Objective: To highlight the importance of the personal experience of users who interact with technology in safety-critical domains and summarize three interaction concepts and the associated theories that provide the means for addressing user experience. Background: In health care, the dominant concepts of interaction are based on theories arising from classic cognitive psychology. These concepts focus mainly on safety and efficiency, with too little consideration being given to user experience. Method: Users in complex socio-technical and safety-critical domains such as health care interact with many technological devices. Enhancing the user experience could improve the design of technology, enhance the well-being of staff, and contribute to modern safety management. We summarize concepts of “interaction” based on modern theories of human–computer interaction, which include the personal experience of users as an important construct. Results and Conclusion: Activity theory, embodiment, and interaction as experience provide a theoretical foundation for considering user experience in safety-critical domains. Using an example from anesthesiology, we demonstrate how each theory provides a unique but complementary view on experience. Finally, the methodological possibilities for considering personal experience in design and evaluations vary among the theories. Application: Considering user experience in health care and potentially other safety-critical domains can provide an additional means of optimizing interaction with technology, contributing to the well-being of staff, and improving safety.
Summary
Tracheal intubation requires the anaesthetist to adopt an awkward body posture. To investigate how posture may be improved, we compared the effects of laryngoscopy technique (GlideScope® vs Macintosh blade) and experience (novices vs experts) on body posture angles and the Rapid Entire Body Assessment postural analysis score. Novices (25 medical students) and experts (26 anaesthetists) were video‐recorded performing intubation in a manikin using both devices. The GlideScope resulted in smaller deflections for all analysed posture angles (all p values < 0.001) except the wrist compared with the Macintosh blade. Novices showed more trunk (p < 0.001) and neck (p = 0.002) flexion than experts. Using the GlideScope resulted in a lower Rapid Entire Body Assessment score compared with using the Macintosh blade (p < 0.001), indicating that the GlideScope resulted in body posture less likely to induce musculoskeletal injuries. From an ergonomic point of view, the GlideScope should be the preferred technique for laryngoscopy.
In anaesthesia, patient simulators have been used for training and research. However, insights from simulator-based research may only translate to real settings if the simulation elicits the same behaviour as the real setting. To this end, we investigated the effects of the case (simulated case vs. real case) and experience level (junior vs. senior) on the distribution of visual attention during the induction of general anaesthesia. We recorded eye-tracking data from 12 junior and 12 senior anaesthetists inducing general anaesthesia in a simulation room and in an actual operating room (48 recordings). Using a classification system from the literature, we assigned each fixation to one of 24 areas of interest and classified the areas of interest into groups related to monitoring, manual, and other tasks. Anaesthetists gave more visual attention to monitoring related areas of interest in simulated cases than in real cases (p = 0.001). We observed no effect of the factor case for manual tasks. For other tasks, anaesthetists gave more visual attention to areas of interest related to other tasks in real cases than in simulated cases (p < 0.001). Experience level did not have an effect on the distribution of visual attention. The results showed that there were differences in the distribution of visual attention by between real and simulated cases. Therefore, researchers need to be careful when translating simulation-based research on topics involving visual attention to the clinical environment.
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