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How sensitive are distortions in students' time perception to changes in demand across laparoscopic training tasks? Volunteers used an endoscopy training simulator to perform two common training tasks. The simpler of the two tasks involved using graspers to move beads from a dish to a small bucket. The more difficult task involved threading beads onto small pegs. In one experiment, 13 participants estimated the duration of each training trial immediately upon its completion. They also completed the NASA-TLX. In another experiment, 15 participants verbally indicated when they thought each successive 31-second interval had elapsed while performing the training trials. Results indicated that errors in temporal judgments were sensitive to differences in task demand using the interval production method but not the retrospective estimation technique. One implication is that interval production shows promise as a secondary task workload measure for laparoscopic tasks, although procedural refinements are needed to maximize the measure's sensitivity.

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Technological innovations are at the forefront of advances in minimally invasive surgery. Reduced visual and haptic cues, along with frame-of-reference problems with location and scale can cause surgeons to become disoriented. While most laparoscopic surgeries are performed via the use of a limited, singlescope, two-dimensional (2-D) view presented on a monitor in the operating room, there is demand for the availability of three-dimensional (3-D), global views. We compared workload, task-completion time, and the ability to recreate spatial mental representations between study participants who used the current scope-view display and those who used a dual-view display that included both the scope view and a computationally generated global view. We found no statistically reliable improvements for the dual-view display over the single-view display for any of our criterion measures, although trends were toward a dual-view advantage for workload in all tasks and accuracy in the reconstruction task, despite participants' claims that they did not utilize the global view during the experiment. Future research is needed to better understand the information available on global views that can enhance performance during surgical tasks and participants' decisions regarding when to use different views to support their performance.

The use of secondary task performance to assess mental workload in a primary task is appealing because the method clearly reflects a central goal of workload assessment – to determine what other functions an operator can undertake while satisfactorily performing the ongoing (primary) technical challenges of a job. For example, does a surgeon performing a suturing task have the cognitive reserves to maintain situation awareness, deal with unanticipated events, or coordinate the efforts of other team members? Unfortunately, secondary task measures have a reputation for being intrusive, artificial, and difficult to use. In the current article, we describe procedures to minimize these concerns, specifically when using an interval production secondary task. Although our suggestions for implementing interval production are based on experience in surgical training environments, the method is grounded in workload assessment research from a variety of other contexts over the past two decades. The methodology appears to be highly adaptable.