Statistical analysis
Primary outcome measures were; 1: differences in BKB sentence results in different stimulated environments; office, ED, ITU and theatre and 2: differences in BKB sentence results with different PPE equipment scenarios; no PPE, wearing PPE and wearing PPE whilst raising voice volume.
Secondary endpoints were; 1: measurement of mean change in voice volume in response to increase in background noise and 2: mean SNRs with different PPE equipment scenarios and environments.
Data were analysed using IBM SPSS Statistics Subscription (IBM, Armonk, USA). Differences in BKB scores for different PPE equipment simulations in each hospital environment were calculated using one-way repeated ANOVA tests. For any environment found to have a statistically significant result, further comparison of differences in BKB sentence results with different PPE equipment scenarios were analysed using the Wilcoxon Signed-Rank test. A p-value of <0.05 was considered significant. The Wilcoxon signed-rank test was used as it compares dependant rather than independent samples.
Patient and Public Involvement This research was conducted without patient involvement. Patients were not consulted to develop outcomes or interpret the results as the focus was staff communication. This may occur if this research is expanded to include clinician-patient communication in the future.