Taylor Natasha, Wyres Martyn, Bollard Martin, Kneafsey Rosie
Faculty of Health and Life Sciences, Coventry University, Coventry, UK.
BMJ Simul Technol Enhanc Learn. 2020 Nov 1;6(6):360-364. doi: 10.1136/bmjstel-2019-000517. eCollection 2020.
The use of brain imaging techniques in healthcare simulation is relatively rare. However, the use of mobile, wireless technique, such as functional near-infrared spectroscopy (fNIRS), is becoming a useful tool for assessing the unique demands of simulation learning. For this study, this imaging technique was used to evaluate cognitive load during simulation learning events.
This study took place in relation to six simulation activities, paired for similarity, and evaluated comparative cognitive change between the three task pairs. The three paired tasks were: receiving a (1) face-to-face and (2) video patient handover; observing a simulated scene in (1) two dimensions and (2) 360° field of vision; and on a simulated patient (1) taking a pulse and (2) taking a pulse and respiratory rate simultaneously. The total number of participants was n=12.
In this study, fNIRS was sensitive to variations in task difficulty in common simulation tools and scenarios, showing an increase in oxygenated haemoglobin concentration and a decrease in deoxygenated haemoglobin concentration, as tasks increased in cognitive load.
Overall, findings confirmed the usefulness of neurohaemoglobin concentration markers as an evaluation tool of cognitive change in healthcare simulation. Study findings suggested that cognitive load increases in more complex cognitive tasks in simulation learning events. Task performance that increased in complexity therefore affected cognitive markers, with increase in mental effort required.
脑成像技术在医疗模拟中的应用相对较少。然而,诸如功能近红外光谱(fNIRS)等移动无线技术正成为评估模拟学习独特需求的有用工具。在本研究中,该成像技术被用于评估模拟学习活动期间的认知负荷。
本研究针对六项模拟活动展开,这些活动按相似性配对,并评估了三个任务对之间的相对认知变化。这三个配对任务分别是:接收(1)面对面和(2)视频形式的患者交接;观察模拟场景,(1)二维和(2)360°视野;以及在模拟患者身上(1)测量脉搏和(2)同时测量脉搏和呼吸频率。参与者总数为n = 12。
在本研究中,fNIRS对常见模拟工具和场景中的任务难度变化敏感,随着任务认知负荷增加,氧合血红蛋白浓度升高,脱氧血红蛋白浓度降低。
总体而言,研究结果证实了神经血红蛋白浓度标记物作为医疗模拟中认知变化评估工具的有效性。研究结果表明,在模拟学习活动中,更复杂的认知任务会增加认知负荷。因此,复杂度增加的任务表现会影响认知标记物,同时所需的心理努力也会增加。