bluuebunny/crossref_metadata_2025 huggingface dataset:
Assessment of Alternative Interfaces for Manual Commanding of Spacecraft Systems
Authors: Billman Dorrit , Schreckenghost Debra , Miri Pardis
Published: October 2014

Astronauts will be responsible for executing a much larger body of procedures as human exploration moves further from Earth and Mission Control. Efficient, reliable methods for executing these procedures, including manual, automated, and mixed execution will be important. We evaluated a new procedure system that integrates step-by-step instruction with the means for execution. While the system allows automation, the critical first step, investigated here, is effectiveness supporting manual execution. We compared manual execution using the new system to a system analogous to the manual-only system currently in use on the International Space Station; we assessed whether manual performance with the new system would be as good or better than with the legacy system. This lays the foundation for integrating automated execution into the flow of procedures designed for humans. In our formative study, we found speed and accuracy of procedure execution was better using the new, integrated interface over the legacy design.
Maps, Space-time Cubes, and Meta-Information for Understanding Path Information
Authors: Bisantz Ann , D’Arcy Jean-Francois , Kerker Dana , Hegde Sudeep , Guan Peiqu , Voshell Martin , Kilgore Ryan
Published: October 2014

Two experiments were conducted to investigate the usefulness of different geospatial representations in interpreting paths and activities of individuals moving through a complex spatial environment. Three-dimensional “space-time cubes” were compared to more traditional two-dimensional map displays both with and without animation/playback of the movements. Additionally, we investigated whether or not providing overlaid meta-information about individuals’ possible locations in between known (“sensed”) locations would improve performance. Results indicated that there were no advantages to, and some indications of increased workload, due to the 3D representation, perhaps because of challenges in interpreting the third (time) dimension. However, providing meta-information about possible locations supported performance when it was necessary for participants to recognize potential meetings or other events that did not occur at sensed locations. Geospatial displays used to support interpretation of movement tracking (e.g., for use in intelligence, surveillance, and reconnaissance applications) should compute and provide meta-information about possible paths between sensed locations. Additionally, if a third (time) dimension is included, additional training and support may be required.
The influence of Chinese-Western Bilingualism on Rationality in Decision Making Behavior
Authors: Chen Na , Rau Patrick Pei-Luen , Yao Nan Thomas
Published: October 2014

This study aimed to investigate the influence of bilingualism on the decision making behavior of Chinese-Western bilinguals. Three tasks, including gain-loss asymmetry, loss aversion and myopic loss aversion, were conducted with 30 Chinese-Western bilingual participants. The results indicated that Chinese-Western bilinguals behaved more rationally in a Chinese language context than in an English language context.
Supporting Representation Management in Intelligence Analysis through Automated Decision Aids
Authors: Voshell Martin , Guarino Sean , Tittle James , Roth Emilie
Published: October 2014

Intelligence analysts—overloaded with complex and disparate data—must incorporate information into cohesive and convincing narratives and explanations. For analysts, data overload can result in developing premature conclusions and limit their ability to effectively conduct comprehensive analyses. Historically, automated decision aids designed to help with these processes have largely failed analysts in managing a fundamental work tradeoff between analytic narrowing and broadening because software tools too often attempt to supplant analyst reasoning, rather than support the iterative process as a whole. Instead of such brittle approaches, previous research suggests analysts would benefit from automation that supports a collaborative partnership throughout the analysis process. The research and development described in this work began with a cognitive analysis of practicing analysts, entailing literature review, interviews, and walkthroughs with a software prototype. Findings from the cognitive analysis were translated into design requirements for decision aids that support representation management across multiple intelligence products. The findings provide insight into under-supported cognitive and collaborative work in modern intelligence analysis with implications for the future design of useful automated decision aids.
Human Factors in Cyber Warfare II
Authors: Mancuso Vincent F. , Christensen James C. , Cowley Jennifer , Finomore Victor , Gonzalez Cleotide , Knott Benjamin
Published: October 2014

Cyber operations offer a unique environment in which the lines between cognition and technology are constantly blurred. Within the greater research community, current work often focuses solely on the technology, often only acknowledging the human in passing, if at all. More recently, the Human Factors community has begun to address human-centered issues in cyber operations, but in comparison to technological communities, we have yet to scratch the surface. Even with publications on Cyber Human Factors gaining momentum, we still lack a complete and holistic understanding of the domain itself, creating a major gap in the field. The purpose of this panel is to continue to expand the role Human Factors in cyber research by introducing the community to current work being done, and to facilitate collaborations to drive future research. We have assembled a panel of scientists across multiple specializations in the Human Factors community to have an open discussion on how we can leverage previous work in human factors and current work in cyber operations to continue to push the bounds of the field.
Human-What Interaction? Understanding User Source Orientation
Authors: Solomon Jacob , Wash Rick
Published: October 2014

Interaction with internet-connected computing devices involves interaction with many distinct agents or sources simultaneously. Hardware, operating systems, web browsers, networking devices, and servers all influence the user experience, as do the engineers and programmers who designed them, the companies or organizations that have developed the systems, other users on the web, and various third-parties such as advertisers. We argue that users cannot be simultaneously engaged towards all of these sources of interaction, and instead must orient themselves to only a subset at any given time. We propose a model of source orientation based on literature from psychology, communications and human-computer interaction. This model describes how users select their source orientation when interacting with computers. We also present examples of how this model can be applied to promote usability in computing systems.
Simulation of Workflow and Threat Characteristics for Cyber Security Incident Response Teams
Authors: Reed Theodore , Abbott Robert G. , Anderson Benjamin , Nauer Kevin , Forsythe Chris
Published: October 2014

Within large organizations, the defense of cyber assets generally involves the use of various mechanisms, such as intrusion detection systems, to alert cyber security personnel to suspicious network activity. Resulting alerts are reviewed by the organization’s cyber security personnel to investigate and assess the threat and initiate appropriate actions to defend the organization’s network assets. While automated software routines are essential to cope with the massive volumes of data transmitted across data networks, the ultimate success of an organization’s efforts to resist adversarial attacks upon their cyber assets relies on the effectiveness of individuals and teams. This paper reports research to understand the factors that impact the effectiveness of Cyber Security Incidence Response Teams (CSIRTs). Specifically, a simulation is described that captures the workflow within a CSIRT. The simulation is then demonstrated in a study comparing the differential response time to threats that vary with respect to key characteristics (attack trajectory, targeted asset and perpetrator). It is shown that the results of the simulation correlate with data from the actual incident response times of a professional CSIRT.
Tablet Interaction Accuracy and Precision
Authors: Hayes Sean T. , Hooten Eli R. , Adams Julie A.
Published: October 2014

Smart phone and tablet mobile devices have changed the way individuals interact with computers. Users can complete tasks efficiently “on the go” using a mobile device’s touch screen; therefore, it is important to investigate touch interaction as it pertains to a mobile (i.e., walking) user. A user evaluation was conducted using a tablet to present a target selection task within a map-based interface. Participants interacted with the mobile device while seated or while walking in an uncontrolled indoor environment. As expected, the mobile target selection error is significantly higher for the mobile users; thus requiring the targets’ effective widths to be significantly larger for mobile users. A primary contribution of this paper is a recommended target width model for mobile users. A further contribution finds that target selection offsets with tablets are consistent with those of mobile phones, in spite of differences in form factor and finger used.
Learning Team Theories and Measurement through the Game Pandemic
Authors: Keebler Joseph R. , DiazGranados Deborah , Smith Dustin C.
Published: October 2014

Teamwork is paramount in many modern day career fields. It is important for HF students and professionals to understand the knowledge, skills, and attitudes requisite for excellent teamwork and to grasp the many hurdles that exist in appropriately measuring its major constructs. Although theories can be imparted didactically, and ideas for measurement discussed, conducting team based research continues to be extremely difficult in particular for measuring team behaviors. This article discusses a potential remedy to this issue through the team-based game “Pandemic©”. This game has players work together on teams of 2-4 individuals whose goal is to cure the world from a set of 4 diseases that are eradicating humanity. It forces individuals to be resourceful and work together - and exemplifies many of the behavioral, attitudinal and cognitive components of teamwork. This article will discuss a) the major theories of teamwork that should be taught alongside this game as an in-class activity, b) the KSAs, team processes, and measurable outcomes that Pandemic entails, and c) an example of ways to integrate the game into semester long activities to give students insight into teamwork and teamwork measurement.
Connecting Students to the Community through Ergonomics Projects
Authors: Cannon Brooke , Strawderman Lesley , Heiselt April
Published: October 2014

April Heiselt, Mississippi State UniversityAt Mississippi State University, students participated in a service-learning project as part of the Industrial Ergonomics course in the department of Industrial and Systems Engineering. The project was completed with community partner, N & W Farms. N & W Farms is a sweet potato farm and distributor with operations including cleaning, sorting, packaging, and shipping sweet potatoes. These operations allowed students to apply their ergonomics and design skills learned in the course as well as acquire a better understanding for how engineering can be applied to benefit the community. This paper will showcase the tools used by the students for the project, a summary of how students applied those tools, and how successful students were when using these tools to find solutions to ergonomic and operations problems at N & W Farms.
Human Factors Methods in a Design Cycle Framework
Authors: Creager James H. , Wardlaw Wesley R. , Hardy Megan , Pappalardo Gabriel , English Addison B. , Choi HeeSun
Published: October 2014

Understanding when, why, where, and how to use human factors methods is a key skill for human factors practitioners. Experienced professionals are very skilled at selecting methods appropriate to the task at hand, but the skill is a result of years of exposure. The current study examines the value of organizing human factors methods into a framework that relates and integrates information in meaningful ways to aid non-experts in selecting appropriate methods. The product design cycle is proposed as a viable framework for addressing this issue, though it is only one of many possible frameworks. Recommendations for future work include the development of additional frameworks targeting other audiences.
Variance in Academia
Authors: Kelling Nicholas , Corso Gregory M. , Cuevas Haydee M. , Keebler Joseph R. , Peres S. Camille , Walker Bruce N.
Published: October 2014

There is a growing concern regarding our academic community that academia has become a less than optimal option for new graduates. As our discipline is strongest when there is an appropriate balance between academia and industry, maintaining a strong academic workforce remains critical. However, apprehension exists on the mind of students regarding the viability of academic careers. Of specific concern is a very high expectation for tenure. Although such expectations may be accurate for some high performing institutions, a more accurate depiction is needed regarding the variance of academic positions. This panel will allow for an open discussion between those interested in academic careers and a multitude of differing academic experiences. Although tenure will be a major component discussed, interactions will also include best practices and tips for academic success.
A Summary Description of OERC’s Research Funding Process
Authors: Albin Thomas J.
Published: October 2014

The Office Ergonomics Research Committee (OERC) is a consortium of companies who work to advance ergonomic research and to disseminate research findings for use in designing and managing work places, systems, processes, and products.

A unique aspect of OERC is its membership, which consists of both product designers and end-users. The resulting dialog between members results in a fertile interaction of ideas regarding gaps in the research base concerning computer-related work, which in turn shapes the OERC research agenda. During the past six years, OERC has funded 24 studies on various topics such as sit/stand work, mouse design, gestural input, lighting, and student computer use.

In this presentation, the organization of OERC, its process for determining research priorities, the funding process, and the research that has been funded are described. OERC has proven to be an effective tool for the advancement and promotion of the human factors and ergonomics knowledge base regarding computer use.
A Conceptual Hierarchy for Ecologically Valid Open-Plan Office Research
Authors: Middlebrooks Rodney C. , Hayden Troy B. , Smith-Jackson Tonya L.
Published: October 2014

The use of open plan offices (OPOs) continues to increase globally. This increasing usage is often justified by the need to support more collaborative office work. Such practices as office hoteling, and touchdown stations using OPO designs are perceived to provide cost savings based on the more efficient use of space. However, the advantages of OPOs continue to be challenged in the literature, and many studies have identified negative consequences for work performance and worker satisfaction. As a complex sociotechnical system, OPOs have been difficult to study in any way that yields ecologically valid results. Research on OPOs has been conducted and can be separated into two primary categories: 1.) Controlled studies in laboratories; and 2.) Survey-based studies eliciting workers’ perceptions. There is a need for an organizing body of concepts and parameters to conduct OPO research that is ecologically valid and less constrained by the need for internal validity at the cost of realism. In this project, the research team developed a conceptual hierarchy (CH) to design an ecologically valid replication of an OPO. The CH provides a structural framework to conduct a single study or series of studies to explore work behavior in OPOs.
Some Considerations About Human Factors In Environment Design
Authors: Rangel de Oliveira Gilberto , Mont’alvÃO Claudia
Published: October 2014

The design process has been discussed for a long time. From the Cartesian to romantic point of view, many authors propose distinct approaches to include users in this process. This paper presents a discussion on whether or not design methods are used by designers and architects. To illustrate design processes of these professionals, an exploratory survey was conducted. The intention was to find out details about design practice and additional information about the knowledge and application of human factors/ergonomics by these professionals in the built environment projects. In this paper, just the results related to human factors/ ergonomics topics are presented and discussed.
Ambulation Aid Use and User Performance for Transit Vehicle Interior Design
Authors: D’Souza Clive , Zhu Xinhui
Published: October 2014

Public transportation plays an important role in shaping urban quality of life. However, urban transportation design and policy-making lacks a strong human factors knowledge base for accommodating a functionally diverse ridership including the aging and mobility impaired. This study examines seating configurations in contemporary low-floor buses and user performance for mobility impaired passengers. Task times in sitting and rising were obtained in a laboratory study using a static full-scale low-floor bus mock-up from – cane users (n=10), walker users (n=22), persons with visual impairment (n=17), and without any impairments (n=17). Significant differences in sitting and rising times across longitudinal vs. transverse seats by user group are demonstrated along with regression estimates to facilitate design evaluations. Implications of these findings, recommendations for improved low-floor bus designs and the relevance of ergonomics methods for safety, usability, and efficiency are presented.
Aircraft Seat in- and Egress Differences between Elderly and Young Adults
Authors: Lijmbach Willem , Miehlke Peter , Vink Peter
Published: October 2014

An aircraft interior should be adjusted to the needs of elderly, but research data in this area are limited. Especially, in- and egress could be an issue. In this paper differences in strategies between elderly and students are studied in a mock-up by analyzing video recordings of the in- and egress in seat rows. It shows that elderly take significantly more in- and egress time, especially for the non-aisle seat. Elderly also use more often support by touching arm rests and backrests. The in- and egress of PRMs could be improved to give the right support, perhaps by redesign and to assign PRMs to special seats.
Designing Classroom Routines to Promote Physical Activity in Children
Authors: Sanders Martha J.
Published: October 2014

Physical inactivity, a risk factor for childhood obesity, may contribute to difficulties with learning, social participation, and chronic disease in adulthood. This study examined the efficacy of ABC for Fitness™, a classroom-based physical activity program, at improving physical fitness in third grade students in two school districts. The sample included 229 students with 110 in the intervention and 129 in the control groups. Outcome measures included body mass index, curl-ups, push-ups, ½ mile run, and flexibility. Over a five month period, intervention schools showed greater improvement than controls in curl-ups and push-ups with trends toward significance in flexibility and ½ mile run. The study demonstrates the potential for designing classroom environments that promote physical fitness in children. Macro-level challenges for implementing programs in school systems are presented.
When Eyewitnesses Misremember
Authors: Resnick Marc L.
Published: October 2014

Eyewitness testimony is a critical component of U.S. jurisprudence in both civil and criminal proceedings. Witnesses are relied on to recount key events, behaviors, and circumstances that contribute to findings of fact surrounding alleged criminal acts or circumstances that are the subject of civil dispute. The contribution of eyewitness testimony depends critically on the reliability of the witnesses’ memory of the events they are describing. Unfortunately, there are significant limits of human episodic memory that may degrade or distort these memories. Compounding this challenge is the poor metacognitive awareness of memory’s limitations. Eyewitnesses may overestimate the quality of their memory in accuracy and precision. They may be unaware of the potential for false details to merge into their episodic memories of an event. Jurists are similarly unaware of the limitations of memory and may rely too heavily on eyewitness testimony when resolving cases. But acknowledging and accounting for the limitations of memory has costs. Without eyewitness testimony many cases would not be viable, so there is a societal need to tolerate these limitations in order to have a working legal system. Human factors professionals, who are testifying as investigators in the case, may be the only source through which jurors can be informed of memory’s limitations when general memory experts are not admitted to testify solely for that purpose. When performed capably, this testimony can significantly improve the outcomes of legal proceedings.
Case Study
Authors: Vredenburgh Alison , Vanderpol Eugene
Published: October 2014

While most motor vehicle operators must obtain a driver’s license, which requires training and a test, child operators of motorized dirt bikes can use these vehicles without any training or experience. In this case, a 10-year-old boy was riding a dirt bike in the desert for the first time. The area where he was riding had desert-like sand and dune conditions on both sides of a 2-lane highway. The boy received some oral instructions from a family friend, and then spent a few hours riding in the dirt. Towards the end of the day, an off-duty ambulance was driving down the highway. The child stopped at the side of the road, looked towards the ambulance, which was the only vehicle on the road in either direction, and then proceeded to cross, clearing the roadway. The ambulance driver panicked, left the road and struck the dirt bike 30 feet off the side of the road in the dirt. The boy suffered a traumatic brain injury with permanent brain damage. Human factors issues from both motor vehicle operators’ perspectives will be discussed.
Our Society in 2025
Authors: Salas Eduardo , Durso Frank , Imada Andrew
Published: October 2014

The future is here, and so is the need to adapt to the changing times. Join us for an engaging forum as we explore what’s next for both the HF/E field and the Society. Together, let’s share ideas on how HFES can adapt its conferences, member needs, and organizational structure to embrace change, focus on the future, and continue to advance the science of HF/E.
The Influence of Mental Workload and Information Reliability on Aerial Search Performance
Authors: Harden J. W. , Bliss J. P. , Bernard A. , Jarsaillon S.
Published: October 2014

Western society continues to become increasingly technological and, by extension, automated. It should come as no surprise, then, that researchers have devoted a considerable amount of time and effort to identifying and understanding psychological constructs, such as cognitive workload and trust, as they apply to the relationship between human and machine, especially in the military domain. The current research seeks to expand on past work by considering the joint influence of workload and system reliability on operator trust, as well as performance, as measured by accuracy in identifying a target stimulus, reaction time, and situation awareness. Results suggested that task workload had a significant impact on all measured aspects of operator performance, but not trust in the automated system. Surprisingly, system reliability had no statistical effect on operator performance or measured trust.
A Systems Approach to Diagnosing and Measuring Teamwork in Complex Sociotechnical Organizations
Authors: Duff Sacha N. , Giudice Katherine Del , Johnston Matthew , Flint Jesse , Kudrick Bonnie
Published: October 2014

This paper presents a novel approach to diagnosing and measuring teamwork in complex sociotechnical systems. First, the underlying theoretical constructs that have inspired the development and use of a multi-level model to study team phenomena from a general systems perspective are presented. Next, in an attempt to theoretically ground the construct, “flow state” will be presented as an isomorphic variable in a multi-level model, meaning it is represented similarly at the system, team, and individual level. Approaching processes embedded in organizations from this perspective allows diagnosis of the systemic influences that contribute most to the variance in performance, identification of pervasive latent systemic failures, and the development of a tailored taxonomy of behavioral teamwork dimensions, which can then be translated into metrics to measure teamwork within any observable complex process.
Rating of Dog Breed Differences
Authors: Finkbeiner Kristin M. , Russell Paul N. , Helton William S.
Published: October 2014

Dogs have attracted the attention of biomimetic roboticists, for example, Sony’s Aibo. Properly designed robots may be able to elicit similar perceptions as dogs. It is important then to analyze the attitudes that people have towards dogs, in particular salient features like breed-membership. In the present paper we developed an electronic questionnaire to assess the existing mental models and categorizations of dog breeds. Subjects were asked to rate representatives of 48 different dog breeds with a 7-point Likert Scale for specific behavioral traits. Based on exploratory data analysis techniques, we found four clusters of breeds: Cluster 1 (Higher Drive, Useful, and Nice), Cluster 2 (Higher Drive, Useful, and not so Nice), Cluster 3 (Higher Drive, not so Useful, and not so Nice) and Cluster 4 (Lower Drive, not so Useful, and Nice). Implications for quadropedal robot design based on pertinent existing perceptions of dog breeds and their traits are discussed.
Postural Risks Associated with Laptop Use on a Bed
Authors: Bubric Katherine , Hedge Alan
Published: October 2014

Laptop use is associated with a number of musculoskeletal risk factors, however there is a deficit of research pertaining to their use in any context other than a traditional desk and chair. Because laptops are designed to be portable, they are utilized in a wide variety of configurations, some of which may place the user at risk of injury. The current study examines the postural risks associated with three configurations females frequently report employing while using a laptop computer while on a bed. Differences in both posture and choice of configuration are examined as potential explanations for previously noted differences in the prevalence of discomfort associated with laptop use between males and females.
Identifying Interruption Clusters in the Emergency Department
Authors: Fong Allan , Meadors Margaret , Batta Neil , Nitzberg Mike , Hettinger A. Zachary , Ratwani Raj
Published: October 2014

Interruptions can adversely affect human performance, particularly in fast-paced and high-risk environments. Much of the research on interruptions has been laboratory based and the extension of these methods to real-world settings has been challenging and limited. This paper discusses the development and usage of a new tool, TaskTracker, to increase understanding of interruptions in the emergency department. With the data collected from this tool we identified several temporal groupings of interruptions, what we define as interruption clusters. We found significantly more clusters during self-initiated computer tasks. In this setting, we also observed the tendencies of assistants, technicians, students, and nurses to interrupt attending physicians in clusters. A deeper understanding of who engages in interruption clusters and why may provide insights for future systemic strategies that could facilitate better communication patterns.
Tailoring Cognitive Task Analysis (CTA) Methods for Use in Healthcare
Authors: Militello Laura , Dominguez Cindy , Ebright Patricia , Moon Brian , Russ Alissa , Weir Charlene
Published: October 2014

Cognitive task analysis (CTA) methods are most widely known for their contributions to military, nuclear power plant, and aviation research. In recent years, however, these methods have been adapted and applied with increasing frequency to address issues in healthcare. CTA methods have been used in the context of designing and integrating health information technology, in pursuit of improved patient safety, and as a means to improve education and training. This panel will 1) reflect on strategies for tailoring CTA methods for use in a range of healthcare settings, 2) highlight challenges to conducting CTA in healthcare settings, and 3) highlight important contributions of CTA in addressing challenging issues in healthcare today.
Postural stress experienced by vaginal surgeons
Authors: Zhu Xinhui , Yurteri-Kaplan Ladin A. , Gutman Robert E. , Sokol Andrew I. , Iglesia Cheryl B. , Park Amy J. , Paquet Victor
Published: October 2014

Increasing attention has been drawn to the prevalence of work-related musculoskeletal disorders (MSDs) among surgeons in various medical specialties; however, the risk of work-related MSDs among gynecologic surgeons has not received much attention. This study aimed to investigate the postural load among gynecologic surgeons for various surgical tasks during vaginal surgery. The frequency and percentage of duration of awkward upper body postures experienced by vaginal surgeons during eleven different vaginal surgical tasks observed during thirteen surgeries were collected using a new observational ergonomic job analysis tool, Ergonomic Posture Assessment in Real Time (ErgoPART). Results indicate that the postural loading is high for many surgical tasks but that the frequency and duration of awkward neck, shoulder, and trunk postures is variable across tasks. Surgeons’ postural load was significantly higher for the transvaginal hysterectomy compared to others. This task, in particular, is a candidate for ergonomics interventions designed to reduce postural stress.
Body Posture during Simulated Tracheal Intubation
Authors: Grundgeiger T. , Happel O. , Grundgeiger J. , Roewer N.
Published: October 2014

Tracheal intubation is an important procedure in anesthesia and emergency medicine. The standard intubation technique is direct laryngoscopy using a Macintosh blade; however, video laryngoscopy has become common and research has shown several advantages of video laryngoscopy over direct laryngoscopy. In the present study we investigated whether video laryngoscopy resulted in the intubating person adopting a more ergonomic body posture than direct laryngoscopy. To this end, 25 medical students were video-recorded intubating a manikin using a GlideScope® or a Macintosh blade. Using the GlideScope® resulted in smaller deflections for all analyzed posture angles than using the Macintosh blade. Similarly, the Rapid Entire Body Assessment (Hignett & McAtamney, 2000) indicated that the GlideScope® resulted in a body posture less likely to induce injuries than the Macintosh blade. Overall, video laryngoscopy using a GlideScope® resulted in a more ergonomic posture compared to the Macintosh blade.
Relationships between Wellness, Fatigue, and Intershift Recovery in Hospital Nurses
Authors: Steege Linsey M. , Pasupathy Kalyan S. , Drake Diane
Published: October 2014

Fatigue and recovery have been associated with health, safety, and performance outcomes in hospital nurses. There is a growing emphasis on fatigue risk management and health promotion programs to support nurses and promote quality in hospitals. However, little is known about the relationships between fatigue and wellness measures in nurses. This study used a tree-based classification method to identify associations between self-reported fatigue, recovery and wellness measures in a survey study of hospital nurses. Significant relationships between multiple wellness measures and acute fatigue, chronic fatigue, and intershift recovery levels were identified. Specifically, the findings include critical levels of wellness measures where fatigue and recovery change. These findings have implications for ongoing efforts to develop effective fatigue management programs in this population.
Using Video Recorded Neonatal Intensive Care Unit Scenarios to Test Agreement between Clinicians’ Assessments
Authors: Nadler Izhak , Globus Omer , Pessach-Gelblum Liat , Strauss Zipora , Ziv Amitai
Published: October 2014

Clinicians in Neonatal Intensive Care Units are required to perform assessments under extreme pressure to determine the illness severity of neonates. Currently there is no reference that indicates the clinical condition of a neonate according to its vital signs. Agreement between clinicians’ assessments can provide initial indication for the clinicians’ ability to systematically perform assessments. Agreement was tested between 16 clinicians who viewed 31 recorded cases and scored the illness severity of a neonate mannequin in each case. The agreement level was fair (0.28), but high correlation between the assessments (0.8<r<0.94) suggests that the clinicians were able to systematically score the cases, and they had similar interpretation about the relative illness severity between cases. Future studies are required to determine the sources for the relative low agreement level and to identify means for improvement. Establishment of a valid reference early warning score is essential to guide the assessment.
Evaluation of hands-on clinical exam performance using marker-less video tracking
Authors: Azari David P. , Pugh Carla M. , Laufer Shlomi , Cohen Elaine , Kwan Calvin , Chen Chia-Hsiung (Eric) , Yen Thomas Y. , Hu Yu Hen , Ray Rebecca D. , Radwin Robert G.
Published: October 2014

This study investigates the potential of using marker-less video tracking for evaluating hands-on clinical skills. Experienced family practitioners attending a national conference were recruited and asked to conduct a breast examination on a simulator that presents different clinical pathologies. Videos were taken of the clinician’s hands during the exam. Video processing software for tracking and quantifying hand motion kinematics was used. Videos were divided into two segments: a general search segment and a mass exploration segment. The general exploration segments exhibited motion patterns which included 72% faster movement and 73% higher acceleration across clinical pathologies. The most complex pathology exhibited 14% greater displacement for pressing/rubbing than for general exploration. Marker-less video kinematic tracking shows promise in discriminating between different examination procedures, clinicians, and pathologies.
Quantifying Physician Activities in Emergency Care
Authors: Abraham Joanna , Kannampallil Thomas G.
Published: October 2014

Emergency departments (ED) are prototypical complex environments. Physician activities in these settings are characterized as episodic, dynamic and collaborative. Using an exploratory study supported by observations, physician shadowing and interviews, we characterize the physician’s activities in an ED including the nature of activities, the time allocated for these activities, how these activities are distributed across the unit and the susceptibility of these activities for interruptions. We found that approximately one-fourth (~25%) of the physician activities (e.g., direct patient care) were localized at specific locations in the unit, while the rest of the activities (e.g., communication) were distributed across the unit and were less predictable. The non-localized activities had a likelihood of interruptions. The results have important implications for mitigating the physician workload, and the design of technologies for monitoring such complex settings.
Gaze and viewing patterns in microsurgery
Authors: Yu Denny , Cha Jackie S. , Kasten Steven J. , Armstrong Thomas J.
Published: October 2014

Gaze disruptions in surgery have been associated with suboptimal surgical workflow, and human factor tools have been developed to quantify these events in cardiovascular and laparoscopic surgeries. Disruptions to workflow may be a particular concern in microsurgery because looking away from the microscope can cause the surgeon to lose view of delicate and precise tasks occurring at the surgical site. However, these viewing patterns in microsurgery have not been investigated. The purpose of this study is to quantify the gaze and viewing patterns during the microsurgery procedure. Event-based task analysis was performed for 14 surgeons performing microsurgery. Results found that average length of procedure was 70±33 minutes. Surgeons were observed to primarily interact with microscope 83±9% during microsurgery. Surgeons were observed to look away from the microscope in order to examine the tool area, patient site, and rest. Frequency of gaze away from the microscope was observed to be 11 disruptions per 10 minutes. Observed gaze demands of microsurgery and the limited opportunity for rests may impact surgeon performance and their risk for musculoskeletal fatigue.
Work Status of Individuals with Advanced Cancer
Authors: Terhaar Abigail , Lee Ju-Whei , Tevaarwerk Amye , Sesto Mary , Wiegmann Douglas , Fisch Michael
Published: October 2014

Lengthening survival times for advanced cancer patients emphasizes the importance of continuing to work after diagnosis. Information and tools are necessary to help these individuals remain working. Before we can develop interventions, we must understand how advanced cancer affects employment. We analyzed Eastern Cooperative Oncology Group’s (ECOG) “Symptom Outcomes and Practice Patterns (SOAPP)” study to investigate what factors were associated with employment of 680 advanced cancer patients. Univariable and multivariable logistic regression analyses were conducted to compare patients identified as stably working (Group A) to patients no longer working (Group B). Improving ECOG performance status, race/ethnicity, receiving hormonal treatment, and decreasing symptom interference were significantly associated with continuing to work. Human factors engineers (HFEs) can help create strategies to mitigate some physical and cognitive workloads that result in work interference. The HFE’s role should increase as the number of advanced cancer patients working rises.
Medical Team Handoffs
Authors: Fletcher Keaton A. , Bedwell Wendy L. , Rosen Michael , Catchople Ken , Lazzara Elizabeth
Published: October 2014

Patient handoffs can look very different depending on the context, but regardless of the situation, they are a major vulnerability in patient care. The current regulations of resident work-hours have increased the frequency of handoffs, thereby increasing the risk to patients and the need to understand how to optimize the procedure. Moreover, the time pressure that many handoffs from one department to the next face pose a unique set of teamwork and communication challenges that need to be further explored. This expert panel will engage in discussion regarding the current state of medical team handoffs: in multiple contexts, how to use technology and the environment to increase their efficiency, and the role of human factors in creating a safer patient handoff.
Glucometer Design for Patients with Vision and Mobility Impairments
Authors: Santos Luis , Olumese Obhafuoso , Vaughn-Cooke Monifa
Published: October 2014

Patient self-management technologies are a critical component of chronic disease care. Although these technologies are intended to support patient activities, low device usability and exclusion of the patient from the design process can produce design impediments that may negatively impact patient adherence and hence treatment outcomes. These design risks are compounded if the patient has a disability (vision, mo-bility, hearing), which is a large percentage of the chronic disease population. We aim to develop a patient-centric design method to evaluate self-management technology usability for disabled patients, specifically focusing on handheld device use for diabetics. Our goal is to identify modular hardware and software de-sign components (buttons, screen, casing, etc.) that support or hinder use, with the ultimate goal to inform design decision making. An initial expert usability analysis (hierarchical task analysis, usability heuristics) was performed for 13 glucometers (diabetes self-management technology). The usability analysis informed the design of an experiment to test disabled user performance and satisfaction for several meter interaction tasks. Prior to performing the study in the diabetes patient population, common diabetes disabilities were simulated in healthy subjects through the use of glasses (retinopathy, glaucoma) and gloves (arthritis, neu-ropathy) to evaluate the experimental protocol. Results suggested a preference of participants for large text, large protruding buttons, and contrast color between case and buttons to facilitate locating buttons. Long-term goals of this research are to support medical device manufacturers to better design handheld devices for high-risk populations and inform Food and Drug Administration handheld medical devices design guidelines.
Tactile Displays of Pulse Oximetry in Integrated and Separated Configurations
Authors: McLanders Mia , Santomauro Chiara , Tran Jimmy , Sanderson Penelope
Published: October 2014

Vibrotactile displays have been trialled in a variety of cognitively demanding domains, including healthcare. Previous work suggests that vibrotactile displays can be used to inform clinicians of patient status, particularly when the displays are alarm-style alerts in surgical or critical care. The goal of the present study is to evaluate how well a common measure of patient well-being—pulse oximetry—can be communicated via an upper-arm vibrotactile prototype. Pulse oximetry includes two important vital signs: heart rate and oxygen saturation. Two displays were tested in a between-subjects design: (1) the Separated display presented heart rate first, followed by oxygen saturation; and (2) the Integrated display communicated both vital signs simultaneously. Participants identified five ranges of heart rate and three levels of oxygen saturation with very high accuracy (>90%), regardless of display type. Although participants’ identification accuracy improved marginally with practice, their initial high level of performance was achieved with minimal training. Findings will inform a broader program of research in which we aim to test whether vibrotactile displays might be useful as a part of multi-modal patient monitoring.
Electronic health records: effects of clutter and stress on physicians’ information search and noticing performance
Authors: Moacdieh Nadine , Ganje Travis , Sarter Nadine
Published: October 2014

Electronic health records (EHRs) in emergency departments (EDs) store and display important medical information and thus play a critical role in medical diagnoses. However, current EHR designs often result in display clutter, a condition where a large amount of poorly organized information is displayed. This can cause delays in finding and noticing relevant information. Clutter may be especially problematic under conditions of stress, which is known to degrade people’s perceptual capacities. The goal of this study was to analyze the effects of EHR clutter and stress on physicians’ ability to search for and notice important information during medical diagnosis procedures. Three simulated EHR pages were developed for this study. Participating physicians were presented with typical ED patient scenarios and the relevant EHR page for each patient. They were required to search the EHR displays to answer a specific question related to each patient and, based on their review of the EHR, they had to confirm or refute a proposed diagnosis. Performance measures and subjective feedback were collected. In general, results showed that clutter increased the time to find a given search target and the time to extract important information, as well as the number of missed targets. The effects of clutter were most pronounced for the EHR page that displayed unorganized lists of medical data, where the presence of stress also exacerbated the effects of clutter on response time. These results emphasize the need to develop display countermeasures to overcome the effects of display clutter in hospital as well as other environments.
Making Sense of Patient Safety Event Data
Authors: Fong Allan , Krevat Seth , Bauer David , Spencer Gabriel , Ratwani Raj
Published: October 2014

Over the past two decades, the focus on capturing and understanding patient safety events has led to the development of several initiatives and programs in hospitals across the country to increase the reporting of these events. Computerized reporting systems are an integral part of these programs. With these systems going live, hospitals now have databases that contain large numbers of patient safety event reports. Now, the challenge is to make sense of and effectively analyze the data by examining trends and predicting future events. The purpose of this practice-orientated paper is to describe and demonstrate how to apply advances in information visualization techniques and methods to patient safety event data with the goal of making these data more understandable and actionable. We will discuss the process of how we developed patient safety event visualizations for a multi-hospital healthcare system and provide visualization techniques, resources, guidelines, and practical examples.
Improving Quality and Safety through Human Factors Collaborations with Healthcare
Authors: Wetterneck Tosha , Kelly Michelle M. , Carayon Pascale , Sesto Mary , Tevaarwerk Amye , Chui Michelle , Stone Jamie , Hoonakker Peter , Musa Al , Holman G. Talley , Beasley John
Published: October 2014

Multiple reports from the Institute of Medicine and the National Academy of Engineering, (IOM 2001; Reid et al., 2005; Kaplan et al., 2013) have called for the use of human factors engineering (HFE) and systems engineering principles and methods/tools to improve health care delivery. Yet, the integration of engineers into health care settings and the education of clinicians and other health care professionals on human factors and systems engineering principles and methods/tools remain in its infancy. A recent editorial by Xiao and Fairbanks (2011), discusses a small, but growing presence of professionals who are “bilingual” in both human factors and medicine. Indeed, Carayon (2011) identified human factors as an innovation that will require diffusion into healthcare through the use of HFE methods and tools, increasing the health care professional knowledge of HFE, and the hiring HFEs in healthcare organizations. To achieve the goal of integration, there will be many “models” of healthcare – human factors collaborations, from experts working together from their different ‘silos’ to true bilingualism. SEIPS, the Systems Engineering Initiative for Patient Safety (Carayon et al., 2006), aims to integrate human factors and systems engineering with healthcare disciplines. Our panel of SEIPS-affiliated engineers and healthcare professionals represents many different types of collaborations across this spectrum and their work spans multiple healthcare settings and disciplines, including: ambulatory primary care, inpatient pediatrics, community pharmacy, and oncology.