Comparing the Visual Perception According to the Performance Using the Eye-Tracking Technology in High-Fidelity Simulation Settings.

Issam Tanoubi,Mihai Georgescu,Caroline Ranger,Judy Morris,Roger Perron,Marie-Rose Paradis,Mathieu Tourangeau,Komi Sodoké,Marie-Ève Bélanger,Pierre Drolet,Arnaud Robitaille

doi:10.3390/bs11030031

Abstract

Introduction: We used eye-tracking technology to explore the visual perception of clinicians during a high-fidelity simulation scenario. We hypothesized that physicians who were able to successfully manage a critical situation would have a different visual focus compared to those who failed. Methods: A convenience sample of 18 first-year emergency medicine residents were enrolled voluntarily to participate in a high-fidelity scenario involving a patient in shock with a 3rd degree atrioventricular block. Their performance was rated as pass or fail and depended on the proper use of the pacing unit. Participants were wearing pre-calibrated eye-tracking glasses throughout the 9-min scenario and infrared (IR) markers installed in the simulator were used to define various Areas of Interest (AOI). Total View Duration (TVD) and Time to First Fixation (TFF) by the participants were recorded for each AOI and the results were used to produce heat maps. Results: Twelve residents succeeded while six failed the scenario. The TVD for the AOI containing the pacing unit was significantly shorter (median [quartile]) for those who succeeded compared to the ones who failed (42 [31–52] sec vs. 70 [61–90] sec, p = 0.0097). The TFF for the AOI containing the ECG and vital signs monitor was also shorter for the participants who succeeded than for those who failed (22 [6–28] sec vs. 30 [27–77] sec, p = 0.0182). Discussion: There seemed to be a connection between the gaze pattern of residents in a high-fidelity bradycardia simulation and their performance. The participants who succeeded looked at the monitor earlier (diagnosis). They also spent less time fixating the pacing unit, using it promptly to address the bradycardia. This study suggests that eye-tracking technology could be used to explore how visual perception, a key information-gathering element, is tied to decision-making and clinical performance.

Highlights

Visual perception is a complex psychological operation used to understand our environment [1]
The heat map is a function of the Total View Duration (TVD) and the number of link them to each Areas of Interest (AOI)
The results showed a similar gaze distribution profile among AOIs regardless of the outcome of the scenario

Summary

Introduction

Visual perception is a complex psychological operation used to understand our environment [1]. The eye-tracking technology aims to report on some key elements of visual perception It is commonly used in many fields such as marketing, neuroscience and industrial engineering [2,3,4]. No research compared gaze pattern and performance in a clinical simulation in a prospective and hypothesis-based manner. This exploratory work aimed to examine the visual perception of clinicians using eye-tracking technology during a high-fidelity simulation scenario and to look for differences between participants who succeeded and those who failed, apart from their expertise, when managing the critically ill simulated patient. As part of situational awareness building, we hypothesized that the practitioner would spend more time looking at the elements of his clinical practice setting that are unknown to him, but which would be crucial for the care of the patient

Methods

Results

Conclusion