Measuring the workload of the anesthesiologist

Area of Science:

• Anesthesiology
• Human Factors Engineering
• Cognitive Psychology

Background:

• Human performance in complex dynamic tasks is significantly influenced by mental workload.
• Understanding workload is crucial for patient safety and optimizing clinical practice in anesthesia.

Purpose of the Study:

• To indirectly measure the mental workload of anesthesia residents during surgical cases.
• To identify specific tasks and phases of anesthesia associated with increased workload.
• To explore the relationship between case complexity, resident experience, and workload.

Main Methods:

• Utilized a secondary (subsidiary) task paradigm, employing mathematical addition problems as a probe for "spare capacity."
• Measured excess response time on the secondary task as an indicator of mental workload.
• Correlated secondary task performance with concurrent clinical activities and subjective workload ratings.

Main Results:

• Excess response time on the secondary task correlated with activities such as manual tasks and communication with attending anesthesiologists.
• The secondary task was either skipped or showed high excess response time in 40% of presentations, indicating significant workload.
• Case complexity and resident experience level interacted to influence workload; subjective ratings identified anesthesia induction and emergence as peak workload periods, dominated by attentional demands.

Conclusions:

• Anesthesiologists' spare cognitive capacity may be frequently limited during patient care.
• The study highlights the utility of secondary task paradigms for quantifying mental workload in real-time clinical settings.
• Further controlled studies are recommended to precisely define factors contributing to increased workload in anesthesia.