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  • 1.
    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.

    The full text will be freely available from 2020-03-21 08:11
  • 2.
    Prytz, Erik
    et al.
    Linköping University, Department of Computer and Information Science, Human-Centered systems. Linköping University, Faculty of Arts and Sciences.
    Norén, Caroline
    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.
    Fixation Differences in Visual Search of Accident Scenes by Novices and Expert Emergency Responders2018In: Human Factors, ISSN 0018-7208, E-ISSN 1547-8181, Vol. 60, no 8, p. 1219-1227Article in journal (Refereed)
    Abstract [en]

    Objective:

    We sought to investigate whether expert–novice differences in visual search behavior found in other domains also apply to accident scenes and the emergency response domain.

    Background:

    Emergency service professionals typically arrive at accidents only after being dispatched when a civilian witness has called an emergency dispatch number. Differences in visual search behavior between the civilian witness (usually a novice in terms of emergency response) and the professional first responders (experts at emergency response) could thus result in the experts being given insufficient or erroneous information, which would lead them to arrive unprepared for the actual situation.

    Method:

    A between-subjects, controlled eye-tracking experiment with 20 novices and 17 experts (rescue and ambulance service personnel) was conducted to explore expert–novice differences in visual search of accident and control images.

    Results:

    The results showed that the experts spent more time looking at task-relevant areas of the accident images than novices did, as predicted by the information reduction hypothesis. The longer time was due to longer fixation durations rather than a larger fixation count.

    Conclusion:

    Expert–novice differences in visual search are present in the emergency domain. Given that this domain is essential to saving lives and also relies heavily on novices as the first link in the chain of response, such differences deserve further exploration.

    Application:

    Visual search behavior from experts can be used for training purposes. Eye-tracking studies of novices can be used to inform the design of emergency dispatch interviews.

  • 3.
    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.

  • 4.
    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)
  • 5.
    Rybing, Jonas
    et al.
    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.
    Hornwall, Johan
    Linköping University, Department of Clinical and Experimental Medicine. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Center for Disaster Medicine and Traumatology.
    Nilsson, Heléne
    Region Östergötland, Center for Disaster Medicine and Traumatology. Linköping University, Faculty of Medicine and Health Sciences. Linköping University, Department of Clinical and Experimental Medicine, Division of Surgery, Orthopedics and Oncology.
    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.
    Bång, Magnus
    Linköping University, Department of Computer and Information Science, Human-Centered systems. Linköping University, Faculty of Science & Engineering.
    Designing a Digital Medical Management Training Simulator Using Distributed Cognition Theory2017In: Journal Simulation & Gaming, ISSN 1046-8781, E-ISSN 1552-826X, Vol. 48, no 1, p. 131-152Article in journal (Refereed)
    Abstract [en]

    Background Training of medical professionals is important to improve care during mass-causality events. Therefore, it is essential to extend knowledge on how to design valid and usable simulation-based training environments.

    Purpose This article investigates how distributed cognition and simulation theory concepts can guide design of simulation-based training environments. We present the design and user evaluation of DigEmergo, a simulator for training and assessing emergency medicine management.

    Design approach A prior Distributed Cognition in Teamwork (DiCoT) analysis of the Emergo Train System (ETS) guided the design process. The design objective of DigEmergo was to be useful, usable, retain distributed cognition features of ETS, and strengthen validity and output reliability.

    Evaluation Eight expert ETS instructors participated in a formative system evaluation. The Technology Assessment Model (TAM) questionnaire was used to measure usefulness and ease of use. Observations and post-test interviews were conducted to contextualize the measures.

    Results The results showed that DigEmergo was perceived as somewhat to quite useful and somewhat easy to use. Overall, expert users considered DigEmergo promising and successful in retaining core ETS features.

    Conclusions The study indicates that a design methodology based on distributed cognition and simulation theory can be successfully combined to guide simulator (re)design and strengthen simulator validity.

  • 6.
    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.

  • 7.
    Prytz, Erik
    et al.
    Linköping University, Department of Computer and Information Science, Human-Centered systems. Linköping University, Faculty of Arts and Sciences.
    Rybing, Jonas
    Linköping University, Department of Computer and Information Science, Human-Centered systems. Linköping University, Faculty of Arts and Sciences.
    Carlsson, Henrik
    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.
    Evaluating learning and simulation exercise efficacy for a course on advanced prehospital trauma2017In: Abstracts of Scientific Papers-WADEM Congress on Disaster and Emergency Medicine 2017, Cambridge University Press, 2017, p. S222-S223Conference paper (Other academic)
    Abstract [en]

    Study/Objective: In this study, we aimed to design a questionnaire battery for course and simulation exercise evaluation, and pilot-test the battery by evaluating a course on Advanced Prehospital Trauma Care (APTC).

    Background: Many course evaluations suffer from simplistic metrics, such as whether the course participants “enjoyed” the course. In contrast, the current study sought to measure (self-estimated) pre- and post-course knowledge, relevant to specific learning objectives, as well as questions pertaining to specific factors of the simulation exercises used in the course (eg, fidelity/realism, learning objective fit, transferability of tools/procedures, usefulness, among others) were selected based on simulation theory and simulation-based training literature.

    Methods: Data were collected during a course on APTC. Twelve students participated. The mean professional experience was 15.5 years. The participants completed an informed consent form prior to the study. They completed a pre-course questionnaire, a post-course questionnaire, and a course evaluation form.

    Results: The mean self-estimated improvement in theoretical knowledge pertaining to the course objectives was 8.23 on a 0 to 10 scale, and 8.25 for practical skills. Greatest improvement was in advanced airway management, physiological reactions to hypothermia, pneumothorax interventions, special considerations for patients injured by explosives (eg, blast injuries and burns), and medical decision making during an active shooter scenario. The evaluation of the simulation exercises received high marks (mean rating 4.53 [3.92-4.92] out of 5.0) on all aspects. The participants rated the overall course quality at 4.67 (on a 0 to 5 scale), with the simulations, practical exercises, and the structure of moving from theory to practice being mentioned as particularly positive.

    Conclusion: Overall, the results showed that the APTC course received high marks on almost all measured factors. Further validation of the questionnaires is needed before general implementation of the battery can be recommended. Such implementation would benefit diverse course development and quality assurance

  • 8.
    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: Abstracts of Scientific Papers-WADEM Congress on Disaster and Emergency Medicine 2017, Cambridge University Press, 2017, Vol. 32, p. S19-S20Conference paper (Refereed)
  • 9.
    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

  • 10.
    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.

  • 11.
    Scerbo, Mark
    et al.
    Department of Psychology, Old Dominion University, Norfolk, VA.
    Britt, Rebecca
    Department of Surgery, Eastern Virginia Medical School, Norfolk, VA.
    Montano, Michael
    Department of Psychology, Old Dominion University, Norfolk, VA.
    Kennedy, Rebecca
    Department of Psychology, Old Dominion University, Norfolk, VA.
    Prytz, Erik
    Department of Psychology, Old Dominion University, Norfolk, VA.
    Stefanidis, Dimitri
    Bariatric Surgery Center, Indiana University, Bloomington, IN.
    The Effects of a retention interval and refresher session on intracorporeal suturing and knot tying skill and mental workload2017In: Surgery, ISSN 0039-6060, E-ISSN 1532-7361, Vol. 161, no 5, p. 1209-1214Article in journal (Refereed)
    Abstract [en]

    Background. The effects of refraining from practice for different intervals on laparoscopic suturing and mental workload was assessed with a secondary task developed by the authors. We expected the inability to practice to produce a decrease in performance on the suturing, knot tying, and secondary task and skills to rebound after a single refresher session.

    Methods. In total, 22 surgical assistant and premedical students trained to Fundamentals of Laparoscopic Surgery proficiency in intracorporeal suturing and knot tying were assessed on that task using a secondary task. Participants refrained from practicing any Fundamentals of Laparoscopic Surgery tasks for 1 or 5 months. At the time of their return, they were assessed immediately on suturing and knot tying with the secondary task, practiced suturing and knot tying for 40 minutes, and then were reassessed.

    Results. The mean suture times from the initial reassessment were greater than the proficiency times but returned to proficiency levels after one practice session, F(2, 40) = 14.5, P < .001, partial h2 = .420. Secondary task scores mirrored the results of suturing time, F(2, 40) = 6.128, P < .005, partial h2 = .235, and were moderated by retention interval.

    Conclusion. When participants who reached proficiency in suturing and knot tying were reassessed after either 1or 5 months without practice, their performance times increased by 35% and secondary task scores decreased by 30%. These deficits, however, were nearly reversed after a single refresher session.

  • 12.
    Prytz, Erik
    et al.
    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 Clinical Sciences. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Center for Disaster Medicine and Traumatology.
    Pilemalm, Sofie
    Linköping University, Department of Management and Engineering, Information Systems. Linköping University, Faculty of Arts and Sciences.
    Stenberg, Rebecca
    Linköping University, Department of Management and Engineering, Business Administration. Linköping University, Faculty of Arts and Sciences.
    Holgersson, Stefan
    Linköping University, Department of Management and Engineering, Information Systems. Linköping University, Faculty of Arts and Sciences.
    Andersson, Tobias
    Linköping University, Department of Science and Technology, Communications and Transport Systems. Linköping University, Faculty of Science & Engineering.
    Att hantera framtidens skadeplatser: scenarier och utgångspunkter för kunskapsutveckling runt räddningsinsatser och skadeplatsarbete2016Report (Other academic)
    Abstract [sv]

    Denna rapport syftar till att presentera ett teoretiskt och metodologiskt underlag för att studera framtidens skadeplats. Rapporten är en del av forskningsprogrammet Effektiva räddningsinsatser på Framtidens Skadeplats som finns vid Centrum för Respons och Räddningssystem (CARER) vid Linköpings universitet. Effektiva räddningsinsatser på framtidens skadeplats är ett 5-årigt forskningsprogram som finansieras av Myndigheten för Stöd och Beredskap (MSB). Programmet tar utgångspunkt i den praktiska hanteringen av olyckor och andra akuta händelser och fokuserar även hur denna hantering bör förändras i takt med samhällsutvecklingen och hur man kan utveckla kunskap, metoder, och teknik som leder till effektiva räddningsinsatser. Denna rapport ska ses som en del av programmets första arbetspaket som handlar om kunskapsutveckling och prognostisering runt vilka olyckor som sker var, när, hur, vilka som skadas och vilka konsekvenser/(kaskad)effekter olika typer av händelser får.

    Målet med denna rapport är att skapa ett underlag för kommande aktiviteter inom forskningsprogrammet genom att beskriva olika skadeplatsscenarier med utgångspunkt i ett antal faktorer för att klassificera och strukturera olika typer av skadeplatser. Faktorerna som används utvecklas i denna rapport genom litteraturstudier, och kan summeras i följande fyra, övergripande kategorier: 1) Typ av händelse, 2) omfattning och allvarlighetsgrad, 3) område och utbredning, samt

    4) tidsaspekter. Utifrån faktorerna konstrueras ett antal framtida skadeplatsscenarier. I linje med MSBs tidigare framtidsanalyser syftar dessa inte till att förutspå de vanligaste eller mest troliga framtida skadeplatserna. Snarare är syftet att på ett strukturerat och detaljerat sätt beskriva möjliga framtida skadeplatser som är av särskilt intresse ur ett praktiker- och forskningsperspektiv.

     

    Totalt har 8 scenarier skapats. De är förankrade i de relevanta faktorer som framtagits för klassificering och strukturering och är skalbara och variationsrika i de faktorer de täcker. Tidshorisonten för scenarierna är ca 20 år framåt i tiden. De åtta scenarierna är följande:

    1. Tågolycka i väglöst land och kallt klimat
    2. Brand i hyreshus i socialt oroligt område
    3. Antagonistisk attack mot en utsatt grupp
    4. Mindre trafikolycka i glesbygd
    5. Mindre trafikolycka på tungt trafikerad väg
    6. Dammbrist och översvämning av Luleälven
    7. Fartygsolycka med utsläpp av giftiga ämnen
    8. Drunkning med eftersök

    Dessa scenarier kommer att användas i det fortsatta arbetet med att studera hur man skapar effektiva räddningsinsatser på framtidens skadeplats genom utveckling av organisation, teknik, och metodik.

  • 13.
    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.

  • 14.
    Prytz, Erik
    et al.
    Linköping University, Department of Computer and Information Science, Human-Centered systems. Linköping University, Faculty of Arts and Sciences.
    Scerbo, Mark
    Old Dominion University, Norfolk, Virginia, Unites States.
    Britt, Rebecca
    Eastern Virginia Western School, Norfolk, Virginia, United States.
    Kennedy, Rebecca
    Old Dominion University, Norfolk, Virginia, Unites States.
    Stefanidis, Dimitrios
    Carolinas Healthcare System, Charlotte, North Carolina, United States.
    Laparoscopic Skill and Mental Workload Measured over Retention Interval2016In: Abstracts to be Presented at the 16th Annual International Meeting on Simulation in Healthcare: January 16th – 20th, 2016 San Diego, CA, 2016Conference paper (Refereed)
    Abstract [en]

    Methods: Fourteen students (3 males, 12 females; ages 23Y28 years) from Eastern

    VirginiaMedical School’sMaster of Surgical Assisting Program participated in this IRB

    approved study. Participants practiced the peg transfer task from the FLS curriculum on

    a box simulator for 20Y30 minutes over 9Y15 weekly sessions. Their course schedule

    required all students to stop training after the 15th week irrespective of their performance

    level. They returned after a 1-month interval to resume training. The dependent

    measure was task completion time. The secondary task presented images of four balls in

    a simulated tunnel, superimposed at 50% transparency over the laparoscopic display so

    that both tasks were in focal vision. Images were presented for 300 msec every 2Y4 sec.

    On half of the presentations, one ball changed its position. Participants had to detect

    those changes by pressing a foot pedal. The dependent variables were the proportion of

    correctly identified targets and false alarms.

    Hypothesis: Performing laparoscopy places heavy demands on visual attention and

    requires extensive practice to achieve proficiency. Recently, some researchers have

    measured the mental workload imposed by laparoscopy using the secondary task

    technique.1,2 According to multiple resource theory, pools of attentional resources are

    distinguished by perceptual/cognitive processing stages, verbal and spatial processing

    codes, and sensory modality with the vision separated into focal and peripheral

    channels.3 Thus, a secondary task that competes for the same resources as a primary

    task will cause interference and can be sensitive to differences in mental workload. In

    this study,mental workload was assessed with a secondary task that uses the same visual

    spatial resources as laparoscopy.We studied effects of refraining from practice during a

    1-month interval. We expected to see a decline in performance after the delay, but our

    goal was to see if decline would be present in the workload measure.

    Results: Three sets of tests were performed: the data for the last two training trials (N

    and N-1), the last training trial (N) and the initial retention test after the delay interval,

    and the initial retention test vs. a final test after 30 minutes of retraining (see Table 1).

    All means were evaluated with dependent t tests (alpha = .05). There were no differences

    between the last two training trials on any measure. The peg task completion

    times were significantly longer on the initial test compared to the last training trial,

    t(13) = 2.36, p G .05. There were no differences between the initial and final test on any

    measure (p 9 .05).

    Conclusion: The results show minimal effects on the peg transfer task from the FLS

    program over a 1-month retention interval. Mean completion times were significantly

    longer after the delay interval, but only by 6 seconds (or less than 10%). There were no

    significant differences on the secondary task. Thus, the slower performance times were

    not accompanied by any appreciable changes in mental workload. These results show

    that 9 Y 15 training sessions were sufficient to establish robust skills for the peg transfer

    task and that these skills were fairly resilient to a moderate disruption in the training

    schedule. Further, the secondary task used in this study was shown to provide an alternative

    index of laparoscopic workload that can complement traditional metrics of

    speed and accuracy. Future research is needed to examine disruption effects over a

    wider range of laparoscopic tasks and longer intervals.

  • 15.
    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.

  • 16.
    Rybing, Jonas
    et al.
    Linköping University, Department of Computer and Information Science, Human-Centered systems. Linköping University, Faculty of Science & Engineering.
    Larsson, Johan
    Linköping University, Faculty of Medicine and Health Sciences, Faculty of Health Sciences, Medical Programme.
    Jonson, Carl-Oscar
    Linköping University, Department of Clinical and Experimental Medicine, Division of Clinical 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.
    Preliminary Validation Results of DigEmergo for Surge Capacity Management2016In: Proceedings of the 13th International Conference on Information Systems for Crisis Response and Management / [ed] Andrea H. Tapia, Pedro Antunes, Victor A. Bañuls, Kathleen Moore and João Porto de Albuquerque, ISCRAM , 2016Conference paper (Refereed)
    Abstract [en]

    This paper presents preliminary analysis from a validation study of a novel emergency medicine command and control training and evaluation simulator: DIGEMERGO®. The simulated emergency scenario was a surge capacity event at a generic emergency department, in which the participants took on a management role as the emergency department’s coordinating head nurse. A between group validation design with medical expert and novice participants was used. Initial analysis examined three triage measures associated with surge capacity management performance: time to triage, amount of patients triaged, and triage accuracy. The results show that experts were significantly more accurate at triaging in-hospital patients, but not incoming trauma patients. No significant differences in time or number of patients triaged was found. These initial results partially indicate simulator validity, but trauma patient triage accuracy suffered from a confounding variable in the triage system used. Analysis of additional measures is undergoing to further investigate validity claims.

  • 17.
    Prytz, Erik
    et al.
    Linköping University, Department of Computer and Information Science, Human-Centered systems. Linköping University, Faculty of Arts and Sciences.
    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. Region Östergötland, Center for Disaster Medicine and Traumatology.
    Workload Differences Across Command Levels and Emergency Response Organizations During a Major Joint Training Exercise2016In: Journal of Emergency Management, ISSN 1543-5865, Vol. 14, no 4, p. 289-297Article in journal (Refereed)
    Abstract [en]

    OBJECTIVE:

    This study reports on an initial test using a validated workload measurement method, the NASA Task Load Index (TLX), as an indicator of joint emergency exercise effectiveness. Prior research on emergency exercises indicates that exercises must be challenging, ie, result in high workload, to be effective. However, this is often problematic with some participants being underloaded and some overloaded. The NASA TLX was used to test for differences in workload between commanders and subordinates and among three different emergency response organizations during a joint emergency exercise.

    DESIGN:

    Questionnaire-based evaluation with professional emergency responders.

    SETTING:

    The study was performed in conjunction with a large-scale interorganizational joint emergency exercise in Sweden.

    PARTICIPANTS:

    A total of 20 participants from the rescue services, 12 from the emergency medical services, and 12 from the police participated in the study (N=44). Ten participants had a command-level role during the exercise and the remaining 34 were subordinates.

    MAIN OUTCOME MEASURE(S):

    The main outcome measures were the workload subscales of the NASA TLX: mental demands, physical demands, temporal demands, performance, effort, and frustration.

    RESULTS:

    The results showed that the organizations experienced different levels of workload, that the commanders experienced a higher workload than the subordinates, and that two out of three organizations fell below the twenty-fifth percentile of average workload scores compiled from 237 prior studies.

    CONCLUSIONS:

    The results support the notion that the NASA TLX could be a useful complementary tool to evaluate exercise designs and outcomes. This should be further explored and verified in additional studies.

  • 18.
    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.

  • 19.
    Prytz, Erik
    et al.
    Linköping University, Department of Computer and Information Science, Human-Centered systems. Linköping University, Faculty of Arts and Sciences. Old Dominion University, Norfolk, VA, USA.
    Scerbo, Mark
    Old Dominion University, Norfolk, VA, USA.
    Changes in stress and subjective workload over time following a workload transition2015In: Theoretical Issues in Ergonomics Science, ISSN 1463-922X, E-ISSN 1464-536X, Vol. 16, no 6, p. 586-605Article in journal (Refereed)
    Abstract [en]

    Workload transitions present individuals with sudden changes in workload. These transitions may affect stress and coping behaviour. Two experiments were performed using a digit detection task that shifted between low and high workload levels to examine transition effects on performance, stress, and effort. The first experiment used a large magnitude transition and resulted in decreased estimates of task engagement and effort. Over time, the levels of subjective stress observed in the transitioned groups approached those of the non-transitioned control groups. The second experiment used a transition more moderate in magnitude. The results were similar to those from the first experiment except that the transition resulted in higher, sustained task engagement and effort. These findings indicate that over time, the perceived stress of transitioned individuals will approach those of non-transitioned individuals; however, the magnitude of the transition may influence individuals to either increase or decrease task-oriented, effortful coping.

  • 20.
    Prytz, Erik
    et al.
    Linköping University, Department of Computer and Information Science, Human-Centered systems. Linköping University, Faculty of Arts and Sciences.
    Rybing, Jonas
    Linköping University, Department of Computer and Information Science, Human-Centered systems. Linköping University, Faculty of Arts and Sciences.
    Evaluation of a Novel Method to Study Interorganizational Coordination in Medical Command and Control Centers2015In: Abstracts of Scientific Papers - 19th World Congress on Disaster and Emergency Medicine, Cambridge University Press, 2015, Vol. 30, p. s4-s5Conference paper (Refereed)
    Abstract [en]

    Study/Objective: Inter-organizational coordination is key to successful medical command and control (C2) during major incidents. However, evaluating this factor is often problematic, in particular during or after real emergencies as compared to controlled training scenarios. The purpose of this case study was to pilot test a non-intrusive data collection method for evaluating operative inter-organizational coordination during medical C2 situations.Background: This study was conducted during a planned major incident in Sweden. The major incident studied was the Göteborgsvarvet half-marathon, the largest half-marathon event in the world with more than 200 000 attending spectators and over 60 000 runners. The studied C2 center included representatives from local hospitals, Göteborgsvarvet organization, police, fire department, ambulance service, the local traffic and infrastructure management office, and emergency dispatch.

    Methods: A combination of qualitative and quantitative methods was employed in this study. The qualitative methods included an ethnographic field study with on-site observations and contextual inquiry interviews. The quantitative methods included validated and experimental questionnaires distributed to the command center personnel at pre-determined intervals. These questionnaires aimed at gathering data on workload, stress, and shared and individual situational awareness.

    Results: The data indicate that the qualitative methods were less intrusive than the quantitative methods. The observations and contextual inquiries could be performed without interruptions while periods of high workload resulted in lower or delayed response rates on the questionnaires. Simple questionnaires produced an 80% response rate, complex questionnaires only 40%.

    Conclusion: The employed method appears useful to evaluate inter-organizational coordination and showed potential to gather meaningful data without being intrusive or disturbing the operative C2 activities. Due to the time-sensitive nature of emergency C2-work, unobtrusive qualitative methods and short, easy to fill out questionnaires are recommended for future studies.  The  results  from  this  pilot  will inform future operative C2 studies during similar planned major incidents.

  • 21.
    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.

  • 22.
    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.

  • 23.
    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.

  • 24.
    Rybing, Jonas
    et al.
    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.
    Hornwall, Johan
    Linköping University, Department of Clinical and Experimental Medicine. Linköping University, Faculty of Health Sciences.
    Jonson, Carl-Oscar
    Linköping University, Department of Clinical and Experimental Medicine, Division of Clinical Sciences. Linköping University, Faculty of Health Sciences. Region Östergötland, Center for Disaster Medicine and Traumatology.
    Nilsson, Heléne
    Linköping University, Department of Clinical and Experimental Medicine, Division of Clinical Sciences. Linköping University, Faculty of Health Sciences.
    Bång, Magnus
    Linköping University, Department of Computer and Information Science, Human-Centered systems. Linköping University, Faculty of Science & Engineering.
    Preliminary evaluation results of DigEmergo - a digital simulator prototype for disaster and emergency management training2015In: Prehospital and Disaster Medicine / [ed] Samuel J. Stratton, New York, 2015, Vol. 30, p. 92-92Conference paper (Refereed)
    Abstract [en]

    Objective

    This abstract presents early findings on a user evaluation of DigEmergo - a digital training simulator prototype for disaster and emergency management. The overall goal of this research project was to design a flexible tool for training and evaluation of emergency response. Therefore we developed DigEmergo; a digital simulator based on Emergo Train System® (ETS; a globally used tabletop simulator) using electronic whiteboards.

    Background

    Disaster and emergency response requires competent and coordinated teams. However, training such teams efficiently is complicated. Full-scale high-fidelity simulations are both expensive to perform and difficult to evaluate. Thus, there is a need for scalable environments, such as digital simulations, to train medical decision-making and team coordination.

    Methods

    The DigEmergo prototype ran on an 87-inch multi-touch digital whiteboard and was evaluated using a training scenario and methodology adapted from ETS. Nine participants with prior ETS experience participated in the evaluation, which was led by two instructors. After completed scenarios first impressions were discussed and questionnaires including open-ended questions were completed.

    Results

    Preliminary results of the qualitative analysis show that the participants were positive towards DigEmergo. Several participants commented on instructor benefits, e.g. ease of setting up exercises and automatic statistics for after action reviews. Common concerns were potential technical issues, that multiple digital whiteboards are needed to avoid clutter, and loss of flexibility as digital whiteboards are less common than regular whiteboards.

    Conclusion

    Experienced users of ETS identified both advantages and disadvantages with a digital version of ETS. Identified benefits concerned the instructors’ tasks, increased control, and automatic data collection. Perceived disadvantages mainly related to concerns regarding the size of the digital whiteboard and potential technical issues. The participants also identified development potential, e.g. a small-scale tablet version of ETS for frequent training. Future work include analysis of collected evaluation data and additional prototype development.

  • 25.
    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.

  • 26.
    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)
  • 27.
    Prytz, Erik
    et al.
    Linköping University, Department of Computer and Information Science, Human-Centered systems. Linköping University, Faculty of Arts and Sciences.
    Scerbo, Mark
    Old Dominion University.
    The effects of a workload transition on stress over time2014In: Proceedings of the Human Factors and Ergonomics Society Annual Meeting, Human Factors and Ergonomics Society, 2014, Vol. 58, p. 1766-1770Conference paper (Refereed)
    Abstract [en]

    The present study explored the effects of a workload transition on three dimensions of stress: task engagement, distress, and worry. Previous research on the effects of workload transitions has generated conflicting results. It was suggested that the concept of a continuous stress appraisal process could potentially resolve these prior conflicting results. A digit-processing task with high and low task demands was used to test this suggested explanation. Subjective reports of stress were measured both one minute and six minutes posttransition to show changes over time. The results showed that a workload transition affects each of the three stress dimensions differently such that task engagement declined over time, distress decreased following a high-to-low transition six minutes posttransition, and worry increased following a transition. These results suggest that distress and worry are more sensitive to workload transitions than task engagement. Further, the appraisal process may partially explain the prior conflicting findings by accounting for changes in stress over time.

  • 28.
    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. 

  • 29.
    Prytz, Erik
    et al.
    Department of Psychology, Old Dominion University.
    Montano, Michael
    Department of Psychology, Old Dominion University.
    Rebecca, Kennedy
    Department of Psychology, Old Dominion University.
    Scerbo, Mark
    Department of Psychology, Old Dominion University.
    Britt, Rebecca
    Surgery, Carolinas Healthcare System, Charlotte, NC, USA.
    Davis, Stephen
    Obstetrics and Gynecology, Eastern Virginia Medical School, Norfolk, VA, USA.
    Stefanidis, Dimitrios
    Surgery, Carolinas Healthcare System, Charlotte, NC, USA.
    Using a Spatial Task to Measure Laparoscopic Mental Workload: Initial Results2013In: Research Abstracts to be Presented at the 13th Annual International Meeting on Simulation in Healthcare, 2013Conference paper (Refereed)
  • 30.
    Prytz, Erik
    et al.
    Old Dominion University, Department of Psychology.
    Scerbo, Mark
    Old Dominion University, Department of Psychology.
    Spatial judgments in the horizontal and vertical planes from different vantage points2012In: Perception, ISSN 0301-0066, E-ISSN 1468-4233, Vol. 41, no 1, p. 26-42Article in journal (Refereed)
  • 31.
    Rebecca, Kennedy
    et al.
    Department of Psychology, Old Dominion University.
    Anderson-Montoya, Brittany
    Department of Psychology, Old Dominion University.
    Scerbo, Mark
    Department of Psychology, Old Dominion University.
    Prytz, Erik
    Department of Psychology, Old Dominion University.
    Belfore, Lee
    Old Dominion University.
    Abuhamad, Alfred
    Eastern Virginia Medical School.
    Davis, Stephen
    Eastern Virginia Medical School.
    chauhan, Suneet
    Eastern Virginia Medical School.
    The Influence of Visual Aids on Detecting Early and Late Decelerations in Maternal-Fetal Heart Rate Patterns2012In: PROCEEDINGS of the HUMAN FACTORS and ERGONOMICS SOCIETY 56th ANNUAL MEETING, 2012, p. 1317-1321Conference paper (Refereed)
    Abstract [en]

    The present study examined how well individuals could differentiate between two different types of signals (early and late decels) in maternal-fetal heart rate tracings with and without the use of a visual aid. Twenty-one undergraduates twice viewed 80 simulated images under four different signal-to-noise (S/N) ratios. Further, the late decels were delayed in 4-sec increments. In one block of trials, the images were presented without a visual aid, and in the other block a visual aid consisting of a large turquoise crosshair was overlaid on the images. The results indicated that lower S/N ratios and shorter onset delays made signals more difficult to distinguish. However, overall levels of accuracy were significantly higher when the visual aid was present. These results provide initial evidence that utilizing visual aids can enhance the ability to detect critical signals in maternal-fetal heart rate patterns.

  • 32.
    Prytz, Erik
    et al.
    Old Dominion University, USA.
    Montano, Michael
    Department of Psychology, Old Dominion University, USA.
    Scerbo, Mark
    Department of Psychology, Old Dominion University, USA.
    Using Fitts’ Law for a 3D Pointing Task on a 2D Display: Effects of Depth and Vantage Point2012In: Proceedings of the Human Factors and Ergonomics Society Annual Meeting, Sage Publications, 2012, Vol. 56, p. 1391-1395Conference paper (Refereed)
  • 33.
    Prytz, Erik
    et al.
    Old Dominion University, USA.
    Scerbo, Mark
    Department of Psychology, Old Dominion University, USA.
    Rebecca, Kennedy
    Department of Psychology, Old Dominion University, USA.
    Spatial Judgments from Different Vantage Points: A Different Perspective2011In: Proceedings of the Human Factors and Ergonomics Society Annual Meeting, Sage Publications, 2011, Vol. 55, p. 1274-1278Conference paper (Refereed)
    Abstract [en]

    Todorovic (2008) reported that there are systematic errors in the perception of 3-D space when viewing 2-D linear perspective drawings depending on the observer’s vantage point. Because Todorovic’s findings were restricted to the horizontal plane, the current study was designed to determine whether the magnitude of these errors would be similar in the vertical plane. Participants viewed a 2D image containing rows of columns aligned on parallel converging lines receding to a vanishing point. They were asked to judge where in the physical room the next column should be placed. The results support Todorovic (2008) in that systematic deviations in the spatial judgments depended on vantage point for both the horizontal and vertical planes. However, the pattern of deviation differed between the two planes. While judgments in both planes failed to compensate adequately for the vantage point shift, the vertical plane induced greater distortions of the stimulus image itself within each vantage point.

  • 34.
    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.

  • 35.
    Prytz, Erik
    et al.
    Santa Anna IT Research Institute, Linköping, Sweden.
    Nilsson, Susanna
    Swedish Defence Research Institute, Linköping, Sweden.
    Jönsson, Arne
    Santa Anna IT Research Institute, Linköping, Sweden.
    The Importance of Eye-contact for Collaboration in AR Systems2010In: 9th IEEE International Symposium on Mixed and Augmented Reality 2010 / [ed] Tobias Höllerer, Vincent Lepetit, Jun Park, IEEE , 2010, p. 119-126Conference paper (Refereed)
    Abstract [en]

    Eye contact is believed to be an important factor in normal human communication and as a result of this a head mounted display (HMD) is often seen as something intrusive and limiting. This can be especially problematic when AR is used in a collaborative setting. The study presented in this paper aims to investigate the effects an HMD-based AR system can have on eye contact behaviour between participants in a collaborative task and thus, in extension, the effects of the HMD on collaboration itself. The focus of the study is on task-oriented collaboration between professionals. The participants worked through three different scenarios alternating between HMDs and regular paper maps with the purpose of managing the crisis response to a simulated major forest fire. Correlations between eye contact between participants and questionnaire items concerning team- and taskwork were analysed, indicating that, for the paper map condition, a high amount of eye contact is associated with low confidence and trust in the artefacts used (i.e. paper map and symbols). The amount of eye-contact in both conditions was very low. It was significantly higher for conditions without HMDs. However, the confidence and trust in the artefacts was generally rated significantly higher with HMDs than without. In conclusion, the decrease in eye contact with HMDs does not seem to have a direct effect on the collaboration in a professional, task-oriented context. This is contrary to popular assumptions and the results are relevant for future design choices for AR systems using HMDs.

  • 36.
    Woltjer, Rogier
    et al.
    Linköping University, Department of Computer and Information Science, CSELAB - Cognitive Systems Engineering Laboratory. Linköping University, The Institute of Technology. Linköping University, Department of Computer and Information Science, Human-Centered systems.
    Prytz, Erik
    Linköping University, Department of Computer and Information Science, CSELAB - Cognitive Systems Engineering Laboratory. Linköping University, The Institute of Technology. Linköping University, Department of Computer and Information Science, Human-Centered systems. Cognitive Science Masters Programme, LiU.
    Smith, Kip
    Linköping University, Department of Computer and Information Science, CSELAB - Cognitive Systems Engineering Laboratory. Linköping University, The Institute of Technology. Linköping University, Department of Computer and Information Science, Human-Centered systems.
    Functional modeling of agile command and control2009In: 14th International Command and Control Research and Technology Symposium (ICCRTS), Washington, DC, USA: DOD CCRP , 2009Conference paper (Refereed)
    Abstract [en]

    A critical element to successful command and control (C2) is developing and updating an accurate and lucid model of the interdependencies between functional units, e.g., multiple platoons of artillery and tanks. Two of the challenges to this understanding are (1) the adoption of a detailed description of interdependency and the associated understanding of interdependent functions (Brehmer, 2007) and (2) the application of that description to both own and opponent forces’ opportunities and vulnerabilities to provide for agility (Alberts, 2007). This paper documents a straightforward approach to modeling functional interdependency that addresses these challenges. The Functional Resonance Analysis Method (FRAM; Hollnagel, 2004) is shown to describe the C2 functions of the DOODA loop (Brehmer, 2007) and the tactical and operational functions of military activity. FRAM models are applied to own and opponent forces in a computer-based dynamic war-game (DKE) to reveal and characterize both agile and unsuccessful C2 practice.

  • 37.
    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.

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