Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2020 Apr;271(4):686-692.
doi: 10.1097/SLA.0000000000003058.

NASA-TLX Assessment of Surgeon Workload Variation Across Specialties

Bethany R Lowndes  1   2 , Katherine L Forsyth  1   2 , Renaldo C Blocker  1   2 , Patrick G Dean  3 , Mark J Truty  3 , Stephanie F Heller  3 , Shanda Blackmon  3 , M Susan Hallbeck  1   2   3 , Heidi Nelson  3
Affiliations

NASA-TLX Assessment of Surgeon Workload Variation Across Specialties

Bethany R Lowndes et al. Ann Surg. 2020 Apr.

Abstract

Objective: With advancements in surgical equipment and procedures, human-system interactions in operating rooms affect surgeon workload and performance. Workload was measured across surgical specialties using surveys to identify potential predictors of high workload for future performance improvement.

Summary background data: Surgical instrumentation and technique advancements have implications for surgeon workload and human-systems interactions. To understand and improve the interaction of components in the work system, NASA-Task Load Index can measure workload across various fields. Baseline workload measurements provide a broad overview of the field and identify areas most in need of improvement.

Methods: Surgeons were administered a modified NASA-Task Load Index survey (0 = low, 20 = high) following each procedure. Patient and procedural factors were retrieved retrospectively.

Results: Thirty-four surgeons (41% female) completed 662 surgery surveys (M = 14.85, SD = 7.94), of which 506 (76%) have associated patient and procedural data. Mental demand (M = 7.7, SD = 5.56), physical demand (M = 7.0, SD = 5.66), and effort (M = 7.8, SD = 5.77) were the highest rated workload subscales. Surgeons reported difficulty levels higher than expected for 22% of procedures, during which workload was significantly higher (P < 0.05) and procedural durations were significantly longer (P > 0.001). Surgeons reported poorer perceived performance during cases with unexpectedly high difficulty (P < 0.001).

Conclusions: When procedural difficulty is greater than expected, there are negative implications for mental and physical demand that result in poorer perceived performance. Investigations are underway to identify patient and surgical variables associated with unexpected difficulty and high workload. Future efforts will focus on re-engineering the surgical planning process and procedural environment to optimize workload and performance for improved surgical care.

PubMed Disclaimer

Comment in

References

    1. Berguer R, Smith W, Chung Y. Performing laparoscopic surgery is significantly more stressful for the surgeon than open surgery. Surg Endosc 2001; 15:1204–1207.
    1. Rasmussen J. Information processing and human-machine interaction. An approach to cognitive engineering. New York, NY:Elsevier Science Inc; 1986.
    1. Hoc JM. From human–machine interaction to human–machine cooperation. Ergonomics 2000; 43:833–843.
    1. Canes D, Berger A, Aron M, et al. Laparo-endoscopic single site (LESS) versus standard laparoscopic left donor nephrectomy: matched-pair comparison. Eur Urol 2010; 57:95–101.
    1. Tsimoyiannis EC, Tsimogiannis KE, Pappas-Gogos G, et al. Different pain scores in single transumbilical incision laparoscopic cholecystectomy versus classic laparoscopic cholecystectomy: a randomized controlled trial. Surg Endosc 2010; 24:1842–1848.

LinkOut - more resources