Multimedia-Enhanced Emergency Medical Procedure Checklist

NASA http://www.nasa.gov/

National Space Biomedical Research Institute (NSBRI) http://www.nsbri.org/

For each mission, certain astronauts receive training as Crew Medical Officers (CMOs) to provide emergency medical care to crew members without guidance from flight surgeons on the ground. On long-duration missions, it is critical that just-in-time training provided to the CMO be efficient, concise, complete and as effective as possible. Dr. F. Jacob Seagull is working to improve current paper-based medical guidance with new technologies such as animation and video. His research will analyze specific medical procedures to generate multimedia design guidelines and use the results to design high- and low-resolution multimedia-based emergency medical procedure instructions. He will test the newly developed multimedia-based instructions through simulation of emergency procedures and pilot their integration into advanced technologies such as handheld computing and hands-free support systems. (NSBRI site: http://www.nsbri.org/Research/Projects/viewdesc.epl?pid=215 )

Collaborators

NASA – Johnson Space Center
http://www.nasa.gov/centers/johnson/home/index.html

Mihriban Whitmore

Habitability & Human Factors Office

http://hefo.jsc.nasa.gov/hhfo/

University of Utah

Dwayne Westenskow

http://abl.med.utah.edu/~dwayne/

Utah STTR related grant:

http://sbir.gsfc.nasa.gov/SBIR/abstracts/sttr01.html

Ibex healthdata (now a picis company)

John Epler

http://www.picis.com/products/technology_ibex.asp

University of Maryland, Baltimore County (UMBC), Emergency Health Services

http://ehs.umbc.edu/

Bruce Walz

http://ehs.umbc.edu/Pages/Walz.html

Detailed description

Project Title: Multimedia-Enhanced Emergency Medical Procedure Checklist

NSBRI Research Area: Smart Medical Systems

Principal Investigator: F. Jacob Seagull, Ph.D.

Because of limited training time and the vital, time-critical nature of emergency medical procedures, it is imperative that the delivery of guidance to the Crew Medical Officer (CMO) on long-term space missions be efficient, concise, complete and effective. In the current emergency medical procedure checklist (EMPC) for the International Space Station (ISS), lack of familiarity and training is a barrier to fluent performance, as CMOs are usually not physicians.

Textual descriptions and static pictures limit the effectiveness of describing how to carry out medical procedures. New technologies can potentially provide more effective guidance such as enhancing EMPCs with animation and video clips. Multimedia-enhanced EMPCs may provide succinct communication of critical perceptual cues and effective demonstration of psychomotor tasks used in emergency medical procedures. However, successful implementation of multimedia support for such procedures depends on applying the media to an interactive format that maximally supports crew performance.

Using multimedia enhancements, which can range from line-drawn animation to high-resolution video, has intuitive appeal and has shown benefit in some tasks; however, there is also evidence that multimedia can distract, slow performance and actually hinder learning in other tasks. There currently are no guidelines for mapping which type of task will benefit from which, if any, particular type of multimedia. Development and evaluation of such a mapping would support not only emergency medical tasks, but other procedures as well.

This research is a joint effort between the University of Maryland Human Factors Research Program (UM-HFRP), University of Utah, and Johnson Space Center's Usability Testing and Analysis Facility (NASA-UTAF). It will focus on the clinical capabilities for responding to medical emergencies, using EMPC protocols for Advanced Trauma Life Support (ATLS) as a testing task model for such an effort. The existing EMPC will be enhanced through the development of high- and low-resolution multimedia-supported computerized checklists to enhanced clinical capabilities. There are ongoing collaborative efforts between UM-HFRP and NASA JSC-UTAF. The University of Maryland and Utah have extensive experience in the use of multimedia to support medical performance, and NASA JSC-UTAF has investigated many aspects of the paper-based EMPC for other usability issues and works closely with the NASA medical community.

The major activities of the project are to:

1. Perform task analysis of specific medical procedures for the long-duration space flight and generate design guidelines for multimedia;

2. Develop high- and low-resolution multimedia-based EMPCs to support the relevant medical tasks using principled human factors approaches;

3. Test the multimedia augmentations of the EMPC through simulations of emergency medical procedures performed by CMOs or CMO analogs;

4. Pilot the integration of multimedia into advanced technologies such as handheld computing and hands-free decision support systems.

In achieving these tasks, the utility of multimedia enhancements for emergency medical procedures can be evaluated. The principles of and design guidelines for such multimedia augmentation can be applied to other NASA procedures and technologies to support crew performance and safety.

University of Maryland Leading researchers

F. Jacob Seagull, PhD

Yan Xiao, PhD

Colin F. Mackenzie, MD

Sharon Henry,MD

Interface from computerized checklist developed at the UM-HFRP, with video-based multimedia (left). A similar product was developed by the Utah group, using line-based animation (right), which would cycle through the frames from top left to bottom right.

The current NASA Medical Procedure Checklist, showing its 1046-page scope (left) and a page from the airway-management portion of the checklist, describing the insertion of a nasal airway (right)