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  • 1.
    Andersson Granberg, Tobias
    et al.
    Linköping University, Department of Science and Technology, Communications and Transport Systems. Linköping University, Faculty of Science & Engineering.
    Jonson, Carl-Oscar
    Linköping University, Department of Biomedical and Clinical Sciences, Division of Surgery, Orthopedics and Oncology. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Regionledningskontoret, Center for Disaster Medicine and Traumatology.
    Prytz, Erik
    Linköping University, Department of Computer and Information Science, Human-Centered systems. Linköping University, Faculty of Arts and Sciences.
    Steins, Krisjanis
    Linköping University, Department of Science and Technology, Communications and Transport Systems. Linköping University, Faculty of Science & Engineering.
    Waldemarsson, Martin
    Linköping University, Department of Science and Technology, Communications and Transport Systems. Linköping University, Faculty of Science & Engineering.
    Sensor Requirements for Logistics Analysis of Emergency Incident Sites2020In: Proceedings of the 17th ISCRAM Conference / [ed] Amanda Lee Hughes, Fiona McNeill, Christopher Zobe, Information Systems for Crisis Response and Management , 2020, p. 952-960Conference paper (Refereed)
    Abstract [en]

    Using sensors to collect data at emergency incident sites can facilitate analysis of the logistic operations. This can be used to improve planning and preparedness for new operations. Furthermore, real-time information from the sensors can serve as operational decision support. In this work in progress, we investigate the requirements on the sensors, and on the sensor data, to facilitate such an analysis. Through observations of exercises, the potential of using sensors for data collection is explored, and the requirements are considered. The results show that the potential benefits are significant, especially for tracking patients, and understanding the interaction between the response actors. However, the sensors need to be quite advanced in order to capture the necessary data.

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  • 2.
    Arkestål, Lukas
    et al.
    Linköping University, Department of Biomedical and Clinical Sciences, Division of Surgery, Orthopedics and Oncology. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Regionledningskontoret, Center for Disaster Medicine and Traumatology.
    Friberg, Marc
    Linköping University, Department of Computer and Information Science, Human-Centered systems. Region Östergötland, Regionledningskontoret, Center for Disaster Medicine and Traumatology. Linköping University, Faculty of Arts and Sciences.
    Loftås, Per
    Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Center for Surgery, Orthopaedics and Cancer Treatment, Department of Surgery in Norrköping.
    Prytz, Erik
    Linköping University, Department of Computer and Information Science, Human-Centered systems. Linköping University, Faculty of Arts and Sciences. Region Östergötland, Regionledningskontoret, Center for Disaster Medicine and Traumatology.
    Jonson, Carl-Oscar
    Linköping University, Department of Biomedical and Clinical Sciences, Division of Surgery, Orthopedics and Oncology. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Regionledningskontoret, Center for Disaster Medicine and Traumatology.
    Junker, Johan
    Linköping University, Department of Biomedical and Clinical Sciences, Division of Surgery, Orthopedics and Oncology. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Regionledningskontoret, Center for Disaster Medicine and Traumatology.
    Development and validation of a Repeatable Exsanguination Simulator Using Live Tissue (RESULT)2023In: 2023 WADEM congress on disaster and emergency medicine, Killarney, Ireland, May 9-12., 2023, Vol. 38, p. s179-s180Conference paper (Refereed)
  • 3.
    Bengtsson, Kristofer
    et al.
    Linköping University, Department of Clinical and Experimental Medicine, Division of Clinical Sciences. Linköping University, Faculty of Medicine and Health Sciences.
    Jonson, Carl-Oscar
    Linköping University, Department of Clinical and Experimental Medicine, Division of Clinical Sciences. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Center for Disaster Medicine and Traumatology.
    Prytz, Erik G.
    Linköping University, Department of Computer and Information Science, Human-Centered systems. Linköping University, Faculty of Arts and Sciences.
    Framtidens skadeplats: intervjuer med landstingens beredskapssamordnare2016Report (Other academic)
    Abstract [sv]

    Syftet med föreliggande studie var att genom intervjuer med beredskapssamordnare från Sveriges landsting försöka skapa en bild av hur uppfattningen var att skadeplatsen såg ut idag och skulle kunna kommat att förändras på sikt. Vidare önskade intervjustudien söka svar på frågor som rörde komplexiteten på skadeplatsen genom att diskutera ledningsförhållanden, samverkan med andra aktörer, alarmerings- och dirigeringsfunktionernas roll i det svenska sjukvårdsystemet samt hur ett möjligt arbete med ett återtagande av förmågan till ett civilt försvar skulle påverka systemet i sin helhet. Överlag har detta syfte uppnåtts genom ett rikt material kring relevanta frågeställningar som belyst ett flertal kritiska aspekter både i dagens situation men även för framtiden.

    Resultatet ger en relativt entydig bild av hur situationen uppfattas på landstingsnivå idag av personalen som behandlar beredskapsfrågorna. Den bild som målas upp fokuserar kanske främst på en upplevd avsaknad av centrala och nationellt övergripande styrningar vilket menligt påverkar förmågan att lyfta ledningsförmågan från regional till nationell nivå vid en större händelse som överstiger den regionala förmågan. Den svenska modellen för att hantera samhällsstörningar av idag är väl anpassad för att hantera händelser inom ramen för det egna länets geografiska område. Befintliga koncept för samverkan och samordning bedöms fungera bra i vardagen, exempelvis vid de vanligaste fallen av skadeplatser: trafik och brand. Detta innebär dock att systemet fungerar väl under förutsättning att händelsen är begränsad i såväl tid och rum som vad avser antalet drabbade. En större händelse eller flera händelser samtidigt på olika platser, särskilt om det finns försvårande faktorer såsom utsläpp av farliga ämnen eller en högre hotbild, skapar försvårande omständigheter som upplevs svårhanterliga idag. I ett framtida scenario upplevs även risken för dessa händelser och terrorattacker att öka. Avhängigheten av IT samt ett samhälle som i allt högre grad förlitar sig på ”just in time”-leveranser gör att sårbarheten har ökat och upplevs fortsätta göra det även i framtiden. Andra viktiga områden som lyfts är nuvarande och befarad framtida brist på kompetent personal samt att utbildnings- och övningsverksamhet inte kan bedrivas i önskvärd utsträckning, delvis på grund av personalbrist och –omsättning.

    Vidare syns den generella uppfattningen vara att det saknas ett tydligt ledarskap på nationell nivå då det sällan, om alls, utkommer några direkta styrningar rörande vad som skall uppnås och i vilken utsträckning. Detta har också påvisats i avsnittet ovan rörande före-, under- och efterperspektivet där det finns en klart övervägande del synpunkter på de två förstnämnda perspektiven. Nationell styrning är alltså något som uppfattas vara efterfrågat och då inte bara avseende ledning under insats utan även i frågor rörande enhetlig utrustning och metodik samt utbildnings- och övningsfrågor. Få respondenter har tagit upp efterperspektivet i någon större utsträckning men då det har förekommit har det framförallt berört erfarenhetshanteringsfrågor och den brist som upplevs finnas inom detta specifika område idag. Erfarenheter från den egna verksamheten, såväl i vardagen som vid insatser vid allvarliga händelser, behöver tas om hand, följas upp och sedan utgöra grund för ett levande utvecklingsarbete.

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    Framtidens skadeplats: intervjuer med landstingens beredskapssamordnare
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  • 4.
    Berggren, Peter
    et al.
    Linköping University, Department of Computer and Information Science, Human-Centered systems. Linköping University, Faculty of Arts and Sciences. Region Östergötland, Center for Disaster Medicine and Traumatology.
    Pettersson, Jenny
    Linköping University, Department of Clinical and Experimental Medicine, Division of Surgery, Orthopedics and Oncology. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Center for Disaster Medicine and Traumatology.
    Jonson, Carl-Oscar
    Linköping University, Department of Clinical and Experimental Medicine, Division of Surgery, Orthopedics and Oncology. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Center for Disaster Medicine and Traumatology.
    Prytz, Erik
    Linköping University, Department of Computer and Information Science, Human-Centered systems. Linköping University, Faculty of Arts and Sciences.
    Carlsson, Henrik
    Linköping University, Department of Clinical and Experimental Medicine, Division of Surgery, Orthopedics and Oncology. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Center for Disaster Medicine and Traumatology.
    Nilsson, Heléne
    Linköping University, Department of Clinical and Experimental Medicine, Division of Surgery, Orthopedics and Oncology. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Center for Disaster Medicine and Traumatology.
    The importance of using the designated duty officers when assessing the medical response organization2017Conference paper (Other academic)
    Abstract [en]

    Background

    An important aspect of disaster medicine is to be proactive and respond quickly when disaster strikes. In Sweden, the role responsible for swift medical response on the regional level is the designated duty officer.

    Methods

    A large exercise to assess national medical response ability was conducted. Seven medical regional staffs (a total of 93 individuals participated as tested participants) were involved in handling a large train accident scenario. The exercise was run for 5 hours, where the different regional staffs were located at their regular command posts. The exercise was organized using Emergo Train Systems.

    Results

    Several capabilities were identified during the exercise as important for the organization to maintain the ability to handle a similar event: documentation and operational picture, communication and terminology, command of resources, strategy for distribution of resources, national co-ordination, and exercise development.

    The designated duty officers were central to the exercise in several aspects: 1) in developing and verifying a realistic scenario and preparing background information, 2) as participants in the exercise, 3) assessors of the staffs’ behaviors, and 4) as domain experts when interpreting the exercise outcome.

    Conclusions

    Using subject matter experts is central to many research domains. However, the more complex a situation is the larger the demand of expertise is. The technical platform allows for coordinating complex exercises, whereas the subject matter expert in terms of the designated duty officer is required to guarantee validity and reliability in these large-scale exercises.

    Key messages:

    • Running complex scenarios to train and test abilities requires subject matter experts in both planning, preparation, implementation, and assessment.

    • Sophisticated simulator and training platforms, such as Emergo Train Systems, facilitates while the designated duty officers are necessary to guarantee validity and reliability in the exercise.

  • 5.
    Berggren, Peter
    et al.
    Swedish Defence Resaerch Agency, Sweden.
    Prytz, Erik
    Old Dominion University, United States of America.
    Johansson, Björn
    Swedish Defence Resaerch Agency, Sweden.
    Nählinder, Staffan
    Swedish Defence Resaerch Agency, Sweden.
    The relationship between Workload, Teamwork, Situation Awareness, and Performance in Teams A microworld study2011In: Proceedings of the Human Factors and Ergonomics Society Annual Meeting, Sage Publications, 2011, Vol. 55, p. 851-855Conference paper (Refereed)
    Abstract [en]

    In modern military organizations teamwork performance is central, yet the underlying factors contributing to such performance are debated. The purpose of this paper was to investigate how several known teamwork measures relate to a prior model of operator performance (Nählinder et al, 2004). This study expands this model to the team level and in the command and control domain. Specifically, this paper studies the relationship between individual and team workload measures, situation awareness measures, and performance measures in 18 two-person teams.                 

    The study has two major findings: Firstly, the various team cognition measures statistically cluster into four meaningful concepts (workload, teamwork, situation awareness and performance).                 

    Secondly, a Structural Equation Model indicates that the relationship between the various individual and team measures can be described in a model resembling the model found in previous studies (Nählinder et al, 2004). In particular, the results show that the general workload in the microworld study has a negative effect on both teamwork and situation awareness. Teamwork, in turn, also affects situation awareness, which has major impact on performance.

  • 6.
    Berggren, Peter
    et al.
    Region Östergötland, Regionledningskontoret, Center for Disaster Medicine and Traumatology.
    Svensson, Filip
    Linköping University.
    Lampi, Maria
    Region Östergötland, Regionledningskontoret, Center for Disaster Medicine and Traumatology.
    Prytz, Erik
    Linköping University, Department of Computer and Information Science, Human-Centered systems. Linköping University, Faculty of Arts and Sciences.
    Battlefield trauma care2018In: Proceedings of the Human Factors and Ergonomics Society 62nd Annual Meeting, Sage Publications, 2018, Vol. 62, p. 634-638, article id 1Conference paper (Refereed)
    Abstract [en]

    Introduction: Rapid and structured medical care is important to increase wounded patients’ chances of survival in modern warfare. This requires a functioning medical chain. 

    Aim: The aim of this study was to expand the knowledge of how the battlefield trauma care affects patient outcome in situations with a large number of casualties in the Swedish armed forces. 

    Methods: An empirical study with a convergent parallel mixed methods design, which included observations and semi-structured interviews. 

    Results: The results show that the trauma care performed at Role 1-units functioned well. The most prominent issue discovered was deficiency in transportation resources for medical evacuation throughout the entire medical chain. 

    Conclusion: Despite that the trauma care performed at Role 1-units functions well, casualties are at risk for preventable complications or death. Improved transportation logistics are required to improve the medical capabilities of the Swedish armed forces.

  • 7.
    Berglund, Aseel
    et al.
    Linköping University, Department of Computer and Information Science, Software and Systems. Linköping University, Faculty of Science & Engineering.
    Berglund, Erik
    Linköping University, Department of Computer and Information Science, Human-Centered systems. Linköping University, Faculty of Science & Engineering.
    Siliberto, Fabio
    University of Roma La Sapienza, Italy.
    Prytz, Erik
    Linköping University, Department of Computer and Information Science, Human-Centered systems. Linköping University, Faculty of Arts and Sciences.
    Effects of Reactive and Strategic Game Mechanics in Motion-based Games2017In: 2017 IEEE 5TH INTERNATIONAL CONFERENCE ON SERIOUS GAMES AND APPLICATIONS FOR HEALTH (SEGAH), IEEE , 2017Conference paper (Refereed)
    Abstract [en]

    Motion-based games offer positive effects on physical, social, and mental health for the players and have been common during the past decade, enabled by commercial motion tracking devices. However, little is known about the impact of game mechanics on the player experience, movement, and performance in motion-based games. In this paper we present results from a study with 35 participants comparing two different game mechanics, one reactive and one strategic, for a casual motion-based game. The assumption was that a more strategic mechanic would lead to less movement but more enjoyment. However, there was no significant difference in player experience, performance, or movement between the two game mechanics. In addition, a key aspect for the players preferred game mechanics was the perceived amount of thinking the game mechanic required.

  • 8.
    Britt, Rebecca C
    et al.
    Department of Surgery, Eastern Virginia Medical School, Norfolk, VA, USA.
    Scerbo, Mark W
    Department of Psychology, Old Dominion University, Norfolk, VA, USA.
    Montano, Michael
    Department of Psychology, Old Dominion University, Norfolk, VA, USA.
    Kennedy, Rebecca A
    Department of Psychology, Old Dominion University, Norfolk, VA, USA.
    Prytz, Erik
    the Department of Psychology, Old Dominion University, Norfolk, VA, USA.
    Stefanidis, Dimitrios
    Carolinas Medical Center, Charlotte, NC, USA.
    Intracorporeal suturing: Transfer from Fundamentals of Laparoscopic Surgery to cadavers results in substantial increase in mental workload2015In: Surgery, ISSN 0039-6060, E-ISSN 1532-7361, Vol. 158, no 5, p. 1428-1433Article in journal (Refereed)
    Abstract [en]

    INTRODUCTION:

    A spatial secondary task developed by the authors was used to measure the mental workload of the participant when transferring suturing skills from a box simulator to more realistic surgical conditions using a fresh cadaver. We hypothesized that laparoscopic suturing on genuine bowel would be more challenging than on the Fundamentals of Laparoscopic Surgery (FLS)-simulated bowel as reflected in differences on both suturing and secondary task scores.

    METHODS:

    We trained 14 surgical assistant students to FLS proficiency in intracorporeal suturing. Participants practiced suturing on the FLS box for 30 minutes and then were tested on both the FLS box and the bowel of a fresh cadaver using the spatial, secondary dual-task conditions developed by the authors.

    RESULTS:

    Suturing times increased by >333% when moving from the FLS platform to the cadaver F(1,13) = 44.04, P < .001. The increased completion times were accompanied by a 70% decrease in secondary task scores, F(1,13) = 21.21, P < .001.

    CONCLUSION:

    The mental workload associated with intracorporeal suturing increases dramatically when trainees transfer from the FLS platform to human tissue under more realistic conditions of suturing. The increase in mental workload is indexed by both an increase in suturing times and a decrease in the ability to attend to the secondary task.

  • 9.
    Brodin, Wilhelm
    et al.
    Linköping University, Department of Computer and Information Science, Human-Centered systems. Linköping University, Faculty of Arts and Sciences.
    Friberg, Marc
    Linköping University, Department of Computer and Information Science, Human-Centered systems. Region Östergötland, Regionledningskontoret, Center for Disaster Medicine and Traumatology. Linköping University, Faculty of Arts and Sciences. Linköping University, Department of Biomedical and Clinical Sciences. Linköping University, Faculty of Medicine and Health Sciences.
    Jonson, Carl-Oscar
    Linköping University, Department of Biomedical and Clinical Sciences, Division of Surgery, Orthopedics and Oncology. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Regionledningskontoret, Center for Disaster Medicine and Traumatology.
    Prytz, Erik
    Linköping University, Department of Computer and Information Science, Human-Centered systems. Linköping University, Faculty of Arts and Sciences. Region Östergötland, Regionledningskontoret, Center for Disaster Medicine and Traumatology. Linköping University, Department of Biomedical and Clinical Sciences. Linköping University, Faculty of Medicine and Health Sciences.
    The effect of cold hands on immediate responder's tourniquet application ability: A within-group trial2023In: Human Factors in Healthcare, ISSN 2772-5014, Vol. 3, article id 100038Article in journal (Refereed)
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  • 10. Brodin, Wilhelm
    et al.
    Friberg, Marc
    Linköping University, Department of Computer and Information Science, Human-Centered systems. Region Östergötland, Regionledningskontoret, Center for Disaster Medicine and Traumatology. Linköping University, Faculty of Arts and Sciences.
    Jonson, Carl-Oscar
    Linköping University, Department of Biomedical and Clinical Sciences, Division of Surgery, Orthopedics and Oncology. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Regionledningskontoret, Center for Disaster Medicine and Traumatology.
    Prytz, Erik
    Linköping University, Department of Computer and Information Science, Human-Centered systems. Linköping University, Faculty of Arts and Sciences. Region Östergötland, Regionledningskontoret, Center for Disaster Medicine and Traumatology.
    The Effect of Different Degrees of Cold Exposure on Medical Laypeople’s Tourniquet Application Time and Quality: A Within-Group Trial2023In: 2023 WADEM congress on disaster and emergency medicine, 2023, Vol. 38, no S1, p. s15-s15Conference paper (Refereed)
  • 11.
    Brodin, Wilhelm
    et al.
    Linköping University, Department of Computer and Information Science, Human-Centered systems. Linköping University, Faculty of Arts and Sciences.
    Friberg, Marc
    Region Östergötland, Regionledningskontoret, Center for Disaster Medicine and Traumatology. Linköping University, Department of Computer and Information Science, Human-Centered systems. Linköping University, Faculty of Science & Engineering. Linköping University, Department of Biomedical and Clinical Sciences. Linköping University, Faculty of Medicine and Health Sciences.
    Jonson, Carl-Oscar
    Linköping University, Department of Biomedical and Clinical Sciences, Division of Surgery, Orthopedics and Oncology. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Regionledningskontoret, Center for Disaster Medicine and Traumatology.
    Prytz, Erik
    Linköping University, Department of Computer and Information Science, Human-Centered systems. Linköping University, Faculty of Arts and Sciences. Region Östergötland, Regionledningskontoret, Center for Disaster Medicine and Traumatology. Linköping University, Faculty of Medicine and Health Sciences. Linköping University, Department of Biomedical and Clinical Sciences.
    The Effect of Presence of Blood on Medical Laypeople’s Ability to Perform First Aid for Massive Bleeding2022In: Proceedings of the Human Factors and Ergonomics Society Annual Meeting, 2022, p. 251-255Conference paper (Refereed)
    Abstract [en]

    There are currently several educational initiatives to teach first aid courses for medical laypeople, such as the Stop the Bleed campaign. Although much research on educational initiatives has been conducted, there are still factors that remain unexplored, such as the potential effects of blood itself on laypeople’s first aid performance and educational experience. This study investigates such potential effects for performance of the first aid techniques tourniquet application and wound packing, in relation to individual differences in disgust sensitivity and medical fear of blood. The results show that the presence of blood will increase the time a medical layperson takes to apply a tourniquet and pack a wound but does not affect the quality of the aid. Additionally, the disgust sensitivity of the medical layperson was found to predict an increase in application time for the wound packing task, but not the tourniquet application task, when blood was present.

  • 12.
    Bång, Magnus
    et al.
    Linköping University, Department of Computer and Information Science, Human-Centered systems. Linköping University, The Institute of Technology.
    Prytz, Erik
    Linköping University, Department of Computer and Information Science, Human-Centered systems. Linköping University, The Institute of Technology.
    Rybing, Jonas
    Linköping University, Department of Computer and Information Science, Human-Centered systems. Linköping University, The Institute of Technology.
    Timpka, Toomas
    Linköping University, Department of Medical and Health Sciences, Division of Community Medicine. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Center for Health and Developmental Care, Center for Public Health.
    Cognitive design of a digital desk for the emergency room setting2014In: 2014 AMIA Annual Symposium / [ed] Westra, Bonnie L, Oxford University Press, 2014Conference paper (Refereed)
  • 13. Forsyth, K. L.
    et al.
    Lowndes, B. R.
    Abdelrahman, A.
    Prytz, Erik
    Linköping University, Department of Computer and Information Science, Human-Centered systems. Linköping University, Faculty of Arts and Sciences.
    Jonson, Carl-Oscar
    Linköping University, Department of Biomedical and Clinical Sciences, Division of Surgery, Orthopedics and Oncology. Linköping University, Faculty of Medicine and Health Sciences.
    Sztajnkrycer, M. D.
    Franz, W. B.
    Blocker, R. C.
    Hallbeck, M. S.
    A Preliminary Investigation of Clinician Perspectives and Just-in-Time Guidance for Tourniquet Use2017Conference paper (Other academic)
  • 14.
    Forsyth, Katherine
    et al.
    Mayo Clinic, Robert D. and Patricia E. Kerns Center for the Science of Health Care Delivery, Rochester, MN, USA / Mayo Clinic, Department of Health Sciences Research, Rochester, MN, USA.
    Lowndes, Bethany
    Mayo Clinic, Robert D. and Patricia E. Kerns Center for the Science of Health Care Delivery, Rochester, MN, USA / Mayo Clinic, Department of Health Sciences Research, Rochester, MN, USA.
    Prytz, Erik
    Linköping University, Department of Computer and Information Science, Human-Centered systems. Linköping University, Faculty of Arts and Sciences.
    Jonson, Carl-Oscar
    Region Östergötland, Center for Disaster Medicine and Traumatology. Linköping University, Faculty of Medicine and Health Sciences.
    Matthew, Sztajnkrycer
    Mayo Clinic, Department of Surgery, Rochester, MN, USA.
    Heller, Stephanie
    Mayo Clinic, Department of Emergency Medicine, Rochester, MN, USA.
    Hallbeck, Susan
    Mayo Clinic, Robert D. and Patricia E. Kerns Center for the Science of Health Care Delivery, Rochester, MN, USA / Mayo Clinic, Department of Health Sciences Research, Rochester, MN, USA.
    Blocker, Renaldo
    Mayo Clinic, Robert D. and Patricia E. Kerns Center for the Science of Health Care Delivery, Rochester, MN, USA / Mayo Clinic, Department of Health Sciences Research, Rochester, MN, USA.
    Improving Instructions to Stop the Bleed2017In: Proceedings of the Human Factors and Ergonomics Society 2017 Annual Meting, Santa Monica: Human Factors and Ergonomics Society, HFES , 2017, p. 588-592Conference paper (Refereed)
    Abstract [en]

    The Stop The Bleed initiative was developed by the Department of Homeland Security to educate lay providers in bleeding reduction strategies. The current study evaluated: (1)three tourniquet instructions using a simulated tourniquet task and (2)participant confidence levels in tourniquet use and lay provider training. Thirty participants with limited clinical experience applied a tourniquet to a simulated limb using one of three instruction sets. Twelve of these participants (40%) participated in a tourniquet training session and focus group to discuss each instruction set. Participants preferred the most simple and pictoral instruction set, and identified opportunities for improvement in each set. Participant confidence in tourniquet use increased significantly following the task and the focus group. After the focus group, participant confidence in instructing lay providers on proper tourniquet use significantly increased. Adding key steps, contextual pictures, and indicators of success to instructions could support lay providers stop the bleed in life-threatening situations

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    Improving Instructions to Stop the Bleed
  • 15.
    Friberg, Marc
    et al.
    Linköping University, Department of Computer and Information Science, Human-Centered systems. Region Östergötland, Regionledningskontoret, Center for Disaster Medicine and Traumatology. Linköping University, Faculty of Arts and Sciences.
    Brodin, Wilhelm
    Jonson, Carl-Oscar
    Linköping University, Department of Biomedical and Clinical Sciences, Division of Surgery, Orthopedics and Oncology. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Regionledningskontoret, Center for Disaster Medicine and Traumatology.
    Prytz, Erik
    Linköping University, Department of Computer and Information Science, Human-Centered systems. Linköping University, Faculty of Arts and Sciences. Region Östergötland, Regionledningskontoret, Center for Disaster Medicine and Traumatology.
    The Effects of Including Blood in First Aid Training on Confidence in Bleeding Control Ability and Intent to Aid2023In: 2023 WADEM congress on disaster and emergency medicine, 2023, Vol. 38, no S1, p. s14-s14Conference paper (Refereed)
  • 16.
    Friberg, Marc
    et al.
    Linköping University, Department of Computer and Information Science, Human-Centered systems. Linköping University, Faculty of Science & Engineering.
    Jonson, Carl-Oscar
    Linköping University, Department of Biomedical and Clinical Sciences, Division of Surgery, Orthopedics and Oncology. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Regionledningskontoret, Center for Disaster Medicine and Traumatology.
    Jaeger, Victor
    Linköping University.
    Prytz, Erik
    Linköping University, Department of Computer and Information Science, Human-Centered systems. Linköping University, Faculty of Arts and Sciences. Region Östergötland, Regionledningskontoret, Center for Disaster Medicine and Traumatology.
    The Effects of Stress on Tourniquet Application and CPR Performance in Layperson and Professional Civilian Populations2023In: Human Factors, ISSN 0018-7208, E-ISSN 1547-8181, Vol. 65, no 3, p. 496-507, article id 00187208211021255Article in journal (Refereed)
    Abstract [en]

    Objective The purpose of this study was to compare laypeoples and professional first responders ability to perform tourniquet application and cardiopulmonary resuscitation (CPR) during calm and stressful circumstances. Background Life-threatening bleeding is a major cause of death that could be prevented by fast and appropriate first aid interventions. Therefore, laypeople are now being trained in bleeding control skills, transforming them from bystanders to immediate responders. However, critics have questioned whether laypeople are able to perform during more stressful conditions. Method Twenty-four laypersons and 31 professional first responders were tested in two conditions: a calm classroom scenario and a stressful scenario consisting of paintball fire and physical exertion. Stress and workload were assessed along with task performance. Results The experimental manipulation was successful in terms of eliciting stress reactions. Tourniquet application performance did not decline in the stressful condition, but some aspects of CPR performance did for both groups. First responders experienced higher task engagement and lower distress, worry and workload than the laypeople in both the calm and stressful conditions. Conclusion Stress did not affect first responders and laypeople differently in terms of performance effects. Stress should therefore not be considered a major obstacle for teaching bleeding control skills to laypeople. Application Tourniquet application can be taught to laypeople in a short amount of time, and they can perform this skill during stress in controlled settings. Concerns about laypeoples ability to perform under stress should not exclude bleeding control skills from first aid courses for civilian laypeople.

  • 17.
    Goolsby, Craig
    et al.
    UCLA, CA USA; UCLA, CA 90502 USA.
    Jonson, Carl-Oscar
    Linköping University, Department of Biomedical and Clinical Sciences, Division of Surgery, Orthopedics and Oncology. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Regionledningskontoret, Center for Disaster Medicine and Traumatology.
    Goralnick, Eric
    Harvard Med Sch, MA USA.
    Dacuyan-Faucher, Nicole
    Natl Ctr Disaster Med & Publ Hlth Med, MD USA; Henry M Jackson Fdn Advancement Mil Med Inc, MD USA.
    Schuler, Keke
    Natl Ctr Disaster Med & Publ Hlth Med, MD USA; Henry M Jackson Fdn Advancement Mil Med Inc, MD USA.
    Kothera, Curt
    InnoVital Syst Inc, MD USA.
    Shah, Amit
    InnoVital Syst Inc, MD USA.
    Cannon, Jeremy
    Univ Penn, PA USA.
    Prytz, Erik
    Linköping University, Department of Computer and Information Science, Human-Centered systems. Linköping University, Faculty of Arts and Sciences. Region Östergötland, Regionledningskontoret, Center for Disaster Medicine and Traumatology.
    The Untrained Publics Ability to Apply the Layperson Audiovisual Assist Tourniquet vs a Combat Application Tourniquet: A Randomized Controlled Trial2023In: Journal of the American College of Surgeons, ISSN 1072-7515, E-ISSN 1879-1190, Vol. 236, no 1, p. 178-186Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: Although the Stop the Bleed campaigns impact is encouraging, gaps remain. These gaps include rapid skill decay, a lack of easy-to-use tourniquets for the untrained public, and training barriers that prevent scalability. A team of academic and industry partners developed the Layperson Audiovisual Assist Tourniquet (LAVA TQ)& mdash;the first audiovisual-enabled tourniquet for public use. LAVA TQ addresses known tourniquet application challenges and is novel in its design and technology. STUDY DESIGN: This study is a prospective, randomized, superiority trial comparing the ability of the untrained public to apply LAVA TQ to a simulated leg vs their ability to apply a Combat Application Tourniquet (CAT). The study team enrolled participants in Boston, MA; Frederick, MD; and Linkoping, Sweden in 2022. The primary outcome was the proportion of successful applications of each tourniquet. Secondary outcomes included: mean time to application, placement position, reasons for failed application, and comfort with the devices. RESULTS: Participants applied the novel LAVA TQ successfully 93% (n = 66 of 71) of the time compared with 22% (n = 16 of 73) success applying CAT (relative risk 4.24 [95% CI 2.74 to 6.57]; p &lt; 0.001). Participants applied LAVA TQ faster (74.1 seconds) than CAT (126 seconds ; p &lt; 0.001) and experienced a greater gain in comfort using LAVA TQ than CAT. CONCLUSIONS: The untrained public is 4 times more likely to apply LAVA TQ correctly than CAT. The public also applies LAVA TQ faster than CAT and has more favorable opinions about its usability. LAVA TQs highly intuitive design and built-in audiovisual guidance solve known problems of layperson education and skill retention and could improve public bleeding control. (c) 2022 by the American College of Surgeons. Published by Wolters Kluwer Health, Inc. All rights reserved.

  • 18.
    Goralnick, Eric
    et al.
    Brigham & Womens Hosp, USA.
    Ezeibe, Chibuike
    Brigham & Womens Hosp, USA.
    Chaudhary, Muhammad Ali
    Brigham & Womens Hosp, USA.
    McCarty, Justin
    Brigham & Womens Hosp, USA.
    Herrera-Escobar, Juan P.
    Brigham & Womens Hosp, USA.
    Andriotti, Tomas
    Brigham & Womens Hosp, MA 02115 USA.
    de Jager, Elzerie
    Brigham & Womens Hosp, MA 02115 USA.
    Ospina-Delgado, Daniel
    Beth Israel Deaconess Med Ctr, USA.
    Goolsby, Craig
    Uniformed Serv Univ Hlth Sci,USA; Natl Ctr Disaster Med & Publ Hlth,USA.
    Hunt, Richard
    Dept Hlth & Human Serv, USA.
    Weissman, Joel S.
    Brigham & Womens Hosp, USA.
    Haider, Adil
    Brigham & Womens Hosp, USA; Aga Khan Univ, Pakistan.
    Jacobs, Lenworth
    Hartford Hosp, USA.
    Prytz, Erik (Contributor)
    Linköping University, Department of Computer and Information Science, Human-Centered systems. Linköping University, Faculty of Arts and Sciences.
    Defining a Research Agenda for Layperson Prehospital Hemorrhage Control A Consensus Statement2020In: JAMA Network Open, E-ISSN 2574-3805, Vol. 3, no 7, article id e209393Article in journal (Refereed)
    Abstract [en]

    Importance  Trauma is the leading cause of death for US individuals younger than 45 years, and uncontrolled hemorrhage is a major cause of trauma mortality. The US military’s medical advancements in the field of prehospital hemorrhage control have reduced battlefield mortality by 44%. However, despite support from many national health care organizations, no integrated approach to research has been made regarding implementation, epidemiology, education, and logistics of prehospital hemorrhage control by layperson immediate responders in the civilian sector.

    Objective  To create a national research agenda to help guide future work for prehospital hemorrhage control by laypersons.

    Evidence Review  The 2-day, in-person, National Stop the Bleed (STB) Research Consensus Conference was conducted on February 27 to 28, 2019, to identify and achieve consensus on research gaps. Participants included (1) subject matter experts, (2) professional society–designated leaders, (3) representatives from the federal government, and (4) representatives from private foundations. Before the conference, participants were provided a scoping review on layperson prehospital hemorrhage control. A 3-round modified Delphi consensus process was conducted to determine high-priority research questions. The top items, with median rating of 8 or more on a Likert scale of 1 to 9 points, were identified and became part of the national STB research agenda.

    Findings  Forty-five participants attended the conference. In round 1, participants submitted 487 research questions. After deduplication and sorting, 162 questions remained across 5 a priori–defined themes. Two subsequent rounds of rating generated consensus on 113 high-priority, 27 uncertain-priority, and 22 low-priority questions. The final prioritized research agenda included the top 24 questions, including 8 for epidemiology and effectiveness, 4 for materials, 9 for education, 2 for global health, and 1 for health policy.

    Conclusions and Relevance  The National STB Research Consensus Conference identified and prioritized a national research agenda to support laypersons in reducing preventable deaths due to life-threatening hemorrhage. Investigators and funding agencies can use this agenda to guide their future work and funding priorities.

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  • 19.
    Hermelin, Jonas
    et al.
    Swedish Defence Research Agency (FOI), Stockholm, Sweden.
    Bengtsson, Kristofer
    Swedish Defence Research Agency (FOI), Stockholm, Sweden.
    Woltjer, Rogier
    Swedish Defence Research Agency (FOI), Stockholm, Sweden.
    Trnka, Jiri
    Swedish Defence Research Agency (FOI), Stockholm, Sweden.
    Thorstensson, Mirko
    Swedish Defence Research Agency (FOI), Stockholm, Sweden.
    Pettersson, Jenny
    Linköping University, Department of Biomedical and Clinical Sciences, Division of Surgery, Orthopedics and Oncology. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Regionledningskontoret, Center for Disaster Medicine and Traumatology.
    Prytz, Erik
    Linköping University, Department of Clinical and Experimental Medicine. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Regionledningskontoret, Center for Disaster Medicine and Traumatology.
    Jonson, Carl-Oscar
    Linköping University, Department of Biomedical and Clinical Sciences, Division of Surgery, Orthopedics and Oncology. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Regionledningskontoret, Center for Disaster Medicine and Traumatology.
    Operationalising resilience for disaster medicine practitioners: capability development through training, simulation and reflection2020In: Cognition, Technology & Work, ISSN 1435-5558, E-ISSN 1435-5566, Vol. 22, no 3, p. 667-683Article in journal (Refereed)
    Abstract [en]

    Resilience has in recent decades been introduced as a term describing a new perspective within the domains of disaster management and safety management. Several theoretical interpretations and definitions of the essence of resilience have been proposed, but less work has described how to operationalise resilience and implement the concept within organisations. This case study describes the implementation of a set of general resilience management guidelines for critical infrastructure within a Swedish Regional Medical Command and Control Team. The case study demonstrates how domain-independent guidelines can be contextualised and introduced at an operational level, through a comprehensive capability development programme. It also demonstrates how a set of conceptual and reflective tools consisting of educational, training and exercise sessions of increasing complexity and realism can be used to move from high-level guidelines to practice. The experience from the case study demonstrates the value of combining (1) developmental learning of practitioners’ cognitive skills through resilience-oriented reflection and interaction with dynamic complex open-ended problems; (2) contextualisation of generic guidelines as a basis for operational methodological support in the operational environment; and (3) the use of simulation-based training as part of a capability development programme with increasing complexity and realism across mixed educational, training and exercise sessions. As an actual example of a resilience implementation effort in a disaster medicine management organisation, the study contributes to the body of knowledge regarding how to implement the concept of resilience in operational practice.

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  • 20.
    Hooke, Alexander
    et al.
    Biomechanics Core Mayo Clinic, Rochester, MN, USA.
    Hallbeck, Susan M.
    Mayo Clinic, Robert D. and Patricia E. Kerns Center for the Science of Health Care Delivery, Rochester, MN, USA.
    Prytz, Erik
    Linköping University, Department of Computer and Information Science, Human-Centered systems. Linköping University, Faculty of Arts and Sciences.
    Jonson, Carl-Oscar
    Linköping University, Department of Clinical and Experimental Medicine, Division of Surgery, Orthopedics and Oncology. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Center for Disaster Medicine and Traumatology.
    Tissue Properties during Tourniquet Application: Mechanical Assessment Informing Design of Trainers2019Conference paper (Other academic)
  • 21.
    Hooke, Alexander W.
    et al.
    Mayo Clin, MN 55905 USA.
    Hallbeck, M. Susan
    Mayo Clin, MN 55905 USA.
    Prytz, Erik
    Linköping University, Department of Computer and Information Science, Human-Centered systems. Linköping University, Faculty of Arts and Sciences.
    Jonson, Carl-Oscar
    Linköping University, Department of Biomedical and Clinical Sciences, Division of Surgery, Orthopedics and Oncology. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Regionledningskontoret, Center for Disaster Medicine and Traumatology.
    Lowndes, Bethany R.
    Mayo Clin, MN 55905 USA; Univ Nebraska Med Ctr, NE 68198 USA.
    Mechanical Assessment of Tissue Properties During Tourniquet Application2021In: Military medicine, ISSN 0026-4075, E-ISSN 1930-613X, Vol. 186, p. 378-383Article in journal (Refereed)
    Abstract [en]

    Introduction: Successful tourniquet application increases survival rate of exsanguinating extremity hemorrhage victims. Tactile feedback during tourniquet application training should reflect human tissue properties in order to increase success in the field. This study aims to understand the mechanical properties of a human limb during tourniquet application. Method: Six cadaveric extremities-three uppers and three lowers-were tested from three body mass index groups: low (&lt;19) healthy (19-24), and overweight (&gt;24). Each specimen donned with a tourniquet and mounted to a servo-hydraulic testing machine, which enabled controlled tightening of the tourniquet while recording the tourniquet tension force and strap displacement. A thin-film pressure sensor placed between the specimen and the tourniquet recorded contact pressure. Each limb was tested with the tourniquet applied at two different sites resulting in testing at the upper arm, forearm, thigh, and shank. Results: The load displacement curves during radial compression were found to be nonlinear overall, with identifiable linear regions. Average contact pressure under the tourniquet strap at 200N and 300N of tension force was 126.3 (sigma= 41.2) mm Hg and 205.3 (sigma = 75.3) mm Hg, respectively. There were no significant differences in tissue stiffness or contact pressure at 300N of tension force between limb (upper vs. lower) or body mass index. At 200N of tension, the upper limb had significantly higher contact pressure than the lower limb (P= 0.040). Relative radial compression was significantly different between upper (16.74, sigma = 4.16%) and lower (10.15, sigma = 2.25%) extremities at 200N tension (P= 0.005). Conclusions: Simulation of tissue compression during tourniquet application may be achieved with a material exhibiting elastic properties to mimic the force-displacement behavior seen in cadaveric tissue or with different layers of material. Different trainers for underweight, healthy, and overweight limbs may not be needed. Separate tourniquet training fixtures should be created for the upper and lower extremities.

  • 22.
    Iversen, Katarina
    et al.
    Linköping University.
    Jonson, Carl-Oscar
    Linköping University, Department of Biomedical and Clinical Sciences, Division of Surgery, Orthopedics and Oncology. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Regionledningskontoret, Center for Disaster Medicine and Traumatology.
    Prytz, Erik
    Linköping University, Department of Computer and Information Science, Human-Centered systems. Linköping University, Faculty of Arts and Sciences. Region Östergötland, Regionledningskontoret, Center for Disaster Medicine and Traumatology.
    Uppföljning av Stop the Bleed-utbildning för räddningstjänsten2021Report (Other academic)
    Abstract [sv]

    I ett samarbete mellan Linköpings universitet och MSB (Myndigheten för samhällsskydd och beredskap) har ett utbildningskoncept baserat på STB (Stop the Bleed) för svensk räddningstjänst tagits fram (Prytz & Jonson, 2019). I samband med utvecklingen av utbildningen genomfördes pilotutbildningar under 2018 och 2019 med Sörmlandskustens Räddningstjänst, Räddningstjänsten i Eskilstuna och Västra Sörmlands Räddningstjänst. Forskning har visat att kunskaperna från utbildning i blödningskontrollerande åtgärder börjar förfalla så snart som 30 dagar efter genomförd utbildning (Pasley et al., 2018), liksom för andra kunskaper som hjärt-lungräddning (HLR; Madden, 2006; Moser & Coleman, 1992; Broomfield, 1996, Zieber & Sedgewick, 2018). Det finns därför ett behov av fler uppföljningsstudier efter utbildningar i blödningskontroll för att förstå hur kunskaper bibehålls över tid (Goralnick et al., 2020). Vidare finns även ett behov att följa upp den praktiska nyttan av utbildningar i blödningskontrollerande första hjälpen-åtgärder och effekten på räddningstjänstens förmåga. 

    Den aktuella studien är en uppföljningsstudie av pilotutbildningen som genomfördes 2018/2019. Forskningsfrågorna som ämnades besvaras i studien var:

    1. Hur har kunskaperna om blödningskontroll förändrats under den tid som gått sedan utbildningen 2018/2019? 
    2. Har den räddningstjänstpersonal som utbildades i blödningskontroll haft praktisk nytta av utbildningen? Hur förberedda upplevde de sig vara i de situationerna? 
    3. Har erfarenheter av skarpa situationer påverkat tilltron personalen har till sin egen förmåga att hantera svåra blödningar? 

    Studien genomfördes som en kvantitativ enkätstudie. Totalt deltog 48 representanter från räddningstjänsterna i Sörmland i studien. Resultatet visar inledningsvis att kunskapsnivån hos räddningstjänstpersonalen är fortsatt hög med goda resultat på kunskapsprovet. Nivån är dock något lägre 2021 än vad den var 2018/2019. Vidare visade resultaten att en majoritet av den räddningstjänstpersonal som svarade på enkäten har hanterat skarpa situationer med blödningar efter att de genomfört pilotutbildningen och att den upplevda nyttan med utbildningen var hög. Deltagarnas självförtroenden gällande hanteringen av skarpa situationer var högre efter utbildningen, jämfört med skarpa situationer de upplevt innan utbildningen. Över lag visar resultatet att denna typ av utbildning ökar räddningstjänstens förmåga att hantera händelser där det förekommer allvarliga blödningar, och att räddningstjänstpersonalen är positivt inställda till utbildningar i den form som gavs i pilotutbildningen 2018/2019.

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  • 23.
    Jonson, Carl-Oscar
    et al.
    Linköping University, Department of Clinical and Experimental Medicine, Division of Surgery, Orthopedics and Oncology. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Center for Disaster Medicine and Traumatology.
    Andersson, Felix
    Linköping University, Department of Clinical and Experimental Medicine. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Center for Disaster Medicine and Traumatology.
    Prytz, Erik
    Linköping University, Department of Computer and Information Science, Human-Centered systems. Linköping University, Faculty of Arts and Sciences. Linköping University, Department of Clinical and Experimental Medicine. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Center for Disaster Medicine and Traumatology.
    Efficacy of Video-Based Instructions for Laypeople Bleeding Control Education2019In: Prehospital and Disaster Medicine, ISSN 1049-023X, E-ISSN 1945-1938, Vol. 34, no s1, p. 90-90Article in journal (Other academic)
    Abstract [en]

    Introduction:

    The Stop the Bleed campaign in the United States aims to teach bleeding control techniques, such as tourniquets, to the public. Educational consortium guidelines advocate using brief web- or video-based material. Another option is posters or flyers distributed at, for example, workplaces or public spaces.

    Aim:

    The aim of the current study was to evaluate the relative efficacy between a flyer and a video to teach tourniquet application skills to members of the public in Sweden.

    Methods:

    A total of 38 participants (27 male, 11 female) from the general public completed the study. Their ages ranged from 19 to 73 (M=32, SD=14). None had prior experience with tourniquet applications. One group (n=18) received tourniquet instructions on a flyer and one (n=20) received a 5-minute video instruction. Both groups completed pre- and post-questionnaires and a practical tourniquet application test.

    Results:

    Independent samples t-tests showed that the video-based instructions resulted in fewer application errors (M=1.40 out of 10, SD=1.19) compared to the flyer group (M=3.61, SD=2.40), t(36)=3.651, p=0.001, and higher post-task satisfaction (M=3.89 out of 5, SD=0.74 compared to M=3.39, SD=1.15). However, the flyer-group was faster (M=86.22 seconds, SD=27.28) compared to the video group (M=112.25, SD=42.22), t(36)=2.229, p=0.032.

    Discussion:

    Video instructions appear superior to flyers in terms of teaching correct tourniquet application to the general public. The longer total application time includes steps taken after bleeding control has been achieved (e.g. securing tourniquet straps and time notation), which may have contributed to the application time difference. The results support the educational guidelines that suggest video-based instructions for teaching basic tourniquet skills to laypeople are more effective.

  • 24.
    Jonson, Carl-Oscar
    et al.
    Linköping University, Department of Biomedical and Clinical Sciences, Division of Surgery, Orthopedics and Oncology. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Regionledningskontoret, Center for Disaster Medicine and Traumatology.
    Pettersson, Jenny
    Linköping University, Department of Biomedical and Clinical Sciences, Division of Surgery, Orthopedics and Oncology. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Regionledningskontoret, Center for Disaster Medicine and Traumatology.
    Friberg, Marc
    Linköping University, Department of Computer and Information Science, Human-Centered systems. Region Östergötland, Regionledningskontoret, Center for Disaster Medicine and Traumatology. Linköping University, Faculty of Arts and Sciences.
    Björnqvist, Anton
    Region Östergötland, Regionledningskontoret, Center for Disaster Medicine and Traumatology. Linköping University, Department of Computer and Information Science, Human-Centered systems. Linköping University, Faculty of Arts and Sciences.
    Berggren, Peter
    Linköping University, Department of Computer and Information Science, Human-Centered systems. Linköping University, Faculty of Arts and Sciences. Region Östergötland, Regionledningskontoret, Center for Disaster Medicine and Traumatology.
    Johansson, Björn
    Linköping University, Department of Computer and Information Science, Human-Centered systems. Linköping University, Faculty of Arts and Sciences.
    Prytz, Erik
    Linköping University, Department of Computer and Information Science, Human-Centered systems. Linköping University, Faculty of Arts and Sciences. Region Östergötland, Regionledningskontoret, Center for Disaster Medicine and Traumatology.
    Identifying Core Competencies for Medical Command and Control Teams Managing Covid-192023In: 2023 WADEM congress on disaster and emergency medicine, 2023, Vol. 38, no S1, p. s216-s216Conference paper (Refereed)
  • 25.
    Jonson, Carl-Oscar
    et al.
    Linköping University, Department of Clinical and Experimental Medicine, Division of Surgery, Orthopedics and Oncology. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Center for Disaster Medicine and Traumatology.
    Pettersson, Jenny
    Linköping University, Department of Clinical and Experimental Medicine. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Center for Disaster Medicine and Traumatology.
    Rybing, Jonas
    Linköping University, Department of Computer and Information Science, Human-Centered systems. Linköping University, Faculty of Arts and Sciences.
    Nilsson, Heléne
    Linköping University, Department of Clinical and Experimental Medicine, Division of Surgery, Orthopedics and Oncology. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Center for Disaster Medicine and Traumatology.
    Prytz, Erik
    Linköping University, Department of Computer and Information Science, Human-Centered systems. Linköping University, Faculty of Arts and Sciences.
    Short simulation exercises to improve emergency department nurses self-efficacy for initial disaster management: Controlled before and after study2017In: Nurse Education Today, ISSN 0260-6917, E-ISSN 1532-2793, Vol. 55, p. 20-25Article in journal (Refereed)
    Abstract [en]

    Introduction: Head nurses at emergency departments often assume responsibility for managing the initial response to a major incident, and to create surge capacity. Training is essential to enable these nurses to perform an effective disaster response. Evaluating the effects of such training is however complicated as real skill only can be demonstrated during a real major incident. Self-efficacy has been proposed as an alternative measure of training effectiveness. Purpose: The aim of this study was to examine if short, small-scale computer-based simulation exercises could improve head emergency nurses general and specific self-efficacy and initial incident management skills. Method: A within-group pretest-posttest design was used to examine 13 head nurses general and specific self efficacy before and after an intervention consisting of three short computer based simulation exercises during a 1-h session. Management skills were assessed using the computer simulation tool DigEmergo. Results: The exercises increased the head nurses general self-efficacy but not their specific self-efficacy. After completing the first two exercises they also exhibited improved management skills as indicated by shorter time to treatment for both trauma and in-hospital patients. Conclusion: This study indicates that short computer based simulation exercises provide opportunities for head nurses to improve management skills and increase their general self-efficacy.

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  • 26.
    Jonson, Carl-Oscar
    et al.
    Linköping University, Department of Clinical and Experimental Medicine, Division of Surgery, Orthopedics and Oncology. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Center for Disaster Medicine and Traumatology.
    Prytz, Erik
    Linköping University, Department of Computer and Information Science, Human-Centered systems. Linköping University, Faculty of Arts and Sciences.
    Janson, Ove
    Linköping University, Department of Clinical and Experimental Medicine. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Center for Disaster Medicine and Traumatology.
    A social network analysis of the emergency medical command during a live CBRNE exercise2017In: Abstracts of Scientific Papers-WADEM Congress on Disaster and Emergency Medicine 2017, Cambridge University Press, 2017, p. S223-S224Conference paper (Other academic)
  • 27.
    Jonson, Carl-Oscar
    et al.
    Linköping University, Department of Clinical and Experimental Medicine, Division of Surgery, Orthopedics and Oncology. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Center for Disaster Medicine and Traumatology.
    Rosenqvist, Simon
    Linköping University, Department of Computer and Information Science. Linköping University, Faculty of Arts and Sciences.
    Forsberg, Rebecca
    Research And Development Center For Disaster Medicine, Unit Of Surgery, Department Of Surgical And Perioperative Science, Umeå University, Umeå.
    Aléx, Jonas
    Research And Development Center For Disaster Medicine, Unit Of Surgery, Department Of Surgical And Perioperative Science, Umeå University, Umeå.
    Prytz, Erik
    Linköping University, Department of Computer and Information Science, Human-Centered systems. Linköping University, Faculty of Arts and Sciences.
    Hierarchical task analysis as a method to support emergency response planning2017In: Prehospital and Disaster Medicine, ISSN 1049-023X, E-ISSN 1945-1938, Vol. 32, p. S19-S20Article in journal (Other academic)
  • 28.
    Kircher, Katja
    et al.
    Statens väg- och transportforskningsinstitut, Människan i transportsystemet, MTS, Sweden.
    Rosberg, Tomas
    Statens väg- och transportforskningsinstitut, Förare och fordon, FOF, Sweden.
    Thorslund, Birgitta
    Statens väg- och transportforskningsinstitut, Förare och fordon, FOF, Sweden.
    Ahlström, Christer
    Statens väg- och transportforskningsinstitut, Människan i transportsystemet, MTS, Sweden.
    Prytz, Erik
    Linköping University, Department of Computer and Information Science, Human-Centered systems. Linköping University, Faculty of Arts and Sciences.
    Bernheim, Lisa
    Linköping University, Department of Computer and Information Science.
    Olsson, Niklas
    Statens väg- och transportforskningsinstitut, Förare och fordon, FOF.
    Moertl, Peter
    Virtual Vehicle Research GmbH, Graz, Austria.
    Train driver attention is influenced by the type of railway signalling system2022In: DDI 2022 Gothenburg: Abstract book, Göteborg: Safer , 2022, p. 50-52Conference paper (Other academic)
    Abstract [en]

    The European Rail Traffic Management System (ERTMS) will replace national standards with the aim to promote cross-border traffic and enhance efficiency. The transition involves a shift from lineside signalling to mostly in- cabin information via a Driver Machine Interface (DMI). Previous research indicates that this may lead to a decrease in driver attention to the outside world and to a decrease in workload, leading to boredom. Using a train simulator, 41 participants drove the same track with the ERTMS system and the Swedish national standard (ATC) while wearing eye- tracking equipment. Subjective workload and boredom assessments were made after each drive. An analysis of the first set of reduced data (15 participants) showed that the formal attentional requirements like the monitoring of speed changes and signals were fulfilled in almost all cases, regardless of system. Overall, however, the data indicate that in line with previous research the drivers focus their attention more to the inside of the train when using the ERTMS system. This is corroborated by the finding that horn blowing is slightly delayed with the ERTMS system. Perceived workload was generally low, with the ERTMS system experienced to be more boring. We draw the preliminary conclusion that while formal attentional requirements are fulfilled for both systems, the ERTMS system likely has a tendency to pull the drivers’ overall attention inwards. Given that for the ERTMS system most relevant information is presented inside of the train on the DMI, this is not surprising, but needs to be addressed by the authorities.

  • 29.
    Kristensson, Per Ola
    et al.
    Cavendish Laboratory, Cambridge University.
    Arnell, Olof
    Linköping University, Department of Computer and Information Science. Linköping University, The Institute of Technology.
    Björk, Annelie
    Linköping University, Department of Computer and Information Science. Linköping University, The Institute of Technology.
    Dahlbäck, Nils
    Linköping University, Department of Computer and Information Science, NLPLAB - Natural Language Processing Laboratory. Linköping University, Faculty of Arts and Sciences.
    Pennerup, Joackim
    Linköping University, Department of Computer and Information Science. Linköping University, The Institute of Technology.
    Prytz, Erik
    Linköping University, Department of Computer and Information Science. Linköping University, The Institute of Technology.
    Wikman, Johan
    Linköping University, Department of Computer and Information Science. Linköping University, The Institute of Technology.
    Åström, Niclas
    Linköping University, Department of Computer and Information Science. Linköping University, The Institute of Technology.
    Info Touch: An Explorative Multi-Touch Visualization Interface for Tagged Photo Collections2008In: NordiCHI '08 Proceedings of the 5th Nordic conference on Human-computer interaction: building bridges, 2008, p. 491-494Conference paper (Refereed)
    Abstract [en]

    We report on a design exploration into how a large multi-touchtabletop display can be used for information visualization. Wedesigned an interface where users explored a tagged photocollection by bi-manual manipulation of the collections’ tagcloud. User feedback showed that despite the availability ofmulti-touch most of the actual interactions were single-touch.However, some particular natural actions, such as grabbing thetag cloud and partitioning it into two parts, were often carriedwith both hands. Thus our user study indicates that multi-touchcan act as a useful complementary interaction method ininformation visualization interfaces.

  • 30.
    Kristiansson (Forsblad), Mattias
    et al.
    Linköping University, Department of Computer and Information Science, Human-Centered systems. Linköping University, Faculty of Arts and Sciences.
    Wiik, Richard
    Linköping University, Department of Computer and Information Science, Human-Centered systems. Linköping University, Faculty of Arts and Sciences.
    Prytz, Erik
    Linköping University, Department of Computer and Information Science, Human-Centered systems. Linköping University, Faculty of Arts and Sciences. Sics East Swedish ICT AB.
    Bodily orientations and actions as constituent parts of remembering objects and intentions before leaving home2014In: Sensoria: A Journal of Mind, Brain, and Culture, ISSN 2203-8469, Vol. 10, no 1, p. 21-27Article in journal (Refereed)
    Abstract [en]

    In this article we report an exploratory video-based analysis of bodily actions - specifically head movements and bodily orientations - of two older adults (+65) in their everyday life, as they are about to leave their homes. We show that action patterns can serve an adaptive function to monitor the physical surrounding of objects and spaces, and we argue that these adaptive functions assist prospective memory processes. First, we found that ongoing activities, some partially unrelated to the activity of leaving home, coupled with the structure of the physical environment could assist the participants in remembering intentions before leaving home. Second, we found that participants attended to, and therefore stayed in control of, important spaces and objects through targeted and redundant scanning of such important spaces. In the context of previous research on the effects of cognitive aging, we hypothesize that these bodily action patterns coupled with the efficient shaping of spaces can be important for the general older population to compensate for a decline in prospective memory ability.

  • 31.
    Lantz Cronqvist, Mattias
    et al.
    Linköping University, Department of Computer and Information Science, Human-Centered systems. Linköping University, Faculty of Science & Engineering.
    Jonson, Carl-Oscar
    Linköping University, Department of Clinical and Experimental Medicine, Division of Surgery, Orthopedics and Oncology. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Regionledningskontoret, Center for Disaster Medicine and Traumatology.
    Prytz, Erik
    Linköping University, Department of Computer and Information Science, Human-Centered systems. Linköping University, Faculty of Arts and Sciences. Linköping University, Department of Clinical and Experimental Medicine. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Regionledningskontoret, Center for Disaster Medicine and Traumatology.
    Development and Initial Validation of a Stochastic Discrete Event Simulation to Assess Disaster Preparedness2019In: Prehospital and Disaster Medicine, ISSN 1049-023X, E-ISSN 1945-1938, Vol. 34, no 1, p. 118-118Article in journal (Other academic)
    Abstract [en]

    Introduction:

    Assessing disaster preparedness in a given region is a complex problem. Current methods are often resource-intensive and may lack generalizability beyond a specific scenario. Computer-based stochastic simulations may be an additional method but would require systems that are valid, flexible, and easy to use. Emergo Train System (ETS) is an analog simulation system used for disaster preparedness assessments.

    Aim:

    To digitalize the ETS model and develop stochastic simulation software for improved disaster preparedness assessments.

    Methods:

    A simulation software was developed in C#. The simulation model was based on ETS. Preliminary verification and validation (V&V) tests were performed, including unit and integration testing, trace validation, and a comparison to a prior analog ETS disaster preparedness assessment exercise.

    Results:

    The software contains medically validated patients from ETS and is capable of automatically running disaster scenarios with stochastic variations in the injury panorama, available resources, geographical location, and other variables. It consists of two main programs: an editor where scenarios can be constructed and a simulation system to evaluate the outcome. Initial V&V testing showed that the software is reliable and internally consistent. The comparison to the analog exercise showed a general high agreement in terms of patient outcome. The analog exercise featured a train derailment with 397 injured, of which 45 patients suffered preventable death. In comparison, the computer simulation ran 100 iterations of the same scenario and indicated that a median of 41 patients (IQR 31 to 44) would suffer a preventable death.

    Discussion:

    Stochastic simulation methods can be a powerful complement to traditional capability assessments methods. The developed simulation software can be used for both assessing emergency preparedness with some validity and as a complement to analog capability assessment exercises, both as input and to validate results. Future work includes comparing the simulation to real disaster outcomes.

  • 32.
    Lidestam, Björn
    et al.
    VTI, Väg- och transportforskningsinstitutet, Sweden.
    Prytz, Erik
    Linköping University, Department of Computer and Information Science, Human-Centered systems. Linköping University, Faculty of Arts and Sciences. Region Östergötland, Regionledningskontoret, Center for Disaster Medicine and Traumatology.
    Åkerstedt, Zandra
    Linköping University.
    Akutvård under ambulansfärd: naturalistiska data från simulerade typsituationer vid körning på testbana2019In: Sammanställning av referat från Transportforum 2019 / [ed] Camilla Ekström, Fredrik Hellman och Mattias Haraldsson, VTI, VTI , 2019Conference paper (Other academic)
    Abstract [sv]

    Background: Målen för detta projekt var att undersöka det aktuella kunskapsläget samt att samla in naturalistiska fordonsdynamiska data samt beteendedata vid olika simulerade utryckningsscenarier för att framöver utforma realistiska och prototypiska körscenarier med tillhörande vårduppgifter för användning i ambulanssimulatorförsök och träning av ambulanspersonal. Methods: För att uppnå målen genomfördes tre delstudier: en litteraturstudie, en workshop och ett fältexperiment på testbana. Results: Resultat Av litteraturstudien framgick det att den tidigare forskningen främst studerat kvaliteten av HLR under transporter. Trots skillnader i definitioner av kvalitet, tillämpade standarder och studiedesign framstår det som att det tveklöst föreligger svårigheter att under transport utföra hjärt–lungräddning (HLR) med hög kvalitet. Några studier har undersökt orsakerna till varför det är svårt att utföra HLR med god kvalitet och det har identifierats faktorer relaterade till transportförfarandet, fordonstyp och vårdutrymmets design. Under workshopen identifierades ett flertal vårdinterventioner som svåra att genomföra under transport; och de ansågs generellt som svårare att genomföra under transport i ambulansen än annars (t.ex. på sjukhus). Det framkom också en del faktorer som ansågs påverka vårdinterventionerna under transport. Dessa påverkansfaktorer kunde delas in i kategorierna rörelserelaterade, designrelaterade, vägbanans statusoch samarbete. Flertalet av dessa faktorer överensstämmer med de faktorer som rapporterats i litteraturstudien. Under fältexperimentet på testbana rapporterade deltagarna ökad arbetsbelastning och ökad svårighet i att utföra vårdinterventionerna allt eftersom transporten bestod av fler och hårdare hastighetsförändringar och kurvtagningar. Med ökad svårighetsgrad ökade även förekomsten av färdrelaterade faktorer, vilket var den kategori som ansågs påverka utförandet av interventionerna i störst utsträckning. Slutsatser Många vårdinterventioner, inte bara HLR, är svåra att utföra under transport. Orsakerna till svårigheterna som uppstår under transport kan hänföras till hur ambulansen rör sig, hur vårdutrymmet är designat, hur vägbanan är beskaffad, och hur samarbetet mellan föraren och den som vårdar patienten fungerar. Rörelserelaterade orsaker ter sig proportionerliga mot svårigheterna att utföra vårdinterventioner – men alla vårdinterventioner påverkas inte på samma sätt och i samma utsträckning, vilket bör studeras vidare.

  • 33.
    Lowndes, Bethany
    et al.
    Mayo Clinic, Robert D. and Patricia E. Kerns Center for the Science of Health Care Delivery, Rochester, MN, USA / Mayo Clinic, Department of Health Sciences Research, Rochester, MN, USA.
    Forsyth, Katherine
    Mayo Clinic, Robert D. and Patricia E. Kerns Center for the Science of Health Care Delivery, Rochester, MN, USA / Mayo Clinic, Department of Health Sciences Research, Rochester, MN, USA.
    Prytz, Erik
    Linköping University, Department of Computer and Information Science, Human-Centered systems. Linköping University, Faculty of Arts and Sciences.
    Jonson, Carl-Oscar
    Region Östergötland, Center for Disaster Medicine and Traumatology. Linköping University, Faculty of Medicine and Health Sciences.
    Abdelrahman, Amro
    Mayo Clinic, Robert D. and Patricia E. Kerns Center for the Science of Health Care Delivery, Rochester, MN, USA / Mayo Clinic, Department of Health Sciences Research, Rochester, MN, USA.
    Matthew, Sztajnkrycer
    Mayo Clinic, Department of Family Medicine, Rochester, MN, USA.
    Franz, III, Walter
    Mayo Clinic, Department of Medicine, Rochester, MN, USA.
    Blocker, Renaldo
    Mayo Clinic, Robert D. and Patricia E. Kerns Center for the Science of Health Care Delivery, Rochester, MN, USA / Mayo Clinic, Department of Health Sciences Research, Rochester, MN, USA.
    Hallbeck, Susan
    Mayo Clinic, Robert D. and Patricia E. Kerns Center for the Science of Health Care Delivery, Rochester, MN, USA / Mayo Clinic, Department of Health Sciences Research, Rochester, MN, USA.
    A Preliminary Comparison of Three Tourniquet Instructions for Just-in-Time Guidance of a Simulated Tourniquet Application2017In: Proceedings of the Human Factors and Ergonomics Society 2017 Annual Meeting, Santa Monica: Human Factors and Ergonomics Society, HFES , 2017, p. 1076-1080Conference paper (Refereed)
    Abstract [en]

    The American College of Surgeons (ACS) and the Department of Homeland Security (DHS) encourage the use of tourniquets as part of the “Stop the Bleed” campaign. Both have provided instructions for layperson tourniquet application in order to save the life of a hemorrhaging trauma victim. This study sought to compare the impact of using ACS and DHS instructions with manufacturer-provided instructions for the completion of simulated tourniquet application steps. Thirty surgical trainees completed a simulated tourniquet application with one of the three instruction sets. Their completion time and success for each step were measured. Participants that received ACS instructions failed the fewest number of steps (p < 0.01) and completed the task faster (Mean (SD) = 70 (33) seconds) compared to those with the manufacturer-provided instructions (p < 0.01). Tourniquet instruction sets need to be refined in order to optimize the success rate of just-in-time guidance for tourniquet application.

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    A Preliminary Comparison of Three Tourniquet Instructions for Just-in-Time Guidance of a Simulated Tourniquet Application
  • 34.
    Lowndes, Bethany
    et al.
    Univ Nebraska Med Ctr, NE 68198 USA; Mayo Clin, MN 55905 USA; Mayo Clin, MN 55905 USA.
    Law, Katherine
    Mayo Clin, MN 55905 USA; Mayo Clin, MN 55905 USA.
    Abdelrahman, Amro
    Mayo Clin, MN 55905 USA; Mayo Clin, MN 55905 USA.
    Prytz, Erik
    Linköping University, Department of Computer and Information Science, Human-Centered systems. Linköping University, Faculty of Arts and Sciences.
    Jonson, Carl-Oscar
    Linköping University, Department of Clinical and Experimental Medicine, Division of Surgery, Orthopedics and Oncology. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Center for Disaster Medicine and Traumatology.
    Sztajnkrycer, Matthew
    Mayo Clin, MN 55905 USA.
    Hawthorne, Hunter
    Mayo Clin, MN 55905 USA; Mayo Clin, MN 55905 USA; Mayo Clin, MN 55905 USA.
    Franz, Walter
    Mayo Clinic, Department of Family Medicine, Rochester, MN, USA.
    Blocker, Renaldo
    Mayo Clin, MN 55905 USA; Mayo Clin, MN 55905 USA.
    Hallbeck, M. Susan
    Mayo Clin, MN 55905 USA; Mayo Clin, MN 55905 USA.
    Preliminary Investigation of Civilian Clinician Perspectives & Just-in-Time Guidance for Tourniquet Use to "Stop the Bleed"2019In: Military medicine, ISSN 0026-4075, E-ISSN 1930-613X, Vol. 184, no 3-4, p. 28-36Article in journal (Refereed)
    Abstract [en]

    Objective

    The American College of Surgeons (ACS) encourages clinicians to provide training to laypeople on tourniquet application. It is unclear whether clinicians are confident in their abilities and equipped with adequate knowledge, skills, and resources. This study aimed to determine surgical trainee knowledge and attitudes regarding tourniquet application and compare the effectiveness of instructions.

    Methods

    Thirty surgical trainees performed a tourniquet application simulation using a Combat Application Tourniquet and one of the three instructions sets developed by ACS, Department of Homeland Security, and the tourniquet manufacturer. Participants reported tourniquet knowledge, attitudes, and confidence and discussed the instructions. One instruction set was updated and compared to the original set with 20 new trainees.

    Results

    Participants with ACS instructions passed the greatest number of steps (p < 0.01) and completed the task significantly faster compared to those with manufacturer instructions (p < 0.01). Participants (80%) reported favorable views toward tourniquets but 30–60% did not align with to ACS tourniquet guidelines. Focus group participants suggested revisions to the ACS instructions. Comparing the original and revised version of these instructions resulted in no significant improvements.

    Conclusions

    ACS instructions provide guidance; however, improvements to tourniquet instruction are needed for success in controlling exsanguinating hemorrhage.

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  • 35.
    Ohlander, Ulrika
    et al.
    Saab AB.
    Linger, Oscar
    Linköping University.
    Hägg, Veronica
    Linköping University.
    Nilsson, Linn
    Linköping University.
    Holmqvist, Åsa
    Linköping University.
    Durefors, Sandra
    Linköping University.
    Alfredson, Jens
    Linköping University, Department of Computer and Information Science. Linköping University, Faculty of Arts and Sciences.
    Prytz, Erik
    Linköping University, Department of Computer and Information Science, Human-Centered systems. Linköping University, Faculty of Arts and Sciences.
    Performance using low-cost gaze-control for simulated flight tasks2016In: Proceedings of the Human Factors and Ergonomics Society Europe Chapter 2016 Annual Conference: Human Factors and User Needs in Transport, Control, and the Workplace / [ed] Dick de Waard, Antonella Toffetti, Rebecca Wiczorek, Andreas Sonderegger, Stefan Röttger, Petr Bouchner, Thomas Franke, Stephen Fairclough, Matthijs Noordzij, and Karel Brookhuis, 2016, p. 201-210Conference paper (Refereed)
    Abstract [en]

    In the current study, interaction using gaze control was compared to computer mouse using the MATB-II (Multi-Attribute Task Battery) environment. The study had two aims; the first was to explore the utility of low-cost technologies in a rapid prototyping and testing environment for aviation. The second aim was to use such an environment to compare a novel interaction device (a low-cost gaze control device) to a familiar interaction device (computer mouse). Method: Thirty participants performed two scenarios with each interaction device. The software MATB-II provided simulated flight tasks and recorded performance. Mental workload was assessed by the NASA Task Load Index (TLX) questionnaire after each scenario. Results: The results showed that gaze control resulted in significantly higher overall mental workload than computer mouse. Performance was better with mouse in two of the four tasks. Conclusions: Concerning the first aim, the study demonstrated the value of low-cost technology for initial user testing before using more expensive high-fidelity environments. Concerning the second aim, the computer mouse resulted in better performance and lower mental workload. This may either be due to higher user familiarity with computer mouse interaction or to limitations of the gaze control equipment and insufficient adjustments of the interface design to optimize for gaze control.

  • 36. Parry, D.
    et al.
    Norris, T.
    Gonzalez, J.
    Gil, M.
    Kostadinov, R.
    Pilemalm, Sofie
    Linköping University, Department of Management and Engineering, Information Systems. Linköping University, Faculty of Arts and Sciences.
    Jonson, Carl-Oscar
    Linköping University, Department of Clinical and Experimental Medicine, Division of Surgery, Orthopedics and Oncology. Linköping University, Faculty of Medicine and Health Sciences.
    Prytz, Erik
    Linköping University, Department of Computer and Information Science, Human-Centered systems. Linköping University, Faculty of Arts and Sciences.
    Khazanchi, D.
    Scott, R.
    Dugdale, J.
    Kirk, R.
    Putting the “eHealth” into Disaster eHealth2017Conference paper (Other academic)
  • 37.
    Pettersson, Jenny
    et al.
    Linköping University, Department of Biomedical and Clinical Sciences, Division of Surgery, Orthopedics and Oncology. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Regionledningskontoret, Center for Disaster Medicine and Traumatology.
    Jonson, Carl-Oscar
    Linköping University, Department of Biomedical and Clinical Sciences, Division of Surgery, Orthopedics and Oncology. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Regionledningskontoret, Center for Disaster Medicine and Traumatology.
    Berggren, Peter
    Region Östergötland, Regionledningskontoret, Center for Disaster Medicine and Traumatology. Linköping University, Department of Biomedical and Clinical Sciences. Linköping University, Faculty of Medicine and Health Sciences.
    Hermelin, Jonas
    Swedish Def Res Agcy, Sweden.
    Trnka, Jiri
    Swedish Def Res Agcy, Sweden.
    Woltjer, Rogier
    Swedish Def Res Agcy, Sweden.
    Prytz, Erik
    Region Östergötland, Regionledningskontoret, Center for Disaster Medicine and Traumatology. Linköping University, Department of Biomedical and Clinical Sciences. Linköping University, Faculty of Medicine and Health Sciences.
    Connecting resilience concepts to operational behaviour: A disaster exercise case study2022In: Journal of Contingencies and Crisis Management, ISSN 0966-0879, E-ISSN 1468-5973, Vol. 30, no 2, p. 127-136Article in journal (Refereed)
    Abstract [en]

    Contemporary crisis management studies often make use of the concept of resilience. However, resilience as a term has a wide variety of meanings and has been criticized as lacking operationalization and empirical validation. The current study aimed to link resilience concepts to observable behaviour within a disaster medicine management system. Resilience concepts, captured in so-called capability cards and further operationalized into six resilience prerequisites, were used in the study. An experienced crisis management team participated in a large-scale crisis management exercise and behaviours were captured through observations, video and audio recordings. Using a markers and strategies analytical framework, two blinded raters classified observable behaviours that exemplified resilient practice. The analysis showed a high degree of agreement (79%) between the combined operationalized capability cards and resilience prerequisites and the empirical classification of behaviours. The current study shows an empirical link from resilience concepts to observable behaviours during an exercise. Observed episodic narratives exemplify empirically connected specific strategies to specific resilience markers. These results demonstrate a method with observed narratives for analyzing resilience in crisis management teams using a markers and strategies approach. Future studies can use the results to create structured observation protocols to evaluate resilient behaviours in crisis management teams.

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  • 38.
    Pettersson, Jenny
    et al.
    Linköping University, Department of Clinical and Experimental Medicine, Division of Surgery, Orthopedics and Oncology. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Regionledningskontoret, Center for Disaster Medicine and Traumatology.
    Jonson, Carl-Oscar
    Linköping University, Department of Clinical and Experimental Medicine, Division of Surgery, Orthopedics and Oncology. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Regionledningskontoret, Center for Disaster Medicine and Traumatology.
    Berggren, Peter
    Linköping University, Department of Clinical and Experimental Medicine. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Regionledningskontoret, Center for Disaster Medicine and Traumatology.
    Woltjer, Rogier
    Swedish Defence Research Agency, Stockholm, Sweden.
    Hermelin, Jonas
    Swedish Defence Research Agency, Stockholm, Sweden.
    Prytz, Erik
    Linköping University, Department of Clinical and Experimental Medicine. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Regionledningskontoret, Center for Disaster Medicine and Traumatology.
    Resilience Training of Regional Medical Command and Control2019In: Prehospital and Disaster Medicine, ISSN 1049-023X, E-ISSN 1945-1938, Prehospital and Disaster Medicine, ISSN 1049-023X, Vol. 34, no 1, p. 164-165Article in journal (Other academic)
    Abstract [en]

    Introduction:

    Resilience is often described as a desirable holistic approach to disaster preparedness. However, the term has a wide variety of meanings and is hard to operationalize and implement in disaster management. A goal for the EU H2020 project DARWIN was to operationalize resilience for incident management teams.

    Aim:

    To test the resilience operationalization by analyzing command team behaviors in a major incident exercise and trace observations to resilience theory.

    Methods:

    A regional medical command and control team (n=11) was observed when performing in a functional simulation exercise of a mass casualty incident (300 injured, 1800 uninjured) following the collision of a cruise ship and an oil tanker close to the Swedish coast. Audio and video recordings of behaviors and communications were reviewed for resilient behaviors based on the DARWIN guidelines using the “resilience markers for small teams” framework (Furniss et al., 2011).

    Results:

    A total of 121 observed instances of resilient behaviors were found in the material. In 95 cases (79%) the observed behaviors followed a priori hypothesized connections between resilient strategies and general markers. Certain marker-strategy combinations occurred frequently, such as 18 observations where the strategy “understand crucial assumptions” occurred together with the marker “adapting to expected and unexpected events.”

    Discussion:

    Resilience has the potential to contribute to a more holistic disaster management approach. The findings that the observations, in general, correspond to the expected relationship between theoretical concretization and contextualization supports the DARWIN effort to operationalize resilience theory. This is a prerequisite for developing observational protocols for training and further studies of resilient behaviors in disaster management teams.

  • 39.
    Pettersson, Jenny
    et al.
    Linköping University, Department of Biomedical and Clinical Sciences, Division of Surgery, Orthopedics and Oncology. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Regionledningskontoret, Center for Disaster Medicine and Traumatology.
    Jonson, Carl-Oscar
    Linköping University, Department of Biomedical and Clinical Sciences, Division of Surgery, Orthopedics and Oncology. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Regionledningskontoret, Center for Disaster Medicine and Traumatology.
    Friberg, Marc
    Linköping University, Department of Computer and Information Science, Human-Centered systems. Region Östergötland, Regionledningskontoret, Center for Disaster Medicine and Traumatology. Linköping University, Faculty of Arts and Sciences.
    Björnqvist, Anton
    Region Östergötland, Regionledningskontoret, Center for Disaster Medicine and Traumatology. Linköping University, Department of Computer and Information Science, Human-Centered systems. Linköping University, Faculty of Science & Engineering.
    Berggren, Peter
    Linköping University, Department of Computer and Information Science, Human-Centered systems. Linköping University, Faculty of Arts and Sciences. Region Östergötland, Regionledningskontoret, Center for Disaster Medicine and Traumatology.
    Frisk, Jessica
    Region Östergötland, Center for Surgery, Orthopaedics and Cancer Treatment, Department of Surgery in Norrköping. Linköping University, Faculty of Medicine and Health Sciences.
    Prytz, Erik
    Linköping University, Department of Computer and Information Science, Human-Centered systems. Linköping University, Faculty of Arts and Sciences. Region Östergötland, Regionledningskontoret, Center for Disaster Medicine and Traumatology.
    Critical Decision-making in Medical Command and Control During Early Covid-19: An Interview Study2023In: 2023 WADEM congress on disaster and emergency medicine, 2023, Vol. 38, no S1, p. s53-s54Conference paper (Refereed)
  • 40.
    Phillips, Rachel
    et al.
    Old Dominion University, USA.
    Friberg, Marc
    Linköping University, Department of Computer and Information Science. Linköping University, Faculty of Science & Engineering. Linköping University, Department of Biomedical and Clinical Sciences. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Regionledningskontoret, Center for Disaster Medicine and Traumatology.
    Lantz Cronqvist, Mattias
    Linköping University, Department of Computer and Information Science, Human-Centered systems. Linköping University, Faculty of Science & Engineering.
    Jonson, Carl-Oscar
    Linköping University, Department of Biomedical and Clinical Sciences, Division of Surgery, Orthopedics and Oncology. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Regionledningskontoret, Center for Disaster Medicine and Traumatology.
    Prytz, Erik
    Linköping University, Department of Computer and Information Science, Human-Centered systems. Linköping University, Faculty of Arts and Sciences. Linköping University, Department of Biomedical and Clinical Sciences. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Regionledningskontoret, Center for Disaster Medicine and Traumatology.
    Visual Blood Loss Estimation Accuracy: Directions for Future Research Based on a Systematic Literature Review2020In: Proceedings of the 2020 HFES 64th International Annual Meeting, Sage Publications, 2020, Vol. 64, no 1, p. 1411-1415Conference paper (Refereed)
    Abstract [en]

    Visual blood loss estimation occurs in a variety of medical contexts and may impact everything from interventions by immediate responders to the likelihood of receiving blood transfusions in a hospital setting. However, research suggests that visual blood loss estimation is inaccurate for laypeople and medical professionals. The aim of the current study was to conduct a systematic literature review to determine the current state of knowledge on visual blood loss estimation accuracy and identify directions for future research. A structured search resulted in 1799 titles that were subsequently screened. A total of 72 articles were coded for comparison. Based on the evaluation, several gaps were identified, most notably related to factors of the situation that may influence estimation accuracy such as blood flow and victim/patient gender. Directions for future research are proposed based on identified gaps.

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  • 41.
    Phillips, Rachel
    et al.
    Old Dominion Univ, VA 23529 USA.
    Friberg, Marc
    Linköping University, Department of Computer and Information Science. Linköping University, Faculty of Science & Engineering. Linköping University, Department of Biomedical and Clinical Sciences. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Regionledningskontoret, Center for Disaster Medicine and Traumatology.
    Lantz Cronqvist, Mattias
    Linköping University, Department of Computer and Information Science, Human-Centered systems. Linköping University, Faculty of Science & Engineering.
    Jonson, Carl-Oscar
    Linköping University, Department of Biomedical and Clinical Sciences, Division of Surgery, Orthopedics and Oncology. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Regionledningskontoret, Center for Disaster Medicine and Traumatology.
    Prytz, Erik
    Linköping University, Department of Computer and Information Science, Human-Centered systems. Linköping University, Faculty of Arts and Sciences. Region Östergötland, Regionledningskontoret, Center for Disaster Medicine and Traumatology. Linköping University, Department of Biomedical and Clinical Sciences. Linköping University, Faculty of Medicine and Health Sciences.
    Visual estimates of blood loss by medical laypeople: Effects of blood loss volume, victim gender, and perspective2020In: PLOS ONE, E-ISSN 1932-6203, Vol. 15, no 11, article id e0242096Article in journal (Refereed)
    Abstract [en]

    A severe hemorrhage can result in death within minutes, before professional first responders have time to arrive. Thus, intervention by bystanders, who may lack medical training, may be necessary to save a victims life in situations with bleeding injuries. Proper intervention requires that bystanders accurately assess the severity of the injury and respond appropriately. As many bystanders lack tools and training, they are limited in terms of the information they can use in their evaluative process. In hemorrhage situations, visible blood loss may serve as a dominant cue to action. Therefore, understanding how medically untrained bystanders (i.e., laypeople) perceive hemorrhage is important. The purpose of the current study was to investigate the ability of laypeople to visually assess blood loss and to examine factors that may impact accuracy and the classification of injury severity. A total of 125 laypeople watched 78 short videos each of individuals experiencing a hemorrhage. Victim gender, volume of blood lost, and camera perspective were systematically manipulated in the videos. The results revealed that laypeople overestimated small volumes of blood loss (from 50 to 200 ml), and underestimated larger volumes (from 400 to 1900 ml). Larger volumes of blood loss were associated with larger estimation errors. Further, blood loss was underestimated more for female victims than male victims and their hemorrhages were less likely to be classified as life-threatening. These results have implications for training and intervention design.

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  • 42.
    Phillips, Rachel
    et al.
    Old Dominion University, Norfolk, VA.
    Friberg, Marc
    Linköping University, Department of Computer and Information Science, Human-Centered systems. Region Östergötland, Regionledningskontoret, Center for Disaster Medicine and Traumatology. Linköping University, Faculty of Arts and Sciences.
    Lantz Cronqvist, Mattias
    Linköping University, Department of Computer and Information Science, Human-Centered systems. Linköping University, Faculty of Science & Engineering.
    Prytz, Erik
    Linköping University, Department of Computer and Information Science, Human-Centered systems. Linköping University, Faculty of Arts and Sciences. Region Östergötland, Regionledningskontoret, Center for Disaster Medicine and Traumatology.
    Comparing Blood Loss Estimates by Medical Laypeople in Online and In-person Formats using SABLE2021In: Proceedings of the Human Factors and Ergonomics Society Annual Meeting, 2021, Vol. 65, p. 1352-1356Conference paper (Refereed)
    Abstract [en]

    To design interventions for teaching laypeople how to respond in hemorrhage situations, it is necessary to understand factors that influence their perception of blood loss. Although lab-based research offers more experimental control, it limits access to certain kinds of participants. Therefore, the purpose of this study was to compare results from an online administration of a web-based application (SABLE) to data collected using the same application in a lab. Participants viewed 78 5-second video clips of simulated bleeding injuries with a male or female victim and different volumes of blood loss. They estimated the volume of blood loss after each video. The results replicated the general findings from prior research and revealed no significant differences in estimations or estimation accuracy between the online and lab-based administration of SABLE. Results are discussed in terms of applicability to research practice. 

  • 43.
    Prytz, Erik
    Department of Psychology, Old Dominion University, Norfolk, VA, USA.
    Workload transitions and stress: changes over time2014Doctoral thesis, monograph (Other academic)
    Abstract [en]

    Workload transitions are situations where operators are suddenly confronted with levels of workload substantially different from previously established levels. Workload transitions may affect the operators' state of stress and coping behaviors but previous research has not conclusively demonstrated the nature of those. The first goal of the current work was to investigate the discrepant findings of the previous literature. Two experiments were conducted where participants were asked to perform a digit detection task that suddenly shifted between low and high event rates (i.e., low and high workload, respectively). The first experiment used a large magnitude transition that resulted in a decrease in reported levels of task engagement and effort. Over time, the reported stress and workload ratings of the transitioned groups approached the nontransitioned control groups. A second experiment was conducted using a moderate magnitude transition. This second experiment replicated the findings from the first experiment, with the key difference being that the transition from a low to more a more moderate level of workload resulted in higher, sustained task engagement and effort. Two main conclusions are drawn from these results. First, over time the stress and workload levels of individuals who experience a transition will approach those reported by nontransitioned individuals. Future workload transition research must therefore consider the effect of the time from transition. Second, the magnitude of the transition may influence the coping response such that a moderate transition may result in increased task-oriented, effortful coping whereas a large magnitude transition may result in decreased effortful coping. 

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    Workload transitions and stress: changes over time
  • 44.
    Prytz, Erik G.
    et al.
    Linköping University, Department of Computer and Information Science, Human-Centered systems. Linköping University, Faculty of Science & Engineering.
    Rybing, Jonas
    Linköping University, Department of Computer and Information Science, Human-Centered systems. Linköping University, Faculty of Science & Engineering.
    Carlström, Eric
    Institute of Health and Care Sciences, University of Gothenburg, Gothenburg, Sweden.
    Khorram-Manesh, Amir
    Prehospital and Disaster Medicine Centre, Sahlgrenska Academy, Gothenburg, Sweden.
    Jonson, Carl-Oscar
    Linköping University, Department of Clinical and Experimental Medicine, Division of Clinical Sciences. Linköping University, Faculty of Medicine and Health Sciences. Östergötlands Läns Landsting, Center for Disaster Medicine and Traumatology, Centre for Teaching and Research in Disaster Medicine and Traumatology.
    Exploring prehospital C2-work during a mass gathering event2015In: International Journal of Emergency Services, ISSN 2047-0894, E-ISSN 2047-0908, Vol. 4, no 2, p. 227-241Article in journal (Refereed)
    Abstract [en]

    Purpose– The purpose of this paper is to explore the workload and shared workload awareness in a staff performing command and control (C2) work during a planned major incident (MI) empirical case in Sweden. Design/methodology/approach– Data on workload and shared awareness were collected during live C2-work using qualitative observations and in-situ interviews mixed with quantitative questionnaires. Findings– A content analysis of the qualitative data revealed categories of workload sources. Quantified workload estimates showed changes in workload levels over time and staff roles, which were also contextualized using the results of the qualitative data. Data on shared awareness indicated that team workload awareness shifted over time according to common patterns. This study demonstrates a promising methodology to study C2-related factors during live EMS work. Research limitations/implications– The observed variations in workload imply that research that relies only on post-task measurements of workload may be inaccurate. Future research could use this method to investigate the connection between workload and performance during different types of MIs. Originality/value– The results can be used to inform future Göteborgsvarvet C2-teams in terms of when, why, and for whom task load changes, which would support predictive allocation of resources.

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  • 45.
    Prytz, Erik G.
    et al.
    Linköping University, Department of Computer and Information Science, Human-Centered systems. Linköping University, Faculty of Science & Engineering.
    Rybing, Jonas
    Linköping University, Department of Computer and Information Science, Human-Centered systems. Linköping University, Faculty of Science & Engineering.
    Jonson, Carl-Oscar
    Linköping University, Department of Clinical and Experimental Medicine, Division of Clinical Sciences. Linköping University, Faculty of Medicine and Health Sciences. Östergötlands Läns Landsting, Center for Disaster Medicine and Traumatology, Centre for Teaching and Research in Disaster Medicine and Traumatology.
    Petterson, Albin
    Linköping University.
    Berggren, Peter
    Swedish Defence Research Agency, Sweden.
    Johansson, Björn
    Linköping University, Department of Computer and Information Science, Human-Centered systems. Linköping University, Faculty of Science & Engineering.
    An exploratory study of a low-level shared awareness measure using mission-critical locations during an emergency exercise2015In: Proceedings of the Human Factors and Ergonomics Society 59th Annual Meeting, Sage Publications, 2015, Vol. 59, no 1, p. 1152-1156Conference paper (Refereed)
    Abstract [en]

    A shared awareness of other teams’ roles and tasks has been linked to successful performance in joint ventures. However, emergency management organizations responding to incidents do not always share critical information necessary for maintaining shared awareness. An instrument called Shared Priorities has previously been applied to measure aspects of shared situation awareness at level 2 and 3 in Endsley’s (1995) model. This paper reports on a shared awareness instrument focused on level 1 situation awareness and its associated level of team shared awareness. Participants in a large emergency response exercise were asked to locate and rank geographical locations based on importance for overall mission success. The results show that organizations tended to rank locations relevant for their own work higher than positions relevant to other organization’s tasks. The different organizations displayed different levels of inter-rater agreement within themselves concerning the ranking of these positions.

  • 46.
    Prytz, Erik
    et al.
    Linköping University, Department of Computer and Information Science, Human-Centered systems. Linköping University, Faculty of Arts and Sciences.
    Grönbäck, Anna-Maria
    Linköping University.
    Steins, Krisjanis
    Linköping University, Department of Science and Technology, Communications and Transport Systems. Linköping University, Faculty of Science & Engineering.
    Goolsby, Craig
    Uniformed Services University of the Health Sciences, USA.
    Andersson Granberg, Tobias
    Linköping University, Department of Science and Technology, Communications and Transport Systems. Linköping University, Faculty of Science & Engineering.
    Jonson, Carl-Oscar
    Linköping University, Department of Biomedical and Clinical Sciences, Division of Surgery, Orthopedics and Oncology. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Regionledningskontoret, Center for Disaster Medicine and Traumatology.
    Evaluating the Effect of Bleeding Control Kit Locations for a Mass Casualty Incident Using Discrete Event Simulation2020In: Proceedings of the 17th ISCRAM Conference / [ed] Amanda Lee Hughes, Fiona McNeill, Christopher Zobe, Information Systems for Crisis Response and Management , 2020, p. 167-178Conference paper (Refereed)
    Abstract [en]

    The purpose of this study was to develop a simulation model to evaluate bleeding control kit location strategies for a mass casualty incident scenario. Specifically, the event simulated was an explosion at a large sports arena. The model included a representation of the arena itself, simulated crowd movements following the detonation of an improvised explosive device, injuries and treatments, and different ways for immediate responders to help injured patients using tourniquets. The simulation model gave logically consistent results in the validation scenarios and the simulation outcomes were in line with the expected outcomes. The results of the different tourniquet location scenarios indicated that decentralized placement (more than one location) is better, easy access is important (between rather than at emergency exits) and that an increased number of available tourniquets will result in an increased number of survivors.

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  • 47.
    Prytz, Erik
    et al.
    Linköping University, Department of Computer and Information Science, Human-Centered systems. Linköping University, Faculty of Arts and Sciences. Region Östergötland, Regionledningskontoret, Center for Disaster Medicine and Traumatology.
    Hallbeck, Susan
    Department of Health Sciences Research, Mayo Clinic, Rochester.
    Goolsby, Craig
    Uniformed Services University of the Health Sciences, National Center for Disaster Medicine and Public Health, Bethesda..
    Jonson, Carl-Oscar
    Linköping University, Department of Biomedical and Clinical Sciences, Division of Surgery, Orthopedics and Oncology. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Regionledningskontoret, Center for Disaster Medicine and Traumatology.
    Langhem, Ronald
    U.S. Dept. of Homeland Security Science and Technology Directorate .
    Mehta, Ranjana
    Texas A&M University .
    Peres, S. Camille
    Texas A&M University .
    Wilson, Darren
    U.S. Dept. of Homeland Security Science and Technology Directorate .
    First and Immediate Responders: Current capability needs and research challenges2019In: Proceedings of the Human Factors and Ergonomics Society Annual Meeting, 2019, Vol. 63, p. 640-641Conference paper (Refereed)
    Abstract [en]

    The purpose of this panel will be to discuss current research and challenges relating to the work of first and immediate responders. The main discussion of the panel will have panelist challenge human factors researchers to consider new directions of research addressing current capability and knowledge gaps faced by the first and immediate responder communities.

  • 48.
    Prytz, Erik
    et al.
    Linköping University, Department of Computer and Information Science, Human-Centered systems. Linköping University, Faculty of Arts and Sciences.
    Hodza-Beganovic, Ruhije
    Region Östergötland, Center for Disaster Medicine and Traumatology.
    Carlsson, Henrik
    Region Östergötland, Center for Disaster Medicine and Traumatology.
    Nilsson, Helene
    Region Östergötland, Center for Disaster Medicine and Traumatology. Linköping University, Department of Clinical and Experimental Medicine, Division of Clinical Sciences. Linköping University, Faculty of Health Sciences.
    Jonson, Carl-Oscar
    Region Östergötland, Center for Disaster Medicine and Traumatology. Linköping University, Department of Clinical and Experimental Medicine, Division of Clinical Sciences. Linköping University, Faculty of Health Sciences.
    Identifying the Educational and Technical Needs of the Emergency Dispatch Service in Kosovo using Hierarchical Task Analysis2015In: Abstracts of Scientific Papers - 19th World Congress on Disaster and Emergency Medicine, Cambridge University Press, 2015, Vol. 30, p. s13-s14Conference paper (Refereed)
    Abstract [en]

    Study/Objective: The objective of this research is to document and evaluate the technical and educational needs for the emergency response system in Pristina, Kosovo. This is a current work in progress, and the part reported here focuses on the needs so far identified through Hierarchical Task Analyses (HTA) of the current dispatch system.

    Background: There is currently a lack of support systems for the emergency services in Pristina. Specifically, there are no support systems to aid coordination of the resources available to the emergency dispatch. This might delay emergency care to patients in need. This project relies on a Man-Technology-Organization (MTO) perspective and aims to create additional capacity for all parts (M, T, and O) in the emergency response chain.

    Methods: The ongoing research project will be conducted in several phases; the first of which is a data collection phase to analyze the needs of the emergency services as an advanced  socio-technical  system.  This  phase  relies  on interviews with staff and an analysis of the current technology in use.

    Results: Eight interviews have been conducted so far in the project. The HTA analyses of the collected data material for the different roles (dispatch, ambulance, and ER-staff) show that there are several time-consuming subtasks that might delay the dispatch of emergency services. Through the HTAs, improvement needs has been identified for all three MTO areas: the human area, the technological area, and the organizational area.

    Conclusion: The overall goal of this project is to create capacity and increase system resilience by introducing educational and technical interventions aimed at reducing or removing the identified, inefficient tasks. This increased capacity should result in faster and more time-efficient prehospital emergency response and, through this, improved patient outcome. The next phase of the project will implement interventions aimed at the needs identified in this project.

  • 49.
    Prytz, Erik
    et al.
    Linköping University, Department of Clinical and Experimental Medicine. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Regionledningskontoret, Center for Disaster Medicine and Traumatology.
    Jacobsson, Ann
    Umeå University, Sweden.
    Jonson, Carl-Oscar
    Linköping University, Department of Clinical and Experimental Medicine, Division of Surgery, Orthopedics and Oncology. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Regionledningskontoret, Center for Disaster Medicine and Traumatology.
    The effect of moulage on immersion, realism and learning in a traffic accident training scenario for police, rescue service and ambulance students2019In: Prehospital and Disaster Medicine, ISSN 1049-023X, E-ISSN 1945-1938, Vol. 34, no 1, p. 17-18Article in journal (Other academic)
    Abstract [en]

    Introduction:

    Moulage is the art of creating faked injuries on actors for training purposes. Moulage is commonly used in disaster and emergency medicine training, as it is believed to improve learning through enhanced realism.

    Aim:

    The aim of the current study was to test the effect of moulage on perceived realism and learning during a joint exercise featuring students from the police, rescue service, and ambulance service.

    Methods:

    The scenario was a car accident with two victims. Students (n = 135) were divided into 12 groups. Moulage was applied to the victim actors for half the groups (n = 67), whereas the other half (n = 68) experienced the scenario without moulage. Victim cards were used in both scenarios. Immersion, realism, and learning was measured on a 100-point scale immediately post-scenario using a questionnaire.

    Results:

    Two (moulage group) by three (student population and police, rescue service, or ambulance) ANOVAS on realism, immersion, and learning found no effects on realism or immersion (all p>0.10). There was an effect of student group on learning, F(2, 92) = 3.518, p = 0.034, partial eta square = 0.071, such that the rescue service students had overall lower scores on learning (M = 53.87, SD = 28.29) compared to the police (M = 66.07, SD = 27.55) and ambulance students (M = 74.99, SD = 24.51). Cohen’s ds for moulage effect was calculated to 0.144 for immersion, 0.112 for realism, and 0.003 for learning.

    Discussion:

    The current study did not find any effects of moulage on immersion, realism, or learning. The effect sizes indicate that any effect of moulage on realism and immersion, should it exist, is in the approximate size of 2-3 points on a 100-point scale. The lack of effect may be due to limitations in the study design, but may also indicate that the use of moulage in addition to victim cards is not necessarily beneficial for novice students’ learning.

  • 50.
    Prytz, Erik
    et al.
    Linköping University, Department of Computer and Information Science, Human-Centered systems. Linköping University, Faculty of Arts and Sciences. Region Östergötland, Regionledningskontoret, Center for Disaster Medicine and Traumatology.
    Johansson, Patrik
    Linköping University, Department of Health, Medicine and Caring Sciences. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Heart Center, Department of Cardiology in Linköping.
    Sederholm Lawesson, Sofia
    Linköping University, Department of Health, Medicine and Caring Sciences, Division of Diagnostics and Specialist Medicine. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Heart Center, Department of Cardiology in Linköping.
    Ericsson, Maria
    Linköping University, Department of Health, Medicine and Caring Sciences, Division of Diagnostics and Specialist Medicine. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Heart Center, Department of Cardiology in Linköping.
    Thylén, Ingela
    Linköping University, Department of Health, Medicine and Caring Sciences, Division of Nursing Sciences and Reproductive Health. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Heart Center, Department of Cardiology in Linköping.
    Pilot evaluation of a persuasive mobile application to change individuals behavior during recurrent myocardial infarction2019In: PROCEEDINGS OF THE 31ST EUROPEAN CONFERENCE ON COGNITIVE ERGONOMICS: DESIGN FOR COGNITION (ECCE 2019), ASSOC COMPUTING MACHINERY , 2019, p. 192-195Conference paper (Refereed)
    Abstract [en]

    Objective: The objective of the current study was to develop and evaluate a persuasive decision-support aiming at reducing pre hospital delay and increasing ambulance service use for patients who suffer from a recurrent myocardial infarction. Materials and methods: The system was developed as a prototype mobile application for smartphones. The system was evaluated by four end-users with previous experience of myocardial infarction. The user tests were complemented with cognitive walkthroughs and heuristic evaluation. Results: A total of 14 persuasive design principles were used to guide the design of the system. The usability was regarded as high with an average score of 82 on the System Usability Scale. The users reported that they found the system highly persuasive. Conclusions: User-centered design together with persuasive design principles through iterative testing and development has resulted in a prototype app with potential to improve patients care seeking behavior. The content in the prototype will be further evaluated before it is integrated in educational interventions.

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