Assessment of visual attention in teams with or without dedicated team leaders: A neonatal simulation-based pilot study utilizing low-cost eye-tracking technology

Prakash Kannan Loganathan, Matthew Pointon, Peter McMeekin, Alan Godfrey, Conor Wall, Michael Wagner, Robert McNicol

Research output: Contribution to journalArticlepeer-review


Background: Eye-tracking technology could be used to study human factors during teamwork.

Objective: To compare the visual attention (VA) of a team member acting as both team leader, and managing the airway, compared to the team member performing a focused task of managing the airway only with a dedicated team leader. To report differences in team performance, behavioural skills, and workload between the two groups using validated tools.

Methods: We conducted a simulation-based, pilot randomized controlled study. Participants included are volunteer paediatric trainees, nurse practitioners and neonatal nurses. Three teams consisting of four team members were formed. Each team participated in two identical neonatal resuscitation simulation scenarios in random order, once with or once without a team leader. Using a commercially available eye-tracking device, we analysed VA in regarding attention to 1) manikin, 2) colleague, and 3) monitor. Only the trainee who was the airway operator would wear eye-tracking glasses in both simulations.

Results: Six simulation scenarios and 24 individual role allocations were analysed. Participants in a no-team leader capacity had a greater number of total fixations on manikin and monitors, though not significant. There were no significant differences in team performance, behavioural skills, and individual workload. Physical demand was reported as significantly higher by participants in the group without a team leader. During debriefing, all the teams expressed their preference of having a dedicated team leader.

Conclusion: In our pilot study using low-cost technology we could not demonstrate the difference in VA with presence of a team leader.
Original languageEnglish
JournalBMJ (Online)
Publication statusAccepted/In press - 25 Nov 2023

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