Fixation Count Research Articles

The Influence of Feedback Content and Feedback Time on Multimedia Learning Achievement of College Students and Its Mechanism.

This study investigated the content of feedback (adaptive, elaborated, and knowledge of correct response, KCR) and time (Immediate and Delayed) influences on multimedia learning of college students. Students from the Northeast Normal University (N = 157) were randomly assigned to one of the six experimental conditions. We tried to explain the influence mechanisms of different feedback effects through subjectively reported motivation, cognitive load, and eye movement trajectory during the feedback period. The results showed that (1) different feedback methods in terms of feedback time and feedback content have significantly different effects on scores. Among them, scores of the immediate feedback group were significantly higher than those of the delayed feedback group, and the scores of the adaptive feedback (AF) group were significantly higher than those of the elaborated feedback (EF) group and the knowledge of the correct response feedback group. (2) Different types of feedback contents have significantly different effects on motivation. The motivation scores reported by the AF group and EF group were significantly higher than those reported by the knowledge of the correct response feedback group. (3) Different feedback methods in terms of feedback time and feedback content had significantly different effects on subjective germane cognitive load reports. Among them, the germane cognitive load score of the immediate feedback group was significantly higher than that of the delayed feedback group. The germane cognitive load scores reported by the AF group were significantly higher than those reported by the EF group and knowledge of the correct response feedback group. (4) The germane cognitive load plays a partial mediating role between the AF and post-test scores. (5) Different feedback methods in feedback time have different effects on eye movement fixation trajectory, which shows that the subjects in the immediate feedback group were significantly less than those in the delayed feedback group in fixation count and fixation time in the interest area of the stem. (6) Consistent with our hypothesis, different feedback methods in feedback content have different effects on eye movement trajectory. In summary, the results show that the AF initiated in this study has a positive effect on multimedia learning of college students; it not only provides empirical evidence for cognitive load theory but also helps educators design adaptive learning feedback according to responses of students.

Eye-tracking based quantification of the safety of human-machine interfaces of complementary protective system functions

Complementary protective measures are of increasing importance with rising degree of automation. As free robots become part of our daily life in industry, on shop floors and beyond, the overall safety of persons has to be ensured. However, assessing the reliability of complementary safety functions remains a challenge, particularly when humans are in the loop. The paper shows how to use the eye-tracking methodology to gain data for assessing the reliability of the human interaction with machine interfaces for complementary protective measures. The paper first identifies factors relevant for eye-tracking, then selects related eye tracking test parameters and finally provides a systematic procedure to assess both, in particular regarding visibility and susceptibility. The methodology is applied and the parameter selection is validated. It is found that in particular the identified and measured parameters fixation count for area of interest (AOI) and the associated average visit duration can be used to assess the factor perceptibility. The parameter deviation of fixation can thereby be used to assess usability. Based on this, a full-scale eye-tracking assessment is proposed for the reliability of the interaction of humans with the machine interfaces of supplementary protective measures. In summary, the preliminary test run execution shows that eye-tracking technology is a promising method for measuring and quantifying the human reliability when interacting with safety-related human-machine interfaces.

Effects of Self-Esteem on Self-Viewing: An Eye-Tracking Investigation on Mirror Gazing.

While some people enjoy looking at their faces in the mirror, others experience emotional distress. Despite these individual differences concerning self-viewing in the mirror, systematic investigations on this topic have not been conducted so far. The present eye-tracking study examined whether personality traits (self-esteem, narcissism propensity, self-disgust) are associated with gaze behavior (gaze duration, fixation count) during free mirror viewing of one’s face. Sixty-eight adults (mean age = 23.5 years; 39 females, 29 males) viewed their faces in the mirror and watched a video of an unknown person matched for gender and age (control condition) for 90 s each. The computed regression analysis showed that higher self-esteem was associated with a shorter gaze duration for both self-face and other-face. This effect may reflect a less critical evaluation of the faces.

Spatial Neglect Midline Diagnostics From Virtual Reality and Eye Tracking in a Free-Viewing Environment.

Purpose: Virtual reality (VR) and eye tracking may provide detailed insights into spatial cognition. We hypothesized that virtual reality and eye tracking may be used to assess sub-types of spatial neglect in stroke patients not readily available from conventional assessments.Method: Eighteen stroke patients with spatial neglect and 16 age and gender matched healthy subjects wearing VR headsets were asked to look around freely in a symmetric 3D museum scene with three pictures. Asymmetry of performance was analyzed to reveal group-level differences and possible neglect sub-types on an individual level.Results: Four out of six VR and eye tracking measures revealed significant differences between patients and controls in this free-viewing task. Gaze-asymmetry between-pictures (including fixation time and count) and head orientation were most sensitive to spatial neglect behavior on a group level analysis. Gaze-asymmetry and head orientation each identified 10 out of 18 (56%), compared to 12 out of 18 (67%) for the best conventional test. Two neglect patients without deviant performance on conventional measures were captured by the VR and eyetracking measures. On the individual level, five stroke patients revealed deviant gaze-asymmetry within-pictures and six patients revealed deviant eye orientation in either direction that were not captured by the group-level analysis.Conclusion: This study is a first step in using VR in combination with eye tracking measures as individual differential neglect subtype diagnostics. This may pave the way for more sensitive and elaborate sub-type diagnostics of spatial neglect that may respond differently to various treatment approaches.

The processing of native advertising compared to banner advertising: an eye-tracking experiment

This paper aims to better understand the effect of visual attention on the processing of banner and native advertisements on Facebook and consequently on brand recognition and brand attitude. Using an eye-tracking experiment (N = 90), we show that a native advertisement attracts more and longer visual attention (i.e., total fixation duration, fixation count, and average visit duration) compared to a banner advertisement. Moreover, we show that longer visual attention (i.e., total fixation duration and average visit duration) increases persuasion knowledge and the recognition of an advertisement, which in turn leads to better brand recognition. Second, we show that neither conceptual persuasion knowledge nor critical processing mediates the effect of visual attention on brand attitude.

The impact of landscape complexity on preference ratings and eye fixation of various urban green space settings

People’s perceptions on landscapes are important in the design process, and are closely associated with viewing behavior. However, little is known about the perceived landscape complexity of different urban green space settings in relation to people’s preference and eye movements. This study, therefore, investigated the influence of landscape complexity on preference ratings and eye fixation of lawn, path, plaza, and waterfront settings of urban green spaces. Six images for each type of setting were selected as stimuli and further classified into three categories based on the participants’ mean ratings of landscape complexity. Forty valid responses were obtained. The results indicated that participants’ ratings of landscape complexity and preference were positively correlated in all types of settings. There were significant differences in fixation count and average fixation duration between images with different levels of landscape complexity in lawn and waterscape settings. Fixation count was positively correlated with landscape complexity level in all lawn, plaza and waterscape setting images. Moreover, average fixation duration was negatively correlated with landscape complexity level in all lawn and waterscape setting images. Preference ratings had no definite relationships with fixation counts and average fixation duration. The findings of this study will help designers and urban park managers to effectively incorporate public perceptions in design and decision-making process. In addition, it provides new insights into the relationship between eye movements and landscape complexity and sheds some light on the application of eye tracking technology in landscape perception studies.

Assessing Deception in Questionnaire Surveys With Eye-Tracking.

Deceit often occurs in questionnaire surveys, which leads to the misreporting of data and poor reliability. The purpose of this study is to explore whether eye-tracking could contribute to the detection of deception in questionnaire surveys, and whether the eye behaviors that appeared in instructed lying still exist in spontaneous lying. Two studies were conducted to explore eye movement behaviors in instructed and spontaneous lying conditions. The results showed that pupil size and fixation behaviors are both reliable indicators to detect lies in questionnaire surveys. Blink and saccade behaviors do not seem to predict deception. Deception resulted in increased pupil size, fixation count and duration. Meanwhile, respondents focused on different areas of the questionnaire when lying versus telling the truth. Furthermore, in the actual deception situation, the linear support vector machine (SVM) deception classifier achieved an accuracy of 74.09%. In sum, this study indicates the eye-tracking signatures of lying are not restricted to instructed deception, demonstrates the potential of using eye-tracking to detect deception in questionnaire surveys, and contributes to the questionnaire surveys of sensitive issues.

Does diacritics-based lexical disambiguation modulate word frequency, length, and predictability effects? An eye-movements investigation of processing Arabic diacritics.

In Arabic, a predominantly consonantal script that features a high incidence of lexical ambiguity (heterophonic homographs), glyph-like marks called diacritics supply vowel information that clarifies how each consonant should be pronounced, and thereby disambiguate the pronunciation of consonantal strings. Diacritics are typically omitted from print except in situations where a particular homograph is not sufficiently disambiguated by the surrounding context. In three experiments we investigated whether the presence of disambiguating diacritics on target homographs modulates word frequency, length, and predictability effects during reading. In all experiments, the subordinate representation of the target homographs was instantiated by the diacritics (in the diacritized conditions), and by the context subsequent to the target homographs. The results replicated the effects of word frequency (Experiment 1), word length (Experiment 2), and predictability (Experiment 3). However, there was no evidence that diacritics-based disambiguation modulated these effects in the current study. Rather, diacritized targets in all experiments attracted longer first pass and later (go past and/or total fixation count) processing. These costs are suggested to be a manifestation of the subordinate bias effect. Furthermore, in all experiments, the diacritics-based disambiguation facilitated later sentence processing, relative to when the diacritics were absent. The reported findings expand existing knowledge about processing of diacritics, their contribution towards lexical ambiguity resolution, and sentence processing.

Parenting practices moderate the link between attention to the eyes and callous unemotional traits in children with Disruptive Behavior Disorder: An eye-tracking study

Callous-unemotional (CU) traits are associated with gaze pattern deficits in youths, though it has not yet been explored if environmental factors could influence this relationship. Since parenting can influence both CU traits and children's emotion processing, the current study sought to test whether parenting moderated the relation between gaze pattern deficits and CU traits in a sample of children with Disruptive Behavior Disorder. The sample included 92 boys (aged 7–12 years) with Conduct Disorder (N = 12) and Oppositional Defiant Disorder (N = 80). All children completed a task, during which they were presented with 24 images depicting happy, sad, fearful, disgusted, angry, and neutral facial expressions. Gaze pattern has been recorded throughout the task with an eye-tracker. Positive parenting moderated the association between CU traits and first fixation duration to the eyes of facial expressions depicting negative emotions. Negative parenting moderated the association between CU traits and fixation count and fixation duration to the eyes of negative emotions. Negative parenting along with reduced attention to emotional cues (i.e., eyes) may identify a group of youths with Disruptive Behavior Disorder diagnosis at risk for severe outcomes.

I Got My Eyes on You: Examination of Sports Celebrity Endorsement Effect on Viewer’s Visual Attention

<p class="Default"><em><span lang="EN-GB">Celebrity endorsement is a widely used method to gather customer visual attention to the advertised product. Viewers' visual attention to the products is clinical for advertisers. This is why advertisers keep their eyes on consumers to know where they're looking. The study was aimed to explore the visual attention of young sports consumers by gender with the help of an eye-tracking system. An experiment was conducted with twenty-eight university students by using Tobii Pro Glasses-2 eye tracker. Fixation durations, counts, and areas were measured to assess the effects of sports celebrity endorsement on visual attention. In major findings, although in the ad where a female sports celebrity was featured, men and women respondents were fixed in similar areas, the men respondents put the maximum focus on the female athlete herself, while the women respondents focus maximum on the product. The present study found that the visual attention of the young sports consumers visual attention to the printed advertisements with sports contents varied by gender. Young consumers can have different connections and associations with celebrities than older consumers. The study gives important information to understand the young sports consumers’ visual attention to the printed advertisements which use sport celebrity endorsements.</span></em></p>

The Relationships between Perceived Design Intensity, Preference, Restorativeness and Eye Movements in Designed Urban Green Space

Recent research has demonstrated that landscape design intensity impacts individuals’ landscape preferences, which may influence their eye movement. Due to the close relationship between restorativeness and landscape preference, we further explore the relationships between design intensity, preference, restorativeness and eye movements. Specifically, using manipulated images as stimuli for 200 students as participants, the effect of urban green space (UGS) design intensity on landscapes’ preference, restorativeness, and eye movement was examined. The results demonstrate that landscape design intensity could contribute to preference and restorativeness and that there is a significant positive relationship between design intensity and eye-tracking metrics, including dwell time percent, fixation percent, fixation count, and visited ranking. Additionally, preference was positively related to restorativeness, dwell time percent, fixation percent, and fixation count, and there is a significant positive relationship between restorativeness and fixation percent. We obtained the most feasible regression equations between design intensity and preference, restorativeness, and eye movement. These results provide a set of guidelines for improving UGS design to achieve its greatest restorative potential and shed new light on the use of eye-tracking technology in landscape perception studies.

Interpretation of a 12-Lead Electrocardiogram by Medical Students: Quantitative Eye-Tracking Approach.

BackgroundAccurate interpretation of a 12-lead electrocardiogram (ECG) demands high levels of skill and expertise. Early training in medical school plays an important role in building the ECG interpretation skill. Thus, understanding how medical students perform the task of interpretation is important for improving this skill.ObjectiveWe aimed to use eye tracking as a tool to research how eye fixation can be used to gain a deeper understanding of how medical students interpret ECGs.MethodsIn total, 16 medical students were recruited to interpret 10 different ECGs each. Their eye movements were recorded using an eye tracker. Fixation heatmaps of where the students looked were generated from the collected data set. Statistical analysis was conducted on the fixation count and duration using the Mann-Whitney U test and the Kruskal-Wallis test.ResultsThe average percentage of correct interpretations was 55.63%, with an SD of 4.63%. After analyzing the average fixation duration, we found that medical students study the three lower leads (rhythm strips) the most using a top-down approach: lead II (mean=2727 ms, SD=456), followed by leads V1 (mean=1476 ms, SD=320) and V5 (mean=1301 ms, SD=236). We also found that medical students develop a personal system of interpretation that adapts to the nature and complexity of the diagnosis. In addition, we found that medical students consider some leads as their guiding point toward finding a hint leading to the correct interpretation.ConclusionsThe use of eye tracking successfully provides a quantitative explanation of how medical students learn to interpret a 12-lead ECG.

How Prior Knowledge Affects Visual Attention of Japanese Mimicry and Onomatopoeia and Learning Outcomes: Evidence from Virtual Reality Eye Tracking

According to the United Nations Sustainable Development Goal (SDG) 4, “achieving inclusive and quality education for all”, foreign language learning has come to be seen as a process of integrating sustainable development into the socio-cultural aspects of education and learning. The aim of this study was to employ virtual reality (VR) eye tracker to examine how students with different levels of prior knowledge process visual behaviors for Japanese Mimicry and Onomatopoeia (MIO) while learning Japanese as a second foreign language. A total of 20 students studying at the Department of Applied Japanese at the university of Southern Taiwan were recruited. Based on the Japanese language proficiency test (JLPT) level, 20 participants were divided into high prior knowledge group (levels N1–N3) with 7 participants, and low prior knowledge group (level N4 or below) with 13 participants. The learning stimuli materials were created by Unreal Engine 4 (UE4) development tool to design a 3D virtual MIO paradise, including 5 theme amusement parks. Through a VR eye tracker, participants’ visual behaviors were tracked and recorded based on 24 different regions of interest (ROIs) (i.e., ROI1–ROI24). This was done to discuss the distribution of visual attention in terms of different ROIs of each theme amusement park based on four eye movement indicators, including latency of first fixation (LFF), duration of first fixation (DFF), total fixation durations (TFD), and fixation counts (FC). Each ROI of the two groups were then compared. In addition, a heat zone map was also generated to show the overall visual distribution of each group. After the experiment, based on the eye movement indicators and test scores in the pre-test and post-test phases, statistical analysis was used to examine and evaluate the differences in visual attention and learning outcomes. The results revealed that the gaze sequences of the two prior knowledge groups gazing at the ROIs in theme parks were different, except for the gaze sequence in the circus theme park. Different prior knowledge groups exhibited differences in visual attention in the ROIs fixated on in each amusement park. Additionally, in terms of TFD and FC of different groups in each amusement park, there was no significant difference except in ROI10, ROI16, and ROI18. Moreover, after receiving cognitive comprehension processes introduced in the VR-simulated MIO scenes, students from both groups achieved higher post-test scores compared with pre-test scores, and such differences had statistical significance. In conclusion, the implications of VR eye movement analysis on developing students’ competence related to learning Japanese and cross-cultural aspects, compatible with sustainable development, were presented.

Assessing the Role of Gaze Tracking in Optimizing Humans-In-The-Loop Telerobotic Operation Using Multimodal Feedback.

A key challenge in achieving effective robot teleoperation is minimizing teleoperators’ cognitive workload and fatigue. We set out to investigate the extent to which gaze tracking data can reveal how teleoperators interact with a system. In this study, we present an analysis of gaze tracking, captured as participants completed a multi-stage task: grasping and emptying the contents of a jar into a container. The task was repeated with different combinations of visual, haptic, and verbal feedback. Our aim was to determine if teleoperation workload can be inferred by combining the gaze duration, fixation count, task completion time, and complexity of robot motion (measured as the sum of robot joint steps) at different stages of the task. Visual information of the robot workspace was captured using four cameras, positioned to capture the robot workspace from different angles. These camera views (aerial, right, eye-level, and left) were displayed through four quadrants (top-left, top-right, bottom-left, and bottom-right quadrants) of participants’ video feedback computer screen, respectively. We found that the gaze duration and the fixation count were highly dependent on the stage of the task and the feedback scenario utilized. The results revealed that combining feedback modalities reduced the cognitive workload (inferred by investigating the correlation between gaze duration, fixation count, task completion time, success or failure of task completion, and robot gripper trajectories), particularly in the task stages that require more precision. There was a significant positive correlation between gaze duration and complexity of robot joint movements. Participants’ gaze outside the areas of interest (distractions) was not influenced by feedback scenarios. A learning effect was observed in the use of the controller for all participants as they repeated the task with different feedback combination scenarios. To design a system for teleoperation, applicable in healthcare, we found that the analysis of teleoperators’ gaze can help understand how teleoperators interact with the system, hence making it possible to develop the system from the teleoperators’ stand point.

The effect of the angry emoji position on consumers’ perception of the sender’s anger

<p id="C2">Emoji are widely adopted in smartphones, for input methods, and on social networks. As ubiquitous characters, emoji transcend linguistic borders and are gaining worldwide popularity. The purpose of this paper is to examine the effect of the position of the angry emoji in negative online consumer reviews on the consumers’ perceptions of the sender’s anger. The present study first proposed the main location effect of the position of the angry emoji on the consumers’ perception of the sender’s anger. That is, compared with the angry emoji at the end of a sentence, the angry emoji in the middle of a sentence led to a stronger perception of anger. Based on visual information processing of the location effect, the current research proposed that the position salience perception and the sentiment-strengthening perception of the angry emoji serially mediated the above main effect. Further, we hypothesized that word review extremity moderated the effect of the position of the angry emoji on the consumers’ perceptions of the sender’s anger. <br/>For this paper, we conducted one eye-tracking experiment and three laboratory experiments. In Study 1, we conducted a pretest, which was the eye-tracking experiment. The product used in the pretest was a thermos mug. Study 1 was a 3 (one emoji at the end of a sentence vs. one in the middle of a sentence vs. no emoji) × 2 (feature description: feature one precedes feature two vs. feature two precedes feature one) between-subjects design. The product used in Study 1 was a laptop. Study 2 was a 2 (the position of the angry emoji at the end vs. in the middle of a sentence) × 2 (feature description: feature one precedes feature two vs. feature two precedes feature one) between-subjects design. Study 2 used a gel-ink pen refill as the target product. In Study 2, we measured the consumers’ perceptions of the sender’s anger, the angry emoji sentiment-strengthening perception, and the position salience perception created by the angry emoji. Study 3 was a 2 (the position of the angry emoji at the end vs. in the middle of a sentence) × 2 (word review extremity: moderate vs. extreme) between-subjects design. Study 3 used a coat as the target product. <br/>The results of the pretest demonstrated the effectiveness of visual information processing on the location effect. The position of the angry emoji influenced the participants’ attention. The angry emoji in the middle of a sentence led to higher fixation counts and longer fixation durations. The results of Study 1 demonstrated the main effect in this paper, which was that an angry emoji in the middle of a sentence led to a stronger perception of the sender’s anger than did an angry emoji at the end of a sentence. The results of Study 2 replicated the results of Study 1 and tested the serial-mediating roles of the position salience perception and the sentiment- strengthening perception of the angry emoji. The results of Study 3 replicated the results of Study 2 and tested the moderating role of word review extremity in the relationship between the position of the angry emoji and the consumers’ perception of the sender’s anger. When we considered the extreme word review, the influence of the position of the angry emoji on the sender’s perception of anger was not significant; however, when we considered the moderate word review, the angry emoji in the middle of a sentence significantly enhanced the consumers’ perception of the sender’s anger. <br/>The current research extended the extant literature in several dimensions. First, it supplemented the literature in the field of marketing on the effects of the emoji on consumers’ responses. Second, it supplemented the literature of application contexts and the influence of the location effect. Third, the present research provided empirical evidence for emoji functions. Fourth, the present study supplemented the literature of online consumer reviews.

Visual Attention Patterns in Adults According to the Use of Things in Aided AAC VSDs: An Eye-tracking Study

Objectives: This study aims to investigate patterns of visual attention on a target object in VSDs (Visual Scene Displays) when they are designed with/without an action of usage of the object. We used eye-tracking technology to evaluate how the action of usage of an object in still photographs influenced the visual attention of adults without disabilities. We tried to examine visual attention on the contents of visual scene displays (VSDs).Methods: 25 college students participated in the study. Eye-tracking technology recorded point-of-gaze while participants viewed 20 photographs. Data from eye-tracking provided information on where participants were visually fixated and paid more attention on the presented VSDs including a target object.Results: Both total fixation duration and average fixation count were statistically significant. Participants visually fixated on the target object longer and more often when the object was being used in the presented VSDs. For AOI (Area Of Interest) time of the first fixation, after analyzing only a partial group that had the data match due to the difference in gaze pattern per subject, the average AOI time of the first fixation was shown to be faster when using an object in 6 out of 10 objects.Conclusion: This study supports the inclusion of an action of an object usage in VSDs suggesting that the act of object usage can partially influence the visual attention pattern of a user.

The potential of salient branding of fresh fruit on the supermarket shelf for consumer brand recall

Product choice in retail stores is influenced by visual recognition and the memory-based presence of brands. As the branding of fresh fruit is uncommon, we tested the effect of visual salient branding on a fresh produce shelf, visual attention, and choice on later brand recall of a fruit product. We showed participants two fresh produce shelves, conducted an eye-tracking experiment to capture visual attention, and administered a structured computer-based questionnaire with open recall of the brands seen during the eye-tracking. We found visual saliency and choice to be significant predictors for brand recall. Visual attention was significant only for the cluttered fresh produce shelf. A higher fixation count improved the probability of recalling the brand.

How time pressure and fingerprint complexity affect fingerprint examiner performance in an Eye Tracking Study

We conducted two experiments to examine the effects of time pressure and task difficulty on the strategies used and task accuracy during fingerprint examination. In Experiment I, we collected behavior and eye movement data from 31 fingerprint examiners in conditions with and without time pressure. In Experiment II, we used the same procedure but added a task difficulty variable. The results showed that, in contrast to the trials without time pressure, the fingerprint examiners used an observation mode with decreased fixation time and made fewer mistakes (stronger discriminability and higher response criterion) when under time pressure (Experiment I). This pattern was only observed when the task was less difficult. When the task was more difficult (Experiment II), the examiners tended to adopt an observation mode with more fixation counts, and time pressure weakened the accuracy of their performance. In conclusion, time pressure can influence decision-making by affecting the cognitive strategies used during fingerprint examination. And task difficulty has a moderating effect on the influence of time pressure.

Local and global context repetitions in contextual cueing.

In contextual cueing tasks, participants can use a repeating local context to learn to detect the target, yet most contextual cueing studies have relied on repeating global context properties. We examined whether observers can use local context repetitions in a similar manner as they use global context repetitions. In addition, we examined how reward-predicting context features modulate the use of local and global contexts. Participants searched through contexts in which either the entire context configuration or only a local context around the target repeated, intermixed with novel contexts. Half of the context items appeared in a color signaling either low or high reward. We found that local context repetitions led to comparable benefits in response times and fixation count as global context repetitions did. Surprisingly, reward magnitude did not affect performance in local nor in global contexts. The results suggest that a local chunk of distractors can be used for context learning and attention guidance in a similar manner as the global context configuration. We suggest that the proportion of repeated and novel context trials is crucial for context learning and that our combination of locally and globally repeating contexts provided an environment that facilitated learning in both context types because it allowed predicting the target location from the context in most of the trials.

Differing Visual Behavior Between Inexperienced and Experienced Critical Care Nurses While Using a Closed-Loop Ventilation System-A Prospective Observational Study.

Introduction: Closed-loop ventilation modes are increasingly being used in intensive care units to ensure more automaticity. Little is known about the visual behavior of health professionals using these ventilation modes. The aim of this study was to analyze gaze patterns of intensive care nurses while ventilating a patient in the closed-loop mode with Intellivent adaptive support ventilation® (I-ASV) and to compare inexperienced with experienced nurses.Materials and Methods: Intensive care nurses underwent eye-tracking during daily care of a patient ventilated in the closed-loop ventilation mode. Five specific areas of interest were predefined (ventilator settings, ventilation curves, numeric values, oxygenation Intellivent, ventilation Intellivent). The main independent variable and primary outcome was dwell time. Secondary outcomes were revisits, average fixation time, first fixation and fixation count on areas of interest in a targeted tracking-time of 60 min. Gaze patterns were compared between I-ASV inexperienced (n = 12) and experienced (n = 16) nurses.Results: In total, 28 participants were included. Overall, dwell time was longer for ventilator settings and numeric values compared to the other areas of interest. Similar results could be obtained for the secondary outcomes. Visual fixation of oxygenation Intellivent and ventilation Intellivent was low. However, dwell time, average fixation time and first fixation on oxygenation Intellivent were longer in experienced compared to inexperienced intensive care nurses.Discussion: Gaze patterns of intensive care nurses were mainly focused on numeric values and settings. Areas of interest related to traditional mechanical ventilation retain high significance for intensive care nurses, despite use of closed-loop mode. More visual attention to oxygenation Intellivent and ventilation Intellivent in experienced nurses implies more routine and familiarity with closed-loop modes in this group. The findings imply the need for constant training and education with new tools in critical care, especially for inexperienced professionals.