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Objectives Ski and snowboard-related injuries are common among Canadian youth. Analyzing the role of risky behaviours that contribute to injury risk is essential for gaining an understanding of injury prevention opportunities. The objective was to determine if rates of risky behaviour seen at the ski hill were lower for children and adolescents exposed to an educational injury prevention video. Methods This single-blinded cluster randomized controlled trial included students (ages 7–16) from 18 Calgary schools who were enrolled in novice levelled school-sanctioned ski and snowboard programs. Consenting schools were randomly assigned to the intervention or control. The control group followed standard preparation including watching a general ski hill orientation video that was created by the ski hill. The intervention group viewed the intervention video focussed on injury prevention. The Risky Behaviour and Actions Assessment Tool was used by blinded research assistants to observe and record students’ risky behaviours at an Alberta ski hill. Results In total, 407 observations estimated the rate of risky behaviour. The overall rate of risky behaviour was 23.31/100 person runs in the control group and 22.95/100 person runs in the intervention group. The most commonly observed risky behaviours in both groups were skiing too close to other skiers/snowboarders and near collision with an object/person. Conclusions Both groups showed similar rates of risky behaviour and demonstrated the same most common type of behaviour. Practical applications: future work should focus on mitigating common risky behaviours.

It is believed youth snow-sports injuries are preventable through adequate safety education. This study evaluated the effectiveness of a ski and snowboard injury prevention video on youth safety knowledge. A cluster randomized controlled trial was conducted among grade 2-9 students participating in a ski-snowboard school program. The intervention group watched a new injury prevention video. The control group watched the general ski-area orientation video. Students completed a 15-question ski-snowboard safety test before, immediately after, and one month after viewing. Within-subject difference between the pre- and post-questionnaire scores was calculated. Linear mixed-effects model assessed difference in knowledge change scores. 1034 students (seven intervention; 10 control schools) were enrolled. Pre- to-post-test knowledge increased by an average of 1.91 in the intervention (n = 388) and 0.10 points in the control (n = 646). The difference between the immediate and one-month post-test was 0.17 for the intervention (n = 122) and 0.60 for the control (n = 130). The mean change score for the immediate post-test was greater in the intervention (1.77; 95% CI: 1.52-2.03). The mean change score between the immediate and one-month post-test was lower (−0.55; 95% CI: −1.07 to 0.02) for the intervention compared with the control. The findings showed a ski-snowboard safety video can increase knowledge immediately after viewing within a school-aged population.

Background Failed peripheral intravenous catheterizations result in multiple painful skin punctures, diagnostic and treatment delays, and increased morbidity and mortality. Incorporating gaze behavior training may increase success rates. Method Using eye tracking glasses with simulated catheterizations, we compared novice (n = 12) and expert nurses’ (n = 10) insertion attempt success rates and eye movements. Results Experts took significantly less time to complete catheterization and had fewer visits and fixations on the area of interest than novices. Conclusions Training gaze behaviors during simulated peripheral intravenous catheterizations may increase novice nurses’ success rates.

Objective We examine the relationships between contemporary progress in on‐road vehicle automation and its coherence with an envisioned “autopia” (automobile utopia) whereby the vehicle operation task is removed from all direct human control. Background The progressive automation of on‐road vehicles toward a completely driverless state is determined by the integration of technological advances into the private automobile market; improvements in transportation infrastructure and systems efficiencies; and the vision of future driving as a crash‐free enterprise. While there are many challenges to address with respect to automated vehicles concerning the remaining driver role, a considerable amount of technology is already present in vehicles and is advancing rapidly. Methods A multidisciplinary team of experts met to discuss the most critical challenges in the changing role of the driver, and associated safety issues, during the transitional phase of vehicle automation where human drivers continue to have an important but truncated role in monitoring and supervising vehicle operations. Results The group endorsed that vehicle automation is an important application of information technology, not only because of its impact on transportation efficiency, but also because road transport is a life critical system in which failures result in deaths and injuries. Five critical challenges were identified: driver independence and mobility, driver acceptance and trust, failure management, third-party testing, and political support. Conclusion Vehicle automation is not technical innovation alone, but is a social as much as a technological revolution consisting of both attendant costs and concomitant benefits.

BackgroundPedestrians are commonly involved in vehicle collisions that result in injuries and fatalities. Pedestrian distraction has become an emerging safety issue as more pedestrians use their mobile phones while walking and crossing the street.ObjectivesThe purpose of this research synthesis and meta-analysis is to determine the extent to which cell phone conversation, text messaging or browsing, and listening to music affect a number of common pedestrian behavioural measures.MethodsA keyword search was developed with a subject librarian that used MeSH terms from selected databases including PsycINFO, SPORTDiscus, Medline and TRID. Supplemental searches were also conducted with Google Scholar and Mendeley.Effect size codingThirty-three studies met inclusion criteria and were subjected to data extraction. Statistical information (ie, M, SD, SE, 95% CI, OR, F, t) was extracted to generate standardised mean difference effect sizes (ie, Cohen’s d) and r effect sizes.ResultsFourteen experimental studies were ultimately included in an N-weighted meta-analysis (k=81 effect sizes), and eight observational studies were included in a qualitative overview. Both mobile phone conversation and text messaging increased rates of hits and close calls. Texting decreased rates of looking left and right prior to and/or during street crossing. As might be expected, text messaging was generally found to have the most detrimental effect on multiple behavioural measures.LimitationsA variety of study quality issues limit the interpretation and generalisation of the results, which are described, as are future study measurement and methods improvements.

Traffic sign comprehension is significantly affected by their compliance with ergonomics design principles. Despite the UN Convention, designs vary among countries. The goal of this study was to establish theoretical and methodological bases for evaluating the design of conventional and alternative signs. Thirty-one conventional signs and 1–3 alternatives for each conventional sign were evaluated for their compliance with three ergonomics guidelines for sign design: physical and conceptual compatibility, familiarity and standardisation. Twenty-seven human factors and ergonomics experts from 10 countries evaluated the signs relative to their compliance with the guidelines. Analysis of variance across alternatives revealed that for 19 of the 31 signs, an alternative design received a significantly higher rating in its ergonomics design than the conventional sign with the same meaning. We also found a very high correlation between the experts’ ratings and comprehension from previous studies. In conclusion, many countries use signs for which better alternative designs exist, and therefore UN Convention signs should be re-examined, and ergonomics experts evaluation can serve as a good surrogate for road users’ comprehension surveys. Practitioner summary: This study presents theoretical and methodological bases for evaluating the design of UN Conventional and alternative traffic signs. Human factors and ergonomics experts evaluated 31 conventional and 68 alternative road signs, based on ergonomics principles for sign design. Results indicated the need to re-examine poorly designed UN Convention signs.

Background Traffic sign design can have a substantial impact on road safety and traffic flow. The current study had three objectives: 1) Cross-validate the importance of ergonomic sign design; 2) Evaluate the ability of ergonomics experts to predict sign comprehension by the average driver; 3) Offer improved sign designs for poorly designed road signs. In a previous study (Ben Bassat et al., 2019), human factors and ergonomics experts evaluated several alternative designs for 31 different road signs, based on three ergonomics criteria – familiarity, standardization, and message/symbol compatibility. Some of these signs were tested in the current study and the correlation between the results of the two studies was analyzed. Method In this study, 805 licensed drivers from five countries were tested on their comprehension of 24 conventional signs and 32 alternative signs. Signs were individually presented on a screen and as soon as the participant decided on the meaning, the sign disappeared, and an experimenter wrote the stated meaning. The verbal responses were coded as correct (perfectly or partially), wrong, or opposite of the true meaning. Sign identification response time was also recorded. Results In all countries across all signs, more drivers comprehended the alternative ergonomically superior signs, and the identification response times were shorter for these sign designs. Furthermore, the correlation between ergonomics experts' ratings as found in previous study and the percent of comprehension for each sign design was statistically significant and positive with r = 0.61. Conclusions Road signs should be designed according to ergonomics-based criteria. Human factors experts' opinions can be a useful tool in improving the design of poorly comprehended signs (or icons) and in designing new signs (or icons).

Cannabis and alcohol are frequently detected in fatal and injury motor vehicle crashes. While epidemiological meta-analyses of cannabis and alcohol have found associations with an increase in crash risk, convergent evidence from driving performance measures is insufficiently quantitatively characterized. Our objectives were to quantify the magnitude of the effect of cannabis and alcohol-alone and in combination-on driving performance and behaviour.Systematic review and meta-analysis. We systematically searched Academic Search Complete, CINAHL, Embase, Scopus, Google Scholar, MEDLINE, PsycINFO, SPORTDiscus and TRID. Of the 616 studies that underwent full-text review, this meta-analysis represents 57 studies and 1725 participants. We extracted data for hazard response time, lateral position variability, lane deviations or excursions, time out of lane, driving speed, driving speed variability, speed violations, time speeding, headway, headway variability and crashes from experimental driving studies (i.e. driving simulator, closed-course, on-road) involving cannabis and/or alcohol administration. We reported meta-analyses of effect sizes using Hedges' g and r.Cannabis alone was associated with impaired lateral control [e.g. g = 0.331, 95% confidence interval (CI) = 0.212-0.451 for lateral position variability; g = 0.198, 95% CI = 0.001-0.395 for lane excursions) and decreased driving speed (g = -0.176, 95% CI = -0.298 to -0.053]. The combination of cannabis and alcohol was associated with greater driving performance decrements than either drug in isolation [e.g. g = 0.480, 95% CI = 0.096-0.865 for lateral position variability (combination versus alcohol); g = 0.525, 95% CI = 0.049-1.002 for time out of lane (versus alcohol); g = 0.336, 95% CI = 0.036-0.636 for lateral position variability (combination versus cannabis; g = 0.475, 95% CI = 0.002-0.949 for time out of lane (combination versus cannabis)]. Subgroup analyses indicated that the effects of cannabis on driving performance measures were similar to low blood alcohol concentrations. A scarcity of data and study heterogeneity limited the interpretation of some measures.This meta-analysis indicates that cannabis, like alcohol, impairs driving, and the combination of the two drugs is more detrimental to driving performance than either in isolation.

Background Insufficient conspicuity of pedestrians at night is a fundamental contributor to injuries and fatalities. Retro-reflective clothing that enhances biological motion perception increases detection and identification of pedestrians at night. Objective To determine how speed of motion and body orientation affect observers’ judgments about the recognisability of pedestrians with bio-motion retro-reflectors. Method The stimuli used in this study were videos of a retro-reflectively outfitted pedestrian on a treadmill filmed in a nighttime road environment. Forty undergraduate students observed videos of pedestrians who were standing, walking or running with the side or back of their body oriented towards the observer. Participants decided which of the two pedestrians was most recognizable as a person. Judgments were made in high beams and low beams at 80 m, 160 m and 240 m. Results For both orientations, observers judged that walking and running pedestrians were more recognizable than standing pedestrians. Observers also judged that running pedestrians were more recognizable than walkers. The effect of pedestrian orientation was dependent on speed. When standing, pedestrians in the back orientation were selected more often, but when running, side-oriented pedestrians were selected as the most recognizable. Conclusions Speed of motion and body orientation affect observers’ judgments of the recognisability of pedestrians wearing retro-reflectors at night. Observers choose moving pedestrians (i.e., those who are walking or running) in biomo retro-reflectors as more recognizable as people than pedestrians who stand. The results fill several gaps in the literature and have practical and future research implications, which are discussed.

We share lessons learned from a collaborative in situ simulation of Ebola preparedness for a large health region. The lessons are to use proactive analysis, undertake in situ simulation, and have professionals in infection prevention and control and those in human factors collaborate. These lessons are applicable as generalizable concepts, not only to Ebola preparedness but also to other infectious diseases, including the “next Ebola.” Implementing these concepts will help contribute to improvements in both patient and provider safety.

Driver distraction is a growing and pervasive issue that requires multiple solutions. Voice-recognition (V-R) systems may decrease the visual-manual (V-M) demands of a wide range of in-vehicle system and smartphone interactions. However, the degree that V-R systems integrated into vehicles or available in mobile phone applications affect driver distraction is incompletely understood. A comprehensive meta-analysis of experimental studies was conducted to address this knowledge gap. To meet study inclusion criteria, drivers had to interact with a V-R system while driving and doing everyday V-R tasks such as dialing, initiating a call, texting, emailing, destination entry or music selection. Coded dependent variables included detection, reaction time, lateral position, speed and headway. Comparisons of V-R systems with baseline driving and/or a V-M condition were also coded. Of 817 identified citations, 43 studies involving 2000 drivers and 183 effect sizes (r) were analyzed in the meta-analysis. Compared to baseline, driving while interacting with a V-R system is associated with increases in reaction time and lane positioning, and decreases in detection. When V-M systems were compared to V-R systems, drivers had slightly better performance with the latter system on reaction time, lane positioning and headway. Although V-R systems have some driving performance advantages over V-M systems, they have a distraction cost relative to driving without any system at all. The pattern of results indicates that V-R systems impose moderate distraction costs on driving. In addition, drivers minimally engage in compensatory performance adjustments such as reducing speed and increasing headway while using V-R systems. Implications of the results for theory, design guidelines and future research are discussed.

This study examines the overall usability of current, commercially available self-monitoring blood glucose (SMBG) meters in order to highlight how the design affects the performance of younger and older adults. Sixteen younger participants (18-27) and 29 elderly participants (65-85) attempted to complete two tasks: 1) set date/time and 2) perform a control solution test, using two meters: the Accu-Check Compact Plus® and 2) the One Touch Ultra 2®. Overall, elderly participants had significantly more difficulty completing the two tasks and committed significantly more errors than younger participants. When using the Accu-Chek® meter to set the date and time 79% of elderly adults failed compared to 12% of younger adults. When using the One Touch® meter, 21% of elderly adults failed to complete the task while none of the younger adults failed. Across the two tasks, elderly participants made, on average, an additional 1.6 errors compared to those in the younger group.

The purpose of this panel session is to reflect on and debate the advances and challenges associated with driving as a teen. Traffic crashes are the leading cause of death in the U.S. and worldwide in this age group. What research has contributed to our understanding of this state of affairs and what research and interventions are still needed? A group of internationally known researchers will present research on the contributions of driving behavior (e.g. secondary task engagement) and driving conditions (e.g. teenage passengers) on teen crash risk and the potential for interventions, such as education, training, and graduated drivers licensing (GDL) to reduce this risk. The breadth and depth of the panelists’ knowledge will be tested by audience questions and directed by the provocateur as a range of additional possible contributions and countermeasures are considered and prioritized.

A systematic review and meta-analysis of naturalistic driving studies involving estimates of safety-critical event risk associated with handheld device use while driving is described. Fifty-seven studies identified from targeted databases, journals and websites were reviewed in depth, and six were ultimately included. These six studies, published between 2006 and 2014, encompass seven sets of naturalistic driver data and describe original research that utilized naturalistic methods to assess the effects of distracting behaviors. Four studies involved non-commercial drivers of light vehicles and two studies involved commercial drivers of trucks and buses. Odds ratios quantifying safety-critical event (SCE) risk associated with talking, dialing, locating or answering, and texting or browsing were extracted. Stratified meta-analysis of pooled odds ratios was used to estimate SCE risk by distraction type; meta-regression was used to test for sources of heterogeneity. The results indicate that tasks that require drivers to take their eyes off the road, such as dialing, locating a phone and texting, increase SCE risk to a greater extent than tasks that do not require eyes off the road such as talking. Although talking on a handheld device did not increase SCE risk, further research is required to determine whether it indirectly influences SCE risk (e.g., by encouraging other cell phone activities). In addition, a number of study biases and quality issues of naturalistic driving studies are discussed.

The purpose of this study was to evaluate the safety and efficiency of a specific ambulance while providers delivered basic and advanced life support. Forty-eight, Emergency Medical Service (EMS) teams were observed delivering care to a simulated patient during an anaphylaxis scenario in a moving ambulance that contained a complete compliment of medical supplies and equipment. A detailed coding system was developed and applied to the audio and video behavioural data. Patterns of interaction among EMS personnel, the patient, equipment and the ambulance interior during the patient simulation scenario were analyzed. The results revealed a number of issues associated with the patient compartment including: potentially unsafe seated and standing positions; hazardous barriers to movement around the patient; difficulties accessing equipment and supplies; and the adequacy of work surfaces and waste disposal. A number of design recommendations are made to guide provider and patient comfort, efficiency and safety.

Contents: Preface. W. Schiff, W. Arnone, Perceiving and Driving: Where Parallel Roads Meet. S.B. Flynn, T.A. Stoffregen, Perceiving and Avoiding Rollover in Agricultural Tractors. J.M. Flach, R. Warren, Low-Altitude Flight. J. Grosz, R.T. Rysdyk, R.J. Bootsma, J.A. Mulder, J.C. van der Vaart, P.C.W. van Wieringen, Perceptual Support for Timing of the Flare in the Landing of an Aircraft. G.E. Riccio, Coordination of Postural Control and Vehicular Control: Implications for Multimodal Perception and Simulation of Self-Motion. G.J.F. Smets, Designing for Telepresence: The Delft Virtual Window System. J.P. Hansen, Representation of System Invariants by Optical Invariants in Configural Displays for Process Control. L.A. Whitaker, V.G. CuQlock-Knopp, Human Exploration and Perception in Off-Road Navigation. H.L. Pick, M.R. Heinrichs, D.R. Montello, K. Smith, C.N. Sullivan, W.B. Thompson, Topographic Map Reading. R.R. Hoffman, R.J. Pike, On the Specification of the Information Available for the Perception and Description of the Natural Terrain. G. Klein, B.W. Crandal, The Role of Mental Simulation in Problem Solving and Decision Making. M.F. Young, M.D. McNeese, A Situated Cognition Approach to Problem Solving. L.D. Segal, Designing Team Workstations: The Choregraphy of Teamwork. P.N. Kugler, G. Lintern, Risk Management and the Evolution of Instability in Large-Scale, Industrial Systems.

Contents: Preface. J.M. Flach, The Ecology of Human-Machine Systems: A Personal History. P.A. Hancock, M.H. Chignell, On Human Factors. K.J. Vicente, A Few Implications of an Ecological Approach to Human Factors. A. Kirlik, Requirements for Psychological Models to Support Design: Toward Ecological Task Analysis. J. Rasmussen, A.M. Pejtersen, Virtual Ecology of Work. D.D. Woods, Toward a Theoretical Base for Representation Design in the Computer Medium: Ecological Perception and Aiding Human Cognition. J.M. Flach, R. Warren, Active Psychophysics: The Relation Between Mind and What Matters. W.H. Warren, Jr., Constructing an Econiche. B.S. Zaff, Designing with Affordances in Mind. M.J. Dainoff, L.S. Mark, Use of a Means-End Abstraction Hierarchy to Conceptualize the Ergonomic Design of Workplaces. R.E. Shaw, O.M. Flascher, E.E. Kadar, Dimensionless Invariants for Intentional Systems: Measuring the Fit of Vehicular Activities to Environmental Layout. G.P. Bingham, M.M. Muchisky, "Center of Mass Perception": Affordances as Dispositions by Dynamics.

Objective An up-to-date meta-analysis of experimental research on talking and driving is needed to provide a comprehensive, empirical, and credible basis for policy, legislation, countermeasures, and future research. Background The effects of cell, mobile, and smart phone use on driving safety continues to be a contentious societal issue. Method All available studies that measured the effects of cell phone use on driving were identified through a variety of search methods and databases. A total of 93 studies containing 106 experiments met the inclusion criteria. Coded independent variables included conversation target (handheld, hands-free, and passenger), setting (laboratory, simulation, or on road), and conversation type (natural, cognitive task, and dialing). Coded dependent variables included reaction time, stimulus detection, lane positioning, speed, headway, eye movements, and collisions. Results The overall sample had 4,382 participants, with driver ages ranging from 14 to 84 years ( M = 25.5, SD = 5.2). Conversation on a handheld or hands-free phone resulted in performance costs when compared with baseline driving for reaction time, stimulus detection, and collisions. Passenger conversation had a similar pattern of effect sizes. Dialing while driving had large performance costs for many variables. Conclusion This meta-analysis found that cell phone and passenger conversation produced moderate performance costs. Drivers minimally compensated while conversing on a cell phone by increasing headway or reducing speed. A number of additional meta-analytic questions are discussed. Application The results can be used to guide legislation, policy, countermeasures, and future research.

The transmission of Ebola Virus (EV) to health care workers (HCW) has been documented in highly-resourced care settings, even with HCW use of personal protective equipment (PPE). This research describes an observational study involving simulated Ebola Virus Disease (EVD) patient scenarios in four tertiary acute care centers. Researchers recorded and analyzed audiovisual data to identify instances of potential HCW EV contamination. Video-analysis was based on a coding taxonomy developed in collaboration with Infection Prevention and Control (IPC) professionals. The analysis focused on events and actions associated with potential HCW contamination during doffing and PPE disposal, and contributing system factors. The events and actions identified included out-of-sync doffing teams, HCW deviations from doffing protocols, and improper disposal of doffed PPE including the compression of PPE in biomedical waste containers containing potentially contaminated sharps. These observations are discussed along with recommendations for the re-design of doffing procedural aids and waste disposal.

Background The rapidly increasing number of older drivers is accentuating the challenges in concurrently identifying older drivers posing an unacceptable risk if they continue to drive, while not discriminating against those capable of safely driving. Attendees of an invitational meeting about the assessment of older drivers were asked to participate in a modified Delphi process designed to develop consensus statements on the assessment of older drivers. Methods Forty-one non-student symposium attendees were invited to participate in two rounds of a survey, in which they were asked to indicate their level of agreement (or disagreement) on a five-point Likert scale to a series of statements about the assessment of older drivers. Consensus was defined as 80% + of respondents either agreeing or disagreeing with a statement. Results More than one-half (n = 23) completed the first round of the survey and 12 participated in the second. There was consensus on the need for a modifiable, fair, rational, and widely accessible multi-step approach to the assessment of older drivers. This would require the engagement and support of physicians and other health-care practitioners in identifying and reporting medically at-risk drivers of any age. At a societal level, alternatives to driving a personal motor vehicle should be developed. Conclusions An on-going dialogue about this complex issue is required. Decisions should be based on explicitly stated principles and informed by the best available evidence.

The body of research on cognitive distraction while driving is vast and spans many decades. To this research, the authors of the target article add three experiments that measure a number of cognitive tasks across laboratory, simulation, and on-road contexts. The pattern of decrements is similar across contexts, when expressed as an index, and when compared to previous research. Measurement, task, and generalizability issues arise from the approaches taken by the authors. For example, the use of “pure” cognitive tasks may not necessarily generalize to everyday driving behavior, wherein visual and physical distractions are inherently interleaved with cognitive tasks. A valuable contribution of the authors’ future research on cognitive distractions would be to predict relative crash risk.

This study evaluated two automated external defibrillators (AEDs) to determine the extent to which different AED designs affect the performance of older adults over the age of 65 years. Forty-two untrained laypersons (20 young adults, M = 27 years old and 22 older adults, M = 71 years old) were randomly assigned to use training versions of either the Medtronic LifePak CR Plus or the Zoll AED Plus during a simulated cardiac arrest using an iStan patient simulator. A number of aspects of AED designs were difficult for the two age groups. Fifty percent of older users and 55% of younger users were able to use the AEDs to deliver a shock to the patient. For those who were able to complete the appropriate tasks steps, younger adults ( M = 109.90, SD = 23.30) delivered the initial shock faster than older adults ( M = 141.46, SD = 50.62). Task completion rates differed by age group and AED type. The most problematic steps across age groups included opening and activating the AED, removing the liner and placing the pads on the patient simulator. This paper will also discuss the implications of the AED evaluations and redesign recommendations.

A two-phase study of crash cart medications in the Emergency Department (ED) is reported. The purpose of the phased study was to determine a standardized layout for emergency medications that would promote safety and efficiency during a code blue event. During Phase I, a comprehensive list of ED medications and crash cart configurations was compiled and compared across three acute care hospitals. Three emergency departments were consulted to catalogue medications and to understand the workflow processes surrounding the crash cart such as medication stocking and inventory control. A number of similarities and differences were found for drug usage and crash cart drug drawer layout across hospitals. Phase II examined how ED nurses accessed and used medications from the crash cart. ED nurses individually designed the primary crash cart drawer by placing pictures of each medication into a ‘jigsaw puzzle’ while thinking aloud. Alphabetization of medications and grouping by ABC (airway, breathing and circulation) emerged as primary access strategies proposed by ED nurses. Implications for these and other design insights are discussed with respect to crash cart safety and efficiency.

In many countries, motorcyclists are over-represented in traffic collision fatalities and injuries compared to vehicle registrations. Why drivers may violate the right-of-way of motorcyclists traveling as lead vehicles in front of drivers is empirically examined in two studies that were conducted with a moderate-fidelity driving simulator. The purpose of the first study was to determine if drivers, who also held a motorcycle license (N = 16), drove cars differently than regular drivers (N = 16) around motorcycles. The two groups did not differ on responses to motorcycling braking events, which was consistent with previous research on car following. The second study compared the driving performance of sixteen novice teenage drivers (M = 16.2 years of age) to 15 experienced drivers (M = 32.9) over the span of six monthly simulator sessions. Novice drivers' perception response times (PRT) to the braking events were significantly longer than those of the experienced drivers. PRTs to motorcycle and lead vehicle braking events decreased over sessions. For all participants, PRTs to the motorcycle events were longer than to the car events. The implications of these results for motorcyclists and drivers with different levels of experience are discussed.

Hybrid interfaces are emerging in-vehicle technologies that have received minimal research attention in the literature concerning potential impacts on driver performance. Hybrid interfaces have the potential to improve driver fuel efficiency but also to distract drivers. Participants drove a number of urban and suburban routes in the University of Calgary Driving Simulator while interacting with a hybrid interface and attempting to drive fuel efficiently. A within-subjects design was used and each participant drove with and without the hybrid interface. With the hybrid interface, significant reductions in acceleration from a stop were observed when compared with driving without the hybrid interface. Participants spent significantly less time looking to the road ahead while driving with the interface than without it. The duration of participant eye glances to the interface did not exceed 1.6 s; however, drivers tended to combine glances to the interface and speedometer. This combination resulted in several glance durations above 1.6 s without looking back to the road ahead. Balancing ecodriving benefits with driver distraction costs is discussed.

This study examined situations where drivers looked-but-failed-to-see (LBFTS) hazards, and whether passenger conversation and gender affected hazard detection rates. To reliably produce LBFTS errors, 40 young drivers (M = 20.3) encountered motorcycles and pedestrians while making left turns in the University of Calgary Driving Simulator (UCDS). Prior to turn initiation the UCDS screens flickered using an extension of change blindness methods. In addition, drivers either drove alone or conversed with an attractive confederate passenger. Measures of LBFTS errors, hazard detection and social factors were analyzed. Higher rates of LBFTS errors and hazard detection occurred while conversing than while driving alone. A discriminant function analysis (DFA) using conversation and gender as predictors accurately classified LBFTS errors. Higher passenger attraction and higher extroversion were related to critical events being missed. The basis of LBFTS errors in divided and selective attention and classification implications are discussed.

To understand why novice teenage drivers are overrepresented in fatal and injury crashes, a longitudinal simulator study examined the development of driver competence and hazard perception during the first six months post graduated licensure. The performance of 16 novice teenage drivers ( M = 16.2 years of age) was compared to a group of 15 experienced adult drivers ( M = 32.9) when a variety of maneuvers and hazards were encountered. Participants attended monthly simulator sessions over a period of six months. The results of the late yellow light event are presented. Drivers were either followed or not followed by another vehicle as they traveled through a number of intersections during the course of two experimental drives per session. The percentage of novice and experienced drivers who ran the late yellow light did not differ nor did approach speeds to the intersection, although several trends across sessions were consistent with increased novice driver risk taking or over-confidence. The presence of a following vehicle did not affect the decision to run the yellow light, but fewer novice drivers actively sampled the rearview mirror. Interestingly, novice drivers were significantly more likely to be caught in the intersection once the light turned red.

Sudden cardiac arrest (SCA) is a major cause of death in Canada and the leading cause of death in the United States and Europe with survival rates as low as 5%. Defibrillation is the key intervention for improving survival from SCA and can increase survival up to 75%. This has sparked the movement to increase public access to defibrillation by placing automated external defibrillators (AEDs) in public areas such as universities, shopping centers, and athletic centers. The effectiveness of AEDs to revive those with SCA is dependent on the design of these devices. The purpose of this study was (1) to evaluate the design features that aid or hinder the effective and timely use of three commercially available AEDs using a heuristic evaluation; (2) to rank the three AEDs in terms of overall usability based on user comments and preference, and the severity of usability heuristic violations; and (3) develop design recommendations to guide the future design of AEDs. Results of the heuristic evaluation indicated that a number of design features influence the overall usability of AEDs, such as the orientation of electrode pads on the adhesive liner. In terms of overall usability, the Philips HeartStart OnSite AED ranked the highest, followed by the Zoll AED Plus, and the HeartSine Samaritan PAD. Recommendations for future AED design include: AEDs should have redundancy in their activation mechanism; pictorials should be minimalistic in design, numbers and location; storage of the electrode pads in a clearly labeled, easily accessible and prominent location; have clearly identifiable liners with labeling indicating the need for removal from the pads; and match the orientation of the electrode pads on the adhesive liner to the correct pad orientation on the patient's chest.

With the heightened interest on medication mix-ups in the media, improvements to patient health and safety are a natural focus for research in medical human factors. Specifically, this project sought to answer the question ‘Does Color Matter?’ with respect to medication containers/labels and their contribution to look-a-like medication mix-ups. Participants were asked to rate the perceptual similarity of pairs of medication ampoules and vials. Ratings were analyzed using Multi-Dimensional Scaling (MDS). A three dimensional solution provided the best fit of the results. Participants rated medication ampoules as highly similar if they shared the same glass color (dimension 1), label color (dimension 2), and label pattern (dimension 3). Ratings of medication vials were similar if they had similar glass color (dimension 1), label pattern (dimension 2) and label color (dimension 3). The results of this study show that color is an important feature used by nurses when judging medications on their similarity. Discussion centers on the practical implications of the results on medication look a-like confusions.

In Calgary, each of the three acute-care adult hospitals had different anesthetic medication carts with their own type and layout of anesthetic medications. A number of anesthesiologists moved among the different sites, increasing the potential for medication errors. The objective of this study was to identify the anesthetic medications to include and to determine how they should be grouped and positioned in a standardized anesthesia medication cart drawer. A standardized list of medications was established. Next, the anesthesia medication cart drawer was filled and photographed, and a jigsaw puzzle was made from the photograph. Anesthesiologists and anesthesia assistants arranged the jigsaw pieces into an ideal drawer. Participants verbalized their rationale for the position of each puzzle piece. Results were collated and analyzed. A mock drawer was developed and reviewed by department members, and minor modifications were made. A final standardized medication drawer (content and positioning) was developed over 30 months, with agreement from anesthesiologists (n = 12) and anesthesia assistants (n = 3) at the three hospitals. Guidelines for placing each medication in the drawer included grouping them according to order of use, frequency of use, similarity of action, severity of harm from misuse, and lack of similar appearance. A finalized template was used for a standardized drawer and installed in every operating room of the three hospitals. Implementation of the standardized medication drawer is expected to reduce the likelihood of medication errors. Future research should include testing the clinical implications of this standardization and applying the methodology to other areas.

Problem The walkability of city neighborhoods is affected by a number of environmental factors including pedestrian safety at night. Insufficient conspicuity or visibility of pedestrians at night by drivers is a fundamental contributor to injuries and fatalities. Pedestrians are considered vulnerable road users and account for about one-fifth or 270,000 of the people killed each year on roads worldwide. Sixty percent of the pedestrian fatalities that occurred in Canada between 2004 and 2008 occurred at night or in reduced lighting. Pedestrians are most at risk during the first hour of darkness and twilight. Dark conditions reduce pedestrian conspicuity, making it harder for pedestrians to ‘stand out’ from their environment and more difficult for drivers to see, which contributes to collisions. Intervention The use of retro-reflective clothing is an effective way for pedestrians to make themselves more conspicuous to drivers. Relative to other kinds of interventions, retro-reflective material on clothing is a simple and cost-effective way to alert drivers to pedestrian presence and behaviour. Retro-reflective clothing enhances biological motion perception and increases detection and identification of pedestrians at night. The material is often found on active wear (e.g., running shoes, jackets, backpacks) and safety apparel (e.g., safety vests, coveralls, hard hats). Unlike other light reflecting surfaces, retro-reflective material is uniquely manufactured to return light back to the source, which helps pedestrians ‘stand out’ in reduced lighting. Identifying the more optimal retro-reflector configurations is important because different configurations have different consequences for pedestrian recognition. Based on a systematic review of the literature, the effectiveness of different configurations of retro-reflective material to improve detection and recognition distance of pedestrians at night will be presented as a set of practical recommendations.

An experimental study was conducted to determine if intersection behaviour benefited from advanced in-vehicle signs presented to older and younger drivers in a head-up display (HUD) format. The University of Calgary Driving Simulator (UCDS) was used to evaluate intersection performance. Measures of those who were able to stop or ran the yellow light, speed over the span of the intersection, perception response time, and eye movements were analyzed to determine if performance improved or whether undesirable adaptive behaviours occurred. In-vehicle signs facilitated an increase in the frequencies of stopping for both younger and older drivers at intersections with relatively short yellow onsets. The speed at the yellow light onset for both those who stopped and those who proceeded through the intersection was reduced by the presence of the in-vehicle signs. The primary behavioral influence of the in-vehicle signs was to cause the drivers' to reduce their velocity in advance of an intersection. Eye movement analyses indicated that younger drivers looked at the in-vehicles signs more often and for longer overall durations than older drivers. Older drivers had slower intersection approach speeds, stopped more accurately, and were more likely to not clear the intersection before the traffic light turned to an all-red phase than younger drivers. The implications of the in-vehicle sign results are discussed in terms of in-vehicle information systems (IVIS) design guidelines and evaluation methods.

To understand why older drivers are over-represented in intersection crashes, this study sought to describe the intersection performance of older and younger drivers when traffic lights changed from green to yellow at the last second. Using a moderate-fidelity driving simulator, time to stop line (TSL) at yellow onset was manipulated as drivers approached intersections at 70 km/h (42 mph). Seventy-seven participants, approximately balanced for gender and age group, volunteered from the age categories of 18 to 24, 25 to 35, 55 to 64, and 65+. Driver decisions to stop or go were predicted using a logistic regression model with time to stop line as the single significant predictor. There were no age differences in perception response time (PRT). Older drivers approached intersections at a lower velocity and stopped more accurately than younger drivers. For those drivers who chose to go through the yellow light, speed profiles across the intersection and intersection clearance indicate that older drivers are more likely to be in the intersection when the light changed to red. A PRT of 1.0 s for yellow signal phasing was sufficient for all age groups.

The purpose of this study was to examine the effect of cell phones on novice drivers and the implications that the results of the study may have on the graduated licensing (GDL) restrictions. Twenty Novices, with less than 6 months of driving experience, and 20 Experienced drivers, with more than 10 years of experience, participated in the study. Perception response time (PRT) to hazards and eye movement measures were analyzed to determine if decrements in driver performance resulted during traffic events compared to baseline responses when using either a cell phone or CD player in the University of Calgary Driving Simulator. Results showed longer PRTs for the Novice compared to Experienced drivers for the lead vehicle braking, pedestrian, and vehicle pull out events. During the CD task increased glances into the vehicle and decreased rearview mirror glances were found. Implications of this research for cell phone restrictions within graduated licensing programs are discussed.