title: A wearable navigation display can improve attentiveness to the surgical field.
abstract: OBJECTIVE
  Surgical navigation is typically shown on a computer display that is distant from the patient, making it difficult for the surgeon to watch the patient while performing a guided task. We investigate whether a light-weight, untracked, wearable display (such as Google Glass, which has the same size and weight as corrective glasses) can improve attentiveness to the surgical field in a simulated surgical task.
  
  
  METHODS
  Three displays were tested: a computer monitor; a peripheral display above the eye; and a through-the-lens display in front of the eye. Twelve subjects performed a task to position and orient a tracked tool on a plastic femur. Both wearable displays were tested on the dominant and non-dominant eyes of each subject. Attentiveness during the task was measured by the time taken to respond to randomly illuminated LEDs on the femur.
  
  
  RESULTS
  Attentiveness was improved with the wearable displays at the cost of a decrease in accuracy. The through-the-lens display performed better than the peripheral display. The peripheral display performed better when on the dominant eye, while the through-the-lens display performed better when on the non-dominant eye.
  
  
  CONCLUSIONS
  Attentiveness to the surgical field can be improved with the use of a light-weight, untracked, wearable display. A through-the-lens display performs better than a peripheral display, and both perform better than a computer monitor. Eye dominance should be considered when positioning the display.
authors.affiliation: School of Computing, Queen's University, Kingston, Canada. jstewart@cs.queensu.ca.
authors.forename: James
authors.initials: J
authors.lastname: Stewart
authors.affiliation: HITLab NZ, University of Canterbury, Christchurch, New Zealand.
authors.forename: Mark
authors.initials: M
authors.lastname: Billinghurst
mesh_terms: D000293:Adolescent; D000328:Adult; D001288:Attention; D003198:Computer Simulation; D003626:Data Display; D006801:Humans; D008297:Male; D008875:Middle Aged; D011930:Reaction Time; D025321:Surgery, Computer-Assisted / Q000379:methods*; D013514:Surgical Procedures, Operative / Q000379:methods*; D013647:Task Performance and Analysis; D055815:Young Adult
keywords: Divided attention; Increased attentiveness; Reaction time improvement; Surgical navigation interface; Wearable display