Understanding visual attention of teams in dynamic medical settings through vital signs monitor use

Abstract

The purpose of this study was to understand how vital signs monitors support teamwork during trauma resuscitation -- the fast-paced and information-rich process of stabilizing critically injured patients. We analyzed 12 videos of simulated resuscitations to characterize trauma team monitor use. To structure our observations, we adopted the feedback loop concept. Our results showed that the monitor was used frequently, especially by team leaders and anesthesiologists. We identified three patterns of monitor use: (i) periods with a low frequency of short looks (glances) to maintain overall process awareness; (ii) periods with a medium frequency of long looks (scrutiny) to monitor trends in patient status; and (iii) peaks with a high frequency of glances to maintain attention on both the patient and monitor during critical tasks. Approximately 75% of looks were 3 seconds or shorter, but many looks (25%) ranged between 3 and 26 seconds. Our results have implications for improving displays by presenting the status of the patient's physiological systems and team activities.