Sheena Johnson

The experience of work‐related stress across occupations

Purpose – To compare the experience of occupational stress across a large and diverse set of occupations. Three stress related variables (psychological well‐being, physical health and job satisfaction) are discussed and comparisons are made between 26 different occupations on each of these measures. The relationship between physical and psychological stress and job satisfaction at an occupational level is also explored.Design/methodology/approach – The measurement tool used is a short stress evaluation tool which provides information on a number of work related stressors and stress outcomes. Out of the full ASSET database 26 occupations were selected for inclusion in this paper.Findings – Six occupations are reporting worse than average scores on each of the factors – physical health, psychological well‐being and job satisfaction (ambulance workers, teachers, social services, customer services – call centres, prison officers and police). Differences across and within occupational groups, for example, teac...

Work Environments, Stress, and Productivity: An Examination Using ASSET.

In this study (N = 16,001), the predictors of productivity (i.e., work performance)were investigated with A Shortened Stress Evaluation Tool (E. B. Faragher, C. L. Cooper, & S. Cartwright, 2004), which incorporates individual work stressors, stress outcomes (physical and psychological well-being), and commitment (both to and from an organization). Psychological well-being, commitment from the organization to the employee, and resources were found to be predictive. Physical health, individual work stressors (with the exception of resources), and commitment from the employee to the organization were not identified as important. The indings are discussed with reference to both previous and future research. The large sample size and broad range of occupations included suggest the findings are generalizable to other employee groupings. Implications for both stress and management theory are discussed.

Customer stressors in service organizations: The impact of age on stress management and burnout

This study examined the impact of age on stress management strategies and burnout as a response to customer stressors. Questionnaire data from 273 retail sector employees revealed that age is negatively related to customer stressors but no direct relationships were found with stress management strategies. Moderation analysis revealed no pattern of interaction between customer stressors and age on burnout, although the older retail employees were less likely to experience cynicism when exposed to disliked customers. A key finding of this study is that older employees’ stress management strategies of emotion control and active coping had a more positive effect on emotional exhaustion and cynicism compared to younger employees. As with previous studies few significant results were found for professional efficacy. The stress management strategies of humour and downplay had limited interaction effects with age. Exploratory analyses of three-way interactions between humour and downplay, customer stressors, and age on burnout revealed systematic findings in the expected direction in high stress situations with younger employees less successfully using these strategies to reduce levels of emotional exhaustion and cynicism. This article shows the competencies of older employees and argues against the deficits of older workers. Practical implications for organizations and supervisors are discussed.

Workplace stress in community pharmacies in England: associations with individual, organizational and job characteristics.

Objectives To describe the levels of workplace stress that community pharmacists perceive and to examine associations with individual, organizational and job characteristics. Methods A cross-sectional mailed survey of 2000 randomly selected community pharmacists practising in England incorporating a validated organizational stress screening tool (ASSET). Results Response rate was 48%. Community pharmacists reported significantly higher levels of stress than other health care workers for seven out of eight work-related stressors. Regression analyses demonstrated significant associations between a number of individual, organizational and job characteristics and stress. Long working days, being a pharmacy manager and working for large multiples were associated with higher reported levels of stress across a number of work-related stressors including work overload, control and the job itself. However, self-reported measures of workload (such as dispensing volume) were not associated with higher stress levels. Conclusions The growth in corporate ownership of community pharmacies, which is associated with more stressful working environments, together with current economic pressures could have consequences not only for the future well-being of pharmacists but also for patient safety.

A prototype percutaneous transhepatic cholangiography training simulator with real-time breathing motion

PurposeWe present here a simulator for interventional radiology focusing on percutaneous transhepatic cholangiography (PTC). This procedure consists of inserting a needle into the biliary tree using fluoroscopy for guidance.MethodsThe requirements of the simulator have been driven by a task analysis. The three main components have been identified: the respiration, the real-time X-ray display (fluoroscopy) and the haptic rendering (sense of touch). The framework for modelling the respiratory motion is based on kinematics laws and on the Chainmail algorithm. The fluoroscopic simulation is performed on the graphic card and makes use of the Beer-Lambert law to compute the X-ray attenuation. Finally, the haptic rendering is integrated to the virtual environment and takes into account the soft-tissue reaction force feedback and maintenance of the initial direction of the needle during the insertion.ResultsFive training scenarios have been created using patient-specific data. Each of these provides the user with variable breathing behaviour, fluoroscopic display tuneable to any device parameters and needle force feedback.ConclusionsA detailed task analysis has been used to design and build the PTC simulator described in this paper. The simulator includes real-time respiratory motion with two independent parameters (rib kinematics and diaphragm action), on-line fluoroscopy implemented on the Graphics Processing Unit and haptic feedback to feel the soft-tissue behaviour of the organs during the needle insertion.

Development and Validation of a Virtual Reality Simulator Human Factors Input to Interventional Radiology Training

Objective: This study developed and validated a virtual reality (VR) simulator for use by interventional radiologists. Background: Research in the area of skill acquisition reports practice as essential to become a task expert. Studies on simulation show skills learned in VR can be successfully transferred to a real-world task. Recently, with improvements in technology, VR simulators have been developed to allow complex medical procedures to be practiced without risking the patient. Method: Three studies are reported. In Study 1, 35 consultant interventional radiologists took part in a cognitive task analysis to empirically establish the key competencies of the Seldinger procedure. In Study 2, 62 participants performed one simulated procedure, and their performance was compared by expertise. In Study 3, the transferability of simulator training to a real-world procedure was assessed with 14 trainees. Results: Study 1 produced 23 key competencies that were implemented as performance measures in the simulator. Study 2 showed the simulator had both face and construct validity, although some issues were identified. Study 3 showed the group that had undergone simulator training received significantly higher mean performance ratings on a subsequent patient procedure. Conclusion: The findings of this study support the centrality of validation in the successful design of simulators and show the utility of simulators as a training device. Application: The studies show the key elements of a validation program for a simulator. In addition to task analysis and face and construct validities, the authors highlight the importance of transfer of training in validation studies.

Virtual reality, ultrasound-guided liver biopsy simulator: Development and performance discrimination

OBJECTIVES The aim of this article was to identify and prospectively investigate simulated ultrasound-guided targeted liver biopsy performance metrics as differentiators between levels of expertise in interventional radiology. METHODS Task analysis produced detailed procedural step documentation allowing identification of critical procedure steps and performance metrics for use in a virtual reality ultrasound-guided targeted liver biopsy procedure. Consultant (n=14; male=11, female=3) and trainee (n=26; male=19, female=7) scores on the performance metrics were compared. Ethical approval was granted by the Liverpool Research Ethics Committee (UK). Independent t-tests and analysis of variance (ANOVA) investigated differences between groups. RESULTS Independent t-tests revealed significant differences between trainees and consultants on three performance metrics: targeting, p=0.018, t=-2.487 (-2.040 to -0.207); probe usage time, p = 0.040, t=2.132 (11.064 to 427.983); mean needle length in beam, p=0.029, t=-2.272 (-0.028 to -0.002). ANOVA reported significant differences across years of experience (0-1, 1-2, 3+ years) on seven performance metrics: no-go area touched, p=0.012; targeting, p=0.025; length of session, p=0.024; probe usage time, p=0.025; total needle distance moved, p=0.038; number of skin contacts, p<0.001; total time in no-go area, p=0.008. More experienced participants consistently received better performance scores on all 19 performance metrics. CONCLUSION It is possible to measure and monitor performance using simulation, with performance metrics providing feedback on skill level and differentiating levels of expertise. However, a transfer of training study is required.

ImaGiNe Seldinger: First simulator for Seldinger technique and angiography training

In vascular interventional radiology, procedures generally start with the Seldinger technique to access the vasculature, using a needle through which a guidewire is inserted, followed by navigation of catheters within the vessels. Visual and tactile skills are learnt in a patient apprenticeship which is expensive and risky for patients. We propose a training alternative through a new virtual simulator supporting the Seldinger technique: ImaGiNe (imaging guided interventional needle) Seldinger. It is composed of two workstations: (1) a simulated pulse is palpated, in an immersive environment, to guide needle puncture and (2) two haptic devices provide a novel interface where a needle can direct a guidewire and catheter within the vessel lumen, using virtual fluoroscopy. Different complexities are provided by 28 real patient datasets. The feel of the simulation is enhanced by replicating, with the haptics, real force and flexibility measurements. A preliminary validation study has demonstrated training effectiveness for skills transfer.

Simulation: Moving from technology challenge to human factors success

Recognition of the many limitations of traditional apprenticeship training is driving new approaches to learning medical procedural skills. Among simulation technologies and methods available today, computer-based systems are topical and bring the benefits of automated, repeatable, and reliable performance assessments. Human factors research is central to simulator model development that is relevant to real-world imaging-guided interventional tasks and to the credentialing programs in which it would be used.

ImaGINe-S: Imaging Guided Interventional Needle Simulation.

We present an integrated system for training visceral needle puncture procedures. Our aim is to provide a cost effective and validated training tool that uses actual patient data to enable interventional radiology trainees to learn how to carry out image-guided needle puncture. The input data required is a computed tomography scan of the patient that is used to create the patient specific models. Force measurements have been made on real tissue and the resulting data is incorporated into the simulator. Respiration and soft tissue deformations are also carried out to further improve the fidelity of the simulator.