scholarly journals Eye-Tracking Metrics Predict Perceived Workload in Robotic Surgical Skills Training

2019 ◽  
Vol 62 (8) ◽  
pp. 1365-1386 ◽  
Author(s):  
Chuhao Wu ◽  
Jackie Cha ◽  
Jay Sulek ◽  
Tian Zhou ◽  
Chandru P. Sundaram ◽  
...  
Keyword(s):  
Robotic Surgery ◽  
Eye Tracking ◽  
Skills Training ◽  
Stereoscopic Vision ◽  
Classification Model ◽  
Surgical Trainees ◽  
High Workload ◽  
Robotic Skills ◽  
Perceived Workload ◽  
Robotic Surgical Training

Objective The aim of this study is to assess the relationship between eye-tracking measures and perceived workload in robotic surgical tasks. Background Robotic techniques provide improved dexterity, stereoscopic vision, and ergonomic control system over laparoscopic surgery, but the complexity of the interfaces and operations may pose new challenges to surgeons and compromise patient safety. Limited studies have objectively quantified workload and its impact on performance in robotic surgery. Although not yet implemented in robotic surgery, minimally intrusive and continuous eye-tracking metrics have been shown to be sensitive to changes in workload in other domains. Methods Eight surgical trainees participated in 15 robotic skills simulation sessions. In each session, participants performed up to 12 simulated exercises. Correlation and mixed-effects analyses were conducted to explore the relationships between eye-tracking metrics and perceived workload. Machine learning classifiers were used to determine the sensitivity of differentiating between low and high workload with eye-tracking features. Results Gaze entropy increased as perceived workload increased, with a correlation of .51. Pupil diameter and gaze entropy distinguished differences in workload between task difficulty levels, and both metrics increased as task level difficulty increased. The classification model using eye-tracking features achieved an accuracy of 84.7% in predicting workload levels. Conclusion Eye-tracking measures can detect perceived workload during robotic tasks. They can potentially be used to identify task contributors to high workload and provide measures for robotic surgery training. Application Workload assessment can be used for real-time monitoring of workload in robotic surgical training and provide assessments for performance and learning.

scholarly journals 1420 ViRtual prOficiency Based prOgression for Robotic Training (VROBOT): A Prospective Cohort Study Protocol

2021 ◽  
Vol 108 (Supplement_6) ◽  
Author(s):  
A Nathan ◽  
S Patel ◽  
M Georgi ◽  
K Hang ◽  
W Mullins ◽  
...  
Keyword(s):  
Robotic Surgery ◽  
Intervention Group ◽  
Skills Training ◽  
Virtual Classroom ◽  
Surgical Skills ◽  
Surgery Training ◽  
Surgical Trainees ◽  
Objective Performance ◽  
Robotic Skills ◽  
Robotic Surgery Training

Abstract Introduction Robotic surgery is an evolving field that requires specialist training. Historically, robotic surgery training has lacked standardisation. Recently, training centres have introduced proficiency-based modules and curriculums to certify and progress the skills of novice robotic surgeons. However, training tends to be self-directed and non-interactive. Limited interactive teaching does exist but can be inaccessible and expensive. We aim to validate the effectiveness of the current Fundamentals of Robotic Surgery (FRS) training curriculum with the addition of interactive virtual classroom teaching. Method 16 novice surgical trainees will be assigned to two training groups. The interventions will be implemented following a one-week robotic skills induction. Both groups will receive access to the FRS curriculum for one week. The intervention group will additionally receive virtual classroom robotic skills training. The primary outcome will be the objective performance scores after training using a synthetic model based on task errors, time taken and contact pressure. In week 3, each group will receive the alternate intervention and objective performance scores will be measured to determine the trajectory of scores. Results Significant objective performance improvement following the intervention will be indicative of intervention quality. Conclusions This will be the first feasibility study evaluating the efficacy of interactive virtual robotic surgery training. It will determine the effect size of virtual classroom training on the development of basic robotic surgical skills in addition to the proficiency-based FRS curriculum. The findings will assist the development and implementation of further resource-efficient virtual robotic surgical skills training programs.

scholarly journals Robotic surgery basic skills training: Evaluation of a pilot multidisciplinary simulation-based curriculum

2013 ◽  
Vol 7 (11-12) ◽  
pp. 430 ◽  
Author(s):  
Kirsten Foell ◽  
Antonio Finelli ◽  
Kazuhiro Yasufuku ◽  
Marcus Q. Bernardini ◽  
Thomas K Waddell ◽  
...  
Keyword(s):  
Robotic Surgery ◽  
Da Vinci ◽  
Basic Skills ◽  
Skills Training ◽  
Educational Process ◽  
Simulation Based ◽  
Robotic Skills ◽  
Competency Based ◽  
Multidisciplinary Simulation ◽  
The Impact

Purpose: Simulation-based training improves clinical skills, while minimizing the impact of the educational process on patient care. We present results of a pilot multidisciplinary, simulation-based robotic surgery basic skills training curriculum (BSTC) for robotic novices.Methods: A 4-week, simulation-based, robotic surgery BSTC was offered to the Departments of Surgery and Obstetrics & Gynecology (ObGyn) at the University of Toronto. The course consisted of various instructional strategies: didactic lecture, self-directed online training modules, introductory hands-on training with the da Vinci robot (dVR) (Intuitive Surgical Inc., Sunnyvale, CA), and dedicated training on the da Vinci Skills Simulator (Intuitive Surgical Inc., Sunnyvale, CA) (dVSS). A third of trainees participated in competency-based dVSS training, all others engaged in traditional time-based training. Pre- and post-course skill testing was conducted on the dVR using 2 standardized skill tasks: ring transfer (RT) and needle passing (NP). Retention of skills was assessed at 5 months post-BSTC.Results: A total of 37 participants completed training. The mean task completion time and number of errors improved significantly post-course on both RT (180.6 vs. 107.4 sec, p < 0.01 and 3.5 vs. 1.3 sec, p < 0.01, respectively) and NP (197.1 vs. 154.1 sec, p < 0.01 and 4.5 vs. 1.8 sec, p = 0.04, respectively) tasks. No significant difference in performance was seen between specialties. Competency-based training was associated with significantly better post-course performance. The dVSS demonstrated excellent face validity.Conclusions: The implementation of a pilot multidisciplinary, simulation-based robotic surgery BSTC revealed significantly improved basic robotic skills among novice trainees, regardless of specialty or level of training. Competency-based training was associated with significantly better acquisition of basic robotic skills.

Navigating the Pathway to Robotic Competency in General Thoracic Surgery

2013 ◽  
Vol 8 (3) ◽  
pp. 184-189 ◽  
Author(s):  
Christopher W. Seder ◽  
Stephen D. Cassivi ◽  
Dennis A. Wigle
Keyword(s):  
Robotic Surgery ◽  
Thoracic Surgery ◽  
Skill Acquisition ◽  
Perioperative Complications ◽  
Lung Resection ◽  
Perioperative Outcomes ◽  
Open Approach ◽  
Robot Assisted ◽  
Robotic Skills ◽  
Competency Based

Objective Although robotic technology has addressed many of the limitations of traditional videoscopic surgery, robotic surgery has not gained widespread acceptance in the general thoracic community. We report our initial robotic surgery experience and propose a structured, competency-based pathway for the development of robotic skills. Methods Between December 2008 and February 2012, a total of 79 robot-assisted pulmonary, mediastinal, benign esophageal, or diaphragmatic procedures were performed. Data on patient characteristics and perioperative outcomes were retrospectively collected and analyzed. During the study period, one surgeon and three residents participated in a triphasic, competency-based pathway designed to teach robotic skills. The pathway consisted of individual preclinical learning followed by mentored preclinical exercises and progressive clinical responsibility. Results The robot-assisted procedures performed included lung resection (n = 38), mediastinal mass resection (n = 19), hiatal or para-esophageal hernia repair (n = 12), and Heller myotomy (n = 7), among others (n = 3). There were no perioperative mortalities, with a 20% complication rate and a 3% readmission rate. Conversion to a thoracoscopic or open approach was required in eight pulmonary resections to facilitate dissection (six) or to control hemorrhage (two). Fewer major perioperative complications were observed in the later half of the experience. All residents who participated in the thoracic surgery robotic pathway perform robot-assisted procedures as part of their clinical practice. Conclusions Robot-assisted thoracic surgery can be safely learned when skill acquisition is guided by a structured, competency-based pathway.

An Improved Classification Model for Depression Detection Using EEG and Eye Tracking Data

2020 ◽  
Vol 19 (3) ◽  
pp. 527-537
Author(s):  
Jing Zhu ◽  
Zihan Wang ◽  
Tao Gong ◽  
Shuai Zeng ◽  
Xiaowei Li ◽  
...  
Keyword(s):  
Eye Tracking ◽  
Classification Model ◽  
Tracking Data ◽  
Depression Detection

Vigilance, Workload, and Boredom: Two Competing Models

2002 ◽  
Vol 46 (17) ◽  
pp. 1531-1535 ◽  
Author(s):  
Caroline R. Alikonis ◽  
Joel S. Warm ◽  
Gerald Matthews ◽  
William N. Dember ◽  
Edward M. Hitchcock ◽  
...  
Keyword(s):  
Information Processing ◽  
Beneficial Effect ◽  
Direct Cost ◽  
Task Engagement ◽  
Processing Load ◽  
High Workload ◽  
Perceived Workload ◽  
Competing Models ◽  
Musical Selection ◽  
High Information

Two models that seek to explain the high workload associated with vigilance tasks are the direct-cost and indirect-cost views. The former attributes the elevated workload to the high information-processing demand of the task; the latter attributes it to efforts to combat the boredom associated with monotonous vigilance tasks. A recent study by Hitchcock et al. (1999) provided support for the direct-cost view by showing that it is possible to lower the workload of vigilance through reductions in the information-processing load while leaving task-induced boredom unaffected. This study provides converging evidence for the direct-cost view: allowing observers to listen to a stress-reducing musical selection, Heart Zones, during a vigil lowered boredom while leaving the perceived workload of the task unaffected. The beneficial effect of the musical selection was limited to boredom; it had no impact upon post-vigil feelings of loss of task engagement and distress.

Can opioid vigilance and patient-centered care coexist? A qualitative study of communicative tensions encountered by surgical trainees

2020 ◽  
Vol 16 (2) ◽  
pp. 91-101
Author(s):  
Elizabeth Troutman Adams, MA ◽  
Elisia L. Cohen, PhD ◽  
Andrew Bernard, MD ◽  
Whittney H. Darnell, PhD ◽  
Douglas R. Oyler, PharmD
Keyword(s):  
Decision Making ◽  
Qualitative Study ◽  
Medical Profession ◽  
Descriptive Analysis ◽  
Skills Training ◽  
Patient Centered Care ◽  
Patient Centered ◽  
Opioid Prescribing ◽  
Surgical Trainees ◽  
Centered Care

Objective: The American health care system's adoption of the patient-centered care (PCC) model has transformed how medical providers communicate with patients about prescription pain medication. Concomitantly, the nation's opioid epidemic has necessitated a proactive response from the medical profession, requiring providers who frequently dispense opioids for acute pain to exercise vigilance in monitoring and limiting outpatient prescriptions. This qualitative study explores how surgical trainees balance PCC directives, including shared decision making, exchanging information with patients, and relationship maintenance, with opioid prescribing vigilance.Design: Investigators conducted interviews with 17 surgical residents and fellows (trainees) who routinely prescribe opioids at an academic medical center.Results: A qualitative descriptive analysis produced four codes, which were reduced to themes depicting problematic intersections between PCC imperatives and opioid vigilance during post-operative opioid-prescribing communication: (a) sharing the decision-making process contended with exerting medical authority, (b) reciprocating information contended with negotiating opioid prescribing terms with patients, (c) maintaining symbiotic relationships contended with prescribing ethics, and (d) achieving patient satisfaction contended with safeguarding opioid medications.Conclusion: Surgical training programs must supply trainees with post-surgical prescribing guidelines and communication skills training. Training should emphasize how PCC directives may work in tandem with--not in opposition to--opioid vigilance.

Influences of Task Management Strategy on Performance and Workload for Supervisory Control

2016 ◽  
Vol 60 (1) ◽  
pp. 856-860
Author(s):  
James R. Bowden ◽  
Christina F. Rusnock
Keyword(s):  
Dual Task ◽  
Supervisory Control ◽  
Management Strategy ◽  
Human Subjects ◽  
Management Strategies ◽  
Task Environment ◽  
Task Management ◽  
High Workload ◽  
Perceived Workload ◽  
Low Performance

Individual differences between task management strategies in a dual task environment – as a possible contributing factor to failures in supervisory control – have not been heavily researched. The purpose of this study was to identify strategies utilized by human subjects operating in a dual task environment to determine the effect of task management strategy on performance and workload outcomes. Participants monitored 8 remote processes while simultaneously executing a cognitively demanding secondary task. Researcher observation and participant feedback were used to identify specifically how tasks were managed. Four competing strategies were identified: Balanced Interleaving, Balanced Multitasking, Adaptive Attack, and Adaptive Avoidance. Findings revealed that the Adaptive Attack and Balanced Multitasking strategies demonstrated more advantageous outcomes toward performance while also resulting in lower participant perceived workload; Balanced Interleaving showed marginally higher performance, but high workload; and Adaptive Avoidance resulted in both low workload and low performance.

scholarly journals Effects of Workload and Workload Transitions on Attention Allocation in a Dual-Task Environment: Evidence From Eye Tracking Metrics

2020 ◽  
Vol 14 (2) ◽  
pp. 132-151
Author(s):  
Nadine Marie Moacdieh ◽  
Shannon P. Devlin ◽  
Hussein Jundi ◽  
Sara Lu Riggs
Keyword(s):  
Eye Tracking ◽  
Dual Task ◽  
Secondary Task ◽  
High Performance ◽  
Mental Workload ◽  
Attention Allocation ◽  
Task Load ◽  
Significant Difference ◽  
High Workload ◽  
And Control

High mental workload, in addition to changes in workload, can negatively affect operators, but it is not clear how sudden versus gradual workload transitions influence performance and visual attention allocation. This knowledge is important as sudden shifts in workload are common in multitasking domains. The objective of this study was to investigate, using performance and eye tracking metrics, how constant versus variable levels of workload affect operators in the context of a dual-task paradigm. An unmanned aerial vehicle command and control simulation varied task load between low, high, gradually transitioning from low to high, and suddenly transitioning from low to high. Performance on a primary and secondary task and several eye tracking measures were calculated. There was no significant difference between sudden and gradual workload transitions in terms of performance or attention allocation overall; however, both sudden and gradual workload transitions changed participants’ strategy in dealing with the primary and secondary task as compared to low/high workload. Also, eye tracking metrics that are not frequently used, such as transition rate and stationary entropy, provided more insight into performance differences. These metrics can potentially be used to better understand operators’ strategies and could form the basis of an adaptive display.

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