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

Abstract

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.

Carga mental en simulación de baja fidelidad asociada con material instruccional interactivo

“…El estudio tampoco permite estimar cuál es el nivel de carga preciso donde ocurre o no ocurre el aprendizaje y asimismo cuál de los factores (demanda mental, demanda física, etc.) tiene mayor correlación con el aprendizaje, dado que se estima que niveles elevados de carga e incluso niveles muy bajos pueden afectar el aprendizaje 26 , lo que se denomina "relación parabólica" 15,17 . Otras limitantes tienen relación con la escasez de trabajos publicados sobre la interpretación de los datos de las escalas [34][35] y que la mayoría de los estudios están realizados sobre desempeño en tareas laborales.…”

“…A su vez, la simulación fue estructurada de modo tal que se dividió en tres componentes: inicio, práctica de la técnica de aspiración de secreciones y retroalimentación 2,18 ; se desarrolló en forma estandarizada para ambos grupos y se consideró el mismo tiempo, número de repeticiones, insumos clínicos, simuladores y condiciones de infraestructura. Inmediatamente 15,17,26 , transcurridos menos de diez minutos desde el final de la retroalimentación, se midió la carga mental con el instrumento NASA-Task Load Index (NASA-TLX), tanto para el grupo control y caso.…”

“…El instrumento ha sido utilizado en distintas investigaciones que incluyen ambientes laborales 26,28,31,33,34,37 , e incluso, más allá de su aplicación original, que era la aviación 26,32 , debido a su facilidad de uso 31 , y también en situaciones de aprendizaje en educación 15,26,35 , siendo validado en estos contextos, tanto en inglés 15,16,26,28,32,33 , como en español 29,36 , ya sea en la versión de cuatro escalas (TLX-4), que excluye rendimiento y frustración, y la que ha sido utilizada en este estudio que incluye las seis escalas (TLX-6) 33 .…”

Development and usability testing of a patient digital twin for critical care education: a mixed methods study

“…The challenges of adapting to the new interface might also have contributed to the moderately high NASA-TLX scores recorded in the domains of mental demand, successful task performance, and overall effort recorded during testing sessions. Additionally, the significant variations observed in the performance, mental demand, effort, and frustration domains of the score could indicate differences among residents in terms of their critical care knowledge and problem-solving capabilities rather than being attributed solely to the interface itself ( 42 ). This subject will require more targeted studies to qualify further.…”

sEMG-controlled forearm bracelet and serious game-based rehabilitation for training manual dexterity in people with multiple sclerosis: a randomised controlled trial

“…This questionnaire was used to assess the perceived workload of the EG in the post-treatment evaluation. This questionnaire has been widely used in aviation, nuclear engineering, medicine and VR applications to understand the perceived task load immediately after the task is performed through mental, emotional and physical dimensions [ 42 , 43 ]. It is divided into six parts (mental demand, physical demand, temporal demand, performance, effort and frustration).…”