Digital Learning has gained importance for vocational training in a broad range of professions. In times of uncertainty, like experienced with the COVID-19 pandemic, this is especially true for the healthcare sector, as classrooms and training facilities may not be accessible or even available. At this point, tools for digital prequalification and learning can generate a decisive benefit, as they allow individual, self-paced transfer of knowledge independently from physical facilities, and as part of on-site or online classroom teaching. Web-based trainings (WBTs) are a good example of appropriate, proven technology, which makes interactive, multi-lingual learning content available on a broad range of mobile devices, like laptops, tablet PCs and smartphones. As WBTs offer manifold possibilities to accommodate information, an adequate user inface is crucial to make this information accessible, but also to reduce the on-screen information where reasonable. In our paper, we present a learning module for nursing training and its user interface. We outline the interaction concept behind it and describe all its interactive elements, such as tabs, buttons, and pop-up boxes. We also show the results of an empirical study featuring eye tracking in which we assess perception, comprehensibility, and motivation.
{"title":"User Interface Assessment of a Tool for Digital Learning in Nursing","authors":"Jan A. Neuhöfer, Sabine Hansen, Tim Wöllenstein","doi":"10.54941/ahfe1002110","DOIUrl":"https://doi.org/10.54941/ahfe1002110","url":null,"abstract":"Digital Learning has gained importance for vocational training in a broad range of professions. In times of uncertainty, like experienced with the COVID-19 pandemic, this is especially true for the healthcare sector, as classrooms and training facilities may not be accessible or even available. At this point, tools for digital prequalification and learning can generate a decisive benefit, as they allow individual, self-paced transfer of knowledge independently from physical facilities, and as part of on-site or online classroom teaching. Web-based trainings (WBTs) are a good example of appropriate, proven technology, which makes interactive, multi-lingual learning content available on a broad range of mobile devices, like laptops, tablet PCs and smartphones. As WBTs offer manifold possibilities to accommodate information, an adequate user inface is crucial to make this information accessible, but also to reduce the on-screen information where reasonable. In our paper, we present a learning module for nursing training and its user interface. We outline the interaction concept behind it and describe all its interactive elements, such as tabs, buttons, and pop-up boxes. We also show the results of an empirical study featuring eye tracking in which we assess perception, comprehensibility, and motivation.","PeriodicalId":389399,"journal":{"name":"Healthcare and Medical Devices","volume":"107 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"1900-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"124229081","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
O. Yilmaz, K. Radermacher, F. Beger, Jonas Roth, A. Janß
Several studies have identified that the Operating Room (OR) is costly to maintain, but also the most profit generating department. The 2019 approved ISO IEEE 11073 SDC family defines a manufacturer independent communication standard, which creates open interoperability in the OR and clinic for the first time. Using SDC, medical device data can be collected and used for display on a central cockpit, documentation purposes during an ongoing operation and also be streamed outside the OR. The goal of this research was to analyze and evaluate how medical device data and context information (current workflow step, location, patient, operator) could be used inside and outside the OR (e.g., maintenance and reparation) to improve clinical processes and benefit patient care. We also analyzed if the availability of such information might affect the efficiency and safety of patient care. A process analysis has been performed with clinical staff from the Uniklinik RWTH Aachen. The planning procedure of the OR management has been discussed and clinical use cases have been discussed with nurses, surgeons and anesthesiologists. Potential improvements using interoperable device data have been developed and corresponding interactive functional models have been implemented and discussed with the user groups. After several iterations, these concepts were implemented as part of surgical, anesthesia and OR management workstations. A formative usability evaluation (using the Thinking Aloud technique and questionnaires) has been carried out with a small user group (n=9) to check whether interoperable device data and context information improved the usability and safety of the clinical processes. Inside the demonstrator OR at the Chair of Medical Engineering (RWTH Aachen University) surgeons and anesthesiologists tested and evaluated different interfaces for OR procedures. During the formative evaluation, interfaces inside a remote SDC workstation were tested for: OR-Light, OR-Table, Video-Switch, High Frequency Cutting device and a navigation interface in combination with a standalone tracking system and a universal foot switch. The results were very promising and showed that most interfaces had a high degree of usability. Potential for improvement has been identified in the handling, comprehensibility and discernibility of the navigation system. In a second part, the developed processes for OR-optimization were discussed and evaluated. The clinical staff (n=9) reported that they need to gather information from various sources and systems during surgery (Ø 4.63 out of 5 on a Likert scale) and that repeated recordings of redundant information into multiple protocols is also required. They supported the access, availability and integration of device context information inside clinical processes. All clinical users agreed that utilizing automatic documentation through interoperable medical devices can save valuable time (Ø 4,85 of 5). A concept, in which workflow step spe
几项研究表明，手术室(OR)的维护成本很高，但也是最能产生利润的部门。2019年批准的ISO IEEE 11073 SDC系列定义了一个独立于制造商的通信标准，首次在手术室和诊所中创建了开放的互操作性。使用SDC，可以收集医疗设备数据并用于在中央驾驶舱上显示，在正在进行的操作期间用于记录目的，也可以在手术室外传输。本研究的目的是分析和评估医疗设备数据和上下文信息(当前工作流程步骤、位置、患者、操作员)如何在手术室内外(例如维护和维修)使用，以改善临床流程并使患者护理受益。我们还分析了这些信息的可用性是否会影响患者护理的效率和安全性。与亚琛工业大学Uniklinik的临床工作人员一起进行了过程分析。讨论了手术室管理的计划程序，并与护士、外科医生和麻醉师讨论了临床用例。已经开发了使用可互操作设备数据的潜在改进，并且已经实现了相应的交互式功能模型，并与用户组进行了讨论。经过几次迭代，这些概念被实现为手术、麻醉和手术室管理工作站的一部分。对一小群用户(n=9)进行了形成性可用性评估(使用Thinking Aloud技术和问卷调查)，以检查可互操作的设备数据和上下文信息是否提高了临床过程的可用性和安全性。在医学工程主席(亚琛工业大学)的示范手术室里，外科医生和麻醉师测试和评估了手术室手术的不同接口。在形成性评估期间，对远程SDC工作站内部的接口进行了测试:OR-Light, OR-Table, Video-Switch, High - Frequency Cutting device和一个结合独立跟踪系统和通用脚踏开关的导航接口。结果非常令人鼓舞，并表明大多数界面都具有高度的可用性。已确定在导航系统的处理、可理解性和可识别性方面有改进的潜力。在第二部分中，讨论和评估了开发的or优化流程。临床工作人员(n=9)报告说，他们需要在手术期间从各种来源和系统收集信息(Ø 4.63(李克特量表5分))，并且还需要将冗余信息重复记录到多个协议中。他们支持临床流程中设备上下文信息的访问、可用性和集成。所有临床用户都同意，通过可互操作的医疗设备使用自动文档可以节省宝贵的时间(Ø 4,85 of 5)。一个建议工作流步骤特定设备设置的概念得到了批准，但也受到了批评。用户看到了节省时间和标准化的好处，但也看到了可能的依赖性和较少独立思考的缺点。声明“收集的数据有助于建立一个数据库，在此基础上手术室管理层可以做出更有效的决策”也得到了批准(Ø 4,88 of 5)。可互操作的医疗设备(使用ISO IEE 11073 SDC)可用于创建有用的数据库，支持节省时间和资源，并有助于在手术室内外进行有效的决策。结合过程支持数据显示和评估用户界面。对于设备属性更改的工作流特定建议被声明为有帮助的，尽管已经表达了关注(见上文)。我们展示了可互操作的SDC医疗设备数据和上下文信息可用于改进和支持临床流程。
{"title":"Usability evaluation of a process optimized integrated workstation based on the IEEE 11073 SDC standard","authors":"O. Yilmaz, K. Radermacher, F. Beger, Jonas Roth, A. Janß","doi":"10.54941/ahfe1003481","DOIUrl":"https://doi.org/10.54941/ahfe1003481","url":null,"abstract":"Several studies have identified that the Operating Room (OR) is costly to maintain, but also the most profit generating department. The 2019 approved ISO IEEE 11073 SDC family defines a manufacturer independent communication standard, which creates open interoperability in the OR and clinic for the first time. Using SDC, medical device data can be collected and used for display on a central cockpit, documentation purposes during an ongoing operation and also be streamed outside the OR. The goal of this research was to analyze and evaluate how medical device data and context information (current workflow step, location, patient, operator) could be used inside and outside the OR (e.g., maintenance and reparation) to improve clinical processes and benefit patient care. We also analyzed if the availability of such information might affect the efficiency and safety of patient care. A process analysis has been performed with clinical staff from the Uniklinik RWTH Aachen. The planning procedure of the OR management has been discussed and clinical use cases have been discussed with nurses, surgeons and anesthesiologists. Potential improvements using interoperable device data have been developed and corresponding interactive functional models have been implemented and discussed with the user groups. After several iterations, these concepts were implemented as part of surgical, anesthesia and OR management workstations. A formative usability evaluation (using the Thinking Aloud technique and questionnaires) has been carried out with a small user group (n=9) to check whether interoperable device data and context information improved the usability and safety of the clinical processes. Inside the demonstrator OR at the Chair of Medical Engineering (RWTH Aachen University) surgeons and anesthesiologists tested and evaluated different interfaces for OR procedures. During the formative evaluation, interfaces inside a remote SDC workstation were tested for: OR-Light, OR-Table, Video-Switch, High Frequency Cutting device and a navigation interface in combination with a standalone tracking system and a universal foot switch. The results were very promising and showed that most interfaces had a high degree of usability. Potential for improvement has been identified in the handling, comprehensibility and discernibility of the navigation system. In a second part, the developed processes for OR-optimization were discussed and evaluated. The clinical staff (n=9) reported that they need to gather information from various sources and systems during surgery (Ø 4.63 out of 5 on a Likert scale) and that repeated recordings of redundant information into multiple protocols is also required. They supported the access, availability and integration of device context information inside clinical processes. All clinical users agreed that utilizing automatic documentation through interoperable medical devices can save valuable time (Ø 4,85 of 5). A concept, in which workflow step spe","PeriodicalId":389399,"journal":{"name":"Healthcare and Medical Devices","volume":"42 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"1900-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"124817250","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Almost all types of education are in some sense multidimensional, even if it is difficult to ascribe formal, or passion-driven, experiential, cognitive-behavioral competences closely related to the subject of education to the teaching subject (an individual or a team). From the perspective of the mission of innovative agonology, the most valuable ways, methods, forms and means of educational activities are those whose use (in a session, in a cycle, or as a ‘passion for life’) stimulates as much as possible some aspect of somatic, mental and social health, but also at least one element (component) of survival.From a broader point of view, i.e. the social mission of evidence-based science, the important premise is that although humans are genetically adapted to operate in terrestrial environments, however, they are also active underground, in water, in the air and in space. In each of these environments, one pole of the continuum of survival possibilities accumulates minimal health criteria, while the opposite pole – a long list of factors that mean inevitable death. This diversity of human operating environments and the roles they fulfill within them implies the legitimacy of recommending very complex educational models, some of which require multilevel selection.Apart from individual career paths, swimming and wrestling (even if pursued without the pressure of sports performance) optimally stimulate the somatic dimension of health (hard-respiratory capacity, strength and endurance of the largest muscle groups and flexibility) compared to other sporting activities. The survival dimension is already diverse. For instance, swimming skills increase the chance of survival in an aquatic environment while hand-to-hand combat skills increase the likelihood of effective self-defense in situations of physical aggression. And wrestling is a contact sport (psychophysical activity involving a permanent ‘dialogue of minds and bodies’), so it qualifies as a model that also stimulates the mental dimension of health. Moreover, in general, also the adepts of other martial arts interact in a peculiar way with the centuries-old heritage of the cultures from which these arts originate (social dimension of health). Unfortunately, the effective and attractive status of educational models based on martial arts is depreciated by the pathology of bloody fights of neo-gladiatorship. These spectacles are promoted and camouflaged in the public sphere precisely under the banner of mixed martial arts (the first part of the phrase ‘mixed’ is only 31.25% of the name).Brazilian capoeira is an example of a multifaceted educational model that combines martial art with music. Although innovative agonology is an appropriate science for formulating justifications at the interface between these two arts (martial art and music), the well-established standards of music education are its competition. These standards include respect for centuries-old traditions and multiculturalism, a comm
{"title":"Multidimensional Educational Models Recommended by Innovative Agonology – Examples of Physical Education and Music Education","authors":"Elizabeth Waszkiewicz","doi":"10.54941/ahfe1003499","DOIUrl":"https://doi.org/10.54941/ahfe1003499","url":null,"abstract":"Almost all types of education are in some sense multidimensional, even if it is difficult to ascribe formal, or passion-driven, experiential, cognitive-behavioral competences closely related to the subject of education to the teaching subject (an individual or a team). From the perspective of the mission of innovative agonology, the most valuable ways, methods, forms and means of educational activities are those whose use (in a session, in a cycle, or as a ‘passion for life’) stimulates as much as possible some aspect of somatic, mental and social health, but also at least one element (component) of survival.From a broader point of view, i.e. the social mission of evidence-based science, the important premise is that although humans are genetically adapted to operate in terrestrial environments, however, they are also active underground, in water, in the air and in space. In each of these environments, one pole of the continuum of survival possibilities accumulates minimal health criteria, while the opposite pole – a long list of factors that mean inevitable death. This diversity of human operating environments and the roles they fulfill within them implies the legitimacy of recommending very complex educational models, some of which require multilevel selection.Apart from individual career paths, swimming and wrestling (even if pursued without the pressure of sports performance) optimally stimulate the somatic dimension of health (hard-respiratory capacity, strength and endurance of the largest muscle groups and flexibility) compared to other sporting activities. The survival dimension is already diverse. For instance, swimming skills increase the chance of survival in an aquatic environment while hand-to-hand combat skills increase the likelihood of effective self-defense in situations of physical aggression. And wrestling is a contact sport (psychophysical activity involving a permanent ‘dialogue of minds and bodies’), so it qualifies as a model that also stimulates the mental dimension of health. Moreover, in general, also the adepts of other martial arts interact in a peculiar way with the centuries-old heritage of the cultures from which these arts originate (social dimension of health). Unfortunately, the effective and attractive status of educational models based on martial arts is depreciated by the pathology of bloody fights of neo-gladiatorship. These spectacles are promoted and camouflaged in the public sphere precisely under the banner of mixed martial arts (the first part of the phrase ‘mixed’ is only 31.25% of the name).Brazilian capoeira is an example of a multifaceted educational model that combines martial art with music. Although innovative agonology is an appropriate science for formulating justifications at the interface between these two arts (martial art and music), the well-established standards of music education are its competition. These standards include respect for centuries-old traditions and multiculturalism, a comm","PeriodicalId":389399,"journal":{"name":"Healthcare and Medical Devices","volume":"4 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"1900-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"123093194","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
A delay in accepting or a refusal of vaccination despite the availability of vaccination services is referred to as vaccine hesitancy. Vaccine hesitancy has gained increased attention, particularly since the outbreak of the COVID-19 pandemic. The most commonly used framework in studies of vaccine hesitancy and its determinants has been the 5C model. The 5C model posits that the five individual-level determinants influencing vaccine hesitancy are confidence, complacency, constraints, calculation, and a feeling of collective responsibility. However, other factors that may also be important in influencing vaccine hesitancy, such as sociodemographic and psychological determinants, have received less attention. Objectives: This study analyzed 1) the effectiveness of the 5C model in predicting the COVID-19 vaccination decision and 2) the association between COVID-19 vaccination decisions and the fear of being infected with COVID-19, attitude toward the media’s COVID-19 vaccination information, monetary incentives, political attitudes, perception of Hong Kong’s future, and attitude toward the vaccination advice of authorities (government officials and healthcare professionals). Methods: This study used data collected in an online questionnaire distributed from May 2022 to June 2022 during the fifth wave of the Omicron variants in Hong Kong. The questionnaire had 32 items measuring the COVID-19 vaccination status, demographic characteristics, the five determinants of the 5C model, and the following six additional factors: 1) fear of being infected with COVID-19, 2) attitude toward the media’s COVID-19 vaccination information, 3) monetary incentive, 4) political attitudes, 5) perception of Hong Kong’s future, and 6) attitude toward the vaccination advice of authorities. Results and Conclusions: For the 5C determinants, only confidence was significantly positively associated with COVID-19 vaccination, whereas complacency, constraints, and collective responsibility were associated when a relaxed p-value (p ≤ 0.25) was used. For the six additional factors, only attitude toward the media’s COVID-19 vaccination information was significantly positively correlated with vaccination status, and when a relaxed p-value (p ≤ 0.25) was used, a fear of being infected with COVID-19, political attitudes, and perception of Hong Kong's future was found to be associated. There was no evidence that calculation, monetary incentives, attitude toward the vaccination advice from authorities, or demographic characteristics were associated with COVID-19 vaccination decisions. The collinearity analysis among the 5C determinants and six additional factors suggested that the six new variables are additional determinants of vaccination decisions.
{"title":"An examination of factors beyond the 5C Model in COVID-19 Vaccine Uptake Decisions","authors":"Junyu Zhao, C. Or","doi":"10.54941/ahfe1003480","DOIUrl":"https://doi.org/10.54941/ahfe1003480","url":null,"abstract":"A delay in accepting or a refusal of vaccination despite the availability of vaccination services is referred to as vaccine hesitancy. Vaccine hesitancy has gained increased attention, particularly since the outbreak of the COVID-19 pandemic. The most commonly used framework in studies of vaccine hesitancy and its determinants has been the 5C model. The 5C model posits that the five individual-level determinants influencing vaccine hesitancy are confidence, complacency, constraints, calculation, and a feeling of collective responsibility. However, other factors that may also be important in influencing vaccine hesitancy, such as sociodemographic and psychological determinants, have received less attention. Objectives: This study analyzed 1) the effectiveness of the 5C model in predicting the COVID-19 vaccination decision and 2) the association between COVID-19 vaccination decisions and the fear of being infected with COVID-19, attitude toward the media’s COVID-19 vaccination information, monetary incentives, political attitudes, perception of Hong Kong’s future, and attitude toward the vaccination advice of authorities (government officials and healthcare professionals). Methods: This study used data collected in an online questionnaire distributed from May 2022 to June 2022 during the fifth wave of the Omicron variants in Hong Kong. The questionnaire had 32 items measuring the COVID-19 vaccination status, demographic characteristics, the five determinants of the 5C model, and the following six additional factors: 1) fear of being infected with COVID-19, 2) attitude toward the media’s COVID-19 vaccination information, 3) monetary incentive, 4) political attitudes, 5) perception of Hong Kong’s future, and 6) attitude toward the vaccination advice of authorities. Results and Conclusions: For the 5C determinants, only confidence was significantly positively associated with COVID-19 vaccination, whereas complacency, constraints, and collective responsibility were associated when a relaxed p-value (p ≤ 0.25) was used. For the six additional factors, only attitude toward the media’s COVID-19 vaccination information was significantly positively correlated with vaccination status, and when a relaxed p-value (p ≤ 0.25) was used, a fear of being infected with COVID-19, political attitudes, and perception of Hong Kong's future was found to be associated. There was no evidence that calculation, monetary incentives, attitude toward the vaccination advice from authorities, or demographic characteristics were associated with COVID-19 vaccination decisions. The collinearity analysis among the 5C determinants and six additional factors suggested that the six new variables are additional determinants of vaccination decisions.","PeriodicalId":389399,"journal":{"name":"Healthcare and Medical Devices","volume":"9 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"1900-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"125479725","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
General Practitioners (GPs) report frustration in locating, customising and prioritising data in Electronic Health Records, which impairs their situation awareness (SA) and consequently impacts decision making and quality of care. Gaining SA in primary care before and during the clinical consultation is challenging, mainly due to barriers including time constraints, fragmented data, limitations in GP-patient interaction, usability issues of the Electronic Health Record (EHR) and information overload. This is enhanced with an increasing ageing population, and patients with multimorbidity. Timely and effective communication of information through data visualizations and visual analytics are promising avenues to address some of the GPs situation awareness needs and barriers, potentially supporting clinicians in making more accurate and rapid decisions. In this paper we propose a taxonomy of situation awareness failure factors in Primary Care, based on interviews with Primary Care GPs and Endsley’s SA error taxonomy. We then discuss design implications towards enhancing situation awareness in Primary Care when using EHR systems, supporting the potential of holistic visualisations to enhance SA before and during the clinical consultation.
{"title":"A Taxonomy of Situation Awareness Failure Factors in Primary Care","authors":"A. Patel, Porat Talya, Weston L. Baxter","doi":"10.54941/ahfe1003473","DOIUrl":"https://doi.org/10.54941/ahfe1003473","url":null,"abstract":"General Practitioners (GPs) report frustration in locating, customising and prioritising data in Electronic Health Records, which impairs their situation awareness (SA) and consequently impacts decision making and quality of care. Gaining SA in primary care before and during the clinical consultation is challenging, mainly due to barriers including time constraints, fragmented data, limitations in GP-patient interaction, usability issues of the Electronic Health Record (EHR) and information overload. This is enhanced with an increasing ageing population, and patients with multimorbidity. Timely and effective communication of information through data visualizations and visual analytics are promising avenues to address some of the GPs situation awareness needs and barriers, potentially supporting clinicians in making more accurate and rapid decisions. In this paper we propose a taxonomy of situation awareness failure factors in Primary Care, based on interviews with Primary Care GPs and Endsley’s SA error taxonomy. We then discuss design implications towards enhancing situation awareness in Primary Care when using EHR systems, supporting the potential of holistic visualisations to enhance SA before and during the clinical consultation.","PeriodicalId":389399,"journal":{"name":"Healthcare and Medical Devices","volume":"18 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"1900-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"127781187","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
J. Kalra, Zoher Rafid-Hamed, Chiamaka Okonkwo, Patrick J Seitzinger
Over recent years, adverse events and medical errors have become topics of increased concern in health care. Despite the efforts of healthcare organizations and providers to prevent medical errors and adverse events, medical errors are still inevitable. Disclosure of an adverse event is essential in managing a medical error's consequences. We have previously reviewed disclosure policies at the provincial level and found no uniform approach to disclosure in Canada. Effective communication between healthcare providers, patients, and their families throughout the disclosure process is vital in supporting and fostering the physician-patient relationship. Given the variability of medical error disclosure policies, comparing the disclosure process between different health authorities may allow us to better understand the best practice model given the proper parameters. Disclosure policies can provide a framework and guidelines for appropriate disclosure, leading to more transparent practices. The purpose of this study is to review and compare the disclosure policies implemented by individual health authorities across Canada. We will evaluate each policy based on the inclusion of the following key points: avoidance of blame; support to the staff; an apology or expression of regret; avoidance of speculation; some form of patient support; education/training to healthcare workers; immediate disclosure; team-based approach; accessibility; and documentation. The clinical significance of the study is to find similarities and differences between various health regions' policies of disclosure as well as report the best practice model for medical error disclosure across Canada. We suggest implementing a uniform national policy that addresses errors in a non-punitive manner and respects the patient's right to an honest disclosure. A prime role exists for the accrediting and regulatory authorities to initiate policy changes and appropriate reforms in the area. Not only should disclosing medical errors be a routine part of medical care to enhance quality improvement, but it would also protect patients' health and autonomy.
{"title":"Quality Care and Patient Safety: A Best Practice Model for Medical Error Disclosure","authors":"J. Kalra, Zoher Rafid-Hamed, Chiamaka Okonkwo, Patrick J Seitzinger","doi":"10.54941/ahfe1003478","DOIUrl":"https://doi.org/10.54941/ahfe1003478","url":null,"abstract":"Over recent years, adverse events and medical errors have become topics of increased concern in health care. Despite the efforts of healthcare organizations and providers to prevent medical errors and adverse events, medical errors are still inevitable. Disclosure of an adverse event is essential in managing a medical error's consequences. We have previously reviewed disclosure policies at the provincial level and found no uniform approach to disclosure in Canada. Effective communication between healthcare providers, patients, and their families throughout the disclosure process is vital in supporting and fostering the physician-patient relationship. Given the variability of medical error disclosure policies, comparing the disclosure process between different health authorities may allow us to better understand the best practice model given the proper parameters. Disclosure policies can provide a framework and guidelines for appropriate disclosure, leading to more transparent practices. The purpose of this study is to review and compare the disclosure policies implemented by individual health authorities across Canada. We will evaluate each policy based on the inclusion of the following key points: avoidance of blame; support to the staff; an apology or expression of regret; avoidance of speculation; some form of patient support; education/training to healthcare workers; immediate disclosure; team-based approach; accessibility; and documentation. The clinical significance of the study is to find similarities and differences between various health regions' policies of disclosure as well as report the best practice model for medical error disclosure across Canada. We suggest implementing a uniform national policy that addresses errors in a non-punitive manner and respects the patient's right to an honest disclosure. A prime role exists for the accrediting and regulatory authorities to initiate policy changes and appropriate reforms in the area. Not only should disclosing medical errors be a routine part of medical care to enhance quality improvement, but it would also protect patients' health and autonomy.","PeriodicalId":389399,"journal":{"name":"Healthcare and Medical Devices","volume":"23 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"1900-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"131380578","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Millions of concussions happen each year in the US alone. A proportionally large number of these concussions are due to high impact sports injury. Currently, there exists no solution to quickly monitor brain functions and test the oculomotor functions of individuals who have suffered a traumatic brain injury in order to diagnose them as having suffered a concussion. What is presently done to diagnose concussions is a CT scan or MRI, which are lengthy procedures to schedule, set up, and conduct; and furthermore, takes additional time to analyze the results in order to arrive at a diagnosis. This prolongation of the diagnosing process is inherently problematic since the longer time it takes between time of injury and time of diagnosis, there is greater risk of decisions and actions which can worsen damage to the brain. The sooner a concussion can be diagnosed, the sooner and better the treatment can be performed for recovery. In order to ameliorate this issue, we seek to develop a device to perform the function of diagnosis and monitoring of brain activity in a more rapid and timely manner. Literature review into the anatomy of vestibular and ocular brain functions was performed; as well as research into various testing and monitoring methodologies of these vestibular and ocular functions. One such method that has proven to be a reliable method for diagnosis is Vestibular Ocular Motor Screening (VOMS), which is a visual and balance test performed by a doctor with a patient. Further research was also done into existing technologies whose functionalities would allow the device in order to perform brain monitoring, visual testing, and ultimately diagnosis; namely EEG, VR, and infrared eye tracking. Currently, very few devices on the market take advantage of these technologies together for medical uses. A device incorporating these technologies together allows would allow for more consistent administering of visual tests and real-time monitoring of brain activity. With a functional prototype, user testing is to be performed in order to assess the function and viability of the device.
{"title":"A Novel Headset System Synchronizing Vision and EEG testing for a Rapid Assessment and Diagnosis of Concussions and Other Brain Injuries","authors":"David Edquilang, Jeff Feng","doi":"10.54941/ahfe1002125","DOIUrl":"https://doi.org/10.54941/ahfe1002125","url":null,"abstract":"Millions of concussions happen each year in the US alone. A proportionally large number of these concussions are due to high impact sports injury. Currently, there exists no solution to quickly monitor brain functions and test the oculomotor functions of individuals who have suffered a traumatic brain injury in order to diagnose them as having suffered a concussion. What is presently done to diagnose concussions is a CT scan or MRI, which are lengthy procedures to schedule, set up, and conduct; and furthermore, takes additional time to analyze the results in order to arrive at a diagnosis. This prolongation of the diagnosing process is inherently problematic since the longer time it takes between time of injury and time of diagnosis, there is greater risk of decisions and actions which can worsen damage to the brain. The sooner a concussion can be diagnosed, the sooner and better the treatment can be performed for recovery. In order to ameliorate this issue, we seek to develop a device to perform the function of diagnosis and monitoring of brain activity in a more rapid and timely manner. Literature review into the anatomy of vestibular and ocular brain functions was performed; as well as research into various testing and monitoring methodologies of these vestibular and ocular functions. One such method that has proven to be a reliable method for diagnosis is Vestibular Ocular Motor Screening (VOMS), which is a visual and balance test performed by a doctor with a patient. Further research was also done into existing technologies whose functionalities would allow the device in order to perform brain monitoring, visual testing, and ultimately diagnosis; namely EEG, VR, and infrared eye tracking. Currently, very few devices on the market take advantage of these technologies together for medical uses. A device incorporating these technologies together allows would allow for more consistent administering of visual tests and real-time monitoring of brain activity. With a functional prototype, user testing is to be performed in order to assess the function and viability of the device.","PeriodicalId":389399,"journal":{"name":"Healthcare and Medical Devices","volume":"1 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"1900-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"130024461","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
We owe the term ‘complementary medicine’ (1932) to Max Friedemann (according to WoS data). Determining who first applied the term ‘complementary approach’ to science would not be easy. Historians and philosophers of science, as well as specialists in the general methodology of sciences, would easily argue that science as a whole is based on the complementary approach. Unfortunately, those accustomed to the separation of individual disciplines (among whom there is no shortage of novices and luminaries of science) miss the important detail that ignoring such an approach leads directly to the dehumanization of science and harms the foundations of sustainable human development en bloc in almost every respect.An inspiring source for such reasoning can be found in the maxim “Let none but geometers enter here” at the entrance to the olive grove that is Plato’s Academy (387 BC to 529 AD), dedicated to the Athenian hero Akademos. Whoever already knew geometry and was given the honour of taking the first and subsequent steps in this symbolic university of antiquity became a living example of the complementary approach. Looking at science precisely from a historical and symbolic perspective entitles us to assign some questions (i.e. issues worthy of being recognized as scientific) to each new step; it also entitles us to assign methods, means and tools (figuratively the compass, ruler, etc.) to answers to these questions. Over time, the generalized sets of questions and answers from symbolic geometry evolved into the general methodology of the sciences, as part of logic.The author of this outline of the methodological foundations of the complementary approach in contemporary scientific research was inspired by four main premises: the achievements of the Lviv-Warsaw school of logic and the methodology of sciences; praxeology (i.e. Tadeusz Kotarbiński’s proper methodology); Albert N. Whitehead’s reflection on Science and the Modern Word; and the cognitive and social mission of innovative agonology. A simple model of the social mission of science is expressed by the triad ‘curiosity - understanding - applications’. The first two terms, on the one hand, show the origin of science ‘from curiosity to satisfying the need for understanding’. On the other hand, they are directly related to the postulate of freedom of scientific research and any idealization of the mission of science. The third part, applications, is admittedly meant to emphasize the positive aspects of science and the hope that, through scientific discoveries, the mission of dignified survival of homo sapiens can be realized with a clear emphasis on respect for all life, the natural environment and human dignity. Unfortunately, the third part of the triad also includes numerous pathologies. The most dangerous are the interferences of authorities and interest groups at various levels in the freedom of science. A sophisticated way to satisfy the selfish goals of these entities is the instrumental
{"title":"Complementary Medicine – An Example of the application of the Basic Research Method of Innovative Agonology","authors":"Roman Maciej Kalina","doi":"10.54941/ahfe1003944","DOIUrl":"https://doi.org/10.54941/ahfe1003944","url":null,"abstract":"We owe the term ‘complementary medicine’ (1932) to Max Friedemann (according to WoS data). Determining who first applied the term ‘complementary approach’ to science would not be easy. Historians and philosophers of science, as well as specialists in the general methodology of sciences, would easily argue that science as a whole is based on the complementary approach. Unfortunately, those accustomed to the separation of individual disciplines (among whom there is no shortage of novices and luminaries of science) miss the important detail that ignoring such an approach leads directly to the dehumanization of science and harms the foundations of sustainable human development en bloc in almost every respect.An inspiring source for such reasoning can be found in the maxim “Let none but geometers enter here” at the entrance to the olive grove that is Plato’s Academy (387 BC to 529 AD), dedicated to the Athenian hero Akademos. Whoever already knew geometry and was given the honour of taking the first and subsequent steps in this symbolic university of antiquity became a living example of the complementary approach. Looking at science precisely from a historical and symbolic perspective entitles us to assign some questions (i.e. issues worthy of being recognized as scientific) to each new step; it also entitles us to assign methods, means and tools (figuratively the compass, ruler, etc.) to answers to these questions. Over time, the generalized sets of questions and answers from symbolic geometry evolved into the general methodology of the sciences, as part of logic.The author of this outline of the methodological foundations of the complementary approach in contemporary scientific research was inspired by four main premises: the achievements of the Lviv-Warsaw school of logic and the methodology of sciences; praxeology (i.e. Tadeusz Kotarbiński’s proper methodology); Albert N. Whitehead’s reflection on Science and the Modern Word; and the cognitive and social mission of innovative agonology. A simple model of the social mission of science is expressed by the triad ‘curiosity - understanding - applications’. The first two terms, on the one hand, show the origin of science ‘from curiosity to satisfying the need for understanding’. On the other hand, they are directly related to the postulate of freedom of scientific research and any idealization of the mission of science. The third part, applications, is admittedly meant to emphasize the positive aspects of science and the hope that, through scientific discoveries, the mission of dignified survival of homo sapiens can be realized with a clear emphasis on respect for all life, the natural environment and human dignity. Unfortunately, the third part of the triad also includes numerous pathologies. The most dangerous are the interferences of authorities and interest groups at various levels in the freedom of science. A sophisticated way to satisfy the selfish goals of these entities is the instrumental ","PeriodicalId":389399,"journal":{"name":"Healthcare and Medical Devices","volume":"54 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"1900-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"127419795","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
The possibility of conducting human factors validations remotely becomes increasingly important, not only due to the COVID-19 pandemic. However, there is a lack of research addressing the reliability of remotely obtained data in the field of medical products. Observability seems to be a key factor and has therefore be ensured in remote setups. This research focuses on producing and analyzing first data to compare lab-based and remote-based setups. The goal is to evaluate if and under which circumstances human factors validations of medical devices could be conducted remotely and which methodological aspects must be considered. In a simulated human factors validation / usability test, two lab-based and two remote-based conditions were investigated. The lab-based observer was present in the test room during the evaluation. Afterwards, the session’s recording could be reviewed as a second variant of the lab-based observation. The remote-based observer had the recording as a resource for observation only and the chance to review it afterwards as a second condition. The observations were based on a simulated human factors validation for two different medical products (device and software). The main basis for data analysis was an observation protocol in which the individual actions to be performed were categorized by the two observer groups according to classification derived from FDA’s Human Factors Guidance. Five human factors professionals in the lab-based and the remote-based setup respectively, with prior knowledge about both products in focus of the evaluation, generated the protocol data. The datasets from the lab-based and the remote-based observations were compared regarding their level of agreement. In addition, the quality of observations was assessed by comparing them to a sample solution, including the effect of the setups on the observers’ cognitive workload. Descriptively assessed, any-two agreement and Cohen´s κ calculations showed differences in observations of the lab-based vs. remote-based setup that became smaller when potentially critical actions were in focus. For the medical software less than 10% of the observations differed compared to around 15% for the medical device considering only critical use errors. The quality of observations was slightly higher when the observer was on-site, and better overall for the medical device compared to medical software regarding percentual agreement with the sample solution. Interestingly, a particularly high cognitive workload occurred when the medical device was observed remotely comparing the total NASA-TLX scores between the setups. Findings do not seem to strongly favor either lab-based or remote-based setups. For the medical device, the lab-based observation seemed to be more appropriate while for the medical software the result is not clear. However, remote observation performed better for the medical software than for the medical device. Observing the evaluation remotely and verifying
{"title":"Comparison of Lab- and Remote-Based Human Factors Validation – A Pilot Study","authors":"Karoline Johnsen, Bernhard Wandtner, M. Thorwarth","doi":"10.54941/ahfe1002128","DOIUrl":"https://doi.org/10.54941/ahfe1002128","url":null,"abstract":"The possibility of conducting human factors validations remotely becomes increasingly important, not only due to the COVID-19 pandemic. However, there is a lack of research addressing the reliability of remotely obtained data in the field of medical products. Observability seems to be a key factor and has therefore be ensured in remote setups. This research focuses on producing and analyzing first data to compare lab-based and remote-based setups. The goal is to evaluate if and under which circumstances human factors validations of medical devices could be conducted remotely and which methodological aspects must be considered. In a simulated human factors validation / usability test, two lab-based and two remote-based conditions were investigated. The lab-based observer was present in the test room during the evaluation. Afterwards, the session’s recording could be reviewed as a second variant of the lab-based observation. The remote-based observer had the recording as a resource for observation only and the chance to review it afterwards as a second condition. The observations were based on a simulated human factors validation for two different medical products (device and software). The main basis for data analysis was an observation protocol in which the individual actions to be performed were categorized by the two observer groups according to classification derived from FDA’s Human Factors Guidance. Five human factors professionals in the lab-based and the remote-based setup respectively, with prior knowledge about both products in focus of the evaluation, generated the protocol data. The datasets from the lab-based and the remote-based observations were compared regarding their level of agreement. In addition, the quality of observations was assessed by comparing them to a sample solution, including the effect of the setups on the observers’ cognitive workload. Descriptively assessed, any-two agreement and Cohen´s κ calculations showed differences in observations of the lab-based vs. remote-based setup that became smaller when potentially critical actions were in focus. For the medical software less than 10% of the observations differed compared to around 15% for the medical device considering only critical use errors. The quality of observations was slightly higher when the observer was on-site, and better overall for the medical device compared to medical software regarding percentual agreement with the sample solution. Interestingly, a particularly high cognitive workload occurred when the medical device was observed remotely comparing the total NASA-TLX scores between the setups. Findings do not seem to strongly favor either lab-based or remote-based setups. For the medical device, the lab-based observation seemed to be more appropriate while for the medical software the result is not clear. However, remote observation performed better for the medical software than for the medical device. Observing the evaluation remotely and verifying ","PeriodicalId":389399,"journal":{"name":"Healthcare and Medical Devices","volume":"30 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"1900-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"127472560","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
J. Kalra, Zoher Rafid-Hamed, Lily Wiebe, Patrick J Seitzinger
Medical errors are a significant public health concern that affects patient care and safety. Highlighted as a substantial problem in the 1999 Institute of Medicine report, medical errors have become the third leading cause of death in the United States of America. Failure to inform the patient of adverse events caused by a medical error compromises patient autonomy. Disclosure of adverse events to patients and families is critical in managing the consequences of a medical error and essential for maintaining patient trust. When errors occur, healthcare practitioners are faced with the ethical and moral dilemmas of if and to whom to disclose the error. Healthcare providers face these disclosure dilemmas across all disciplines, locations, and generations and have far-reaching implications on healthcare quality and the progress of medicine. We have previously reported the Canadian provincial initiatives encouraging open disclosure of adverse events and have suggested its integration into a 'no-fault' model. Though similar in content, the Canadian provincial initiatives remain isolated because of their non-mandatory nature and absence of federal or provincial laws on disclosure. The purpose of this study was to review and compare the disclosure policies implemented by individual health care regions/authorities in various parts of Canada to identify quality issues related to medical error disclosure based on several ethical and professional principles. The complexities of medical error disclosure to patients present ideal opportunities for medical educators to probe how learners balance the moral complexities involved in error disclosure. Effective communication between health care providers, patients, and their families throughout the disclosure process is integral in sustaining and developing the physician-patient relationship. We believe that the disclosure policies can provide a framework and guidelines for appropriate disclosure, leading to more transparent practices. We suggest that disclosure practice can be improved by creating a uniform policy centered on addressing errors in a non-punitive manner and respecting the patient's right to an honest disclosure and be implemented as part of the standard of care.
{"title":"Medical Error Disclosure: A Quality Perspective and Ethical Dilemma in Healthcare Delivery","authors":"J. Kalra, Zoher Rafid-Hamed, Lily Wiebe, Patrick J Seitzinger","doi":"10.54941/ahfe1002107","DOIUrl":"https://doi.org/10.54941/ahfe1002107","url":null,"abstract":"Medical errors are a significant public health concern that affects patient care and safety. Highlighted as a substantial problem in the 1999 Institute of Medicine report, medical errors have become the third leading cause of death in the United States of America. Failure to inform the patient of adverse events caused by a medical error compromises patient autonomy. Disclosure of adverse events to patients and families is critical in managing the consequences of a medical error and essential for maintaining patient trust. When errors occur, healthcare practitioners are faced with the ethical and moral dilemmas of if and to whom to disclose the error. Healthcare providers face these disclosure dilemmas across all disciplines, locations, and generations and have far-reaching implications on healthcare quality and the progress of medicine. We have previously reported the Canadian provincial initiatives encouraging open disclosure of adverse events and have suggested its integration into a 'no-fault' model. Though similar in content, the Canadian provincial initiatives remain isolated because of their non-mandatory nature and absence of federal or provincial laws on disclosure. The purpose of this study was to review and compare the disclosure policies implemented by individual health care regions/authorities in various parts of Canada to identify quality issues related to medical error disclosure based on several ethical and professional principles. The complexities of medical error disclosure to patients present ideal opportunities for medical educators to probe how learners balance the moral complexities involved in error disclosure. Effective communication between health care providers, patients, and their families throughout the disclosure process is integral in sustaining and developing the physician-patient relationship. We believe that the disclosure policies can provide a framework and guidelines for appropriate disclosure, leading to more transparent practices. We suggest that disclosure practice can be improved by creating a uniform policy centered on addressing errors in a non-punitive manner and respecting the patient's right to an honest disclosure and be implemented as part of the standard of care.","PeriodicalId":389399,"journal":{"name":"Healthcare and Medical Devices","volume":"1 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"1900-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"115736688","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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