Cognitive load and performance in immersive virtual reality versus conventional virtual reality simulation training of laparoscopic surgery: a randomized trial

Frederiksen, Joakim Grant; Sørensen, Stine Maya Dreier; Konge, Lars; Svendsen, Morten Bo Søndergaard; Nobel-Jørgensen, Morten; Bjerrum, Flemming; Andersen, Steven Arild Wuyts

doi:10.1007/s00464-019-06887-8

Cited by 192 publications

(188 citation statements)

References 31 publications

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“…Drawing conclusions about the difference in workload between real and simulated tasks was not the primary aim of this study, but results indicated workload to be considerably higher in the virtual compared to the real block stacking task (similar results have been observed during surgical simulation; Frederiksen et al 2019). As discussed previously, cognitive load plays an important role in optimising learning (Guadagnoli and Lee 2004;Kirschner 2002), but it is likely that the relationship between real and simulated tasks is very much specific to the task in question and dependent on the fidelity of the VR environment.…”

Section: Discussionmentioning

confidence: 72%

“…Although previous studies have attempted to gauge cognitive load during VR tasks (Bharathan et al 2013;Frederiksen et al 2019;Naismith et al 2015), they fall short by using overly simple unidimensional measures, instruments that do not address the unique sources of load posed by virtual simulation (e.g. the NASA-TLX), or by ignoring multiple sources of load.…”

Section: Introductionmentioning

confidence: 99%

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Development and validation of a simulation workload measure: the simulation task load index (SIM-TLX)

2019

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Virtual reality (VR) simulation offers significant potential for human factors training as it provides a novel approach which enables training in environments that are otherwise dangerous, impractical or expensive to simulate. While VR training has been adopted in many environments, such as heavy industry, surgery and aviation, there remains an inadequate understanding of how virtual simulations impact cognitive factors. One such factor, which needs careful consideration during the design of VR simulations, is the degree of mental or cognitive load experienced during training. This study aimed to validate a newly developed measure of workload, based on existing instruments (e.g. the NASA-TLX), but tailored to the specific demands placed on users of simulated environments. While participants completed a VR puzzle game, a series of experimental manipulations of workload were used to assess the sensitivity of the new instrument. The manipulations affected the questionnaire subscales (mental demands; physical demands; temporal demands; frustration; task complexity; situational stress; distraction; perceptual strain; task control; presence) as predicted in all cases (ps < .05), except for presence, which displayed little relationship with other aspects of task load. The scale was also found to have good convergent validity with an alternate index of task load. The findings support the sensitivity of the new instrument for assessing task load in virtual reality. Overall, this study contributes to the understanding of mental workload in simulated environments and provides a practical tool for use in both future research and applications in the field.

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Section: Discussionmentioning

confidence: 72%

Section: Introductionmentioning

confidence: 99%

Development and validation of a simulation workload measure: the simulation task load index (SIM-TLX)

2019

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“…It has been found that the MSAQ is a valid evaluation tool and that it is advantageous to use this multidimensional questionnaire rather than the one-dimensional form [ 52 ]. The questionnaire has been widely used in studies dealing with virtual environments [ 53 - 55 ]. The scale ranges from 1 (not at all) to 9 (severely).…”

Section: Methodsmentioning

confidence: 99%

Results and Guidelines From a Repeated-Measures Design Experiment Comparing Standing and Seated Full-Body Gesture-Based Immersive Virtual Reality Exergames: Within-Subjects Evaluation

Xu¹,

Li²,

He³

et al. 2020

JMIR Serious Games

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Background Although full-body seated exercises have been studied in a wide range of settings (ie, homes, hospitals, and daycare centers), they have rarely been converted to seated exergames. In addition, there is an increasing number of studies on immersive virtual reality (iVR) full-body gesture-based standing exergames, but the suitability and usefulness of seated exergames remain largely unexplored. Objective This study aimed to evaluate the difference between playing a full-body gesture-based iVR standing exergame and seated exergame in terms of gameplay performance, intrinsic motivation, and motion sickness. Methods A total of 52 participants completed the experiment. The order of the game mode (standing and sitting) was counterbalanced. Gameplay performance was evaluated by action or gesture completion time and the number of missed gestures. Exertion was measured by the average heart rate (HR) percentage (AvgHR%), increased HR%, calories burned, and the Borg 6-20 questionnaire. Intrinsic motivation was assessed with the Intrinsic Motivation Inventory (IMI), whereas motion sickness was assessed via the Motion Sickness Assessment Questionnaire (MSAQ). In addition, we measured the fear of falling using a 10-point Likert scale questionnaire. Results Players missed more gestures in the seated exergame than in the standing exergame, but the overall miss rate was low (2.3/120, 1.9%). The analysis yielded significantly higher AvgHR%, increased HR%, calories burned, and Borg 6-20 rating of perceived exertion values for the seated exergame (all P<.001). The seated exergame was rated significantly higher on peripheral sickness (P=.02) and sopite-related sickness (MSAQ) (P=.004) than the standing exergame. The score of the subscale “value/usefulness” from IMI was reported to be higher for the seated exergame than the standing exergame. There was no significant difference between the seated exergame and standing exergame in terms of intrinsic motivation (interest/enjoyment, P=.96; perceived competence, P=.26; pressure/tension, P=.42) and the fear of falling (P=.25). Conclusions Seated iVR full-body gesture-based exergames can be valuable complements to standing exergames. Seated exergames have the potential to lead to higher exertion, provide higher value to players, and be more applicable in small spaces compared with standing exergames. However, gestures for seated exergames need to be designed carefully to minimize motion sickness, and more time should be given to users to perform gestures in seated exergames compared with standing exergames.

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“…For instance, Harris et al (2019c) compared cognitive demands between real and virtual versions of a block stacking game ("Jenga") using a self-report measure of task load, the SIM-TLX. Similarly, Frederiksen et al (2020) compared cognitive load between head mounted immersive VR and standard screen presentation on a surgical training simulation, finding cognitive load (indexed by secondary task reaction time) to be significantly elevated in the immersive VR condition. Cognitive load is particularly relevant in the context of education and training as an optimal level of load is important for successful learning outcomes (Kirschner, 2002).…”

Section: Psychological Fidelitymentioning

confidence: 99%

A Framework for the Testing and Validation of Simulated Environments in Experimentation and Training

et al. 2020

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New computer technologies, like virtual reality (VR), have created opportunities to study human behavior and train skills in novel ways. VR holds significant promise for maximizing the efficiency and effectiveness of skill learning in a variety of settings (e.g., sport, medicine, safety-critical industries) through immersive learning and augmentation of existing training methods. In many cases the adoption of VR for training has, however, preceded rigorous testing and validation of the simulation tool. In order for VR to be implemented successfully for both training and psychological experimentation it is necessary to first establish whether the simulation captures fundamental features of the real task and environment, and elicits realistic behaviors. Unfortunately evaluation of VR environments too often confuses presentation and function, and relies on superficial visual features that are not the key determinants of successful training outcomes. Therefore evidence-based methods of establishing the fidelity and validity of VR environments are required. To this end, we outline a taxonomy of the subtypes of fidelity and validity, and propose a variety of practical methods for testing and validating VR training simulations. Ultimately, a successful VR environment is one that enables transfer of learning to the real-world. We propose that key elements of psychological, affective and ergonomic fidelity, are the real determinants of successful transfer. By adopting an evidence-based approach to VR simulation design and testing it is possible to develop valid environments that allow the potential of VR training to be maximized.

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Cognitive load and performance in immersive virtual reality versus conventional virtual reality simulation training of laparoscopic surgery: a randomized trial

Cited by 192 publications

References 31 publications

Development and validation of a simulation workload measure: the simulation task load index (SIM-TLX)

Development and validation of a simulation workload measure: the simulation task load index (SIM-TLX)

Results and Guidelines From a Repeated-Measures Design Experiment Comparing Standing and Seated Full-Body Gesture-Based Immersive Virtual Reality Exergames: Within-Subjects Evaluation

A Framework for the Testing and Validation of Simulated Environments in Experimentation and Training

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