Presentation
HE14 - The effects of digitally remapping sensory information in complex healthcare tasks
DescriptionIndividual differences in cognitive processes, like memory capacity, attentional control, and processing speed, significantly influence cognitive ability and performance. These individual differences are described by the American Psychological Association as the characteristics that set individuals apart in terms of their cognitive capabilities (APA Dictionary of Psychology, 2023). Differences in attentional abilities, especially in complex work environments (Chérif et al., 2018), impact performance. However, increasing attentional ability is not possible (Lavie, 2006; Scalf et. al., 2013). Cognitive aids have then emerged as tools designed to help and support individual attentional processes, reducing the restrictions imposed by these cognitive limitations (McLaughlin & Byrne, 2020).
Intensive Care Units (ICUs) demand timely decision-making and critical assessments (Buckley et al., 1997 as cited in Espin et al., 2010). ICU nurses work in high-stress settings with constant distractions, often stemming from irrelevant information to the task. Drews (2007) observed 1138 activities, including direct patient care, documentation, and administrative tasks. The study's findings demonstrated that 335 of the actions that were observed had interruptions, the majority of which occurred while caring for the patients. Most interruptions were caused by other nurses, followed by alarms. The patient handoff, a critical process involving information transfer and patient care responsibility, is susceptible to distractions. Inadequate communication during handoffs leads to serious medical errors, with communication failures responsible for up to 80% of these errors (Donchin et al., 1995). Distractions including background noise, patient call lights, several information panels, and equipment alarms interfere with an efficient handoff. Distractions during handoffs are expected to be followed by the original activity; nevertheless, research indicates that this results in inefficient patient handoffs (Vanderzwan et. al., 2023).
According to Wickens's (1984) Multiple Resource Theory (MRT), the modality of competing stimuli can significantly impact cognitive workload. In order to improve human performance and lessen cognitive burden, interface design and redesign have been guided by the Multiple Resource Theory (MRT). Examples of this are research demonstrating that the use of auditory alerts for navigation will reduce the cognitive workload during driving (Recarte & Nunes, 2003), and research demonstrating the benefits of combining visual displays and audio warnings on medical equipment to aid medical personnel analysis of vital patient data and lower the possibility of information overload (Drews & Doig, 2014). However, when it comes to aiding nurses in fast-paced scenarios we cannot just redesign interfaces in the ICUs, this is because there are too many displays, people, and environmental factors that would make this an extensive job. Instead, the creation of cognitive aids may result in mitigating the effect of distractors on task performance.
The goal of this study was to examine the effect of a cognitive aid that remapped sensory information. Although the technology to enact this form of aid is still on the horizon, it will be possible to use augmented reality technologies. Remapping is a form of Augmented Reality (AR) that converts sensory input from one modality to another, in this research, the conversion of auditory instructions into a visual display was used. This study aims to contribute to the current body of literature on cognitive aids by examining how information remapping can help with cognitive workload and reduce errors in distracting environments.
We hypothesized that the remapping of information in a distracting environment will improve information retention and reduce distraction as well as recall of the presented information. We investigated the possible advantages of remapped information using two participant groups. This research had a between-subject design, with two different conditions. In Condition 1 the scenario did not provide remapped information, meaning that the medical handoff conversation remained audible. In contrast, Condition 2 introduced the novel concept of remapped information, where the medical handoff conversation was changed from an auditory to an on-screen text format.
111 participants aged between 18 and 63 years old (M = 27.32) took an online survey which included a pre-screener, consent, and demographic information. Requirements included 20/20 vision or correctable vision, normal hearing, and English as a first language. Participants were randomly assigned to non-remapped or remapped conditions. They view a simulated ICU patient hand-off video, interrupted for ADHD and Attentional Control Scale questionnaires. All participants completed the recall test at the end, with some answering a NASA TLX workload survey. The study investigated how remapping impacts attentional ability and workload.
To see if there were differences between conditions we performed an independent sample t-test to compare the results of the groups on the recall test and the NASA TLX. This analysis revealed no statistically significant difference, (t(109) = -1.60, p > 0.05). The same was true for scores on the NASA TLX, we did not find any differences in group rating of their mental demand, physical demand, temporal demand, effort, or performance.
The study's findings provide important new understandings of the function of knowledge remapping as a cognitive assist. Regardless of the lack of significant differences between groups, this study highlights how complex cognitive processes are and how much more research has to be done in this area. These results encourage us to investigate the complexities of individual attentional abilities and the moderating variables that could affect the effectiveness of cognitive aids. Results will inform the design of cognitive aids for error reduction in fast-paced scenarios.
References:
Beck, D. M., Scalf, P. E., Torralbo, A., & Tapia, E. (2013). Competition explains limited attention and perceptual resources: Implications for perceptual load and dilution theories. Frontiers in Psychology, 4, 243.
"Individual Differences" (2023). In APA Dictionary of Psychology (2nd ed.). American Psychological Association. https://www.apa.org/pubs/dictionaries/index
Chérif, L., Wood, V., Marois, A., Labonté, K., & Vachon, F. (2018). Multitasking in the military: Cognitive consequences and potential solutions. Applied Cognitive Psychology, 32(4), 429–439.
Donchin, Y., Gopher, D., Olin, M., Badihi, Y., Biesky, M. R., Sprung, C. L., Pizov, R., & Cotev, S. (1995). A look into the nature and causes of human errors in the intensive care unit. Critical Care Medicine, 23(2), 294–300.
Drews, F. A. (2007). The frequency and impact of task interruptions in the ICU. Proceedings of the Human Factors and Ergonomics Society. Annual Meeting Human Factors and Ergonomics Society. Meeting, 51(11), 683–686.
Drews, F. A., & Doig, A. (2014). Evaluation of a configural vital signs display for intensive care unit nurses. Human Factors, 56(3), 569–580.
Espin, S., Wickson-Griffiths, A., Wilson, M., & Lingard, L. (2010). To report or not to report: A descriptive study exploring ICU nurses’ perceptions of error and error reporting. Intensive & Critical Care Nursing: The Official Journal of the British Association of Critical Care Nurses, 26(1), 1–9.
Lavie, N. (2006). The role of perceptual load in visual awareness. Brain Research, 1080(1), 91–100.
McLaughlin, A. C., & Byrne, V. E. (2020). A fundamental cognitive taxonomy for cognition aids. Human Factors, 62(6), 865–873.
Recarte, M. A., & Nunes, L. M. (2003). Mental workload while driving: Effects on visual search, discrimination, and decision making. Journal of Experimental Psychology. Applied, 9(2), 119–137.
Scalf, P. E., Torralbo, A., Tapia, E., & Beck, D. M. (2013). Competition explains limited attention and perceptual resources: Implications for perceptual load and dilution theories. Frontiers in Psychology, 4, 243.
Unsworth, N., & Miller, A. L. (2021). Individual differences in the intensity and consistency of attention. Current Directions in Psychological Science, 30(5), 391–400.
Vanderzwan, K. J., Kilroy, S., Daniels, A., & O’Rourke, J. (2023). Nurse-to-nurse handoff with distractors and interruptions: An integrative review. Nurse Education in Practice, 67, 103550.
Wickens, C. D. (1984). Processing resources in attention. In R. Para-suraman & R. Davies (Eds.), Varieties of attention(pp. 63–101).New York: Academic Press
Intensive Care Units (ICUs) demand timely decision-making and critical assessments (Buckley et al., 1997 as cited in Espin et al., 2010). ICU nurses work in high-stress settings with constant distractions, often stemming from irrelevant information to the task. Drews (2007) observed 1138 activities, including direct patient care, documentation, and administrative tasks. The study's findings demonstrated that 335 of the actions that were observed had interruptions, the majority of which occurred while caring for the patients. Most interruptions were caused by other nurses, followed by alarms. The patient handoff, a critical process involving information transfer and patient care responsibility, is susceptible to distractions. Inadequate communication during handoffs leads to serious medical errors, with communication failures responsible for up to 80% of these errors (Donchin et al., 1995). Distractions including background noise, patient call lights, several information panels, and equipment alarms interfere with an efficient handoff. Distractions during handoffs are expected to be followed by the original activity; nevertheless, research indicates that this results in inefficient patient handoffs (Vanderzwan et. al., 2023).
According to Wickens's (1984) Multiple Resource Theory (MRT), the modality of competing stimuli can significantly impact cognitive workload. In order to improve human performance and lessen cognitive burden, interface design and redesign have been guided by the Multiple Resource Theory (MRT). Examples of this are research demonstrating that the use of auditory alerts for navigation will reduce the cognitive workload during driving (Recarte & Nunes, 2003), and research demonstrating the benefits of combining visual displays and audio warnings on medical equipment to aid medical personnel analysis of vital patient data and lower the possibility of information overload (Drews & Doig, 2014). However, when it comes to aiding nurses in fast-paced scenarios we cannot just redesign interfaces in the ICUs, this is because there are too many displays, people, and environmental factors that would make this an extensive job. Instead, the creation of cognitive aids may result in mitigating the effect of distractors on task performance.
The goal of this study was to examine the effect of a cognitive aid that remapped sensory information. Although the technology to enact this form of aid is still on the horizon, it will be possible to use augmented reality technologies. Remapping is a form of Augmented Reality (AR) that converts sensory input from one modality to another, in this research, the conversion of auditory instructions into a visual display was used. This study aims to contribute to the current body of literature on cognitive aids by examining how information remapping can help with cognitive workload and reduce errors in distracting environments.
We hypothesized that the remapping of information in a distracting environment will improve information retention and reduce distraction as well as recall of the presented information. We investigated the possible advantages of remapped information using two participant groups. This research had a between-subject design, with two different conditions. In Condition 1 the scenario did not provide remapped information, meaning that the medical handoff conversation remained audible. In contrast, Condition 2 introduced the novel concept of remapped information, where the medical handoff conversation was changed from an auditory to an on-screen text format.
111 participants aged between 18 and 63 years old (M = 27.32) took an online survey which included a pre-screener, consent, and demographic information. Requirements included 20/20 vision or correctable vision, normal hearing, and English as a first language. Participants were randomly assigned to non-remapped or remapped conditions. They view a simulated ICU patient hand-off video, interrupted for ADHD and Attentional Control Scale questionnaires. All participants completed the recall test at the end, with some answering a NASA TLX workload survey. The study investigated how remapping impacts attentional ability and workload.
To see if there were differences between conditions we performed an independent sample t-test to compare the results of the groups on the recall test and the NASA TLX. This analysis revealed no statistically significant difference, (t(109) = -1.60, p > 0.05). The same was true for scores on the NASA TLX, we did not find any differences in group rating of their mental demand, physical demand, temporal demand, effort, or performance.
The study's findings provide important new understandings of the function of knowledge remapping as a cognitive assist. Regardless of the lack of significant differences between groups, this study highlights how complex cognitive processes are and how much more research has to be done in this area. These results encourage us to investigate the complexities of individual attentional abilities and the moderating variables that could affect the effectiveness of cognitive aids. Results will inform the design of cognitive aids for error reduction in fast-paced scenarios.
References:
Beck, D. M., Scalf, P. E., Torralbo, A., & Tapia, E. (2013). Competition explains limited attention and perceptual resources: Implications for perceptual load and dilution theories. Frontiers in Psychology, 4, 243.
"Individual Differences" (2023). In APA Dictionary of Psychology (2nd ed.). American Psychological Association. https://www.apa.org/pubs/dictionaries/index
Chérif, L., Wood, V., Marois, A., Labonté, K., & Vachon, F. (2018). Multitasking in the military: Cognitive consequences and potential solutions. Applied Cognitive Psychology, 32(4), 429–439.
Donchin, Y., Gopher, D., Olin, M., Badihi, Y., Biesky, M. R., Sprung, C. L., Pizov, R., & Cotev, S. (1995). A look into the nature and causes of human errors in the intensive care unit. Critical Care Medicine, 23(2), 294–300.
Drews, F. A. (2007). The frequency and impact of task interruptions in the ICU. Proceedings of the Human Factors and Ergonomics Society. Annual Meeting Human Factors and Ergonomics Society. Meeting, 51(11), 683–686.
Drews, F. A., & Doig, A. (2014). Evaluation of a configural vital signs display for intensive care unit nurses. Human Factors, 56(3), 569–580.
Espin, S., Wickson-Griffiths, A., Wilson, M., & Lingard, L. (2010). To report or not to report: A descriptive study exploring ICU nurses’ perceptions of error and error reporting. Intensive & Critical Care Nursing: The Official Journal of the British Association of Critical Care Nurses, 26(1), 1–9.
Lavie, N. (2006). The role of perceptual load in visual awareness. Brain Research, 1080(1), 91–100.
McLaughlin, A. C., & Byrne, V. E. (2020). A fundamental cognitive taxonomy for cognition aids. Human Factors, 62(6), 865–873.
Recarte, M. A., & Nunes, L. M. (2003). Mental workload while driving: Effects on visual search, discrimination, and decision making. Journal of Experimental Psychology. Applied, 9(2), 119–137.
Scalf, P. E., Torralbo, A., Tapia, E., & Beck, D. M. (2013). Competition explains limited attention and perceptual resources: Implications for perceptual load and dilution theories. Frontiers in Psychology, 4, 243.
Unsworth, N., & Miller, A. L. (2021). Individual differences in the intensity and consistency of attention. Current Directions in Psychological Science, 30(5), 391–400.
Vanderzwan, K. J., Kilroy, S., Daniels, A., & O’Rourke, J. (2023). Nurse-to-nurse handoff with distractors and interruptions: An integrative review. Nurse Education in Practice, 67, 103550.
Wickens, C. D. (1984). Processing resources in attention. In R. Para-suraman & R. Davies (Eds.), Varieties of attention(pp. 63–101).New York: Academic Press
Event Type
Poster Presentation
TimeTuesday, March 264:45pm - 6:15pm CDT
LocationSalon C
Digital Health
Simulation and Education
Hospital Environments
Medical and Drug Delivery Devices
Patient Safety Research and Initiatives