title: Image-guided navigation: the surgeon's perspective on performance consequences and human factors issues.
abstract: BACKGROUND
  Image-guided navigation (IGN) represents a first step in the automation of surgical functions. The use of IGN can involve several human factors issues that must be taken into account when evaluating their impact on surgical performance and patient safety.
  
  
  METHODS
  A nationwide survey was conducted among 213 surgeons from 112 German hospitals in order to assess the perceived performance consequences and human factors issues of IGN, including changes of situation awareness, performance and workload, as well as issues of overreliance, skill degradation and usability.
  
  
  RESULTS
  Generally, surgeons report improved performance and patient safety related to the use of IGN. However, issues of increased time pressure and mental demands were reported by inexperienced users. Furthermore, overreliance on IGN represents a risk, albeit only in a minority of respondents.
  
  
  CONCLUSIONS
  IGN is evaluated as a helpful tool for surgeons. However, special care should be taken to provide surgeons with sufficient time and training during familiarization with an IGN system.
authors.affiliation: Department of Work, Engineering and Organizational Psychology, Institute of Psychology and Ergonomics, Technische Universität Berlin (TUB), Germany. dietrich.manzey@tu-berlin.de
authors.forename: Dietrich
authors.initials: D
authors.lastname: Manzey
authors.forename: Stefan
authors.initials: S
authors.lastname: Röttger
authors.forename: J Elin
authors.initials: JE
authors.lastname: Bahner-Heyne
authors.forename: Dirk
authors.initials: D
authors.lastname: Schulze-Kissing
authors.forename: Andreas
authors.initials: A
authors.lastname: Dietz
authors.forename: Jürgen
authors.initials: J
authors.lastname: Meixensberger
authors.forename: Gero
authors.initials: G
authors.lastname: Strauss
mesh_terms: D001291:Attitude of Health Personnel; D005858:Germany; D010820:Physicians / Q000706:statistics & numerical data*; D010818:Practice Patterns, Physicians' / Q000706:statistics & numerical data*; D025321:Surgery, Computer-Assisted / Q000706:statistics & numerical data*; D016526:Workload / Q000706:statistics & numerical data*