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Objective Measurement of Learners' Cognitive Load During Simulation-Based Trauma Team Training: A Pilot Study
Sandra Hyunsoo Park1, Scott A Goldberg2, Abdulrahman Al-Ballaa3
1STRATUS Center for Medical Simulation, Brigham and Women's Hospital, Boston, Massachusetts; Department of Emergency Medicine, Harvard Medical School, Boston, Massachusetts.
The Journal of Surgical Research
|July 11, 2022
Summary
Cognitive overload in surgical training can be measured using heart rate variability (HRV). The low-frequency/high-frequency (LF/HF) ratio, a validated proxy for cognitive load, increased during simulation scenarios compared to debriefings.
Area of Science:
- Medical Simulation
- Surgical Education
- Cognitive Load Assessment
Background:
- Cognitive overload negatively impacts learning and clinical performance in surgery.
- Objective biomarkers are needed to assess cognitive load during training.
Purpose of the Study:
- To investigate learners' cognitive load during simulation-based trauma team training.
- To utilize an objective digital biomarker, the low-frequency/high-frequency (LF/HF) ratio, to assess cognitive load.
Main Methods:
- A cross-sectional study involving 10 subjects in a 3-hour simulation-based interprofessional trauma team training program.
- Learners wore heart rate sensors to measure interbeat intervals in real-time.
- The LF/HF ratio was calculated as a proxy for cognitive load during different simulation phases and scenario difficulties.
Main Results:
- LF/HF ratios were significantly higher during simulation scenarios compared to debriefing sessions across all three scenarios (P < 0.001).
- Multiple-patient scenarios resulted in a higher cognitive load (LF/HF ratio of 4.79) compared to single-patient scenarios (LF/HF ratio of 3.88).
- The LF/HF ratio demonstrated fluctuations correlating with simulation phases and scenario complexity.
Conclusions:
- The LF/HF ratio, derived from heart rate variability, is a feasible and objective marker for assessing cognitive load in surgical simulation.
- This metric effectively detects cognitive load changes during different phases and varying difficulties of trauma team training scenarios.
