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Record W4409673334 · doi:10.2196/67111

Association of Virtual Nurses’ Workflow and Cognitive Fatigue During Inpatient Encounters: Cross-Sectional Study

2025· article· en· W4409673334 on OpenAlexvenueno aff
Saif Khairat, Joseph G. Morelli, W.-I. Liao, Julia Aucoin, Barbara S. Edson, Cheryl B. Jones

Bibliographic record

VenueJMIR Human Factors · 2025
Typearticle
Languageen
FieldPsychology
TopicSleep and Work-Related Fatigue
Canadian institutionsnot available
FundersNational Center for Advancing Translational Sciences
KeywordsWorkflowCognitionCross-sectional studyNursingMedicineComputer sciencePsychiatryDatabase

Abstract

fetched live from OpenAlex

Background: The virtual nursing delivery model enables the provision of expert nursing care from a remote location, using technology such as audio and video communication, remote monitoring devices, and access to electronic health records. Virtual nurses spend an extensive amount of time on computers to provide care, and little is known about how this workflow may affect and contribute to cognitive fatigue. Objective: This study aimed to use eye tracking technology and pupil size variation to determine instances of virtual nurse cognitive fatigue during their typical workflow. Methods: This study examined the virtual nursing workflow by recording and analyzing virtual nurse encounters using eye tracking. This cross-sectional study was conducted during regular 12-hour shifts at a major Southeastern health center in the United States. Results: The study found that 75% (22/29) of virtual nursing encounters demonstrated a first fatigue instance at 9.8 minutes during patient discharges and at 11.9 minutes during patient admissions. Conclusions: This study provides valuable insights into virtual nursing workflow design and how it may impact the cognitive fatigue levels of nurses providing inpatient virtual care.

Fetched live from OpenAlex and de-inverted. Abstracts are not stored in this database: the inverted indexes are 8.6 GB of the frame’s 9.3 GB of text, and the host has 13 GB free.

How this classification was reachedexpand

Full frame machine prediction

Teacher imitation

Not calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.

metaresearch head score (Codex)0.001
metaresearch head score (Gemma)0.003
Version: metacan-v3-hybrid-931329e0061cValidation status: machine_predicted_unvalidated
Candidate categoriesnone
Consensus categoriesnone
DomainCandidate signal: none · Consensus signal: none
Study designCandidate signal: Observational · Consensus signal: Observational
GenreCandidate signal: Empirical · Consensus signal: Empirical
Teacher disagreement score0.003
Threshold uncertainty score0.007

Distilled classifier scores by category (both heads)

CategoryCodexGemma
Metaresearch0.0010.003
Meta-epidemiology (narrow)0.0000.000
Meta-epidemiology (broad)0.0000.000
Bibliometrics0.0010.000
Science and technology studies0.0000.000
Scholarly communication0.0000.001
Open science0.0000.001
Research integrity0.0000.000
Insufficient payload (model declined to judge)0.0010.000

Machine scores (provisional)

The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.

Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.

Opus teacher head0.024
GPT teacher head0.361
Teacher spread0.337 · how far apart the two teachers sit on this one work
Validation statusscore_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from it

Classification

machine, unvalidated

Machine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.

The models applied no category: nothing in the taxonomy fit this work.
Study designObservational
Domainnot available
GenreEmpirical

How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".

Quick stats

Citations5
Published2025
Admission routes1
Has abstractyes

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