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PubMed1995

Effects of jet engine noise and performance feedback on perceived workload in a monitoring task.

This study examined the effects of exposure to intermittent jet aircraft noise (70 dBA or 95 dBA maximum intensity) and knowledge of results concerning signal detections (hit-KR) on performance efficiency and perceived workload in a 40-min visual vigilance task. The noise featured a Doppler-like quality in which planes seemed to approach from the monitor's left and recede to the right. Perceptual sensitivity (d') was poorer in the context of noise than in quiet but only in the presence of hit-KR. The lack of noise-related performance differences in the absence of hit-KR most likely reflected a "floor effect" rather than some special relation between noise and feedback. When compared to subjects performing in quiet, those who operated in noise were less able to profit from hit-KR, a result that may reflect the effects of noise on information processing. In addition to its negative effects on signal detectability, noise elevated the perceived workload, as measured by the NASA-TLX. This effect was robust; it was independent of the presence of hit-KR, even though hit-KR generally lowered the overall level of perceived workload. The results provide the initial experimental demonstration that perceived workload is a sensitive measure of the effects of aircraft noise in monitoring tasks.

Adolescent↗

PubMed2006

Total workload as related to psychological well-being and symptoms in full-time employed female and male white-collar workers.

Most research on the combined effects of paid and unpaid workload has related these factors to stress, depression, and physical symptoms. Thus, comparative knowledge concerning positive aspects of human functioning, such as health and well-being and how they relate to total workload of employed women and men, is limited. Our aim in this study was to investigate how total workload including paid and unpaid work is related to psychological well-being and symptoms in full-time employed women and men. We obtained data on workload, general symptoms, and the Ryff scales covering self-acceptance, environmental mastery, positive relations, personal growth, purpose in life, and autonomy from questionnaires mailed to a stratified sample of highly educated white-collar workers aged between 32 and 58 years. Data from women (n = 430) and men (n = 400) living in partner relationships with at least one child showed that increasing hours of unpaid work was associated with decreasing levels of self-acceptance and environmental mastery in women, whereas paid work was associated with increasing levels of personal growth and decreasing levels of purpose in life. For men, paid work was associated with increasing levels of personal growth and more symptoms. We discuss factors underlying the gender-specific relationships between paid and unpaid work, psychological well-being, and symptoms.

Adult↗

PubMed2006

The Warrington workload tool: determining its use in one trust.

With recent advances in chronic disease management and with earlier discharge from the acute sector, it has become increasingly important for district nurses to monitor and evidence their increasing workload, to monitor demand and capacity. The district nursing service in the author's trust has employed an adaptation of the Warrington workload tool, over several years, to demonstrate and evidence their workload. However, many dispute the accuracy of such tools. This audit set out to discover how accurately the tool was being calculated. The findings have cast doubt on the tool's accurate completion and highlighted an ongoing training need to ensure improvement in its use. The tool is to be further supported with the inclusion of a caseload profiling tool to provide qualitative evidence of the service that the nurses now provide. It was also identified that the service needs evidence that their resource needs are met in response to workload tool data to ensure the tool continues to be used in a proactive manner.

Attitude of Health Personnel↗

PubMed2004

Fellowship training, workload, fatigue and physical stress: a prospective observational study.

BACKGROUND: Fatigue in physician trainees may compromise patient safety and the well-being of the trainees and limit the educational opportunities provided by training programs. Anecdotal evidence suggests that the on-call workload and physical demands experienced by trainees are significant despite duty-hour regulation and support from nursing staff, other trainees and staff physicians. METHODS: We measured the workload and the level of fatigue and physical stress of 11 senior fellows during 35 shifts in the critical care unit at the Hospital for Sick Children in Toronto. We determined number of rostered hours, number of admissions and discharges, number and type of procedures, nurse:patient ratios and related measures of workload. Fellows self-reported the number of pages they received and the amount of time they slept. We estimated physical stress by using a commercially available pedometer to measure the distance walked, by using ambulatory electrocardiographic monitoring to determine arrhythmias and by determining urine specific gravity and ketone levels to estimate hydration. RESULTS: The number of rostered hours were within current Ontario guidelines. The mean shift duration was 25.5 hours (range 24-27 hours). The fellows worked on average 69 hours (range 55-106) per week. On average during a shift, the fellows received 41 pages, were on non-sleeping breaks for 1.2 hours, slept 1.9 hours and walked 6.3 km. Ketonuria was found in participants in 7 (21%) of the 33 shifts during which it was measured. Arrhythmia (1 atrial, 1 ventricular) or heart rate abnormalities occurred in all 6 participants. These fellows were the most senior in-house physician for a mean of 9.4 hours per shift and were responsible for performing invasive procedures in two-thirds of their shifts. INTERPRETATION: Established Canadian and proposed American guidelines expose trainees to significant on-call workload, physical stress and sleep deprivation.

Arrhythmias, Cardiac↗

PubMed2004

Family physician workloads and access to care in Winnipeg: 1991 to 2001.

BACKGROUND: Current perceptions of family physician (FP) shortages in Canada have prompted policies to expand medical schools. Our objective was to assess how FP supply, workloads and access to care have changed over the past decade. METHODS: We used an anonymized physician and population registry and administrative health service data from Winnipeg for the period 1991/92 to 2000/01. We calculated the following measures of supply and workload: ratios of FPs to population, of population to FPs and of FP full-time equivalents (FTEs) to population, as well as FP activity ratios (sum of FTEs/number of FPs), annual number of visits per FP and visits per FP per full-time day of work. Trends in FP remuneration were analyzed by age and sex. We also measured standardized visit rates and stratified the analysis by populations deemed at risk of needing FP services. RESULTS: In 2000/01 FPs between 30 and 49 years of age (64% of the workforce) provided 20% fewer visits per year than their same-age peers did 10 years previously. Conversely, FPs 60 to 69 years of age (11% of the workforce) provided 33% more visits per year than the corresponding group a decade earlier. On a per capita basis, the number of FPs declined by 5%, from 97 per 100 000 population in 1991/92 to 92 per 100 000 population in 2000/01, which paralleled changes in national estimates of FP supply. Per capita visit rates among Winnipeg citizens (3.5 per year in 2000/01) and average workloads among FPs (4193 visits per year in 2000/01) were stable over the decade. INTERPRETATION: Despite relative homeostasis in aggregate FP supply and use, there have been substantial temporal shifts in the volume of services provided by FPs of different age groups. Younger FPs are providing many fewer visits and older FPs are providing many more visits than their same-age predecessors did 10 years ago, a finding that was independent of physician sex. Given these data, the perpetual focus of policy-makers and care providers on increasing numbers of FPs will not help in diagnosing or treating issues of supply, workloads and access to care.

Adult↗

PubMed2001

Eye activity correlates of workload during a visuospatial memory task.

Changes in six measures of eye activity were assessed as a function of task workload in a target identification memory task. Eleven participants completed four 2-hr blocks of a mock anti-air-warfare task, in which they were required to examine and remember target classifications (friend/enemy) for subsequent prosecution (fire upon/allow to pass), while targets moved steadily toward two centrally located ship icons. Target density served as the task workload variable; between one and nine targets were simultaneously present on the display. For each participant, moving estimates of blink frequency and duration, fixation frequency and dwell time, saccadic extent, and mean pupil diameter, integrated over periods of 10 to 20 s, demonstrated systematic changes as a function of target density. Nonlinear regression analyses found blink frequency, fixation frequency, and pupil diameter to be the most predictive variables relating eye activity to target density. Participant-specific artificial neural network models, developed through training on two or three sessions and subsequently tested on a different session from the same participant, correlated well with actual target density levels (mean R = 0.66). Results indicate that moving mean estimation and artificial neural network techniques enable information from multiple eye measures to be combined to produce reliable near-real-time indicators of workload in some visuospatial tasks. Potential applications include the monitoring of visual activity of system opetators for indications of visual workload and scanning efficiency.

Adult↗

PubMed1998

Context effects in subjective mental workload ratings.

The impact of performance context on subjective mental workload ratings was assessed with the Subjective Workload Assessment Technique (SWAT) and the NASA Task Load Index (TLX). In Experiment 1, a strong context effect was demonstrated. A low range of task difficulty produced considerably higher ratings on a common set of difficulty levels than did a high range of task difficulty. In Experiment 2, increasing the participants' range of experiences during practice eliminated the context effect. We recommend that methods for standardizing context, such as providing experience with the complete difficulty range, be developed for subjective mental workload evaluations. Actual or potential applications of this research include providing methodologies for controlling context effects in practical assessments of mental workload to increase the validity of subjective measures.

Adult↗

PubMedDate not supplied

Effects of a psychophysiological system for adaptive automation on performance, workload, and the event-related potential P300 component.

The present study examined the effects of an electroencephalographic- (EEG-) based system for adaptive automation on tracking performance and workload. In addition, event-related potentials (ERPs) to a secondary task were derived to determine whether they would provide an additional degree of workload specificity. Participants were run in an adaptive automation condition, in which the system switched between manual and automatic task modes based on the value of each individual's own EEG engagement index; a yoked control condition; or another control group, in which task mode switches followed a random pattern. Adaptive automation improved performance and resulted in lower levels of workload. Further, the P300 component of the ERP paralleled the sensitivity to task demands of the performance and subjective measures across conditions. These results indicate that it is possible to improve performance with a psychophysiological adaptive automation system and that ERPs may provide an alternative means for distinguishing among levels of cognitive task demand in such systems. Actual or potential applications of this research include improved methods for assessing operator workload and performance.

Adaptation, Psychological↗

PubMed1991

[Evaluation of workload in middle-aged steel workers by measuring urinary excretion of catecholamines and cortisol].

To evaluate physical and mental workload in middle-aged workers, urinary excretion of catecholamines and cortisol and self-reported scores of fatigue, stress and arousal in middle-aged steel workers were compared with those in young steel workers. Noradrenaline excretion in daytime of the day-off was higher in middle-aged workers than that in young workers. In the work days, noradrenaline excretion during working hours increased in both age groups when compared with that in the day-off. The work-related increase in noradrenaline excretion was more evident in the middle-aged group than in the young group. Adrenaline excretion during working hours was greater in the middle-aged group than that in the young group, whereas the adrenaline value in the day-off was almost the same in the two age-groups. Age-difference was hardly observed in dopamine and cortisol excretion. These findings suggest that the workload in middle-aged workers was greater than that in young workers. However, self-reported scores of fatigue and stress in middle-aged workers were less than those in young workers, suggesting inconsistency between subjective score of workload and urinary levels of catecholamines. These age-related differences in urinary levels of noradrenaline and adrenaline were not so obvious in workers engaged in automated and mechanized work (vigilance task) when compared to workers engaged in less automated and less mechanized work. It is considered that factory automation might reduce the workload in middle-aged workers.

Adult↗

PubMed2006

Clinical and education workload measurements using personal digital assistant-based software.

OBJECTIVE: There are no accepted and practical measures of the relative clinical and educational activities of pediatricians who work in an academic health science center. Such measures are necessary for justification of existing and future human resource plans and evaluation of the activities and performance of physicians. The limited literature on the measurement of physician workload usually focuses on a specific subspecialty group and does not account for such issues as indirect patient care, such as telephone calls or e-mail consultations; variables that affect the delivery of clinical care, including patient acuity and complexity; and the presence of students during the patient care activities. After completing a pilot study that assessed the educational workload of faculty members, we adapted existing personal digital assistant technology and software to document clinical and educational activities. METHODS: Twenty full-time physicians from 4 subspecialty pediatric divisions participated in a 2-week evaluation project in May through June 2005. Clinical activities, with and without trainees, and educational activities were collected with the use of personal digital assistants. Software allowed an individualized division-specific drop-down menu. Information that was collected included clinical (location of activity, diagnosis, and time requirement) and educational activities. After completion of a 2-week data collection period, each physician was asked to complete a 5-question evaluation form. RESULTS: The project was completed successfully with capture of additional clinical and educational activities. A 5-question evaluation form was completed by 70% of the participants at the end of the 2-week data collection. Data on clinical and educational activities were analyzed qualitatively and graphed. CONCLUSIONS: This method of workload data collection added significant information in capturing activities that are not measured in traditional workload evaluations for either clinical activities, such as e-mail, telephone, and patient information review, or educational endeavors, including mentoring and educational lectures and presentations.

Academic Medical Centers↗

PubMed2006

Workload, study methods, and motivation of students within a BVSc program.

The workloads, study methods, and motivation of students in a five-year BVSc program were studied using questionnaires and focus groups. Students in each year of the program were asked, on three occasions over an academic year, to record details of their out-of-class study time for each course they were taking and to record the study methods they used, how they prioritized their time between subjects, and how they allocated time to study and leisure activities. Mean response rates were 57% (range: 43-85%). Overall mean out-of-class study time ranged from 19 hours per week in Year 2 to 28 hours per week in Year 4. Study time was related to the level of interest the student had in the subject, the demands of assessments, and the number of subjects being studied. Study methods were related to students' perceptions of the requirements of the subject as well as to their interest in it. Reliance on memorization and the use of set study materials were the predominant methods for courses with low interest scores, whereas higher interest was associated with a broad range of study methods. Leisure time was ring-fenced, especially when workloads were high. Students' motivation was high when they were studying subjects that were new or were seen as relevant to clinical practice; when working with animals or with enthusiastic faculty members; and when involved in subjects more tightly focused on the ultimate goal of becoming a practitioner. It was poor when students were faced with high workloads, disciplines becoming "stale," excessive detail, and low perceptions of relevance. Constant assessment activities were also seen as a burden. In terms of good learning practices, workload and the demands of assessment were considered to be antagonistic. A tension between these perceptions of students and the values of faculty in terms of the development of critical thinking skills in the program is evident.

Education, Veterinary↗

PubMed1997

Factors influencing mental workload indexes.

Several findings of the author's own mental workload research are reviewed. Especially, factors, except task demand, influencing mental workload indexes are discussed. First, an experiment using the National Aeronautics and Space Administration Task Load Index (NASA TLX) is reviewed and the effects of a prior task load on a subsequent subjective workload are described. In a physiological measures section, the low reliability of the heart rate variability (HRV) parameters when the subjects' respiration pattern are highly irregular, and the existence of low sweat respondent, although perspiration seems to be sensitive to the workload, are indicated. Furthermore, results of the task specific physiological responses and of a HRV parameter affected by the individual characteristics, like type A behavior pattern, are shown. Discrepancy between autonomic nervous system activity measures may be solvable by introducing a new concept of autonomic space (synergism of sympathetic and parasympathetic nervous system). Finally, the need for strategies of data management concerning the individual differences is emphasized.

Autonomic Nervous System↗

PubMed1997

[Multivariate discriminant analysis for assessing mental workload during duel task operation].

In order to investigate the efficiency of multivariate discriminant analysis in the assessment of mental workload during dual task operations, various psychophysiological indices and performance were recorded. The dual task consisted of the primary visual tracking task and the secondary Oddball task. The results indicated that tracking error, latency of P3 and IBI of HR correlated well with the mental workload and the multivariate discriminant analysis succeeded in classifying the levels of mental workload with higher conformation rate than those using the single index. It suggests that multivariate discriminant analysis is meaningful in the assessment of mental workload under dual task situations.

Aerospace Medicine↗

PubMed1998

Occupational workload of fisherwomen in India.

A group of 60 fisherwomen, aged 20 to 50 yrs., were studied to evaluate their occupational workloads. Of the eight activities involved in fish handling, only four, viz., sorting, washing, drying, and selling, which are most frequently carried out by the fisherwomen, were selected. The heart rate responses and rating of perceived exertion (RPE) were used as measures of occupational workload. Based on the findings, the occupational workload could be classified as "moderately heavy". A significant influence of age and body weight on the physiological workload was observed, being negatively correlated with age and positively with weight.

Adult↗

PubMed2003

Wireless virtual instrument measurement of surgeons' physical and mental workloads for robotic versus manual minimally invasive surgery.

The human-technology interface in traditional minimally invasive surgery (MIS) is difficult for the surgeon. Efforts to improve this interface include the use of robotic surgery systems. Ergonomics studies are required to help understand and improve the MIS user interface. We have developed a tetherless virtual instrument (VI) ergonomics workstation for measuring the physical workloads and stress levels of surgeons performing MIS. The workstation records physiological measures of workload and stress and audio and multiple channels of video. The workstation frees up the subject so that studies can be performed in complex and realistic settings, including the operating room. We illustrate the use of the tetherless ergonomics workstation in a study to compare performance and workload for manual and robotically-assisted MIS. The surgeon volunteers were experienced with manual MIS but had no previous experience with the robotic system. The study results showed that the robotic system reduced the workload and stress levels for these subjects but somewhat degraded their performance. Additional studies are needed to determine the relative effects on performance of user inexperience and the robotic interface.

Ergonomics↗

PubMed2006

[Nonlinear analysis of multi-channel EEG and its application to mental workload detection].

Mental workload research is important to people's health and work efficiency, Psychophysiological measures such as electroencephalography (EEG), ECG and respiration measures can be used to predict mental workload level. A Multi-channel phase-space reconstruction method is proposed in this paper which rearranges signal serials by the correlation coefficients and select time delay by signal determinism. The study of determinism and correlation dimension on simulative data exhibits a good performance. The result of EEG series shows a clearly consistency to workload level variety. The method is useful for multi-channel signals nonlinear analysis and mental workload detection.

Adult↗

PubMed2006

Workload and reward in the Quality and Outcomes Framework of the 2004 general practice contract.

BACKGROUND: The Quality and Outcomes Framework (QOF) of the 2004 UK General Medical Services (GMS) contract links up to 20% of practice income to performance measured against 146 quality indicators. AIM: To examine the distribution of workload and payment in the clinical domains of the QOF, and to compare payment based on true prevalence to the implemented system applying an adjusted prevalence factor. We aimed also to assess the performance of the implemented payment system against its three stated objectives: to reduce variation in payment compared to a system based on true prevalence, to fairly link reward to workload, and finally, to help tackle health inequalities. DESIGN OF STUDY: Retrospective analysis of publicly available QOF data. SETTING: Nine hundred and three GMS general practices in Scotland. METHOD: Comparison of payment under the implemented Adjusted Disease Prevalence Factor, and under an alternative True Disease Prevalence Factor. RESULTS: Variation in total clinical QOF payment per 1000 patients registered is significantly reduced compared to a payment system based on true prevalence. Payment is poorly related to workload in terms of the number of patients on the disease register, with up to 44 fold variation in payment per patient on the disease register for practices delivering the same quality of care. Practices serving deprived populations are systematically penalized under the implemented payment system, compared to one based on true prevalence. CONCLUSIONS: The implemented adjustment for prevalence succeeds in its aim of reducing variation in practice income, but at the cost of making the relationship between workload and reward highly inequitable and perpetuating the inverse care law.

Family Practice↗

PubMed1998

Frequency of patients' consulting in general practice and workload generated by frequent attenders: comparisons between practices.

BACKGROUND: Patients who attend frequently may present a problem for general practitioners (GPs) in several ways. The frequency of patients' consulting, comparisons between practices, and the effect of frequent consulting on the clinical workload have not been quantified previously. AIMS: To examine the distribution of the number of consultations per patient in four general practices. To estimate the clinical workload generated by frequent attenders. To model the data to demonstrate the contribution of age, sex, and practice on the likelihood of attending frequently. METHOD: Analysis and modelling of a validated data set of date records of consultations collected routinely over a 41-month period from four practices in and around Leeds, representing 44,146 patients and 470,712 consultations. RESULTS: A minority of patients consulted with extreme frequency. All practices had similar distributions but varied with respect to the numbers of frequent attenders, and the frequencies of their consulting. The most frequent 1% of attenders accounted for 6% of all consultations, and the most frequent 3% for 15% of all consultations. Females and older people were more likely to be frequent attenders. CONCLUSION: Frequent attenders have an important effect on GPs clinical workload. Between one in six and one in seven consultations are with the top 3% of attenders. Further research is needed to explain the behaviour underpinning frequent attendance in order to identify appropriate management strategies; such strategies could have an important effect on clinical workload.

Adolescent↗