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The Relationship Between Technical Skills, Cognitive Workload, and Errors During Robotic Surgical Exercises

Roberts, Sidney I. and Cen, Steven Y. and Nguyen, Jessica H. and Perez, Laura C. and Medina, Luis G. and Ma, Runzhuo and Marshall, Sandra and Kocielnik, Rafal and Anandkumar, Anima and Hung, Andrew J. (2022) The Relationship Between Technical Skills, Cognitive Workload, and Errors During Robotic Surgical Exercises. Journal of Endourology, 36 (5). pp. 712-720. ISSN 0892-7790. PMCID The Relationship Between Technical Skills, Cognitive Workload, and Errors During Robotic Surgical Exercises. doi:10.1089/end.2021.0790. https://resolver.caltech.edu/CaltechAUTHORS:20220912-920381000

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Abstract

Purpose: We attempt to understand the relationship between surgeon technical skills, cognitive workload, and errors during a simulated robotic dissection task. Materials and Methods: Participant surgeons performed a robotic surgery dissection exercise. Participants were grouped based on surgical experience. Technical skills were evaluated utilizing the validated Global Evaluative Assessment of Robotic Skills (GEARS) assessment tool. The dissection task was evaluated for errors during active dissection or passive retraction maneuvers. We quantified cognitive workload of surgeon participants as an index of cognitive activity (ICA), derived from task-evoked pupillary response metrics; ICA ranged 0 to 1, with 1 representing maximum ICA. Generalized estimating equation (GEE) was used for all modelings to establish relationships between surgeon technical skills, cognitive workload, and errors. Results: We found a strong association between technical skills as measured by multiple GEARS domains (depth perception, force sensitivity, and robotic control) and passive errors, with higher GEARS scores associated with a lower relative risk of errors (all p < 0.01). For novice surgeons, as average GEARS scores increased, the average estimated ICA decreased. In contrast, as average GEARS increased for expert surgeons, the average estimated ICA increased. When exhibiting optimal technical skill (maximal GEARS scores), novices and experts reached a similar range of ICA scores (ICA: 0.47 and 0.42, respectively). Conclusions: This study found that there is an optimal cognitive workload level for surgeons of all experience levels during our robotic surgical exercise. Select technical skill domains were strong predictors of errors. Future research will explore whether an ideal cognitive workload range truly optimizes surgical training and reduces surgical errors.


Item Type:Article
Related URLs:
URLURL TypeDescription
https://doi.org/10.1089/end.2021.0790DOIArticle
ORCID:
AuthorORCID
Anandkumar, Anima0000-0002-6974-6797
Hung, Andrew J.0000-0002-7201-6736
Issue or Number:5
PubMed Central ID:The Relationship Between Technical Skills, Cognitive Workload, and Errors During Robotic Surgical Exercises
DOI:10.1089/end.2021.0790
Record Number:CaltechAUTHORS:20220912-920381000
Persistent URL:https://resolver.caltech.edu/CaltechAUTHORS:20220912-920381000
Usage Policy:No commercial reproduction, distribution, display or performance rights in this work are provided.
ID Code:116901
Collection:CaltechAUTHORS
Deposited By: Tony Diaz
Deposited On:22 Sep 2022 19:56
Last Modified:12 Oct 2022 23:06

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