Visual processing patterns of adults with traumatic brain injury when viewing image-based grids and visual scenes.

Many individuals with traumatic brain injury (TBI) rely on augmentative and alternative communication (AAC) supports to meet functional communication needs. The use of images to display message content may be advantageous for this population, given deficits in literacy, visual processing, and cognition. Grid and visual scene displays are two options for presenting images within AAC systems. Eye-tracking technology was utilized to evaluate the visual processing patterns of 13 adults with a history of TBI and 13 adults without TBI when interpreting themes depicted in grid and visual scene displays. Results indicated that differential processing and effort was required when interpreting the two display types. Both groups of participants required significantly more visual fixation time and exhibited patterns consistent with greater cognitive effort when identifying themes depicted in grids compared to visual scenes (i.e., greater numbers of short fixations). The participants with TBI were overall less efficient than those without TBI when identifying themes presented in both AAC display types. These results add to the growing body of evidence indicating that visual scenes may more effectively represent complex concepts than decontextualized, grid-based images for individuals with TBI. Additional clinical implications are discussed.

Identification and Expression of Themes Depicted in Visual Scene and Grid Displays by Adults With Traumatic Brain Injury.

Purpose The study purpose was to compare the speed and accuracy with which people with traumatic brain injury (TBI) identified themes depicted in visual scene and grid displays. Additionally, we compared the verbal responses associated with the 2 display types to determine whether adults with TBI tended to produce more action or naming messages. Method Thirteen adults with and 13 without TBI viewed grid and visual scene displays matched for content and theme. They then provided verbal responses stating the theme or central idea of each image. Results Although no significant differences were noted between groups for theme identification accuracy, adults with TBI required significantly more time than adults without TBI to process both display types. Both participant groups more rapidly and accurately identified visual scenes than grid displays. Additionally, participants with and without TBI produced more action messages in response to visual scenes and naming messages in response to grid displays. Conclusions This investigation provides preliminary evidence that themes that depicted visual scenes maybe more rapidly and accurately identified than those depicted in grid displays. Additionally, visual scenes may more effectively represent action messages, and grids may more effectively represent naming messages for people with TBI.

Using Medical Mannequins to Train Nurses in Stroke Swallowing Screening.

Screening patients admitted with stroke symptoms for risk of aspiration is often the responsibility of registered nurses (RNs). Simulation technology has become a widely used evidence-based form of training for healthcare professionals. The purpose of this study was to determine if the use of medical simulation mannequins as a training component is feasible when training and evaluating nurses administering swallowing screenings to stroke patients. A total of 32 RNs were divided into one of two training groups: didactic training only or didactic training plus simulation. Acquisition of skills was assessed immediately post-training and compared between the groups revealing significant differences between simulation group and didactic-only group for interpretation (p = 0.01) and administration (p = 0.05) accuracies. Following training to 100 % accuracy for post-training baseline competency, maintenance of skills across participants was assessed three more times over 6 weeks with the third follow-up screening completed with a standardized patient (live patient actor). While interpretation performance at each subsequent trial never equaled the baseline 100 % post-training accuracy (p = 0.001), steady improvement in performance was observed with each follow-up assessment. For screening administration, no significant differences in skills were evident between post-training baseline competency and the 6-week follow-up (p = 0.269) further confirming improvement in skills over time. Extension of screening administration and interpretation skills to the standardized patient was evident. Findings indicate that simulation training using medical mannequins can be used to train and evaluate nurses for obtainment and maintenance of swallowing screening competency.