155 A Machine Learning-Based Approach for Predicting Surgeons’ Subjective Experience and Skill Levels: Neuroimaging Study

2021 ◽  
Vol 108 (Supplement_6) ◽  
Author(s):  
H O Keles ◽  
C Cengiz ◽  
I Demiral ◽  
M M Ozmen ◽  
A Omurtag

Abstract Aim Measuring cognitive load is important for surgical education and patient safety. Traditional approaches of measuring cognitive load of surgeons utilise behavioural metrics to measure performance and surveys and questionnaires to collect reports of subjective experience. There is a need for more automated, more accurate and objective evaluation methods. Method Functional neuroimaging data was collected using wireless NIRS device from sixteen surgeons (11 attending surgeons and 5 surgery resident) and 17 students while they performed two laparoscopic tasks (Peg transfer and String pass). Participant’s subjective mental load was assessed using NASA-TLX survey. Machine learning approaches were used for predicting the subjective experience and skill levels. Results The Prefrontal cortex (PFC) activations were greater in students who reported higher-than-median task load, as measured by the NASA-TLX survey. However, in the case of attending surgeons the opposite tendency was observed, namely higher activations in lower v higher task loaded subjects. We found response was greater in the left PFC of students particularly near dorso- and ventrolateral areas. We quantified the ability of PFC activation to predict differences in skill and task load using machine learning while focusing on the effects of NIRS channel separation distance on the results. Our results showed that the classification of skill level and subjective task load could be predicted based on PFC activation with an accuracy of nearly 90%. Conclusions The high accuracy of results is encouraging and suggest the integration of the strategy developed in this study as a promising approach to design automated, more accurate and objective evaluation methods.

PLoS ONE ◽  
2021 ◽  
Vol 16 (2) ◽  
pp. e0247117
Author(s):  
Hasan Onur Keles ◽  
Canberk Cengiz ◽  
Irem Demiral ◽  
Mehmet Mahir Ozmen ◽  
Ahmet Omurtag

Measuring cognitive load is important for surgical education and patient safety. Traditional approaches of measuring cognitive load of surgeons utilise behavioural metrics to measure performance and surveys and questionnaires to collect reports of subjective experience. These have disadvantages such as sporadic data, occasionally intrusive methodologies, subjective or misleading self-reporting. In addition, traditional approaches use subjective metrics that cannot distinguish between skill levels. Functional neuroimaging data was collected using a high density, wireless NIRS device from sixteen surgeons (11 attending surgeons and 5 surgery resident) and 17 students while they performed two laparoscopic tasks (Peg transfer and String pass). Participant’s subjective mental load was assessed using the NASA-TLX survey. Machine learning approaches were used for predicting the subjective experience and skill levels. The Prefrontal cortex (PFC) activations were greater in students who reported higher-than-median task load, as measured by the NASA-TLX survey. However in the case of attending surgeons the opposite tendency was observed, namely higher activations in the lower v higher task loaded subjects. We found that response was greater in the left PFC of students particularly near the dorso- and ventrolateral areas. We quantified the ability of PFC activation to predict the differences in skill and task load using machine learning while focussing on the effects of NIRS channel separation distance on the results. Our results showed that the classification of skill level and subjective task load could be predicted based on PFC activation with an accuracy of nearly 90%. Our finding shows that there is sufficient information available in the optical signals to make accurate predictions about the surgeons’ subjective experiences and skill levels. The high accuracy of results is encouraging and suggest the integration of the strategy developed in this study as a promising approach to design automated, more accurate and objective evaluation methods.


2018 ◽  
Vol 09 (04) ◽  
pp. 791-802 ◽  
Author(s):  
Dean Karavite ◽  
Matthew Miller ◽  
Mark Ramos ◽  
Susan Rettig ◽  
Rachael Ross ◽  
...  

Background Surveillance for surgical site infections (SSIs) after ambulatory surgery in children requires a detailed manual chart review to assess criteria defined by the National Health and Safety Network (NHSN). Electronic health records (EHRs) impose an inefficient search process where infection preventionists must manually review every postsurgical encounter (< 30 days). Using text mining and business intelligence software, we developed an information foraging application, the SSI Workbench, to visually present which postsurgical encounters included SSI-related terms and synonyms, antibiotic, and culture orders. Objective This article compares the Workbench and EHR on four dimensions: (1) effectiveness, (2) efficiency, (3) workload, and (4) usability. Methods Comparative usability test of Workbench and EHR. Objective test metrics are time per case, encounters reviewed per case, time per encounter, and retrieval of information meeting NHSN definitions. Subjective measures are cognitive load using the National Aeronautics and Space Administration (NASA) Task Load Index (NASA TLX), and a questionnaire on system usability and utility. Results Eight infection preventionists participated in the test. There was no difference in effectiveness as subjects retrieved information from all cases, using both systems, to meet the NHSN criteria. There was no difference in efficiency in time per case between the Workbench and EHR (8.58 vs. 7.39 minutes, p = 0.36). However, with the Workbench subjects opened fewer encounters per case (3.0 vs. 7.5, p = 0.002), spent more time per encounter (2.23 vs. 0.92 minutes, p = 0.002), rated the Workbench lower in cognitive load (NASA TLX, 24 vs. 33, p = 0.02), and significantly higher in measures of usability. Conclusion Compared with the EHR, the Workbench was more usable, short, and reduced cognitive load. In overall efficiency, the Workbench did not save time, but demonstrated a shift from between-encounter foraging to within-encounter foraging and was rated as significantly more efficient. Our results suggest that infection surveillance can be better supported by systems applying information foraging theory.


2016 ◽  
Author(s):  
Teng Zhang ◽  
Zhipeng Chen ◽  
Ji Wu ◽  
Sam Lai ◽  
Wenhui Lei ◽  
...  

2020 ◽  
Vol 10 (5) ◽  
pp. 92
Author(s):  
Ramtin Zargari Marandi ◽  
Camilla Ann Fjelsted ◽  
Iris Hrustanovic ◽  
Rikke Dan Olesen ◽  
Parisa Gazerani

The affective dimension of pain contributes to pain perception. Cognitive load may influence pain-related feelings. Eye tracking has proven useful for detecting cognitive load effects objectively by using relevant eye movement characteristics. In this study, we investigated whether eye movement characteristics differ in response to pain-related feelings in the presence of low and high cognitive loads. A set of validated, control, and pain-related sounds were applied to provoke pain-related feelings. Twelve healthy young participants (six females) performed a cognitive task at two load levels, once with the control and once with pain-related sounds in a randomized order. During the tasks, eye movements and task performance were recorded. Afterwards, the participants were asked to fill out questionnaires on their pain perception in response to the applied cognitive loads. Our findings indicate that an increased cognitive load was associated with a decreased saccade peak velocity, saccade frequency, and fixation frequency, as well as an increased fixation duration and pupil dilation range. Among the oculometrics, pain-related feelings were reflected only in the pupillary responses to a low cognitive load. The performance and perceived cognitive load decreased and increased, respectively, with the task load level and were not influenced by the pain-related sounds. Pain-related feelings were lower when performing the task compared with when no task was being performed in an independent group of participants. This might be due to the cognitive engagement during the task. This study demonstrated that cognitive processing could moderate the feelings associated with pain perception.


Author(s):  
Ahmed Ezzat ◽  
Alexandros Kogkas ◽  
Josephine Holt ◽  
Rudrik Thakkar ◽  
Ara Darzi ◽  
...  

Abstract Background Within surgery, assistive robotic devices (ARD) have reported improved patient outcomes. ARD can offer the surgical team a “third hand” to perform wider tasks and more degrees of motion in comparison with conventional laparoscopy. We test an eye-tracking based robotic scrub nurse (RSN) in a simulated operating room based on a novel real-time framework for theatre-wide 3D gaze localization in a mobile fashion. Methods Surgeons performed segmental resection of pig colon and handsewn end-to-end anastomosis while wearing eye-tracking glasses (ETG) assisted by distributed RGB-D motion sensors. To select instruments, surgeons (ST) fixed their gaze on a screen, initiating the RSN to pick up and transfer the item. Comparison was made between the task with the assistance of a human scrub nurse (HSNt) versus the task with the assistance of robotic and human scrub nurse (R&HSNt). Task load (NASA-TLX), technology acceptance (Van der Laan’s), metric data on performance and team communication were measured. Results Overall, 10 ST participated. NASA-TLX feedback for ST on HSNt vs R&HSNt usage revealed no significant difference in mental, physical or temporal demands and no change in task performance. ST reported significantly higher frustration score with R&HSNt. Van der Laan’s scores showed positive usefulness and satisfaction scores in using the RSN. No significant difference in operating time was observed. Conclusions We report initial findings of our eye-tracking based RSN. This enables mobile, unrestricted hands-free human–robot interaction intra-operatively. Importantly, this platform is deemed non-inferior to HSNt and accepted by ST and HSN test users.


2021 ◽  
Vol 108 (Supplement_3) ◽  
Author(s):  
J A Sánchez-Margallo ◽  
J Castillo Rabazo ◽  
D Durán Rey ◽  
I López-Agudelo ◽  
M R González-Portillo ◽  
...  

Abstract INTRODUCTION This study presents the first steps and results towards the development of a system for predicting the quality of surgical performance and workload in laparoscopic training. MATERIAL AND METHODS Surgeons wore a smartwatch which recorded their heart rate and hand motion during each laparoscopic procedure. Data was then correlated with both the Surgery Task Load Index (SURG-TLX) subjective questionnaire and the Global Operational Assessment of Laparoscopic Skills (GOALS) objective evaluation tool. Statistical analysis was conducted in order to study the relationship between parameters and to compare the results according to the surgeons’ level of experience. RESULTS Nine laparoscopic surgeons participated in this study, five gynecologists and four digestive surgeons. Gynecological surgeons showed a positive correlation between their level of experience, heart rate, hand motion, and GOALS score, except for bimanual dexterity. The reduction in the variability of hand accelerations led to improved tissue handling. Digestive surgeons showed a negative correlation between their level of experience and the reported temporal demand and complexity of the procedure. Novice digestive surgeons reported increased workload during surgery, mainly in mental, physical, and temporal workload. In both surgical specialties, it was observed that reduction in surgical workload was associated with improved GOALS score. CONCLUSIONS Preliminary results showed that bimanual dexterity is independent of the experience of gynecological surgeons. During laparoscopic surgical procedures, reduced variability in hand accelerations leads to better tissue manipulation. In addition, in gynecological and upper gastrointestinal procedures, reduced surgical workload is associated with improved surgical performance.


2020 ◽  
Vol 58 (6) ◽  
pp. 1357-1367 ◽  
Author(s):  
Samaneh Siyar ◽  
Hamed Azarnoush ◽  
Saeid Rashidi ◽  
Alexander Winkler-Schwartz ◽  
Vincent Bissonnette ◽  
...  

2022 ◽  
Vol 8 (2) ◽  
pp. 333-338
Author(s):  
Muhammad Qurthuby

Giving excessive workloads causes work stress both physically and psychologically and emotional reactions. The excess workload experienced by drivers and swampers at PT XYZ results in reduced attention at work, decreased work motivation, and decreased skill levels, thus affecting drivers and swampers productivity and the chance of a work accident is very high. This study aims to measure the Mental Workload of Job Driver and Swampers Fuel Tank Using the NASA-TLX Method. The NASA-TLX score obtained 93.8, driver 2  get 83.7, driver 3  91.3, swamper 1  91, swamper 2 89.5, and swamper 3 94.7. Elements of mental workload that are very influential are Mental Demand with a percentage of 22%, Effort 20%, Physical Demand 18%, Own Performance 15%, Frustation Level 15% and Temporal Demand 12%.


2021 ◽  
Vol ahead-of-print (ahead-of-print) ◽  
Author(s):  
Kyoungsik Na

PurposeThis study explores the effects of cognitive load on the propensity to reformulate queries during information seeking on the web.Design/methodology/approachThis study employs an experimental design to analyze the effect of manipulations of cognitive load on the propensity for query reformulation between experimental and control groups. In total, three affective components that contribute to cognitive load were manipulated: mental demand, temporal demand and frustration.FindingsA significant difference in the propensity of query reformulation behavior was found between searchers exposed to cognitive load manipulations and searchers who were not exposed. Those exposed to cognitive load manipulations made half as many search query reformulations as searchers not exposed. Furthermore, the National Aeronautical and Space Administration Task Load Index (NASA-TLX) cognitive load scores of searchers who were exposed to the three cognitive load manipulations were higher than those of searchers who were not exposed indicating that the manipulation was effective. Query reformulation behavior did not differ across task types.Originality/valueThe findings suggest that a dual-task method and NASA-TLX assessment serve as good indicators of cognitive load. Because the findings show that cognitive load hinders a searcher's interaction with information search tools, this study provides empirical support for reducing cognitive load when designing information systems or user interfaces.


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