Eye tracking to investigate cue processing in medical decision making : A scoping review
- Authors: Al-Moteri, Modi , Symmons, Mark , Plummer, Virginia , Cooper, Simon J.
- Date: 2017
- Type: Text , Journal article , Review
- Relation: Computers in Human Behavior Vol. 66, no. (2017), p. 52-66
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- Description: Eye-tracking techniques have been adopted as a research tool for a wide range of applications in healthcare studies. Recently, healthcare researchers have started to show interest in using eye-tracking techniques to study medical decision-making. Mapping the literature pertaining to eye tracking using a systematic approach is valuable at this point to bring together all the studies to date on how medical decision-makers make decisions, and the results may contribute to clinical training. This review follows Arksey and O'Malley's scoping review framework to improve our understanding of visual cue processing in medical decision-making. A diverse range of studies was identified, and the results are presented descriptively to develop a more coherent understanding of different aspects of cue processing and errors in medical decision-making. The review shows the need for more extensive investigations of cue processing and medical decision-making. Crown Copyright (C) 2016 Published by Elsevier Ltd. All rights reserved.
Inattentional blindness and pattern-matching failure : The case of failure to recognize clinical cues
- Authors: Al-Moteri, Modi , Symmons, Mark , Cooper, Simon J. , Plummer, Virginia
- Date: 2018
- Type: Text , Journal article
- Relation: Applied Ergonomics Vol. 73, no. (2018), p. 174-182
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- Description: Eye-tracking methodology was used to investigate lapses in the appropriate treatment of ward patients due to not noticing critical cues of deterioration. Forty nursing participants with different levels of experience participated in an interactive screen-based simulation of hypovolemic shock. The results show that 65% of the participants exhibited at least one episode of non-fixation on clinically relevant, fully visible cues that were in plain sight. Thirty-five percent of participants dwelt for sufficient time (>200 ms) on important cues for perception to take place, but no action followed, indicating they had pattern-matching failure. When participants fail to notice what, they should notice in patient status until it is too late, this can have serious consequences. Much work needs to be done, since these human perceptual limitations can affect patient safety in general wards.
Clinical deterioration of ward patients in the presence of antecedents : A systematic review and narrative synthesis
- Authors: Al-Moteri, Modi , Plummer, Virginia , Cooper, Simon J. , Symmons, Mark
- Date: 2019
- Type: Text , Journal article , Review
- Relation: Australian Critical Care Vol. 32, no. 5 (2019), p. 411-420
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- Description: Aim: The aim of this review was to identify and synthesise published accounts of recognising and responding to patient deterioration in the presence of deterioration antecedents. Design: The systematic review canvassed four electronic databases/ search engines for studies of adult ward patients who had altered physiological parameters before developing major adverse events. Synthesis Methods: The findings were synthesised using a narrative approach. Results: Clinical deterioration can be missed by nurses, even with adequate charting. Delays in recognising and responding to patient deterioration remains an international patient safety concern, and strategies to enhance recognition of patient deterioration have not achieved consistent improvements. The lack of significant and sustained improvement through targeted training suggests the problem may be rooted in human behaviour and local ward culture. Nurses play a pivotal role in recognising and responding to patient deterioration; however, patient records do not facilitate tracking of all nurse decisions and actions, and any undocumented care cannot be easily captured by auditing processes. Conclusion: Failure to recognise clinical deterioration was evident even with adequate charting. It is not clear if nurses do not recognise clinical deterioration because they failed to interpret the signs of deterioration or they made a conscious decision not to escalate based on their clinical judgement or they lacked attention at the time of the event. Whatever the reason, focus is warranted for nurses' decisionmaking after the recording of clinical deterioration signs and the role of human factors in delayed recognition, before maximum benefit of any strategy can be achieved.
Nurses' cognitive and perceptual bias in the identification of clinical deterioration cues
- Authors: Al-Moteri, Modi , Cooper, Simon J. , Symmons, Mark , Plummer, Virginia
- Date: 2020
- Type: Text , Journal article
- Relation: Australian Critical Care Vol. 33, no. 4 (2020), p. 333-342
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- Description: Background: Perception and processing of clinical cues have rarely been investigated in the nursing literature despite their relevance to the early identification and management of clinical deterioration. Aim: This study used a hypovolemic shock scenario from the Feedback Incorporating Review and Simulation Techniques to Act on Clinical Trends (FIRST2ACT) virtual simulation program, equipped with an eye tracker, to investigate cue processing during the management of patient deterioration. Result: The study revealed that attention deviation distorted interpretation of subsequent cues, causing 63% of participants to exhibit a cognitive bias (heightened sensitivity to specific but noncritical cues) and 65% to exhibit at least one episode of nonfixation on clinically relevant cues. Attention deviation and distorted interpretations of clinical cues will have an impact on patient safety. Conclusion: The findings are likely to have important implications for understanding error and associated training implications. © 2019 Australian College of Critical Care Nurses Ltd
Rapid visual search games and accuracy of students' clinical observation skills : a comparative study
- Authors: Al-Moteri, Modi , Alrehaili, Amani , Plummer, Virginia , Yaseen, Ruba , Alhakami, Reem
- Date: 2021
- Type: Text , Journal article
- Relation: Clinical Simulation in Nursing Vol. 55, no. (2021), p. 19-26
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- Description: Background: Rapid visual search (RVS) games require a player to search for a target against a distracting background. Playing RVS is known to improve observation and related skills for those professions that require ultimate observation skills. Aim: To examine whether using RVS games improves clinical observation of nursing students. Method: Post intervention assessment design was used in which participants were assigned to either RVS group or non-RVS group and their performance was compared to assess the impact of RVS games on students’ observational skills. Finding: Study findings revealed that RVS improved identification of cues that are highly visual in nature and related to liver cirrhosis. This may indicate that the RVS groups were more focused on the clinical markers than were the non-RVS group. © 2021. **Please note that there are multiple authors for this article therefore only the name of the first 5 including Federation University Australia affiliate “Virginia Plummer” is provided in this record**
The impact of COVID-19 on the service of emergency department
- Authors: Alharthi, Shaia , Al-Moteri, Modi , Plummer, Virginia , Thobiaty, Abdulellah
- Date: 2021
- Type: Text , Journal article
- Relation: Healthcare (Switzerland) Vol. 9, no. 10 (2021), p.
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- Description: (1) Introduction: the COVID-19 pandemic significantly impacted the number and acuity of emergency departments (ED) patients, specifically those with non-COVID-19-related health problems. However, the exact impact of the COVID-19 pandemic on ED services is the subject of comprehensive debate. (2) Aim: to gain insight into the consequences of the first wave of the COVID-19 pandemic based on non-COVID-19 presentations and patient acuity using the Canadian Triage and Acuity Scale (CTAS). (3) Method: in Phase 1, the ED records of one of the main regional non-COVID-19 hospitals in Saudi Arabia were retrospectively audited from August 2020 to February 2021—after the first wave of COVID-19—then compared to information collected for the same period in previous year. Phase 2 included calculating the waiting time to identify delays and issues that may impact the triage effectiveness. (4) Results: a change across all CTAS levels was observed post the 1st wave of COVID-19 pandemic. Specifically, there was an increase in the number of patients presenting as higher acuity (CTAS 1 and 2) and a decrease in patients presenting as lower acuity (CTAS 4 and 5). Longer waiting times for patients presenting to ED were also reported. Specifically, 83% of patients presenting as higher acuity experienced a delay. (5) Conclusion: further studies are required to investigate association between the 1st wave of COVID-19 and patient presentations and/or acuity or patient demand and ED capacity. © 2021 by the authors. Licensee MDPI, Basel, Switzerland.
Coping strategies and burden dimensions of family caregivers for people diagnosed with obsessive–compulsive disorder
- Authors: El-Slamon, Marwa , Al-Moteri, Modi , Plummer, Virginia , Alkarani, Ahmed , Ahmed, Mona
- Date: 2022
- Type: Text , Journal article
- Relation: Healthcare (Switzerland) Vol. 10, no. 3 (2022), p.
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- Description: (1) Background: Obsessive–compulsive disorder (OCD) is a chronic mental disorder that can be a source of emotional, financial and/or social burden for family caregivers. Few studies have investigated family caregiving for patients diagnosed with OCD in relation to the coping strategies being used from a theoretical perspective. This study evaluated the burden and coping strategies of family caregivers for people diagnosed with OCD. (2) Methods: A cross-sectional study was conducted, in which 123 participants diagnosed with OCD and their caregivers were surveyed using three types of scales: obsessive–compulsive scale; coping scale; and burden scale. (3) Results: Of the participants with OCD and their caregivers, 53% and 31% were male and 47% and 69% were female, respectively. Around 80% of the OCD patients were considered young and their age ranged from 20–40 years old. Forty percent of caregivers in the current study reported a high burden level. The caregivers of those who had severe OCD symptoms had a lower coping level compared to the caregivers of those with less severe symptoms and those urban caregivers were able to better cope than rural caregivers. There was an association between OCD symptom severity and financial, work-related, social and family relationships, mental and health burdens for family caregivers. Meanwhile, the greater coping level of family caregivers, the lesser social and family, mental, and spouse relationship burden (p < 0.05); (4) Conclusions: The family caregivers of people diagnosed with OCD have specific aspects of burden and coping which require support by designing strategic interventions for family caregiver coping. © 2022 by the authors. Licensee MDPI, Basel, Switzerland.
Decision-making errors during recognizing and responding to clinical deterioration : gaze path-cued retrospective think-aloud
- Authors: Al-Moteri, Modi , Plummer, Virginia , Cooper, Simon
- Date: 2022
- Type: Text , Journal article
- Relation: Clinical Simulation in Nursing Vol. 73, no. (2022), p. 29-36
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- Description: Background: Using individuals. own eye gaze path and mouse click tracks has proven to be a valuable technique for identifying a broad range of underlying cognitive processes and lapses of decision-making. Aim: The study aims to investigate nurses. decision-making errors in clinical deterioration. Method: Tobii eye tracker(R) was used to collect eye movements and mouse clicks of eighteen participants followed by gaze path retrospective interview. Finding: Thematic analysis revealed several forms of cognitive bias including anchoring, availability and confirmation bias, commission error and Yin-yang out. A distraction effect was apparent in nurses' ability to perceive, process data and to intervene. © 2022
The experiences of people with diabetes during covid-19 pandemic lockdown
- Authors: Al-Moteri, Modi , Plummer, Virginia , Youssef, Hanan , Yaseen, Ruba , Al Malki, Mohammed , Elryah, Ahmed , Al Karani, Ahmed
- Date: 2022
- Type: Text , Journal article
- Relation: International Journal of Environmental Research and Public Health Vol. 19, no. 1 (2022), p.
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- Description: Little is known about the theoretical foundation underling the response of people with diabetes managing their everyday routines during COVID-19 pandemic lockdown. Aim: To explore the experience of people with diabetes during COVID-19 pandemic lockdown in light of the risk perception, response and behavioral change theories. Method: A qualitative descriptive design was employed, and Braun and Clark’s six step analysis were used for thematic analysis. Semi-structured interviews were conducted online using Zoom Videos Communication. Result: Five themes were defined as follows: (1) perceived the threat and faced their fears, (2) appraised the damage, (3) identified the challenges, (4) modified their routine, and (5) identified the strengths that facilitate the efficacy of their response. There were eight sub-themes within the themes. Conclusion: The results of this study may provide an opportunity for nurses to reflect on issues highlighted by the patients regarding more effective communication, knowledge and skill development for people to support self-care during national emergencies. © 2021 by the authors. Licensee MDPI, Basel, Switzerland.
The road to developing standard time for efficient nursing care : a time and motion analysis
- Authors: Al-Moteri, Modi , Alzahrani, Amer , Althobiti, Ensherah , Plummer, Virginia , Sahrah, Afnan , Alkhaldi, Maha , Rajab, Eishah , Alsalmi, Amani , Abdullah, Merhamah , Abduelazeez, Afra , Caslangen, Mari-zel , Ismail, Mariam , Alqurashi, Talal
- Date: 2023
- Type: Text , Journal article
- Relation: Healthcare (Switzerland) Vol. 11, no. 15 (2023), p.
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- Description: (1) Background: The amount of time nurses spend with their patients is essential to improving the quality of patient care. Studies have shown that nurses spend a considerable amount of time on a variety of activities––which are often not taken into account while estimating nurse-to-patient care time allocation––that could potentially be eliminated, combined or delegated with greater productivity. The current study aimed to calculate standard time for each activity category by quantifying the amount of time required by nurses to complete an activity category and determine the adjustment time that can be given during work, as well as determine factors that can be altered to improve the efficiency of nursing care on inpatient general wards of a governmental hospital. (2) Method: A time and motion study was conducted over two weeks using 1-to-1 continuous observations of nurses as they performed their duties on inpatient general wards, while observers recorded each single activity, and specifically the time and movements required to complete those activities. (3) Result: There was 5100 min of observations over 10 working days. Nurses spent 69% (330 min) of time during their 8 h morning shift on direct patient care, (19.4%) ward/room activities (18%), documentation (14%), indirect patient care (12%) and professional communication (5%). Around 94 min of activities seem to be wasted and can be potentially detrimental to nurses’ overall productivity and threaten patient care quality. The standard number of hours that represents the best estimate of a general ward nurse regarding the optimal speed at which the staff nurse can provide care related activities was computed and proposed. (4) Conclusions: The findings obtained from time–motion studies can help in developing more efficient and productive nursing work for more optimal care of patients. © 2023 by the authors.