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Proceedings of the International Symposium of Human Factors and Ergonomics in Healthcare. International Symposium of Human Factors and Ergonomics in Healthcare最新文献

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Understanding the Use of Pharmacological Knowledge Base Tool Use for Safe Medication Management 了解使用药理学知识库工具进行安全用药管理
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引用次数: 0
Role of Trust in AI-Driven Healthcare Systems: Discussion from the Perspective of Patient Safety 信任在人工智能驱动的医疗系统中的作用:从患者安全的角度讨论
Mehmet Bilal Unver, Onur Asan
In the field of healthcare, enhancing patient safety depends on several factors (e.g., regulation, technology, care quality, physical environment, human factors) that are interconnected. Artificial Intelligence (AI), along with an increasing realm of use, functions as a component of the overall healthcare system from a multi-agent systems viewpoint. Far from a stand-alone agent, AI cannot be held liable for the flawed decisions in healthcare. Also, AI does not have the capacity to be trusted according to the most prevalent definitions of trust because it does not possess emotive states or cannot be held responsible for their actions. A positive experience of AI reliance come to be indicative of ‘trustworthiness’ rather than ‘trust’, implying further consequences related to the patient safety. From a multi-agent systems viewpoint, ‘trust’ requires all the environmental, psychological and technical conditions being responsive to patient safety. It is fertilized for the overall system in which ‘responsibility’, ‘accountability’, ‘privacy’, ‘transparency; and ‘fairness’ need to be secured for all the parties involved in AI-driven healthcare, given the ethical and legal concerns and their threat to the trust.
在医疗保健领域,提高患者安全取决于几个相互关联的因素(例如,法规、技术、护理质量、物理环境、人为因素)。从多代理系统的角度来看,人工智能(AI)随着使用领域的增加,作为整个医疗保健系统的一个组成部分发挥作用。人工智能远不是一个独立的代理,它不能对医疗保健领域的错误决策负责。此外,根据最流行的信任定义,人工智能没有被信任的能力,因为它没有情绪状态,也不能对它们的行为负责。对人工智能的积极依赖表明了“可信赖性”而不是“信任”,这意味着与患者安全相关的进一步后果。从多主体系统的角度来看,“信任”要求所有环境、心理和技术条件都对患者安全作出反应。在整个系统中,“责任”、“问责制”、“隐私”、“透明度”;考虑到道德和法律问题以及它们对信任的威胁,人工智能驱动的医疗保健的所有相关方都需要确保“公平”。
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引用次数: 3
Simulating Emergency Medical Situations in Usability Testing 在可用性测试中模拟紧急医疗情况
Jonathan Avedikian, Stephanie DeMarco Bartlett
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引用次数: 0
Team Coordination Dynamics Measurement in Enroute Care Training: Defining Requirements and Usability Study 全程护理培训中的团队协调动态测量:需求定义与可用性研究
Jennifer Winner, Jayde M. King, Jamie C. Gorman, David A. Grimm
Prior research indicates a need for objective and reliable measures of team communication and coordination. This need rings true for United States Air Force (USAF) teams, whose instructors heavily employ subjective evaluations within fast-paced training. Instructors must observe a multitude of teams and their communications, leaving room for varied evaluations and missed opportunities for feedback. Recent studies have advanced and tested team coordination measures based on dynamical systems theory, yielding results that illustrate the relationship between team communication flow and performance. This work leverages those measures and applies them in the context of USAF medical training. In this study, we assess the usability of a Team Dynamics Measurement System prototype. Users (n = 4) completed 15 tasks and evaluated system usability, perceived mental effort, system satisfaction, and task difficulty. Results indicate marginally acceptable overall system usability. These results helped identify essential interface modifications for future iterations. Future work and use cases for instructor support are discussed.
先前的研究表明,需要客观可靠的团队沟通和协调措施。这种需求对美国空军(USAF)团队来说是真实的,他们的教官在快节奏的训练中大量使用主观评估。教师必须观察多个团队及其沟通,为各种评估留出空间,并错过反馈的机会。最近的研究在动力系统理论的基础上提出并测试了团队协调措施,得出的结果说明了团队沟通流与绩效之间的关系。这项工作利用了这些措施,并将其应用于美国空军医学培训。在本研究中,我们评估了团队动力测量系统原型的可用性。用户(n = 4)完成了15个任务,并评估了系统可用性、感知心理努力、系统满意度和任务难度。结果表明总体系统可用性勉强可以接受。这些结果有助于为将来的迭代确定必要的接口修改。讨论了讲师支持的未来工作和用例。
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引用次数: 1
Conducting User Experience Interviews during a Clinical Trial 在临床试验期间进行用户体验访谈
B. Loring
Over the course of two years, the author and colleagues conducted user experience (UX) research as part of two clinical trials. This paper describes the research methodology, the challenges encountered, the rewards, and the lessons learned from the experience. The subject of the clinical trials was a novel treatment for a degenerative disease that has no cure and few successful treatments. The trials involved pairs of patients and caregivers and lasted up to 12 months. The ability to compare the perceived effectiveness of the treatment and changes in quality of life with the clinical endpoints helped guide the design of the treatment regimen, and the experience was rewarding for the UX researchers themselves.
在两年的时间里,作者及其同事进行了用户体验(UX)研究,作为两项临床试验的一部分。本文描述了研究方法,遇到的挑战,回报,以及从经验中吸取的教训。临床试验的主题是一种治疗退行性疾病的新方法,这种疾病无法治愈,也很少有成功的治疗方法。这些试验涉及成对的患者和护理人员,持续时间长达12个月。与临床终点比较治疗的感知有效性和生活质量变化的能力有助于指导治疗方案的设计,并且经验对UX研究人员本身是有益的。
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引用次数: 0
Over Triage: Injury Classification Mistake or Hindsight Bias? 伤情分类:损伤分类错误还是后见之明?
Richard Simonson, J. Keebler, Rosemarie Fernandez, E. Lazzara, Alex Chaparro
Patient triage is a critical stage in providing patients with the appropriate level of care required. Multiple metrics are considered in determining appropriate triage at the time of assessment. Due to the complexity of healthcare intervention, patients are often under- or over-triaged. Initiatives to reduce incorrect triages have been developed and implemented. These initiatives, however, may be based on hindsight bias and subsequently result in inaccurate assessments of triage accuracy and lead to improper triage-based education initiatives. This submission proposes the application of the SEIPS framework as a method of mitigating challenges introduced in the triage accuracy assessments due to this potential hindsight bias.
患者分诊是为患者提供所需的适当护理水平的关键阶段。在评估时,在确定适当的分类时要考虑多个指标。由于医疗干预的复杂性,患者往往是不足或过度分类。已经制定和实施了减少错误分类的措施。然而,这些举措可能基于后见之明的偏见,随后导致对分诊准确性的不准确评估,并导致不适当的基于分诊的教育举措。本意见书建议应用SEIPS框架,作为减轻因这种潜在的后见之明偏见而在分诊准确性评估中引入的挑战的方法。
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引用次数: 0
From Reactive to Proactive Safety: Joint Activity Monitoring for Infection Prevention. 从被动安全到主动安全:预防感染的联合活动监测。
Dane A Morey, Michael F Rayo, Mengyun Li

Despite the promise of a proactive approach to safety, a lack of resources and tangible measures have limited its implementation in organizations. We are exploring Joint Activity Monitoring (JAM) as one key component of a proactive safety program within the domain of infection prevention. However, despite a conceptual alignment to the requirements of a proactive monitoring capability, our experiences instrumenting daily work tools with the capabilities to support continuous, unobtrusive, real-time monitoring have revealed additional organizational and technological requirements. In this paper, we describe our strategies and challenges in developing this capability and discuss implications for supporting successful proactive safety implementations.

尽管承诺采取积极主动的安全措施,但缺乏资源和切实措施限制了其在组织中的实施。我们正在探索联合活动监测(JAM)作为感染预防领域主动安全计划的一个关键组成部分。然而,尽管在概念上与主动监视能力的需求保持一致,但是我们使用日常工作工具来支持连续的、不引人注目的、实时的监视的经验已经揭示了额外的组织和技术需求。在本文中,我们描述了开发这种能力的策略和挑战,并讨论了支持成功的主动安全实现的含义。
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引用次数: 3
FUN AND GAMES: DESIGNING A GAMIFIED CENTRAL VENOUS CATHETERIZATION TRAINING SIMULATOR. 趣味与游戏:设计一个游戏化的中心静脉置管训练模拟器。
Haroula M Tzamaras, Jason Martinez, Dailen C Brown, Jessica M Gonzalez-Vargas, Jason Z Moore, Scarlett R Miller

Gamification, or adding elements of games to training systems, has the potential to increase learner engagement and information retention. However, the use of gamification has yet to be explored in Central Venous Catheterization (CVC) trainers which teach a commonly performed medical procedure with high incidence rates. In order to combat these errors, a Dynamic Haptic Robotic Trainer (DHRT) was developed, which focuses on vessel identification and access. A DHRT+ system is currently under development that focuses on whole procedure training (e.g. sterilization and catheter insertion), including a gamified Graphical User Interface. The goal of this paper was to (1) develop a game-like, patient-centered interface to foster personalized learning and (2) understand the perceived utility of gamification for CVC skill development with expert doctors. This paper outlines some of the potential benefits and deficits of the use of gamification in medical trainers that can be used to drive simulation design.

游戏化,或将游戏元素添加到训练系统中,有可能提高学习者的参与度和信息保留率。然而,游戏化的使用尚未在中心静脉导管(CVC)培训师中进行探索,该培训师教授一种常见的高发病率医疗程序。为了克服这些错误,开发了一种动态触觉机器人训练器(DHRT),专注于船只识别和访问。DHRT+系统目前正在开发中,专注于全过程培训(如灭菌和导管插入),包括游戏化图形用户界面。本文的目标是(1)开发一个类似游戏的、以患者为中心的界面,以促进个性化学习;(2)与专家医生一起了解游戏化对CVC技能发展的感知效用。本文概述了在医学训练器中使用游戏化的一些潜在好处和不足,这些训练器可用于驱动模拟设计。
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引用次数: 0
Creation of a High Fidelity, Cost Effective, Real World Surgical Simulation for Surgical Education 创造高保真度,成本效益,真实世界的外科模拟外科教育
L. Stewart, E. De La Rosa
Background How do surgical residents learn to operate? What is a surgical plane? How does one learn to see and dissect the plane? How do surgical residents learn tissue handling and suturing (sewing)? One method to learn and practice performing surgery is through the use of simulation training. Surgical training models include laparoscopic box trainers (a plastic box with holes for instruments) with synthetic materials inside to simulate tissues, or computer-based virtual reality simulation for laparoscopic, endoscopic, and robotic techniques. These methods, however, do not use real tissues. They lack the haptic and kinesthetic feedback of real tissue. These simulations fail to recreate the fidelity of soft tissues, do not foster the ability to accurately see surgical planes, do not accurately mimic the act of dissecting surgical planes, do not allow for complex surgical procedures, and do not provide accurate experience to learn tissue handling and suturing. Despite their poor performance, these plastic and virtual trainers are extremely costly to purchase, maintain, and keep up to date - with prices starting at $700 for basic plastic training boxes to thousands of dollars for virtual simulation. Also, there are additional costs of maintenance and software curriculum. Despite the cost of software, virtual simulators do not include a simulation for every surgery. Our aim was to create a life-like surgical simulation as close to real world as possible that allows trainees to learn how to see and dissect surgical planes, learn how soft tissues move, and learn the dynamics of soft tissue manipulation. We created a laparoscopic simulator using porcine tissues for gallbladder removal, acid reflux surgery, and surgery to treat swallowing difficulties (cholecystectomy, Nissen fundoplication, and Heller myotomy, respectively). Second year general surgery residents were able to practice these procedures on real tissues, enabling them to learn the steps of each procedure, increase manual dexterity, improve use of laparoscopic equipment, all while maintaining life-like haptic, soft-tissue feedback and enabling them to develop the ability to see real surgical planes. Methods The abdomen was recreated by purchasing intact porcine liver, gallbladder, (Cholecystectomy simulation) and intact esophagus, stomach, and diaphragm (Nissen and Heller simulation) from a packing supplier. Each organ system was placed into a laparoscopic trainer box with the ability to re-create laparoscopic ports. Surgical residents were then able to perform the procedures using real laparoscopic instruments, laparoscopic camera/video imaging, and real-time electrocautery. The simulation included all critical steps of each procedure such as obtaining the critical view of safety and removing the gallbladder from the liver bed (cholecystectomy), wrapping the stomach around the esophagus and laparoscopic suturing (Nissen fundoplication), and dissecting the muscular portion of the esophageal
背景外科住院医师如何学习手术?什么是外科飞机?一个人如何学会观察和解剖飞机呢?外科住院医师如何学习组织处理和缝合?一种学习和练习外科手术的方法是通过模拟训练。手术训练模型包括腹腔镜盒子训练器(一种带有器械孔的塑料盒子),里面有合成材料来模拟组织,或者基于计算机的腹腔镜、内窥镜和机器人技术的虚拟现实模拟。然而,这些方法不使用真实的组织。它们缺乏真实组织的触觉和动觉反馈。这些模拟不能重建软组织的保真度,不能培养准确看到手术平面的能力,不能准确模拟解剖手术平面的行为,不允许复杂的外科手术,也不能提供准确的经验来学习组织处理和缝合。尽管它们的性能很差,但这些塑料和虚拟训练器的购买、维护和更新都非常昂贵——从基本的塑料训练盒700美元到虚拟模拟的数千美元不等。此外,还有维护和软件课程的额外费用。尽管软件成本很高,但虚拟模拟器并不包括对每一次手术的模拟。我们的目标是创造一个逼真的手术模拟,尽可能接近现实世界,让学员学习如何看到和解剖手术平面,学习软组织如何移动,并学习软组织操纵的动力学。我们用猪组织制作了一个腹腔镜模拟器,用于胆囊切除、胃酸反流手术和治疗吞咽困难的手术(分别为胆囊切除术、尼森盆底切除术和海勒肌切开术)。第二年,普通外科住院医生能够在真实的组织上练习这些程序,使他们能够学习每个程序的步骤,提高手的灵活性,改善腹腔镜设备的使用,同时保持栩栩如生的触觉,软组织反馈,使他们能够发展看到真实手术平面的能力。方法从包装供应商处购买完整的猪肝、胆囊(胆囊切除术模拟)和完整的食管、胃和膈(Nissen和Heller模拟)重建腹部。每个器官系统被放置在一个能够重建腹腔镜端口的腹腔镜训练箱中。外科住院医师随后能够使用真正的腹腔镜器械、腹腔镜摄像机/视频成像和实时电灼进行手术。模拟包括每个手术的所有关键步骤,如获得安全的关键视图并从肝床取出胆囊(胆囊切除术),将胃包裹在食管周围并进行腹腔镜缝合(Nissen底复制),以及解剖食管壁的肌肉部分(Heller肌切开术)。由于这些猪组织很容易获得,因此在每次会议期间建立了几个站点来教授多名居民(10-12名居民/会议)。外科医生通过皮肤或触觉反馈和动觉反馈来发展软组织的触觉知觉(Okamura, 2009)。动觉反馈是指软组织沿腹腔镜器械轴传递的力和压力(Okamura, 2009)。这种软组织模拟重现了在正常手术环境之外体验软组织反馈感觉的能力。真实的组织学习可以让学员学习如何看到手术平面,学习软组织的感觉和运动,提高手术解剖的熟练程度,并学习如何在腹腔镜下缝合。这是唯一一个在手术环境外重建软组织运动和可视化解剖平面的模型。由于该模型使用了手术室中使用的腹腔镜器械,住院医师也熟悉了腹腔镜器械,从而平坦了另一条学习曲线。文献回顾发现,这是唯一真正的组织模拟进行前肠程序专门用于住院医师培训。通过建立具有固有准确软组织手术平面的真实解剖模型,外科学员可以在安全、低压的环境中获得更真实的手术经验和技能,而不会牺牲肝脏学习和手术可视化,这对安全进行腹腔镜手术至关重要。所有参与刺激的住院医生都报告了积极的反馈,并认为这有助于他们的外科教育。
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引用次数: 0
Can We Use Design Approaches to Increase Comfort and Reduce Suffering at End-of-Life: A Focused Literature Review 我们是否可以使用设计方法来增加生命末期的舒适和减少痛苦:一篇重点文献综述
Meg Schwellnus, Chantal M. J. Trudel, Zsófia Orosz
End-of-life (EoL) care is often a difficult period for all involved: the person who is dying, their family and friends, and care providers. A review and analysis of literature on design for end-of-life care led to identifying common themes that may influence end-of-life experience, design categories which aim to support EoL care, and continuing challenges that may undermine EoL experience. An additional review researched impacts of the COVID-19 pandemic on EoL experiences. The results of both reviews are presented here, as well as some suggestions for future directions in EoL design.
临终关怀对所有相关人员来说通常都是一段困难的时期:临终者、他们的家人和朋友以及护理提供者。通过对临终关怀设计文献的回顾和分析,确定了可能影响临终体验的共同主题,旨在支持临终关怀的设计类别,以及可能破坏临终关怀体验的持续挑战。另一项综述研究了COVID-19大流行对EoL经验的影响。本文介绍了这两项研究的结果,并对EoL设计的未来方向提出了一些建议。
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引用次数: 0
期刊
Proceedings of the International Symposium of Human Factors and Ergonomics in Healthcare. International Symposium of Human Factors and Ergonomics in Healthcare
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