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

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.

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

10.2196/16036 ◽  
2020 ◽  
Vol 7 (2) ◽  
pp. e16036
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%; 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.

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

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.

Clinical Implementation of a Parent Questionnaire to Identify Seizures in High-Risk Children

2020 ◽  
Vol 35 (7) ◽  
pp. 485-491
Author(s):  
Celia Greenlaw ◽  
Sarah Nuss ◽  
Cristina Camayd-Muñoz ◽  
Rinat Jonas ◽  
Julie Vanier Rollins ◽  
...  
Keyword(s):  
High Risk ◽  
Low Cost ◽  
Numerical Data ◽  
Primary Care Providers ◽  
Autism Spectrum ◽  
Categorical Variables ◽  
Care Providers ◽  
Clinical Implementation ◽  
Parent Questionnaire ◽  
High Risk Children

Background: This study evaluated the effectiveness of a parent-completed questionnaire for detecting seizures in high-risk children. Methods: A 2-part seizure screen for children up to 12 years of age with suspected autism spectrum disorder, developmental delay, or seizure, was implemented in 12 Massachusetts clinics serving populations with high health disparities. Primary care providers and developmental behavioral pediatricians administered part 1, a brief highly sensitive screen. If the result was positive, a research assistant administered part 2, a more detailed screen with higher specificity. Positive part 2 results prompted a specialized assessment by a pediatric neurologist. Screening data were evaluated for detection of seizures or other diagnoses, reason for conducting the screen, and appointment outcomes. Data analysis included chi-squared tests, percentages for categorical variables, and means for numerical data. Results: Of 207 administered seizure questionnaires, 78% of children screened positive on part 1. Of those, 94% of families completed part 2 by telephone, and 64 individuals screened positive. The screen helped to detect 15 new seizure diagnoses and 35 other neurologic diagnoses. Average time to first scheduled appointment was 23.8 days. The no-show rate was 7%. Conclusions: The seizure questionnaire effectively identified seizures and other disorders in a diverse population of high-risk children. Broader use of this low-cost screening tool could improve access to care for children with suspected seizures, increase seizure recognition, and help allocate resources more effectively.

An Evaluation of the Taxiway Navigation and Situation Awareness (T-NASA) System in High-Fidelity Simulation

1998 ◽  
Author(s):  
Robert S. McCann ◽  
Becky L. Hooey ◽  
Bonny Parke ◽  
David C. Foyle ◽  
Anthony D. Andre ◽  
...  
Keyword(s):  
Situation Awareness ◽  
High Fidelity ◽  
High Fidelity Simulation

scholarly journals Avatar-based versus conventional vital signs display in a central monitor for monitoring multiple patients: A multicenter computer-based laboratory study

2019 ◽  
Author(s):  
Olivier Garot ◽  
Julian Rössler ◽  
Juliane Pfarr ◽  
Michael T. Ganter ◽  
Donat R. Spahn ◽  
...  
Keyword(s):  
Patient Safety ◽  
Laboratory Study ◽  
Situation Awareness ◽  
Vital Sign ◽  
Vital Signs ◽  
Waveform Data ◽  
Perceived Workload ◽  
Computer Based ◽  
Nasa Tlx ◽  
Multiple Patients

Abstract Background Maintaining adequate situation awareness is crucial for patient safety. Previous studies found that the use of avatar-based monitoring (Visual Patient Technology) improved the perception of vital signs compared to conventional monitoring showing numerical and waveform data; and was further associated with a reduction of perceived workload. In this study, we aimed to evaluate the effectiveness of Visual Patient Technology on perceptive performance and perceived workload when monitoring multiple patients at the same time, such as in central station monitors in intensive care units or operating rooms.Methods A prospective, within-subject, computer-based laboratory study was performed in two tertiary care hospitals in Switzerland in 2018. Thirty-eight physician and nurse anesthetists volunteered for the study. The participants were shown four different central monitor scenarios in sequence, where each scenario displayed two critical and four healthy patients simultaneously for 10 or 30 seconds. After each scenario, participants had to recall the vital signs of the critical patients. Perceived workload was assessed with the National Aeronautics and Space Association Task-Load-Index (NASA TLX) questionnaire.Results In the 10-second scenarios, the median number of perceived vital signs significantly improved from 7 to 11 using avatar-based versus conventional monitoring with a median of differences of 5 vital signs, p < 0.001. At the same time, the median NASA TLX scores were significantly lower for avatar-based monitoring (67 vs. 77) with a median of differences of 5 points, p = 0.024. In the 30-second scenarios, vital sign perception and workload did not differ significantly.Conclusions In central monitor multiple patient monitoring, we found a significant improvement of vital sign perception and reduction of perceived cognitive workload using Visual Patient Technology, compared to conventional monitoring. The technology enabled improved assessment of patient status and may, thereby, increase situation awareness and enhance patient safety.

scholarly journals The Modification of Vital Signs According to Nursing Students’ Experiences Undergoing Cardiopulmonary Resuscitation Training via High-Fidelity Simulation: Quasi-Experimental Study

10.2196/11061 ◽  
2018 ◽  
Vol 6 (3) ◽  
pp. e11061 ◽  
Author(s):  
David Fernández-Ayuso ◽  
Rosa Fernández-Ayuso ◽  
Cristino Del-Campo-Cazallas ◽  
José Luis Pérez-Olmo ◽  
Borja Matías-Pompa ◽  
...  
Keyword(s):  
Experimental Study ◽  
Nursing Students ◽  
Cardiopulmonary Resuscitation ◽  
Vital Signs ◽  
High Fidelity ◽  
High Fidelity Simulation ◽  
Resuscitation Training ◽  
Quasi Experimental

Accuracy and Computational Complexity Analysis of Design Models Created by Virtual Sculpting

2005 ◽  
Author(s):  
Weihan Zhang ◽  
Xiaobo Peng ◽  
Ming C. Leu ◽  
Denis Blackmore
Keyword(s):  
Computational Complexity ◽  
Complexity Analysis ◽  
Numerical Data ◽  
High Fidelity ◽  
High Fidelity Simulation ◽  
Orientation Data ◽  
Virtual Sculpting ◽  
Adequate Accuracy ◽  
Haptic Sensation ◽  
Solid Block

We have developed an experimental virtual sculpting system with haptic interface, which allows the user to create a freeform model interactively. The virtual sculpting method is based on the metaphor of carving a solid block into a 3D freeform object. The PHANToM™ manipulator is used to provide the position and orientation data of the sculpting tool and to generate haptic sensation to the user’s hand during the sculpting process. The goal is to provide a high-fidelity simulation system with real-time performance and adequate accuracy of the generated model. In order to understand the limitations on the geometric details that can be generated, we perform an accuracy analysis in different aspects. The computational complexity due to various parameters of the virtual sculpting system is also analyzed. Numerical data are presented to verify the analytical results.

scholarly journals Comparing the Visual Perception According to the Performance Using the Eye-Tracking Technology in High-Fidelity Simulation Settings

2021 ◽  
Vol 11 (3) ◽  
pp. 31
Author(s):  
Issam Tanoubi ◽  
Mathieu Tourangeau ◽  
Komi Sodoké ◽  
Roger Perron ◽  
Pierre Drolet ◽  
...  
Keyword(s):  
Visual Perception ◽  
Eye Tracking ◽  
Clinical Performance ◽  
Vital Signs ◽  
High Fidelity ◽  
High Fidelity Simulation ◽  
Convenience Sample ◽  
Total View ◽  
Simulation Scenario ◽  
Tracking Technology

Introduction: We used eye-tracking technology to explore the visual perception of clinicians during a high-fidelity simulation scenario. We hypothesized that physicians who were able to successfully manage a critical situation would have a different visual focus compared to those who failed. Methods: A convenience sample of 18 first-year emergency medicine residents were enrolled voluntarily to participate in a high-fidelity scenario involving a patient in shock with a 3rd degree atrioventricular block. Their performance was rated as pass or fail and depended on the proper use of the pacing unit. Participants were wearing pre-calibrated eye-tracking glasses throughout the 9-min scenario and infrared (IR) markers installed in the simulator were used to define various Areas of Interest (AOI). Total View Duration (TVD) and Time to First Fixation (TFF) by the participants were recorded for each AOI and the results were used to produce heat maps. Results: Twelve residents succeeded while six failed the scenario. The TVD for the AOI containing the pacing unit was significantly shorter (median [quartile]) for those who succeeded compared to the ones who failed (42 [31–52] sec vs. 70 [61–90] sec, p = 0.0097). The TFF for the AOI containing the ECG and vital signs monitor was also shorter for the participants who succeeded than for those who failed (22 [6–28] sec vs. 30 [27–77] sec, p = 0.0182). Discussion: There seemed to be a connection between the gaze pattern of residents in a high-fidelity bradycardia simulation and their performance. The participants who succeeded looked at the monitor earlier (diagnosis). They also spent less time fixating the pacing unit, using it promptly to address the bradycardia. This study suggests that eye-tracking technology could be used to explore how visual perception, a key information-gathering element, is tied to decision-making and clinical performance.

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