Using Cognitive Load to Differentiate Experience Levels for Performing Endobronchial Ultrasound Bronchoscopy

Area of Science:

• Medical procedures
• Pulmonology
• Medical education

Background:

• Endobronchial ultrasound (EBUS) bronchoscopy is crucial for diagnosing lung conditions.
• The cognitive demands of EBUS bronchoscopy have not been previously studied.
• Understanding cognitive load can identify critical procedural steps.

Purpose of the Study:

• To assess if cognitive load measurements can distinguish between different experience levels in EBUS bronchoscopy.
• To determine the relative importance of various procedural steps in EBUS bronchoscopy based on cognitive load.

Main Methods:

• A controlled observational study involving 8 bronchoscopists of varying experience.
• Continuous pupillometry via eye-tracking glasses to measure pupil dilation.
• Surgery Task Load Index (SURG-TLX) assessment post-procedure.
• Timing of procedural steps and recording of critical time points.

Main Results:

• Higher experience levels correlated with lower perceived workload, task complexity, physical, and mental demands (SURG-TLX).
• Pupillometry showed maximal pupil dilation during image optimization for all participants.
• Expert bronchoscopists dedicated a greater proportion of procedural time to image optimization compared to novices and intermediates.

Conclusions:

• Both SURG-TLX and pupillometry effectively measure cognitive load in EBUS bronchoscopy.
• These methods can identify critical procedural steps and differentiate expertise levels.
• Image optimization is a key area where cognitive load varies significantly with experience.