Surgery Task Load Index in Cardiac Surgery: Measuring Cognitive Load Among Teams

Area of Science:

• Medical research
• Human factors engineering
• Surgical team performance

Background:

• The NASA Task Load Index (TLX) is a standard for assessing perceived cognitive load but lacks temporal sensitivity.
• The Surgery Task Load Index (SURG-TLX) was developed to measure cognitive load within surgical teams.
• Existing methods often fail to capture dynamic changes in cognitive load during complex procedures.

Purpose of the Study:

• To evaluate the temporal sensitivity of SURG-TLX in measuring individual cognitive load during cardiac surgery.
• To examine the relationship between individual and team cognitive load and surgical complexity proxies (e.g., bypass and surgery length).
• To assess cognitive load variations across different roles (surgeon, anesthesiologist, perfusionist) throughout the procedure.

Main Methods:

• Retrospective administration of SURG-TLX immediately after cardiac surgery cases.
• Assessment of cognitive load at three distinct phases: before, during, and after cardiopulmonary bypass.
• Correlation analysis between individual/team cognitive load measures and procedure duration (bypass and overall surgery length).

Main Results:

• Perceived cognitive load significantly varied throughout the cardiac surgery procedure, with distinct levels before, during, and after cardiopulmonary bypass.
• Anesthesiologists reported lower cognitive load during bypass compared to surgeons and perfusionists.
• Higher perceived cognitive load for both surgeons and the overall team was positively associated with longer bypass and surgery durations.

Conclusions:

• SURG-TLX is a valuable tool for measuring cognitive load dynamically over time in real-world cardiac surgery settings.
• The findings support the utility of SURG-TLX for both individual role assessment and team-wide cognitive load evaluation.
• Understanding temporal cognitive load patterns can inform strategies for optimizing surgical team performance and patient safety.