Pupil diameter differentiates expertise in dental radiography visual search.

Nora Castner,Katharina Scheiter,Constanze Keutel,Tobias Appel,Fabian Hüttig,Juliane Richter,Andrew Duchowski,Enkelejda Kasneci,Thérése Eder,Susana Martinez-Conde

doi:10.1371/journal.pone.0223941

Nora Castner, Katharina Scheiter + Show 8 more

Open Access

https://doi.org/10.1371/journal.pone.0223941

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Abstract

Expert behavior is characterized by rapid information processing abilities, dependent on more structured schemata in long-term memory designated for their domain-specific tasks. From this understanding, expertise can effectively reduce cognitive load on a domain-specific task. However, certain tasks could still evoke different gradations of load even for an expert, e.g., when having to detect subtle anomalies in dental radiographs. Our aim was to measure pupil diameter response to anomalies of varying levels of difficulty in expert and student dentists' visual examination of panoramic radiographs. We found that students' pupil diameter dilated significantly from baseline compared to experts, but anomaly difficulty had no effect on pupillary response. In contrast, experts' pupil diameter responded to varying levels of anomaly difficulty, where more difficult anomalies evoked greater pupil dilation from baseline. Experts thus showed proportional pupillary response indicative of increasing cognitive load with increasingly difficult anomalies, whereas students showed pupillary response indicative of higher cognitive load for all anomalies when compared to experts.

Highlights

Visual inspection is a commonly performed task in many contemporary professions, e.g. radiologists and other medical personnel frequently examine medical radiographs to diagnose and treat patients, airport security scan X-rays of luggage for prohibited items, etc. [1, 2]
The degree of difficulty in accurate pathology detection can affect gaze behavior, which can be indicative of the reasoning strategies used. With this intention in mind, we looked at expert and novice dentists’ pupillary response while fixating on anomalies of varying difficulty in panoramic radiographs
We measured pupil diameter change from baseline when gazing on anomalies of varying difficulty during visual search of dental panoramic radiographs

Summary

Introduction

Visual inspection is a commonly performed task in many contemporary professions, e.g. radiologists and other medical personnel frequently examine medical radiographs to diagnose and treat patients, airport security scan X-rays of luggage for prohibited items, etc. [1, 2]. [1, 2] In such tasks, expert visual inspection is derived from domain knowledge and is optimized for a short period of search. The theory that expert aptitude develops a more structured longterm memory designated for domain-specific tasks [16] offers insight into experts’ faster and more accurate abilities [5]. Long-term working memory, proposed by Ericsson and Kintsch [16], offers this explanation for how experts seemingly effortlessly handle their domain-specific tasks. Their memory structuring facilitates their ability to maintain working memory at optimal capacity, avoiding overload, which affects productivity and performance. Medical professionals have been thought to proficiently employ heuristics in their decision-making strategies, i.e. visual search of radiographs [20] and diagnostic reasoning in case examinations [21, 22]

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