scholarly journals Exploring the use of high and low demand simulation for human performance assessment during multiorgan retrieval with the joint scrub practitioner

2020 ◽  
pp. bmjstel-2019-000558
Author(s):  
Gala Morozova ◽  
Amanda Martindale ◽  
Hugh Richards ◽  
John Stirling ◽  
Ian Currie
Keyword(s):  
Team Performance ◽  
Human Performance ◽  
Technical Skills ◽  
Mental Effort ◽  
Anaesthetic Machine ◽  
Self Report ◽  
Main Body ◽  
En Bloc ◽  
Organ Retrieval ◽  
Practitioner Role

IntroductionThe National Organ Retrieval Service (NORS) 2015 review recommended a Joint Scrub Practitioner for abdominal and cardiac teams during combined organ retrieval. To evaluate the feasibility of this role, and to understand the functional implications, this study explores the use of simulation and provides a novel and comprehensive approach to assess individual and team performance in simulated multiorgan retrievals.MethodsTwo high-fidelity simulations were conducted in an operating theatre with porcine organs, en bloc, placed in a mannequin. For donation after brainstem death (DBD) simulation, an anaesthetic machine provided simulated physiological output. Retrievals following donation after circulatory death (DCD) began with rapid arrival in theatre of the mannequin. Cardiothoracic (lead surgeon) and abdominal (lead and assistant surgeons; joint scrub practitioner, n=9) teams combined for the retrievals. Data collected before, during and after simulations used self-report and expert observers to assess: attitudinal expectations, mental readiness, mental effort, non-technical skills, teamwork, task workload and social validation perceptions.ResultsAttitudinal changes regarding feasibility of a joint scrub practitioner for DBD and DCD are displayed in the main body. There were no significant differences in mental readiness prior to simulations nor in mental effort indicated afterwards; however, variance was noted between simulations for individual team members. Non-technical skills were slightly lower in DCD than in DBD. Global ratings of teamwork were significantly (p<0.05) lower in DCD than in DBD. Measures of attitude indicated less support for the proposed joint scrub practitioner role for DCD than for DBD.DiscussionThe paper posits that the joint scrub practitioner role in DCD multiorgan retrieval may bring serious and unanticipated challenges. Further work to determine the feasibility of the NORS recommendation is required. Measures of team performance and individual psychological response can inform organ retrieval feasibility considerations nationally and internationally.

Short Stress State Questionnaire

2015 ◽  
Vol 31 (1) ◽  
pp. 20-30 ◽  
Author(s):  
William S. Helton ◽  
Katharina Näswall
Keyword(s):  
Stress State ◽  
Factor Structure ◽  
Human Performance ◽  
Self Report ◽  
Confirmatory Factor ◽  
Stress States ◽  
Related Stress ◽  
Using Data ◽  
Task Conditions ◽  
Multiple Samples

Conscious appraisals of stress, or stress states, are an important aspect of human performance. This article presents evidence supporting the validity and measurement characteristics of a short multidimensional self-report measure of stress state, the Short Stress State Questionnaire (SSSQ; Helton, 2004 ). The SSSQ measures task engagement, distress, and worry. A confirmatory factor analysis of the SSSQ using data pooled from multiple samples suggests the SSSQ does have a three factor structure and post-task changes are not due to changes in factor structure, but to mean level changes (state changes). In addition, the SSSQ demonstrates sensitivity to task stressors in line with hypotheses. Different task conditions elicited unique patterns of stress state on the three factors of the SSSQ in line with prior predictions. The 24-item SSSQ is a valid measure of stress state which may be useful to researchers interested in conscious appraisals of task-related stress.

scholarly journals Exploring the Effect of Communication Patterns and Transparency on Performance in a Human-Robot Team

2019 ◽  
Vol 63 (1) ◽  
pp. 160-164 ◽  
Author(s):  
Shan G. Lakhmani ◽  
Julia L. Wright ◽  
Michael R. Schwartz ◽  
Daniel Barber
Keyword(s):  
Information Sharing ◽  
Team Performance ◽  
Human Performance ◽  
Target Identification ◽  
Communication Patterns ◽  
Human Robot Interaction ◽  
Communication Pattern ◽  
Identification Task ◽  
Robot Interaction ◽  
Human Agent

Human-robot interaction requires communication, however what form this communication should take to facilitate effective team performance is still undetermined. One notion is that effective human-agent communications can be achieved by combining transparent information-sharing techniques with specific communication patterns. This study examines how transparency and a robot’s communication patterns interact to affect human performance in a human-robot teaming task. Participants’ performance in a target identification task was affected by the robot’s communication pattern. Participants missed identifying more targets when they worked with a bidirectionally communicating robot than when they were working with a unidirectionally communicating one. Furthermore, working with a bidirectionally communicating robot led to fewer correct identifications than working with a unidirectionally communicating robot, but only when the robot provided less transparency information. The implications these findings have for future robot interface designs are discussed.

scholarly journals Cognitive load in intralingual and interlingual respeaking – a preliminary study

2016 ◽  
Vol 52 (2) ◽  
Author(s):  
Agnieszka Szarkowska ◽  
Krzysztof Krejtz ◽  
Łukasz Dutka ◽  
Olga Pilipczuk
Keyword(s):  
Cognitive Load ◽  
Mental Effort ◽  
Self Report ◽  
Preliminary Results ◽  
Two Measures ◽  
Preliminary Study ◽  
Over Time

AbstractIn this paper we present preliminary results of the study on the cognitive load in intralingual and interlingual respeaking. We tested 57 subjects from three groups: interpreters, translators and controls while respeaking 5-minute videos in two language combinations: Polish to Polish (intralingual) and English to Polish (interlingual). Using two measures of cognitive load: self-report and EEG (Emotiv), we found that in most cases cognitive load was higher in interlingual respeaking. Self-reported mental effort that the participants had to expend to complete the respeaking tasks was lower in the group of interpreters, suggesting some parallels between interpreting and respeaking competences. EEG measures showed significant differences between respeaking tasks and experimental groups in cognitive load over time.

Assessing Medication Safety Technology in the Intensive Care Unit

2007 ◽  
Vol 51 (11) ◽  
pp. 692-696 ◽  
Author(s):  
Michael Rayo ◽  
Phil Smith ◽  
Matthew B. Weinger ◽  
Jason Slagle
Keyword(s):  
Intensive Care ◽  
Human Performance ◽  
Systems Approach ◽  
Medication Administration ◽  
Self Report ◽  
Future Research ◽  
Rapid Infusion ◽  
Safety Technology ◽  
Care Processes ◽  
The Impact

Understanding the strengths and weaknesses of a technology in the context of the distributed system in which it is working is critical to assessing and improving the performance of that system. Taking a systems approach requires knowledge about how all agents in a system work together to achieve the goals of that system. With these aims, the alerting mechanism of infusion pumps containing Dose-Error Reduction Software (DERS) was studied to determine its effectiveness in the Intensive Care Units (ICU's) of three hospitals. In 1,146 of the 9,557 pump alerts (12.0%), the alert caused the clinician to change the input. Of these, 1,030 were changed to within the hospital's recommended dosing limits. The alert was overridden for 8,400 (88.0%) of the alerts. The data show that this technology successfully informed clinicians over 1000 times that unintended doses had been inputted and stopped those doses from reaching the patient, thereby averting potential Medication Events. The data also suggest that, because nearly 90% of the alerts were overridden, a well-intended and valuable alert may be perceived by the clinicians as a false alarm and may be overlooked. Another key finding from this analysis was that clinicians may have used potentially unsafe workarounds to administer intravenous drug boluses (i.e., more rapid infusion of a defined dose or volume) and to keep the patient's line active between infusions. In a separate parallel study, clinician self-report of potentially harmful medication events was studied. During 559 hours of direct observation, clinicians detected 27 (IV and non-IV) medication events. All of the reported events were outside of the scope of what DERS technology was designed to detect. In addition, during the same time period the technology detected five potentially harmful IV medication events that the clinicians did not report. The results of these two studies indicate two possible classes of solutions that could reduce the impact and likelihood of medication administration errors. One class of solutions involves the procedures and policies of the hospital, ensuring that process and technology implementations are optimally tuned, taking human performance and the current practice of the clinicians into account. The other class of solutions involves using new strategies and technologies to ensure that each system agent has access to other agents' perspectives, and the broader system's perspective. Studies such as these can provide insight into the use of safety technology during critical care processes and provide direction for future research, including more effective design of alerting mechanisms of ICU devices.

Assessing Individual Differences in Decision Making Styles: Analytical vs. Intuitive

2002 ◽  
Vol 46 (12) ◽  
pp. 953-957 ◽  
Author(s):  
Thomas E. Nygren ◽  
Rebecca J. White
Keyword(s):  
Decision Making ◽  
Individual Differences ◽  
Human Performance ◽  
Self Report ◽  
Dynamic Decision Making ◽  
Complex Dynamic ◽  
Decision Style ◽  
Decision Strategies ◽  
Decision Making Styles ◽  
Report Measure

Decision strategies are often characterized as being intuition-based or analytically-based. The use of these strategies is proposed to be associated with individual differences in propensity toward using different decision making styles. A reliable self-report measure, the Decision Making Styles Inventory (DMI), consisting of 15 items on each of three scales was constructed. The items were found to differentiate among an “analytical”, an “intuitive”, and a “regret-based” emotional decision making style. The analytical and intuitive scales were found to predict differences in performance in a complex dynamic decision making task. on a decision making subtask, a greater general reliance on an analytical decision making style was found to lead to poorer performance. Greater reliance on a more intuitive approach had no effect on this subtask, but was found to predict better performance as workload levels increased. These findings suggest that human performance may be significantly influenced when either a more intuitive or analytical decision style is used. Implications for training the adaptive decision maker are discussed.

Part 1: Impact of Capsulectomy Type on Post-Explantation Systemic Symptom Improvement: Findings From the ASERF Systemic Symptoms in Women-Biospecimen Analysis Study

2021 ◽  
Author(s):  
Caroline Glicksman ◽  
Patricia McGuire ◽  
Marshall Kadin ◽  
Marisa Lawrence ◽  
Melinda Haws ◽  
...  
Keyword(s):  
Clinical Laboratory ◽  
Breast Implant ◽  
Demographic Data ◽  
Breast Implants ◽  
Self Report ◽  
Symptom Improvement ◽  
En Bloc ◽  
Laboratory Findings ◽  
Systemic Symptoms ◽  
One Year

Abstract Background Breast Implant Illness (BII) is a term used to describe a variety of symptoms by patients with breast implants for which there are no abnormal physical or laboratory findings to explain their symptoms. There currently exists a difference of opinion among clinicians and patients concerning the diagnosis and treatment of patients self-reporting BII. Objectives The first aim of this study was to determine if there is a valid indication for "en bloc" capsulectomy in patients self-reporting BII and if the type of capsulectomy performed alters long-term symptom improvement. The second goal was to identify any clinical laboratory differences between the cohorts. This study was funded by the Aesthetic Surgery Education and Research Foundation (ASERF). Methods A prospective blinded study enrolled 150 consecutive subjects divided equally into three cohorts: (A) women with systemic symptoms they attribute to their implants who requested implant removal, (B) women with breast implants requesting removal or exchange who do not have symptoms they attribute to their implants, and (C) women undergoing cosmetic mastopexy who have never had any implanted medical device. The subject's baseline demographic data and a systemic symptoms survey, including PROMIS ® validated questionnaires, was obtained before surgery and at 3-6 weeks, 6 months, and one year. Blood was collected from all three cohorts and implant capsules were collected from Cohorts A and B. Results 150 patients were enrolled between 2019- 2021. Follow-up at 3-6 weeks for all three cohorts was between 98-100%, 78-98% at 6-months, and one year data is currently at 80%. The type of capsulectomy; intact total, total, or partial all showed similar symptom improvement with no statistical difference in the reduction of symptoms based on the type of capsulectomy. Conclusions This study addresses one of the most discussed questions by plastic surgeons, patients, their advocates, and social media. The findings show that patients who self-report BII demonstrate a statistically significant improvement in their symptoms after explantation and that this improvement persists for at least 6 months. This improvement in self-reported systemic was seen regardless of the type of capsulectomy performed.

Developing a Team Behavioural Marker Framework Using Observations of Simulator-Based Exercises to Improve Team Effectiveness: A Drilling Team Case Study

2017 ◽  
Vol 48 (3) ◽  
pp. 299-313 ◽  
Author(s):  
Margaret T. Crichton ◽  
Scott Moffat ◽  
Lauren Crichton
Keyword(s):  
Team Performance ◽  
Technical Skills ◽  
Technical Training ◽  
Team Members ◽  
Four Dimensions ◽  
Training Course ◽  
Effective Performance ◽  
Team Interactions ◽  
Training Exercises

Background. Due to the challenge of conducting observations of drilling team behaviours on an offshore installation during actual operations, a high fidelity simulator provided the opportunity to observe team behaviours when managing complex and uncertain situations. Aim. This article describes how such observations were used to develop a team behavioural marker framework subsequently used for debriefing. Method. Team behaviours and interactions were recorded during 25 simulator-based training exercises which had been integrated into a technical training course. These were then analysed, and four dimensions, with example behaviours, were identified. Results. The behavioural markers formed the basis of training objectives, and provided structure for debriefing team performance. The use of the simulator provided concrete examples of both effective and ineffective behaviours. Conclusions. Notable improvements in drilling team interactions and behaviours were noted over the course of five exercises, which ranged in complexity and uncertainty, throughout the training course. Enhancing team non-technical skills will lead to safer and more effective performance, and facilitate the transfer from training to actual operations. Team members also became more familiar with the concepts and terminology of non-technical skills and integrated behavioural markers into workplace practices such as Tool Box Talks, Stop Work Authority, and Time-Outs.

Effect of Obstetric Team Training on Team Performance and Medical Technical Skills

2013 ◽  
Vol 33 (4) ◽  
pp. 203-204
Author(s):  
A.F. Fransen ◽  
J. van de Ven ◽  
A.E. Merién ◽  
L.D. de Wit-Zuurendonk ◽  
S. Houterman ◽  
...  
Keyword(s):  
Team Performance ◽  
Technical Skills ◽  
Team Training

Measuring the Impact of Advanced Technologies and Reorganization on Human Performance in a Combat Information Center

2000 ◽  
Vol 44 (37) ◽  
pp. 642-645 ◽  
Author(s):  
Jared T. Freeman ◽  
Gwendolyn E. Campbell ◽  
Greg Hildebrand
Keyword(s):  
Human Behavior ◽  
Team Performance ◽  
Preliminary Data ◽  
Human Performance ◽  
Novel Technology ◽  
Advanced Technologies ◽  
Information Center ◽  
And Control ◽  
The Impact ◽  
The U.S

Systematically evaluating the impact of novel technology and organizational structure on team performance is a complex, multidimensional task. We define several of these dimensions that are of particular interest in the development of new command and control teams and technologies for the U.S. Navy. In addition, we describe an approach to stimulating and measuring human behavior on these dimensions, and an experiment in which this approach is applied. Preliminary data are presented.

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