Impact of Time Delay on Simulated Operative Video Telementoring: A Pilot Study

Abstract

INTRODUCTION: As NASA and private spaceflight companies push forward with plans for missions to cis-lunar and interplanetary space, the risk of surgical emergency increases. At latencies above 500 ms, telesurgery is not likely to be successful, so near-real-time telementoring is a more viable option. We examined the effect of a 700-ms time delay on the performance of first year surgical residents on a simulated task requiring significant feedback from a mentor in a pilot study.METHODS: A simulated surgical task requiring precision and accuracy with built-in error detection was used. Each resident underwent two trials, one with a mentor in the same room and one with the mentor using a teleconference with time delay. Outcomes measured included time to complete task, game pieces successfully removed, number of errors, and scores on the NASA Task Load Index by both mentor and operator. Data were analyzed using paired t-tests.RESULTS: The time delay group removed significantly fewer pieces successfully than the real time group (3.0 vs. 1.6, P = 0.02). There was no difference in the NASA Task Load Index (TLX) scores for the operators between the two groups, but the mentor reported significantly higher scores on Mental Demand (5.6 vs. 12.0, P = 0.04) and Effort (6.2 vs. 11.8, P = 0.05) during the time-delayed trials.DISCUSSION: A 750-ms time delay significantly degraded performance on the task. Though operator TLX scores were not affected, mentor TLX scores indicated significantly increased mental load. Telementoring is viable, but more onerous than in-person mentoring.Kamine TH, Smith BW, Fernandez GL. Impact of time delay on simulated operative video telementoring: a pilot study. Aerosp Med Hum Perform. 2022; 93(2):123–127.

Enabling Human Space Exploration Missions Through Progressively Earth Independent Medical Operations (EIMO)

“…Distance, communication latency, and reduced data channel capacity will delay ground-based assistance and eliminate expeditious evacuation [8] , [11] , [12] , [13] . For some conditions, delays in management advice could result in loss of crew life or irreversible disabilities.…”

“…The history of terrestrial and space exploration strongly supports the value of extensive pre-mission planning [20], [26]. Based on the Concept of Operations documents for the planned Gateway and Mars missions and present-day mission operations it is possible to determine several high-yield domains of pre-mission EIMO planning (see Table 1) [10], [12].…”

“…Determine the required onboard Knowledge, Skills, and Abilities (KSA) 11. Determine required skills for each crewmember 12.…”

“…Additionally, resupply missions will be far less frequent and evacuation back to Earth may take as long as 2 weeks [12] . A physician on Earth can still help with time-sensitive medical decisions but procedural guidance becomes more difficult meaning CMOs will need additional training [13] . The prolonged evacuation time and limited ability to send additional supplies means the onboard medical system must be substantially more robust than on ISS [9] .…”