Eye-tracking analysis for situation awareness of incontinence pad changing during older adult nursing training: An observational study

AIM

This study aims to investigate eye tracking in the practical training of incontinence pad change, which is commonly required in older adult nursing.

BACKGROUND

Some competencies possessed by skilled and experienced personnel are difficult to verbalize into textbooks. However, this is crucial for education, especially nursing practice education. Eye-gaze analysis is one such tool that can aid the efficient transfer of knowledge to students. Therefore, eye-gaze analysis, a novel technology for visualizing situational awareness and decision-making, has recently gained traction in healthcare.

DESIGN

An observation study METHODS: Ten nursing faculty members and 13 nursing students with prior incontinence pad change experience participated in this study using an older adult simulator. There were two groups of students - S1 with more recent experience in older adult care and incontinence pad changing and S2 with less. Areas of interest (AOIs) during incontinence pad preparation and fitting were determined based on gaze fixation and the time spent fixating on these areas was compared.

RESULTS

Students took longer than nursing faculty members. When visualizing the eye movements between the AOIs in the network, the faculty nurses and S1 alternated their gaze between the new incontinence pad and the buttocks and between other AOIs. Simultaneously, S2 tended to gaze or stare only at the new incontinence pad.

CONCLUSION

The presented data may help interpret visual-based situational awareness and establish effective nursing education, especially in acquiring skills that are difficult to verbalize.

The free-viewing matrix task: A reliable measure of attention allocation in psychopathology

Aberrant attention allocation has been implicated in the etiology and maintenance of a range of psychopathologies. However, three decades of research, relying primarily on manual response-time tasks, have been challenged on the grounds of poor reliability of its attention bias indices. Here, in a large, multisite, international study we provide reliability information for a new eye-tracking-based measure of attention allocation and its relation to psychopathology and age. Data from 1567 participants, across a wide range of psychiatric diagnoses and ages, were aggregated from nine sites around the world. Of these, 213 participants also provided retest data. Acceptable overall internal consistency and test-retest reliability were observed among adult participants (Cronbach's alpha = 0.86 and r(213) = 0.89, respectively), as well as across all examined psychopathologies. Youth demonstrated lower internal consistency scores (Cronbach's alpha = 0.65). Finally, the percent dwell time index derived from the task statistically differentiated between healthy participants and participants diagnosed with social anxiety disorder, major depression, and post-traumatic stress disorder. These results potentially address a long-standing reliability crisis in this research field. Aberrant attention allocation patterns in a variety of psychiatric disorders may be targeted with the hope of affecting symptoms. The attention allocation index derived from the matrix task offers reliable means to measure such cognitive target engagement in clinical contexts.

A Scalable Off-the-Shelf Framework for Measuring Patterns of Attention in Young Children and its Application in Autism Spectrum Disorder

Autism spectrum disorder (ASD) is associated with deficits in the processing of social information and difficulties in social interaction, and individuals with ASD exhibit atypical attention and gaze. Traditionally, gaze studies have relied upon precise and constrained means of monitoring attention using expensive equipment in laboratories. In this work we develop a low-cost off-the-shelf alternative for measuring attention that can be used in natural settings. The head and iris positions of 104 16-31 months children, an age range appropriate for ASD screening and diagnosis, 22 of them diagnosed with ASD, were recorded using the front facing camera in an iPad while they watched on the device screen a movie displaying dynamic stimuli, social stimuli on the left and nonsocial stimuli on the right. The head and iris position were then automatically analyzed via computer vision algorithms to detect the direction of attention. Children in the ASD group paid less attention to the movie, showed less attention to the social as compared to the nonsocial stimuli, and often fixated their attention to one side of the screen. The proposed method provides a low-cost means of monitoring attention to properly designed stimuli, demonstrating that the integration of stimuli design and automatic response analysis results in the opportunity to use off-the-shelf cameras to assess behavioral biomarkers.

Hands-free Adjustment of the Microscope in Microneurosurgery

BACKGROUND

In microneurosurgery, the operating microscope plays a vital role. The classical neurosurgical operation is bimanual, that is, the microsurgical instruments are operated with both hands. Often, operations have to be carried out in narrow corridors at the depth of several centimeters. With current technology, the operator must manually adjust the field of view during surgery-which poses a disruption in the operating flow. Until now, technical adjuncts existed in the form of a mouthpiece to move the stereo camera unit or voice commands and foot pedals to control other interaction tasks like optical configuration. However, these have not been widely adopted due to usability issues. This study tests 2 novel hands-free interaction concepts based on head positioning and gaze tracking as an attempt to reduce the disruption during microneurosurgery and increase the efficiency of the user.

METHODS

Technical equipment included the Pentero 900 microscope (Carl Zeiss Microscopy GmbH, Jena, Germany), HTC Vive Pro (HTC, Taoyuan District (HQ), Taiwan), and an inbuilt 3D-printed target probe. Eleven neurosurgeons including 7 residents and 4 consultants participated in the study. The tasks created for this study were with the intention to mimic real microneurosurgical tasks to maintain applicative accuracy while testing the interaction concepts. The tasks involved visualization system adjustment to the specific target and touching the target. The first trial was conducted in a virtual reality setting applying the novel hands-free interaction concepts, and the second trial was conducted performing the same tasks on a 3D-printed target probe using manual field of view adjustment. The participants completed both trials with the same predetermined tasks, in order to validate the feasibility of the novel technology. The data collected for this study were obtained with the help of review protocols, detailed post-trial interviews, video and audio recordings, along with time measurements while performing the tasks.

RESULTS

The user study conducted at the Charité Hospital in Berlin found that the gaze-tracking and head-positioning- based microscope adjustment were 18% and 29% faster, respectively, than the classical bimanual adjustment of the microscope. Focused user interviews showed the users' proclivity for the new interaction concepts, as they offered minimal disruption between the simultaneous target selection and camera position adjustment.

CONCLUSIONS

The hands-free interaction concepts presented in this study demonstrated a more efficient execution of the microneurosurgical tasks than the classical manual microscope and were assessed to be more preferable by both residents and consultant neurosurgeons.