Journal of Clinical Monitoring and Computing

, Volume 28, Issue 5, pp 475–480

The influence of anaesthetists’ experience on workload, performance and visual attention during simulated critical incidents

  • Christian M. Schulz
  • Erich Schneider
  • Stefan Kohlbecher
  • Alexander Hapfelmeier
  • Fabian Heuser
  • Klaus J. Wagner
  • Eberhard F. Kochs
  • Gerhard Schneider
Original Research

Abstract

Development of accurate Situation Awareness (SA) depends on experience and may be impaired during excessive workload. In order to gain adequate SA for decision making and performance, anaesthetists need to distribute visual attention effectively. Therefore, we hypothesized that in more experienced anaesthetists performance is better and increase of physiological workload is less during critical incidents. Additionally, we investigated the relation between physiological workload indicators and distribution of visual attention. In fifteen anaesthetists, the increase of pupil size and heart rate was assessed in course of a simulated critical incident. Simulator log files were used for performance assessment. An eye-tracking device (EyeSeeCam) provided data about the anaesthetists’ distribution of visual attention. Performance was assessed as time until definitive treatment. T tests and multivariate generalized linear models (MANOVA) were used for retrospective statistical analysis. Mean pupil diameter increase was 8.1 % (SD ± 4.3) in the less experienced and 15.8 % (±10.4) in the more experienced subjects (p = 0.191). Mean heart rate increase was 10.2 % (±6.7) and 10.5 % (±8.3, p = 0.956), respectively. Performance did not depend on experience. Pupil diameter and heart rate increases were associated with a shift of visual attention from monitoring towards manual tasks (not significant). For the first time, the following four variables were assessed simultaneously: physiological workload indicators, performance, experience, and distribution of visual attention between “monitoring” and “manual” tasks. However, we were unable to detect significant interactions between these variables. This experimental model could prove valuable in the investigation of gaining and maintaining SA in the operation theatre.

Keywords

Eye-tracking Workload Situation awareness Visual attention Gaze behaviour EyeSeeCam 

Supplementary material

Supplementary material 1 (AVI 146371 kb)

Copyright information

© Springer Science+Business Media New York 2013

Authors and Affiliations

  • Christian M. Schulz
    • 1
  • Erich Schneider
    • 2
  • Stefan Kohlbecher
    • 2
  • Alexander Hapfelmeier
    • 3
  • Fabian Heuser
    • 1
  • Klaus J. Wagner
    • 1
  • Eberhard F. Kochs
    • 1
  • Gerhard Schneider
    • 4
  1. 1.Department of Anaesthesiology, Klinikum Rechts der IsarTechnische Universität MünchenMunichGermany
  2. 2.Institute of Clinical NeurosciencesLudwig-Maximilians-Universität MünchenMunichGermany
  3. 3.Institute of Medical Statistics and EpidemiologyTechnische Universität MünchenMunichGermany
  4. 4.Department of Anaesthesiology IUniversity Witten/Herdecke, Helios Clinic WuppertalWuppertalGermany

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