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Perceived surgeon workload of performing primary and revision total hip arthroplasty (THA) and total knee arthroplasty (TKA) is challenging to quantify. The National Aeronautics and Space Administration Task Load Index (NASA TLX) survey was developed to quantify experiences following aviation and has been applied to healthcare fields. Our purposes were to 1) quantify the workload endured by surgeons who are performing primary and revision TKA and THA and 2) compare these values to their Center for Medicare & Medicaid Services (CMS) reimbursement. A prospective cohort of 5 fellowship-trained adult reconstruction surgeons completed NASA TLX surveys following primary and revision TKA/THA cases. A total of 122 surveys consisting of 70 TKA (48 primaries and 22 revisions) and 55 THA surveys (38 primaries and 17 revisions) were completed. Patient demographics and surgical variables were recorded. Final NASA TLX workloads were compared to 2021 CMS work relative value units. Compared to primary TKA, revision TKA had 176% increased intraoperative workload (P <.001), 233% increased mental burden (P <.001), and 150% increased physical burden (P <.001). Compared to primary THA, revision THA had 106% increased intraoperative workload (P <.001), 96% increased mental burden (P <.001), and 91% increased physical burden (P <.001). Operative time was higher in revision versus primary TKA (118 versus 84.5 minutes, P =.05) and THA (150 versus 115 minutes, P =.001). Based upon 2021 CMS data, revision TKA and THA would need to be compensated by an additional 36% and 12.3%, respectively, to parallel intraoperative efforts. Revision hip and knee arthroplasty places a major mental and physical workload upon surgeons and is disproportionately compensated by CMS. [ABSTRACT FROM AUTHOR]

Game platforms have different impacts on player experience in terms of affective states and workloads. By studying these impacts, we can uncover detailed aspects of the gaming experience. Traditionally, understanding player experience has relied on subjective methods, such as self-reported surveys, where players reflect on their experience and effort levels. However, complementing these subjective measures with electroencephalogram (EEG) analysis introduces an objective approach to assessing player experience. In this study, we examined player experiences across PlayStation 5, Nintendo Switch, and Meta Quest 2. Using a mixed-methods approach, we merged subjective user assessments with EEG data to investigate brain activity, affective states, and workload during low- and high-stimulation games. We recruited 30 participants to play two games across three platforms. Our findings reveal that there is a statistically significant difference between these three platforms for seven out of nine experience factors. Also, three platforms have different impacts on play experience and brain activity. Additionally, we utilized a linear model to associate player experience aspects such arousal, frustration, and mental workload with different brain regions using EEG data. [ABSTRACT FROM AUTHOR]

The aim of the study was to explore the effect of perceived team workload on team performance among nuclear fire brigades of the Hungarian nuclear power plant. Our sample consisted of six firefighting teams (N = 42 individuals) who were involved in two high-fidelity simulated scenarios with different task complexity. Team workload was measured by the NASA Task Load Index, while team performance was evaluated by a team of experts. Our results showed that teams generally managed to maintain a standard performance in both cases, although they perceived there to be a higher workload during the complex scenario. Our results further revealed that perceived 'physical demand' and 'effort' factors contributed to the increased level of workload in the complex task. Finally, in the case of the simple simulated scenario, workload and team performance were not related to each other, while the two were positively correlated in the complex scenario. [ABSTRACT FROM AUTHOR]

Information technologies exist to enable us to either do things we have not done before or do familiar things more efficiently. Metaverse (i.e. extended reality: XR) enables novel forms of engrossing telepresence, but it also may make mundate tasks more effortless. Such technologies increasingly facilitate our work, education, healthcare, consumption and entertainment; however, at the same time, metaverse bring a host of challenges. Therefore, we pose the question whether XR technologies, specifically Augmented Reality (AR) and Virtual Reality (VR), either increase or decrease the difficulties of carrying out everyday tasks. In the current study we conducted a 2 (AR: with vs. without) × 2 (VR: with vs. without) between-subject experiment where participants faced a shopping-related task (including navigating, movement, hand-interaction, information processing, information searching, storing, decision making, and simple calculation) to examine a proposed series of hypotheses. The NASA Task Load Index (NASA-TLX) was used to measure subjective workload when using an XR-mediated information system including six sub-dimensions of frustration, performance, effort, physical, mental, and temporal demand. The findings indicate that AR was significantly associated with overall workload, especially mental demand and effort, while VR had no significant effect on any workload sub-dimensions. There was a significant interaction effect between AR and VR on physical demand, effort, and overall workload. The results imply that the resources and cost of operating XR-mediated realities are different and higher than physical reality. [ABSTRACT FROM AUTHOR]

Robotic-assisted procedures gain increasing acceptance for daily surgical routine. However, structured training programs are designed for surgeons with high expertise. Hence, a comprehensive training curriculum was established to ensure a basic competence in robotic abdominal surgery for young surgeons during their residency. The aim of the current work is to propose a feasible and effective training concept. The development process of this training curriculum is based on a comprehensive literature review which led to the concept of "robotic curriculum for young surgeons" (RoCS). It was implemented in the daily routine of a German university hospital starting in 2020. The robotic assessment questionnaire (RAQ) was used for electronic data collection. After the initial phase adjustments, it led to an improvement of the initial version of the curriculum. RoCS is a multimodal training program containing basic training through assistance at the operation table during robotic-assisted operations and basic console training. Key elements are the robotic team time-out (rTTO), perioperative process standardization including feasible personnel scheduling and useful procedure clustering into organ systems, procedural steps and procedural step complexity. Evaluation of standardized communication, performance assessment, patient factors and individual overall workload using NASA Task Load Index is realizable. Flexibility and adaptability to internal organization processes of surgical departments are the main advantages of the concept. RoCS is a strong training tool to meet the specific needs of young surgeons and evaluate their learning success of robotic procedural training. Furthermore, comparison within the different robotic systems should be considered. Further studies are needed to validate a multicenter concept design. [ABSTRACT FROM AUTHOR]

The cognitive demands associated with performing a task involve at least two dimensions: (1) the load dimension that is related to the assumed task difficulty and (2) the effort dimension that reflects the resources invested in a task. This study considers whether this distinction is actually relevant to translators and interpreters when they report load and effort and, if so, how the assumed psychological reality of these two dimensions is related to task performance. In this study, professional translators and interpreters performed naturalistic tasks with comparable stimuli, working from English into German. After each task, they were asked to rate their experienced load and effort as part of the NASA Task Load Index. Their performance was measured by analysing process and product indicators that correspond in interpreting and translation. Results indicate that while self-reported load and effort are highly correlated, their relationships to process or product measures appear to be more complex. [ABSTRACT FROM AUTHOR]

Background : Health care providers health and safety are crucial not only for continuous and safe patient care, but also for control of any pandemic. Aim/Objectives: Our study assessed the mental workload status of doctors who are catering to mainly industrial workforce.Methodology: A cross sectional study was carried out in a tertiary care hospital for three months during the pandemic. Data was collected and assessed using NASA TASK LOAD INDEX containing 6 dimensions, and stress levels were assessed using perceived stress scale. Results:A total of 104 participants responded to the survey; of which 40(38.5%)were female and 64(61.5%) were male. The percentage of people with high mental demand were 68(65.4%), the overall major contributor to this high workload seen in the participants was Effort demand . The participants with higher levels of workload were 90(86.5%). Among them females were 37.8 % and males were 62.2 %. The perceived stress scale showed 2(1.9%) of participants were in low stress, 80(76.9%) were in moderate stress and 22(21.2%) were in high stress. The calculated overall workload mean scores was 66.23+15.383 and perceived stress was 22.01+5.55 which is positively correlated and statistically significant. Conclusions:A considerate proportion of doctors experience high workload and stress levels. Doctors being Frontline workers were more vulnerable for mental health problems which are still underreported and is expected to be very considerate. There is a need to implant ways to decrease the stress levels of doctors and for better patient care. [ABSTRACT FROM AUTHOR]

Background: Guidelines recommend that relatives be present during cardiopulmonary resuscitation (CPR). This randomised trial investigated the effects of two different behaviour patterns of relatives on rescuers' perceived stress and quality of CPR. Material and methods: Teams of three to four physicians were randomised to perform CPR in the presence of no relatives (control group), a withdrawn relative, or an agitated relative, played by actors according to a scripted role, and to three different models of leadership (randomly determined by the team or tutor or left open). The scenarios were video-recorded. Hands-on time was primary, and the secondary outcomes comprised compliance to CPR algorithms, perceived workload, and the influence of leadership. Results: 1229 physicians randomised to 366 teams took part. The presence of a relative did not affect hands-on time (91% [87–93] vs. 92% [88–94] for "withdrawn" and 92 [88–93] for "agitated" relatives; p = 0.15). The teams interacted significantly less with a "withdrawn" than with an "agitated" relative (11 [7–16]% vs. 23 [15–30]% of the time spent for resuscitation, p < 0.01). The teams confronted with an "agitated" relative showed more unsafe defibrillations, higher ventilation rates, and a delay in starting CPR (all p < 0.05 vs. control). The presence of a relative increased frustration, effort, and perceived temporal demands (all <0.05 compared to control); in addition, an "agitated" relative increased mental demands and total task load (both p < 0.05 compared to "withdrawn" and control group). The type of leadership condition did not show any effects. Conclusions: Interaction with a relative accounted for up to 25% of resuscitation time. Whereas the presence of a relative per se increased the task load in different domains, only the presence of an "agitated" relative had a marginal detrimental effect on CPR quality (GERMAN study registers number DRKS00024761). [ABSTRACT FROM AUTHOR]

Whilst increasing mental workload has been shown to have a detrimental effect on cycling performance and more generally to increase the risk of harm, no studies have measured how mental workload changes as a function of ultra-distance cycling, indoors or outdoors. Our objective was to measure the difference in mental workload, as indicated by changes in EEG theta power, components of HRV and psychomotor vigilance and as reported using the 'NASA Task Load Index questionnaire', before and after a 5 h indoor ride and outdoor ride completed at 65% of functional threshold power. Results of the NASA-TLX indicated the mental demand of outdoor cycling to be significantly less than that of indoor cycling. There were significant differences in the PVT results between the pre and the post outdoor ride average and median response times. The slowest 10% PVT responses were significantly slower pre than post the indoor ride. There were significant differences in HRV between pre and post outdoor and indoor rides, specifically, in the average RR intervals, RMSSD (ms2), LFPower (ms2), NN50. There were modest changes in indicators of mental workload during an ultra-distance cycle ride. As such, mental workload during ultra-distance cycling is unlikely to be a contributory factor to decreases in performance or to an increased likelihood of accident and injury. [ABSTRACT FROM AUTHOR]

Studies on the effect of music on task performance are contradictory about this relationship's direction and valence. Task characteristics may be accounting for these inconclusive findings. Thus, this study employs effort to mediate music's effect on task performance (objective and perceived) under a stressful decision-making process. This is a between-group experiment with three conditions: slow-tempo music, fast-tempo music, or no music. We designed a computer web interface, where participants did a stressful task. Results demonstrated that participants made a strong effort under the conditions with music. Hence, turning the music off under stressful activities is favorable in terms of performance. The article contributes to understanding the interaction between music and task performance, expanding the discussion within a stressful task. [ABSTRACT FROM AUTHOR]

ObjectiveThe three-dimensional (3D) exoscope is a novel apparatus introduced in recent years. Although an operating microscope (OM) is customarily used, this novel application offers several advantages. Therefore, this study aimed to determine the feasibility of deploying a robotic-guided 3D-exoscope for microneurosurgery and gauge its subsequent performance.MethodsThe use of a 3D exoscope was compared with that of OM during 16 surgical procedures. Postoperatively, surgeons completed an eight-item Likert-scale satisfaction survey. As a second step, a predefined surgical task was then undertaken by surgeons with varying levels of experience, assessing the time entailed. Two questionnaires, the satisfaction survey and NASA task load index (NASA-TLX), were administered.ResultsDuring routine procedures, the exoscope proved superior in magnification and ergonomic maintenance, showing inferior image contrast, quality, and illumination. It again ranked higher in magnification and ergonomic maintenance during the suturing task, and the OM excelled in treatment satisfaction and stereoscopic orientation. Workload assessment using the NASA-TLX revealed no difference by modality in the pairwise analysis of all components. At varying levels of experience, beginners bear a significantly higher burden in all principle components than mid-level and expert participants (p = 0.0018). Completion times for the suturing task did not differ (p = 0.22).ConclusionThe quality of visualization by 3D exoscope seems adequate for treatment and its ergonomic benefit is superior to that of OM. Although experienced surgeons performed a surgical simulation faster under the OM, no difference was evident in NASA-TLX surveys. The 3D exoscope is an excellent alternative to the OM.

Stephan Hess,1 Martin Dubach,2 Mirko Meboldt,1 Lukas Foggensteiner3 1Swiss Federal Institute of Technology in Zurich (ETH Zurich), Zurich, Switzerland; 2Peripal AG; 3University Hospitals Birmingham NHS Foundation Trust, Birmingham, United KingdomCorrespondence: Stephan HessSwiss Federal Institute of Technology in Zurich (ETH Zurich), Leonhardstrasse 21, Zurich CH 8092, SwitzerlandTel +41 44 632 48 62Email stehess@ethz.chIntroduction: It is estimated that there are currently over 3 million patients receiving dialysis treatment worldwide. With effective pre-dialysis counselling, a majority of patients choose the home-based therapy peritoneal dialysis (PD) but only approximately 11% of prevalent dialysis patients use this modality. Connection-assist devices can overcome the challenges posed by decreased manual dexterity and/or visual acuity, and can allow more patients to be treated with home-based therapies. As part of the CE marking authorization, a connection device has been evaluated for safety and ease of use in a usability study.Methods: Fifteen patients and nine carers volunteered in this study, ranging from 23 to 86 years in age and from 0.3 to 24 years in experience in the PD therapy. The operating cycle consisted of eight tasks, each having several handling steps. The data analysis focused on the task effectiveness and the subjects’ subjective feedback from the NASA task load index (N-TLX) questionnaire and semi-structured interviews.Results: Of 1248 handling steps performed in total, 38 use errors were observed and discussed with the subjects. This equates to 97% of all handling steps being performed safely and easily. In all six dimensions of the N-TLX, more than 50 percent of subjects rated the task load 50 points or less on the scale. Regarding the handling of the device, 13 of 15 of the patients and 8 of 9 of the carers gave positive feedback.Discussion: Safety and ease of use was demonstrated by evaluating task effectiveness (97% SU), interviews and N-TLX. Additionally the study provided valuable individual user feedback, which will inform the final design of the system for PD. The majority of patients and carers gave positive feedback regarding use and handling of this connection device. Innovative connection devices in general promise to reduce the barriers to using this home-based dialysis treatment.Keywords: patient safety, usability study, ease of use, connection-assist device, peritoneal dialysis, NASA Task Load Index

Optimizing a display interface design for rollers is the focus of this study, in which the effects of cognitive load of the operator are taken into consideration, which greatly contribute to acquiring interface information accurately and enhancing cognitive efficiency. To reduce the cognitive demand of the operator, a commonly used generic display interface is modified in this study. Three methods are used to measure the cognitive load, including subjective (NASA Task Load Index) and physiological (eye movement) measurements and through task performance. These three measurements are used with two groups of subjects: those who view the original and those who are given the modified version during four given tasks. The findings show that the modified interface has a significant impact on eye movement and completion time of the four tasks. After a comprehensive analysis of the results from the three types of measurement, it is found that the modified interface is less cognitively demanding than the original interface and allows a higher cognitive performance, which accordingly demonstrates that the modifications made are effective in reducing cognitive load. This study therefore provides the scientific basis for advancing interface designs and evaluating the display interface designs for engineering equipment. [ABSTRACT FROM AUTHOR]

Background: Guidelines recommend that relatives be present during cardiopulmonary resuscitation (CPR). This randomised trial investigated the effects of two different behaviour patterns of relatives on rescuers’ perceived stress and quality of CPR. Material and methods: Teams of three to four physicians were randomised to perform CPR in the presence of no relatives (control group), a withdrawn relative, or an agitated relative, played by actors according to a scripted role, and to three different models of leadership (randomly determined by the team or tutor or left open). The scenarios were video-recorded. Hands-on time was primary, and the secondary outcomes comprised compliance to CPR algorithms, perceived workload, and the influence of leadership. Results: 1229 physicians randomised to 366 teams took part. The presence of a relative did not affect hands-on time (91% [87–93] vs. 92% [88–94] for “withdrawn” and 92 [88–93] for “agitated” relatives; p = 0.15). The teams interacted significantly less with a “withdrawn” than with an “agitated” relative (11 [7–16]% vs. 23 [15–30]% of the time spent for resuscitation, p < 0.01). The teams confronted with an “agitated” relative showed more unsafe defibrillations, higher ventilation rates, and a delay in starting CPR (all p < 0.05 vs. control). The presence of a relative increased frustration, effort, and perceived temporal demands (all p < 0.05 compared to “withdrawn” and control group). The type of leadership condition did not show any effects. Conclusions: Interaction with a relative accounted for up to 25% of resuscitation time. Whereas the presence of a relative per se increased the task load in different domains, only the presence of an “agitated” relative had a marginal detrimental effect on CPR quality (GERMAN study registers number DRKS00024761).

Whilst increasing mental workload has been shown to have a detrimental effect on cycling performance and more generally to increase the risk of harm, no studies have measured how mental workload changes as a function of ultra-distance cycling, indoors or outdoors. Our objective was to measure the difference in mental workload, as indicated by changes in EEG theta power, components of HRV and psychomotor vigilance and as reported using the ‘NASA Task Load Index questionnaire’, before and after a 5 h indoor ride and outdoor ride completed at 65% of functional threshold power. Results of the NASA-TLX indicated the mental demand of outdoor cycling to be significantly less than that of indoor cycling. There were significant differences in the PVT results between the pre and the post outdoor ride average and median response times. The slowest 10% PVT responses were significantly slower pre than post the indoor ride. There were significant differences in HRV between pre and post outdoor and indoor rides, specifically, in the average RR intervals, RMSSD (ms2), LFPower (ms2), NN50. There were modest changes in indicators of mental workload during an ultra-distance cycle ride. As such, mental workload during ultra-distance cycling is unlikely to be a contributory factor to decreases in performance or to an increased likelihood of accident and injury.

Purpose. The aim of this study was to investigate musculoskeletal disorders (MSDs) and associated factors among Iranian office personnel. Materials and methods. In this cross-sectional study, 359 Iranian office workers were included. Data were gathered using a demographic questionnaire, the Nordic musculoskeletal questionnaire, the numeric rating scale, rapid office strain assessment (ROSA) and the NASA task load index (NASA-TLX). Results. Our findings showed that the highest prevalence rate of MSDs within the last 12 months and the highest pain/discomfort severity were related to the participants' necks. The mean performance, mental demand and effort subscale scores of the NASA-TLX were higher than other subscales (physical demand, temporal demand and frustration level). ROSA scores showed that 53.8% of the participants were in action level 1 (low MSD risk) and the rest (46.2%) were in action level 2 (high MSD risk). The pain/discomfort severity in the shoulders, elbows, wrists/hands, thighs and ankles/feet was correlated to the final ROSA score. Age, gender, body mass index and some NASA-TLX subscales (effort, mental demand and performance) were associated with symptoms of MSDs in different body regions. Conclusions. Improving workplace conditions (both mentally and physically) is suggested for reducing and eliminating musculoskeletal problems among office workers. [ABSTRACT FROM AUTHOR]

BACKGROUND: Administrative staff may be exposed to a great deal of the mental workload (MWL) due to the long working hours and the responsibility of responding to large numbers of clients. Occupational burnout (OB) is one of the issues that can be affected by MWL. The aim of the present study was to investigate the relationship between mental MWL and OB, as well as the internal interactions between OB dimensions. MATERIALS AND METHODS: This cross-sectional and descriptive (correlation) study was conducted among faculty members and administrative staff of public health school of Yazd province. Samples were collected through the simple random sampling. NASA task load index and Maslach questionnaire were used for the assessment of MWL and OB, respectively. Frequency and percentage were used for the descriptive analysis. Spearman, Mann–Whitney U, and Kruskal–Wallis H tests were used for inferential statistics. RESULTS: Ultimately, 29 individuals from faculty members and 82 individuals from administrative staff participated in this study. Most of the participants (73.9%) had experienced many MWL instances in performing their jobs duties. No significant relationship between MWL with OB and MWL with any of the demographic characteristics was found, as well (P > 0.05). In case of OB, a significant relationship was discovered between depersonalization with gender and personal accomplishment with work section (P < 0.05). CONCLUSIONS: MWL cannot be considered as a contributing factor of OB of the administrative staff because no significant relationship has been noted between them. Reducing working hours, selection of suitable staff, and allowing a few minutes to rest on a daily basis represent the suggested solutions for reducing the MWL of staff.

Concept maps, which are graphical tools for organizing and connecting knowledge, hold promise for supporting students across disciplines in exercising systems thinking while tackling sustainability issues. We conducted a study to quantify cognitive load and performance (as an indicator of cognitive flexibility) among undergraduate students (N = 25) when engaging in sustainability concept mapping, as compared to simple listing tasks. Participants created two concept maps and two lists, engaging with four sustainability topics: water availability, climate change, food security, and renewable energy. During tasks, perceived and neurological cognitive load were assessed using the NASA Task Load Index (TLX) and a B-Alert X10 electroencephalogram (EEG), respectively. Concept mapping performance was quantified using established Traditional and Categorical Methods. Participants experienced higher perceived load (p < 0.001) and similar neurological load (p = 0.291) during concept mapping, as compared to listing. Higher neurological load during concept mapping was associated only with lower effort (ρ = −0.416, p < 0.01). Concept maps demonstrating greater breadth and connectedness of knowledge were associated with lower perceived total workload (ρ = −0.354, p < 0.05). Also, no concept map performance metric was associated with increased neurological load (p > 0.05). As such, we propose that concept maps may indeed be a uniquely-suited tool for helping students mediate cognitive load during systems thinking, thereby supporting educators in furthering education for sustainable development. [ABSTRACT FROM AUTHOR]

BACKGROUND: In a traditional endotracheal tube (ETT), there is a linear outward pull through its attachment to the ventilator tubing that leads to risk of accidental dislodgement. This study was conducted to assess the ETT flow characteristics and to evaluate providers' intubation experience using two ETT's in a simulated setting. METHODS: Respiratory pressure-volume dynamics for the 2 ETTs were studied in a simulation laboratory by using 3 different flow settings and 2 different test lungs. The time taken for successful intubation on a mannikin was compared by direct observation of 33 separate intubation attempts by 11 different providers. Comfort with intubation by using both tubes was assessed with a Likert scale-based survey. The potential increase in physical and cognitive work load of nurses and respiratory therapists was assessed by the NASA task load index. RESULTS: There were slightly lower average tidal volumes delivered with SecureTube compared with the standard tube at different peak inspiratory pressures. Similarly, the same tidal volume delivered with a different flow and bag compliance required slightly higher peak inspiratory pressure compared with the standard ETT. Among providers, there was no difference in the average time to intubate when using either tube. All survey respondents (N = 11) rated intubation attempts with the SecureTube to be very easy compared with the standard tube. The NASA task load index (N = 26) showed very low task loads on all the tasks. CONCLUSIONS: There was minimal impact on flow resistance on pressure or volume with the SecureTube compared with the standard tube. Most providers felt comfortable intubating with the SecureTube and took a comparable amount of time to intubate in a simulated setting. We observed low task load scores for securement, maintenance, and manipulation per nurses and respiratory therapists. [ABSTRACT FROM AUTHOR]

Background: Neonatal nurse practitioner (NNP) workload is not well studied, and metrics specific to NNP practice are lacking. Factors such as changes in resident duty hours, increasing neonatal intensive care unit admissions, and a shortage of NNPs contribute to NNP workload. Increased workload has been shown to be detrimental to providers and can affect quality of care.Purpose: This study quantified NNP workload using a subjective workload metric, the NASA Task Load Index, and a newly developed objective workload metric specific to NNP practice.Methods: The NNP group at a level IV academic medical center was studied. The sample included 22 NNPs and 47 workload experiences.Results: A comparison of scores from the NASA Task Load Index and objective workload metric showed a moderate correlation (r = 0.503). Mental demand workload scores had the highest contribution to workload. Feelings of frustration also contributed to workload.Implications For Practice: The NASA Task Load Index can be utilized to measure the workload of NNPs. The objective workload metric has potential to quantify NNP workload pending further validation studies and is a simple, straightforward tool.Implications For Research: Additional research is needed regarding NNP workload and methods to quantify workload. Larger studies are needed to validate the objective workload metric. [ABSTRACT FROM AUTHOR]

Objective: We examined the effects of spatial uncertainty, field dependence/independence (FD/I), and sex on vigilance performance and perceived workload in elementary school children.Background: Building on previous work in which children demonstrated their ability to evaluate workload, we tested whether spatial-uncertainty manipulations in a vigilance task would elicit in children the same deleterious effects on performance and workload as it does with adults. We also examined individual difference effects associated with FD/I and sex to determine their influence on both performance and workload.Method: In the low-uncertainty task, stimuli appeared in the center of the computer screen; in the high-uncertainty task, they appeared in one of the four quadrants of the screen. Neutral events consisted of uppercase letter strings. Critical signals consisted of a single lowercase letter among uppercase letters. Following each vigil, children completed a workload assessment via a modified version of the NASA Task Load Index.Results: Children showed lower perceptual sensitivity, greater response latency variability (RTSD), and a higher response criterion in the uncertain display condition. Workload scores reflected these performance differences. Field-dependent children showed lower perceptual sensitivity and greater RTSD than did field-independent children. The two groups exhibited differing workload profiles. Despite no objective performance differences, boys reported greater workload than girls.Conclusion: The scale demonstrated sensitivity and diagnosticity with regard to both the task variable and individual differences.Application: These findings contribute to the emerging field of "educational ergonomics" and indicate that appropriate assessment tools might identify children who are experiencing increased workload. [ABSTRACT FROM AUTHOR]

In pursuit of improving the quality of residents' education, the Southeastern Section of the American Urological Association (SES AUA) hosts an annual robotic training course for its residents. The workshop involves performing a robotic live porcine nephrectomy as well as virtual reality robotic training modules. The aim of this study was to evaluate workload levels of urology residents when performing a live porcine nephrectomy and the virtual reality robotic surgery training modules employed during this workshop. Twenty-one residents from 14 SES AUA programs participated in 2015. On the first-day residents were taught with didactic lectures by faculty. On the second day, trainees were divided into two groups. Half were asked to perform training modules of the Mimic da Vinci-Trainer (MdVT, Mimic Technologies, Inc., Seattle, WA, USA) for 4 h, while the other half performed nephrectomy procedures on a live porcine model using the da Vinci Si robot (Intuitive Surgical Inc., Sunnyvale, CA, USA). After the first 4 h the groups changed places for another 4-h session. All trainees were asked to complete the NASA-TLX 1-page questionnaire following both the MdVT simulation and live animal model sessions. A significant interface and TLX interaction was observed. The interface by TLX interaction was further analyzed to determine whether the scores of each of the six TLX scales varied across the two interfaces. The means of the TLX scores observed at the two interfaces were similar. The only significant difference was observed for frustration, which was significantly higher at the simulation than the animal model, t (20) = 4.12, p = 0.001. This could be due to trainees' familiarity with live anatomical structures over skill set simulations which remain a real challenge to novice surgeons. Another reason might be that the simulator provides performance metrics for specific performance traits as well as composite scores for entire exercises. Novice trainees experienced substantial mental workload while performing tasks on both the simulator and the live animal model during the robotics course. The NASA-TLX profiles demonstrated that the live animal model and the MdVT were similar in difficulty, as indicated by their comparable workload profiles. [ABSTRACT FROM AUTHOR]

Background: Distractions are recognized as a significant factor affecting performance in safety critical domains. Although operating rooms are generally full of distractions, the effect of distractions on robot-assisted surgical (RAS) performance is unclear. Our aim was to investigate the effect of distractions on RAS performance using both objective and subjective measures.Methods: Fifteen participants performed a knot-tying task using the da Vinci Surgical System and were exposed to 3 distractions: (1) passive distraction entailed listening to noise with a constant heart rate, (2) active distraction included listening to noise and acknowledging a change of random heart rate from 60 to 120 bpm, and (3) interactive distraction consisted of answering math questions. The objective kinematics of the surgical instrument tips were used to evaluate performance. Electromyography (EMG) of the forearm and hand muscles of the participants were collected. The median EMG frequency (EMG(fmed)) and the EMG envelope (EMG(env)) were analyzed. NASA Task Load Index and Fundamentals of Laparoscopic Surgery score were used to evaluate the subjective performance. One-way repeated analysis of variance was applied to examine the effects of distraction on skills performance. Spearman's correlations were conducted to compare objective and subjective measures.Results: Significant distraction effect was found for all objective kinematics measures (P < .05). There were significant distraction effects for EMG measures (EMG(env), P < .004; EMG(fmed), P = .031). Significant distraction effects were also found for subjective measurements.Conclusions: Distraction impairs surgical skills performance and increases muscle work. Understanding how the surgeons cope with distractions is important in developing surgical education. [ABSTRACT FROM AUTHOR]

Background: Working in the operating room is characterized by high demands and overall workload of the surgical team. Surgeons often report that they feel more stressed when operating as a primary surgeon than in the function as an assistant which has been confirmed in recent studies. In this study, intra-individual workload was assessed in both intraoperative functions using a multidimensional approach that combined objective and subjective measures in a realistic work setting. Methods: Surgeons' intraoperative psychophysiologic workload was assessed through a mobile health system. 25 surgeons agreed to take part in the 24-hour monitoring by giving their written informed consent. The mobile health system contained a sensor electronic module integrated in a chest belt and measuring physiological parameters such as heart rate (HR), breathing rate (BR), and skin temperature. Subjective workload was assessed pre- and postoperatively using an electronic version of the NASA-TLX on a smartphone. The smartphone served as a communication unit and transferred objective and subjective measures to a communication server where data were stored and analyzed. Results: Working as a primary surgeon did not result in higher workload. Neither NASA-TLX ratings nor physiological workload indicators were related to intraoperative function. In contrast, length of surgeries had a significant impact on intraoperative physical demands ( p < 0.05; η = 0.283), temporal demands ( p < 0.05; η = 0.260), effort ( p < 0.05; η = 0.287), and NASA-TLX sum score ( p < 0.01; η = 0.287). Conclusions: Intra-individual workload differences do not relate to intraoperative role of surgeons when length of surgery is considered as covariate. An intelligent operating management that considers the length of surgeries by implementing short breaks could contribute to the optimization of intraoperative workload and the preservation of surgeons' health, respectively. The value of mobile health systems for continuous psychophysiologic workload assessment was shown. [ABSTRACT FROM AUTHOR]

Adaptive cruise control (ACC), a driver assistance system that controls longitudinal motion, has been introduced in consumer cars in 1995. A next milestone is highly automated driving (HAD), a system that automates both longitudinal and lateral motion. We investigated the effects of ACC and HAD on drivers’ workload and situation awareness through a meta-analysis and narrative review of simulator and on-road studies. Based on a total of 32 studies, the unweighted mean self-reported workload was 43.5% for manual driving, 38.6% for ACC driving, and 22.7% for HAD (0% = minimum, 100 = maximum on the NASA Task Load Index or Rating Scale Mental Effort). Based on 12 studies, the number of tasks completed on an in-vehicle display relative to manual driving (100%) was 112% for ACC and 261% for HAD. Drivers of a highly automated car, and to a lesser extent ACC drivers, are likely to pick up tasks that are unrelated to driving. Both ACC and HAD can result in improved situation awareness compared to manual driving if drivers are motivated or instructed to detect objects in the environment. However, if drivers are engaged in non-driving tasks, situation awareness deteriorates for ACC and HAD compared to manual driving. The results of this review are consistent with the hypothesis that, from a Human Factors perspective, HAD is markedly different from ACC driving, because the driver of a highly automated car has the possibility, for better or worse, to divert attention to secondary tasks, whereas an ACC driver still has to attend to the roadway. [ABSTRACT FROM AUTHOR]

Objective: The aim of this study was to compare the effectiveness of a new index of perceived mental workload, the Multiple Resource Questionnaire (MRQ), with the standard measure of workload used in the study of vigilance, the NASA Task Load Index (NASA-TLX). Background: The NASA-TLX has been used extensively to demonstrate that vigilance tasks impose a high level of workload on observers. However, this instrument does not specify the information-processing resources needed for task performance. The MRQ offers a tool to measure the workload associated with vigilance assignments in which such resources can be identified. Method: Two experiments were performed in which factors known to influence task demand were varied. Included were the detection of stimulus presence or absence, detecting critical signals by means of successive-type (absolute judgment) and simultaneous-type (comparative judgment) discriminations, and operating under multitask vs. single-task conditions. Results: The MRQ paralleled the NASA-TLX in showing that vigilance tasks generally induce high levels of workload and that workload scores are greater in detecting stimulus absence than presence and in making successive as compared to simultaneous- type discriminations. Additionally, the MRQ was more effective than the NASA-TLX in reflecting higher workload in the context of multitask than in single-task conditions. The resource profiles obtained with MRQ fit well with the nature of the vigilance tasks employed, testifying to the scale’s content validity. Conclusion: The MRQ may be a meaningful addition to the NASA-TLX for measuring the workload of vigilance assignments. Application: By uncovering knowledge representation associated with different tasks, the MRQ may aid in designing operational vigilance displays. [ABSTRACT FROM AUTHOR]

With nearly 60% of domestic energy consumption relating to space heating, the interaction between users and their heating controls is crucial in reducing consumption. Yet, many heating controls are complex and exclude people due to the demands placed upon their capabilities in terms of vision, reach, dexterity and thinking. This study explores the scale of and reasons for user exclusion in relation to digital programmable thermostats. The Exclusion Calculator was used to estimate the percentage of the population excluded from the use of three products. Full user testing was then conducted to elicit specific usability problems of the devices. The participants were a group of 14 younger users (aged 24–44) and 10 older users (aged 62–75). The exclusion calculations underestimated the actual exclusion significantly for both age ranges (p<0.05). None of the older users were able to complete the programming of the thermostats. Additionally, the cognitive demands of these systems were considered using a subjective workload assessment method, based on the NASA Task Load Index, and were found to be excessive. In conclusion, this study makes recommendations to facilitate the design of more inclusive digital programmable thermostats. It is argued that such changes could result in reductions in domestic heat energy consumption. [ABSTRACT FROM AUTHOR]

The objective of this work is to demonstrate the utility of the National Aeronautics and Space Administration-Task Load Index (NASA-TLX) as a metric for collecting workload data in human systems technologies. Past work has demonstrated that the NASA-TLX is a useful measure for assessing subjective workload data with robot operators. In the current experiment, participants completed a battery of spatial ability measures. They then completed four test conditions under which they operated a robot through low- and high-difficulty courses, under direct line of sight and tele-operation. Prior to and after each of these four conditions, participants completed a computerized version of the NASA-TLX Performance was determined by examining course completion time, the total number of collisions made during operation, and, in some instances, the accumulation of points achieved by stacking cylinders with a gripper arm. Analysis of the NASA-TLX data confirmed a difference in subjective workload between high- and low-difficulty course conditions. In addition, higher aggregate spatial ability was correlated with superior operator performance under each of the experimental conditions. The NASA-TLX is a valuable tool that can be used in many research environments to assess subjective workload data. Furthermore, better understanding of the relationship between spatial abilities and robot operation can assist in the selection and training of future operators, as well as in the design of superior human system technologies. [ABSTRACT FROM AUTHOR]

This paper presents results from a user evaluation of a real multiple robot system in which the human's perceived workload and performance were measured. Participants completed tasks with one, two and four real heterogeneous mobile ground-based robots for indoor material transportation tasks. Twelve participants completed four trials of each task over two days. Generally speaking, little difference was found between the one- and two-robot tasks; however, perceived workload significantly increased while performance decreased during the four-robot task. A correlation analysis found that perceived workload increased as the number of commands (in total and by command type) and completion times increased. The highest number of accidents and user errors occurred during the four-robot task. In order to increase the number of robots a single human can supervise, the human must be provided with capabilities that reduce the number of required commands while also optimising the human's interactions with the robots. [ABSTRACT FROM AUTHOR]

This study investigated the effects of target size and error rate on cognitive demand during augmented reality (AR) interactions. In a repeated-measures laboratory study, twenty participants performed two AR tasks (omni-directional pointing and cube placing) with different target sizes and error rates. During the AR tasks, we measured cerebral oxygenation using functional near-infrared spectroscopy (fNIRS), perceived workload using the NASA-TLX questionnaire, stress using the Short Stress State Questionnaire, and task performance (task completion time). The results showed that the AR tasks with more interaction errors increased cerebral oxygenation, perceived workload, and task completion time while the target size significantly affected physical demand and task completion time. These results suggest that appropriate target sizes and low system errors may reduce potential cognitive demand in AR interactions. [ABSTRACT FROM AUTHOR]

Objective: The three-dimensional (3D) exoscope is a novel apparatus introduced in recent years. Although an operating microscope (OM) is customarily used, this novel application offers several advantages. Therefore, this study aimed to determine the feasibility of deploying a robotic-guided 3D-exoscope for microneurosurgery and gauge its subsequent performance., Methods: The use of a 3D exoscope was compared with that of OM during 16 surgical procedures. Postoperatively, surgeons completed an eight-item Likert-scale satisfaction survey. As a second step, a predefined surgical task was then undertaken by surgeons with varying levels of experience, assessing the time entailed. Two questionnaires, the satisfaction survey and NASA task load index (NASA-TLX), were administered., Results: During routine procedures, the exoscope proved superior in magnification and ergonomic maintenance, showing inferior image contrast, quality, and illumination. It again ranked higher in magnification and ergonomic maintenance during the suturing task, and the OM excelled in treatment satisfaction and stereoscopic orientation. Workload assessment using the NASA-TLX revealed no difference by modality in the pairwise analysis of all components. At varying levels of experience, beginners bear a significantly higher burden in all principle components than mid-level and expert participants ( p = 0.0018). Completion times for the suturing task did not differ ( p = 0.22)., Conclusion: The quality of visualization by 3D exoscope seems adequate for treatment and its ergonomic benefit is superior to that of OM. Although experienced surgeons performed a surgical simulation faster under the OM, no difference was evident in NASA-TLX surveys. The 3D exoscope is an excellent alternative to the OM., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2022 Keric, Krenzlin, Kurz, Wesp, Kalasauskas and Ringel.)

Background: Administrative staff may be exposed to a great deal of the mental workload (MWL) due to the long working hours and the responsibility of responding to large numbers of clients. Occupational burnout (OB) is one of the issues that can be affected by MWL. The aim of the present study was to investigate the relationship between mental MWL and OB, as well as the internal interactions between OB dimensions., Materials and Methods: This cross-sectional and descriptive (correlation) study was conducted among faculty members and administrative staff of public health school of Yazd province. Samples were collected through the simple random sampling. NASA task load index and Maslach questionnaire were used for the assessment of MWL and OB, respectively. Frequency and percentage were used for the descriptive analysis. Spearman, Mann-Whitney U, and Kruskal-Wallis H tests were used for inferential statistics., Results: Ultimately, 29 individuals from faculty members and 82 individuals from administrative staff participated in this study. Most of the participants (73.9%) had experienced many MWL instances in performing their jobs duties. No significant relationship between MWL with OB and MWL with any of the demographic characteristics was found, as well ( P > 0.05). In case of OB, a significant relationship was discovered between depersonalization with gender and personal accomplishment with work section ( P < 0.05)., Conclusions: MWL cannot be considered as a contributing factor of OB of the administrative staff because no significant relationship has been noted between them. Reducing working hours, selection of suitable staff, and allowing a few minutes to rest on a daily basis represent the suggested solutions for reducing the MWL of staff., Competing Interests: There are no conflicts of interest., (Copyright: © 2021 Journal of Education and Health Promotion.)

Background: Electronic health record (EHR) usability and physician task load both contribute to physician professional burnout. The association between perceived EHR usability and workload has not previously been studied at a national level. Better understanding these interactions could give further information as to the drivers of extraneous task load.Objective: This study aimed to determine the relationship between physician-perceived EHR usability and workload by specialty and evaluate for associations with professional burnout.Methods: A secondary analysis of a cross-sectional survey of US physicians from all specialties was conducted from October 2017 to March 2018. Among the 1250 physicians invited to respond to the subsurvey analyzed here, 848 (67.8%) completed it. EHR usability was assessed with the System Usability Scale (SUS; range: 0-100). Provider task load (PTL) was assessed using the mental demand, physical demand, temporal demand, and effort required subscales of the National Aeronautics and Space Administration Task Load Index (range: 0-400). Burnout was measured using the Maslach Burnout Inventory.Results: The mean scores were 46.1 (SD 22.1) for SUS and 262.5 (SD 71.7) for PTL. On multivariable analysis adjusting for age, gender, relationship status, medical specialty, practice setting, hours worked per week, and number of nights on call per week, physician-rated EHR usability was associated with PTL, with each 1-point increase in SUS score (indicating more favorable) associated with a 0.57-point decrease in PTL score (P<.001). On mediation analysis, higher SUS score was associated with lower PTL score, which was associated with lower odds of burnout.Conclusions: A strong association was observed between EHR usability and workload among US physicians, with more favorable usability associated with less workload. Both outcomes were associated with the odds of burnout, with task load acting as a mediator between EHR usability and burnout. Improving EHR usability while decreasing task load has the potential to allow practicing physicians more working memory for medical decision making and patient communication. [ABSTRACT FROM AUTHOR]