Medicine and Health Sciences Commons^™

Barriers To Mental Health Seeking Among Army Aviation Personnel: A Preliminary Report, Aric J. Raus

National Training Aircraft Symposium (NTAS)

This research explores barriers to mental health seeking, self-reported symptoms, and perspectives on self-help mental-wellness options among U.S. Army Aviation Personnel. Safe aviation operations require constant focus and mental clarity. These requirements expand when considering the implications and added stress of military operations, especially in combat scenarios. Yet, recent studies demonstrate that aviation personnel avoid seeking healthcare due to fears of losing their medical certification. This report provides preliminary results from the first known study on barriers to mental health seeking among U.S. Army aviation personnel. Utilizing an anonymous survey instrument, facilitated primarily through Social Media recruiting of current and …

Flying Under The Radar: A Survey Of Collegiate Pilots’ Mental Health To Identify Aeromedical Nondisclosure And Healthcare-Seeking Behaviors, Emily Faulconer, Lauren Pitts

Publications

The disclosure of a new or existing mental health condition in a pilot complicates their medical certification status. It has been proposed that the threat of losing medical certification often discourages pilots from seeking treatment for mental health issues or disclosing such information to aeromedical professionals, contributing to a barrier to seeking healthcare that affects pilots of all certification levels. The current study focused on the nondisclosure and healthcare-seeking behaviors of the collegiate pilot population(N = 2,452)at a large, accredited, private institution that offers flight training in accordance with Pilot Schools (2022). Data collected from our anonymous online survey over …

Ems To Trauma Care Transitions: An Investigation Of Patient And Handoff Outcomes, Richard Simonson

Doctoral Dissertations and Master's Theses

The helicopter as a method of emergency medical service transportation of trauma patients has a long history of effective use-cases dating back to its inception during the Vietnam war. Compared to ground-based emergency medical transit, helicopters have been able to reach severely injured patients in environments with challenging terrain features that ground-based medical services cannot traverse. Additionally, the helicopter offers quicker and more direct-route transit options that result in both quicker response and shorter transportation times compared to their ground-based alternative. Further, research has indicated that helicopter ambulance teams utilize paramedics with more experience than ground ambulance paramedics. Prior research …

Comparison Of Schedules, Stress, Sleep Problems, Fatigue, Mental Health And Well-Being Of Low Cost And Network Carrier Pilots, Marion Venus

International Journal of Aviation, Aeronautics, and Aerospace

Objective

This research investigates and compares working-conditions, duty rosters, stress, sleep problems, fatigue levels, mental health, and well-being of pilots working for network (NWCs), and low-cost carriers (LCCs). This study extends previous research by investigating working conditions, pilots’ actual rosters, fatigue and mental health of two groups of pilots flying for LCC or NWC.

Method

A comprehensive cross-sectional online survey was completed by N=338 pilots (185 NWC, 153 LCC pilots). All pilots reported their roster data of the last 2 months during peak flight season, psychosocial and work-related stress (e.g., high job insecurity, less total flight-experience, lower income, more time …

Interactions Of International Pilots' Stress, Fatigue, Symptoms Of Depression, Anxiety, Common Mental Disorders And Wellbeing, Marion Venus, Martin Grosse Holtforth

International Journal of Aviation, Aeronautics, and Aerospace

Objective

This study Investigates more dimensions than previous studies simultaneously: pilots’ duty rosters, stress, sleep difficulties, fatigue levels, wellbeing, symptoms of depression, anxiety, and common mental disorders (CMD), and how they are interrelated.

Background

Several scientific studies have confirmed that fatigue can pose a significant risk to flight safety. Other studies reported positive depression screening results for more pilots, compared with the general population.

Method

A cross-sectional online survey was completed by 406 international pilots, who reported their duty rosters of the last two months. Pilots also self-assessed their stress-levels, sleep problems, fatigue, wellbeing, and mental health.

Results

Although pilots …

Fatigue In Aircraft Maintenance Technician Schools, Natalie Zimmermann, Peng Hao Wang, Keegan Pullen

International Journal of Aviation, Aeronautics, and Aerospace

Fatigue has long been identified as a human factor in aviation. Subsequently, a series of studies have highlighted fatigue-related elements within the context of the aviation industry, focusing on the flight deck – with some extension to flight students – and aviation maintenance activities. However, the latter has not been as deeply examined as its flight crew-centered counterpart. Similarly – if not more significantly – fatigue experienced by aircraft maintenance technician (AMT) students is scarcely explored, especially in comparison to the research conducted to understand fatigue in flight schools. AMT students are subject to comparable, but not the same, experiences …

Divergent Attitudes Regarding The Benefits Of Face Masks In Aviation Colleges And Universities, Andrew R. Dattel, Peiheng Gao, Hanzi Xie, Maxine E. Lubner

Publications

Opinions and practices regarding face masks (FM) to attenuate COVID-19’s spread remains polarized across the United States. We examined whether these attitudes extend to the aviation collegiate community. A 14-question survey was sent to 90 aviation colleges and universities throughout the country. Responses were solicited from students, faculty, and staff. Of the 598 respondents, 77% were students, 13% were faculty, and 10% were staff. Pilots comprised 66% of the respondents. A Principal Component Analysis reduced the questions to two scales: Benefits and Inconvenience. Females, non-pilots, and older respondents reported greater benefits to wearing a FMand fewer inconveniences. A multiple regression …

Face Mask Effects Of Co2, Heart Rate, Respiration Rate, And Oxygen Saturation On Instructor Pilots, Andrew R. Dattel, Nicola M. O'Toole, Guillermina Lopez, Kenneth P. Byrnes

Publications

The COVID-19 pandemic has required people to take new measures to mitigate the spread of the communicable virus. Guidelines from health organizations, government offices, and universities have been disseminated. Adherence to these guidelines cannot be more critical for flight training. This study explored the effects face masks had on CO2, heart rate, respiration rate, and oxygen saturation while wearing a face mask at an oxygen level simulated to 5,000 feet. Thirty-two instructor pilots (IP) volunteered to participate in the study. IPs spent 90 minutes in a normobaric chamber while wearing a cloth face mask or a paper face mask. Participants …

Influence Of Social Isolation During Prolonged Simulated Weightlessness By Hindlimb Unloading, Candice G.T. Tahimic, Amber M. Paul, Ann-Sofie Schreurs, Samantha M. Torres, Linda Rubinstein, Sonette Steczina

Publications

The hindlimb unloading (HU) model has been used extensively to simulate the cephalad fluid shift and musculoskeletal disuse observed in spaceflight with its application expanding to study immune, cardiovascular and central nervous system responses, among others. Most HU studies are performed with singly housed animals, although social isolation also can substantially impact behavior and physiology, and therefore may confound HU experimental results. Other HU variants that allow for paired housing have been developed although no systematic assessment has been made to understand the effects of social isolation on HU outcomes. Hence, we aimed to determine the contribution of social isolation …

Human Factors Applied To Perioperative Process Improvement, Joseph R. Keebler, Elizabeth H. Lazzara, Elizabeth Blickensderfer, Thomas D. Looke

Publications

• Human factors/ergonomics (HF/E) is its own scientific discipline that can be applied to understanding performance in perioperative medicine.
• Humans are not perfect decision makers and are affected by a variety of factors that can greatly harm their ability to perform, including attention, bias, stress, and fatigue.
• HF/E has a unique perspective on human error, and HF/E can illustrate how moving away from blame can enhance safety.
• HF/E offers strategies for undertaking a systematic approach to assessment of work processes in perioperative medicine that can be used to increase safety and wellbeing of patients and providers.

Multicenter Handoff Collaborative, Philip E. Greilich, Joseph R. Keebler

Publications

Communication and team-based care are at the heart of patient safety. As anesthesia professionals, we witness this at its very best and worst when transferring patients to and from the operating room (see article by Dr. Lorinc on types of transfers in this issue). In response, we have an opportunity to take a leading role in redesigning the most ubiquitous teaming event in hospitals in a manner that promotes team-based behaviors. The impact of unreliable handoffs on communication failures and medical errors is well known. To combat this issue, mandates by The Joint Commission (TJC) in 2006 and the American …

Understanding Teamwork In The Provision Of Cancer Care: Highlighting The Role Of Trust, Elizabeth H. Lazzara, Joseph R. Keebler, Soosi Day, Deborah Diazgranados, Minggui Pan, Michael A. King, Shin-Ping Tu

Publications

Team science research has indicated that trust is a critical variable of teamwork, contributing greatly to a team’s performance. Trust has long been examined in health care with research focusing on the development of trust by patients with their health care practitioners. Studies have indicated that trust is linked to patient satisfaction, adherence to treatment, continuity of care, and improved outcomes. We explore the construct of trust using a case example of a patient who received a surgical procedure for a precancerous polyp. We apply the principle of trust to the case as well as present the literature on trust …

Highlighting Trust In The Provision Of Cancer Care, Elizabeth Lazzara, Joseph Keebler, Soosi Day, Deborah Diazgranados, Minngui Pan, Mike King, Shin-Ping Tu

Publications

Slides:

• Patient Case
• Definition & Explanation of Trust
• Application of Trust to Cancer Case
• Implications for Clinical Care
• Implications for Research

Test-Retest Reliability Of The Sway Balance Mobile Application, Ryan Z. Amick, Alex Chaparro, Jeremy A. Patterson, Michael J. Jorgensen

Publications

The SWAY Balance Mobile Application is an FDA-cleared balance testing system which uses the built-in tri-axial accelerometers of a mobile electronic device to objectively assess postural movement. The system was designed to provide a means of quantitative balance assessment in clinical and on-field environments. The purpose of this study was to determine the intrasession and intersession reliability, as well as the minimum difference to be considered real, of the SWAY Balance Mobile Application.

The Template Of Events For Applied And Critical Healthcare Simulation (Teach Sim): A Tool For Systematic Simulation Scenario Design, Lauren E. Benishek, Elizabeth H. Lazzara, William L. Gaught, Lygia L. Arcaro, Okuda Yasuharu, Eduardo Salas

Publications

Simulation-based training (SBT) affords practice opportunities for improving the quality of clinicians’ technical and nontechnical skills. However, the development of practice scenarios is a process plagued by a set of challenges that must be addressed for the full learning potential of SBT to be realized. Scenario templates are useful tools for assisting with SBT and navigating its inherent challenges. This article describes existing SBT templates, explores considerations in choosing an appropriate template, and introduces the Template of Events for Applied and Critical Healthcare Simulation (TEACH Sim) as a tool for facilitating the formation of practice scenarios in accordance with an …

Promoting Teamwork In Translational Medical Teams: Insights And Recommendations From Science And Practice, Lauren E. Benishek, Ashley M. Hughes, Megan E. Gregory, Shirley C. Sonesh, Eduardo Salas, Elizabeth H. Lazzara

Publications

Translational medical teams are transdisciplinary, highly collaborative, and operate within dynamic environments to solve time-sensitive and complex problems. These teams are tasked with turning observations in the laboratory and clinic into effective interventions that improve the health of individuals and the public. The nature of the problems they seek to solve requires coordination among clinicians, scientists, and experts from various scientific disciplines. Characteristically, translational medical teams have complex compositions, structure, and pluralistic goals, which pose significant challenges and barriers to enacting effective teamwork, compromising team performance. Given these challenges, it is imperative to glean insights from teams research and the …

Differential Effects Of Refractive Blur On Day And Nighttime Driving Performance, Joanne M. Wood, Michael J. Collins, Alex Chaparro, Ralph Marszalek, Trent Carberry, Philippe Lacherez, Byoung Sun Chu

Publications

PURPOSE. To investigate the effect of different levels of refractive blur on real-world driving performance measured under day and nighttime conditions.

METHODS. Participants included 12 visually normal, young adults (mean age = 25.+- 5.2 years) who drove an instrumented research vehicle around a 4 km closed road circuit with three different levels of binocular spherical refractive blur (+0.50 diopter sphere [DS], +1.00 DS, +2.00 DS) compared with a baseline condition. The subjects wore optimal spherocylinder correction and the additional blur lenses were mounted in modified fullfield goggles; the order of testing of the blur conditions was randomized. Driving …

Patient Safety In The Cardiac Operating Room: Human Factors And Teamwork: A Scientific Study From The American Heart Association, Joyce A. Wahr, Richard L. Prager, J. H. Abernathy Iii, Elizabeth A. Martinez, Eduardo Salas, Patricia C. Seifert, Robert C. Groom, Bruce D. Spiess, Bruce E. Searles, Thoralf M. Sundt Iii, Juan A. Sanchez, Scott A. Shappell, Michael H. Culig, Elizabeth H. Lazzara, David C. Fitzgerald, Vinod H. Thourani, Pirooz Eghtesady, John S. Ikonomidis, Michael R. England, Frank W. Selke, Nancy A. Nussmeier

Publications

The cardiac surgical operating room (OR) is a complex environment in which highly trained subspecialists interact with each other using sophisticated equipment to care for patients with severe cardiac disease and significant comorbidities. Thousands of patient lives have been saved or significantly improved with the advent of modern cardiac surgery. Indeed, both mortality and morbidity for coronary artery bypass surgery have decreased during the past decade. Nonetheless, the highly skilled and dedicated personnel in cardiac ORs are human and will make errors. Refined techniques, advanced technologies, and enhanced coordination of care have led to significant improvements in cardiac surgery outcomes.

Useful Field Of View Predicts Driving In The Presence Of Distracters, Joanne M. Wood, Alex Chaparro, Philippe Lacherez, Louise Hickson

Publications

Purpose. The Useful Field of View (UFOV®) test has been shown to be highly effective in predicting crash risk among older adults. An important question which we examined in this study is whether this association is due to the ability of the UFOV to predict difficulties in attention-demanding driving situations that involve either visual or auditory distracters.

Methods. Participants included 92 community-living adults (mean age 73.6 +- 5.4 years; range 65– 88 years) who completed all three subtests of the UFOV involving assessment of visual processing speed (subtest 1), divided attention (subtest 2), and selective attention (subtest 3); driving safety …

Latent Print Examination And Human Factors: Improving The Practice Through A Systems Approach: The Report Of The Expert Working Group On Human Factors In Latent Print Analysis, David H. Kaye, Thomas Busey, Melissa R. Gische, Gerry Laporte, Scott A. Shappell, Et Al.

Publications

Fingerprints have provided a valuable method of personal identification in forensic science and criminal investigations for more than 100 years. Fingerprints left at crime scenes generally are latent prints—unintentional reproductions of the arrangement of ridges on the skin made by the transfer of materials (such as amino acids, proteins, polypeptides, and salts) to a surface. Palms and the soles of feet also have friction ridge skin that can leave latent prints. The examination of a latent print consists of a series of steps involving a comparison of the latent print to a known (or exemplar) print. Courts have accepted latent …

Tools For Evaluating Team Performance In Simulation-Based Training, Michael A. Rosen, Sallie J. Weaver, Elizabeth H. Lazzara, Eduardo Salas, Teresa Wu, Salvatore Silvestri, Nicola Schiebel, Sandra Almeida, Heidi B. King

Publications

Teamwork training constitutes one of the core approaches for moving healthcare systems toward increased levels of quality and safety, and simulation provides a powerful method of delivering this training, especially for face-paced and dynamic specialty areas such as Emergency Medicine. Team performance measurement and evaluation plays an integral role in ensuring that simulation-based training for teams (SBTT) is systematic and effective. However, this component of SBTT systems is overlooked frequently. This article addresses this gap by providing a review and practical introduction to the process of developing and implementing evaluation systems in SBTT. First, an overview of team performance evaluation …

Simulation-Based Team Training At The Sharp End: A Qualitative Study Of Simulation-Based Team Training Design, Implementation, And Evaluation In Healthcare, Sallie J. Weaver, Eduardo Salas, Rebecca Lyons, Elizabeth H. Lazzara, Michael A. Rosen, Deborah Diazgranados, Julia G. Grim, Jeffrey S. Augenstein, David J. Birnbach, Heidi King

Publications

This article provides a qualitative review of the published literature dealing with the design, implementation, and evaluation of simulation-based team training (SBTT) in healthcare with the purpose of providing synthesis of the present state of the science to guide practice and future research. A systematic literature review was conducted and produced 27 articles meeting the inclusion criteria. These articles were coded using a low-inference content analysis coding scheme designed to extract important information about the training program. Results are summarized in 10 themes describing important considerations for what occurs before, during, and after a training event. Both across disciplines and …

Promoting Teamwork: An Event-Based Approach To Simulation-Based Teamwork Training For Emergency Medicine Residents, Michael A. Rosen, Eduardo Salas, Teresa S. Wu, Salvatore Silvestri, Elizabeth H. Lazzara, Rebecca Lyons, Sally J. Weaver, Heidi B. King

Publications

The growing complexity of patient care requires that emergency physicians (EPs) master not only knowledge and procedural skills, but also the ability to effectively communicate with patients and other care providers and to coordinate patient care activities. EPs must become good team players, and consequently an emergency medicine (EM) residency program must systematically train these skills. However, because teamwork-related competencies are relatively new considerations in health care, there is a gap in the methods available to accomplish this goal. This article outlines how teamwork training for residents can be accomplished by employing simulation-based training (SBT) techniques and contributes tools and …

Simulation-Based Training For Patient Safety: 10 Principles That Matter, Eduardo Salas, Katherine A. Wilson, Elizabeth Lazzara, Heidi B. King, Jeffery S. Augenstein

Publications

Simulation-based training can improve patient care when factors influencing its design, delivery, evaluation, and transfer are taken into consideration. In this paper, we provide a number of principles and practical tips that organizations in health care can use to begin implementing effective simulation-based training as a way to enhance patient safety. We commend the health care community for their efforts thus far. We hope that the information provided in this paper will encourage thinking beyond the "bells and whistles" of the simulation and bring to light full potential of simulation-based training in health care and patient safety.

Tyrosine As A Countermeasure To Performance Decrement During Sleep Loss, Douglas A. Wiegmann, David F. Neri, Robert R. Stanny, Scott Shappell, Andrew M. Mccardie, David L. Mckay

Publications

The fatigue and cognitive performance deficits associated with sleep loss and stress have motivated the search for effective nonpharmacological countermeasures. The purpose of the present study was to examine the potential behavioral effects of tyrosine, an amino-acid presursor to dopamine and norepinephrine, during an episode of continuous nighttime work involving one night of sleep loss.

Effects Of Dextro-Methamphetamine On Subjective Fatigue, C. A. Dejohn, Scott Shappell, D. F. Neri

Publications

Declining aircrew performance during periods of sustained flight operations (SUSOPs) has underscored the need to develop effective countermeasures. This paper reports on the ability of the central nervous system (CNS) stimulant d-methamphetamine to alleviate the detrimental effects of a simulated SUSOPs on subjective fatigue. Subjective fatigue was repeatedly measured by three questionnaires. The simulated SUSOP started at 1800 and consisted of a 9-h planning session followed by 4 h of rest and a 14-h mission. After 6 h of sleep, the 9/4/14 work/rest/work pattern was repeated. At 4 1/2 h into the second mission, 13 subjects were administered 10 mg …