Visual attention on a respiratory function monitor during simulated neonatal resuscitation: an eye-tracking study

Katz, Trixie A; Weinberg, Danielle; Fishman, Claire E.; Tremoulet, Patrice D.; Pas, Arjan B. te; Sarcevic, Aleksandra; Foglia, Elizabeth E.

doi:10.1136/archdischild-2017-314449

Cited by 37 publications

(28 citation statements)

References 24 publications

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“…Eye-tracking can be used to assess and quantify VA as a measure of human performance within clinical settings 3 4 17–22. However, there is a lack of data on VA during neonatal resuscitation.…”

Section: Discussionmentioning

confidence: 99%

Effect of monitor positioning on visual attention and situation awareness during neonatal resuscitation: a randomised simulation study

Law,

Cheung,

van Os

et al. 2019

Arch Dis Child Fetal Neonatal Ed

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ObjectivesTo compare situation awareness (SA), visual attention (VA) and protocol adherence in simulated neonatal resuscitations using two different monitor positions.DesignRandomised controlled simulation study.SettingsSimulation lab at the Royal Alexandra Hospital, Edmonton, Canada.ParticipantsHealthcare providers (HCPs) with Neonatal Resuscitation Program (NRP) certification within the last 2 years and trained in neonatal endotracheal intubations.InterventionHCPs were randomised to either central (eye-level on the radiant warmer) or peripheral (above eye-level, wall-mounted) monitor positions. Each led a complex resuscitation with a high-fidelity mannequin and a standardised assistant. To measure SA, situation awareness global assessment tool (SAGAT) was used, where simulations were paused at three predetermined points, with five questions asked each pause. Videos were analysed for SAGAT and adherence to a NRP checklist. Eye-tracking glasses recorded participants’ VA.Main outcome measureThe main outcome was SA as measured by composite SAGAT score. Secondary outcomes included VA and adherence to NRP checklist.ResultsThirty simulations were performed; 29 were completed per protocol and analysed. Twenty-two eye-tracking recordings were of sufficient quality and analysed. Median composite SAGAT was 11.5/15 central versus 11/15 peripheral, p=0.56. Checklist scores 46/50 central versus 46/50 peripheral, p=0.75. Most VA was directed at the mannequin (30.6% central vs 34.1% peripheral, p=0.76), and the monitor (28.7% central vs 20.5% peripheral, p=0.06).ConclusionsSimulation, SAGAT and eye-tracking can be used to evaluate human factors of neonatal resuscitation. During simulated neonatal resuscitation, monitor position did not affect SA, VA or protocol adherence.

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Section: Discussionmentioning

confidence: 99%

Effect of monitor positioning on visual attention and situation awareness during neonatal resuscitation: a randomised simulation study

Law,

Cheung,

van Os

et al. 2019

Arch Dis Child Fetal Neonatal Ed

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“…Enhanced technological advances have seen the introduction of eye tracking software as a potential aid in both simulation training (87,88) and in delivery room care (89). Foglia studied 24 providers interacting with a respiratory function monitor during simulated neonatal resuscitation and found that users were willing to wear the glasses and looked at exhaled tidal volume more than any other RFM parameter (88). In a similar study Wagner found that providers use of glasses was acceptable and their use enhanced understanding of providers' gaze and perspective during simulated neonatal airway management (87).…”

Section: High Fidelity Vs Low Fidelity Simulationmentioning

confidence: 99%

Simulation in Neonatal Resuscitation

Garvey

Dempsey

2020

Front. Pediatr.

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Approximately 1 in 10 newborns will require basic resuscitation interventions at birth. Some infants progress to require more advanced measures including the provision of positive pressure ventilation, chest compressions, intubation and administration of volume/cardiac medications. Although advanced resuscitation is infrequent, it is crucial that personnel adequately trained in these techniques are available to provide such resuscitative measures. In 2000, Louis Halmalek et al. called for a "New Paradigm in Pediatric Medical Education: Teaching Neonatal Resuscitation in a Simulated Delivery Room Environment." This was one of the first articles to highlight simulation as a method of teaching newborn resuscitation. The last decades have seen an exponential growth in the area of simulation in newborn care, in particular in newborn resuscitation and stabilization. Simulation is best defined as an instructional strategy "used to replace or amplify real experiences with guided experiences that evoke or replicate substantial aspects of the real world in a fully interactive manner." Simulation training has now become an important point of how we structure training and deliver improved healthcare to patients. Some of the key aspects of simulation training include feedback, deliberate practice, outcome measurement, retention of skills and curriculum integration. The term "Train to win" is often used in sporting parlance to define how great teams succeed. The major difference between sports teams is that generally their game day comes once a week, whereas in newborn resuscitation every day is potentially "game day." In this review we aim to summarize the current evidence on the use of simulation based education and training in neonatal resuscitation, with particular emphasis on the evidence supporting its effectiveness. We will also highlight recent advances in the development of simulation based medical education in the context of newborn resuscitation to ensure we "train to win."

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“…We have, however, previously emphasized that resuscitators must have appropriate training so they can accurately interpret the results of such monitoring in real time [14]. Eye tracking technology has demonstrated that providers spend more time looking at the exhaled tidal volume waveform data than any other RFM parameter to guide positive pressure ventilation [15] suggesting further training is required on the importance of EtCO 2 levels during resuscitation.…”

Section: Discussionmentioning

confidence: 99%

End-tidal carbon dioxide levels during resuscitation and carbon dioxide levels in the immediate neonatal period and intraventricular haemorrhage

et al. 2019

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Abnormal levels of end-tidal carbon dioxide (EtCO 2 ) during resuscitation in the delivery suite are associated with intraventricular haemorrhage (IVH) development. Our aim was to determine whether carbon dioxide (CO 2 ) levels in the first 3 days after birth reflected abnormal EtCO 2 levels in the delivery suite, and hence, a prolonged rather than an early insult resulted in IVH. In addition, we determined if greater EtCO 2 level fluctuations during resuscitation occurred in infants who developed IVH. EtCO 2 levels during delivery suite resuscitation and CO 2 levels on the neonatal unit were evaluated in 58 infants (median gestational age 27.3 weeks). Delta EtCO 2 was the difference between the highest and lowest level of EtCO 2 . Thirteen infants developed a grade 3-4 IVH (severe group). There were no significant differences in CO 2 levels between those who did and did not develop an IVH (or severe IVH) on the NICU. The delta EtCO 2 during resuscitation differed between infants with any IVH (6.2 (5.4-7.5) kPa) or no .3) kPA) (p < 0.001) after adjusting for differences in gestational age. Delta EtCO 2 levels gave an area under the ROC curve of 0.940 for prediction of IVH.Conclusion: The results emphasize the importance of monitoring EtCO 2 levels in the delivery suite.

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Visual attention on a respiratory function monitor during simulated neonatal resuscitation: an eye-tracking study

Cited by 37 publications

References 24 publications

Effect of monitor positioning on visual attention and situation awareness during neonatal resuscitation: a randomised simulation study

Effect of monitor positioning on visual attention and situation awareness during neonatal resuscitation: a randomised simulation study

Simulation in Neonatal Resuscitation

End-tidal carbon dioxide levels during resuscitation and carbon dioxide levels in the immediate neonatal period and intraventricular haemorrhage

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