Using Real-Time Lung Visuals to Reduce Mental Strain and Improve Diagnosis Speed

Effect of Real-Time Respiratory Mechanics Visualization ("Digital Twin") on Clinician Cognitive Workload and Diagnostic Latency: A Randomized Crossover Simulation Trial

The goal of this clinical simulation study is to learn if a "Digital Twin" graphical lung display reduce the mental workload of clinicians. The study also evaluates if this helps physicians diagnose and manage ventilator-related crises more effectively than standard ventilator screens.

The main questions it aims to answer are:

Does the Digital Twin display lower the cognitive stress (mental workload) experienced by clinicians during a crisis? Does the Digital Twin display reduce the time it takes for clinicians to identify specific respiratory complications? Does the use of real-time physiological visualization improve the accuracy of clinical decision-making? Researchers will compare the performance of clinicians using a standard ventilator display (the "Black Box" condition) to their performance when provided with an additional synchronized 3D lung and advanced waveform display (the "Digital Twin" condition).

Participants will:

Complete four randomized mechanical ventilation crisis scenarios using a high-fidelity lung simulator (ASL 5000).

Manage scenarios involving high airway resistance, low lung compliance, auto-PEEP, and patient-ventilator asynchrony.

Undergo a 14-day "washout" period between sessions to ensure no memory bias between the control and intervention groups.

Complete a NASA-TLX survey after each scenario to measure their perceived mental, physical, and temporal demand.

Inclusion Criteria:

• Licensed physicians currently practicing in intensive care units (ICU), neuro-intensive care units (NICU), or respiratory departments.
• For the Junior Stratum: Physicians currently in a standardized residency training program or in their first two years of a sub-specialty fellowship. For the Senior Stratum: Senior attending physicians or senior fellows with more than 5 years of experience in intensive care medicine.
• Basic proficiency in operating the mechanical ventilators used in the study (e.g., Hamilton, Dräger, or Puritan Bennett).
• Willingness to participate in two simulation sessions separated by a 14-day interval.

Exclusion Criteria:

• Prior formal training or significant experience using the ASL 5000 / RespiSim "Digital Twin" or Aurora interface.
• Physical limitations that prevent the operation of a mechanical ventilator or the viewing of a digital monitor.
• Refusal to provide informed consent for video recording of the simulation session for data adjudication.