Simulation-Based Mock-Up Evaluation of a Universal Operating Room.

Designing or renovating a physical environment for healthcare is a complex process and is critical for both the staff and the patients who rely on the environment to support and facilitate patient care. Conducting a simulation-based mock-up evaluation as part of the design process can enhance patient safety, staff efficiency, as well as user experience, and can yield financial returns. A large urban tertiary care center located in Vancouver, Canada followed a framework to evaluate the proposed design template for 28 universal operating rooms (ORs) included within the OR Renewal Project scope. Simulation scenarios were enacted by nursing staff, surgeons, anesthesiologists, residents, radiology techs, and anesthesia assistants. Video and debriefing data were used to conduct link analyses, as well as analyses of observed behaviors including congestions and bumps to generate recommendations for evidence-based design changes that were presented to the project team. Recommendations incorporated into the design included relocating doors, booms, equipment, and supplies, as well as reconfigurations to workstations. These recommendations were also incorporated into the mock-up and retested to iteratively develop and evaluate the design. Findings suggest that incorporating the recommended design changes resulted in better room utilization, decreased congestion, and enhanced access to equipment.

Analysis of eye-tracking behaviours in a pediatric trauma simulation.

ABSTRACTEye-tracking devices are able to capture eye movements, which are further characterized by fixations. The application of eye tracking in a trauma setting has not been explored. Visual fixation can be utilized as a surrogate measure of attention during the management of a trauma patient. We aimed to determine the feasibility of using eye tracking and to characterize eye tracking behaviours of pediatric emergency medicine physicians during management of a simulated pediatric trauma patient. Each participant was equipped with a head-mounted eye-tracking device during a standardized simulated pediatric trauma scenario. Each session was video recorded, with visual fixations defined as >0.2 seconds, and characterized by start time, duration, and the area of interest. Data from seven videos were analysed; 35% of eye fixations were directed towards the mannequin, 16% towards the monitor, and 13% towards the bedside doctor. Visual eye tracking in a trauma simulation is feasible. Frequency of fixations tends to be highest towards the patient. Eye tracking within trauma simulation may provide new insights into quality improvement and inform advancements in pediatric trauma.

Driving Skills Training for Older Adults: An Assessment of DriveSharp.

RÉSUMÉ Les procédures de formation cognitive informatique visent à augmenter la sécurité en améliorant les compétences relatives à la conduite, comme la vitesse-de-traitement et le Useful Field of View. L'étude actuelle a évalué l'efficacité du DriveSharp dans la formation des conducteurs âgés dans un cadre de classe réaliste. Les participants (n = 24) ont assisté à 10 heures de cours de DriveSharp pendant 5 semaines. Les séances pré- et post-test ont evalués améliorations sur un essai dynamique de la perception du risque, Trails A et Trails B. Un groupe de contrôle (n = 18) a terminé seulement les séances pré- et post-test. En classe, les temps de formation étaient plus bas que prévus. L'amélioration des participants aux jeux ont stabilisée après la première évaluation, et le groupe de DriveSharp n'a pas démontré une amélioration significative des performances sur les tests, par rapport au groupe de contrôle. Parmi plusieurs questions relatives à la facilité d'utilisation, les plus problématiques étaient le malentendudes objectifs de la tâche et la différence entre la formation et l'évaluation. Il y a plusieurs implications pour ceux qui utilisent DriveSharp pour améliorer la sécurité des conducteurs âgés.

Short-term reliability of a brief hazard perception test.

Hazard perception tests (HPTs) have been successfully implemented in some countries as a part of the driver licensing process and, while their validity has been evaluated, their short-term stability is unknown. This study examined the short-term reliability of a brief, dynamic version of the HPT. Fifty-five young adults (Mage=21 yrs) with at least two years of post-licensing driving experience completed parallel, 21-scene HPTs with a one-month interval separating each test. Minimal practice effects (∼0.1s) were manifested. Internal consistency (Cronbach's alpha) averaged 0.73 for the two forms. The correlation between the two tests was 0.55 (p<0.001) and correcting for lack of reliability increased the correlation to 0.72. Thus, a brief form of the HPT demonstrates acceptable short-term reliability in drivers whose hazard perception should be stable, an important feature for implementation and consumer acceptance. One implication of these results is that valid HPT scores should predict future crash risk, a desirable property for user acceptance of such tests. However, short-term stability should be assessed over longer periods and in other driver groups, particularly novices and older adults, in whom inter-individual differences in the development of hazard perception skill may render HPT tests unstable, even over short intervals.

A comparison of static and dynamic hazard perception tests.

Hazard perception is a vital component to safe driving and hazard perception tests (HPTs) are being used with greater frequency for driver training, assessment and licensure. In this study, we compared a dynamic HPT (Scialfa et al., 2011), which presents short video scenes to observers and a static HPT (Scialfa et al., 2012), which uses still images. Both tests require the observer to indicate the presence of a traffic conflict that would lead to a collision between the "camera" vehicle and another road user or fixed object. Young adult drivers (n=56) completed both forms of the HPT, along with a modified version of the Driver Behavior Questionnaire (Reason et al., 1990) and a measure of simple reaction time. Self-reported collision and moving violation data were also collected. As in previous work, both static and dynamic HPTs had good reliability. The correlation between composite static and dynamic scores was approximately .40, but was reduced to approximately .25 when simple reaction time was controlled. Both HPTs predicted lapses and errors on the Driver Behavior Questionnaire, but neither predicted self-reported collisions or moving violations. Discussion focuses on the differences in visual cues available in dynamic and static scenes and how these differences could influence decisions about potential hazards.

The effects of driving experience on responses to a static hazard perception test.

Novice drivers exhibit deficits in hazard perception that are likely to increase their risk of collisions. We developed a static hazard perception test that presents still images to observers and requires them to indicate the presence of a traffic conflict that would lead to a collision. Responses to these scenes were obtained for young adult novice (N=29) and experienced drivers (N=27). Additionally, participants rated the hazard risk and clutter of each scene. Novice drivers rated traffic conflicts as less hazardous and responded more slowly to them. Using a subset of 21 scenes, we were able to discriminate novice and experienced young adult drivers with a classification accuracy of 78% and a scale reliability (Cronbach's alpha) of .91. The potential applications of this research include the development of standardized hazard perception tests that can be used for driver evaluation, training and licensure.