deletions | additions       diff --git a/begin_section_Introduction_Preliminary_efforts__.tex b/begin_section_Introduction_Preliminary_efforts__.tex  index efd8d9a..ee10cc0 100644  --- a/begin_section_Introduction_Preliminary_efforts__.tex  +++ b/begin_section_Introduction_Preliminary_efforts__.tex 
...
\begin{section}{Introduction}  Preliminary efforts and reading led to the creation of Narrative Descriptions. The user was asked to describe an event, and associated emotions. Then a discussion was added with three points of view, personal, interpersonal-communicative, and organizational. Originally these were for discussion within our group. Later we suggested a written narrative focus be added with consideration of probable uses: editing and re-reading, a naive reader, a teaching file, a categorization or an ontology. These could be characterized as goals or \emph{work points}  Work with Narrative Discussions revealed complexity that required additions for a complete examination of events. We discovered John Flanagan’s early work on the Critical Incident Technique (CIT) \cite{Flanagan1953}, His goal was finding scientific basis for assessment of WWII student pilots who failed in training. Reasons given by examiners were often cliches or lacked depth. The large careful study with well defined goals led to many other applications both in aviation and later in manufacturing, business, management and nursing \cite{Fivars198012}. (PubMed alone has 2543 articles and 231 review articles on CIT in Nursing.) Early attempts to cope with medical error tended to focus on a model of Blame and Train. Considering safety studies from other fields suggested there was much greater complexity. To a psychiatrist it appeared there was little attempt to search for problems out of awareness, due to unconscious, denied or unobserved detail. We combined the approach of examining specific events (CIT) with pushing the user to consider emotional reactions and states in our Complex Context Critical Incident Report (CCCIR). The user also needed to apply multiple points of view other than their own and others to include the nature of communication, or lack thereof, and systemic and organizational factors.\marginpar{\color{red}I just want to emphasize we want our tools to be used by anyone, anywhere, and in any brief available time.}} We also asked them to include any possible relevant associations, what comes to mind, even if it was a tune, a book, a movie, a distant memory of an event. \cite{Devlin2014} Keywords should be added for future categorization or teaching. \emph{Work Points} could indicate ideas to be explored, related concepts, or plans of action or solution. The rather complicated template embraces and clarifies complex situations and the final tool was called a Complex Context Critical Incident Report (CCCIR).   While users can fairly rapidly learn to use such a template a simpler unit was needed for self-training in close observation and participant observation. Repetitive use also increases recall, associations, and sometimes resolves minor impasse. We call these SwampNotes and they are based on a short (300-400 word) note card. While computers can speed up these tools all that is necessary is pencil and paper. We hope these tools may be useful in worlds as different as academic medical centers and pre-literate tribal societies.