Developing a subjective instrument for laparoscopic surgical workload in a high fidelity simulator using the NASA-TLX and SURG-TLX

Jiahui Ma, Bethany Lowndes, Kristin Chrouser, Susan Hallbeck, Bernadette McCrory

Research output: Contribution to journalArticlepeer-review

2 Scopus citations


The Surgery Task Load Index (SURG-TLX) and National Aeronautics and Space Administration Task Load Index (NASA-TLX) are subjective workload assessment instruments. These instruments have three coinciding workload dimensions, but each has three unique dimensions. Each dimension is explained by a unique descriptor. It was hypothesized that the SURG-TLX and NASA-TLX workload ratings would differ when assessing the same surgical methods and tasks. Accordingly, the aim of this study was to assess the SURG- and NASA-TLX dimensions toward the creation of a novel workload instrument to better predict simulated laparoscopic surgical workload. Twenty-five (25) participants were selected at a large, midwestern teaching hospital to conduct two simulated surgical tasks using four different laparoscopic methods. Each participant completed a total of eight trials and after each trial workload was assessed using both the NASA-TLX and SURG-TLX. The overall NASA-TLX dimensions were rated significantly higher (greater workload) compared to the overall SURG-TLX dimensions (F = 12.04, p = 0.001). Principle component analysis of workload dimensions suggests that a new surgical subjective workload measurement instrument should include the dimensions of Mental Demand, Physical Demand, Temporal Demand, Performance, Frustration and Situational Stress. However, validation of this novel tool is needed.

Original languageEnglish (US)
Pages (from-to)161-169
Number of pages9
JournalIISE Transactions on Healthcare Systems Engineering
Issue number2
StatePublished - 2020


  • Surgical workload instrument
  • laparoscopic surgery

ASJC Scopus subject areas

  • Safety, Risk, Reliability and Quality
  • Safety Research
  • Public Health, Environmental and Occupational Health


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