NASA-TLX Assessment of Surgeon Workload Variation Across Specialties.

OCCUPATIONAL APPLICATIONS The findings from the current study illustrate the adverse effects of concurrent physical and mental demands on shoulder muscle activation. Furthermore, the results also suggest that the effects of concurrent physical and mental demands are more pronounced during static, as opposed to dynamic, exertions. As such, it is important to consider the interaction of said work parameters (i.e., force levels, mental demands, and type of exertion) when evaluating/designing tasks. Occupational tasks requiring concurrent physical and mental work should be redesigned to reduce static loading (by changing postures or providing frequent breaks). With tasks requiring static exertions, other physical parameters (such as force) should be reduced to minimize interference due to additional cognitive processing. To conclude, concurrent physical and mental demands affect muscle activation and impede worker performance; ergonomists should consider this interaction during task design/redesign, evaluations of injury risk, and potential causal models of injury development. TECHNICAL ABSTRACT Background: Static work is considered an occupational risk factor in the development of injuries, thus there is an emphasis on employing dynamic exertions to work tasks. With workers experiencing concurrent physical and mental demands in their daily jobs, it is unclear whether these exertion types affect overall task demands differentially. Objective: The aim of this study was to compare exertion-dependent physiological responses due to concurrent physical and mental workload during intermittent shoulder exertion. Methods: Twelve young participants, balanced by gender, performed intermittent static and dynamic shoulder abduction for 3 minutes at three levels of physical workload (low, moderate, and high) in the absence and presence of a mental arithmetic task. Study measures included muscle activity, muscle oxygenation, motor and mental arithmetic task performance, and subjective responses (NASA-Task Load Index and Borg CR10 Scale). Results: Static exertions and higher physical demands adversely affected physiological responses (i.e., muscle activity and oxygenation) and performance measures, and they were associated with higher levels of perceived exertion and workload. Additional mental demands negatively affected muscle activity, mental task performance, and subjective workload measures. However, these results were more pronounced during static exertions at high physical demand levels. Conclusions: Results indicated that certain job parameters (static exertions and high physical demands) are more susceptible to interference with mental demands than others (dynamic exertions and low demands). When assessing overall demands placed on workers during concurrent physical and mental work, it is important to consider the interaction of work parameters, specifically physical demand levels and exertion type, with mental demands.

Surgeon Workload in Colorectal Surgery: Perceived Drivers of Procedural Difficulty

Surgeon workload, or human "cost" of performing a procedure, is not well understood in light of emerging surgical technologies. This pilot study quantified surgeon workload for colorectal procedures and identified patient, surgeon, and procedural factors impacting workload. Innovative technologies and procedures in surgery have generally been promoted for the advancement of patient care. The resulting surgeon workload is poorly studied with little knowledge of the contributing factors impacting workload. Surgeons completed NASA-Task Load Index (NASA-TLX) questionnaires to self-assess workload following abdominopelvic colon and rectal procedures. Corresponding patient data were retrieved from the medical record. Descriptive statistics, correlations, and ANOVA were performed to compare surgeon and patient factors, procedure type, and surgical approach on workload overall and by subscales. Seven attending surgeons rated 238 surgeries, of which 218 (92%) had corresponding patient data. Surgeon experience and patient demographics had inconsistent effects on workload. A statistically significant 3-way interaction was identified among disease process, procedure type, and surgical approach on workload (F(9, 146) = 2.17, P = 0.027), but was limited to open procedures for neoplasia and inflammatory bowel disease patients. Proctectomy and colectomy procedures compared across open, laparoscopic, and robotic approaches showed significant differences in overall workload and subscales, where the robotic procedures required significantly less mental demand, physical demand, and effort, than open or laparoscopic (P < 0.05). Patient characteristics, disease process, and surgical experience had inconsistent effects on surgeon workload. Major differences in workload were identified for procedure type and surgical approach, where robotic procedures required less mental demand, physical demand, and effort.

Constraints are common in soccer training to develop physical, technical-tactical, and mental training concurrently. This study examined how different scoring systems influence physical, tactical, and mental demands during large-sided games in soccer. Eighteen youth-elite male (17.39 ± 1.04 y) soccer players completed three 8 vs. 8 large-sided games where the different score systems were i) official score system (OSS; i.e., 1 goal = 1 goal), ii) double the value of the goal—4 min (DVx4; i.e., 1 goal = 1 goal from 0.00 to 7.59 min, and 1 goal = 2 goals from 8.00 to 12.00 min), and iii) double the value of the goal—8 min (DVx8; i.e., 1 goal = 1 goal from 0.00 to 3.59 min, and 1 goal = 2 goals from 4.00 to 12.00 min). Physical demands and tactical behaviors were recorded during tasks using a global positioning system and video camera. Mental fatigue was recorded pre- and post-task using a visual analogue scale. Also, the ratio of perceived exertion and mental load were recorded after tasks were finished. Results reported the highest values of mental and physical demands in DVx4. Mental fatigue increased during all three large-sided games, although this increase was significantly higher in DVx4 compared with OSS (p = 0.006) and DVx8 (p = 0.027). Tactical behavior showed a trend towards more direct play during DVx4, which was less observed during DVx8, and not at all during OSS. In conclusion, changing the scoring system affects physical, tactical, and mental demands.

Objective To compare the subjects' scores of National Aeronautics and Space Administration-task load index (NASA-TLX), the indexes of ECG and performance between the reverse target tracking task and the ordinary target tracking task which simply simulatereverse operationof carrier aircraft landing, and to preliminarily investigate the effect ofreverse operationon pilot's mental workload and its influence factors. Methods Twenty-five young male subjects accomplished the reverse and the ordinary target tracking tasks with two degrees of difficulty. ECG signals were recorded during the resting period before the task, periods of each task and the resting period after the task. Each subjects filled in NASA-TLX scale after the completion of each task and had a score feedback for each task. The scores of NASA-TLX and the indexes of performance were analyzed by analysis of variance (ANOVA) in 2×2 factorial design. The indexes of ECG were analyzed by Friedman M test and the multiple comparisons were carried out by LSD-t test. Results The scores of NASA-TLX and the average tracking distance of the reverse target tracking task were higher than those of the ordinary target tracking task (F=21.70, 16.14, P<0.05) and the highest appeared in the reverse dual task (F=6.67, P<0.05). HR also had the corresponding change (χ2=34.87, P<0.05), but the indexes of HRV had no significant differences. Conclusions Mental workload of the reverse operation task is higher than that of the ordinary operation task if the other conditions are the same. The reverse operation impacts mental workload severer when more information processing is required. Mental demand, physical demand and frustration level are the major influence factors of causing high mental workload in reverse operations. Key words: Workload; Cognition; Habituation, psychophysiologic; Work capacity evaluation; Electrocardiography

Vocal effort is a widely measured outcome in the treatment of laryngeal dystonia. Although it is known to be multifaceted with both physical and psychological contributors, the most frequently used vocal effort scales in laryngeal dystonia are limited to capturing its physical components. In this study, we hypothesized that the cognitive workload associated with speaking, assessed by the mental subscale of the NASA Task Load Index (NASA-TLX), would show positive correlations with the perception of vocal effort, as measured by the OMNI Vocal Effort Scale (OMNI-VES), in adductor laryngeal dystonia (ADLD) patients. ADLD patients scheduled for Botox treatment at a single tertiary care center were identified and prospectively enrolled. Patients completed the NASA-TLX, an assessment of task-related workload with six subscales, and the OMNI-VES just prior to, 1 week following, and 4-6 weeks following Botox administration. Twenty five patients completed measures for all timepoints. All NASA-TLX subscales, including mental demand, physical demand, temporal demand, performance, effort, and frustration, correlated with OMNI-VES (p < 0.05) on multilevel bivariate regression. On multilevel multivariate regression, both mental and physical demand correlated with OMNI-VES (p < 0.05) with coefficients of 0.036 and 0.032, respectively. Both cognitive load and physical effort associated with speaking, as measured by the NASA-TLX, contributed to the perception of vocal effort in ADLD patients. Understanding vocal effort and its contributing factors is important to tracking and understanding ADLD treatment outcomes.

A descriptive study of the multidisciplinary healthcare experiences of inpatient resuscitation events

Mixed Reality (MR) is proven in the literature to support precise spatial dental drill positioning by superimposing 3D widgets. Despite this, the related knowledge about widget's visual design and interactive user feedback is still limited. Therefore, this study is contributed to by co-designed MR drill tool positioning widgets with two expert dentists and three MR experts. The results of co-design are two static widgets (SWs): a simple entry point, a target axis, and two dynamic widgets (DWs), variants of dynamic error visualization with and without a target axis (DWTA and DWEP). We evaluated the co-designed widgets in a virtual reality simulation supported by a realistic setup with a tracked phantom patient, a virtual magnifying loupe, and a dentist's foot pedal. The user study involved 35 dentists with various backgrounds and years of experience. The findings demonstrated significant results; DWs outperform SWs in positional and rotational precision, especially with younger generations and subjects with gaming experiences. The user preference remains for DWs (19) instead of SWs (16). However, findings indicated that the precision positively correlates with the time trade-off. The post-experience questionnaire (NASA-TLX) showed that DWs increase mental and physical demand, effort, and frustration more than SWs. Comparisons between DWEP and DWTA show that the DW's complexity level influences time, physical and mental demands. The DWs are extensible to diverse medical and industrial scenarios that demand precision.

Subjective mental workload in Type A women

Health care is one of the leading sectors of the national economy in Latvia, where employees according to the official statistics make up 6.7% of all employees in the country. In 2022. Today, physical load and stress at work are an integral part of everyday life in various professions. It places a heavy burden on workers` mental and physical abilities. Work related musculoskeletal disorders (WRMSD`s) are the most common causes of occupational diseases, injuries, and disabilities for various professions, including staff in the operating block. When cognitive demands increase and are not balanced with employees' abilities, employees' health suffers (Bakker &amp;#38; Demerouti, 2007; Johnson &amp;#38; Hall, 1988; Karasek, 1979). The aim of this study was to investigate the interaction of physical and mental strain for surgeons and nurses in operating theater.Methods and materials. The research was performed at one of the hospitals in Latvia. Altogether participated 8 operating surgeons (7 males, 1 female) and 10 surgery nurses (2 males, 8 females). Interaction of mental and physical load was determined using subjective and multidimensional assessment tool: The NASA Task Load Index (NASA-TLX) (Hart, 2006). This method is a multidimensional rating system for assessment of general or total workload based on results of the six sub scales: mental demands, physical demands, temporary demands, task performance, effort and frustration. Psychosocial aspects were considered when assessing mental strain, including working hours, work content, work team interrelations.ResultsThe results of NASA-TLX analysis show that highest degree of total workload considering mental and physical load interaction was identified for physicians  surgeons (75 points). Surgeons have a very high responsibility on the executable work, and they have been involved in responsible decision making, for example, saving the patient's life. Physical demands of the surgeons are mainly based in connection with postural load (prolonged standing on legs, forced working postures) and repetitive hand-arm movements. As work of surgery nurses is characterized with prolonged standing on legs and compulsive posture, load on upper limbs, the NASA-TLX analysis shows that physical load of surgery nurses is evaluated up to 78 points, but temporal load indicator for surgery nurses resulted in 83 points (highest degree), work performance conforms to 80 points, which indicates a high level of responsibility. Conclusion The interaction of a mental and physical load using NASA-TLX method allowed to estimate the total workload and compare the significance in percent (or weight scores) of different demands (stress at work, an effort, frustration, quality of performance, a.o.). The physical workload is higher for surgery nurses than for operating surgeons, as according to the NASA-TLX analysis psycho-emotional workload (responsibility for the patient's life, time pressure, decision making) is higher than physical workload for operating surgeons. Physical workload (frequent arm movements, standing, lifting and carrying) for surgery nurses significantly influences their total workload.Acknowledgment: This research has been supported by the project “Work Related Musculoskeletal Disorders and Psychosocial Risks for Operating Room Health Care Staff”, Agreement No. LU-BA-PA-2024/1-0044, UL registration No. ESS2024/465.

Background: The concept of Mental Workload (MW) evaluates the cognitive resources invested by an athlete relative to their available capacity. While crucial for performance, its perception varies significantly across different athletic contexts. Objective: This study aimed to analyze the differences in perceived workload, as measured by the NASA-TLX, based on two factors: type of sport (individual, team, or combat) and sport qualification level (international medalists, national-level competitors, or recreational athletes). Methods: A total of 183 athletes completed the NASA Task Load Index (NASA-TLX). Sport type (individual, team, combat) and qualification (international medalists, national-level, recreational) were treated as between-subject factors. One-way and two-way ANOVAs were used to test main and interaction effects. Results: The results revealed significant main effects for both sport qualification and sport type on the dimensions of Mental Demand, Physical Demand, Temporal Demand, and Effort. Professional athletes consistently reported higher workloads than recreational athletes. Combat sports were perceived as the most physically and mentally demanding, while team sports were associated with the lowest effort. Crucially, a significant interaction effect was found for Temporal Demand, indicating that national-level competitors in team sports experience a unique peak in time pressure not observed in other groups. No significant differences were found for the Performance or Frustration dimensions. Conclusion: These findings demonstrate that MW is a multifactorial construct shaped by both an athlete's expertise and the specific demands of their sport. The results highlight the need for a differentiated approach to workload management and provide a valuable tool for coaches and sport psychologists to better tailor training programs.

IntroductionLearner workload during simulated team-based resuscitations is not well understood. In this descriptive study, we measured the workload of learners in different team roles during simulated paediatric cardiopulmonary resuscitation.MethodsPaediatric emergency...

141 Frequency and Effect of Interruptions on Resident Workload in the Emergency Department

The communication of a project's design to craft professionals can affect project performance significantly. Despite advancements in 3D computer modeling and integrated information systems in recent decades, the spatial design is still primarily delivered to the construction workforce in 2D drawings of various views. These views must be combined and encoded to understand all orientations of the engineering element effectively. Three-dimensional computer aided design (3D CAD) and additive manufacturing (3D printing) provide promising alternative formats for presenting spatial engineering information. By asking craft professionals to complete a reconstructing task of a simple structural frame using 2D drawings, a 3D CAD interface, and a 3D printed model, the cognitive workload demands can be measured. After completing the task, the craft professionals were surveyed on their perceptions of mental workload in six main factors using the NASA Task Load Index (TLX): mental demand, physical demand, temporal demand, performance, effort, and frustration. In addition, the subjects provided insights into their preferences for the different model types. Lower workload scores generally are desirable and indicate lower demands on an individual's mental resources, allowing for concurrent processing of other information. The results found that a physical 3D model, on average, requires lower composite cognitive workloads than either 2D drawings or a 3D computer model. The paper's primary contribution to the overall body of knowledge is the understandng of the cognitive demands of craft professionals when presented with spatial engineering information in various formats.

This study aimed to examine the association between workload and patient safety culture (PSC) among intensive care unit (ICU) nurses. ICU nurses play a vital role in promoting patient safety and are essential indicators in any healthcare system including ICUs. Research studies focusing on the relationship between nursing workload and PSC among ICU nurses are limited. Descriptive correlational design. The study participants involved 380 ICU nurses at two hospitals in Riyadh, Saudi Arabia. Data were collected between February 2019-April 2019 and were analysed using SPSS v.22 statistical software. This study was guided by the STROBE checklist. The results showed that ICU nurses have high positive perceptions in the following PSC subscales: teamwork within units, organisational learning-continuous improvement, frequency of events reported, feedback and communication about error, management support for patient safety, teamwork across units, supervisor/manager expectations and actions promoting patient safety, handoffs and transitions, nonpunitive response to errors, staffing and overall perceptions of patient safety. However, the participants collectively considered the overall grade on patient safety as poor. The participants had high mean scores in physical demand, effort, mental demand and overall workload. A statistically significant variability existed in the mean scores of the PSC subscales and workload of ICU nurses. The overall workload was significantly and negatively associated with the PSC perceptions of ICU nurses. The ICU nurses experienced high overall workload, physical demand, effort and mental demand which influenced the poor grade of their overall perceived PSC. Identifying differences and associations with the perceptions of ICU nurses regarding workload and PSC is important because such perceptions may affect their delivery of nursing care. Hospital and nursing administrators must use the study results to find strategies that address workload issues and enhance patient safety.