NASA Task Load Index Scale to Evaluate the Cognitive Workload during Cardiac Anesthesia Based Simulation Scenarios

Simulation-based education is an important tool for anesthesiology educators given the work hour restrictions and limited exposure of anesthesiology residents to high acuity cardiac cases. Cognitive load is key to learning, performance, and resilience. When working with new and complicated information in an environment prone to changes and distractions, working memory has a limited capacity, duration, and is diminished by excessive cognitive workload. When this capacity is surpassed, learning and performance are impaired. Wecreated cardiac anesthesia-based high fidelity simulation scenarios to determine how to bestmeasure cognitive load by administering the NASA Task Load Index(NASA-TLX). We recreated a cardiac operating room by mimicking a complex learning environment that places high demand on the novice learners. Fourteen anesthesiology residents participated in this study for determination of cognitive load using NASA-TLX. This scale measures effort, frustration, performance, mental demand, physical demand, and temporal demand. The residents perceived mental demand as the most challenging, with a mean of 15.21 ± 1.86; followed by effort, demand with a mean of 14.32±2.49. We determined that using the NASA-TLX Scale to measure and report cognitive load provides an opportunity to effectively evaluate cognitive distress during the acquisition of new skills and enhance physician resilience.