Abstract
IntroductionAs specialized medical professionals such as radiologists, pathologists, and cardiologists gain education and experience, their diagnostic efficiency and accuracy change, and they show altered eye movement patterns during medical image interpretation. Existing research in this area is limited to interpretation of static medical images, such as digitized whole slide biopsies, making it difficult to understand how expertise development might manifest during dynamic image interpretation, such as with angiograms or volumetric scans.MethodsA two-group (novice, expert) comparative pilot study examined the feasibility and utility of tracking and interpreting eye movement patterns while cardiologists viewed video-based coronary angiograms. A non-invasive eye tracking system recorded cardiologists’ (n = 8) visual behaviour while they viewed and diagnosed a series of eight angiogram videos. Analyses assessed frame-by-frame video navigation behaviour, eye fixation behaviour, and resulting diagnostic decision making.ResultsRelative to novices, expert cardiologists demonstrated shorter and less variable video review times, fewer eye fixations and saccadic eye movements, and less time spent paused on individual video frames. Novices showed repeated eye fixations on critical image frames and regions, though these were not predictive of accurate diagnostic decisions.DiscussionThese preliminary results demonstrate interpretive decision errors among novices, suggesting they identify and process critical diagnostic features, but sometimes fail to accurately interpret those features. Results also showcase the feasibility of tracking and understanding eye movements during video-based coronary angiogram interpretation and suggest that eye tracking may be valuable for informing assessments of competency progression during medical education and training.
Highlights
As specialized medical professionals such as radiologists, pathologists, and cardiologists gain education and experience, their diagnostic efficiency and accuracy change, and they show altered eye movement patterns during medical image interpretation
This paper is the first of its kind to consider whether eye tracking might be a valuable tool for identifying and quantifying the development of visual interpretive skills in novice cardiologists interpreting coronary angiograms
This research informs curricula and assessment methods for medical education and training, suggesting novel techniques for accelerating novice learning [5] and objectively assessing competency development [6]. To date this existing research is restricted to reviewing static images, which is unfortunate given that several medical specialties increasingly involve the review of dynamic visual imagery, such as when reviewing coronary angiograms or volumetric CT scans, or performing diagnostic fluoroscopy or laparoscopy
Summary
As specialized medical professionals such as radiologists, pathologists, and cardiologists gain education and experience, their diagnostic efficiency and accuracy change, and they show altered eye movement patterns during medical image interpretation. This research informs curricula and assessment methods for medical education and training, suggesting novel techniques for accelerating novice learning [5] and objectively assessing competency development [6] To date this existing research is restricted to reviewing static images, which is unfortunate given that several medical specialties increasingly involve the review of dynamic visual imagery, such as when reviewing coronary angiograms or volumetric CT scans, or performing diagnostic fluoroscopy or laparoscopy. In these domains, educating and training the visual interpretive process is the linchpin to accurate diagnostic decision making
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