Cognitive Load, Performance
Conditions
Brief summary
In this study, the investigators examine the cognitive load (CL) and performance of a laparoscopic procedure in immersive virtual reality and controlled virtual reality in a randomized, controlled setup. Virtual reality (VR) simulators combined with head mounted displays (HMDs) enable highly immersive virtual reality (IVR) for surgical skills training, potentially bridging the gap between the simulation environment and real-life operating room (OR) conditions. However, the increased complexity of the learning situation in IVR could potentially induce high CL thereby inhibiting performance and learning.
Interventions
OTHERImmersive virtual reality
In the IVR environment, four different 360-degrees videos were in sequence played as backdrop during the procedure. The videos reflected real life situations in the operating room with two videos representing calm periods, one video representing a light stressor and one video representing a severe stressor with a bleeding (2 ml/s) being triggered in the simulation. Participants complete the procedures while wearing the head mounted device.
Sponsors
Copenhagen Academy for Medical Education and Simulation
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
OTHER
Masking
NONE
Masking description
Participants and the principal investigators were blinded to performance metrics by the simulator during the supervised procedure and the three test procedures. Participants and the data collector could not be blinded to the allocation/intervention. The investigator in charge of the statistical analysis was blinded to participants' group allocation.
Intervention model description
A single-center randomized trial was designed according to the CONSORT statement
Eligibility
Sex/Gender
ALL
Healthy volunteers
Yes
Inclusion criteria
* First year resident
Exclusion criteria
* Previous participation in trials involving laparoscopic training * Prior experience with laparoscopic surgery (having performed one or more laparoscopic procedures as primary surgeon, including supervised procedures) * Not speaking Danish on a conversational level
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Cognitive load | 6 months | Measurement of the participants cognitive load during four different time periods during the three procedures. Cognitive load was estimated by secondary-task reaction time. The investigators used an external and commercially available reaction timer (American Educational Products LLC, USA) to measure participants response time (in hundreds seconds) to an auditory stimulus (a beep). Reaction time was measured before and after the simulation to provide an individual baseline, and during the simulation at t=80 s, t=130 s, t=180 s and t=240 s. All reaction time measurements were done in series of four repeated measurements. It was also noted if the reaction time was measured while the participant was using the foot pedal for cauterization in the simulation. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Time to completion of procedure | 6 months | Time to completion of procedure (measured in seconds) |
| Diathermy damage | 6 months | Damage to surrounding tissue during the procedure (in number of incidents) |
| Efficience of instrument movements (length) | 6 months | Measurement of movement of the left and right hand in meters |
| Efficience of instrument movements (degrees) | 6 months | Measurement of angular movements of the left and right hand in degrees |
| Blood loss | 6 months | Blood loss during the procedure (in ml) |
Other
| Measure | Time frame | Description |
|---|---|---|
| Motion sickness | 6 months | Motion sickness was assessed using a post-procedure questionnaire. The investigators used the MSAQ (Motion Sickness Assesment Questionnaire) developed by Gianaros et al in 2001. The questionnaire consisted of 16 statements and the participants had to rate how accurately the statements describe their experience in a numbered scale from 1 (not at all) to 9 (severely). The 16 statements were divided into for categories: Gastrointestinal; Central; Peripheral; Sopite-related. The overall motion sickness score was obtained by calculating the percentage of total points scored: (sum of points from all items/144) \* 100. Subscale scores was obtained by calculating the percent of points scored within each factor: (sum of gastrointestinal items/36) \* 100; (sum of central items/45) \* 100; (sum of peripheral items/27) \* 100; (sum of sopite-related items/36) \* 100. |
Countries
Denmark
Outcome results
None listed