Informative Vibrotactile Displays to Support Attention and Task Management in Anesthesiology.

Abstract

The task set of an anesthesiologist, like that of operators in many complex, data-rich domains, requires effective management of attention, which must be divided among multiple tasks and task-relevant data sources. The inefficient allocation of attentional resources can lead to errors in monitoring a patient’s physiology, which constitute a significant portion of preventable medical errors. To better support attention management and multitasking performance without additionally loading the visual or auditory channels, this dissertation describes work to develop novel “continuously-informing” vibrotactile displays of physiological data. These displays use coded vibration patterns to communicate blood pressure and respiration data in real time. A theory-based approach was taken in the design of these displays to support the properties of “preattentive reference”: the signals can be processed in parallel without interfering with ongoing tasks, include partial information to support efficient task-switching, and can be processed in a mentally economical way. A series of research activities identified: 1) types of information that could best support anesthesiologists in task management decisions; 2) how to display this information via vibrotactile signals in ways that minimize perceptual interference from effects such as vibrotactile adaptation, masking, and tactile “change blindness”; 3) how to encode the information in vibrotactile patterns to minimize interference with concurrent tasks at cognitive processing stages; and 4) mappings between signal modulations and the represented data that best support economical processing. An evaluation study, set in a high-fidelity clinical simulation, showed substantial improvements in anesthesiologists’ multitasking performance, including faster detection and correction of serious health events, and fewer unnecessary interruptions of ongoing tasks with continuously-informing tactile displays, when compared to performance with traditional (visual/auditory) display configurations. This work contributes to theories and models of tactile and multimodal information processing, specifically concerning the performance effects of perceptual and cognitive interferences when information is processed via two or more sensory channels concurrently. It also demonstrates how a vibrotactile display designed to support properties of preattentive reference can improve attention management and multitask performance, thus showing promise for reducing the prevalence of monitoring errors and system awareness issues in anesthesiology and other complex, data rich domains.