Journal of surgical education · 2026
Regulating Trainee Workload in Laparoscopic Simulation: Evidence from NASA-TLX and Pupillometry Analysis.
СтатьяРандомизированное исследованиеНазвание и аннотация: Перевод в очереди
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Wu Yun, Zheng Bin
Аннотация
OBJECTIVE: To explore whether a workload-adapted training protocol was associated with differences in trainee workload during laparoscopic simulation, using both self-reported and physiological measures. We hypothesized that adapting task difficulty to trainee progression would be associated with lower workload variability than a fixed-difficulty protocol.
DESIGN: A randomized, controlled experimental pilot study. Participants were randomized into an Experimental group (workload-adapted protocol: task difficulty increased from low to high) or a Control group (fixed-medium difficulty). Workload was assessed using NASA-Task Load Index (NASA-TLX) and real-time pupillary response (Tobii Pro Nano). Data were analyzed using mixed ANOVA, Levene's test for equality of variances, and Pearson correlation.
SETTING: Surgical Simulation Research Lab, University of Alberta, Edmonton, Alberta, Canada.
PARTICIPANTS: Twenty-two novice participants (university students) with no prior laparoscopic experience were recruited. All 22 participants completed the full training curriculum and subjective assessments; valid pupillary data were obtained from 16 participants.
RESULTS: NASA-TLX scores decreased significantly over time in both groups during training (p < 0.001). No significant between-group differences were observed in mean NASA-TLX scores or pupil size values (p > 0.05). However, the Control group showed significantly greater variance than the Experimental group for both NASA-TLX scores (p = 0.04) and pupil size (p = 0.03). These findings suggest that the workload-adapted protocol was associated with lower workload variability during training. A weak but statistically significant positive correlation was observed between NASA-TLX scores and pupil size (r = 0.19, p = 0.020).
CONCLUSIONS: These findings suggest that, within this pilot sample, the workload-adapted protocol was associated with lower workload variability during training. The observed association between pupillary response and NASA-TLX scores suggests that pupillometry may serve as a complementary physiological measure of trainee workload. These exploratory findings warrant validation in larger studies.
DESIGN: A randomized, controlled experimental pilot study. Participants were randomized into an Experimental group (workload-adapted protocol: task difficulty increased from low to high) or a Control group (fixed-medium difficulty). Workload was assessed using NASA-Task Load Index (NASA-TLX) and real-time pupillary response (Tobii Pro Nano). Data were analyzed using mixed ANOVA, Levene's test for equality of variances, and Pearson correlation.
SETTING: Surgical Simulation Research Lab, University of Alberta, Edmonton, Alberta, Canada.
PARTICIPANTS: Twenty-two novice participants (university students) with no prior laparoscopic experience were recruited. All 22 participants completed the full training curriculum and subjective assessments; valid pupillary data were obtained from 16 participants.
RESULTS: NASA-TLX scores decreased significantly over time in both groups during training (p < 0.001). No significant between-group differences were observed in mean NASA-TLX scores or pupil size values (p > 0.05). However, the Control group showed significantly greater variance than the Experimental group for both NASA-TLX scores (p = 0.04) and pupil size (p = 0.03). These findings suggest that the workload-adapted protocol was associated with lower workload variability during training. A weak but statistically significant positive correlation was observed between NASA-TLX scores and pupil size (r = 0.19, p = 0.020).
CONCLUSIONS: These findings suggest that, within this pilot sample, the workload-adapted protocol was associated with lower workload variability during training. The observed association between pupillary response and NASA-TLX scores suggests that pupillometry may serve as a complementary physiological measure of trainee workload. These exploratory findings warrant validation in larger studies.