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Multiagent First-Person Perspective Analysis for Leadership Assessment in Pediatric Emergency Simulations: A

Hisataka Nozawa1, Ayumi Kunikata1, Yuki Sakai2

  • 1Department of Pediatrics, The University of Tokyo Hospital, Tokyo, Japan.

Critical Care Explorations
|June 12, 2026
PubMed
Summary

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This pilot study shows that multiagent, time-synchronized first-person perspective analysis (FPA) is feasible for assessing leadership behaviors in emergency simulations. Gaze data from smart glasses provided observer-independent metrics on leader attention and team interaction.

Area of Science:

  • Medical Simulation
  • Human Factors Engineering
  • Leadership Studies

Background:

  • Conventional leadership assessments lack observer-independent metrics.
  • Effective leadership and teamwork are interdependent, requiring synchronized multiagent analysis.
  • This study explores applying first-person perspective analysis (FPA) in emergency simulations.

Purpose of the Study:

  • To examine the feasibility of multiagent, spatiotemporally synchronized FPA in emergency simulations.
  • To assess leadership behaviors using objective, gaze-based metrics.
  • To evaluate the integration of wearable technology in high-fidelity simulations.

Main Methods:

  • Exploratory simulation study in a pediatric intensive care unit (PICU) setting.
  • Two physicians served as team leaders, evaluated with the Ottawa Global Rating Scale.
Keywords:
advanced cardiac life supportartificial intelligencecrew resource managementhealthcareleadershipmedical education

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  • Wearable smart glasses captured first-person video and gaze data, analyzed with deep learning object detection (You Only Look Once, version 8).

    • Main Results:

    • Multiagent, time-synchronized FPA was successfully implemented without interruptions.
    • Leaders spent approximately 80% of the scenario fixating on relevant areas.
    • Objective gaze analysis revealed differences in patient-directed fixation and eye contact frequency between leaders.

    Conclusions:

    • Multiagent, time-synchronized FPA is feasible for leadership assessment in emergency simulations.
    • Gaze-based behavioral information offers objective metrics for evaluating leadership.
    • This technology can enhance the understanding of leadership dynamics in team-based critical care.