Video-based reflection on neonatal interventions during COVID-19 using eye-tracking glasses: an observational study

Wagner, Michael; Boer, Maria C den; Jansen, Sophie; Groepel, Peter; Visser, Remco; Witlox, Ruben S G M; Bekker, Vincent; Lopriore, Enrico; Berger, Angelika; Pas, Arjan B Te

doi:10.1136/archdischild-2021-321806

Cited by 9 publications

(4 citation statements)

References 22 publications

(21 reference statements)

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“…The use of ET technology, previously reported as not hindering or limiting participants in their performance [ 16 , 31 ], provided the opportunity to understand the gaze behavior of successful and unsuccessful participants when changing power supply. Based on these results training materials could be modified and the findings should be considered in the next generation of peripherals to increase patient safety and satisfaction.…”

Section: Discussionmentioning

confidence: 99%

Human Factors Evaluation of HeartMate 3 Left Ventricular Assist Device Peripherals: An Eye Tracking Supported Simulation Study

et al. 2023

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Background Despite recent design improvements, human factors issues continue to challenge left ventricular assist device (LVAD) therapy. The aim of this study was to evaluate user experience of former non-HeartMate 3 (HM3) LVAD patients post heart transplantation (HTX) and laypersons (LP) with HM3 LVAD peripherals in simulated everyday and emergency scenarios. Methods This single center cohort study included untrained HTX and LP. Seven scenarios, including battery exchanges (without alarm, advisory alarm, dim light, consolidated bag), change of power supply, driveline dis-/reconnection and controller exchange were simulated. Subjects’ gaze behavior was recorded using eye tracking technology. Success rate, pump-off-time, duration to success (DTS), percental fixation duration per areas of interest and post-scenario-survey results were defined as outcome measures. Results Thirty subjects completed 210 scenarios, initially solving 82.4% (HTX vs. LP, p = 1.00). Changing power supply revealed highest complexity (DTS = 251 ± 93s, p = 0.76): 26.7% succeeded at first attempt (p = 0.68), 56.7% at second attempt, with significantly more LP failing (p = 0.04), resulting in 10 hazards from driveline disconnections (pump-off-time 2-118s, p = 0.25). Comparison on initial success showed differences in fixation durations for seven areas of interest (p < 0.037). Decreasing DTS during battery exchanges (p < 0.001) indicate high learnability. Exchanging batteries within the bag took longer (median DTS = 75.0 (IQR = 45.0)s, p = 0.09), especially in elderly subjects (r = 0.61, p < 0.001). Subjects with less initial success were more afraid of making mistakes (p = 0.048). Conclusion This eye tracking based human factors study provided insights into user experiences in handling HM3 peripherals. It highlights unintuitive and hazardous characteristics, providing guidance for future user-centered design of LVAD wearables.

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Section: Discussionmentioning

confidence: 99%

Human Factors Evaluation of HeartMate 3 Left Ventricular Assist Device Peripherals: An Eye Tracking Supported Simulation Study

et al. 2023

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“…For differences between experts ( n = 6) and non-experts ( n = 6), the relative dwell time (focus on a specific AOI) as well as the absolute time to first fixation in the case specific AOI, and total duration of echocardiography were assessed. The usability of the eye-tracking glasses was evaluated by all participants ( n = 15) after the last scenario using a questionnaire with 11 items about comfort and distraction (5-point Likert scale for each item) which was also used in a previous feasibility study [ 17 ]. Baseline characteristics included age, gender, medical background, years of professional experience as well as years of experience in echocardiography.…”

Section: Methodsmentioning

confidence: 99%

Eye-tracking during simulation-based echocardiography: a feasibility study

Hafner,

Scharner,

Hermann

et al. 2023

BMC Med Educ

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Introduction Due to the technical progress point-of-care ultrasound (POCUS) is increasingly used in critical care medicine. However, optimal training strategies and support for novices have not been thoroughly researched so far. Eye-tracking, which offers insights into the gaze behavior of experts may be a useful tool for better understanding. The aim of this study was to investigate the technical feasibility and usability of eye-tracking during echocardiography as well as to analyze differences of gaze patterns between experts and non-experts. Methods Nine experts in echocardiography and six non-experts were equipped with eye-tracking glasses (Tobii, Stockholm, Sweden), while performing six medical cases on a simulator. For each view case specific areas of interests (AOI) were defined by the first three experts depending on the underlying pathology. Technical feasibility, participants’ subjective experience on the usability of the eye-tracking glasses as well as the differences of relative dwell time (focus) inside the areas of interest (AOI) between six experts and six non-experts were evaluated. Results Technical feasibility of eye-tracking during echocardiography was achieved with an accordance of 96% between the visual area orally described by participants and the area marked by the glasses. Experts had longer relative dwell time in the case specific AOI (50.6% versus 38.4%, p = 0.072) and performed ultrasound examinations faster (138 s versus 227 s, p = 0.068). Furthermore, experts fixated earlier in the AOI (5 s versus 10 s, p = 0.033). Conclusion This feasibility study demonstrates that eye-tracking can be used to analyze experts and non-experts gaze patterns during POCUS. Although, in this study the experts had a longer fixation time in the defined AOIs compared to non-experts, further studies are needed to investigate if eye-tracking could improve teaching of POCUS.

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“…The utilization of video recording is an excellent example of how technology can be used to record simulations or real clinical situations for clinical education and research. After a critical or even only after a routine situation, a video recording, either with a designated video recording system or from a first-person perspective using eye-tracking glasses ( 9 ), can be reflected together with the whole team to identify problems such as the environment, the algorithm adherence, or teamwork and communication. After that, this knowledge can be used for targeted training to improve the workflow in the delivery room, intensive care unit, and individual and team behavior.…”

Section: Individualized Trainingmentioning

confidence: 99%

Editorial: Future medical education in pediatrics and neonatology

Wagner

Deindl²,

Schmölzer³

2023

Front. Pediatr.

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Editorial on the Research Topic Future medical education in pediatrics and neonatology Pediatric and neonatal emergencies generate high-stress levels and an immense cognitive load for healthcare providers. For decades, a "see one, do one, teach one" approach was a common strategy within medical training (1). However, this approach is a challenge for patient safety, as providers used to perform procedures on patients for the very first time. Nowadays, a "see one, simulate many, do many, teach one" is acknowledged as more appropriate, where students and healthcare providers can practice skills and emergencies safely without harming patients (2). Simulation-based medical education is usually performed as either low-fidelity or high-fidelity training utilizing manikins and specific technology for on-site training (3). However, the COVID-19 pandemic demonstrated that traditional simulation-based medical education is not preserved from the outage and that healthcare and educational systems should be prepared for new educational challenges such as virtual teaching approaches (4). In this special issue of Frontiers in Pediatrics about future medical education in pediatrics and neonatology, we aimed to collect research articles focusing on promising and innovative new teaching methods for student training and clinical education. Virtual teachingOne strategy to overcome traditional training approaches with the need to be on-site, often limited due to staff shortages and lack of space to perform training, is a switch to virtual education strategies. Recently, there has been a significant increase in serious game applications (5). Serious games can augment learning and establish continuous algorithm and decision-making skills (5). The authors Bardelli et al. introduced a new computer game called "DIANA: Digital Application in Newborn Assessment", which enables virtual training of neonatal life support on a computer, and the authors demonstrated the equivalence of this virtual training to conventional training. Furthermore, telemedicine for tele-simulation was also described as an option for distance training with the advantage of integrating external experts from other countries in the skill or team training process (6, 7). Löllgen et al. combined both serious gaming and tele-simulation utilizing avatars as surrogates for human participants to enable remote team training in multiple institutions simultaneously. They suggested this methodology as a feasible alternative to connect educators and trainees virtually at the same place. Whereas this training needs to be synchronized for participants, TYPE

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Video-based reflection on neonatal interventions during COVID-19 using eye-tracking glasses: an observational study

Cited by 9 publications

References 22 publications

Human Factors Evaluation of HeartMate 3 Left Ventricular Assist Device Peripherals: An Eye Tracking Supported Simulation Study

Human Factors Evaluation of HeartMate 3 Left Ventricular Assist Device Peripherals: An Eye Tracking Supported Simulation Study

Eye-tracking during simulation-based echocardiography: a feasibility study

Editorial: Future medical education in pediatrics and neonatology

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