Assessing Surgical Task Load and Performance: A Comparison of Simulation and Maritime Operation

Area of Science:

• Medical simulation
• Surgical performance analysis
• Maritime medicine

Background:

• Operating at sea presents unique challenges to surgical procedures.
• Vessel motion can impact surgeon's task load and performance.
• Simulators are crucial for training and evaluating surgical skills in adverse environments.

Purpose of the Study:

• To evaluate the impact of simulated and actual vessel motion on surgical task load and performance.
• To compare surgical performance and workload in a simulator versus a real-world at-sea environment.

Main Methods:

• A phased approach was used, including a feasibility study, simulator-based testing (Phase II), and at-sea testing (Phase III) aboard the U.S. Naval Ship Brunswick.
• Participants performed surgical tasks on mannequins.
• Surgical Task Load Index (TLX) was used to measure workload.
• Subject matter experts evaluated simulated surgeries.

Main Results:

• Surgical Task Load Index (TLX) scores were significantly higher in the at-sea phase (Phase III) compared to the simulator phase (Phase II), especially in higher sea states.
• Surgical performance was comparable between the simulator (84%) and at-sea (89%) phases.
• Simulated vessel motion effectively replicated the conditions experienced at sea.

Conclusions:

• While simulated vessel motion accurately reflects real-world conditions for surgical simulation, actual sea conditions lead to increased perceived surgical workload.
• Surgical performance was not significantly affected by sea state in either the simulated or actual at-sea environments.
• Factors beyond motion, such as travel stress, may contribute to increased workload at sea.