Development of a customizable interactions questionnaire (CIQ) for evaluating interactions with objects in augmented/virtual reality.

As new methods for interacting with systems are being developed for use within augmented or virtual reality, their impact on the quality of the user's experience needs to be assessed. Although many instruments exist for evaluating the overall user experience or the computer interface used to complete tasks, few provide measures that can be used to evaluate the specific forms of interaction typically used in these environments. This paper describes the development of a customizable questionnaire for measuring the subjective user experience that focuses on the quality of the interactions with objects in augmented reality/virtual reality (AR/VR) worlds, which we are calling the Customizable Interactions Questionnaire, or (CIQ). The final questionnaire measures five factors that are related to user satisfaction while using the system: quality of interactions, assessment of task performance, comfort, quality of sensory enhancements, and consistency with expectations.

Improving ATLS performance in simulated pediatric trauma resuscitation using a checklist.

OBJECTIVE: To develop a checklist for use during pediatric trauma resuscitation and test its effectiveness during simulated resuscitations. BACKGROUND: Checklists have been used to support a wide range of complex medical activities and have effectively reduced errors and improved outcomes in different medical settings. Checklists have not been evaluated in the domain of trauma resuscitation. METHODS: A focus group of trauma specialists was organized to develop a checklist for pediatric trauma resuscitation. This checklist was then tested in simulated trauma resuscitations to evaluate its impact on team performance. Resuscitations conducted with and without the checklist were compared using the Advanced Trauma Life Support (ATLS) performance score, designed to measure adherence to ATLS protocol, and surveys of team members' subjective workload. RESULTS: The focus group generated a checklist with 56 items divided into 5 sections corresponding to different phases of trauma resuscitation. In simulation testing, the total ATLS performance score was 4.9 points higher with a checklist than without (P < 0.001), with most of this difference related to improvement in performance of the secondary survey (+3.3 points, P < 0.001). Overall, workload scores were not affected by the addition of the checklist. CONCLUSIONS: Implementing a checklist during simulated pediatric trauma resuscitation improves adherence to the ATLS protocol without increasing the workload of trauma team members.

Tailored strategy to match anatomy and physiology with intervention can improve outcomes of symptomatic neonates with Ebstein anomaly.

Objective: Neonatal presentation of Ebstein anomaly (EA) represents the most severe form of this condition. Despite significant advances, operative mortality remains high and management decisions represent a formidable challenge. We used a strategy aimed to match anatomy and physiology with type and time of intervention to increase survival. Methods: We performed a review of all patients with fetal or neonatal diagnosis of EA managed at a single center between 2007 and 2020. Results: Among 18 patients with EA, 8 underwent neonatal intervention. The most common indication included cyanosis and heart failure (8/8), end organ dysfunction (6/8), and maldistribution of cardiac output (6/8). Only 2/8 had antegrade pulmonary blood flow. Associated conditions included pulmonary regurgitation in 4/8, atrial tachyarrhythmia in 4, and a ventricular septal defect in 3. Three patients underwent initial stabilization with main pulmonary artery occlusion including bilateral pulmonary artery banding in 2. Five patients underwent biventricular repair with conversion to right ventricle exclusion in 2 cases. Three others underwent the Starnes procedure as initially planned. The median age at surgery was 10 days (range, 1-30) and median weight 2.6 kg (range, 1.9-4.0). The median duration of mechanical ventilation and intensive care unit stay were 9 days (range, 5-34) and 30 days (range, 15-100), respectively. Operative mortality was 1/8. At a median follow-up of 130 months (range, 5-146), there were no late deaths, and all survivors remain in functional class I and free of valvular reintervention. Conclusions: Symptomatic neonates with EA can be effectively managed with good outcomes. Preoperative stabilization and choice of management pathway on the basis of anatomy and physiology can help reduce morbidity and mortality.

Thinking graphically: Connecting vision and cognition during graph comprehension.

Task analytic theories of graph comprehension account for the perceptual and conceptual processes required to extract specific information from graphs. Comparatively, the processes underlying information integration have received less attention. We propose a new framework for information integration that highlights visual integration and cognitive integration. During visual integration, pattern recognition processes are used to form visual clusters of information; these visual clusters are then used to reason about the graph during cognitive integration. In 3 experiments, the processes required to extract specific information and to integrate information were examined by collecting verbal protocol and eye movement data. Results supported the task analytic theories for specific information extraction and the processes of visual and cognitive integration for integrative questions. Further, the integrative processes scaled up as graph complexity increased, highlighting the importance of these processes for integration in more complex graphs. Finally, based on this framework, design principles to improve both visual and cognitive integration are described.

The effect of interruption duration and demand on resuming suspended goals.

The time to resume task goals after an interruption varied depending on the duration and cognitive demand of interruptions, as predicted by the memory for goals model (Altmann & Trafton, 2002). Three experiments using an interleaved tasks interruption paradigm showed that longer and more demanding interruptions led to longer resumption times in a hierarchical, interactive task. The resumption time profile for durations up to 1 min supported the role of decay in defining resumption costs, and the interaction between duration and demand supported the importance of goal rehearsal in mitigating decay. These findings supported the memory for goals model, and had practical implications for context where tasks are frequently interleaved such as office settings, driving, emergency rooms, and aircraft cockpits.

Multiple interpretations of long-term working memory theory: Reply to Delaney and Ericsson (2016).

This reply is in response to Delaney and Ericsson (2016), who argue that the results of our recent research (Foroughi, Werner, Barragán, & Boehm-Davis, 2015) can be explained by Ericsson and Kintsch's (1995) long-term working memory (LTWM) theory. Our original work was designed to test the prediction made by LTWM theory that interruptions of up to 30 s in duration would not disrupt reading performance. We conducted the work following the method and outcome measures recommended by Ericsson and Kintsch (1995). Our data were clear: interruptions disrupted reading comprehension. We believe that these data do not support predictions made by LTWM theory. Although we appreciate Delaney and Ericsson's (2016) comments, we are unsure how best to move forward because it appears that some of their comments are not consistent with the published work on LTWM theory. Because of the inconsistent and contradictory claims surrounding LTWM theory, the theory does not appear to be falsifiable, or is in danger of becoming unfalsifiable. Creating and testing theory is vital for the advancement of psychological science, but it appears that testing predictions made by LTWM would be very difficult, if not impossible, given the fluid state of the theory. (PsycINFO Database Record

Individual differences in working-memory capacity and task resumption following interruptions.

Previous research has shown that there is a time cost (i.e., a resumption lag) associated with resuming a task following an interruption and that the longer the duration of the interruption, the greater the time cost (i.e., resumption lag increases as interruption duration increases). The memory-for-goals model (Altmann & Trafton, 2002) suggests that this greater time cost is a result of increased interference caused by longer duration interruptions. Therefore, the goal for this research was to determine whether individuals who can better manage interference, i.e., individuals with higher working-memory capacity (WMC), can resume tasks more quickly following interruptions than those who cannot manage interference as well (i.e., individuals with lower WMC). A procedural interruption task with 3 different interruption durations and a measure of WMC were completed by 229 students. In line with previous research, we found a strong positive relationship between interruption duration and resumption lag. We found a strong negative effect of WMC on resumption lag (i.e., increases in WMC reduced resumption lags). Notably, WMC moderated the effect of interruption duration on resumption lag (i.e., increases in WMC attenuated the positive relationship between interruption duration and resumption lag). Specifically, individuals with high WMC experienced small increases in resumption lag as interruption duration increased, whereas individuals with low WMC experienced substantial increases in resumption lag as interruption duration increased. Our data suggest that individuals with higher WMC are less susceptible to interference caused by interruptions. (PsycINFO Database Record

Interruptions disrupt reading comprehension.

Previous research suggests that being interrupted while reading a text does not disrupt the later recognition or recall of information from that text. This research is used as support for Ericsson and Kintsch's (1995) long-term working memory (LT-WM) theory, which posits that disruptions while reading (e.g., interruptions) do not impair subsequent text comprehension. However, to fully comprehend a text, individuals may need to do more than recognize or recall information that has been presented in the text at a later time. Reading comprehension often requires individuals to connect and synthesize information across a text (e.g., successfully identifying complex topics such as themes and tones) and not just make a familiarity-based decision (i.e., recognition). The goal for this study was to determine whether interruptions while reading disrupt reading comprehension when the questions assessing comprehension require participants to connect and synthesize information across the passage. In Experiment 1, interruptions disrupted reading comprehension. In Experiment 2, interruptions disrupted reading comprehension but not recognition of information from the text. In Experiment 3, the addition of a 15-s time-out prior to the interruption successfully removed these negative effects. These data suggest that the time it takes to process the information needed to successfully comprehend text when reading is greater than that required for recognition. Any interference (e.g., an interruption) that occurs during the comprehension process may disrupt reading comprehension. This evidence supports the need for transient activation of information in working memory for successful text comprehension and does not support LT-WM theory.

Stage I palliation for hypoplastic left heart syndrome in low birth weight neonates: can we justify it?

OBJECTIVE: Although the outcome of cardiac surgery in neonates with low birth weight (LBW) has improved, LBW remains a risk factor for surgical palliation. Few surgical series of LBW patients include those with hypoplastic left heart syndrome (HLHS). To identify variables associated with poor outcome in this group, we reviewed our experience with patients with HLHS and LBW who underwent Stage I Norwood palliation. METHODS: Between January 1998 and December 2000, 20 consecutive LBW (<2500 g) neonates with HLHS (n=13) or HLHS variant (n=7) underwent surgical palliation. Retrospective review of all patient data and analysis to identify risk factors was performed. RESULTS: Mean age at surgery was 5.1+/-4.6 days (range 1-17), mean weight was 1.98+/-0.44 kg (range 1.1-2.5), including nine patients under 2 kg. Ten patients were born at <35 weeks gestation. Anatomic diagnosis included HLHS in 13 patients (10 with aortic atresia), unbalanced atrioventricular canal defect in two, double outlet right ventricle in two and other variants in three. Mean ascending aortic size was 4.0+/-1.8 mm (range 1.5-8). Associated cardiac defects were present in three patients, and a genetic syndrome and/or congenital anomaly was present in four of them. Mean circulatory arrest time was 60+/-10 min. Extracorporeal support was used perioperatively in 10 patients. Early mortality was 9/20 (45%). At a mean follow up at 22+/-10 months (range 8-38), six patients underwent stage II, and are awaiting stage III; four patients have completed their Fontan. Anatomic variant, ascending aortic size, prematurity, age at surgery, weight, duration of circulatory arrest, cardiopulmonary bypass time and associated non-cardiac anomalies were not risk factors for poor outcome whereas restrictive pulmonary venous drainage and coronary artery anomalies were associated with decreased survival. CONCLUSION: LBW newborns with HLHS and physiologic variants have an increased early surgical risk but have acceptable intermediate survival rates for subsequent palliation including Fontan. LBW and prematurity should not be contraindications to early surgical palliation.

Do interruptions affect quality of work?

OBJECTIVE: The aim of this study was to determine if interruptions affect the quality of work. BACKGROUND: Interruptions are commonplace at home and in the office. Previous research in this area has traditionally involved time and errors as the primary measures of disruption. Little is known about the effect interruptions have on quality of work. METHOD: Fifty-four students outlined and wrote three essays using a within-subjects design. During Condition 1, interruptions occurred while participants were outlining. During Condition 2, interruptions occurred while they were writing. No interruptions occurred in Condition 3. RESULTS: Quality of work was significantly reduced in both interruption conditions when compared to the non-interruption condition. The number of words produced was significantly reduced when participants were interrupted while writing the essay but not when outlining the essay. CONCLUSION: This research represents a crucial first step in understanding the effect interruptions have on quality of work. Our research suggests that interruptions negatively impact quality of work during a complex, creative writing task. Since interruptions are such a prevalent part of daily life, more research needs to be conducted to determine what other tasks are negatively impacted. Moreover, the underlying mechanism(s) causing these decrements needs to be identified. Finally, strategies and systems need to be designed and put in place to help counteract the decline in quality of work caused by interruptions.

Human factors methods to reduce medication error: using task analysis in a pediatric and adult pharmacy.

Medication error is an issue that no hospital is immune from, leading to 7,000 deaths and 1.3 million patient injuries each year. The purpose of this study was to decrease the risk and occurrence of medication errors by analyzing the hospital pharmacy. Task analyses were performed and it was found that communication, expectation, and procedural issues were leading to the occurrence of the most common type of medication error in the pharmacy. Recommendations were made to improve the process and reduce the occurrence of this type of error.

Mitigating disruptive effects of interruptions through training: what needs to be practiced?

It is generally accepted that, with practice, people improve on most tasks. However, when tasks have multiple parts, it is not always clear what aspects of the tasks practice or training should focus on. This research explores the features that allow training to improve the ability to resume a task after an interruption, specifically focusing on task-specific versus general interruption/resumption-process mechanisms that could account for improved performance. Three experiments using multiple combinations of primary tasks and interruptions were conducted with undergraduate psychology students. The first experiment showed that for one primary and interruption task-pair, people were able to resume the primary task faster when they had previous practice with the interruption. The second experiment replicated this finding for two other sets of primary and interruption task-pairs. Finally, the third experiment showed that people were able to resume a primary task faster only when they had previous practice with that specific primary and interruption task-pair. Experience with other primary and interruption task-pairs, or practice on the primary task alone, did not facilitate resumption. This suggests that a critical component in resuming after an interruption is the relationship between two tasks. These findings are in line with a task-specific mechanism of resumption and incompatible with a general-process mechanism. These findings have practical implications for developing training programs and mitigation strategies to lessen the disruptive effects of interruptions which plague both our personal and professional environments.

Reducing the disruptive effects of interruption: a cognitive framework for analysing the costs and benefits of intervention strategies.

Interruptions are ubiquitous, and they can lead to disastrous consequences. The goal of this paper is to describe remedies that have been proposed to reduce the disruption caused by interruptions based on an understanding of how principles of human cognitive processing bear on the sequence of events that take place during an interruption. We show that interruptions tap disparate cognitive operations, from attention to decision making to memory. We illustrate how these cognitive processes can lead to interruption-induced errors, and how they can help in understanding potential problems with remedies that have been proposed to ameliorate those effects. We present a framework in which the load imposed by the task and the cost of an error suggests the types of solutions that should be considered for a given domain. We then discuss the implications of this approach for understanding and reducing the negative effect of interruptions in transportation domains.

Discoveries and developments in human-computer interaction.

OBJECTIVE: This paper describes contributions made to the science and practice of human-computer interaction (HCI), primarily through Human Factors and the society's annual proceedings. BACKGROUND: Research in HCI began to appear in publications associated with the Society around 1980 and has continued through the present. METHOD: A search of the literature appearing in either the journal or the proceedings was done to identify the specific contributions made by researchers in this area. RESULTS: More than 2,300 papers were identified, some comparing the actual or predicted performance of a new device, display format, or computer-based system with an existing or alternative system. Other work describes methods for evaluating systems performance. CONCLUSION: This work has had a tremendous impact, particularly the work of Fitts, Smith and Mosier, and Virzi. APPLICATION: Work on HCI has contributed to (a) current national and international guidelines, (b) the development of user interface management systems, (c) the provision of guidance as to where best to invest resources when evaluating computing systems, and (d) the prediction of human performance using those systems.

Anesthesia management of a patient with a laryngotracheo-esophageal cleft.

Laryngotracheo-esophageal cleft is a rare congenital anomaly that results from complete or partial failure of the development of the tracheoesophageal septum. The presenting symptoms include stridor, respiratory distress, and coughing or cyanotic episodes with feeding. There are four classifications for laryngeal clefts; the severity depends on the type present. We discuss the anesthesia management of a neonate with a Type IV cleft who presented for an emergency gastric division to prevent pulmonary aspiration and later returned for final repair of the defect.

Pilot performance, strategy, and workload while executing approaches at steep angles and with lower landing minima.

OBJECTIVE: We examined the willingness and ability of general aviation pilots to execute steep approaches in low-visibility conditions into nontowered airports. BACKGROUND: Executing steep approaches in poor weather is required for a proposed Small Aircraft Transportation System (SATS) that consists of small aircraft flying direct routes to a network of regional airports. METHOD: Across two experiments, 17 pilots rated for Instrument Flight Rules at George Mason University or Virginia Tech flew a Cessna 172R simulator into Blacksburg, Virginia. Pilots were familiarized with the simulator and asked to fly approaches with either a 200- or 400-foot ceiling (at approach angles of 3 degrees, 5 degrees, and 7 degrees in the first experiment, 3 degrees and 6 degrees in the second). Pilots rated subjective workload and the simulator recorded flight parameters for each set of approaches. RESULTS: Approaches with a 5 degree approach angle produced safe landings with minimal deviations from normal descent control configurations and were rated as having a moderate level of workload. Approaches with 6 degree and 7 degree approach angles produced safe landings but high workload ratings. Pilots reduced power to control the speed of descent and flew the aircraft slightly above the glide path to gain time to control the landing. CONCLUSION: Although the 6 degree and 7 degree approaches may not be practical for routine approaches, they may be achievable in the event of an emergency. APPLICATION: Further work using other aircraft flying under a wider variety of conditions is needed before implementing SATS-type flights into airports intended to supplant or complement commercial operations in larger airports.

Recovering from interruptions: implications for driver distraction research.

This research adopted a model of goal activation to study the mechanisms underlying interrupted task performance. The effects of interruption timing, type of interruption, and age on task time and primary task resumption time were explored under conditions in which attention was switched back and forth between two tasks, much as when drivers shift attention between attending to the road and to an in-vehicle task. The timing of interruptions had a significant impact on task resumption times, indicating that the most costly time to interrupt task performance is during the middle of a task. However, this effect was overshadowed by age-related performance decrements for older participants. Interruptions that prevented strategic rehearsal of goals resulted in longer resumption times as compared with interruptions that allowed rehearsal. Actual or potential applications of this research include the design of in-vehicle device user interfaces, the timing of in-vehicle messages, and current metrics for assessing driver distraction.