Image-guided navigation: the surgeon's perspective on performance consequences and human factors issues.

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.