BackgroundThe NASA Task Load IndeX (NASA-TLX) is a questionnaire widely used in aviation. This index might help for attesting the quality of a scenario in high-delity simulation (HFS) in healthcare.The main purpose of this study was to observe whether the score of NASA-TLX for critical care simulated scenarios, designed for residents, was consistent with the values reported in the literature.The second purpose was to describe relationships between NASA-TLX, performance and generated stress during HFS.
MethodsAll residents in anaesthesia and intensive care undergoing HFS were included. The primary endpoint was the task load generated by each scenario assessed by NASA-TLX. Based on literature, the NASA-TLX scores between 39 and 61 were considered as acceptable level. Stress level (Visual Analogue Scale for stress), speci c technical and non-technical skills performances (Team Emergency Assessment Measure) were also assessed.
ResultsFifty-three residents actively participated in one of ten different scenarios, between June to December 2017. Median NASA-TLX score of scenarios was 61 [48][49][50][51][52][53][54][55][56][57][58][59][60][61][62][63][64][65]. Five scenarios (50%) generated acceptable task load level. There was no association between NASA-TLX score and technical or Team Emergency Assessment Measure performance scores, but an association between NASA-TLX and the stress level (rho = 4.7, p = 0.001) was observed.
ConclusionsSimulation scenarios generate different task loads for residents; the task load was deemed acceptable for half of the scenarios. The NASA-TLX could be considered as a tool to assess the pedagogic adequacy of scenarios. Scenario and generated stress level, but not task load, can modify residents' performance during simulation. This should be considered when planning normative simulation.