PS2 - 04: LOOKS CAN BE DECEIVING: GAZE PATTERN DIFFERENCES BETWEEN NOVICES AND EXPERTS DURING PLACEMENT OF CENTRAL LINES
Hong-En Chen, BS1, Cheyenne C Sonntag, MD2, Rohan S Prabhu, BTech1, David F Pepley, MS1, David C Han, MD2, Jason Z Moore, PhD1, Scarlett R Miller, PhD1; 1Penn State University, 2Penn State Hershey Medical Center
Introduction: Image guided procedures are commonly performed by surgeons. During these procedures, attention is split between the image (typically ultrasound), and the patient undergoing the procedure. Eye tracking has shown promise as a means to quantify and understand the development of surgical expertise. The purpose of this study was to assess the homogeneity of gaze patterns of procedural experts, as well as to determine differences in gaze patterns between novices and experts in the placement of central venous catheters (CVC).
Methods: Experts (n=10), residents (n=4), and novices (n=4) in CVC placement completed needle insertions using a simulator. Reported average CVC procedure experience was greater than 200 lines among experts, 20 lines for residents, and no experience for novices. Eye tracking was performed using Tobii Pro Glasses 2 to determine eye gaze patterns. An ANOVA test and Tukey’s pairwise comparison was used to compare differences in gaze fixation patterns between the different levels of expertise. Statistics were analyzed at a significance level of 0.05 using SPSS v24.0.
Results: The mean completion time was 32.9±7.3 seconds for experts, 42.6±8.8 seconds for residents, and 56.7±34.7 seconds for novices. The 18 participants focused on two main areas of interest: the ultrasound screen and tracking the needle and probe. The mean percent of time spent gazing at the ultrasound screen was significantly different (p < 0.020) between experts (75.8%) and novices (51.5%).
Conclusion:During ultrasound guided CVC placement, experts spend significantly more time focusing on the ultrasound screen and less time tracking the needle and probe. This difference would suggest that where one’s attention is directed during the procedure changes as more expertise is gained. Where one should be looking during image guided procedures represents a variable that can be measured, assessed, and taught as part of a curriculum in teaching image guided procedures.