Amy Irwin

Discrimination learning induced by training with identical stimuli

Sensory stimuli become easier to detect or distinguish with practice. It is generally assumed that the task-relevant stimulus dimension becomes increasingly more salient as a result of attentively performing the task at a level that is neither too easy nor too difficult. However, here we show improved auditory frequency discrimination following training with physically identical tones that were impossible to discriminate. We also show that learning transfers across tone frequencies and across modalities: training on a silent visuospatial computer game improved thresholds on the auditory discrimination task. We suggest that three processes are necessary for optimal perceptual learning: sensitization through exposure to the stimulus, modality- and dimension-specific attention, and general arousal.

A comparison of adaptive procedures for rapid and reliable threshold assessment and training in naive listeners.

In psychoacoustic studies there is often a need to assess performance indices quickly and reliably. The aim of this study was to establish a quick and reliable procedure for evaluating thresholds in backward masking and frequency discrimination tasks. Based on simulations, four procedures likely to produce the best results were selected, and data collected from 20 naive adult listeners on each. Each procedure used one of two adaptive methods (staircase or maximum-likelihood estimation, each targeting the 79% correct point on the psychometric function) and two response paradigms (3-interval, 2-alternative forced-choice AXB or 3-interval; 3-alternative forced-choice oddball). All procedures yielded statistically equivalent threshold estimates in both backward masking and frequency discrimination, with a trend to lower thresholds for oddball procedures in frequency discrimination. Oddball procedures were both more efficient and more reliable (test-retest) in backward masking, but all four procedures were equally efficient and reliable in frequency discrimination. Fitted psychometric functions yielded similar thresholds to averaging over reversals in staircase procedures. Learning was observed across threshold-assessment blocks and experimental sessions. In four additional groups, each of ten listeners, trained on the different procedures, no differences in performance improvement or rate of learning were observed, suggesting that learning is independent of procedure.

Listening to urban soundscapes: Physiological validity of perceptual dimensions

Predominantly, the impact of environmental noise is measured using sound level, ignoring the influence of other factors on subjective experience. The present study tested physiological responses to natural urban soundscapes, using functional magnetic resonance imaging and vector cardiogram. City-based recordings were matched in overall sound level (71 decibel A-weighted scale), but differed on ratings of pleasantness and vibrancy. Listening to soundscapes evoked significant activity in a number of auditory brain regions. Compared with soundscapes that evoked no (neutral) emotional response, those evoking a pleasant or unpleasant emotional response engaged an additional neural circuit including the right amygdala. Ratings of vibrancy had little effect overall, and brain responses were more sensitive to pleasantness than was heart rate. A novel finding is that urban soundscapes with similar loudness can have dramatically different effects on the brains response to the environment.

The Effect of Proximity, Tall Man Lettering, and Time Pressure on Accurate Visual Perception of Drug Names

Objective: The aim of this study is to assess the effect of proximity and time pressure on accurate and effective visual search during medication selection from a computer screen. Background: The presence of multiple similar objects in proximity to a target object increases the difficulty of a visual search. Visual similarity between drug names can also lead to selection error. The proximity of several similarly named drugs within a visual field could, therefore, adversely affect visual search. Method: In Study 1, 60 nonpharmacy participants selected a target drug name from an array of mock drug packets shown on a computer screen, where one or four similarly named nontargets might be present. Of the participants, 30 completed the task with a time constraint, and the remainder did not. In Study 2, the same experiment was repeated with 28 pharmacy staff. Results: In Study 1, the proximity of multiple similarly named nontargets within the specified visual field reduced selection accuracy and increased reaction times in the nonpharmacists. Time constraint also had an adverse effect. In Study 2, the pharmacy participants showed increased reaction times when multiple nontargets were present, but the time constraint had no effect. There was no effect of Tall Man lettering. Conclusion: The presence of multiple similarly named medications in close proximity to a target medication increases the difficulty of the visual search for the target. Tall Man lettering has no impact on this adverse effect. Application: The widespread use of the alphabetical system in medication storage increases the risk of proximity-based errors in drug selection.

Evaluation of the prototype anaesthetic non-technical skills for anaesthetic practitioners (ANTS-AP) system: a behavioural rating system to assess the non-technical skills used by staff assisting the anaesthetist

This study tested the reliability, validity and usability of a prototype behavioural rating system for the non‐technical skills of assistants working with the anaesthetist. Anaesthetic nurses and operating department practitioners (n = 48) used the prototype Anaesthetic Non‐technical Skills for Anaesthetic Practitioners (ANTS‐AP) system to rate the non‐technical skills of anaesthetic assistants in 12 videos of simulated theatre work. Test–retest reliability was assessed with a sub‐sample (n = 12). The skill categories assessed were ‘situation awareness’, ‘teamwork and communication’ and ‘task management’. The internal consistency for the ratings of elements in categories was acceptable (Cronbachs α of 0.78, 0.77 and 0.69, respectively), with more modest inter‐rater reliability (intraclass correlations for categories 0.54, 0.70, 0.86), test–retest reliability (intraclass correlations 0.68, 0.58, 0.38) and accuracy (weighted kappa 0.39). Most participants considered the system complete (n = 42, 87%), the wording clear (n = 48, 100%) and the system useful for structuring observation (n = 48, 100%).

Retrospective analysis of DATIX dispensing error reports from Scottish NHS hospitals.

Aimu2002 The primary objective was to analyse reported dispensing errors, and contributing factors, in Scottish National Health Service hospitals by coding and quantifying error reports from the DATIX patient‐safety software. The secondary objective was to gather managerial responses to dispensing error in order to gain a perspective on interventions already in place.

A mixed methods investigation into the use of non-technical skills by community and hospital pharmacists

BACKGROUNDnNon-technical skills refer to the social and cognitive factors that may influence efficient and safe job performance. Non-technical skills are an important element of patient safety in a variety of health care disciplines, including surgery, anesthesia and nursing. However, the use of non-technical skills in pharmacy practice has not yet been fully assessed.nnnOBJECTIVEnTo examine attitudes toward, and use of, non-technical skills by pharmacy personnel.nnnMETHODSnA mixed methods approach was used: An attitude survey explored pharmacy personnel attitudes towards non-technical skills and inter-professional collaboration, with community and hospital pharmacy staff (nxa0=xa062). Qualitative interviews were then conducted using the critical incident technique, with community pharmacists (nxa0=xa011).nnnRESULTSnThe survey results demonstrated differences in the opinions of community and hospital pharmacists on three non-technical skill constructs: team structure, mutual support, and situation monitoring, with community pharmacists reporting significantly more positive attitudes about all three constructs. Both groups reported low levels of collaboration with primary care physicians. The interviews identified five non-technical skills as key elements of successful pharmacist performance from the interview transcripts: teamwork; leadership; task management; situation awareness; decision-making.nnnCONCLUSIONnThe survey and interviews identified the non-technical skills that are important to pharmacists. This represents the first step towards the development of a behavioral rating system for training purposes that could potentially improve the non-technical skills of pharmacists and enhance patient safety.

An analysis of British regional accent and contextual cue effects on speechreading performance

The aim of this paper was to examine the effect of regional accent on speechreading accuracy and the utility of contextual cues in reducing accent effects. Study 1: Participants were recruited from Nottingham (n=24) and Glasgow (n=17). Their task was to speechread 240 visually presented sentences spoken by 12 talkers, half with a Glaswegian accent, half a Nottingham accent. Both participant groups found the Glaswegian talkers less intelligible (p<0.05). A significant interaction between participant location and accent type (p<0.05) indicated that both participant groups showed an advantage for speechreading talkers with their own accent over the opposite group. Study 2: Participants were recruited from Nottingham (n=15). The same visual sentences were used, but each one was presented with a contextual cue. The results showed that speechreading performance was significantly improved when a contextual cue was used (p<0.05). However the Nottingham observers still found the Glaswegian talkers less intelligible than the Nottingham talkers (p<0.05). The findings of this paper suggest that accent type may have an influence upon visual speech intelligibility and as such may impact upon the design, and results, of tests of speechreading ability.

The impact of patient aggression on community pharmacists: a critical incident study

The impact of patient aggression on healthcare staff has been an important research topic over the past decade. However, the majority of that research has focused primarily on hospital staff, with only a minority of studies examining staff in primary care settings such as pharmacies or doctors surgeries. Moreover, whilst there is an indication that patient aggression can impact the quality of patient care, no research has been conducted to examine how the impact of aggression on staff could affect patient safety.

Dealing with aggressive methadone patients in community pharmacy: A critical incident study

BACKGROUNDnCommunity pharmacists are an important link between methadone patients and the health service in the United Kingdom. However, many pharmacists feel ill prepared to deal with methadone patients, with aggressive behavior a particular concern.nnnOBJECTIVEnTo assess the perceived impact of methadone patient aggression on pharmacy practice.nnnMETHODSnSixteen registered pharmacists with a minimum of 3 years work experience were recruited from within 3 Scottish health boards. Critical incident interviews were conducted to assess pharmacist behavior during an interaction with an aggressive methadone patient.nnnRESULTSnFactors considered by pharmacists to have a negative impact on an interaction with an aggressive methadone patient included intoxication of the patient, the presence of a new or an inexperienced pharmacist, and a restricted time frame for dispensing methadone. Positive factors when dealing with aggressive patients were authoritative behavior by the pharmacist, a separate dispensing area for methadone patients, or a solid counter and a positive relationship between pharmacist and patient.nnnCONCLUSIONnAggression from methadone patients is a risk when dispensing methadone. However, action can be taken by the pharmacist to minimize the impact of that aggression on pharmacy practice. The provision of further training and support, particularly to inexperienced pharmacists, could further reduce the negative impact of patient aggression. The present study indicates that such training could be based on nontechnical skills to strengthen current leadership and teamwork behaviors.