Key result
High-fidelity simulation scenarios generate a median task load score of ~62 among intensive care residents.
Why the study?
The NASA-TLX questionnaire may help attest scenario quality in high-fidelity simulation, but whether scores for critical care scenarios designed for residents match literature values, and relate to performance and stress, was unclear.
Does high-fidelity simulation generate acceptable task load and how does it relate to stress and performance in anaesthesia and intensive care residents?
Observational (n=53)
No
Does high-fidelity simulation generate acceptable task load and how does it relate to stress and performance in anaesthesia and intensive care residents?
NASA-TLX can be used to assess the pedagogic adequacy of high-fidelity simulation scenarios, demonstrating that task load correlates with stress but not directly with performance in residents.
NASA-TLX may aid simulation calibration for anesthesia/ICU residents; hypothesis-generating for task load–stress links without performance correlation.
Background The NASA Task Load IndeX (NASA-TLX) is a questionnaire widely used in aviation. This index might help for attesting the quality of a scenario in high-fidelity simulation (HFS) in healthcare. The main purpose of this study was to observe whether the score of NASA-TLX for critical care simulated scenarios, designed for residents, was consistent with the values reported in the literature. The second purpose was to describe relationships between NASA-TLX, performance and generated stress during HFS. Methods All residents in anaesthesia and intensive care undergoing HFS were included. The primary endpoint was the task load generated by each scenario assessed by NASA-TLX. Based on literature, the NASA-TLX scores between 39 and 61 were considered as acceptable level. Stress level (Visual Analogue Scale for stress), specific technical and non-technical skills performances (Team Emergency Assessment Measure) were also assessed. Results Fifty-three residents actively participated in one of ten different scenarios, between June to December 2017. Median NASA-TLX score of scenarios was 61 [48–65]. Five scenarios (50%) generated acceptable task load level. There was no association between NASA-TLX score and technical or Team Emergency Assessment Measure performance scores, but an association between NASA-TLX and the stress level (rho = 4.7, p = 0.001) was observed. Conclusions Simulation scenarios generate different task loads for residents; the task load was deemed acceptable for half of the scenarios. The NASA-TLX could be considered as a tool to assess the pedagogic adequacy of scenarios. Scenario and generated stress level, but not task load, can modify residents’ performance during simulation. This should be considered when planning normative simulation.
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Favre-Félix et al. (2021) conducted an observational in Anaesthesia and intensive care residents undergoing high-fidelity simulation (n=53). High-fidelity simulation (HFS) scenarios was evaluated on Task load generated by each scenario assessed by NASA-TLX. High-fidelity simulation scenarios generated a median NASA-TLX task load score of 61.7 among anesthesia and intensive care residents, with half of the scenarios producing an acceptable task load.
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