Training with cognitive load improves performance under similar conditions in a real surgical task

Area of Science:

• Medical Simulation
• Surgical Education
• Cognitive Load Theory

Background:

• Cognitive load significantly impacts bimanual surgical task performance.
• Virtual reality (VR) simulators offer a controlled environment to study these effects.
• Investigating the benefits of training under cognitive load is crucial for surgical skill development.

Purpose of the Study:

• To determine if repeated training with enhanced cognitive load in VR improves surgical task performance.
• To assess the transferability of VR-based cognitive load training to real surgical tasks.
• To evaluate the impact of cognitive load on bimanual dexterity in a surgical context.

Main Methods:

• 11 subjects were randomized into Control, VR, and VR + Cognitive Load (CL) groups.
• Training involved a peg transfer task in VR, with CL applied via math problems for the VR + CL group.
• Performance was assessed via pre-test, post-test, retention test, and a transfer task on pig intestine under cognitive load.

Main Results:

• The VR + CL group demonstrated significantly better performance on the bimanual dexterity transfer test compared to Control and VR groups.
• While VR training alone showed some benefit, adding cognitive load during training yielded superior results for the transfer task.
• Statistical analysis indicated significant differences favoring the VR + CL group in specific performance metrics.

Conclusions:

• Training surgical tasks under cognitive load using VR simulation can enhance performance on actual surgical procedures.
• This approach shows potential for improving surgical skills, particularly bimanual dexterity, in demanding operational conditions.
• Cognitive load training in VR is a promising method for surgical skill acquisition and retention.