Conventional methods to gather information about surgeon's stress status and evaluate teamwork are typically based on expert supervision and self-reports. These measurements are highly operator-dependent (who may be prone to personal experience, cognitive, and emotional biases) require to interrupt the execution of tasks (i.e. invasiveness and low temporal resolution), and do not include information related to team members' stress demand (i.e. paucity of user's insights). It is therefore clear how these measurements alone cannot be used to accurately and properly assess the ongoing stress level experienced by the members of a team and consequently their teamwork. Neurophysiological (Electroencephalogram - EEG, Electrocardiogram - ECG, Electrodermal Activity -EDA, Electrooculogram - EOG) and Biological measures (blood, saliva and urine) have gained momentum in different research and operative areas and represent an objective, unobtrusive, and a powerful tool to determine user's affective stress state on the basis of mind-body relations. Coherently with this aspect, Industries started to be very interested in evaluating stress aspects together with skills acquisition since this kind of insights provide additional values for user's stress assessment, management, and safety. The computation and combination of synthetic neurophysiological and biological indexes for the investigation of surgeon's stress level will therefore radically change the entire field of stress management in the operating room (OR) and teamwork assessment.
Although tools like TRM (Team Resource Management) training are adopted to facilitate open communication, stress management, teamwork, and safety protocols [1]-[3], they do not allow to assess the ongoing stress level experienced by the different surgeons and operators, therefore to manage and eventually intervene on team dynamics and mitigate risky working conditions while dealing with the tasks in the OR. In fact, most of state-of-the-art solutions are still based on survey or performance-related data [4], [5]. In addition, despite a plethora of available stress evaluation methodologies, there is no one-size-fits-all approach. For example, a recent review on surgical applications highlighted how multidisciplinary surgical teams must possess the ability to control distractors and mastering communication and stressful events for an effective teamwork in emergency situations [6]. In Aviation, the EU has launched the Flightpath 2050 program to set out a specific roadmap called ¿Strategic Research and Innovation Agenda¿ (SRIA) in researching innovative methodologies to understand and assess HFs (https://www.sesarju.eu/sria). In this connection the EU Regulation (E\U) 2017/373 (GM1 ATS.OR.310) acknowledges `Stress¿ as an important problem to be assessed and managed on Air Traffic Controllers teams [7]. Finally, even if ongoing EU projects aim at providing evidence and solutions to improve teamwork (e.g. ALIGNING MINDS [link], TeamUp [link], AutoML [link]), they do not include neurophysiological signals or biological data analysis, and most importantly solutions aiming at combining different kind of data (behavioural, subjective, and neurophysiological) for a comprehensive operators' stress and teamwork assessment. In this context, the CHALLENGES methodology will undoubtedly have a remarkable immediate impact. For example, the capability of having online access to insight and objective information regarding the operators' stress level through the use of neurophysiological (EEG, ECG, and EDA) and biological (cortisol) measures will endow a tool by which support external supervisor during the operators assessment, or the team itself for a more accurate stress management. In fact, thanks to the multidisciplinary expertise and multimodal concept, CHALLENGES will pave the way for an innovative methodology able to leverage knowledge-based (conventional methods) and data-driven (neurophysiological and biological data processing) approaches for assessing operator's stress in a way that makes it applicable in cross-domain contexts. The CHALLENGES methodology will therefore innovate domains of Social Science, Safety Management System (SMS), Human Factors, and Neuroergonomics as it will open new frontiers for investigating human behaviour in specific user-centred and stressful contexts, improving stress management training, and team management. Moreover, the project will likely foster the development of preventive tools by which monitoring in real-time the operators' stress level and enhance safety and mitigate error commission, hence improving work effectiveness. In an even wider perspective, CHALLENGES methodology will establish new potential "channels of communication" based on online measures of single-member and team performance enabling relevant outcomes for a huge set of European social challenges such as Smart & Connected Environments (i.e. Industry 4.0), Education, Health & Safety.
References
[1] T. K. Landauer, et al. (1998) "An introduction to latent semantic analysis", Discourse Process.
[2] R. H. Stevens, et al. (2018) "Neuroergonomics: Quantitative Modeling of Individual, Shared, and Team Neurodynamic Information", Hum. Factors
[3] J. C. Gorman, et al. (2020) "Measuring Real-Time Team Cognition During Team Training", Hum. Factors
[4] J. C. Gorman et al. (2013) "Analysis of semantic content and its relation to team neurophysiology during submarine crew training", in Lecture Notes in Computer Science
[5] J. C. Gorman et al. (2016) "Cross-Level Effects between Neurophysiology and Communication during Team Training", Hum. Factors
[6] A. Kurmann et al. (2012) "Human factors in the operating room - The surgeon's view", Trends Anaesth. Crit. Care
[7] N. Anna (2017) "Easy Access Rules for ATM-ANS (Regulation (EU) 2017/373)"