The Influence of Audible Alarm Loudness and Type on Clinical Multitasking

Bruder, Alexandra L.; Rothwell, Clayton D.; Fuhr, Laura; Shotwell, Matthew S.; Edworthy, Judy; Schlesinger, Joseph J.

doi:10.1007/s10916-021-01794-9

Cited by 9 publications

(5 citation statements)

References 55 publications

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“…To revisit our goal of improving alarm learnability, discernibility, and relevance, our system demonstrated advances in all three areas. Good participant performance and decreased perceived workload through the use of auditory icons to increase learnability of auditory alarms builds on and supports previous research [ 8 , 27 ]. Our system also utilized multisensory alarms to increase discernibility by aiding in perceiving, locating, and determining priority for alarms.…”

Section: Discussionsupporting

confidence: 80%

“…To address this issue, Edworthy et al developed auditory icons, which are auditory sounds with an innate relation to what the alarm signifies (e.g., a lub-dub sound for heart rate monitoring) [ 2 ]. These auditory icons had significantly higher accuracy rates, quicker response times, and improved overall performance when compared to standard alarms [ 2 , 8 ]. After demonstrating success in the research setting, auditory icon alarms were approved for clinical use in the 2020 amendment to the International Electrotechnical Commission (IEC) 60,601–1–8 standard [ 9 , 10 ].…”

Section: Introductionmentioning

confidence: 99%

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Improved Patient Monitoring with a Novel Multisensory Smartwatch Application

et al. 2022

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The design of medical alarms has been heavily criticized in the past decade. Auditory medical alarms have poor learnability, discernibility, and relevance, leading to poor patient outcomes, and alarm fatigue, and overall poor informatic system design. We developed a novel trimodal patient monitoring smartwatch application for patient monitoring. Participants completed two phases: (1) control and (2) our novel trimodal system while identifying alarms (heart rate, oxygenation, and blood pressure) and completing a cognitively demanding task. Alarms were auditory icons presented as either solo or co-alarms. Participant performance was assessed by accuracy and response time (RT) of alarm identification. Using the novel system, accuracy was significantly improved overall (p < 0.01) and in co-alarm situations (p < 0.01), but not for solo alarms (p = 0.484). RT was also significantly faster (p < 0.01) while using the novel system for all alarm types. Participants reported decreased mental workload using the novel system. This feasibility study shows that our novel alarm system performs better than current standards. Improvements in accuracy, RT and perceived mental workload indicate the potential of this system to have a positive impact on medical informatic systems and clinical monitoring, for both the patient and the clinician.

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Section: Discussionsupporting

confidence: 80%

Section: Introductionmentioning

confidence: 99%

Improved Patient Monitoring with a Novel Multisensory Smartwatch Application

et al. 2022

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“…In this regard, both Edworthy and colleagues and Sanderson and colleagues have offered exemplary models in their work on auditory alerts in medical settings. These research programs have performed preliminary field work (Deschamps & Sanderson, 2021;Kristensen et al, 2015) and tested alerts against background noise (Bennett et al, 2019;Bruder et al, 2022), during multitasking (Bruder et al, 2022;Davidson et al, 2019;Deschamps et al, 2022;Knight et al, 2020) , and in the presence of simultaneous auditory alerts (Edworthy et al, 2022), with evaluation research sampling from the target listener end-user populations (Atyeo & Sanderson, 2015;Wright et al, 2020). Sustained, programmatic research programs like these can ensure the successful design of auditory alerts.…”

Section: Future Directionsmentioning

confidence: 99%

Auditory Icons, Earcons, Spearcons, and Speech: A Systematic Review and Meta-Analysis of Brief Audio Alerts in Human-Machine Interfaces

Nees

Liebman

2023

Auditory Perception & Cognition

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Auditory displays commonly are used in safety-critical domains and are a vital component of universal and inclusive design practices. Despite several decades of research on brief auditory alerts for representing status and processes in user interfaces, there is no clear heuristic guidance for which type(s) of auditory alerts should be preferred for designing interfaces. We used evidence synthesis (systematic review and meta-analysis) to examine the effectiveness of different types of brief audio alerts. We identified articles comparing auditory icons (real-world sounds with an ecological relationship to their referent), earcons (abstract sounds with no ecological relationship to their referent), spearcons (accelerated/compressed speech), and speech alerts. We used meta-analysis to compare alerts across five different outcomes: accuracy, reaction time, subjective ratings, workload, and dual-task interference. For accuracy and reaction time, results indicated speech, spearcons, and other types of alerts (usually hybrid, e.g., spearcons plus speech) were superior to auditory icons, which in turn were superior to earcons. Earcons also were inferior to all other options with respect to subjective ratings. Analyses generally suggested parity among alert types for workload and dual-task interference. Based on currently available evidence, it appears that speech, spearcons, and hybrid (e.g., spearcons plus speech) auditory alerts result in better performance than auditory icons and especially earcons. Still, high heterogeneity in our analyses cannot rule out a wide range of possible effects, and our analyses could not directly address some of the concerns that have been raised regarding speech-based alerts. These findings can help to guide the selection of brief audio alerts in interface design.

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“…The experiment modeled after the experimental paradigm validated by Schlesinger et al (2018) and Bruder et al (2021) manipulated a within-subjects design: a complex visual distraction task type (five types), a speech intelligibility response task (coordinate response measure [CRM]), an easy visual distraction task, alarm type (two types: tonal alarm vs. the informative alarm), alarm level (+2 dB SNR), and background noise (background noise vs. background noise + music [jazz/funk music without vocals to not mask human speech–playlist). Trials were organized into four sequential blocks corresponding to the alarm type and background noise combinations (tonal alarm/informative icon, background noise/background noise + music) with only one type of alarm in each block.…”

Section: Methodsmentioning

confidence: 99%

The impact of formal musical training on speech intelligibility performance: Implications for music pedagogy in high-consequence industries

Bruder

Rothwell²,

Baillargeon

et al. 2023

Psychology of Music

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In high-risk industries, responding accurately and promptly to spoken commands is crucial to ensure safety and productivity. When simultaneous sounds occur, it increases the difficulty of responding efficiently and accurately. This study examined responses to spoken commands in an audio-visual multitasking paradigm that simulated a high-consequence working environment. Participants had varying levels of formal music training (FMT): no FMT, 1–3, 3–5, and 5+ years of FMT. We found that FMT groups were similar in accuracy overall and background music decreased accuracy for all groups. The degree of FMT significantly impacted non-response. Additionally, there was an interaction where the no FMT group responded 1.5-fold less frequently in the presence of background music; however, participants with 5+ years of FMT had no decrease. Considering the similar accuracy with less frequent responding, the 5+ years FMT group appears well calibrated to when they were unsure of the answer, suggestive of improved meta-cognition which could be valuable in high-risk industry settings. Future research can examine performance within different types or quality of musical training, and pedagogical approaches can be compared.

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The Influence of Audible Alarm Loudness and Type on Clinical Multitasking

Cited by 9 publications

References 55 publications

Improved Patient Monitoring with a Novel Multisensory Smartwatch Application

Improved Patient Monitoring with a Novel Multisensory Smartwatch Application

Auditory Icons, Earcons, Spearcons, and Speech: A Systematic Review and Meta-Analysis of Brief Audio Alerts in Human-Machine Interfaces

The impact of formal musical training on speech intelligibility performance: Implications for music pedagogy in high-consequence industries

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