High-Fidelity Simulation to Assess Task Load Index and Performance: A Prospective Observational Study.

Area of Science:

• Medical Simulation
• Human Factors Engineering
• Anesthesiology Education

Background:

• The NASA Task Load Index (NASA-TLX) is a validated tool for measuring workload in aviation.
• Its application in healthcare high-fidelity simulation is emerging for scenario quality assessment.
• Understanding workload in critical care simulation is crucial for resident training.

Purpose of the Study:

• To evaluate the NASA Task Load Index scores for critical care simulation scenarios against established literature benchmarks.
• To investigate the relationship between NASA Task Load Index, resident performance, and induced stress during high-fidelity simulation.

Main Methods:

• Fifty-three anesthesiology and intensive care residents participated in 10 high-fidelity simulation scenarios.
• Task load was measured using the NASA Task Load Index (NASA-TLX).
• Stress levels (Visual Analogue Scale) and performance (Team Emergency Assessment Measure) were also assessed.

Main Results:

• The median NASA Task Load Index score was 61, with 5 out of 10 scenarios falling within the acceptable range (39-61).
• No significant association was found between NASA Task Load Index scores and technical or non-technical skills performance.
• A significant positive correlation was observed between NASA Task Load Index scores and stress levels (rho=4.7, P=.001).

Conclusions:

• Half of the simulated critical care scenarios demonstrated acceptable task load levels as measured by the NASA Task Load Index.
• The NASA Task Load Index shows potential as a tool for evaluating the pedagogical suitability of simulation scenarios.
• While stress influences resident performance, task load itself did not directly correlate with performance outcomes in this study.