Comparison of the Effects of Automated and Manual Record Keeping on Anesthetists’ Monitoring Performance: Randomized Controlled Simulation Study

Background Anesthesia information management systems (AIMSs) automatically import real-time vital signs from physiological monitors to anesthetic records, replacing part of anesthetists’ traditional manual record keeping. However, only a handful of studies have examined the effects of AIMSs on anesthetists’ monitoring performance. Objective This study aimed to compare the effects of AIMS use and manual record keeping on anesthetists’ monitoring performance, using a full-scale high-fidelity simulation. Methods This simulation study was a randomized controlled trial with a parallel group design that compared the effects of two record-keeping methods (AIMS vs manual) on anesthetists’ monitoring performance. Twenty anesthetists at a tertiary hospital in Hong Kong were randomly assigned to either the AIMS or manual condition, and they participated in a 45-minute scenario in a high-fidelity simulation environment. Participants took over a case involving general anesthesia for below-knee amputation surgery and performed record keeping. The three primary outcomes were participants’ (1) vigilance detection accuracy (%), (2) situation awareness accuracy (%), and (3) subjective mental workload (0-100). Results With regard to the primary outcomes, there was no significant difference in participants’ vigilance detection accuracy (AIMS, 56.7% vs manual, 56.7%; P=.50), and subjective mental workload was significantly lower in the AIMS condition than in the manual condition (AIMS, 34.2 vs manual, 46.7; P=.02). However, the result for situation awareness accuracy was inconclusive as the study did not have enough power to detect a difference between the two conditions. Conclusions Our findings suggest that it is promising for AIMS use to become a mainstay of anesthesia record keeping. AIMSs are effective in reducing anesthetists’ workload and improving the quality of their anesthetic record keeping, without compromising vigilance.

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Comparison of the Effects of Automated and Manual Record Keeping on Anesthetists’ Monitoring Performance: Randomized Controlled Simulation Study (Preprint)

10.2196/preprints.16036 ◽

2019 ◽

Author(s):

Man-Kei Tse ◽

Simon Y W Li ◽

Tsz Hin Chiu ◽

Chung Wai Lau ◽

Ka Man Lam ◽

...

Keyword(s):

Situation Awareness ◽

Simulation Study ◽

Mental Workload ◽

Detection Accuracy ◽

High Fidelity ◽

High Fidelity Simulation ◽

Record Keeping ◽

Randomized Controlled ◽

Monitoring Performance ◽

Manual Record

BACKGROUND Anesthesia information management systems (AIMSs) automatically import real-time vital signs from physiological monitors to anesthetic records, replacing part of anesthetists’ traditional manual record keeping. However, only a handful of studies have examined the effects of AIMSs on anesthetists’ monitoring performance. OBJECTIVE This study aimed to compare the effects of AIMS use and manual record keeping on anesthetists’ monitoring performance, using a full-scale high-fidelity simulation. METHODS This simulation study was a randomized controlled trial with a parallel group design that compared the effects of two record-keeping methods (AIMS vs manual) on anesthetists’ monitoring performance. Twenty anesthetists at a tertiary hospital in Hong Kong were randomly assigned to either the AIMS or manual condition, and they participated in a 45-minute scenario in a high-fidelity simulation environment. Participants took over a case involving general anesthesia for below-knee amputation surgery and performed record keeping. The three primary outcomes were participants’ (1) vigilance detection accuracy (%), (2) situation awareness accuracy (%), and (3) subjective mental workload (0-100). RESULTS With regard to the primary outcomes, there was no significant difference in participants’ vigilance detection accuracy (AIMS, 56.7% vs manual, 56.7%; <i>P</i>=.50), and subjective mental workload was significantly lower in the AIMS condition than in the manual condition (AIMS, 34.2 vs manual, 46.7; <i>P</i>=.02). However, the result for situation awareness accuracy was inconclusive as the study did not have enough power to detect a difference between the two conditions. CONCLUSIONS Our findings suggest that it is promising for AIMS use to become a mainstay of anesthesia record keeping. AIMSs are effective in reducing anesthetists’ workload and improving the quality of their anesthetic record keeping, without compromising vigilance.

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User perceptions of different monitor modalities during high-fidelity simulation: Visual-Patient-avatar, Split Screen and Conventional - a qualitative analysis (Preprint)

10.2196/preprints.34677 ◽

2021 ◽

Author(s):

Samira Akbas ◽

Sadiq Said ◽

Tadzio Raoul Roche ◽

Christoph Beat Nöthiger ◽

Donat Rudolf Spahn ◽

...

Keyword(s):

Situation Awareness ◽

Simulation Study ◽

Vital Signs ◽

Numerical Data ◽

New Technique ◽

High Fidelity ◽

High Fidelity Simulation ◽

Care Providers ◽

Clinical Implementation ◽

Waveform Data

BACKGROUND Patient safety during anaesthesia is crucially dependent on the monitoring of vital signs. However, the values obtained must also be perceived and correctly classified by the attending care providers. To facilitate these processes, we developed Visual-Patient-avatar- an animated virtual model of the monitored patient, which innovatively presents numerical and waveform data following user-centred design principles. After a high-fidelity simulation study, we analysed participants' perceptions of three different monitor modalities, including this new technique. OBJECTIVE After a high-fidelity simulation study, we analysed participants' perceptions of three different monitor modalities, including this new technique. METHODS This study was a researcher-initiated, single-centre, qualitative study. We asked 92 care providers right after finishing three simulated emergency scenarios about their positive and negative opinions concerning the different monitor modalities. Following qualitative research methods, we processed the field notes obtained and derived main categories and corresponding subthemes. RESULTS We gained a total of 307 statements. Visual-Patient-avatar was the most occurring term in both positive and negative responses. We identified three main categories and divided them into eleven positive and negative subthemes. In assigning the statements to one of the topics, we achieved substantial inter-rater reliability. Most of the statements concerned the design and usability features of the avatar, respectively, the Split Screen mode. CONCLUSIONS This study qualitatively reviewed the clinical applicability of the Visual-Patient-avatar technique in a high-fidelity simulation study and revealed strengths and limitations of the avatar only und Split Screen modality. We received valuable suggestions for improving the design. The requirement of training before clinical implementation was reinforced. The responses regarding the Split Screen suggested that this symbiotic modality generates improved situation awareness combined with numerical data and accurate curves.

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