Using a sequence of earcons to monitor multiple simulated patients

Anna Hickling, Birgit Brecknell, Robert G. Loeb, Penelope Sanderson

Research output: Contribution to journalArticlepeer-review

13 Scopus citations


Objective: The aim of this study was to determine whether a sequence of earcons can effectively convey the status of multiple processes, such as the status of multiple patients in a clinical setting. Background: Clinicians often monitor multiple patients. An auditory display that intermittently conveys the status of multiple patients may help. Method: Nonclinician participants listened to sequences of 500-ms earcons that each represented the heart rate (HR) and oxygen saturation (SpO2) levels of a different simulated patient. In each sequence, one, two, or three patients had an abnormal level of HR and/or SpO2. In Experiment 1, participants reported which of nine patients in a sequence were abnormal. In Experiment 2, participants identified the vital signs of one, two, or three abnormal patients in sequences of one, five, or nine patients, where the interstimulus interval (ISI) between earcons was 150 ms. Experiment 3 used the five-sequence condition of Experiment 2, but the ISI was either 150 ms or 800 ms. Results: Participants reported which patient(s) were abnormal with median 95% accuracy. Identification accuracy for vital signs decreased as the number of abnormal patients increased from one to three, p < .001, but accuracy was unaffected by number of patients in a sequence. Overall, identification accuracy was significantly higher with an ISI of 800 ms (89%) compared with an ISI of 150 ms (83%), p < .001. Conclusion: A multiple-patient display can be created by cycling through earcons that represent individual patients. Application: The principles underlying the multiple-patient display can be extended to other vital signs, designs, and domains.

Original languageEnglish (US)
Pages (from-to)268-288
Number of pages21
JournalHuman Factors
Issue number2
StatePublished - Mar 2017


  • Auditory displays
  • Medical monitoring
  • Neonatal medicine
  • Pulse oximetry
  • Sonification

ASJC Scopus subject areas

  • Human Factors and Ergonomics
  • Applied Psychology
  • Behavioral Neuroscience


Dive into the research topics of 'Using a sequence of earcons to monitor multiple simulated patients'. Together they form a unique fingerprint.

Cite this