Continuous monitoring of cognitive load using advanced computerized analysis of brain signals during virtual simulator training for laparoscopic surgery, reflects laparoscopic dexterity. A comparative study using a novel wireless device

TL;DR

This study demonstrates that advanced brain signal analysis using a wireless EEG device can effectively monitor cognitive load during laparoscopic surgery simulation, correlating brain biomarkers with performance improvements.

Contribution

It introduces a novel wireless EEG biomarker, VC9, for real-time assessment of cognitive load during surgical simulation, showing higher sensitivity than traditional measures.

Findings

Behavioral performance improved with practice.

Theta band activity decreased with better performance.

VC9 biomarker correlated with reduced cognitive load.

Abstract

Simulation-based training is an effective tool for acquiring practical skills, specifically to train new surgeons in a controlled and hazard-free environment, it is however important to measure participants cognitive load to decide whether they are ready to go into a real surgery. In the present study we measured performance on a surgery simulator of medical students and interns, while their brain activity was monitored by a mobile EEG device. 38 medical studentswere underwent 3 experiments undergoing a task with Simbionix simulator, while their brain activity was measured using a single-channel EEG device (Aurora by Neurosteer). On each experiment, participants performed 3 repeats of a simulator task using laparoscopic hands. The retention between tasks was different on each experiment, to examine changes in performance and cognitive load biomarkers that occur during the task or as a results of night sleep consolidation. The participants behavioral performance improved with trial repetition in all 3 experiments. In Exps. 1 & 2, the theta band activity significantly decreased with better individual performance, as exhibited by some of the behavioral measurements of the simulator. The novel VC9 biomarker (previously shown to correlate with cognitive load), exhibited a significant decrease with better individual performance shown by all behavioral measurements. In correspondence with previous research, theta decreased with lower cognitive load and higher performance and the novel biomarker, VC9, showed higher sensitivity to load changes. Together, these measurements might be for neuroimaging assessment of cognitive load while performing simulator laparoscopic tasks. This could potentially be expanded to evaluate efficacy of different medical simulations to provide more efficient training to medical staff and to measure cognitive and mental load in real laparoscopic surgeries.