Developing a subjective instrument for laparoscopic surgical workload in a high fidelity simulator using the NASA-TLX and SURG-TLX

Abstract

The Surgery Task Load Index (SURG-TLX) and National Aeronautics and Space Administration Task Load Index (NASA-TLX) are subjective workload assessment instruments. These instruments have three coinciding workload dimensions, but each has three unique dimensions. Each dimension is explained by a unique descriptor. It was hypothesized that the SURG-TLX and NASA-TLX workload ratings would differ when assessing the same surgical methods and tasks. Accordingly, the aim of this study was to assess the SURG- and NASA-TLX dimensions toward the creation of a novel workload instrument to better predict simulated laparoscopic surgical workload. Twenty-five (25) participants were selected at a large, midwestern teaching hospital to conduct two simulated surgical tasks using four different laparoscopic methods. Each participant completed a total of eight trials and after each trial workload was assessed using both the NASA-TLX and SURG-TLX. The overall NASA-TLX dimensions were rated significantly higher (greater workload) compared to the overall SURG-TLX dimensions (F = 12.04, p = 0.001). Principle component analysis of workload dimensions suggests that a new surgical subjective workload measurement instrument should include the dimensions of Mental Demand, Physical Demand, Temporal Demand, Performance, Frustration and Situational Stress. However, validation of this novel tool is needed.

Keywords:

• Surgical workload instrument
• NASA-TLX
• SURG-TLX
• laparoscopic surgery

Disclosure statement

No potential conflict of interest was reported by the authors.

Additional information

Funding

This project was supported, in part, under grant number 1R36HS023146-01 from the Agency for Healthcare Research and Quality (AHRQ), U.S. Department of Health and Human Services (HHS). The authors are solely responsible for this document's contents, findings and conclusions, which do not necessarily represent the views of AHRQ. Readers should not interpret any statement in this report as an official position of AHRQ or of HHS. None of the authors has any affiliation or financial involvement that conflicts with the material presented in this report.