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脑电图监测静脉置管期间认知表现的可行性:脑电图分心静脉通路(E-DIVA)。

Feasibility of EEG to monitor cognitive performance during venous cannulation: EEG Distracted Intravenous Access (E-DIVA).

作者信息

Lowe David J, James Scott A, Lloyd Adam, Clegg Gareth R

机构信息

Emergency Department, Glasgow Royal Infirmary, Glasgow, UK.

Department of Anaesthesia, Critical Care & Pain, University of Glasgow, Glasgow, UK.

出版信息

BMJ Simul Technol Enhanc Learn. 2016 Jun 1;2(3):68-72. doi: 10.1136/bmjstel-2015-000082. eCollection 2016.

Abstract

BACKGROUND

The feasibility study aims to evaluate the use of EEG in measuring workload during a simulated intravenous cannulation task. Cognitive workload is strongly linked to performance, but current methods to assess workload are unreliable. The paper presents the use of EEG to compare the cognitive workload between an expert and novice group completing a simple clinical task.

METHODS

2 groups of volunteers (10 final year medical students and 10 emergency medicine consultants) were invited to take part in the study. Each participant was asked to perform 3 components of the simulation protocol: intravenous cannulation, a simple arithmetic test and finally these tasks combined. Error rate, speed of task completion and an EEG-based measure of cognitive workload were recorded for each element.

RESULTS

EEG cognitive workload during the combined cannulation and arithmetic task is significantly greater in novice participants when compared with expert operators performing the same task combination. EEG workload mean measured for novice and experts was 0.62 and 0.54, respectively (p=0.001, 95% CI 0.09 to 0.30). There was no significant difference between novice and expert EEG workload when the tasks were performed individually.

CONCLUSIONS

EEG provides the opportunity to monitor and analyse the impact of cognitive load on clinical performance. Despite the significant challenges in set up and protocol design, there is a potential to develop educational interventions to optimise clinician's awareness of cognitive load. In addition, it may enable the use of metrics to monitor the impact of different interventions and select those that optimise clinical performance.

摘要

背景

本可行性研究旨在评估脑电图(EEG)在模拟静脉穿刺任务中测量工作量的应用。认知工作量与表现密切相关,但当前评估工作量的方法并不可靠。本文介绍了使用脑电图来比较专家组和新手组在完成一项简单临床任务时的认知工作量。

方法

邀请两组志愿者(10名医学专业最后一年的学生和10名急诊医学顾问)参与研究。要求每位参与者执行模拟方案的三个部分:静脉穿刺、简单算术测试,最后是将这些任务结合起来。记录每个部分的错误率、任务完成速度以及基于脑电图的认知工作量测量值。

结果

与执行相同任务组合的专家操作员相比,新手参与者在静脉穿刺和算术组合任务期间的脑电图认知工作量显著更大。新手和专家的脑电图工作量平均值分别为0.62和0.54(p = 0.001,95%置信区间为0.09至0.30)。当单独执行任务时,新手和专家的脑电图工作量没有显著差异。

结论

脑电图提供了监测和分析认知负荷对临床性能影响的机会。尽管在设置和方案设计方面存在重大挑战,但仍有可能开发教育干预措施,以优化临床医生对认知负荷的认识。此外,它可能使我们能够使用指标来监测不同干预措施的影响,并选择那些能优化临床性能的措施。

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