scholarly journals Toward a better understanding of task demands, workload, and performance during physician-computer interactions

2016 ◽  
Vol 23 (6) ◽  
pp. 1113-1120 ◽  
Author(s):  
Lukasz M Mazur ◽  
Prithima R Mosaly ◽  
Carlton Moore ◽  
Elizabeth Comitz ◽  
Fei Yu ◽  
...  
Keyword(s):  
Task Demands ◽  
Systematic Assessment ◽  
Quality Metric ◽  
Task Load ◽  
Simulated Environment ◽  
Eeg Data ◽  
And Performance ◽  
Nasa Task Load Index ◽  
Future Work ◽  
Computer Interactions

Abstract Objective To assess the relationship between (1) task demands and workload, (2) task demands and performance, and (3) workload and performance, all during physician-computer interactions in a simulated environment. Methods Two experiments were performed in 2 different electronic medical record (EMR) environments: WebCIS ( n = 12) and Epic ( n = 17). Each participant was instructed to complete a set of prespecified tasks on 3 routine clinical EMR-based scenarios: urinary tract infection (UTI), pneumonia (PN), and heart failure (HF). Task demands were quantified using behavioral responses (click and time analysis). At the end of each scenario, subjective workload was measured using the NASA-Task-Load Index (NASA-TLX). Physiological workload was measured using pupillary dilation and electroencephalography (EEG) data collected throughout the scenarios. Performance was quantified based on the maximum severity of omission errors. Results Data analysis indicated that the PN and HF scenarios were significantly more demanding than the UTI scenario for participants using WebCIS ( P < .01), and that the PN scenario was significantly more demanding than the UTI and HF scenarios for participants using Epic ( P < .01). In both experiments, the regression analysis indicated a significant relationship only between task demands and performance ( P < .01). Discussion Results suggest that task demands as experienced by participants are related to participants' performance. Future work may support the notion that task demands could be used as a quality metric that is likely representative of performance, and perhaps patient outcomes. Conclusion The present study is a reasonable next step in a systematic assessment of how task demands and workload are related to performance in EMR-evolving environments.

Verbal Cues and Attentional Focus: A Simulated Target-Shooting Experiment

2017 ◽  
Vol 5 (1) ◽  
pp. 148-159 ◽  
Author(s):  
Louisa D. Raisbeck ◽  
Jed A. Diekfuss
Keyword(s):  
Attentional Focus ◽  
Focus Of Attention ◽  
Verbal Cues ◽  
Task Load ◽  
External Focus ◽  
Gun Barrel ◽  
Internal Focus ◽  
And Performance ◽  
Nasa Task Load Index ◽  
Learning And Performance

Performance benefits exist for an external focus of attention compared with an internal focus of attention for performance and learning (Wulf, 2013). It is unknown, however, if varying the number of verbal cues affects learning and performance. Focus of attention and the number of verbal cues were manipulated during a simulated handgun-shooting task. For the internal focus conditions, participants were told to focus on their hand, arm, and wrist, whereas the external focus instructions were to focus on the gun, gun barrel, and gun stock. To manipulate the number of verbal cues, participants received instruction to focus on a single verbal cue or multiple verbal cues. Shooting performance was assessed at baseline, acquisition, and at two separate retention phases (immediate, delayed) that included transfer tests. Participants completed the NASA—Task Load Index to assess workload following all trials. Participants who received one verbal cue performed significantly better during immediate retention than those who received three verbal cues. Participants who used external focus of attention instructions had higher performance and reported less workload at delayed retention compared to those who used internal focus instructions. This research provides further support for the benefits of an external focus and highlights the importance of minimizing the number of verbal cues.

Quantification of physician workload for radiotherapy planning, and possible associations with performance.

2012 ◽  
Vol 30 (34_suppl) ◽  
pp. 245-245
Author(s):  
Lukasz M. Mazur ◽  
Prithima Mosaly ◽  
Ellen Jones ◽  
Lesley Hoyle ◽  
Bhishamjit S. Chera ◽  
...  
Keyword(s):  
Treatment Plan ◽  
Radiotherapy Planning ◽  
Task Completion ◽  
Task Load ◽  
Human Cost ◽  
Self Assessments ◽  
And Performance ◽  
The Individual ◽  
Nasa Task Load Index ◽  
Physician Workload

245 Background: Workload is a hypothetical construct representing the overall human cost incurred during a task. Across disciplines, the NASA Task Load Index (TLX) has been used as a subjective measure of workload. It quantifies six dimensions of work (mental, physical, and temporal demands, frustration, effort, and performance) on a scale of 1-100 scale, with scores >55 (i.e. overworked) associated with lesser performance. We herein quantify differences in physician workload for planning a relatively “simple” (palliative 2 field opposed lateral brain) versus relatively “complex” (curative 4 field pancreas) case. Further, we explore the association between workload and performance to define TLX levels where performance could be expected to decline. Methods: Nine physicians planned two cases, each case involving three tasks (i.e., task 1 - review written patient medical records; task 2 - review diagnostic images and design of treatment fields; and task 3 - review and approval of the treatment plan). After completing each case, TLX scores of each case/task was collected. Differences in workload between cases/tasks were assessed via ANOVA. The association between workload and performance (assessed using time-to-task completion and self-assessments) was assessed via Pearson’s correlation test. Results: 54 TLX workload and performance assessments were obtained. Workloads for the simple brain case/tasks averaged 41-48, versus 62-69 for the complex pancreas case/tasks (p<0.001 via ANOVA). There were no differences between tasks for the individual cases (p>0.1). There was a correlation between TLX scores and time-to-complete (r=0.54, p<0.001), and with physician self-assessments (r=-0.74, p<0.001). There was a trend towards reduced performance with TLX scores > 55. Conclusions: Physician workload levels are markedly lower for “simple” versus “complex” cases, indicating that TLX is a reliable tool to quantify workload. Performance appears to decline at TLX levels > 55, which is consistent with findings from other industries. Thus, we propose workload assessment (via TLX) to be considered as an independent quality measure to assess the quality assurance (QA) of processes used to deliver radiation therapy.

Workload, Error Detection, and Experienced Stress in a Simulated Pharmacy Verification Task

2002 ◽  
Vol 95 (1) ◽  
pp. 27-46 ◽  
Author(s):  
Sean Reilley ◽  
Anthony F. Grasha ◽  
John Schafer
Keyword(s):  
Error Detection ◽  
Human Performance ◽  
Negative Mood ◽  
Data Entry ◽  
Field Studies ◽  
Detection Accuracy ◽  
Task Load ◽  
High Workload ◽  
And Performance ◽  
Nasa Task Load Index

The relationships among workload, stress, and performance efficiency are topics of applied interest and theoretical importance to researchers concerned with human performance. Such interest extends to a variety of occupational areas including inpatient, outpatient, and community pharmacies. In that context, these relationships have become a consumer health issue given concerns that workload contributes to job stress and a significant decline in dispensing accuracy. In the present study, 102 trained college-aged individuals evaluated simulated pharmacy prescriptions for errors under conditions of either low workload (72 orders over 120 min. on task) or high workload (120 orders over 120 min. on task) in a high-fidelity simulated pharmacy environment. Overall, cumulative and detection theory indices of error detection were compatible with estimates from pharmacy field studies. When rates of sensitivity and specificity for detection were examined, substantial variations in the identification of errors (sensitivity) and difficulties with detection of data-entry mistakes were observed in the high workload condition, but only modest effects emerged for the low workload condition. Although increases in objective workload were associated with modest declines in detection accuracy, objective workload did nor significantly affect negative mood (Mood Adjective Checklist) or perceived workload (NASA-Task Load Index) as expected.

scholarly journals Colonoscopy Trainers Experience Greater Stress During Insertion than Withdrawal: Implications for Endoscopic Curricula

2019 ◽  
Author(s):  
Madeline Lemke ◽  
Alison Banwell ◽  
Natalie Rubinger ◽  
Michelle Wiepjes ◽  
Mark Ropeleski ◽  
...  
Keyword(s):  
Phase I ◽  
Cognitive Load ◽  
Phase Ii ◽  
Simulation Training ◽  
Skills Training ◽  
Task Load ◽  
Simulated Environment ◽  
Competency Based ◽  
Insertion Techniques ◽  
Nasa Task Load Index

Abstract Background Optimal colonoscopy training curricula should minimize stress and cognitive load. This study aimed to determine whether withdrawal or insertion colonoscopy skills training is associated with less stress or cognitive load for trainees or trainers. Methods In Phase I, participants were randomized to train on either insertion or withdrawal in a simulated environment. In Phase II, participants were randomized to begin with either insertion or withdrawal in patient encounters. Salivary cortisol levels, heart rate, and State-Trait Anxiety Inventory (STAI) surveys were used to assess stress in trainees and trainers. NASA Task Load Index (TLX) survey was used to assess cognitive workload in trainees. Results In Phase I, trainee stress increased during the simulation training during both withdrawal and insertion compared to baseline, while trainer stress changed minimally. Cognitive load was higher for trainees during withdrawal (P = 0.005). In Phase II, trainers’ STAI scores were greater during insertion training (P = 0.013). Trainees’ stress was highest prior to beginning patient training and decreased during training, while trainer’s stress increased during training. Trainees reported insertion training being of greater value (70.0%), while trainers reported withdrawal was preferred (77.8%). Conclusion Trainees and trainers exhibit important differences in stress during colonoscopy skills training. Trainees reported more stress during simulation training and greatest cognitive load during simulation withdrawal, whereas trainers reported greatest stress during patient encounters, particularly training of insertion techniques. Attention to the effect of stress on trainees and trainers and the drivers of stress is warranted and could be incorporated in competency based medical education.

scholarly journals High fidelity simulation to assess task load index and performance: a prospective observational study

2021 ◽  
Author(s):  
Jérémy Favre-Félix ◽  
Mikhail Dziadzko ◽  
Christian Bauer ◽  
Antoine Duclos ◽  
Jean-Jacques Lehot ◽  
...  
Keyword(s):  
Stress Level ◽  
Load Level ◽  
High Fidelity ◽  
High Fidelity Simulation ◽  
Task Load ◽  
Assessment Measure ◽  
Nasa Tlx ◽  
And Performance ◽  
Nasa Task Load Index ◽  
Or Team

Abstract Background The NASA Task Load IndeX (NASA-TLX) is a questionnaire widely used in aviation. This index might help for attesting the quality of a scenario in high-fidelity simulation (HFS) in healthcare. The main purpose of this study was to observe whether the score of NASA-TLX for critical care simulated scenarios, designed for residents, was consistent with the values reported in the literature. The second purpose was to describe relationships between NASA-TLX, performance and generated stress during HFS. Methods All residents in anaesthesia and intensive care undergoing HFS were included. The primary endpoint was the task load generated by each scenario assessed by NASA-TLX. Based on literature, the NASA-TLX scores between 39 and 61 were considered as acceptable level. Stress level (Visual Analogue Scale for stress), specific technical and non-technical skills performances (Team Emergency Assessment Measure) were also assessed. Results Fifty-three residents actively participated in one of ten different scenarios, between June to December 2017. Median NASA-TLX score of scenarios was 61 [48–65]. Five scenarios (50%) generated acceptable task load level. There was no association between NASA-TLX score and technical or Team Emergency Assessment Measure performance scores, but an association between NASA-TLX and the stress level (rho = 4.7, p = 0.001) was observed. Conclusions Simulation scenarios generate different task loads for residents; the task load was deemed acceptable for half of the scenarios. The NASA-TLX could be considered as a tool to assess the pedagogic adequacy of scenarios. Scenario and generated stress level, but not task load, can modify residents’ performance during simulation. This should be considered when planning normative simulation.

scholarly journals Surgical Specialty and Case Number May Influence Surgeon Workload

2019 ◽  
Vol 63 (1) ◽  
pp. 679-682
Author(s):  
Madeline K. Niichel ◽  
Bethany R. Lowndes ◽  
Anna R. Linden ◽  
Renaldo C. Blocker ◽  
M. Susan Hallbeck ◽  
...  
Keyword(s):  
Patient Characteristics ◽  
Large Set ◽  
Surgical Specialty ◽  
Work Systems ◽  
Work System ◽  
Task Load ◽  
Perceived Workload ◽  
Nasa Task Load Index ◽  
Future Work ◽  
Case Number

Studies utilizing a systems perspective show that individual work system elements impact surgeon workload. However, limited work has shown how multiple elements together can affect perceived workload in the healthcare domain. Using NASA-Task Load Index (NASA-TLX), this study aimed to compare operating room workload across two work system factors (surgical specialty and case number of the day) using a large set of self-reported surgeon workload data. Thirty-two surgeons completed 545 workload surveys across a three month period. Surgeons reported significant differences in composite workload scores across the surgical specialties (F(7,544)=3.622, p=0.001). Significant interactions were identified between surgical specialty and case number for composite workload, F(20,534)=1.72, p=0.027. While such findings are promising, future work is needed across multiple institutions to establish baseline workload values across specialties with different patient characteristics and work systems.

Interactive Effects of Physical and Mental Workload on Subjective Workload Assessment

2002 ◽  
Vol 46 (13) ◽  
pp. 1100-1104
Author(s):  
Angela Astin ◽  
Maury A. Nussbaum
Keyword(s):  
Mental Workload ◽  
Assessment Tools ◽  
Interactive Effects ◽  
Physical Workload ◽  
Assessment Scores ◽  
Task Load ◽  
Subjective Workload ◽  
Mental Demands ◽  
And Performance ◽  
Nasa Task Load Index

Relatively little research has investigated subjective workload assessment during tasks involving both physical and mental demands. Development of more comprehensive workload assessment tools depends on understanding the effects of physical and mental activity on an individual's perception of workload. This study investigated the interaction between the two types of demands and the potential effects of such interactions on subjective workload assessment and performance. Common subjective workload assessment tools (Borg CR-10 Scale, Visual Analog Scale, NASA Task Load Index) were used to record changes in perceived workload during varying levels of physical and mental demands. Thirteen participants completed all conditions with the results summarized to identify potential trends in the data. The results suggest that a physical demand component did not affect subjective mental workload assessment (p = 0.9916). in addition, the presence of mental demands did not affect physical workload assessment (p = 0.9183). High correlations were found between the subjective mental workload assessment scores and mental performance (r = −0.8 and–0.9).

scholarly journals Wearable Technologies in Field Hockey Competitions: A Scoping Review

Sensors ◽  
2021 ◽  
Vol 21 (15) ◽  
pp. 5242
Author(s):  
Jolene Ziyuan Lim ◽  
Alexiaa Sim ◽  
Pui Wah Kong
Keyword(s):  
Heart Rate ◽  
Inertial Sensors ◽  
Wearable Devices ◽  
Field Hockey ◽  
Heart Rate Monitors ◽  
Search Terms ◽  
Physiological Demands ◽  
And Performance ◽  
Future Work ◽  
Skin Temperatures

The aim of this review is to investigate the common wearable devices currently used in field hockey competitions, and to understand the hockey-specific parameters these devices measure. A systematic search was conducted by using three electronic databases and search terms that included field hockey, wearables, accelerometers, inertial sensors, global positioning system (GPS), heart rate monitors, load, performance analysis, player activity profiles, and competitions from the earliest record. The review included 39 studies that used wearable devices during competitions. GPS units were found to be the most common wearable in elite field hockey competitions, followed by heart rate monitors. Wearables in field hockey are mostly used to measure player activity profiles and physiological demands. Inconsistencies in sampling rates and performance bands make comparisons between studies challenging. Nonetheless, this review demonstrated that wearable devices are being used for various applications in field hockey. Researchers, engineers, coaches, and sport scientists can consider using GPS units of higher sampling rates, as well as including additional variables such as skin temperatures and injury associations, to provide a more thorough evaluation of players’ physical and physiological performances. Future work should include goalkeepers and non-elite players who are less studied in the current literature.

scholarly journals Desktop lighting for comfortable use of a computer screen

Work ◽  
2021 ◽  
Vol 68 (s1) ◽  
pp. S209-S221
Author(s):  
Lu Han ◽  
Hechen Zhang ◽  
Zhongxia Xiang ◽  
Jinze Shang ◽  
Shabila Anjani ◽  
...  
Keyword(s):  
High Intensity ◽  
Motion Tracking ◽  
Tracking System ◽  
Computer User ◽  
Eye Tracker ◽  
Computer Screen ◽  
Task Load ◽  
Trunk Movements ◽  
Motion Tracking System ◽  
Nasa Task Load Index

BACKGROUND: The contrast between a bright computer screen and a dark ambient environment may influence comfort of the users, especially on their eyes. OBJECTIVE: The objective of this research is to identify the optimal desktop lighting for the comfortable use of the computer screen in a dark environment. METHODS: An experiment was designed where seven illumination setups were introduced for the users to perform their leisure tasks on a computer screen. Fifteen healthy subjects participated in the experiments. During each session, durations of the eye blinks, fixations and saccades of the user were recorded by an eye tracker. His/her neck and trunk movements were recorded by a motion tracking system as well. The comfort/discomfort questionnaire, localized postural discomfort questionnaire, NASA task load index and computer user questionnaire were used to record the overall comfort/discomfort, the local perceived physical discomfort, the cognitive workload, and general/eye health problems, respectively. RESULTS: Subjective and objective measurement results indicated that users felt more comfortable with high intensity warm lights using a computer screen. We also identified that the eye fixation durations, as well as the scores of two questions in the computer user questionnaire, have significant negative correlations with comfort. On the other side, the durations of blinks and the scores of three questions in the computer user questionnaire, were significantly correlated with discomfort. CONCLUSION: The warm (3000K) and high intensity (1500 lux) light reduced the visual and cognitive fatigue of the user and therefore improve the comfort of the user during the use of a computer screen.

scholarly journals Distractions in the cardiac catheterisation laboratory: impact for cardiologists and patient safety

Open Heart ◽  
2020 ◽  
Vol 7 (2) ◽  
pp. e001260
Author(s):  
Kalaivani Mahadevan ◽  
Elena Cowan ◽  
Navneet Kalsi ◽  
Helena Bolam ◽  
Richard Arnett ◽  
...  
Keyword(s):  
Patient Safety ◽  
Cardiac Catheterisation ◽  
Physical Workload ◽  
Effort Level ◽  
Task Load ◽  
Cardiac Procedures ◽  
Primary Operator ◽  
Operating Theatres ◽  
St Elevation ◽  
And Performance

ObjectiveTo understand human factors (HF) contributing to disturbances during invasive cardiac procedures, including frequency and nature of distractions, and assessment of operator workload.MethodsSingle centre prospective observational evaluation of 194 cardiac procedures in three adult cardiac catheterisation laboratories over 6 weeks. A proforma including frequency, nature, magnitude and level of procedural risk at the time of each distraction/interruption was completed for each case. The primary operator completed a National Aeronautical and Space Administration (NASA) task load questionnaire rating mental/physical effort, level of frustration, time-urgency, and overall effort and performance.Results264 distractions occurred in 106 (55%) out of 194 procedures observed; 80% were not relevant to the case being undertaken; 14% were urgent including discussions of potential ST-elevation myocardial infarction requiring emergency angioplasty. In procedures where distractions were observed, frequency per case ranged from 1 to 16 (mean 2.5, SD ±2.2); 43 were documented during high-risk stages of the procedure. Operator rating of NASA task load parameters demonstrated higher levels of mental and physical workload and effort during cases in which distractions occurred.ConclusionsIn this first description of HF in adult cardiac catheter laboratories, we found that fewer than half of all procedures were completed without interruption/distraction. The majority were unnecessary and without relation to the case or list. We propose the introduction of a ‘sterile cockpit’ environment within catheter laboratories, as adapted from aviation and used in surgical operating theatres, to minimise non-emergent interruptions and disturbances, to improve operator conditions and overall patient safety.

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