Pilot study: Designing Medical Alarm Sounds For Semantic Association And Ease Of Learning

Gasthurie Kanagachandran; Paul Beatty

摘要

The performance of a new set of alarm sounds, generated from recordings of words descriptive of the situation relevant to the alarm and based on the principle of phonic abbreviation, were tested. Twenty-one volunteers aged from 24 to 54 were recruited for the study. Before being trained to recognise the sounds, they correctly identified 16.57% (range 0.00% to 76.19%) of the descriptive words used. The mean correct identification rates for the sounds after training was 56.35% (range 17.78% to 93.02%). Limited urgency mapping testing showed that the intrinsic urgencies of the low, medium and high priority forms of the sounds were statistically significantly separate (p<0.01). These results suggest that it may well be possible to construct a set of alarm sounds, for use on physiological monitoring instruments, using the concept of phonic abbreviation, which may have superior learnability to other systems without being unacceptably easy for casual hearers to understand. Introduction Following the work of Block et al (2002), the current IEC 60601-1-8 (IEC, 2005) standard for medical equipment alarms offers equipment manufacturers the option to create melodic alarms that distinguish the physical or physiological system that each alarm represents. The logic of such alarms is that their meanings should be easier to remember than abstract sounds, and therefore they might improve the speed and accuracy of clinician response. However, two studies by Williams and Beatty (2005), and Sanderson, Wee and Lacherez (2006) have shown that there are difficulties in learning and memorising the meanings of the melodic alarms in the IEC standard. The notion that melodic alarms might be easier to learn and remember, stems from a study by Block (1992) that found that anaesthetists rapidly achieved good learning of the meaning of a set of such alarms. However, unlike those in the IEC standard, the alarms Block tested had names associating the alarm source with a simple phrase usually taken from the title of a popular song (e.g. oxygenation and ‘Love is Blue'). Could the difference in reported performance be attributed to the effect of this clear associative labelling rather than something to do with the design of the alarm sounds themselves?In a survey of the preferences of anaesthetists for the type of sounds that might be used to form the basis of new alarms an overwhelming majority preferred using a synthesised voice to produce a verbal alarm. However, there are practical objections to using such verbal alarms. In critical care, alarms on equipment are audible to patients, who may be conscious, and to visitors. Both groups might be disturbed by the implications of such alarms. Even where a ‘public' alarm of this type might only be heard by medical staff, as in an operating theatre, it may still not be advisable for everyone to be informed about the detailed meaning of an alarm intended for action primarily by the anaesthetist. This paper reports the results of a pilot study to test whether a set of alarms based on vocalisations of key-words explicitly describing the meaning of an alarm could be used to create an abstract sound that would preserve sufficient inherent semantic association to be easier to learn and memorise, but would still be sufficiently abstract to be unintelligible to a casual untrained hearer. We have termed these sorts of alarms ‘phonic abbreviations'. Method Construction of the new alarm soundsThe sounds would be tested within the same overall framework as the IEC melodic alarms. In this framework there are 8 physical or physiological systems referred to (ventilation, perfusion, infusion of drugs or fluids, cardiac performance, oxygenation, temperature, power failure and general alarm) each with its own basic alarm sound. For each of these systems there are modifications to the basic alarm sound according to the urgency to be indicated. All the alarms have a medium and high priority form and the general alarm also has a low prio

机译：测试了一组新的警报声音的性能，这些声音是根据描述与警报有关的情况的单词记录并基于语音缩写原理生成的。招募了21名24至54岁的志愿者进行这项研究。在接受训练以识别声音之前，他们正确地识别了所用描述性单词的16.57％（范围为0.00％至76.19％）。训练后声音的平均正确识别率为56.35％（范围为17.78％至93.02％）。有限的紧急度映射测试显示，低，中和高优先级形式的声音的内在紧急度在统计学上显着分开（p <0.01）。这些结果表明，很可能有可能使用语音缩写的概念来构建一套用于生理监测仪器的警报声音，该缩写可能比其他系统具有更好的易学性，而对于普通听众来说却不容易理解。简介在Block等人（2002）的工作之后，当前针对医疗设备警报的IEC 60601-1-8（IEC，2005）标准为设备制造商提供了创建旋律警报的选项，该旋律警报可以区分每种警报代表的物理或生理系统。此类警报的逻辑是，其含义应比抽象声音更容易记住，因此它们可以提高临床医生响应的速度和准确性。但是，Williams和Beatty（2005）以及Sanderson，Wee和Lacherez（2006）的两项研究表明，在学习和记忆IEC标准中旋律警报的含义方面存在困难。 Block（1992）的一项研究发现，旋律警报可能更容易学习和记住，这一发现发现麻醉师很快就对这类警报的含义有了很好的了解。但是，与IEC标准中的警报不同，被测试的警报块具有将警报源与一个简单短语相关联的名称，该短语通常取自一首流行歌曲的标题（例如，充氧和“爱是蓝色”）。报告的性能差异是否归因于这种清晰的关联标签效果，而不是与警报声音本身的设计有关？在麻醉师对可能用于形成声音的声音类型的偏好调查中在新警报的基础上，绝大多数人首选使用合成语音来生成语音警报。但是，使用此类口头警报存在实际的反对意见。在重症监护中，可能有意识的患者和访客会听到设备警报。两组都可能会受到此类警报的影响。即使在手术室中只能由医务人员听到这种“公共”警报的地方，也仍然不建议每个人都知道主要由麻醉师使用的警报的详细含义。本文报告了一项初步研究的结果，以测试是否可以使用基于明确表达警报含义的关键字发声的警报集来创建抽象声音，该声音将保留足够的固有语义关联，以便于学习和备忘录，但仍然足够抽象，以至于未经培训的临时听众都无法理解。我们将这类警报称为“语音缩写”。新警报声音的方法构造应在与IEC旋律警报相同的总体框架内测试声音。在此框架中，涉及8个物理或生理系统（通风，灌注，输注药物或液体，心脏功能，充氧，温度，电源故障和一般警报），每个系统都有其自身的基本警报声音。对于这些系统中的每一个，都会根据要显示的紧急程度对基本警报声音进行修改。所有警报均具有中高优先级形式，普通警报也具有低优先级

Pilot study: Designing Medical Alarm Sounds For Semantic Association And Ease Of Learning

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