For a study, it was determined that Robotic-assisted bronchoscopy (RB) and electromagnetic navigational bronchoscopy (ENB) both necessitated a high level of decision-making and psychomotor skill. The overall effort expended by individuals in reaction to a task was known as cognitive load theory, and it was strongly tied to the usability of medical technology. The high cognitive burden was linked to poor surgical results and was a learning bottleneck that impairs performance. This study determined the cognitive burden associated with ENB and RB in experienced ENB practitioners who were learning RB. Researchers did ENB and RB on a human cadaver model of peripheral pulmonary nodules by six experienced ENB bronchoscopists. Researchers utilized the Surgery Task Burden Index (SURG-TLX) and biometric changes to quantify cognitive load. After each peripheral pulmonary nodule biopsy using ENB and RB, the provider was given the SURG-TLX questionnaire. For each biopsy attempt, pupillary dilation and screen changes were continually recorded by Researchers throughout the process to acquire biometric measurements of cognitive stress. The length of the procedure and the biopsy outcome were also documented.
A total of forty procedures (ENB and RB) were studied. The biggest contributions to cognitive load in ENB and RB were task complexity (23%) and mental demand (21.4%). The RB had a considerably lower cumulative SURG-TLX (69.25 vs. 101.25; P<0.01). ENB had a longer total process duration (6.7 minutes; SD 1.5) than RB (4.4 minutes; SD 1.5; P=0.01). The diameter of the pupil was similar across the modalities (RB vs. ENB); however, it was larger during the biopsy portion (4.25 mm) than during the navigation portion (RB vs. ENB) (4.01 mm). Existing ENB practitioners were able to manage the inherent cognitive load of RB, and RB appeared to be less mentally demanding in this study. For RB’s future development and training, task complexity and mental effort should be prioritized by Researchers. Regardless of bronchoscopic mode, the biopsy part should focus on education and training.
Reference:www.atsjournals.org/doi/full/10.34197/ats-scholar.2020-0033OC
