What Can Analytics for Teamwork Proxemics Reveal About Positioning Dynamics In Clinical Simulations?

Effective teamwork is critical to improve patient outcomes in healthcare. However, achieving this capabilityrequires that pre-service nurses develop the spatial abilities they will require in their clinical placements, suchas: learning when to remain close to the patient and to other team members; positioning themselves correctlyat the right time; and deciding on specific team formations (e.g. face-to-face or side-by-side) to enable effectiveinteraction or avoid disrupting clinical procedures. However, positioning dynamics are ephemeral and caneasily become occluded by the multiple tasks nurses have to accomplish. Digital traces automatically capturedby indoor positioning sensors can be used to address this problem for the purpose of improving nurses' reflection, learning and professional development. This paper presents; i) a qualitative study that illustrateshow to elicit spatial behaviours from educators' pedagogical expectations, and ii) a modelling approachthat transforms nurses' low-level position traces into higher-order proxemics constructs, informed by sucheducatos' expectations, in the context of simulation-based teamwork training. To illustrate our modellingapproach, we conducted an in-the-wild study with 55 undergraduate students and five educators from whompositioning traces were captured in eleven authentic nursing education classes. Low-levelx-ydata was usedto model three proxemic constructs: i) co-presence in interactional spaces, ii) socio-spatial formations (i.e.f-formations), and ii) presence in spaces of interest. Through a number of vignettes, we illustrate how indoorpositioning analytics can be used to address questions that educators and researchers have about teamwork inhealthcare simulation settings.

[1]  Michael Prilla,et al.  Fostering Collaborative Redesign of Work Practice: Challenges for Tools Supporting Reflection at Work , 2013, ECSCW.

[2]  Peter J. Gates,et al.  Standardising the Classification of Harm Associated with Medication Errors: The Harm Associated with Medication Error Classification (HAMEC) , 2019, Drug Safety.

[3]  Social processes and spatial form: An analysis of the conceptual problems of urban planning , 1970 .

[4]  Susan R. Fussell,et al.  Where did we turn wrong?: unpacking the effect of culture and technology on attributions of team performance , 2008, CSCW.

[5]  Joaquín Torres-Sospedra,et al.  A Meta-Review of Indoor Positioning Systems , 2019, Sensors.

[6]  Ahmad M. Alghraibeh,et al.  Preferred Interpersonal Distances: A Global Comparison , 2017 .

[7]  N. Dael,et al.  Measuring body movement: Current and future directions in proxemics and kinesics. , 2015 .

[8]  Nébia Maria Almeida de Figueiredo,et al.  Proxemic behavior of nursing in the hemodialysis setting , 2017 .

[9]  Ciro Cattuto,et al.  Close Encounters in a Pediatric Ward: Measuring Face-to-Face Proximity and Mixing Patterns with Wearable Sensors , 2011, PloS one.

[10]  A. Cheng,et al.  More Than One Way to Debrief: A Critical Review of Healthcare Simulation Debriefing Methods , 2016, Simulation in healthcare : journal of the Society for Simulation in Healthcare.

[11]  J. Paige,et al.  Debriefing the Interprofessional Team in Medical Simulation , 2020 .

[12]  Zhan Zhang,et al.  Constructing Awareness Through Speech, Gesture, Gaze and Movement During a Time-Critical Medical Task , 2015, ECSCW.

[13]  Michael A. West,et al.  Effective Teamwork: Practical Lessons from Organizational Research , 2004 .

[14]  Gerry Stahl,et al.  Theories of Cognition in CSCW , 2011, ECSCW.

[15]  Andrew Petrosoniak,et al.  Tracking workflow during high-stakes resuscitation: the application of a novel clinician movement tracing tool during in situ trauma simulation , 2018, BMJ Simulation & Technology Enhanced Learning.

[16]  E. Hall,et al.  The Hidden Dimension , 1970 .

[17]  C. Haythornthwaite Social network analysis: An approach and technique for the study of information exchange☆ , 1996 .

[18]  Ann Hendrich,et al.  A 36-hospital time and motion study: how do medical-surgical nurses spend their time? , 2008, The Permanente journal.

[19]  Radan Martinec Interpersonal resources in action , 2001 .

[20]  Travis J. Wiltshire,et al.  Toward understanding social cues and signals in human–robot interaction: effects of robot gaze and proxemic behavior , 2013, Front. Psychol..

[21]  David Williamson Shaffer,et al.  Epistemic Network Analysis: A Worked Example of Theory-Based Learning Analytics , 2017 .

[22]  Nazmus Saquib,et al.  Sensei , 2018, Proc. ACM Interact. Mob. Wearable Ubiquitous Technol..

[23]  Neal Wiggermann,et al.  What Bed Size Does a Patient Need? The Relationship Between Body Mass Index and Space Required to Turn in Bed , 2017, Nursing research.

[24]  Zhe Li,et al.  Making sense: Sensor-based investigation of clinician activities in complex critical care environments , 2011, J. Biomed. Informatics.

[25]  Cecilia Mascolo,et al.  Measuring Interaction Proxemics with Wearable Light Tags , 2018, Proc. ACM Interact. Mob. Wearable Ubiquitous Technol..

[26]  Stephen Viller,et al.  The Group Facilitator: A CSCW Perspective , 1991, ECSCW.

[27]  Gabriele Marini,et al.  Towards indoor localisation analytics for modelling flows of movements , 2019, UbiComp/ISWC Adjunct.

[28]  Yvonne Rogers,et al.  HuddleLamp: Spatially-Aware Mobile Displays for Ad-hoc Around-the-Table Collaboration , 2014, ITS '14.

[29]  David M. Gaba,et al.  The Role of Debriefing in Simulation-Based Learning , 2007, Simulation in healthcare : journal of the Society for Simulation in Healthcare.

[30]  Lionel M. Ni,et al.  A Survey on Wireless Indoor Localization from the Device Perspective , 2016, ACM Comput. Surv..

[31]  Steve W J Kozlowski,et al.  Unpacking team process dynamics and emergent phenomena: Challenges, conceptual advances, and innovative methods. , 2018, The American psychologist.

[32]  R. Kershner,et al.  Making Decisions about Organising the Primary Classroom Environment as a Context for Learning: The Views of Three Experienced Teachers and Their Pupils. , 2000 .

[33]  Marius Popa,et al.  Indoor Positioning inside an Office Building Using BLE , 2017, 2017 21st International Conference on Control Systems and Computer Science (CSCS).

[34]  T. M. Ciolek The proxemics lexicon: A first approximation , 1983 .

[35]  Niall O' Mahony,et al.  Adaptive Multimodal Localisation Techniques for Mobile Robots in Unstructured Environments : A Review , 2019, 2019 IEEE 5th World Forum on Internet of Things (WF-IoT).

[36]  Kenton O'Hara,et al.  F-Formations in Cooking Together: A Digital Ethnography Using YouTube , 2013, INTERACT.

[37]  F. Nakamura,et al.  Past, present, and future of the technological tracking methods to assess tactical variables in team sports: A systematic review , 2020 .

[38]  A. Cheng,et al.  Cognitive Load Theory for debriefing simulations: implications for faculty development , 2018, Advances in Simulation.

[39]  Saul Greenberg,et al.  Proxemic Interactions: From Theory to Practice , 2015, Proxemic Interactions.

[40]  A. Pentland,et al.  Meeting mediator: enhancing group collaborationusing sociometric feedback , 2008, CSCW.

[41]  Gunnar Ellingsen,et al.  A Review of 25 Years of CSCW Research in Healthcare: Contributions, Challenges and Future Agendas , 2012, Computer Supported Cooperative Work (CSCW).

[42]  Muhammad Aamir Cheema,et al.  Indoor location-based services: challenges and opportunities , 2018, SIGSPACIAL.

[43]  Vittorio Murino,et al.  Towards Computational Proxemics: Inferring Social Relations from Interpersonal Distances , 2011, 2011 IEEE Third Int'l Conference on Privacy, Security, Risk and Trust and 2011 IEEE Third Int'l Conference on Social Computing.

[44]  A. Merry,et al.  Capturing the experience of the hospital-stay journey from admission to discharge using diaries completed by patients in their own words: a qualitative study , 2019, BMJ Open.

[45]  Laurie R. Weingart,et al.  Dynamics in Groups: Are We There Yet? , 2011 .

[46]  Martinez-MaldonadoRoberto,et al.  Teacher Tracking with Integrity What Indoor Positioning Can Reveal About Instructional Proxemics , 2020 .

[47]  M. White,et al.  Environmental Issues in Patient Care Management: Proxemics, Personal Space, and Territoriality , 2008, Rehabilitation nursing : the official journal of the Association of Rehabilitation Nurses.

[48]  B. Gundogan,et al.  Reflective practice in health care and how to reflect effectively , 2017, International journal of surgery. Oncology.

[49]  E. Hall,et al.  Proxemics [and Comments and Replies] , 1968, Current Anthropology.

[50]  Janet E. Gardner Spatial Ability in Registered Nurses , 2014 .

[51]  Roberto Martínez Maldonado,et al.  Towards Collaboration Translucence: Giving Meaning to Multimodal Group Data , 2019, CHI.

[52]  L. Mondada Interactional space and the study of embodied talk-in-interaction , 2013 .

[53]  Takashi Ozeki,et al.  Analysis of interactions between lecturers and students , 2018, LAK.

[54]  Alex Pentland,et al.  Wearable sensors for pervasive healthcare management , 2009, 2009 3rd International Conference on Pervasive Computing Technologies for Healthcare.

[55]  D. Meyer,et al.  Supporting Online Material Materials and Methods Som Text Figs. S1 to S6 References Evidence for a Collective Intelligence Factor in the Performance of Human Groups , 2022 .

[56]  Andrea Landherr,et al.  A Critical Review of Centrality Measures in Social Networks , 2010, Bus. Inf. Syst. Eng..

[57]  Kirk Goldsberry,et al.  CourtVision : New Visual and Spatial Analytics for the NBA , 2012 .

[58]  Johnny Saldaña,et al.  The Coding Manual for Qualitative Researchers , 2009 .

[59]  Liz Berragan,et al.  Simulation: an effective pedagogical approach for nursing? , 2011, Nurse education today.

[60]  Marva Foster,et al.  Use of Simulation to Develop Teamwork Skills in Prelicensure Nursing Students: An Integrative Review. , 2018, Nurse educator.

[61]  T. Grundgeiger,et al.  Rapid Preparation of Eye Tracking Data For Debriefing In Medical Training: A Feasibility Study , 2019, Proceedings of the Human Factors and Ergonomics Society Annual Meeting.

[62]  Jane Moore,et al.  Social Interaction and Collaboration among Oncology Nurses , 2015, Nursing research and practice.

[63]  Yvonne Rogers,et al.  Using F-formations to analyse spatial patterns of interaction in physical environments , 2011, CSCW.

[64]  Gonçalo Lopes,et al.  HiveTracker: 3D positioning for ubiquitous embedded systems , 2019, UbiComp/ISWC Adjunct.

[65]  R S Newbower,et al.  An Analysis of Major Errors and Equipment Failures in Anesthesia Management: Considerations for Prevention and Detection , 1984, Anesthesiology.

[66]  Roberto Martínez Maldonado,et al.  Where Is the Nurse? Towards Automatically Visualising Meaningful Team Movement in Healthcare Education , 2018, AIED.

[67]  David Williamson Shaffer,et al.  A Tutorial on Epistemic Network Analysis: Analyzing the Structure of Connections in Cognitive, Social, and Interaction Data , 2016, J. Learn. Anal..

[68]  Kenton O'Hara,et al.  Interaction proxemics and image use in neurosurgery , 2012, CHI.

[69]  Roberto Martínez Maldonado,et al.  From Data to Insights: A Layered Storytelling Approach for Multimodal Learning Analytics , 2020, CHI.

[70]  D. Brunt,et al.  Verbal and social interactions in the nurse-patient relationship in forensic psychiatric nursing care: a model and its philosophical and theoretical foundation. , 2007, Nursing inquiry.

[71]  Päivi Häkkinen,et al.  Conceptualizing the Awareness of Collaboration: A Qualitative Study of a Global Virtual Team , 2005, Computer Supported Cooperative Work (CSCW).

[72]  M. Boos,et al.  Laborious but Elaborate: The Benefits of Really Studying Team Dynamics , 2019, Front. Psychol..

[73]  Pierre Dillenbourg,et al.  Translating Head Motion into Attention - Towards Processing of Student's Body-Language , 2015, EDM.

[74]  Gleicia Martins de Melo,et al.  Nursing team communication with regard pain in newborns: a descriptive study , 2013 .

[75]  Jessica L Doolen,et al.  Nursing Simulation Research: What Are the Perceived Gaps? , 2016 .

[76]  Francesco Setti,et al.  F-Formation Detection: Individuating Free-Standing Conversational Groups in Images , 2015, PloS one.

[77]  Stephen M Fiore,et al.  The Science of Team Science: A Review of the Empirical Evidence and Research Gaps on Collaboration in Science , 2018, The American psychologist.

[78]  J. Hindmarsh,et al.  Knowing Bodies at Work: Embodiment and Ephemeral Teamwork in Anaesthesia , 2007 .

[79]  Elizabeth Bagley,et al.  Epistemic network analysis : a Prototype for 21 st Century assessment of Learning , 2009 .

[80]  Edward T. Hall,et al.  A System for the Notation of Proxemic Behavior1 , 1963 .

[81]  David Williamson Shaffer,et al.  Quantifying the qualitative with epistemic network analysis: A human factors case study of task-allocation communication in a primary care team , 2018, IISE transactions on healthcare systems engineering.

[82]  Carey E. Priebe,et al.  An integrative framework for sensor-based measurement of teamwork in healthcare , 2015, J. Am. Medical Informatics Assoc..