Adaptation at the Edge: When the System is Complex, the Stakes High, and the Operator Novice

Abstract

Cognitive systems engineering explores how experts adapt to dynamic systems in highly technical domains. In a series of interviews, we looked at how patients with type 2 diabetes attempt to manage their own dynamic blood glucose regulatory system. In this paper, we identify the limitations of explicit knowledge and of rules-based and procedures-based instruction for managing blood glucose levels. Next, we outline the roles of problem detection and identification, sensemaking, decision making, and planning/replanning in system control. Finally, we suggest the potential power of mental models as a foundation for self-regulation. This investigation of an uncommon domain supports the generality of the control challenges under presented by uncertainty, complexity, and high stakes. It also suggests instructional strategies that might better help people with type 2 diabetes with critical self-management.