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Anesth Analg 2008; 106:1787-1797
© 2008 International Anesthesia Research Society
doi: 10.1213/ane.0b013e31817325cb
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TECHNOLOGY, COMPUTING AND SIMULATION

Advanced Auditory Displays and Head-Mounted Displays: Advantages and Disadvantages for Monitoring by the Distracted Anesthesiologist

Penelope M. Sanderson, PhD, FASSA*, Marcus O. Watson, PhD{dagger}, Walter John Russell, MBBS, DIC, FANZCA, FRCA{ddagger}, Simon Jenkins, MBBS, FANZCA§, David Liu, BEng(Hons)||, Norris Green, MBBS, FANZCA, Kristen Llewelyn, MBBS#, Phil Cole, BEng, BSc**, Vivian Shek, BIT(Hons), BPsy||, and Stas S. Krupenia, PhD{dagger}{dagger}

From the *ARC Key Centre for Human Factors and School of Medicine, The University of Queensland, St. Lucia, Queensland; {dagger}School of Medicine, The University of Queensland, St Lucia, Queensland, Australia; {ddagger}Department of Anaesthesia, Pain Medicine and Hyperbaric Medicine, Royal Adelaide Hospital, South Australia, and University of Adelaide; §Royal Adelaide Hospital and University of Adelaide, Adelaide, Australia; ||School of Information Technology and Electrical Engineering, The University of Queensland, St Lucia, Queensland, Australia; ¶Department of Anaesthesia, Princess Alexandra Hospital, Brisbane, Australia and The University of Queensland; #Royal Adelaide Hospital, Adelaide, Australia; **Cognitive Engineering Research Group, The University of Queensland, St Lucia, Australia; and {dagger}{dagger}School of Psychology, The University of Queensland, St Lucia, Australia.

Address correspondence to Penelope Sanderson, ARC Key Centre for Human Factors The University of Queensland, St Lucia, QLD 4072, Australia. Address e-mail to psanderson{at}itee.uq.edu.au.

Abstract

BACKGROUND: In a full-scale anesthesia simulator study we examined the relative effectiveness of advanced auditory displays for respiratory and blood pressure monitoring and of head-mounted displays (HMDs) as supplements to standard intraoperative monitoring.

METHODS: Participants were 16 residents and attendings. While performing a reading-based distractor task, participants supervised the activities of a resident (an actor) who they were told was junior to them. If participants detected an event that could eventually harm the simulated patient, they told the resident, pressed a button on the computer screen, and/or informed a nearby experimenter. Participants completed four 22-min anesthesia scenarios. Displays were presented in a counterbalanced order that varied across participants and included: (1) Visual (visual monitor with variable-tone pulse oximetry), (2) HMD (Visual plus HMD), (3) Audio (Visual plus auditory displays for respiratory rate, tidal volume, end-tidal CO2, and noninvasive arterial blood pressure), and (4) Both (Visual plus HMD plus Audio).

RESULTS: Participants detected significantly more events with Audio (mean = 90%, median = 100%, P < 0.02) and Both (mean = 92%, median = 100%, P < 0.05) but not with HMD (mean = 75%, median = 67%, ns) compared with the Visual condition (mean = 52%, median = 50%). For events detected, there was no difference in detection times across display conditions. Participants self-rated monitoring as easier in the HMD, Audio and Both conditions and their responding as faster in the HMD and Both conditions than in the Visual condition.

CONCLUSIONS: Advanced auditory displays help the distracted anesthesiologist maintain peripheral awareness of a simulated patient's status, whereas a HMD does not significantly improve performance. Further studies should test these findings in other intraoperative contexts.






Lippincott, Williams & Wilkins Anesthesia & Analgesia® is published for the International Anesthesia Research Society® by Lippincott Williams & Wilkins with the assistance of Stanford University Libraries' HighWire Press®. Copyright 2006 by the International Anesthesia Research Society. Online ISSN: 1526-7598   Print ISSN: 0003-2999 HighWire Press
Copyright © 2008 by the International Anesthesia Research Society.