Are you copying me? Leveraging Expert Visual Scan Path to Transmit Visual Literacy In Novice Histology Students

Abstract

Histology requires visual literacy, the recognition and interpretation of tissue organization in the body, but this is a challenging skill for novice students to acquire. Developing pattern recognition requires expert guidance and exposure to diverse visual objects, which is limited by minimal contact hours in health sciences curricula. Using eye tracking, visual literacy is interpreted through visual scan paths. Novice students demonstrate improved visual scan paths and recognition of simple tissues after feed forward training (FFT) of an expert’s scan path, but this has yet to be tested in more complex tissues. The aim of the current IRB approved (#19‐1820) study is to apply FFT to complex histological tissues. Evidence suggests a high mental rotation test (MRT) score, ability to cognitively rotate and manipulate 2D objects, correlates with accelerated learning of visual objects. To account to MRT differences, this study evenly distributed participants into two groups, based on their MRT scores; while sex was evenly distributed. Both groups were a part of a two‐phase study. In phase one, group A received FFT on a series of 3 gastrointestinal (GI) organ micrographs showing: areas where the expert’s eyes fixated, pathway the eyes traveled across the micrograph (scan path), without focusing on distractors (saccades), and the total distance their eyes traveled across the image (total scan path distance). Group B viewed the same training micrographs, but FFT was omitted. Both groups were tested on visual identification of the 3 GI organs while their eye movements were captured by an eye‐tracking device, Gazepoint. Phase two was identical to phase one, except, students were exposed to the lymphatic system and group B received the FFT. 3,150 data points (N = 25) were collected and analyzed with MATLAB and SPSS. Neither group had a significant difference in scan path distance (A: p = 0.96; B: p = 0.83), or average fixation numbers (A: p = 0.25; B: p = 0.70) when analyzed individually. At phase two, both groups answered significantly faster (A: p < 0.01; B: p = 0.04) and their mean saccade length reduced (A: p = 0.01; B: p = 0.02). One‐way ANOVA on phase one data revealed female participants in both groups exhibiting less proficiency in visual search patterns with a significantly higher average fixation number (p < 0.01) and total scan path distance (p < 0.001) compared to their male counterparts. A linear regression revealed no correlation between the MRT and tissue identification accuracy (r = 0.35, p = 0.15), suggesting a high MRT may not be related to success in histology. Our data suggests watching an expert’s scan path improves visual literacy, and, for the first time, that there is a sex difference in histological search strategies. Future studies should examine if amount of time examining tissue specific areas of interest predict accuracy in testing.