NASA Task Load Index Research Articles

Relationship between mental workload and musculoskeletal disorders with intention to leave service among nurses working at neonatal and pediatric departments: a cross-sectional study in Iran

BackgroundDespite the challenge of nursing shortage in the world and its subsequent impact on care quality as well as aggravation of the situation by intention to leave service, this issue has not been properly addressed, especially among neonatal and pediatric nurses. The present study aims to identify the relationship between mental workload and musculoskeletal disorders with intention to leave the service among nurses working at neonatal and pediatric departments.MethodsThis descriptive-analytical study was conducted on 145 nurses working at neonatal and pediatric departments in six hospitals in Bushehr Province using full-census method. The data were collected using national aeronautics and space administration-task load index (NASA-TLX), Cornell musculoskeletal discomfort questionnaire(CMDQ) and Mobley and Horner’s voluntary turnover questionnaire. The data were analyzed using descriptive statistics, independent t-test, Mann-Whitney U test, one-way analysis of variance (ANOVA), Kruskal-Wallis test, Pearson’s and Spearman correlation tests and hierarchical linear regression in simultaneous model in SPSS 19.0.ResultsThe mean score of intention to leave the service was 9.57 ± 3.20 (higher than the moderate level) and the mean mental workload was 71.65 ± 15.14 (high level). Pain in at least one of the legs (100%), back (77.3%) and knees (76.6%) was highly prevalent. However, no statistically significant correlation was found between musculoskeletal disorder categories and intention to leave the service (p > 0.05). The regression analysis results revealed among mental workload domains, only effort-induced workload was negatively and significantly correlated with intention to leave the service (p = 0.003; β=-0.078). However, the number of night shifts per month was positively and significantly correlated with intention to leave the service (p = 0.001; β = 0.176).ConclusionsPlanning for appropriate allocation of night shifts, investigating the etiology of musculoskeletal disorders and providing solutions for reducing mental workload should be prioritized by policymakers, while maintaining pediatric nurses’ motivation for making efforts.

Eye-controlled endoscopy — a benchtop trial of a novel robotic steering platform — iGAZE2

The endoscopic control system has remained similar in design for many decades The remit of advanced therapeutic endoscopy continues to expand requiring precision control and high cognitive workloads. Robotic systems are emerging, but all still require bimanual control and expensive and large new systems. Eye tracking is an exciting area that can be used as an endoscope control system. This is a study to establish the feasibility of an eye-controlled endoscope and compare its performance and cognitive demand to use of a conventional endoscope. An eye gaze-control system consisting of eye-tracking glasses, customised software and a small motor unit was built and attached to a conventional endoscope. Twelve non-endoscopists used both the eye gaze system and a conventional endoscope to complete a benchtop task in a simulated oesophagus and stomach. Completion of tasks was timed. Subjective feedback was collected from each participant on task load using the NASA Task Load Index. Participants were significantly quicker completing the task using iGAZE2 vs a conventional endoscope (65.02 ± 16.34s vs 104.21 ± 51.31s, p = 0.013) Participants were also significantly quicker completing retroflexion using iGAZE2 vs a conventional endoscope (8.48 ± 3.08 vs 11.38 ± 5.36s, p = 0.036). Participants reported a significantly lower workload (raw NASA-TLX score) when using iGAZE2 vs the conventional endoscope (152.1 ± 63.4 vs 319.6 ± 81.6, p = 0.0001) (Fig. 7). Users found iGAZE2 to have a significantly lower temporal demand, mental demand, effort, mental demand, physical demand, and frustration level. The eye gaze system is an exciting, small, and retrofittable system to any endoscope. The system shows exciting potential as a novel endoscopic control system with a significantly lower workload and better performance in novices suggesting a more intuitive control system.

The Effect of Directional Tactile Memory of the Back of the User on Reaction Time and Accuracy

Tactile memory is the cognitive process of storing and recalling information that has been perceived through the sense of touch. Directional tactile memory involves the encoding and retrieval of sensory data associated with a tactile experience, allowing individuals to remember and recognize directional information encoded through the sense of touch. A new method for providing directional tactile feedback, at the back of the user, has been developed to investigate the efficacy of directional tactile memory, its decay over time, and its impact during a concurrent cognitive task. Two experiments were presented. In the first experiment, tactile memory deterioration, with a visual or a tactile cue, was tested with different action-cue latencies (10 s and 20 s). In the second experiment, we considered tactile memory deterioration when there was an increased cognitive load as the participants played Tetris. Forty volunteers participated in the two experiments using purpose-built tactile seats with nine motors controlled by an Arduino. The performance data (error and reaction times) were analyzed statistically, and a NASA task load index (NASA-TLX) questionnaire was administered to measure the subjective workload after each of the two experiments. The findings highlighted that the directional tactile memory of the back can guide individuals to the correct point on the screen and that it can be maintained for at least 20 s. There was no statistically significant difference in the number of errors or reaction time with a visual or tactile action cue. However, being involved in a concurrent cognitive task (playing Tetris) adversely affected the reaction time, the number of errors, and the directional tactile memory, which degraded as the time between the directional cue and the action cue increased. Participants perceived the performance while playing Tetris as significantly more mentally and perceptually demanding, requiring more mental and physical effort and being more frustrating. These trials revealed a new potential for a human–machine interface system, leveraging directional tactile memory, which might be utilized to increase the safety of autonomous vehicles.

Factors influencing fatigue, mental workload and burnout among Chinese health care workers during public emergencies: an online cross-sectional study

ObjectivesThe purpose of this study was to investigate fatigue, mental workload, and burnout among health care workers (HCWs) and explore the possible underlying factors.Materials and methodsAn online cross-sectional survey design was used to collect data from HCWs in Chongqing, China. The online survey included the Fatigue Severity Scale, NASA Task Load Index, and Chinese version of the Maslach Burnout Inventory-General Survey to assess fatigue, mental workload, and burnout, respectively, and was conducted from February 1 to March 1, 2023.ResultsIn this study, the incidence of fatigue and burnout among HCWs was 76.40% and 89.14%, respectively, and the incidence of moderate to intolerable mental workloads was 90.26%. Work–family conflict, current symptoms, number of days of COVID-19 positivity, mental workload, burnout and reduced personal accomplishment were significantly associated with fatigue. Mental workload was affected by fatigue and reduced personal accomplishment. Furthermore, burnout was influenced by marital status and fatigue. Moreover, there was a correlation among mental workload, fatigue, and burnout.ConclusionsFatigue, mental workload and burnout had a high incidence and were influenced by multiple factors during COVID-19 public emergencies in China.

Relationship between physical fatigue and mental fatigue based on multimodal measurement under different load levels

Based on multimodal measurement methods of NASA task load index (NASA-TLX), task performance, surface electromyography (sEMG), heart rate (HR), and functional near-infrared spectroscopy (fNIRS), this study conducted experimental measurements and analyses under 16 different load levels of physical fatigue and mental fatigue combination conditions. This study observed the interaction between physical fatigue and mental fatigue at different levels, and at the subjective level, the effect of physical fatigue on mental fatigue was greater than that of mental fatigue on physical fatigue. Secondly, the results of fNIRS analysis showed that the premotor cortex is affected by physical fatigue, and the dorsolateral prefrontal cortex is affected by mental fatigue. Finally, this study constructed a fatigue classification model with an accuracy of 95.3%, which takes multimodal physiological data as input and 16 fatigue states as output. The research results will provide a basis for fatigue analysis, evaluation, and improvement in complex working situations.

The mediating effect of coping styles between emergency capacity and mental workload among clinical nurses: A cross-sectional study.

This study aimed to examine the relationship between emergency capacity, coping styles, and mental workload among nurses. Emergency capacity, coping styles, and mental workload are all variables associated with work. Identifying the relationship between these variables can facilitate administrators to implement tailored and effective intervention strategies to improve individual performance, quality of care, and medical safety. A quantitative cross-sectional study was carried out to investigate 605 Chinese clinical nurses in seven tertiary hospitals by using personal information form, emergency capacity scale for nurses, simplified coping skill questionnaire, and the NASA-Task Load Index. Emergency capacity and mental workload were found at moderate levels. The multiple linear regression model suggested that spinsterhood, no children, high workload, always anxiety or nervousness, and lower monthly income were the influencing factors of mental workload. Positive coping style was positively correlated with emergency capacity and negatively correlated with mental workload. Negative coping style was negatively related to emergency capacity and positively related to mental workload. Additionally, coping styles played a partial mediating role in the relationship between emergency capacity and mental workload through constructing a structural equation model, but the effects of positive coping style and negative coping style are opposite. Our results showed that coping styles played a mediating role in the relationship between emergency capacity and mental workload. Managers can alleviate the mental workload of nurses by cultivating positive coping styles and improving emergency capacity. Mental workload of nurses deserves more attention in medical institutions. The results of our study provide evidence for improving employee health, promoting positive behaviors, and optimizing organizational management. Nursing managers should take feasible measures to fulfill nurses' needs for emergency capacity and coping strategies to alleviate nurses' mental workload, so as to stimulate their intrinsic motivation and positive organizational behavior.

Usability assessment of a greenhouse context-aware alert system for small-scale farmers

In the dynamic landscape of modern agriculture, integrating technology holds immense potential to enhance efficiency and productivity for small-scale farmers. This study presents a user-centric evaluation of an intelligent context-aware alert system, tailored for small-scale greenhouse farming. We employed standardized questionnaires, including the NASA Task Load Index and the User Experience Questionnaire, to assess the system's perceived utility, mental workload, and overall user experience. Our findings reveal the high perceived utility of the system among farmers. Farmers participating in the assessment indicated a strong intention to utilize the system for crop monitoring. Moreover, the system demonstrated a moderate mental workload, suggesting ease of use and potential acceptance by users. Our evaluation highlighted an excellent user experience, with scores ranging from very good to extremely good across all dimensions. Furthermore, user preferences for alert mechanisms underscored the importance of adaptable notifications, with voice and text alerts favored for comprehensive information dissemination. Light and voice alerts were preferred during manual tasks. This study highlights the significance of user-centered design in agricultural technology, offering insights to enhance the usability and the adoption of alert systems in small-scale farming environments. The positive reception of the system's utility and the moderate mental workload suggest that such technology can be readily adopted by farmers, thereby improving monitoring and management practices in greenhouse farming. The preference for adaptable alert mechanisms further emphasizes the need for flexible and context-sensitive solutions in agricultural technology.

Using Virtual Reality to teach ultrasound-guided needling skills for regional anaesthesia: A randomised controlled trial

Study objectiveWe previously designed and validated a virtual reality-based simulator to help train novices in ultrasound-guided needling skills necessary for safe and competent ultrasound-guided regional anaesthesia. This study was designed to compare the performance and error rates of novices trained by a human faculty aided with the assistance of this virtual reality simulator (virtual reality-assisted training), versus novices trained wholly by humans (conventional training). Design, setting, and participantsIn this single centre, randomised controlled study, we used a standardised teaching protocol, rigorous blinding, iterative training of assessors, and validated global rating scale and composite error score checklists to assess skills learning of novice participants. Main resultsWe recruited 45 novices and scored 270 assessments of performance and error rates. Inter-rater correlation coefficient of reliability of scoring between assessors for the global rating scale was 0.84 (95%CI 0.68–0.92) and for the composite error score checklist was 0.87 (95%CI 0.73–0.93). After adjustment for age, sex, Depression, Anxiety and Stress-21, and baseline score, there was no statistical difference for virtual reality-assisted training compared to conventional training in final global rating score (average treatment effect −3.30 (95%CI-13.07–6.48), p = 0.51) or in the final composite error score (average treatment effect 1.14 (95%CI -0.60–2.88), p = 0.20). Realism in the virtual reality simulator was similar to real-life when measured by the Presence Questionnaire, all components p > 0.79; and task workload assessed by the NASA-Task Load Index was not statistically different between groups, average treatment effect 5.02 (95%CI -3.51–13.54), p = 0.25. Results were achieved in the virtual reality-assisted group with half the human faculty involvement. ConclusionNovices trained using a hybrid, virtual reality-assisted teaching program showed no superiority to novices trained using a conventional teaching program, but with less burden on teaching resources.

Better operating room efficiency and reduced staff demand: Individualised versus off-the-shelf total knee arthroplasty.

The purpose of this pilot cross-sectional study was to compare the operating room (OR) efficiency and intraoperative staff task load when performing individualised versus off-the-shelf (OTS) total knee arthroplasty (TKA). A consecutive series of 28 patients randomised (1:1) to receive either OTS TKA or individualised TKA were included. The OR staff workload was assessed with the NASA Task Load Index (TLX), a subjective grading system assessing mental demand, physical demand, temporal demand, performance, effort and frustration on a scale from 0 (very low) to 20 (very high). The time for patient preparation, surgical time, closureand total OR time was recorded to assess OR efficiency. Effect sizes of differences between OTS and individualised TKA were expressed as mean differences (MDs) with 95% confidence intervals (CIs). Patients in both cohorts were similar in age (OTS vs. individualised TKA (median [IQR]), 67 [63-76] vs. 71 [68-79]; p = 0.207) and body mass index (BMI) (29 [24-33] vs. 29 [26-31]; p = 0.807), and there were no significant differences in other preoperative characteristics. The OR staff perceived individualised TKA as less demanding than OTS TKA: Individualised TKA was rated significantly better across the six domains of the NASA TLX: mental demand by 5.6 points, physical demand by 6.3 points, temporal demand by 5.3 points, performance by 3.6 points, effort by 5.9 pointsand frustration by 5.8 points. Individualised TKA resulted in statistically significantly shorter mean total OR time (MD, 10 min; p = 0.018). The staff in the OR found that individualised TKA is less mentally, physicallyand temporally demanding than OTS TKA. The average total time spent in the OR during individualised TKA is 10 minless than during OTS TKA. This study constitutes a part of a larger registered randomised controlled trial comparing patient satisfaction following OTS versus individualised TKA (NCT04460989). Level III.

From Distraction to Action: Elevating Situation Awareness with Visual Assistance in Level 3 Autonomous Driving

This study examines the impact of visual assistance and cognitive load on situation awareness (SA) during takeover events in Level 3 (L3) autonomous driving, where drivers are permitted to engage in Non-Driving Related Tasks (NDRTs). Utilizing a driving simulator, the research explores how different NDRTs, occupying various sensory channels, influence drivers’ SA under two visual assistance conditions: full marking and key marking. Results from the Situation Awareness Global Assessment Technique (SAGAT) and NASA Task Load Index (NASA-TLX) scales, along with eye-tracking data, demonstrate significant interactions between visual assistance conditions and tasks, highlighting key marking’s superior effectiveness in enhancing SA across all NDRTs. The study reveals that cognitive workload, largely arising from NDRTs rather than road attention, remains unaffected by visual assistance conditions. Findings suggest that drivers’ strategies for allocating attention are consistent, regardless of the visual task presence. This research contributes to understanding SA in autonomous driving takeovers, offering valuable insights for developing Human-Machine Interface (HMI) designs to improve SA and takeover performance in autonomous driving systems.

Aerosol Box Use in Reducing Health Care Worker Contamination During Airway Procedures (AIRWAY) Study: Secondary Workload and Provider Outcomes in a Simulation-Based Trial.

An aerosol box aims to reduce the risk of healthcare provider (HCP) exposure to infections during aerosol generating medical procedures (AGMPs), but little is known about its impact on workload of team members. We conducted a secondary analysis of data from a prospective, multicenter, randomized controlled trial evaluating the impact of aerosol box use on patterns of HCP contamination during AGMPs. The objectives of this study are to: 1) evaluate the effect of aerosol box use on HCP workload, 2) identify factors associated with HCP workload when using an aerosol box, and 3) describe the challenges perceived by HCPs of aerosol box use. Simulation-based randomized trial, conducted from May to December 2021. Four pediatric simulation centers. Teams of two HCPs were randomly assigned to control (no aerosol box) or intervention groups (aerosol box). Each team performed three scenarios requiring different pediatric airway management (bag-valve-mask [BVM] ventilation, laryngeal mask airway [LMA] insertion, and endotracheal intubation [ETI] with video laryngoscopy) on a simulated COVID-19 patient. National Aeronautics and Space Administration-Task Load Index (NASA-TLX) is a standard tool that measures subjective workload with six subscales. A total of 64 teams (128 participants) were recruited. The use of aerosol box was associated with significantly higher frustration during LMA insertion (28.71 vs. 17.42; mean difference, 11.29; 95% CI, 0.92-21.66; p = 0.033). For ETI, there was a significant increase in most subscales in the intervention group, but there was no significant difference for BMV. Average NASA-TLX scores were all in the "low" range for both groups (range: control BVM 23.06, sd 13.91 to intervention ETI 38.15; sd 20.45). The effect of provider role on workloads was statistically significant only for physical demand ( p = 0.001). As the complexity of procedure increased (BVM → LMA → ETI), the workload increased in all six subscales ( p < 0.05). The use of aerosol box increased workload during ETI but not with BVM and LMA insertion. Overall workload scores remained in the "low" range, and there was no significant difference between airway provider and assistant.

Debriefer cognitive load during Traditional Reflective Debriefing vs. Rapid Cycle Deliberate Practice interdisciplinary team training

BackgroundCognitive load impacts performance of debriefers and learners during simulations, but limited data exists examining debriefer cognitive load. The aim of this study is to compare the cognitive load of the debriefers during simulation-based team training (SbTT) with Rapid Cycle Deliberate Practice (RCDP) debriefing and Traditional Reflective Debriefing (TRD). We hypothesize that cognitive load will be reduced during RCDP compared to TRD.MethodsThis study was part of a large-scale, interdisciplinary team training program at Children’s Healthcare of Atlanta Egleston Pediatric Emergency Department, with 164 learners (physicians, nurses, medical technicians, paramedics, and respiratory therapists (RTs)). Eight debriefers (main facilitators and discipline-specific coaches) led 28 workshops, which were quasi-randomized to either RCDP or TRD. Each session began with a baseline medical resuscitation scenario and cognitive load measurement using the NASA Task Load Index (TLX), and the NASA TLX was repeated immediately following either TRD or RCDP debriefing. Raw scores of the NASA TLX before and after intervention were compared. ANOVA tests were used to compare differences in NASA TLX scores before and after intervention between the RCDP and TRD groups.ResultsFor all debriefers, mean NASA TLX scores for physical demands and frustration significantly decreased (− 0.8, p = 0.004 and − 1.3, p = 0.002) in TRD and mean perceived performance success significantly increased (+ 2.4, p < 0.001). For RCDP, perceived performance success increased post-debriefing (+ 3.6, p < 0.001), time demands decreased (− 1.0, p = 0.04), and frustration decreased (− 2.0, p < 0.001). Comparing TRD directly to RCDP, perceived performance success was greater in RCDP than TRD (3.6 vs. 2.4, p = 0.04). Main facilitators had lower effort and mental demand in RCDP and greater perceived success (p < 0.001).ConclusionRCDP had greater perceived success than TRD for debriefers. Main facilitators also report reduced effort and baseline mental demand in RCDP. For less experienced debriefers, newer simulation programs, or large team training sessions such as our study, RCDP may be a less mentally demanding debriefing methodology for facilitators.

Lights, Sirens, and Load: Anticipatory emergency medical treatment planning causes cognitive load during emergency response driving among paramedicine students

Paramedics face various unconventional and secondary task demands while driving ambulances, leading to significant cognitive load, especially during lights-and-sirens responses. Previous research suggests that high cognitive load negatively affects driving performance, increasing the risk of accidents, particularly for inexperienced drivers. The current study investigated the impact of anticipatory treatment planning on cognitive load during emergency driving, as assessed through the use of a driving simulator. We recruited 28 non-paramedic participants to complete a simulated baseline drive with no task and a cognitive load manipulation using the 1-back task. We also recruited 18 paramedicine students who completed a drive while considering two cases they were travelling to: cardiac arrest and infant seizure, representing varying difficulty in required treatment. The results indicated that both cases imposed considerable cognitive load, as indicated by NASA Task Load Index responses, comparable to the 1-back task and significantly higher than driving with no load. These findings suggest that contemplating cases and treatment plans may impact the safety of novice paramedics driving ambulances for emergency response. Further research should explore the influence of experience and the presence of a second individual in the vehicle to generalise to broader emergency response driving contexts.

3D printing in anatomical lung segmentectomies: A randomized pilot trial

ObjectiveThis pilot study evaluated the impact of using a 3D printed model of the patient's bronchovascular lung anatomy on the mental workload and fatigue of surgeons during full thoracoscopic segmentectomy. DesignWe performed a feasibility pilot study of a prospective randomized controlled trial with 2 parallel arms. All included patients underwent digital 3D visual reconstruction of their bronchovascular anatomy and were randomized into the following two groups: Digital arm (only a virtual 3D model was available) and Digital + Object arm (both virtual and printed 3D models were available). The primary end-point was the surgeons’ mental workload measured using the National Aeronautics and Space Administration-Task Load Index (NASA-TLX) score. SettingBetween October 28, 2020 and October 05, 2021, we successively investigated all anatomic segmentectomies performed via thoracoscopy in the Thoracic Department of the Montsouris Mutualiste Institute, except for S6 segmentectomies and S4+5 left bi-segmentectomies. ParticipantsWe assessed 102 patients for anatomical segmentectomy. Among the, 40 were randomly assigned, and 34 were deemed analysable, with 17 patients included in each arm. ResultsComparison of the two groups, each comprising 17 patients, revealed no statistically significant difference in primary or secondary end-points. The consultation of the visual digital model was significantly less frequent when a 3D printed model was available (6 versus 54 consultations, p = 0.001). Notably, both arms exhibited high NASA-TLX scores, particularly in terms of mental demand, temporal demand, and effort scores. ConclusionIn our pilot study, 3D printed models and digital 3D reconstructions for pre-operative planning had an equivalent effect on thoracoscopic anatomic segmentectomy for experienced surgeons. The originality of this study lies in its focus on the impact of 3D printing of bronchovascular anatomy on surgeons, rather than solely on the surgical procedure.

#1600 The effect of integrated real-time hemodialysis surveillance on staff workload and time efficacy—a multicenter prospective study

Abstract Background and Aims For many years, dialysis data have been manually registered and transferred to the patients’ electronic health records by dialysis staff. However, manual documentation can be associated with poor data completeness, delayed recognition of inadequate dialysis prescriptions, and high staff workload. We studied the effect of introducing a new integrated, digitalized haemodialysis surveillance system, the Treatment Guidance System (TGS), on staff workload and time saving in clinics from a large multi-national dialysis provider. To measure the effect of introducing the new TGS system on staff workload and time saving. Method This was a prospective, observational multicenter study conducted between November 2021 and January 2023 in five countries: Saudi Arabia, Spain, Portugal, UK, and Kazakhstan. Inclusion criteria were clinics with adequate digital infrastructure, introducing the TGS. Only staff without prior experience with TGS were included in this study. Staff workload was determined using the NASA Task Load Index (TLS) at three timepoints: 1: two weeks prior to introduction of the TGS, 2: one month after introduction of the TGS, and 3: three months after introduction of the TGS. Time saving was determined by observation of the time used for dialysis data documentation by an independent person at timepoints 1 and 3. Differences in staff workload were determined by Friedman's two-way analysis of variance by ranks with Bonferroni correction for multiple tests, while time saving was determined by Wilcox signed rank test. Results In total, 223 participants from 20 clinics were included in the study, 56% were female, age distribution was 32.1% &amp;lt;30 years, 58.8% 30-49 years, and 9.1% ≥50 years, and dialysis experience was 17.5% ≤2 years, 27.9% 2-5 years, 33.3% 5-10 years, and 21.2% &amp;gt;10 years. The staff adaptability to the introduction of TGS at their workplace and the workload perception improved significantly over all domains of the NASA TLS (Table 1). While most domains improved by approximately 50%, median physical demand improved by more than 60% (Table 1). There was some variation of the observed time used for documentation between different countries, however, the observed time decreased in all countries from median (25-75%) 9:35 (5:36-14:41) minutes at timepoint 1 to 5:22 (2:05-9:22) minutes at timepoint 3 (p &amp;lt; 0.001). The largest saving was noted in the United Kingdom (14:06 (11:01-18:25) to 5:17 (4:56-5:45) minutes), while the smallest saving was noted in Kazakhstan, where only 3 individuals were observed (3:37 to 3:08). Conclusion Introduction of the novel, digitalized, integrated real-time dialysis documentation system TGS greatly reduced staff workload and time spent with documentation of dialysis treatments. Digitalization and automation of haemodialysis treatment has the potential to improve dialysis treatment, which will be further elucidated by the analysis of data quality and completeness in the current study.

Paramedic Mental Workload in Pandemic Covid-19 Era

The number of Covid-19 patients hospitalized continues to increase in line with the increase in Covid-19 cases in Indonesia. The increasing number of Covid-19 patients in hospitals is increasing the workload of paramedics. High workloads will cause saturation and fatigue. In addition, an increase in the number of Covid-19 patients increases anxiety and depression will be infected when treating patients. Paramedics should also use personal protective equipment during shift guards which causes dehydration and discomfort. This situation can degrade the quality of service to patients. The study aims to measure the mental workload of paramedics by NASA-TLX (National Aeronautics and Space Administration Task Load Index) method and find out the factors that affect mental workload levels. This research is a quantitative research with a cross sectional approach. The research was conducted at Hospital X type C in Malang Regency in October 2020. The samples used were all 100 Hospital X paramedics. Research instruments in the form of questionnaires shared through Google Form. Data analysis is done with descriptive analysis and Chi-Square analysis with p value &lt;0.05. The results found paramedics had a low mental workload of 1%, a moderate mental load of 3%, a high mental workload of 47%, and a very high mental workload of 49%. The Chi-Square test results found that age factors had an effect on the mental workload level of paramedics.

Forming a view: a human factors case study of augmented reality collaboration in assembly

Industry 4.0 technology is promoted as improving manufacturing flexibility, and competitiveness; though Australia has been slow to adopt. The Australian Navy shipbuilding program provides opportunities for accelerating technology adoption, revitalising manufacturing productivity and competitiveness. Adopting a sociotechnical systems lens, our research sought to identify usability, workload, and user experience of an augmented reality head-mounted display (AR-HMD) deployed to complete multiple work tasks in a workflow (electrical assembly, collaborative robot (cobot) mediated inspection, and remote troubleshooting using video call). Usability was rated ‘average’ (System Usability Scale mean = 69.8) and workload ‘acceptable’ (NASA Task Load Index mean = 25.8) for the AR-HMD alone, with usability of the integrated work system (IWS) rated ‘good’ (SUS mean = 79.2). Results suggest software interfaces, tracking, and gesturing methods for the AR-HMD require improvement. This trial shows the AR-HMD provides a versatile platform for integrating multiple digital technologies without hindering effectiveness of end-user performance, potentially benefiting productivity and quality.

Quantifying the effects of training in lung transplantation: Lessons from NASA

IntroductionSequential lung transplantation is a complex procedure. The traditional training model continues to centre around operative experience with progressively increasing delegation of stages of the procedure. However, little evidence exists on the effects this has on surgical trainers. The NASA-TLX is a subjective, multi-dimensional assessment tool that rates perceived workload. We sought to employ this as a means of assessing the impact that training in lung transplantation has on trainers. MethodsWe prospectively collected the NASA-TLX data for 60 patients undergoing bilateral sequential lung transplantation. In 30 cases the operation was performed entirely by the senior surgeon (SS) who implanted both lungs. In 30 operations the senior surgeon implanted the right lung (SSR) and supervised a trainee implanting the left lung (TL). ResultsThe overall weighted rating was significantly lower for the surgeon undertaking the case themselves rather than training (p <0.001). Cases were comparable in terms of case type, donor ischaemic time and peri-operative characteristics. Mental and temporal demand were greater throughout training cases (p<0.001, p<0.05). There was less effect on frustration, physical demand and effort. Perceived performance showed no significant difference between the groups. ConclusionThe NASA task load index can be used to inform the effects of training lung transplantation on trainers. Training leads to greater mental and temporal demands with less effect on other factors. Crucially, there was no significant difference in perceived performance. As the specialty continues to be confronted with diverse challenges, this study should give confidence to those training the transplant surgeons of the future, as well as providing them with a mechanism to reflect on their own training performance. ACGME CompetenciesInterpersonal and communication skillsPractice-based learning and improvement

Analisis Pengukuran Beban Kerja Mental Pekerja Produksi CV. Hikmah Jaya Garment Menggunakan Metode NASA-TLX dan RSME

Hikmah Jaya Garment is a company that produces various clothing equipment and apparel manufacturing. With the number of production requests that continue to increase every time as well as the application of the make-to-order system which causes an uncertain production schedule, it causes the emergence of its own work demands for workers. These conditions can affect the quality of the production results they are working on, so this study aims to analyze the mental workload experienced by employees at CV. Hikmah Jaya Garment is a reference for providing improvement solutions to increase work productivity. This research uses the National Aeronautics and Space Administration Task Load Index (NASA-TLX) and Rating Scale Mental Effort (RSME) methods through a questionnaire containing factors or indicators of mental workload to workers. Based on the results of calculations and analysis, the average NASA-TLX score is 74.9% and the average RSME score is 83.1%, which means that the mental workload experienced by workers is in a high category with the amount of effort expended included in a large enough category. These high results cause less than optimal worker productivity so there are several recommendations for improvement in the aspects of workload indicators. Keywords: Mental Workload, NASA-TLX, Production, RSME, 5S

A prospective study of surgeons’ workloads and associated factors in real-world practice

New technologies such as laparoscopic and robotic surgery are spreading, and there is a demand for physicians to keep up with novel methods. In contrast to the recent focus on healthcare professional burnout, the mental and physical costs during surgery are not well-understood. We aimed to quantify surgeons’ workloads in daily urological surgical practice and clarify potential background factors associated with such workloads. Urologists in Hokkaido, Japan, were invited to this study. Between December 2020 and December 2021, participants repeatedly reported workloads, which were assessed using the National Aeronautics and Space Administration-Task Load Index (NASA-TLX), after each surgery in conjunction with participants’ names, patients’ backgrounds, their roles (independent operator, operator under supervision, instructor, and 1st or 2nd assistant), and surgical outcomes, via SurveyMonkey®. Because of the heterogeneity among individuals, a linear mixed-effects model was utilized to analyze factors associated with NASA-TLX, calculating the parameter estimates (PE) of regression coefficients for each factor and their 95% confidence interval (CI). Sixty-five urologists (5 women) joined the study, and 2169 data were collected within 7 days after surgeries. A linear mixed-effects model revealed that female surgeons (PE + 15.56, 95% CI 2.36–28.77), urgent/emergency surgery (PE + 6.65, 95% CI 4.59–8.70), intraoperative complications (PE + 9.26, 95% CI 6.76–11.76), and near-miss incidents (PE + 3.81, 95% CI 2.27–5.36) were associated with higher workloads. Regarding the surgeons’ role, operator under supervision (PE + 12.46, 95% CI 9.86–15.06) showed the highest workloads. Surgeons’ workloads decreased as the number of previous cases of the same procedure increased. Surgeons’ workloads were associated with various factors. Given that the highest workloads were for operators under supervision, instructors should be aware of trainees’ high workloads and devise appropriate instructional interventions.