‘Sorry, I meant the patient's left side’: impact of distraction on left–right discrimination

@article{McKinley2015SorryIM,
  title={‘Sorry, I meant the patient's left side’: impact of distraction on left–right discrimination},
  author={John McKinley and Martin Dempster and Gerard J. Gormley},
  journal={Medical Education},
  year={2015},
  volume={49},
  pages={427 - 435}
}
Medical students can have difficulty in distinguishing left from right. Many infamous medical errors have occurred when a procedure has been performed on the wrong side, such as in the removal of the wrong kidney. Clinicians encounter many distractions during their work. There is limited information on how these affect performance. 
‘What … you can't tell left from right?’ Medical students’ experiences in making laterality decisions
TLDR
Evidence suggests that a significant proportion of the population, including medical students, experience difficulty in left–right discrimination (LRD), and there have been calls to raise awareness of this issue in medical education.
‘When Right could be so Wrong’. Laterality Errors in Healthcare
TLDR
It is proposed that a laterality misjudgment may have been a contributory factor in the sinking of the Titanic and, even though he was almost immediately told to correct it, it was too late and the side of the starboard bow was ripped out by the iceberg.
Difficulty with right–left discrimination: A clinical problem?
TLDR
In a cohort of nearly 800 adults, about 9% of adults make right–left decisions on a daily basis, but for a substantial proportion of the population, distinguishing right from left is difficult.
It’s not you, it’s the design - common problems with patient monitoring reported by anesthesiologists: a mixed qualitative and quantitative study
TLDR
This study provides an overview of the problems anesthesiologists face in patient monitoring, e.g, hardware problems, human factor aspects, and systemic factor aspects (e.g., insufficient standardization between manufacturers).
Effects of a standardized distraction on caregivers’ perceptive performance with avatar-based and conventional patient monitoring: a multicenter comparative study
TLDR
Avatar-based monitoring improved anesthesia providers’ perceptive performance under distraction and reduced perceived workload, a situation awareness-based technology that displays patient status as an animated patient model that could help to improve caregivers’ situation awareness, especially in high-workload situations.
Left-handers, retrained left-handers and right-handers: A comparative study
Present study was aimed at further extension of the scientific data concerning the influence of retraining in left-handers as well as concerning some disabilities ascribed to the left-handedness.
Empirical Study of Non-Reversing Magic Mirrors for Augmented Reality Anatomy Learning
TLDR
The perceptual differences between anNRMM and RMM design are explored and the first empirical study comparing these two concepts for the purpose of anatomy learning is presented, demonstrating that medical students perform significantly better at identifying anatomically correct placement of virtual organs in an NRMM, however, interaction was significantly more difficult compared to an RMM.
The Impact of Handedness, Sex, and Cognitive Abilities on Left–Right Discrimination: A Behavioral Study
TLDR
An advantage of left-handers in both identifying left hands and in verifying “left” propositions and a negative correlation of LRD reaction time with visuo-spatial and verbal long-term memory was found independently of sex, providing new insights into the relationship between cognitive skills and performance on LRD.
Using an animated patient avatar to improve perception of vital sign information by anaesthesia professionals
TLDR
Empirical evidence is provided that an animated avatar offers the opportunity to transmit vital sign information significantly more quickly than conventional monitoring and with improved confidence and reduced cognitive effort could help care providers gain situation awareness more efficiently.
User perceptions of avatar-based patient monitoring: a mixed qualitative and quantitative study
TLDR
This mixed method study provides evidence that the included anesthesiologists considered the new avatar-based technology to be intuitive and easy to learn and that the technology enabled them to get an overview of the situation quickly.
...
1
2
...

References

SHOWING 1-10 OF 45 REFERENCES
The effect of distractions in the operating room during endourological procedures
TLDR
Equipment problems and communication, the latter both procedure-related and medically irrelevant, have the largest impact on the sterile team and regularly interrupt procedures and should be minimized.
DISTRACTION IN THE UROLOGY OPERATING THEATRE
TLDR
The research needed to improve the design of this surgical system is termed ‘human factors’ or ergonomic research, and involves adapting the operating theatre to increase efficiency and usability for all theatre-based professionals.
Difficulties in right-left discrimination in a normal population.
  • S. Wolf
  • Psychology, Medicine
    Archives of neurology
  • 1973
In a group of physicians and their spouses, 17.5% of 382 women, and 8.8% of 408 men stated that they experienced frequent confusion in right-left orientation. Right-left confusion occurs often in
Wrong-sided and wrong-level neurosurgery: a national survey.
TLDR
The data suggest that the prevention of such errors will require neurosurgeons to recognize risk factors and increase the use of intraoperative imaging, and there are significant limitations to the survey-based methodology.
Wrong-side/wrong-site, wrong-procedure, and wrong-patient adverse events: Are they preventable?
HYPOTHESIS Wrong-side/wrong-site, wrong-procedure, and wrong-patient adverse events (WSPEs) are devastating, unacceptable, and often result in litigation, but their frequency and root causes are
Experienced surgeons can do more than one thing at a time: effect of distraction on performance of a simple laparoscopic and cognitive task by experienced and novice surgeons
TLDR
The experienced surgeons were able to attend equally to both tasks, whereas the novices attended to the surgical task at the expense of some aspects of cognitive task performance.
Right-left discrimination among medical students: questionnaire and psychometric study
TLDR
Male students were better than female students at distinguishing right from left, and aspiring surgeons was better than aspiring general practitioners or medical doctors.
Wrong-site craniotomy: analysis of 35 cases and systems for prevention.
TLDR
It is demonstrated that a broad range of events and factors can cause human errors to breach patient safeguards and lead to a wrong-site craniotomy; however, in essentially all cases the WSCs were preventable with strict adherence to comprehensive and thorough protocols.
Human factors in the management of the critically ill patient.
TLDR
A human factors approach is adopted to examine determinants of clinical reliability in the management of critically ill patients and provides a useful framework for understanding and rectifying the causes of error and unreliability, particularly in complex systems such as critical care.
Self-Report of Right-Left Confusion in College Men and Women
TLDR
Self-report questionnaires of difficulty in right-left discrimination and handedness were given to male and female undergraduates and questioned since the results, at least as a function of handedness, depended on the question asked.
...
1
2
3
4
5
...