Laparoscopic Surgery Simulation, Mental Workload, Psychomotor Performance, Stress
Conditions
Keywords
Preferred Music, White Noise, Laparoscopic Simulation, Simulation Training, SURG-TLX, Heart Rate Variability, Surgical Education
Brief summary
This single-blinded, three-arm randomized controlled trial evaluated the effects of different auditory environments on laparoscopic task performance and mental workload among novice surgeons in a simulated setting. Sixty participants were randomly assigned to one of three groups: preferred music, white noise, or silent control. Participants completed standardized laparoscopic simulation tasks. The primary outcome was task completion time. Secondary outcomes included mental workload assessed using the Surgical Task Load Index (SURG-TLX), perceived stress, and heart rate variability. The study aimed to determine whether preferred music enhances technical performance while reducing cognitive workload during laparoscopic simulation.
Detailed description
Background Laparoscopic surgery requires advanced psychomotor coordination, sustained concentration, and effective stress management. Environmental auditory stimuli may influence cognitive performance and operative efficiency, yet evidence remains limited, particularly among novice surgeons. Objective To compare the effects of preferred music, white noise, and silence on laparoscopic performance and mental workload. Methods Participants were randomized equally into three intervention groups. All participants performed standardized laparoscopic simulation exercises under their assigned auditory condition. Technical performance, subjective workload, and physiological stress were evaluated using validated assessment tools. Hypothesis Preferred music improves laparoscopic performance and reduces mental workload compared with white noise or silence.
Interventions
BEHAVIORALBehavioral: Preferred Music
Participants listened to their own self-selected preferred music through headphones while performing standardized laparoscopic simulation tasks. The music was chosen by each participant before the simulation and played continuously throughout the intervention session. The simulation protocol, task instructions, and assessment procedures were identical for all study groups.
BEHAVIORALWhite Noise
Participants listened to standardized white noise through headphones while performing standardized laparoscopic simulation tasks. The white noise was played continuously throughout the intervention session. All simulation tasks, instructions, and assessment procedures were identical to those used in the other study groups.
BEHAVIORALSIlent Control
Participants performed the standardized laparoscopic simulation tasks under a silent environment without exposure to any auditory stimulus. All simulation tasks, instructions, and assessment procedures were identical to those used in the intervention groups.
Sponsors
Hospital Universiti Sains Malaysia
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
BASIC_SCIENCE
Masking
TRIPLE (Subject, Caregiver, Outcomes Assessor)
Intervention model description
Participants were randomly assigned in a 1:1:1 ratio to one of three parallel groups: preferred music, white noise, or silent control. Each participant completed the standardized laparoscopic simulation task under the assigned auditory condition only.
Eligibility
Sex/Gender
ALL
Healthy volunteers
Yes
Inclusion criteria
* House officers or novice medical doctors * Previous exposure to surgical posting with basic laparoscopic experience * Able to understand study procedures * Willing to provide written informed consent
Exclusion criteria
* Hearing impairment * Visual impairment affecting simulator use * Physical disability affecting laparoscopic performance * Current use of medications affecting autonomic nervous system function * Declined consent
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Laparoscopic task completion time | Immediately upon completion of the laparoscopic simulation task (Day 1). | Time required for participants to complete the standardized laparoscopic simulation task under the assigned auditory condition (preferred music, white noise, or silent control). Task completion time was recorded in seconds using the laparoscopic simulator's timing system. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| SURG-TLX score | Immediately after completion of the laparoscopic simulation task (Day 1). | Mental workload measured using the Surgical Task Load Index (SURG-TLX) questionnaire. The SURG-TLX generates a weighted overall workload score ranging from 0 to 10, with higher scores indicating greater mental workload (worse outcome). |
| Heart Rate Variability | Baseline (before simulation) and immediately after completion of the laparoscopic simulation task (Day 1). | Heart rate variability parameters were measured using a validated heart rate monitoring device before and after the laparoscopic simulation to assess autonomic nervous system activity. Outcomes included time-domain and frequency-domain HRV indices. The direction of better or worse outcome depends on the specific HRV parameter analyzed. |
| Perceived Stress Score | Baseline (before simulation) and immediately after completion of the laparoscopic simulation task (Day 1). | Subjective stress assessed using the Visual Analogue Scale (VAS) ranging from 0 to 10, where 0 indicates no perceived stress and 10 indicates the highest perceived stress. Higher scores indicate greater perceived stress (worse outcome). |
| Technical Performance Score | Baseline (before randomization) and immediately upon completion of the intervention laparoscopic simulation task (Day 1). | Overall technical performance assessed using the LapSim laparoscopic simulator. The LapSim overall performance score is an automatically generated composite score based on performance metrics including task completion, instrument handling, movement efficiency, accuracy, and errors. Scores range from 0 to 100, with higher scores indicating better laparoscopic technical performance. |
Countries
Malaysia
Outcome results
None listed