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Improving Pulse Oximetry Pitch Perception with Multisensory Perceptual Training

Schlesinger, Joseph J. MD*†; Stevenson, Ryan A. PhD‡§‖¶**; Shotwell, Matthew S. PhD*#; Wallace, Mark T. PhD‡§‖**††

doi: 10.1213/ANE.0000000000000222
Technology, Computing, and Simulation: Brief Report

The pulse oximeter is a critical monitor in anesthesia practice designed to improve patient safety. Here, we present an approach to improve the ability of anesthesiologists to monitor arterial oxygen saturation via pulse oximetry through an audiovisual training process. Fifteen residents’ abilities to detect auditory changes in pulse oximetry were measured before and after perceptual training. Training resulted in a 9% (95% confidence interval, 4%–14%, P = 0.0004, t 166 = 3.60) increase in detection accuracy, and a 72-millisecond (95% confidence interval, 40–103 milliseconds, P < 0.0001, t 166 = −4.52) speeding of response times in attentionally demanding and noisy conditions that were designed to simulate an operating room. This study illustrates the benefits of multisensory training and sets the stage for further work to better define the role of perceptual training in clinical anesthesiology.

Published ahead of print May 5, 2014

From the *Department of Anesthesiology, Division of Critical Care Medicine, and Department of Anesthesiology, BH Robbins Scholars Program, Department of Hearing and Speech Sciences, Vanderbilt University Medical Center; §Vanderbilt Brain Institute; Vanderbilt Kennedy Center, Nashville, Tennessee; Department of Psychology, University of Toronto, Toronto, Ontario, Canada; #Department of Biostatistics, Vanderbilt University, Nashville, Tennessee; **Department of Psychology, Vanderbilt University, Nashville, Tennessee; and ††Department of Psychiatry, Vanderbilt University, Nashville, Tennessee.

Accepted for publication January 29, 2014.

Published ahead of print May 5, 2014

Funding: Joseph Schlesinger: Vanderbilt Institute for Clinical and Translational Research VR2236; Ryan Stevenson: Banting Postdoctoral Fellowship, NIH 1F32 DC011993; Mark Wallace: Vanderbilt Brain Institute.

The authors declare no conflicts of interest.

This report was previously presented, in part, at the American Society of Anesthesiologists, Society of Critical Care Anesthesiologists, Society for Neuroscience, American Medical Association, Association of University Anesthesiologists, Society of Critical Care Medicine, and Society for Technology in Anesthesia.

Reprints will not be available from the authors.

Address correspondence to Joseph J. Schlesinger, MD, 1211 21st Avenue South, Medical Arts Building, Suite 526, Nashville, TN, 37212. Address e-mail to

© 2014 International Anesthesia Research Society