Psychophysiologic measures of cognitive load in physician team leaders during trauma resuscitation

Abstract

In the high-paced and dynamic clinical setting of an emergency department, a physician's ability to manage mental resources and mitigate the effects of cognitive overload is critical to patient safety. Although the ability to regulate cognitive assets during crises is seen as the hallmark of expertise in a resuscitation setting, the specific psychological strategies used by these domain experts and the patterns of their expression remain unknown. This study aims to combine traditional cognitive load rating scales with physiologic data from newer wearable devices to measure cognitive state of physician team leaders during real-life resuscitations. Eye-tracking, galvanic skin response, and heart rate measures were captured from five expert physicians during five trauma resuscitations. Physiologic measures were correlated with psychometric scores collected using a cued-recall debriefing protocol. Results varied between participants and trials; overall, skin conductance response amplitude and frequency and eye tracking metrics showed the strongest correlation to Paas scores. Regression analysis revealed that a quadratic model is more representative of the psychometric-physiologic relationship than a linear model for most measures. The findings of this experiment support existing evidence that multiple physiologic measures should be employed to most accurately measure cognitive load in a real-world setting.