ABSTRACT Billions of dollars are spent annually on urine specimen collection and analysis as they are critical clinical components vital to human health. The mid-stream clean catch (MSCC) process is the gold standard of ambulatory urine specimen collection for clinical diagnosis of urinary tract infections (UTI). The MSCC process is over 60 years old and is plagued by ridiculously high specimen contamination rates. The MSCC has resisted numerous attempts aimed at improving it. The purpose of this study was to determine if utilizing the concepts of Human Systems Engineering (HSE) could improve the urine specimen collection process. HSE concepts were not only targeted toward the problems, they were also used in the quest to develop effective solutions. Results obtained demonstrate that HSE concepts, when applied to urine specimen collection, can and do make a difference in terms of specimen quality and patient satisfaction. One low cost easily implemented targeted HSE-informed intervention effort resulted in a specimen contamination rate reduction of 16.6%. A second targeted HSE-informed intervention involving the redesign of the specimen cup, its instruction set, and additional sign placement made it three times less likely for participants to provide a contaminated MSCC sample. The redesigned specimen cup automatically captures and isolates an initial void sample from an MSCC sample, both derived from one continuously provided patient specimen. Clinical utility comes in the form of improved MSCC specimen quality and a separated initial void available for analysis using Nucleic Acid Amplification Testing (NAAT) or other test protocols. Capturing and isolating both an initial void and an MSCC at the same time allows for a more complete diagnostic workup utilizing a higher quality MSCC without requiring the patient to follow two different protocols to urinate into two different specimen cups. The redesigned specimen cup also provides for automatic overflow prevention, incorporates a new ergonomic grip, and a saddle adapter that provides affordances for both women and men in terms of urine capture and the reduced likelihood of urinating on one’s self.

Traditional usability methods in Human-Computer Interaction (HCI) have been extensively used to understand the usability of products. Measurements of user experience (UX) in traditional HCI studies mostly rely on task performance and observable user interactions with the product or services, such as usability tests, contextual inquiry, and subjective self-report data, including questionnaires, interviews, and usability tests. However, these studies fail to directly reflect a user’s psychological involvement and further fail to explain the cognitive processing and the related emotional arousal. Thus, capturing how users think and feel when they are using a product remains a vital challenge of user experience evaluation studies. Conversely, recent research has revealed that sensor-based affect detection technologies, such as eye tracking, electroencephalography (EEG), galvanic skin response (GSR), and facial expression analysis, effectively capture affective states and physiological responses. These methods are efficient indicators of cognitive involvement and emotional arousal and constitute effective strategies for a comprehensive measurement of UX. The literature review shows that the impacts of sensor-based affect detection systems to the UX can be categorized in two groups: (1) confirmatory to validate the results obtained from the traditional usability methods in UX evaluations; and (2) complementary to enhance the findings or provide more precise and valid evidence. Both provided comprehensive findings to uncover the issues related to mental and physiological pathways to enhance the design of product and services. Therefore, this dissertation claims that it can be efficient to integrate sensor-based affect detection technologies to solve the current gaps or weaknesses of traditional usability methods. The dissertation revealed that the multi-sensor-based UX evaluation approach through biometrics tools and software corroborated user experience identified by traditional UX methods during an online purchasing task. The use these systems enhanced the findings and provided more precise and valid evidence to predict the consumer purchasing preferences. Thus, their impact was “complementary” on overall UX evaluation. The dissertation also provided information of the unique contributions of each tool and recommended some ways user experience researchers can combine both sensor-based and traditional UX approaches to explain consumer purchasing preferences.

Learners' attitudes and beliefs during the initial stages of learning have a profound impact on their future decisions, practice habits, and persistence. In music education, however, surprisingly little research has explored how physical equipment design might influence novices' attitudes and beliefs. The current study addresses this gap by examining how novices' motivation and perception differ based on the physical design of the musical instrument they interact with while learning. Fifty-two adult participants completed an online survey measuring their expectancies (e.g., confidence), value beliefs (e.g., enjoyment, interest, and social merit), and anticipated persistence while attempting to learn the electric guitar. Afterward, participants attempted to learn and perform several beginner-level tasks while using a conventionally designed or ergonomically designed guitar. The conventionally designed guitar was a commercially available model marketed toward beginner and intermediate-level guitarists. In contrast, the ergonomic guitar was a custom model based on expert design recommendations to improve ease of use, comfort, and user experience. Participant learning expectations and values were assessed before and after a one-hour practice session. Results revealed that novices who used the ergonomic guitar reported significant gains in anticipated learning enjoyment. Alternatively, novices who used the conventional guitar exhibited no such change. Beyond this relationship however, the ergonomic guitar was not found to meaningfully affect participants' confidence, interest, physical discomfort, and task difficulty perceptions. Additionally, the ergonomic guitar did not have a statistically significant influence on learning persistence ratings. One important implication extracted from this study is that a single practice session may not provide enough time or experience to affect a novices' attitudes and beliefs toward learning. Future studies may seek to remedy this study limitation by using a longitudinal design or longer practice task trials. Despite this limitation however, this exploratory study highlights the need for researchers, music educators, and instrument manufacturers to carefully consider how the physical design of a musical instrument may impact learning attitudes, choices, and persistence over time. Additionally, this study offers the first attempt at extending the equipment design literature to music education and Expectancy-Value Theory.

Preoperative team briefings have been suggested to be important for improving team performance in the operating room. Many high risk environments have accepted team briefings; however healthcare has been slower to follow. While applying briefings in the operating room has shown positive benefits including improved communication and perceptions of teamwork, most research has only focused on feasibility of implementation and not on understanding how the quality of briefings can impact subsequent surgical procedures. Thus, there are no formal protocols or methodologies that have been developed.

The goal of this study was to relate specific characteristics of team briefings back to objective measures of team performance. The study employed cognitive interviews, prospective observations, and principle component regression to characterize and model the relationship between team briefing characteristics and non-routine events (NREs) in gynecological surgery. Interviews were conducted with 13 team members representing each role on the surgical team and data were collected for 24 pre-operative team briefings and 45 subsequent surgical cases. The findings revealed that variations within the team briefing are associated with differences in team-related outcomes, namely NREs, during the subsequent surgical procedures. Synthesis of the data highlighted three important trends which include the need to promote team communication during the briefing, the importance of attendance by all surgical team members, and the value of holding a briefing prior to each surgical procedure. These findings have implications for development of formal briefing protocols.

Pre-operative team briefings are beneficial for team performance in the operating room. Future research will be needed to continue understanding this relationship between how briefings are conducted and team performance to establish more consistent approaches and as well as for the continuing assessment of team briefings and other similar team-related events in the operating room.

Fixed-pointer moving-scale tape displays are a compact way to present wide range dynamic data, and are commonly employed in aircraft and spacecraft to display the primary parameters of airspeed, altitude and heading. A limitation of the moving tape format is its inability to natively display off scale target, reference or 'bug' values. The hypothesis tested was that a non-linear fisheye presentation (made possible by modern display technology) would maintain the essential functionality and compactness of existing moving tape displays while increasing situational awareness by ecologically displaying a wider set of reference values. Experimentation showed that the speed and accuracy of reading the center system value was not significantly changed with two types of expanded range displays. The limited situational awareness tests did not show a significant improvement with the new displays, but since no functionality was degraded further testing of expanded range displays may be productive.

The objective of this project was to evaluate human factors based cognitive aids on endoscope reprocessing. The project stems from recent failures in reprocessing (cleaning) endoscopes, contributing to the spread of harmful bacterial and viral agents between patients. Three themes were found to represent a majority of problems: 1) lack of visibility (parts and tools were difficult to identify), 2) high memory demands, and 3) insufficient user feedback. In an effort to improve completion rate and eliminate error, cognitive aids were designed utilizing human factors principles that would replace existing manufacturer visual aids. Then, a usability test was conducted, which compared the endoscope reprocessing performance of novices using the standard manufacturer-provided visual aids and the new cognitive aids. Participants successfully completed 87.1% of the reprocessing procedure in the experimental condition with the use of the cognitive aids, compared to 46.3% in the control condition using only existing support materials. Twenty-five of sixty subtasks showed significant improvement in completion rates. When given a cognitive aid designed with human factors principles, participants were able to more successfully complete the reprocessing task. This resulted in an endoscope that was more likely to be safe for patient use.