Two experiments were performed to examine how frame of reference (world-referenced vs. screen-referenced) and target expectancy can modulate the effects of target cuing in directing attention for see-through helmet-mounted displays (HMDs). In the first experiment, the degree of world referencing was varied by the spatial accuracy of the cue; in the second, the degree of world referencing was varied more radically between a world-referenced HMD and a hand-held display. Participants were asked to detect, identify, and give azimuth information for targets hidden in terrain presented in the far domain (i.e., the world) while performing a monitoring task in the near domain (i.e., the display). The results of both experiments revealed a cost-benefit trade-off for cuing such that the presence of cuing aided the target detection task for expected targets but drew attention away from the presence of unexpected targets in the environment. Analyses support the observation that this effect can be mediated by the display: The world-referenced display reduced the cost of cognitive tunneling relative to the screen-referenced display in Experiment 1; this cost was further reduced in Experiment 2 when participants were using a hand-held display. Potential applications of this research include important design guidelines and specifications for automated target recognition systems as well as any terrain-and-targeting display system in which superimposed symbology is included, specifically in assessing the costs and benefits of attentional cuing and the means by which this information is displayed.

This paper surveys current work on the design of alarms for anesthesia environments and notes some of the problems arising from the need to interpret alarms in context. Anesthetists' responses to audible alarms in the operating room were observed across four types of surgical procedure (laparoscopic, arthroscopic, cardiac, and intracranial) and across three phases of a procedure (induction, maintenance, and emergence). Alarms were classified as (a) requiring a corrective response, (b) being the intended result of a decision, (c) being ignored as a nuisance alarm, or (d) functioning as a reminder. Results revealed strong effects of the type of procedure and phase of procedure on the number and rate of audible alarms. Some alarms were relatively confined to specific phases; others were seen across phases, and responses differed according to phase. These results were interpreted in light of their significance for the development of effective alarm systems. Actual or potential applications of this research include the design of alarm systems that are more informative and more sensitive to operative context than are current systems.

In healthcare, the sustained presence of hierarchy between team members has been cited as a common contributor to communication breakdowns. Hierarchy serves to accentuate either actual or perceived chains of command, which may result in team members failing to challenge decisions made by leaders, despite concerns about adverse patient outcomes. While other tools suggest improved communication, none focus specifically on communication skills for team followers, nor do they provide techniques to immediately challenge authority and escalate assertiveness at a given moment in real time. This article presents data that show one such strategy, called the Effective Followership Algorithm, offering statistically significant improvements in team communication across the professional continuum from students and residents to experienced clinicians.

Auditory signals can take the form of "auditory displays" that communicate information redundant to visual displays.These redundant displays may allow offioading some visual workload to the auditory channel. The current study examines the effect of visual, auditory and redundant displays on the performance of a dual-task simulation of patient monitoring. Subjects performed manual compensatory tracking task while monitoring six vital signs of a simulated patient, detecting deviations from normal levels. Monitoring was presented in three display conditions: auditory only, visual only, and redundant. Results indicate that the detection of deviations in visual and redundant conditions were not significantly different, but faster than the auditory display. However, performance in the tracking task was degraded least in the auditory condition, and the redundant display resulted in poorest performance--an example of a negative redundancy-gain.Reasons for this finding are examined through data from eye-movement recordings. This negative redundancy gain is also discussed.

No abstract