Guiding Attention via a Cognitive Aid During a Simulated In-Hospital Cardiac Arrest Scenario: A Salience Effort Expectancy Value Model Analysis

Objective To investigate the effect of a cognitive aid on the visual attention distribution of the operator using the Salience Effort Expectancy Value (SEEV) model. Background Cognitive aids aim to support an operator during the execution of a task. The effect of cognitive aids on performance is frequently evaluated but whether a cognitive aid improved, for example, attention distribution has not been considered. Method We built the Expectancy Value (EV) model version which can be considered to indicate optimal attention distribution for a given event. We analyzed the eye tracking data of emergency physicians while using a cognitive aid application versus no application during a simulated in-hospital cardiac arrest scenario. Results The EV model could fit the attention distribution in such a simulated emergency situation. Partially supporting our hypothesis, the cognitive aid application group showed a significantly better EV model fit than the no application group in the first phases of the event, but a worse fit in the last phase. Conclusion We demonstrated that a cognitive aid affected attention distribution and that the SEEV model provides the means of capturing these effects. We suggest that the aid supported and improved visual attention distribution in the stressful first phases of a cardiopulmonary resuscitation but may have focused attention on objects that are relevant for lower priority goals in the last phase. Application The SEEV model can provide insights into expected and unexpected effects of cognitive aids on visual attention distribution and may help to design better artifacts.

The Effects of Diminished Reality on the Detection of and Response to Notifications

Many environments contain visual and auditory distractions. Cognitive aids help limit these distractions, support attention, and improve task performance. One way this is done is by adding information to the environment via Augmented Reality (AR). Attention may also be supported by removing distractors using Diminished Reality (DR), a form of AR that computationally erases, de-emphasizes, or otherwise diminishes external stimuli. However, there was no research investigating the design of the control and display system for DR technology and the question of how to redirect or gain someone’s attention when their environment is diminished had not been addressed. This study explored the acceptability and effectiveness of notifications with varying attributes and fills that gap in research. Results indicated that low specificity notifications in a diminished environment are rated as being subjectively better than notifications of other formats; low specificity messages were also recalled at a greater rate.

Diminishing Reality: Potential Benefits and Risks

Within distracting environments, it is difficult to maintain attentional focus on complex tasks. Cognitive aids can support attention by adding relevant information to the environment, such as via augmented reality (AR). However, there may be a benefit in removing elements from the environment, such as irrelevant alarms, displays, and conversations. De-emphasis of distracting elements is a type of AR called Diminished Reality (DR). Although de-emphasizing distraction may help focus on a primary task, it may also reduce situational awareness (SA) of other activities that may become relevant. In the current study, participants will assemble a medical ventilator during a simulated emergency while experiencing varying levels of DR. Participants will also be probed to assess secondary SA. We anticipate that participants will have better accuracy and completion times in the full DR conditions but their SA will suffer. Future applications include the design of future DR systems and improved training methods.

Adaptive Repetition: A Fuzzy Logic based Control Strategy for Active Exploration in 3D-Virtual Learning Environments

In past decade, the use of cognitive aids such as textual, visual and audio in 3D-Virtual Learning Environments is increasing day by day as it guide and facilitate both the students and teachers to perform the task with ease in Virtual Environment. In recent studies, it has been observed that the use of cognitive aids in virtual learning environments reduce mental load on learner but at the same time it also minimizes active exploration which negatively affect their performance in non-supervised environment. Therefore, some researchers have shown negative concern about the use of cognitive aids in 3D-Virtual Learning Environments (3D-VLEs). In this paper, we presents the idea of ”Adaptive Repetition” as control strategy for active exploration in 3D-VLEs. At the beginning of experiment in 3D-VLEs , students is given full support to perform the experiment with help of cognitive aids. Using a fuzzy logic based approach , the amount of aids are minimized whenever the experiment is repeated. The adaptive repetition approach put the students in active learning process and enables them to actively explore the learning environment. Ultimately, the negative effects of using cognitive aids in 3D-VLEs is minimized.

Preparation for airway management in Australia and New Zealand ICUs during the COVID -19 pandemic

Background This paper aimed to describe the airway practices of intensive care units (ICUs) in Australia and New Zealand specific to patients presenting with COVID-19 and to inform whether consistent clinical practice was achieved. Specific clinical airway guidelines were endorsed in March 2020 by the Australian and New Zealand Intensive Care Society (ANZICS) and College of Intensive Care Medicine (CICM). Methods and findings Prospective, structured questionnaire for all ICU directors in Australia and New Zealand was completed by 69 ICU directors after email invitation from ANZICS. The online questionnaire was accessible for three weeks during September 2020 and analysed by cloud-based software. Basic ICU demographics (private or public, metropolitan or rural) and location, purchasing, airway management practices, guideline uptake, checklist and cognitive aid use and staff training relevant to airway management during the COVID-19 pandemic were the main outcome measures. The 69 ICU directors reported significant simulation-based inter-professional airway training of staff (97%), and use of video laryngoscopy (94%), intubation checklists (94%), cognitive aids (83%) and PPE “spotters” (89%) during the airway management of patients with COVID-19. Tracheal intubation was almost always performed by a Specialist (97% of ICUs), who was more likely to be an intensivist than an anaesthetist (61% vs 36%). There was a more frequent adoption of specific airway guidelines for the management of COVID-19 patients in public ICUs (94% vs 71%) and reliance on specialist intensivists to perform intubations in private ICUs (92% vs 53%). Conclusion There was a high uptake of a standardised approach to airway management in COVID-19 patients in ICUs in Australia and New Zealand, likely due to endorsement of national guidelines.