Audio, Visual, and Electrodermal Arousal Signals as Predictors of Mental Fatigue Following Sustained Cognitive Work.

Lapses in vigilance and slowed reactions due to mental fatigue can increase risk of accidents and injuries and degrade performance. This paper describes a method for rapid, unobtrusive detection of mental fatigue based on changes in electrodermal arousal (EDA), and changes in neuromotor coordination derived from speaking. Twenty-nine Soldiers completed a 2-hour battery of cognitive tasks intended to induce fatigue. Behavioral markers derived from audio and video during speech were acquired before and after the 2hour cognitive load tasks, as was EDA. Exposure to cognitive load produced detectable increases in neuromotor variability in speech and facial measures after load and even after a recovery period. A Gaussian mixture model classifier with crossvalidation and fusion across speech, video, and EDA produced an accuracy of AUC=0.99 in detecting a change in cognitive fatigue relative to a personalized baseline.

Predicting changes in performance due to cognitive fatigue: A multimodal approach based on speech motor coordination and electrodermal activity.

OBJECTIVE: Military job and training activities place significant demands on service members' (SMs') cognitive resources, increasing risk of injury and degrading performance. Early detection of cognitive fatigue is essential to reduce risk and support optimal function. This paper describes a multimodal approach, based on changes in measures of speech motor coordination and electrodermal activity (EDA), for predicting changes in performance following sustained cognitive effort. METHODS: Twenty-nine active duty SMs completed computer-based cognitive tasks for 2 h (load period). Measures of speech derived from audio were acquired, along with concurrent measures of EDA, before and after the load period. Cognitive performance was assessed before and during the load period using the Automated Neuropsychological Assessment Metrics Military Battery (ANAM MIL). Subjective assessments of cognitive effort and alertness were obtained intermittently. RESULTS: Across the load period, participants' ratings of cognitive workload increased, while alertness ratings declined. Cognitive performance declined significantly during the first half of the load period. Three speech and arousal features predicted cognitive performance changes during this period with statistically significant accuracy: EDA (r = 0.43, p = 0.01), articulator velocity coordination (r = 0.50, p = 0.00), and vocal creak (r = 0.35, p = 0.03). Fusing predictions from these features predicted performance changes with r = 0.68 (p = 0.00). CONCLUSIONS: Results suggest that speech and arousal measures may be used to predict changes in performance associated with cognitive fatigue. This work supports ongoing efforts to develop reliable, unobtrusive measures for cognitive state assessment aimed at reducing injury risk, informing return to work decisions, and supporting diverse mobile healthcare applications in civilian and military settings.

On-the-Go Training: Downloadable Modules to Train Medical Students to Care for Adult Female Sexual Assault Survivors.

Introduction: Every medical provider encounters patients who have experienced sexual assault, and a patient's interaction with the medical system can impact long-term outcomes. Training to provide appropriate, compassionate care for this population is lacking in most medical school curricula. This educational resource contains three downloadable modules to train medical students in providing improved care for adult female survivors of sexual assault so students can feel more confident and empowered in caring for this population. Methods: The modules are composed of an informational video on initial medical management, a patient interview simulation video, and a set of audio interviews on suggestions for practice. Interdisciplinary experts assisted in the modules' development. Associated materials include a 10 question pre- and posttest of medical knowledge, with additional survey questions to assess student attitudes and satisfaction outcomes. Results: A cohort of 32 medical student volunteers from all class years tested the modules. Overall, student scores improved 20% (95% confidence interval, 16%-23%) from pre- to posttest. Students reported that their comfort in caring for an adult female sexual assault survivor increased after completion of the modules (p = .025). On the whole, students reported on the postsurvey that the modules enhanced their education, improved their comfort, and were appropriate for their level of education. Discussion: These modules can enrich an undergraduate medical curriculum in a currently underaddressed topic, the care of female survivors of sexual assault. Empowering and educating students to care for this patient population can result in improved health outcomes.