Quantifying the effects of training in lung transplantation: Lessons from NASA.

Background: Sequential lung transplantation is a complex procedure. The traditional training model continues to center around operative experience with progressively increasing delegation of stages of the procedure. However, little evidence exists on the effects this has on surgical trainers. The NASA-TLX is a subjective, multidimensional assessment tool that rates perceived workload. We sought to employ this as a means of assessing the impact that training in lung transplantation has on trainers. Methods: We prospectively collected the NASA-TLX data for 60 patients undergoing bilateral sequential lung transplantation. In 30 cases, the operation was performed entirely by the senior surgeon (SS) who implanted both lungs. In 30 operations, the senior surgeon implanted the right lung (SSR) and supervised a trainee implanting the left lung (TL). Results: The overall weighted rating was significantly lower for the surgeons undertaking the case themselves rather than training ( Conclusions: The NASA task load index can be used to inform the effects of training in lung transplantation on trainers. Training leads to greater mental and temporal demands with less effect on other factors. Crucially, there was no significant difference in perceived performance. As the specialty continues to be confronted with diverse challenges, this study should give confidence to those training the transplant surgeons of the future, as well as provide them with a mechanism to reflect on their own training performance. ACGME Competencies: Interpersonal and communication skills.Practice-based learning and improvement.