Regulating Trainee Workload in Laparoscopic Simulation: Evidence from NASA-TLX and Pupillometry Analysis

Area of Science:

• Medical Education
• Surgical Simulation
• Human Factors Engineering

Background:

• Optimizing trainee workload is crucial for effective surgical education.
• Traditional fixed-difficulty training may lead to suboptimal workload management.
• Objective measures of workload are needed to complement subjective assessments.

Purpose of the Study:

• To investigate if a workload-adapted training protocol reduces trainee workload variability during laparoscopic simulation.
• To compare self-reported workload (NASA-Task Load Index) and physiological measures (pupillary response) between adapted and fixed-difficulty protocols.

Main Methods:

• A randomized controlled pilot study involving 22 novice participants.
• Participants were assigned to either a workload-adapted or a fixed-medium difficulty protocol.
• Workload was assessed using NASA-Task Load Index and real-time pupillary response.

Main Results:

• Both groups showed decreased NASA-Task Load Index scores over time.
• No significant differences in mean workload scores or pupil size were found between groups.
• The workload-adapted group exhibited significantly lower variability in both NASA-Task Load Index scores and pupil size compared to the fixed-difficulty group.

Conclusions:

• A workload-adapted training protocol appears to be associated with reduced workload variability in laparoscopic simulation.
• Pupillometry shows potential as a complementary physiological measure for assessing trainee workload.
• Further validation in larger studies is recommended.