The National Aeronautics and Space Administration‐task load index: NASA‐TLX: evaluation of its use in surgery. Issue 11 (8th June 2022)

• Record Type: Journal Article
• Authors: Bell, Stephen W.; Kong, Joseph C. H.; Clark, David A.; Carne, Peter; Skinner, Stewart; Pillinger, Stephen; Burton, Paul; Brown, Wendy
• Is Part Of: ANZ journal of surgery. Volume 92:Issue 11(2022)
• Page Start: 3022
• Page End: 3028
• Publication Date: 2022-06-08
• Subjects: bariatric surgery -- NASA TLX -- surgical research; Surgery -- Periodicals; 617.005
• DOI: 10.1111/ans.17830
• Languages: English
• ISSNs: 1445-1433

Abstract

Abstract: Background: The technical difficulty an operation creates for a surgeon is difficult to measure. Current measures are poor surrogates. In both research and teaching settings it would be valuable to be able to accurately measure this degree of difficulty. The National Aeronautics and Space Administration Task Load Index (NASA TLX) is a multi‐dimensional scale designed to obtain workload estimates relating to a task. This study aimed to evaluate the NASA TLX as an objective measure of technical difficulty of an operation. Methods: Seven surgeons performed 127 pre‐defined operations (minimally invasive right hemicolectomy & re‐do bariatric surgery) and recorded a NASA TLX score after each operation. These scores were compared to numerous clinical parameters and the score was correlated with the subjective measure of whether the surgeon categorized the operation as "easy", "moderate" or "difficult". Results: The NASA TLX score was significantly correlated with operative duration, blood loss, previous abdominal surgery and the surgeons' assessment of difficulty. It did not correlate with intra‐operative or post‐operative complications, conversion to open surgery or length of stay. Conclusions: The NASA TLX score provides a graded numerical score that that correlated significantly with the surgeon's assessment of the technical difficulty, and with operative duration, intra‐operative blood loss and previous abdominal surgery. This novel application of this tool could be employed in both research and teaching settings to score surgical difficulty and monitor a trainee's proficiency over time. Abstract : The NASA TLX score provides a graded ordinal numerical score that correlates well with the surgeon's assessment of the technical difficulty of an operation, along with a history of previous abdominal surgery, operative time and intra‐operative blood loss. This provides a potential tool that can be used in both research and teaching settings to measure changes in technical difficulty with the introduction of a new technique or technology, along with a trainee's progress over time.