Understanding effects of inverted motion control during robotic skills tasks to cognitive workload and performance
TimeThursday, April 1512:30pm - 12:50pm EDT
LocationEducation and Simulation
DescriptionRobotic-assisted surgery (RAS) have been increasingly prevalent, particularly in surgical specialties such as urology, obstetrics and gynecology, and general surgery. Minimally invasive (MI) procedures are now conducted through conventional laparoscopy or RAS, with RAS overcoming limitations of laparoscopic techniques such as limited visibility, spatial incompatibility, and motor control challenges due to the fulcrum effect. The fulcrum effect during laparoscopy describes the translation of lateral motions from the tool handle to be scaled and inverted at the tool tip, and surgical trainees must be overcome challenges associated with this effect for surgical proficiency. However, RAS technology negates this effect and directly translates the motions of the surgeons’ hands to the same direction at the tool tip (i.e., robotic instrument). With current medical trainees learning both laparoscopic and robotic techniques, negative transfer of skill and increases in cognitive workload may occur while switching between techniques. Furthermore, with the increase in new robotic surgical devices in MI surgery that are controlled differently than current platforms, it is critical to understand how the introduction of new technology affects the workload and performance for skills training. A study was completed to investigate the effects of changes in motion (i.e., regular and in inverted motion) during a simulated robotic surgical skills task on users’ cognitive workload and performance. Participants completed 6-minute sessions of the peg transfer task, with alternating one-minute trials of regular and inverted motion controls. Cognitive workload was measured using a 32-channel wearable electroencephalogram (EEG) and task performance was measured. An established EEG processing pipeline was followed to obtain the alpha, low beta, high beta, and theta band power from each channel. A total of 160 trials (n=4) were obtained, and it was found that there were significant differences in alpha and theta power between the two motions in the frontal EEG channels. Performance differences were also observed, such as increased number of errors and increased task completion time between the changes of motion. This demonstrates that the introduction of new technology and techniques may cause negative transference of skill to increase cognitive workload and decrease performance of surgeons, which can lead to patient harm. As there continues to be shifts in medical practice due to the introduction of advanced technologies, new paradigms for skills training and medical education are required.