Abstract
Purpose
Current training for laparoscopy focuses only on the enhancement of manual skill and does not give advice on improving trainees’ posture. However, a poor posture can result in increased static muscle loading, faster fatigue, and impaired psychomotor task performance. In this paper, the authors propose a method, named subliminal persuasion, which gives the trainee real-time advice for correcting the upper limb posture during laparoscopic training like the expert but leads to a lower increment in the workload.
Methods
A 9-axis inertial measurement unit was used to compute the upper limb posture, and a Detection Reaction Time device was developed and used to measure the workload. A monitor displayed not only images from laparoscope, but also a visual stimulus, a transparent red cross superimposed to the laparoscopic images, when the trainee had incorrect upper limb posture. One group was exposed, when their posture was not correct during training, to a short (about 33 ms) subliminal visual stimulus. The control group instead was exposed to longer (about 660 ms) supraliminal visual stimuli.
Results
We found that subliminal visual stimulation is a valid method to improve trainees’ upper limb posture during laparoscopic training. Moreover, the additional workload required for subconscious processing of subliminal visual stimuli is less than the one required for supraliminal visual stimuli, which is processed instead at the conscious level.
Conclusions
We propose subliminal persuasion as a method to give subconscious real-time stimuli to improve upper limb posture during laparoscopic training. Its effectiveness and efficiency were confirmed against supraliminal stimuli transmitted at the conscious level: Subliminal persuasion improved upper limb posture of trainees, with a smaller increase on the overall workload.
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Acknowledgments
This study was partially supported by the research institute of science and engineering, Waseda University. This research has been supported by the JSPS Scientific Research-C Grant [24500616], the JSPS Grant-in-Aid for Young Scientists (Wakate B) [25750259], the Waseda University Grant for Special Research Projects (for new full-time faculty) [2014S-091], the Global COE Program “Global Robot Academia”, MEXT, Japan, and the Consolidated Research Institute for Advanced Science and Medical Care, Waseda University (ASMeW). It was also partially supported by a Grant by STMicroelectronics, which also provided the core sensors and the microcontroller. The authors would like to express their thanks to the Italian Ministry of Foreign Affairs, General Directorate for Cultural Promotion and Cooperation, for its support to RoboCasa. The authors would also like to express their gratitude to Life Performance Research for their support to the research.
Conflict of interest
The authors declare no conflicts of interest in preparing this article.
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Zhang, D., Sessa, S., Kong, W. et al. Development of subliminal persuasion system to improve the upper limb posture in laparoscopic training: a preliminary study. Int J CARS 10, 1863–1871 (2015). https://doi.org/10.1007/s11548-015-1198-x
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DOI: https://doi.org/10.1007/s11548-015-1198-x