Authors (including presenting author) :
Tsoi SCT (1)(3), Leung YWN (1)(2), Kwan HYC (4)
Affiliation :
(1) Nethersole Clinical Simulation Training Centre, Pamela Youde Nethersole Eastern Hospital, HKEC
(2) Department of Intensive Care, Pamela Youde Nethersole Eastern Hospital, HKEC
(3) Nursing Services Division, Pamela Youde Nethersole Eastern Hospital, HKEC
(4) Department of Respiratory Medicine, Kowloon Hospital, KCC
Introduction :
Eye-tracking technology emerges as a potentially useful learner assessment tool in different medical specialties by providing observable and objective parameters to reveal participant performance.
Core Medical Skills Course for Basic Physician Trainees (CMSC-BPT) was developed to enhance bedside procedural skills via different skill stations and scenario-based simulation training. This training course provides structured training to all basic physician trainees and to maintain quality in patient care. It was the first application of eye-tracking technology in the medical simulation of Hong Kong to evaluate the training and procedural skills performance.
Objectives :
To determine if eye-tracking technology can accurately distinguish between novice and experts in the procedural skills, specifically of the focused assessment using video laryngoscope in the intubation procedure.
Methodology :
A convenience sample of basic physician trainees and trainers in the training was invited voluntarily to participate. Each participant performed a standardized scenario with patient intubation, and they have to wear eye-tracking devices performed intubation procedures before and after the training. Their gaze patterns were recorded by a commercially available eye-tracking device. The primary outcome was total gaze time on the area of interest (AOI) in three critical areas defined in intubation (Patient chest area, vital sign monitor, and screen of video laryngoscope). The secondary outcomes include total time to fixation, mean number of fixations, and mean duration of the first fixation on the AOI.
Basic physician trainees were named under the group as “novice”, and trainers were named as “experts”.
Result & Outcome :
Three classes of CMSC-BPT were held from 7 to 14 August 2021 in Nethersole Clinical Simulation Training Centre (NCSTC). Total 131 doctors completed the training.
Fifteen novices and 2 experts joined the study. For total gaze time on the AOI, experts and post-training novices fixated their gaze significantly longer than pre-training. This means a more focus approach was adopted by novices after having the training course.
Experts and post-training novices demonstrated similar visual pattern, and significant a smaller number of fixation (From 427 to 87). This means the novices spent less time in searching.
Both findings illustrated the successful skills transfer and visual patterns from expert to participants.
Eye-tracking technology showed the potential to evaluate the effectiveness of procedural skills transfer. The total gaze time on the AOI may be a useful metric to help in the assessment of competency in the procedural skills. In addition, the evaluation of gaze patterns may help educators identify the performance gap and caliber training strategies. Future studies are indicated to validate these metrics in a larger cohort.
