[Analysis of the anesthesiologist's vigilance with an eye-tracking device. A pilot study for evaluation of the method under the conditions of a modern operating theatre].
BACKGROUND
With the inclusion of new monitoring devices over the last two decades, the distribution of the anesthesiologists vigilance has changed which might influence the ergonomic profile of an optimal anesthesia workstation. The aim of this pilot study was the evaluation of an eyetracking device to analyze the vigilance distribution of an anesthesiologist during routine cases in an operating theatre of the 21st century.


METHODS
Five anesthesiologist with different levels of training were followed during different types of surgery using a video camera-based eye-tracking system. The films were analyzed by an independent observer and rated according to defined regions of interest (ROI). Then typical scan-paths were identified and quantitatively analyzed.


RESULTS
The eye-tracking studies proved to be technically of high quality but were time-consuming. Only few disturbances to the operating room (OR) personnel were recorded according to their subjective impressions but bias of behaviour due to the measurement procedure itself cannot be completely excluded. The vigilance of the anesthesiologist towards different factors was dependent on the level of professional training, the type of anesthesia and the type of surgery. Certain factors such as documentation (10-15%) or external disturbances (approximately 20%) proved to be relatively constant. Typical scan-paths could also be identified.


CONCLUSIONS
Eye-tracking studies proved to be a suitable way to analyze the distribution of vigilance of anesthesiologists in a modern operating theatre. For further studies examining the influence of detailed modifications of the OR environment, a standardized study design with the same level of education, the same anesthesia technique and the same surgical procedure needs to be chosen.
Schulz-Stübner
S
S
Klinik für Anästhesiologie am Universitätsklinikum, RWTH Aachen. schust@t-online.de
Jungk
A
A
Kunitz
O
O
Rossaint
R
R
D000328:Adult; D000758:Anesthesia; D001143:Arousal; D003201:Computers; D006804:Ergonomics; D005133:Eye Movements; D005260:Female; D006801:Humans; D008297:Male; D016343:Monitoring, Intraoperative / Q000592:standards*; D009873:Operating Rooms; D010865:Pilot Projects; D013514:Surgical Procedures, Operative