Introduction to Cognitive Ergonomics and the OR Black Box with Dr. Patricia Trbovich

In this episode, Dr. Patricia Trbovich, Associate Professor at the University of Toronto, Badeau Family Research Chair in Patient Safety and Quality Improvement, and leader of the HumanEra team, shares her journey into human factors research and her focus on improving surgical safety through cognitive ergonomics. She explains cognitive ergonomics as designing systems that support how clinicians think, make decisions, and manage information under pressure. In high stakes environments like the operating room, failing to account for cognitive load can overload clinicians and force excessive task switching, often mistaken for multitasking, which increases the risk of error.

Dr. Trbovich discusses her team’s research identifying peak interruption periods for anesthesiologists during emergence and for nurses during closing counts. She describes how tools such as the OR Black Box, NASA Task Load Index surveys, behavioral observations, and physiologic measures help capture work as it is actually done. Importantly, Black Box Platform data reveals not only safety threats but also resilience supports and psychological safety. She also shares practical strategies to preserve cognitive bandwidth in the OR, including proactively signaling rising cognitive load, reducing unnecessary interruptions, and using checklists and visual cues to minimize task switching and error risk.