Tailoring reveals information requirements: the case of anaesthesia alarms

We discuss the phenomenon of system tailoring in the context of data from an observational study of anaesthesia. We found that anaesthetists tailor their monitoring equipment so that the auditory alarms are more informative. However, the occurrence of tailoring by anaesthetists in the operating theatre was infrequent, even though the flexibility to tailor exists on many of the patient monitoring systems used in the study. We present an influence diagram to explain how alarm tailoring can increase situation awareness in the operating theatre but why factors inhibiting tailoring prevent widespread use. Extending the influence diagram, we discuss ways that more informative displays could achieve the results sought by anaesthetists when they tailor their alarm systems. In particular, we argue that we should improve our designs rather than simply provide more flexible tailoring systems. because users often find tailoring a complex task. We conclude that properly designed auditory displays may benefit anaesthetists in achieving greater patient situation awareness and that designers should consider carefully how factors promoting and inhibiting tailoring will affect the end-users' likelihood of conducting tailoring. (C) 2004 Elsevier B.V. All rights reserved.

The effects of ambient music on simulated anaesthesia monitoring

We examined the effect of no music, classical music or rock music on simulated patient monitoring. Twenty-four non-anaesthetist participants with high or low levels of musical training were trained to monitor visual and auditory displays of patients' vital signs. In nine anaesthesia test scenarios, participants were asked every 50-70 s whether one of five vital signs was abnormal and the trend of its direction. Abnormality judgements were unaffected by music or musical training. Trend judgements were more accurate when music was playing (p = 0.0004). Musical participants reported trends more accurately (p = 0.004), and non-musical participants tended to benefit more from music than did the musical participants (p = 0.063). Music may provide a pitch and rhythm standard from which participants can judge changes in vital signs from auditory displays. Nonetheless, both groups reported that it was easier to monitor the patient with no music (p = 0.0001), and easier to rely upon the auditory displays with no music (p = 0.014).

Cue salience in multiple cue attentional capture

The predominant use of single element cues in visual attentional capture research motivated examination using dual capture cues. Participants in these studies viewed computer screens briefly displaying sequences of feature-defined positional cues and targets, with target identification response time recorded. Five initial experiments utilising the features of colour (purple) and intensity (bold font), and reported at EPC 2005, revealed contingent capture influences and suggested capture by colour cues may be more powerful than single cue literature has indicated. Three follow-up experiments manipulated displays and defining features to see if the conclusions remained. Experiments 6 and 7 investigated whether target identification in the initial series was based on a featural or singleton search. Experiment 8 then tested "onset' versus "purple" under the condition of specific attentional set, a featural change that appeared to remove purple colour dominance evidenced in the initial experimental series. Overall, outcomes of both experimental series suggest strong salience involvement with overtones of contingent capture for specific featural selections. The novel multi-cue approach revealed the significance of relative salience within these selections.

The effect of music on monitoring a simulated anaesthetised patient with sonfication

The idea of sonifying anaesthetised patients’ vital signs is gaining acceptance, but some anaesthetists are concerned about additional noise in the operating theatre. We tested the effect of ambient music (jazz, classical and rock) on participants’ ability to monitor a simulated anaesthetised patient with sonification and visual monitors. Participants liked working with ambient music when workload was low. Participants preferred rock music, but reported working better with classical. Ambient music has less effect on participants’ ability to monitor the simulated patient than a distractor task does. We discuss practical implications of these findings.

Earcon for intermittent information in monitoring environments

In this paper we discuss the first of a series of experiments evaluating earcons for critical care environments. We examine peoples’ ability to monitor earcons conveying systolic and diastolic blood pressure while conducting a distractor task. The results showed that when a beacon is present prior to the earcon, participants’ judgment of pitch and duration information improved. The results of the study also indicated presence of historical information in the earcon may interfere with participants’ judgments. However, since participants felt more confident in their recall of previous values when the historical information was present, the results may reflect insufficient training.

The influence of memory for prior instances on performance in a conflict detection task

In 3 experiments, the authors examined the role of memory for prior instances for making relative judgments in conflict detection. Participants saw pairs of aircraft either repeatedly conflict with each other or pass safely before being tested on new aircraft pairs, which varied in similarity to the training pairs. Performance was influenced by the similarity between aircraft pairs. Detection time was faster when a conflict pair resembled a pair that had repeatedly conflicted. Detection time was slower, and participants missed conflicts, when a conflict pair resembled a pair that had repeatedly passed safely. The findings identify aircraft features that are used as inputs into the memory decision process and provide an indication of the processes involved in the use of memory for prior instances to make relative judgments.

Using psilocybin to investigate the relationship between attention, working memory, and the serotonin 1A and 2A receptors

Increasing evidence suggests a link between attention, working memory, serotonin (5-HT), and prefrontal cortex activity. In an attempt to tease out the relationship between these elements, this study tested the effects of the hallucinogenic mixed 5-HT1A/2A receptor agonist psilocybin alone and after pretreatment with the 5-HT2A antagonist ketanserin. Eight healthy human volunteers were rested on a multiple-object tracking task and spatial working memory task under the four conditions: placebo, psilocybin (215 mu g/kg), ketanserin (50 mg), and psilocybin and ketanserin. Psilocybin significantly reduced attentional tracking ability, but had no significant effect on spatial working memory, suggesting a functional dissociation between the two tasks. Pretreatment with ketanserin did not attenuate the effect of psilocybin on attentional performance, suggestinga primary involvement of the 5-HT1A receptor in the observed defecit. Based on physiological and pharmacological data,we speculate that this impaired attentional performance may reflect a reduced ability to suppress or ignore distracting stimuli rather than reduced attentional capacity. The clinical relevance of these results is also discussed.

The value of a small microkernel for dreamy memory and the RAMpage memory hierarchy

This paper explores potential for the RAMpage memory hierarchy to use a microkernel with a small memory footprint, in a specialized cache-speed static RAM (tightly-coupled memory, TCM). Dreamy memory is DRAM kept in low-power mode, unless referenced. Simulations show that a small microkernel suits RAMpage well, in that it achieves significantly better speed and energy gains than a standard hierarchy from adding TCM. RAMpage, in its best 128KB L2 case, gained 11% speed using TCM, and reduced energy 14%. Equivalent conventional hierarchy gains were under 1%. While 1MB L2 was significantly faster against lower-energy cases for the smaller L2, the larger SRAM's energy does not justify the speed gain. Using a 128KB L2 cache in a conventional architecture resulted in a best-case overall run time of 2.58s, compared with the best dreamy mode run time (RAMpage without context switches on misses) of 3.34s, a speed penalty of 29%. Energy in the fastest 128KB L2 case was 2.18J vs. 1.50J, a reduction of 31%. The same RAMpage configuration without dreamy mode took 2.83s as simulated, and used 2.39J, an acceptable trade-off (penalty under 10%) for being able to switch easily to a lower-energy mode.