Investigating the Role of Labelling and Packaging on Medication Error

<p>Medication administration error contributes to deaths and injury in hospitals, especially in the area of anaesthesia. Labelling and packaging contribute to medication error. The current study examined the role of labelling and packaging in medication error and compared medically trained and medically naive participants. Using eye-tracking equipment, Study 1A investigated the distribution of fixations across 32 pre-existing medication labels and packages. Both groups of participants fixated less on the dose and top of medications than on the name and ‘other’ features. Both medical experience and packaging type influenced on which label areas participants fixated. Medical participants fixated on dose more than control participants; there were no other differences between groups. In Study 1B participants viewed a target medication, they were then asked whether it was present in an array. The target was present in 50% of arrays. Distractors varied in similarity to the target. Signal detection theory analysis of discriminability through d’ revealed that medical participants were significantly better than control participants at discriminating whether or not the target was in the array. Bias analyses through C revealed that there was no difference between the biases of the two groups. Both groups of participants adopted a liberal criterion which increased the occurrence of false alarms. Across all trials, participants were most likely to select a distractor that differed only in the dose of the medication. Divided attention can increase medication error rates, therefore Study 1C utilised the same procedure as Study 1B and added a divided attention task. During the divided attention task participants saw a string of either five or seven letters and were later asked to recall one of the letters. Both groups of participants recalled fewer letters in the seven-letter compared to five-letter condition. There was no difference in the overall performance of the two groups on the divided attention task. Both groups showed a significant reduction in discriminability under the seven- compared to five-letter divided attention condition. Medical participants had significantly higher discriminability indices than control participants. Both groups of participants adopted a liberal criterion, however control participants were more biased than medical professionals. Control participants displayed an increase in bias in the seven-letter, compared to five-letter condition; the bias of medical participants was not influenced by the divided attention task. As in Study 1B, participants were most likely to select a distractor that differed only in the dose of the medication.</p>

Investigating the Role of Labelling and Packaging on Medication Error

<p>Medication administration error contributes to deaths and injury in hospitals, especially in the area of anaesthesia. Labelling and packaging contribute to medication error. The current study examined the role of labelling and packaging in medication error and compared medically trained and medically naive participants. Using eye-tracking equipment, Study 1A investigated the distribution of fixations across 32 pre-existing medication labels and packages. Both groups of participants fixated less on the dose and top of medications than on the name and ‘other’ features. Both medical experience and packaging type influenced on which label areas participants fixated. Medical participants fixated on dose more than control participants; there were no other differences between groups. In Study 1B participants viewed a target medication, they were then asked whether it was present in an array. The target was present in 50% of arrays. Distractors varied in similarity to the target. Signal detection theory analysis of discriminability through d’ revealed that medical participants were significantly better than control participants at discriminating whether or not the target was in the array. Bias analyses through C revealed that there was no difference between the biases of the two groups. Both groups of participants adopted a liberal criterion which increased the occurrence of false alarms. Across all trials, participants were most likely to select a distractor that differed only in the dose of the medication. Divided attention can increase medication error rates, therefore Study 1C utilised the same procedure as Study 1B and added a divided attention task. During the divided attention task participants saw a string of either five or seven letters and were later asked to recall one of the letters. Both groups of participants recalled fewer letters in the seven-letter compared to five-letter condition. There was no difference in the overall performance of the two groups on the divided attention task. Both groups showed a significant reduction in discriminability under the seven- compared to five-letter divided attention condition. Medical participants had significantly higher discriminability indices than control participants. Both groups of participants adopted a liberal criterion, however control participants were more biased than medical professionals. Control participants displayed an increase in bias in the seven-letter, compared to five-letter condition; the bias of medical participants was not influenced by the divided attention task. As in Study 1B, participants were most likely to select a distractor that differed only in the dose of the medication.</p>

Interacting with virtual objects via embodied avatar hands reduces pain intensity and diverts attention

The current study introduces a new paradigm for exploring cognitive factors in pain. Interacting with virtual objects via embodied avatar hands increased the illusion of “being there” in the virtual world, increased VR analgesia for acute pain, and reduced accuracy on an attention demanding task. Twenty-four healthy volunteer college students participated in this within-subject randomized crossover design study. During Phase 1, each participant received brief thermal pain stimuli during interactive embodied avatar VR vs. passive VR (no avatar and no interactivity), VR treatment order randomized. After each pain stimulus, participants provided subjective 0–10 ratings of pain. Compared to the passive VR condition, during the interactive avatar VR, participants reported significant reductions in (1) worst pain, (2) pain unpleasantness, (3) time thinking about pain and (4). they had significantly more fun during the pain stimulus (p = .000 for each). During Phase 2, participants performed a divided attention task in each of the two VR conditions. Participants made significantly more errors on the divided attention task during the interactive avatar VR condition, compared to passive VR, implicating an attention mechanism for how virtual reality reduces pain and helping understand how VR influences pain perception.Trial registration: NCT04245475. Date of registration: 29/01/2020.

Interacting With Virtual Objects via Embodied Avatar Hands Increases the Illusion of Presence, Increases Distraction, and Modulates VR Analgesia Effectiveness: A Randomized Crossover Trial.

The current study introduces a new experimental environment and apparatus for exploring cognitive factors in pain. Interacting with virtual objects via embodied avatar hands increased the illusion of “being there” in the virtual world, increased VR analgesia for acute pain, and reduced accuracy on an attention demanding task. Twenty-four healthy volunteer college students participated in this within-subject randomized crossover design study. During Phase 1, each participant received brief thermal pain stimuli during interactive embodied avatar VR vs. passive VR (no avatar and no interactivity), VR treatment order randomized. After each pain stimulus, participants provided subjective 0-10 ratings of pain. Compared to the passive VR condition, during the interactive avatar VR, participants reported significant reductions in 1). worst pain, 2). pain unpleasantness, 3). time thinking about pain and 4). they had significantly more fun during the pain stimulus (p = .000 for each). During Phase 2, participants performed a divided attention task in each VR condition. Participants made significantly more errors on the divided attention task during the interactive avatar VR condition, compared to passive VR, implicating an attention mechanism for how virtual reality reduces pain and helping understand how VR influences pain perception.

The Effect of Divided Attention with Bounce Drop Jump on Dynamic Postural Stability

This study determined the effect of divided attention on controlling postural stability during a drop vertical jump task. In total, 30 participants were tested for drop vertical jumps from a 30-cm high platform and landing on a single leg with or without divided attention tasks. Three-dimensional marker trajectories and ground reaction forces were collected simultaneously. Vertical ground reaction force, loading rate, and dynamic postural stability index were analyzed with or without divided attention tasks. The paired sample t test indicated a significantly low knee flexion angle, high vertical ground reaction force, and increased loading rate in the divided attention task. Moreover, participants showed an increased vertical stability index and dynamic postural stability index in the divided attention task than in the nondivided attention task. Thus, results demonstrated that the divided attention task could affect posture control, leading to poor dynamic posture stability and possibly increasing lower extremity injury risk. The influence of the divided attention task on movement quality likely indicates that an athlete can no longer focus his attention on the bounce drop jump maneuver. Therefore, the bounce drop jump combined with dynamic postural stability index could be used in posture stability screening.

Microsaccades and covert attention: Evidence from a continuous, divided attention task

A substantial question in understanding expert behavior is isolating where experts look, and which aspects of their environment they process. While tracking the position of gaze provides some insight into this process, our ability to attend covertly to regions of space other than the current point of fixation, severely limits the diagnostic power of such data. Over the past decade, evidence has emerged suggesting that microscopic eye movements present during periods of fixation may be linked to the spatial distribution of covert attention, potentially offering a powerful tool for studying expert behavior. To date, the majority of studies in this field have tested the link under the constraints of a trial by trial, forced-response task. In the current study we sought to examine the effect when participants performed a continuous, divided-attention task, with the hope of bridging the gap to a range of more ecological, real-world tasks. We report various aspects of the eye movement and response data including (i) the relationship between microsaccades and drift correction, (ii) response behavior in brief time periods immediately following a microsaccade, (iii) response behavior briefly preceding a microsaccade. Analysis failed to reveal a link between task accuracy and the direction of a microsaccade. Most striking however, we found evidence for a timelocked relationship between the side of space responded to and the direction of the most recent microsaccade. The paper hence provides preliminary evidence that microsaccades may indeed be used to track the ongoing allocation of spatial attention.

Divided Attention Selectively Impairs Value-Directed Encoding

In the present study, we examined the effect of value-directed encoding on recognition memory and how various divided attention tasks at encoding alter value-directed remembering. In the first experiment, participants encoded words that were assigned either high or low point values in multiple study-test phases. The points corresponded to the value the participants could earn by successfully recognizing the words in an upcoming recognition memory task. Importantly, participants were instructed that their goal was to maximize their score in this memory task. The second experiment was modified such that while studying the words participants simultaneously completed a divided attention task (either articulatory suppression or random number generation). The third experiment used a non-verbal tone detection divided attention task (easy or difficult versions). Subjective states of recollection (i.e., “Remember”) and familiarity (i.e., “Know”) were assessed at retrieval in all experiments. In Experiment 1, high value words were recognized more effectively than low value words, and this difference was primarily driven by increases in “Remember” responses with no difference in “Know” responses. In Experiment 2, the pattern of subjective judgment results from the articulatory suppression condition replicated Experiment 1. However, in the random number generation condition, the effect of value on recognition memory was lost. This same pattern of results was found in Experiment 3 which implemented a different variant of the divided attention task. Overall, these data suggest that executive processes are used when encoding valuable information and that value-directed improvements to memory are not merely the result of differential rehearsal.