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Wooldridge AR, Morgan J, Ramadhani WA, Hanson K, Vazquez-Melendez E, Kendhari H, Shaikh N, Riech T, Mischler M, Krzyzaniak S, Barton G, Formella KT, Abbott ZR, Farmer JN, Ebert-Allen R, Croland T. Interactions in Sociotechnical Systems: Achieving Balance in the Use of an Augmented Reality Mobile Application. HUMAN FACTORS 2024; 66:658-682. [PMID: 35549474 DOI: 10.1177/00187208221093830] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
OBJECTIVE We explore relationships between barriers and facilitators experienced by users to understand dynamic interactions in sociotechnical systems and improve a mobile phone-based augmented reality application that teaches users about the contents of a standardized pediatric code cart. BACKGROUND Understanding interactions between performance obstacles and facilitators can provide guidance to (re)designing sociotechnical systems to improve system outcomes. Clinicians should know about contents and organization of code carts, and an augmented reality mobile application may improve that knowledge but changes the sociotechnical system in which they learn. Prior work identified barriers and facilitators impacting the use of this application-participants described dimensions together, indicating interactions that are explored in the current study. METHOD We conducted four focus groups (number of clinicians = 18) and two interviews with clinicians who used the application. We performed a secondary analysis of focus group data exploring interactions between previously identified barriers and facilitators to application use. We used epistemic network analysis to visualize these interactions. RESULTS Work system barriers interacted with barriers and facilitators interacted with facilitators to amplify cumulative negative or positive impact, respectively. Facilitators balanced barriers, mitigating negative impact. Facilitators also exacerbated barriers, worsening negative impact. CONCLUSION Barriers and facilitators interact and can amplify, balance, and exacerbate each other-notably, positives are not always positive. To obtain desired outcomes, interactions must be further considered in sociotechnical system design, for example, the potential improvements to the application we identified.
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Affiliation(s)
| | | | | | - Keith Hanson
- University of Illinois College of Medicine at Peoria, IL, USA
| | | | | | - Nadia Shaikh
- University of Illinois College of Medicine at Peoria, IL, USA
| | - Teresa Riech
- University of Illinois College of Medicine at Peoria, IL, USA
| | | | | | - Ginger Barton
- OSF HealthCare Children's Hospital of Illinois, Peoria, IL, USA
| | - Kyle T Formella
- Jump Simulation, Peoria, IL, USA
- OSF HealthCare, Peoria, IL, USA
| | | | - John N Farmer
- Jump Simulation, Peoria, IL, USA
- OSF HealthCare, Peoria, IL, USA
| | | | - Trina Croland
- University of Illinois College of Medicine at Peoria, IL, USA
- OSF HealthCare Children's Hospital of Illinois, Peoria, IL, USA
- Jump Simulation, Peoria, IL, USA
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Wooldridge AR, Ramadhani WA, Hanson K, Vazquez-Melendez E, Kendhari H, Shaikh N, Riech T, Mischler M, Krzyzaniak S, Barton G, Formella KT, Abbott ZR, Farmer JN, Ebert-Allen R, Croland T. Walking the line: balancing performance barriers and facilitators in an augmented reality mobile application for paediatric code cart training. ERGONOMICS 2022; 65:334-347. [PMID: 34253153 DOI: 10.1080/00140139.2021.1954685] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/22/2020] [Accepted: 07/07/2021] [Indexed: 06/13/2023]
Abstract
An augmented reality (AR) mobile smartphone application was developed for clinicians to improve their knowledge about the contents and organisation of a standardised paediatric code cart, an important tool in safe, effective paediatric resuscitations. This study used focus groups and interviews with 22 clinicians to identify work system barriers and facilitators to use of the application. We identified twelve dimensions of barriers and facilitators: convenience, device ownership, device size and type, gamification, interface design, movement/physical space, perception of others, spatial presence, technological experience, technological glitches, workload, and the perception and attitude towards code cart and resuscitation. These dimensions can guide improvement efforts, e.g. redesigning the interface, providing non-AR modes, improving the tutorial. We propose nine principles to guide the design of other digital health technologies incorporating AR. In particular, the workload demands created by using AR must be considered and accounted for in the design and implementation of such technologies. Practitioner summary: Augmented reality (AR) may prepare workers for situations that do not occur frequently. This study investigates barriers and facilitators to using an AR mobile smartphone application developed to improve clinician knowledge about code carts, leading to improvements to the application and principles to guide the design of other AR-based technologies.
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Affiliation(s)
- Abigail R Wooldridge
- Department of Industrial and Enterprise Systems Engineering, University of Illinois at Urbana-Champaign, Urbana, IL, USA
| | - Widya A Ramadhani
- Illinois School of Architecture, University of Illinois at Urbana-Champaign, Urbana, IL, USA
| | - Keith Hanson
- Department of Pediatrics, University of Illinois College of Medicine at Peoria, Peoria, IL, USA
| | - Elsa Vazquez-Melendez
- Department of Pediatrics, University of Illinois College of Medicine at Peoria, Peoria, IL, USA
| | - Harleena Kendhari
- Department of Pediatrics, University of Illinois College of Medicine at Peoria, Peoria, IL, USA
| | - Nadia Shaikh
- Department of Pediatrics, University of Illinois College of Medicine at Peoria, Peoria, IL, USA
| | - Teresa Riech
- Department of Pediatrics, University of Illinois College of Medicine at Peoria, Peoria, IL, USA
- Department of Emergency Medicine, University of Illinois College of Medicine at Peoria, Peoria, IL, USA
| | - Matthew Mischler
- Department of Pediatrics, University of Illinois College of Medicine at Peoria, Peoria, IL, USA
- Department of Emergency Medicine, University of Illinois College of Medicine at Peoria, Peoria, IL, USA
| | - Sara Krzyzaniak
- Department of Emergency Medicine, Stanford Medicine, Stanford, CA, USA
| | - Ginger Barton
- OSF Healthcare Children's Hospital of Illinois, Peoria, IL, USA
| | - Kyle T Formella
- Jump Simulation Center, Peoria, IL, USA
- OSF Healthcare, Peoria, IL, USA
| | - Zachary R Abbott
- Jump Simulation Center, Peoria, IL, USA
- OSF Healthcare, Peoria, IL, USA
| | - John N Farmer
- Jump Simulation Center, Peoria, IL, USA
- OSF Healthcare, Peoria, IL, USA
| | | | - Trina Croland
- Department of Pediatrics, University of Illinois College of Medicine at Peoria, Peoria, IL, USA
- Jump Simulation Center, Peoria, IL, USA
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