Continuous Monitoring of Mental Load During Virtual Simulator Training for Laparoscopic Surgery Reflects Laparoscopic Dexterity: A Comparative Study Using a Novel Wireless Device

Frontiers in Neuroscience

Neuroscience

Eli Kakiashvilli¹  Amitai Bickel²  Denis Drobot²  Maxim Bez³  Lior Molcho⁴  Nathan Intrator⁵  Neta B. Maimon⁶ 

[1] Department of Surgery A, Galilee Medical Center, Nahariyya, Israel;Faculty of Medicine in the Galilee, Bar-Ilan University, Safed, Israel;Department of Surgery A, Galilee Medical Center, Nahariyya, Israel;Medical Corps, Israel Defense Forces, Ramat Gan, Israel;Neurosteer Ltd, Herzliya, Israel;Neurosteer Ltd, Herzliya, Israel;Blavatnik School of Computer Science, Tel Aviv University, Tel Aviv, Israel;The School of Psychological Sciences, Tel Aviv University, Tel Aviv, Israel;Neurosteer Ltd, Herzliya, Israel;

关键词: cognitive load;    surgical simulator training;    EEG biomarker;    laparoscopic operations;    brain assessment;    mental load assessment;    machine learning;   

DOI  :  10.3389/fnins.2021.694010

 received in 2021-04-12, accepted in 2021-11-22,  发布年份 2022

来源: Frontiers

【 摘 要 】

IntroductionCognitive Load Theory (CLT) relates to the efficiency with which individuals manipulate the limited capacity of working memory load. Repeated training generally results in individual performance increase and cognitive load decrease, as measured by both behavioral and neuroimaging methods. One of the known biomarkers for cognitive load is frontal theta band, measured by an EEG. Simulation-based training is an effective tool for acquiring practical skills, specifically to train new surgeons in a controlled and hazard-free environment. Measuring the cognitive load of young surgeons undergoing such training can help to determine whether they are ready to take part in a real surgery. In this study, we measured the performance of medical students and interns in a surgery simulator, while their brain activity was monitored by a single-channel EEG.MethodsA total of 38 medical students and interns were divided into three groups and underwent three experiments examining their behavioral performances. The participants were performing a task while being monitored by the Simbionix LAP MENTOR™. Their brain activity was simultaneously measured using a single-channel EEG with novel signal processing (Aurora by Neurosteer®). Each experiment included three trials of a simulator task performed with laparoscopic hands. The time retention between the tasks was different in each experiment, in order to examine changes in performance and cognitive load biomarkers that occurred during the task or as a result of nighttime sleep consolidation.ResultsThe participants’ behavioral performance improved with trial repetition in all three experiments. In Experiments 1 and 2, delta band and the novel VC9 biomarker (previously shown to correlate with cognitive load) exhibited a significant decrease in activity with trial repetition. Additionally, delta, VC9, and, to some extent, theta activity decreased with better individual performance.DiscussionIn correspondence with previous research, EEG markers delta, VC9, and theta (partially) decreased with lower cognitive load and higher performance; the novel biomarker, VC9, showed higher sensitivity to lower cognitive load levels. Together, these measurements may be used for the neuroimaging assessment of cognitive load while performing simulator laparoscopic tasks. This can potentially be expanded to evaluate the efficacy of different medical simulations to provide more efficient training to medical staff and measure cognitive and mental loads in real laparoscopic surgeries.

【 授权许可】

Unknown   
Copyright © 2022 Maimon, Bez, Drobot, Molcho, Intrator, Kakiashvilli and Bickel.