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Cognitive load and performance in immersive virtual reality versus conventional virtual reality simulation training of laparoscopic surgery: a randomized trial

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@article{494864daf98f42a683340c097e0cd765,
title = "Cognitive load and performance in immersive virtual reality versus conventional virtual reality simulation training of laparoscopic surgery: a randomized trial",
abstract = "Background: Virtual reality simulators combined with head-mounted displays enable highly immersive virtual reality (VR) for surgical skills training, potentially bridging the gap between the simulation environment and real-life operating room conditions. However, the increased complexity of the learning situation in immersive VR could potentially induce high cognitive load thereby inhibiting performance and learning. This study aims to compare cognitive load and performance in immersive VR and conventional VR simulation training. Methods: A randomized controlled trial of residents (n = 31) performing laparoscopic salpingectomies with an ectopic pregnancy in either immersive VR or conventional VR simulation. Cognitive load was estimated by secondary-task reaction time at baseline, and during nonstressor and stressor phases of the procedure. Simulator metrics were used to evaluate performance. Results: Cognitive load was increased by 66{\%} and 58{\%} during immersive VR and conventional VR simulation, respectively (p < 0.001), compared to baseline. A light stressor induced a further increase in cognitive load by 15.2{\%} and a severe stressor by 43.1{\%} in the immersive VR group compared to 23{\%} (severe stressor) in the conventional VR group. Immersive VR also caused a significantly worse performance on most simulator metrics. Conclusion: Immersive VR simulation training induces a higher cognitive load and results in a poorer performance than conventional VR simulation training in laparoscopy. High extraneous load and element interactivity in the immersive VR are suggested as mechanisms explaining this finding. However, immersive VR offers some potential advantages over conventional VR such as more real-life conditions but we only recommend introducing immersive VR in surgical skills training after initial training in conventional VR.",
keywords = "Cognitive load, Head-mounted device, Immersive virtual reality, Laparoscopic surgical skills training, Simulation",
author = "Frederiksen, {Joakim Grant} and S{\o}rensen, {Stine Maya Dreier} and Lars Konge and Svendsen, {Morten Bo S{\o}ndergaard} and Morten Nobel-J{\o}rgensen and Flemming Bjerrum and Andersen, {Steven Arild Wuyts}",
year = "2019",
month = "1",
day = "1",
doi = "10.1007/s00464-019-06887-8",
language = "English",
journal = "Surgical Endoscopy and Other Interventional Techniques",
issn = "0930-2794",
publisher = "Springer New York LLC",

}

RIS

TY - JOUR

T1 - Cognitive load and performance in immersive virtual reality versus conventional virtual reality simulation training of laparoscopic surgery

T2 - a randomized trial

AU - Frederiksen, Joakim Grant

AU - Sørensen, Stine Maya Dreier

AU - Konge, Lars

AU - Svendsen, Morten Bo Søndergaard

AU - Nobel-Jørgensen, Morten

AU - Bjerrum, Flemming

AU - Andersen, Steven Arild Wuyts

PY - 2019/1/1

Y1 - 2019/1/1

N2 - Background: Virtual reality simulators combined with head-mounted displays enable highly immersive virtual reality (VR) for surgical skills training, potentially bridging the gap between the simulation environment and real-life operating room conditions. However, the increased complexity of the learning situation in immersive VR could potentially induce high cognitive load thereby inhibiting performance and learning. This study aims to compare cognitive load and performance in immersive VR and conventional VR simulation training. Methods: A randomized controlled trial of residents (n = 31) performing laparoscopic salpingectomies with an ectopic pregnancy in either immersive VR or conventional VR simulation. Cognitive load was estimated by secondary-task reaction time at baseline, and during nonstressor and stressor phases of the procedure. Simulator metrics were used to evaluate performance. Results: Cognitive load was increased by 66% and 58% during immersive VR and conventional VR simulation, respectively (p < 0.001), compared to baseline. A light stressor induced a further increase in cognitive load by 15.2% and a severe stressor by 43.1% in the immersive VR group compared to 23% (severe stressor) in the conventional VR group. Immersive VR also caused a significantly worse performance on most simulator metrics. Conclusion: Immersive VR simulation training induces a higher cognitive load and results in a poorer performance than conventional VR simulation training in laparoscopy. High extraneous load and element interactivity in the immersive VR are suggested as mechanisms explaining this finding. However, immersive VR offers some potential advantages over conventional VR such as more real-life conditions but we only recommend introducing immersive VR in surgical skills training after initial training in conventional VR.

AB - Background: Virtual reality simulators combined with head-mounted displays enable highly immersive virtual reality (VR) for surgical skills training, potentially bridging the gap between the simulation environment and real-life operating room conditions. However, the increased complexity of the learning situation in immersive VR could potentially induce high cognitive load thereby inhibiting performance and learning. This study aims to compare cognitive load and performance in immersive VR and conventional VR simulation training. Methods: A randomized controlled trial of residents (n = 31) performing laparoscopic salpingectomies with an ectopic pregnancy in either immersive VR or conventional VR simulation. Cognitive load was estimated by secondary-task reaction time at baseline, and during nonstressor and stressor phases of the procedure. Simulator metrics were used to evaluate performance. Results: Cognitive load was increased by 66% and 58% during immersive VR and conventional VR simulation, respectively (p < 0.001), compared to baseline. A light stressor induced a further increase in cognitive load by 15.2% and a severe stressor by 43.1% in the immersive VR group compared to 23% (severe stressor) in the conventional VR group. Immersive VR also caused a significantly worse performance on most simulator metrics. Conclusion: Immersive VR simulation training induces a higher cognitive load and results in a poorer performance than conventional VR simulation training in laparoscopy. High extraneous load and element interactivity in the immersive VR are suggested as mechanisms explaining this finding. However, immersive VR offers some potential advantages over conventional VR such as more real-life conditions but we only recommend introducing immersive VR in surgical skills training after initial training in conventional VR.

KW - Cognitive load

KW - Head-mounted device

KW - Immersive virtual reality

KW - Laparoscopic surgical skills training

KW - Simulation

UR - http://www.scopus.com/inward/record.url?scp=85067078896&partnerID=8YFLogxK

U2 - 10.1007/s00464-019-06887-8

DO - 10.1007/s00464-019-06887-8

M3 - Journal article

JO - Surgical Endoscopy and Other Interventional Techniques

JF - Surgical Endoscopy and Other Interventional Techniques

SN - 0930-2794

ER -

ID: 57584806