The Effect of training, aim pattern and target type on the ergonomics and efficiency of handheld scanners

Handheld scanning is a prevalent industrial task that is prone to injury due to the repetitive motion of the task. Studies conducted with Rochester Institute of Technology and Honeywell have sought to discover the ergonomic and efficiency benefits of various scanning technologies and methods. One factor not fully investigated in these earlier works is the effect of training on the proper use of scanners. This thesis study compares trained and untrained user performance and ergonomics during a series of scanning tasks using a hand held omni-directional scanner. Comparison is based on such variables as target type (image that is scanned), aiming pattern (image projected from scanner) and time stress (self-paced versus time stress paced). Through this study is the potential to assess the value of training on efficiency and ergonomics during hand held scanner use. A trained and an untrained group (each consisting of eight subjects) performed scanning tasks daily for ten days. Wrist postures and task completion times were recorded throughout the study as well as perceived comfort and usability. Results show that the untrained group tended to have greater wrist deviations and thus poorer ergonomics overall. With the exception of the first day, the trained and untrained groups did not differ in terms of efficiency. As a result of this first day difference, level of training seemed to affect efficiency over time resulting in a quick learning curve for the untrained group. There was a significant aim pattern-target type relationship for both training groups in terms of ergonomics and efficiency. Results suggest aim pattern preference was a function of training level. Under time stress, the effect on ergonomics depended on wrist posture and training level, but the trained group tended to have a more detrimental effect to ergonomics than the untrained group. As expected, efficiency increased under time stress, but time stress had no significant effect on perceived usability and comfort

Augmented Reality Technology to Facilitate Proficiency in Emergency Medical Procedures

Background: Augmented reality (AR) conveys an experience during which the user’s real-time environment is enhanced by computer-generated perceptual information; it is being investigated as a solution to enhance medical education and clinical practice. There is little literature on its utility for teaching emergency procedures. Methods: A within-subjects trial was performed comparing traditional training to AR guidance for two emergency procedures. Lay-subjects and emergency medical technicians received video training and AR guidance for performing bag-valve-mask ventilation and needle-decompression. Subjects performed both procedures in a simulation setting after each training modality. Subject performance, acceptability and usability were analyzed. Results: There was no difference in procedural performance between lay or EMT subjects for AR training, and no difference in subject-reported usefulness between the AR and control training. Conclusion: AR mediated guidance for emergency medical procedures is feasible and efficacious. Subject performance after AR training was statistically undistinguishable from a didactic educational modality

The impact of interoperability of electronic health records on ambulatory physician practices: a discrete-event simulation study

Background The effect of health information technology (HIT) on efficiency and workload among clinical and nonclinical staff has been debated, with conflicting evidence about whether electronic health records (EHRs) increase or decrease effort. None of this paper to date, however, examines the effect of interoperability quantitatively using discrete event simulation techniques.Objective To estimate the impact of EHR systems with various levels of interoperability on day-to-day tasks and operations of ambulatory physician offices.Methods Interviews and observations were used to collect workflow data from 12 adult primary and specialty practices. A discrete event simulation model was constructed to represent patient flows and clinical and administrative tasks of physicians and staff members.Results High levels of EHR interoperability were associated with reduced time spent by providers on four tasks: preparing lab reports, requesting lab orders, prescribing medications, and writing referrals. The implementation of an EHR was associated with less time spent by administrators but more time spent by physicians, compared with time spent at paper-based practices. In addition, the presence of EHRs and of interoperability did not significantly affect the time usage of registered nurses or the total visit time and waiting time of patients.Conclusion This paper suggests that the impact of using HIT on clinical and nonclinical staff work efficiency varies, however, overall it appears to improve time efficiency more for administrators than for physicians and nurses

Physician Perceptions of the Electronic Problem List in Pediatric Trauma Care.

OBJECTIVE: To describe physician perceptions of the potential goals, characteristics, and content of the electronic problem list (PL) in pediatric trauma. METHODS: We conducted 12 semistructured interviews with physicians involved in the pediatric trauma care process, including residents, fellows, and attendings from four services: emergency medicine, surgery, anesthesia, and pediatric critical care. Using qualitative content analysis, we identified PL goals, characteristics, and patient-related information from these interviews and the hospitals PL etiquette document of guideline. RESULTS: We identified five goals of the PL (to document the patients problems, to make sense of the patients problems, to make decisions about the care plan, to know who is involved in the patients care, and to communicate with others), seven characteristics of the PL (completeness, efficiency, accessibility, multiple users, organized, created before arrival, and representing uncertainty), and 22 patient-related information elements (e.g., injuries, vitals). Physicians suggested criteria for a PL varied across services with respect to goals, characteristics, and patient-related information. CONCLUSION: Physicians involved in pediatric trauma care described the electronic PL as ideally more than a list of a patients medical diagnoses and injuries. The information elements mentioned are typically found in other parts of the patients electronic record besides the PL, such as past medical history and labs. Future work is needed to evaluate the optimal design of the PL so that users with emergent cases, such as pediatric trauma, have access to key information related to the patients immediate problems