PMID- 29465749
OWN - NLM
STAT- MEDLINE
DCOM- 20181211
LR  - 20230221
IS  - 1365-2168 (Electronic)
IS  - 0007-1323 (Print)
IS  - 0007-1323 (Linking)
VI  - 105
IP  - 5
DP  - 2018 Apr
TI  - Systematic review of measurement tools to assess surgeons' intraoperative 
      cognitive workload.
PG  - 491-501
LID - 10.1002/bjs.10795 [doi]
AB  - BACKGROUND: Surgeons in the operating theatre deal constantly with high-demand 
      tasks that require simultaneous processing of a large amount of information. In 
      certain situations, high cognitive load occurs, which may impact negatively on a 
      surgeon's performance. This systematic review aims to provide a comprehensive 
      understanding of the different methods used to assess surgeons' cognitive load, 
      and a critique of the reliability and validity of current assessment metrics. 
      METHODS: A search strategy encompassing MEDLINE, Embase, Web of Science, 
      PsycINFO, ACM Digital Library, IEEE Xplore, PROSPERO and the Cochrane database 
      was developed to identify peer-reviewed articles published from inception to 
      November 2016. Quality was assessed by using the Medical Education Research Study 
      Quality Instrument (MERSQI). A summary table was created to describe study 
      design, setting, specialty, participants, cognitive load measures and MERSQI 
      score. RESULTS: Of 391 articles retrieved, 84 met the inclusion criteria, 
      totalling 2053 unique participants. Most studies were carried out in a simulated 
      setting (59 studies, 70 per cent). Sixty studies (71 per cent) used 
      self-reporting methods, of which the NASA Task Load Index (NASA-TLX) was the most 
      commonly applied tool (44 studies, 52 per cent). Heart rate variability analysis 
      was the most used real-time method (11 studies, 13 per cent). CONCLUSION: 
      Self-report instruments are valuable when the aim is to assess the overall 
      cognitive load in different surgical procedures and assess learning curves within 
      competence-based surgical education. When the aim is to assess cognitive load 
      related to specific operative stages, real-time tools should be used, as they 
      allow capture of cognitive load fluctuation. A combination of both subjective and 
      objective methods might provide optimal measurement of surgeons' cognition.
CI  - (c) 2018 BJS Society Ltd Published by John Wiley & Sons Ltd.
FAU - Dias, R D
AU  - Dias RD
AUID- ORCID: 0000-0003-4959-5052
AD  - STRATUS Center for Medical Simulation, Brigham and Women's Hospital, Boston, 
      Massachusetts, USA.
AD  - Harvard Medical School, Boston, Massachusetts, USA.
FAU - Ngo-Howard, M C
AU  - Ngo-Howard MC
AD  - Department of Otolaryngology - Head and Neck Surgery, Boston University School of 
      Medicine, Boston, Massachusetts, USA.
AD  - Medical Robotics and Computer Assisted Surgery Laboratory, Division of Cardiac 
      Surgery, Veterans Affairs Boston Healthcare System, West Roxbury, Massachusetts, 
      USA.
FAU - Boskovski, M T
AU  - Boskovski MT
AD  - Department of Surgery, Brigham and Women's Hospital, Boston, Massachusetts, USA.
AD  - Harvard Medical School, Boston, Massachusetts, USA.
FAU - Zenati, M A
AU  - Zenati MA
AD  - Harvard Medical School, Boston, Massachusetts, USA.
AD  - Medical Robotics and Computer Assisted Surgery Laboratory, Division of Cardiac 
      Surgery, Veterans Affairs Boston Healthcare System, West Roxbury, Massachusetts, 
      USA.
FAU - Yule, S J
AU  - Yule SJ
AD  - STRATUS Center for Medical Simulation, Brigham and Women's Hospital, Boston, 
      Massachusetts, USA.
AD  - Center for Surgery and Public Health, Brigham and Women's Hospital, Boston, 
      Massachusetts, USA.
AD  - Department of Surgery, Brigham and Women's Hospital, Boston, Massachusetts, USA.
AD  - Harvard Medical School, Boston, Massachusetts, USA.
LA  - eng
GR  - R01 HL126896/HL/NHLBI NIH HHS/United States
PT  - Journal Article
PT  - Research Support, N.I.H., Extramural
PT  - Systematic Review
DEP - 20180221
PL  - England
TA  - Br J Surg
JT  - The British journal of surgery
JID - 0372553
SB  - IM
MH  - *Clinical Competence
MH  - Cognition/*physiology
MH  - Humans
MH  - *Self Report
MH  - Surgeons/*psychology
MH  - Workload/*psychology
PMC - PMC5878696
MID - NIHMS921855
EDAT- 2018/02/22 06:00
MHDA- 2018/12/12 06:00
PMCR- 2019/02/21
CRDT- 2018/02/22 06:00
PHST- 2017/08/21 00:00 [received]
PHST- 2017/10/09 00:00 [revised]
PHST- 2017/11/17 00:00 [accepted]
PHST- 2018/02/22 06:00 [pubmed]
PHST- 2018/12/12 06:00 [medline]
PHST- 2018/02/22 06:00 [entrez]
PHST- 2019/02/21 00:00 [pmc-release]
AID - bjs.10795 [pii]
AID - 10.1002/bjs.10795 [doi]
PST - ppublish
SO  - Br J Surg. 2018 Apr;105(5):491-501. doi: 10.1002/bjs.10795. Epub 2018 Feb 21.