Immersive Rehearsal in a Simulated Environment.

Introduction: Recent advancements in virtual environment (VE) technology and the increasing use of VEs for treatment are opening up possibilities for rehearsal in safe and rich environments. Research has shown that VEs can be used to treat individuals with posttraumatic stress disorder (PTSD), but little research has been done to suggest guidelines for creating an effective environment. The aim of this study was to determine the design of systems that would allow military veterans to rehearse potentially stressful events in a VE before having to step into the actual environment.

Evaluating e-consultation implementations based on use and time-line across various specialties.

Background: Electronic Consultation (e-consults) can provide improved access, enhance patient and provider satisfaction, and reduce beneficiary travel expenses. We explored how e-consults were implemented across three specialty areas, diabetes (Diab), gastroenterology (GI), and neurosurgery (Neuro), at two Veterans Affairs hospitals in terms of strategies for use and time-lines.

Methods: We conducted observations and electronically shadowed patient e-consultations submitted to a specialty care service by primary care provider(s) at the two sites during a thirteen-month period.

Impact of Diabetes E-Consults on Outpatient Clinic Workflow.

Background: An e-consult is an electronic communication system between clinicians, usually a primary care physician (PCP) and a medical or surgical specialist, regarding general or patient-specific, low complexity questions that would not need an in-person consultation. The objectives of this study were to understand and quantify the impact of the e-consult initiative on outpatient clinic workflow and outcomes.

Methods: We collected data from 5 different Veterans Affairs (VA) outpatient clinics and interviewed several physicians and staff members.

Computational model of sustained acceleration effects on human cognitive performance.

Introduction: Extreme acceleration maneuvers encountered in modern agile fighter aircraft can wreak havoc on human physiology, thereby significantly influencing cognitive task performance. As oxygen content declines under acceleration stress, the activity of high order cortical tissue reduces to ensure sufficient metabolic resources are available for critical life-sustaining autonomic functions. Consequently, cognitive abilities reliant on these affected areas suffer significant performance degradations.

The management of test results in primary care: does an electronic medical record make a difference?

Background And Objectives: It is unknown whether an electronic medical record (EMR) improves the management of test results in primary care offices.

Methods: As part of a larger assessment using observations, interviews, and chart audits at eight family medicine offices in SW Ohio, we documented five results management steps (right place in chart, signature, interpretation, patient notification, and abnormal result follow-up) for laboratory and imaging test results from 25 patient charts in each office. We noted the type of records used (EMR or paper) and how many management steps had standardized results management processes in place.

Management of test results in family medicine offices.

Purpose: We wanted to explore test results management systems in family medicine offices and to delineate the components of quality in results management.

Methods: Using a multimethod protocol, we intensively studied 4 purposefully chosen family medicine offices using observations, interviews, and surveys. Data analysis consisted of iterative qualitative analysis, descriptive frequencies, and individual case studies, followed by a comparative case analysis.

Configural features of helmet-mounted displays to enhance pilot situation awareness.

Background: In the current research, we used configural displays to investigate what design features contribute to the formation of operator situation awareness (SA). Configural displays have been shown to provide better performance for integration tasks, yet the design aspects of these displays which affect the formation of operator SA have not been determined.

Objective: We compared the design features of three configural attitude head-up displays (HUD) [joint strike fighter (JSF), dual articulated (DA), and arc segment attitude reference (ASAR)] presented on a helmet mounted display (HMD) across four experiments to quantify what aspects of configural displays would affect pilot SA.

An analysis of control reversal errors during unusual attitude recoveries using helmet-mounted display symbology.

Background: Spatial disorientation (SD) refers to pilots' inability to accurately interpret the attitude of their aircraft with respect to Earth. Unfortunately, SD statistics have held constant for the past few decades, through the transition from the head-down attitude indicator (Al) to the head-up display (HUD) as the attitude instrument. The newest attitude-indicating device to find its way into military cockpits is the helmet-mounted display (HMD).