Korean J Anesthesiol.  2018 Aug;71(4):317-322. 10.4097/kja.d.18.00016.

Using eye tracking technology to compare the effectiveness of malignant hyperthermia cognitive aid design

• King R
• Hanhan J
• Harrison T
• Kou A
• Howard SK
• Borg LK
• Shum C
• Udani AD
• Mariano ER
• The ADAPT (Anesthesiology-Directed Advanced Procedural Training) Research Group

• KMID: 2418532
• DOI: http://doi.org/10.4097/kja.d.18.00016

Abstract

BACKGROUND
Malignant hyperthermia is a rare but potentially fatal complication of anesthesia, and several different cognitive aids designed to facilitate a timely and accurate response to this crisis currently exist. Eye tracking technology can measure voluntary and involuntary eye movements, gaze fixation within an area of interest, and speed of visual response and has been used to a limited extent in anesthesiology.
METHODS
With eye tracking technology, we compared the accessibility of five malignant hyperthermia cognitive aids by collecting gaze data from twelve volunteer participants. Recordings were reviewed and annotated to measure the time required for participants to locate objects on the cognitive aid to provide an answer; cumulative time to answer was the primary outcome.
RESULTS
For the primary outcome, there were differences detected between cumulative time to answer survival curves (P < 0.001). Participants demonstrated the shortest cumulative time to answer when viewing the Society for Pediatric Anesthesia (SPA) cognitive aid compared to four other publicly available cognitive aids for malignant hyperthermia, and this outcome was not influenced by the anesthesiologists' years of experience.
CONCLUSIONS
This is the first study to utilize eye tracking technology in a comparative evaluation of cognitive aid design, and our experience suggests that there may be additional applications of eye tracking technology in healthcare and medical education. Potentially advantageous design features of the SPA cognitive aid include a single page, linear layout, and simple typescript with minimal use of single color blocking.

Keyword

Cognitive aid; Crisis management; Design; Eye tracking; Malignant hyperthermia

MeSH Terms

Anesthesia
Anesthesiology
Delivery of Health Care
Education, Medical
Eye Movements
Malignant Hyperthermia*
Volunteers