System Reliability, Trust, and Complacency in Fetal Heart Rate Monitoring

As more sophisticated fetal heart rate monitoring systems are introduced into hospitals, it is important to understand how system reliability affects the potential for complacency in users. The goal of the present study was to examine differences in system reliability on trust and patterns of responding to system alerts tied to simulated fetal heart rate tracings. Three reliability conditions were examined: low reliability, high reliability, and a single error condition. The results showed that participants were more likely to respond appropriately when the system issued correct alerts and less likely to respond appropriately to incorrect alerts. Further, not one participant rejected the incorrect alert in the single error condition. Subjective reports of trust did not differ across reliability conditions. These results confirm the idea that a FHR monitoring system with high levels of reliability can lull operators into a state of complacency where incorrect alerts are more likely to go unnoticed.