cognitive walkthrough of the query formulation process, quantitative estimation of cognitive load, and usability testing. The usability testing was designed to determine the ease in which users could complete a query drawing on question stems presented to the user. The results suggest that there are features in the QUI that contribute to a greater cognitive load and result in greater effort on the part of the subject. The results of usability testing are consistent with these findings. The study suggested several ways in which the QUI can be improved.

Usability Evaluation of an Innovative Smoking Cessation Program: The Smoke Clinic is an innovative web-based comprehensive smoking cessation clinic. It is interactive, easily accessible, and is designed to be tailored to individual’s needs and personal smoking history. The objective of this evaluation is to characterize the dimensions of the Smoke Clinic web site that promote productive use and meaningful engagement, as well as, to document features or aspects of the interface that may impede such use. Our approach employs two classes of usability evaluation including a) usability inspection and b) usability testing. Usability inspection is designed to characterize dimensions of the interface that adhere to usability principles and to note violations of these principles. We employ 2 classes of inspection methods including a cognitive walkthrough which is scenario or task based and a heuristic evaluation which emphasizes dimensions of the screen. The system is evaluated on the basis of a small set of well-tested design principles such as visibility of system status, user control and freedom, consistency and standards, flexibility and efficiency of use, etc. Heuristic evaluation and the cognitive walkthrough typically identify different classes of problems and are complementary methods of evaluation.

Program in Mental Health Informatics: Evidence-based medicine coupled with emerging information technologies represent an unprecedented opportunity to greatly improve the delivery of mental health care. In particular, the proliferation of high quality guidelines and other on-line resources can have a significant impact on the quality of treatment. However, there remain formidable barriers to the dissemination of cutting-edge research and its application to clinical practice. The program in mental health informatics in the Department of Psychiatry is a recent initiative spearheaded by Vimla Patel. The mission of the overall program are to 1) promote evidence-based practices in psychiatry through the use of information technologies and related resources, 2) identify and reduce barriers to such practices and 3) promote scholarship in the area through a range of activities (e.g., courses and seminars). There are currently several related on-going projects.

Selected Publications

Patel, V.L., Kaufman, D.R., & Arocha, J.F. (in press) Emerging Paradigms of Cognition and Medical Decision Making. Journal of Biomedical Informatics.

Wang, D., Kaufman, D.R., Mendonca, E.A., Seol, Y.H. Johnson, S.B., & Cimino, J.J. (in press). The Cognitive Demands of an Innovative Query User Interface. In the Proceedings of the American Medical Informatics Annual Fall Symposium. Philadelphia: Hanley & Belfus.

Patel, V. L. & Arocha, J. F., & Kaufman, D. R. (2001). A primer on aspects of cognition for medical informatics. Journal of American Medical Informatics Association. 8 324-343.

Patel, V.L.& Kaufman, D.R. ( 2001). The Skilled Craftsman and the Scientist Practitioner: Reflections on Problem-Based Learning and Medical Education. The Chronicle of Higher Education., B12 Feb 2.

Patel, V.L.& Kaufman, D.R. ( 2001). The Skilled Craftsman and the Scientist Practitioner: Reflections on Problem-Based Learning and Medical Education. The Chronicle of Higher Education, B12 Feb 2,

Patel, V.L., Kaufman, D.R., & Arocha, J. F. (2000). Conceptual Change in the Biomedical and Health Sciences. In R. Glaser (ed.) Advances in Instructional Psychology, Volume 5 (329-392). Hillsdale, N.J.: Lawrence Erlbaum Associates

Kaufman, D.R., Ranney, M., Lewis, E.S, Thanukos, A, & Brem, S. (2000). Was Apatosaurus a Vegan? Dinosaur Knowledge Rocks When Learning about Evolution. In L. Gleitman & A.K. Joshi (eds.), Proceedings of the Twenty-First Annual Meeting of the Cognitive Science Society (pp. 741-746). Mawah, NJ: Lawrence Erlbaum Associates

Kaufman, D.R., Vosniadou, S., diSessa, A. & Thagard, P. (2000). Scientific Explanation, Systematicity, and Conceptual Change. In L. Gleitman & A.K. Joshi (eds.), Proceedings of the Twenty-First Annual Meeting of the Cognitive Science Society. Mawah, NJ: Lawrence Erlbaum Associates (pp. 5-9)

Kaufman, D.R., Kushniruk, A.W. & Patel, V.L (1999). A cognitive analysis of computer-based patient record systems: Effects of technology on medical reasoning. In Abbas Moallem (ed) Proceedings of the Silicon Valley Ergonomics Conference & Exposition (pp 21-28). Silicon Valley Ergonomics Institute. San Jose, CA.

Patel, V.L., Kaufman, D.R., Allen, V.G., Shortliffe, E.H., Cimino, J.J., & Greenes, R.A. (1999) Toward a framework for computer-mediated collaborative design in medical informatics. Methods of Information in Medicine 1999; 38: 158-176.

Kaufman, D.R., Kushniruk, A.W., Yale, J.F & Patel, V.L (1999). Conceptual Knowledge and Decision Strategies in Relation to Hypercholesterolemia and Coronary Heart Disease. International Journal of Medical Informatics, 55, 159-177.

Patel, V.L. & Kaufman, D.R. (1998) Medical Informatics and the Science of Cognition. Journal of the American Medical Informatics Association; 5: 493-502.

Patel, V.L. & Kaufman, D.R. (1998) Science and Practice: A Case for Medical Informatics as a Local Science of Design. Journal of the American Medical Informatics Association; 5: 489-492.

Kaufman, D.R. & Patel, V.L. (1998) Progressions of mental models in understanding circulatory physiology. In I. Singh & R. Parasuraman (eds) Human Cognition: A Multidisciplinary Perspective. New Delhi, India: Sage Publications; (pp. 300-326).

Patel, V.L., Kaufman, D.R. & Magder, S (1996). The acquisition of medical expertise in complex dynamic decision-making environments. In A. Ericsson (ed.), The road to excellence: The acquisition of expert performance in the arts and sciences, sports and games (pp. 127-165). Hillsdale, NJ: Erlbaum.

Kaufman, D.R. Patel, V.L., & Magder, S (1996). The Explanatory Role of Spontaneously Generated Analogies in a Reasoning about Physiological Concepts. International Journal of Science Education, 18, 369-386.

Patel, V.L. & Kaufman, D.R. (2000) Clinical Reasoning and Biomedical Knowledge. In J. Higgs & M. Jones (Eds.), Clinical reasoning in the health professions (pp. 117-128). Oxford, UK: Butterworth Heinemann

Kushniruk, A. W., Kaufman, D.R., Patel, V.L., Lévesque, Y., & Lottin, P. (1996) Assessment of a Computerized Patient Record System: A Cognitive Approach to Evaluating an Emerging Medical Technology. M.D. Computing, 13, 406-415

Patel, V.L., Kaufman, D.R., & Arocha, J. F. (1995) Steering through the murky waters of a scientific conflict: Situated and symbolic models of clinical cognition. Artificial Intelligence in Medicine. 413-438 (7)

Patel, V.L., Arocha, J.F. & Kaufman, D.R. (1994) Diagnostic Reasoning and Expertise. Psychology of Learning and Motivation, 31, 137-252.