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Given the widespread adverse outcomes of stress – exacerbated by the current pandemic – wearable sensing provides unique opportunities for automated stress tracking to inform well-being interventions. However, its success in the wild and at scale depends on the robustness and validity of automated stress inference, which is limited in current systems. In this work, we enumerate the properties of robustness and validity necessary for achieving viable automated stress inference using wearable sensors, and we underscore present challenges to constructing and evaluating these systems. Using these criteria as guiding principles, we present automated stress inference results from a large (N=606) in situ longitudinal wearable and contextual sensing study of information workers. Using a multimodal approach encompassing a wearable sensor, relative location tracking, smartphone usage, and environmental sensing, we trained regression models to predict daily self-reported perceived stress in a participant-independent fashion. Our models significantly outperformed baseline variants with shuffled stress scores and were consistent with small-to-moderate effects. Our findings highlight the performance disparity between robust and valid approaches to automated perceived stress inference and current approaches and suggest that further performance gains might require additional sensing modalities and enhanced contextual awareness than existing approaches. [ABSTRACT FROM AUTHOR]

Introduction: In recent decades, the lack of educational resources for cadaveric dissections has complicated the hands-on otological surgical training of otorhinolaryngology residents due to the poor availability of cadaver temporal bones, facilities, and limited hours for practice. Since students must gain adequate and patient-safe surgical skills, novel training methods need to be considered. In this proof-of-concept study, a new virtual reality (VR) software is described; this was used during a national temporal bone dissection course where we investigated its feasibility for otological surgical training. Methods: A total of 11 otorhinolaryngology residents attended the annual 2-day hands-on temporal bone dissection course; they were divided into two groups with similar experience levels. Both groups received a lecture on temporal bone anatomy. A total of 22 cadaver temporal bones were harvested for the course; 11 of these bones were imaged by computed tomography. VR software designed for preoperative planning was then used to create 3D models of the imaged temporal bones. Prior to dissection training, the first group underwent a 30-min VR session, where they identified 24 surgically relevant anatomical landmarks on their individual temporal bone. The second group proceeded directly to dissection training. On the second day, the groups were switched. The feasibility of VR training was assessed with three different metrics: surgical performance evaluation using a modified Hopkins objective structured assessment of technical skill (OSATS), time for the surgical exposure of anatomical landmarks, and the user experience collected with a Likert scale questionnaire. Results: No differences were noted in the overall performance between the groups. However, participants with prior VR training had a lower mean time for surgical exposure of anatomical landmarks (antrum 22.09 vs. 27.64 min, p = 0.33; incus 60.00 vs. 76.00, p = 0.03; PSCC 71.83 vs. 88.50, p = 0.17) during dissection training. The participants considered VR beneficial for anatomy teaching, surgery planning, and training. Conclusion: This study demonstrated the feasibility of implementing VR training in a temporal bone dissection course. The VR training demonstrated that even short expert-guided VR sessions are beneficial, and VR training prior to the dissections has a positive effect on the time needed to perform surgical tasks while maintaining comparable performance scores. [ABSTRACT FROM AUTHOR]

Background Eye tracking is a powerful tool for unobtrusive and real time assessment of workload in clinical settings. Before the complex eye tracking derived surrogates can be proactively utilized to improve surgical safety, the indications, validity and reliability requires careful evaluation. Methods We conducted a systematic review of literature from 2010 to 2020 according to PRISMA guidelines. A search on PubMed, Cochrane, Scopus, Web of science, PsycInfo and Google scholar databases was conducted on July 2020. The following search query was used" ("eye tracking" OR "gaze tracking") AND (surgery OR surgical OR operative OR intraoperative) AND (workload OR stress)". Short papers, no peer reviewed or papers in which eye-tracking methodology was not used to investigate workload or stress factors in surgery, were omitted. Results A total of 17 (N = 17) studies were identified eligible to this review. Most of the studies (n = 15) measured workload in simulated setting. Task difficulty and expertise were the most studied factors. Studies consistently showed surgeon's eye movements such as pupil responses, gaze patterns, blinks were associated with the level of perceived workload. However, differences between measurements in operational room and simulated environments have been found. Conclusion Pupil responses, blink rate and gaze indices are valid indicators of workload. However, the effect of distractions and non-technical factors on workload is underrepresented aspect in the literature even though recognized as underlying factors in successful surgery. [ABSTRACT FROM AUTHOR]

Background. Evaluation of microsurgical proficiency is conventionally subjective, time consuming, and unreliable. Eye movement–based metrics have been promising not only in detection of surgical expertise but also in identifying actual cognitive stress and workload. We investigated if pupil dilations and blinks could be utilized in parallel to accurately classify microsurgical proficiency and its moderating features, especially task-related stress. Methods. Participants (n = 11) were divided into groups based on prior experience in microsurgery: novices (n = 6) with no experience and trained microsurgeons (n = 5). All participants conducted standardized suturing tasks with authentic instruments and a surgical microscope. A support vector machine classifier was used to classify features of microsurgical expertise based on percentage changes in pupil size. Results. A total of 109 successful sutures with 1090 segments were recorded. Classification of expertise from sutures achieved accuracies between 74.3% and 76.0%. Classification from individual segments based on these same features was not feasible. Conclusions. Combined gaze metrics are applicable for classifying surgical proficiency during a defined task. Pupil dilation is also sensitive to external stress factors; however, the usefulness of blinks is impaired by low blink rates. The results can be translated to surgical education to improve feedback and should be investigated individually in the context of actual performance and in real patient operations. Combined gaze metrics may be ultimately utilized to help microsurgeons monitor their performance and workload in real time—which may lead to prevention of errors. [ABSTRACT FROM AUTHOR]

We hypothesize that effective collaboration is facilitated when individuals and environmental components form a synergy where they work together and regulate one another to produce stable patterns of behavior, or regularity, as well as adaptively reorganize to form new behaviors, or irregularity. We tested this hypothesis in a study with 32 triads who collaboratively solved a challenging visual computer programming task for 20 min following an introductory warm‐up phase. Multidimensional recurrence quantification analysis was used to examine fine‐grained (i.e., every 10 s) collective patterns of regularity across team members' speech rate, body movement, and team interaction with the shared user interface. We found that teams exhibited significant patterns of regularity as compared to shuffled baselines, but there were no systematic trends in regularity across time. We also found that periods of regularity were associated with a reduction in overall behavior. Notably, the production of irregular behavior predicted expert‐coded metrics of collaborative activity, such as teams' ability to construct shared knowledge and effectively negotiate and coordinate execution of solutions, net of overall behavioral production and behavioral self‐similarity. Our findings support the theory that groups can interact to form interpersonal synergies and indicate that information about system‐level dynamics is a viable way to understand and predict effective collaborative processes. [ABSTRACT FROM AUTHOR]