Investigating effect of standardized total body skin examination using sequence-networks

Snehal Dhengre, Hannah Nam, Matthew Helm, Ling Rothrock

Research output: Contribution to journalArticlepeer-review


This study employs sequence-network analysis to investigate the influence of instructing a standardized procedure on total-body skin examination (TBSE) performance. A between-subjects study was conducted with thirty-one participants comprising medical students and attending physicians. Among these participants, fifteen were randomly assigned to the uninstructed group and sixteen to the instructed group. The participants' gaze and field of view were recorded using eye tracking glasses while performing TBSE on a male and a female standardized patient. The recordings were then transcribed to depict the examination process. The instructed group missed significantly fewer body parts (p = 0.045) and had higher time efficiency (p = 0.007) while examining the female patient, but no significant difference was observed for the male patient examination. Furthermore, the examination sequences of the instructed group contained lesser variability than the uninstructed group. Hence, implementing a standard optimal procedure to perform TBSE could minimize the likelihood of missing body parts, increase examination efficiency, and improve performance consistency. This study demonstrated the potential of sequence-network analysis to study human performance in sequential tasks.

Original languageEnglish (US)
Article number104219
JournalApplied Ergonomics
StatePublished - Apr 2024

All Science Journal Classification (ASJC) codes

  • Human Factors and Ergonomics
  • Physical Therapy, Sports Therapy and Rehabilitation
  • Safety, Risk, Reliability and Quality
  • Engineering (miscellaneous)

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