Gaze Performance Adjustment During Needlestick Application: Can We Reduce Harm?

BACKGROUND: Novice health care students suffer more needlestick injuries (NSIs) than experts. NSIs may be prevented by learning experts' behavior during this procedure. Eye tracking offers the possibility to study both experts' and novices' eye behavior during this task. PURPOSE: The aim of this study was to offer novel information about the understanding of eye behavior in human errors during handling needles. METHODS: A group of third-year nursing students performed 3 subcutaneous injections in a simulated abdominal pad while their eye behavior was recorded. Similarly, the gaze patterns of experts were recorded and then compared with the novices. RESULTS: Total task time for experts was faster than that for novices (P < .001), but both groups showed similar accuracy (P = .959). However, novices demonstrated gazing longer at the syringe rather than the abdominal pad compared with experts (P = .009). Finally, experts demonstrated fewer attention switches than novices (P = .002). CONCLUSION: Novices demonstrated more tool-tracking eye behaviors with longer dwelling time and attentional switches than did experts, which may translate into errors in clinical performance with needles.

Skill learning from kinesthetic feedback.

BACKGROUND: It is important for a surgeon to perform surgical tasks under appropriate guidance from visual and kinesthetic feedback. However, our knowledge on kinesthetic (muscle) memory and its role in learning motor skills remains elementary. OBJECTIVES: To discover the effect of exclusive kinesthetic training on kinesthetic memory in both performance and learning. METHODS: In Phase 1, a total of twenty participants duplicated five 2 dimensional movements of increasing complexity via passive kinesthetic guidance, without visual or auditory stimuli. Five participants were asked to repeat the task in the Phase 2 over a period of three weeks, for a total of nine sessions. RESULTS: Subjects accurately recalled movement direction using kinesthetic memory, but recalling movement length was less precise. Over the nine training sessions, error occurrence dropped after the sixth session. CONCLUSIONS: Muscle memory constructs the foundation for kinesthetic training. Knowledge gained helps surgeons learn skills from kinesthetic information in the condition where visual feedback is limited.