Dr. Miyazaki eye tracking study

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Eye tracking expands training possibilities, even when remote

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An interview with Dr.Miyazaki about combining eye tracking with teaching to bring a realistic experience to his students both near and far.

Traditional medical training, especially in surgical areas, employs a model that encourages in-person teaching techniques to offer a hands-on learning approach. This requires both course study in the early years, and in-person observations and modeling as the student progresses through their education. However, now with current social distancing requirements, many medical educators are faced with the need to pivot to remote learning and virtual training scenarios even for these hands-on experiences. We spoke to Douglas W. Miyazaki, M.D., a board-certified OB/GYN and Fellow of the American College of Obstetricians and Gynecologists, about how he combines eye tracking with his teaching method to bring a realistic experience to his students both near and far.

How one physician uses eye tracking in practice

Dr. Miyazaki is the inventor of the Miya Model, a pelvic model used to teach gynecological surgery. Currently, there are 40 institutions across the U.S. using this model. This tool allows him to demonstrate and teach surgeries in a simulated setting rather than on live patients. He uses eye tracking to not only teach students, but also to assess skills competencies.

As a self-professed technologically challenged individual, he was pleasantly surprised that the Tobii wearable eye trackers were so “turnkey and easy to use,” and was amazed by how much information he could get from just seeing where he looks during a surgery. Using this technology, he uncovered several benefits in the forms of what he called, “economies of motion and economies of learning.

Dr. Miyazaki teaching OBGYN students

Key benefits of eye tracking in surgical training

Benefit 1 — visually demonstrating techniques from the teacher’s perspective

Teaching students how to conduct procedures was the main reason Dr. Miyazaki wanted to add eye tracking to his model. “The ability to actually see through the surgeon’s eyes is important,” and “visualizing where their hand motions are is critical to success,” says Miyazaki. He goes on to explain that the actual angles of the surgeon’s hands during the surgery make a big difference since holding them a degree too far in either direction can cause unintended consequences. Eye tracking has the unique ability to show views that no other video mechanisms can do well. By using eye tracking, students can remotely see live surgical procedures and then can replay training sessions later for in-depth review.

Benefit 2 — creating a personalized learning experience

Dr. Miyazaki observed differences in the learning experience between students who eye tracked themselves and those who watched videos of others conducting the procedure. He explained the students seemed to have a personal connection, were more engaged, and had a deeper comprehension of what they did wrong when replaying eye tracking video captured of themselves doing the work. Whereas, when students watched someone else do a procedure on video their learning experience was totally different.

[Eye tracking] reinforces knowledge of anatomy and steps in mechanics of how to hold instruments.
Dr. Douglas W. Miyazaki, M.D

In his experience, this seems to shorten their learning curve as they tend to understand and correct their skills more quickly when they see where they themselves should adjust.

Dr. Miyazaki's OB GYN students

Benefit 3 — assessing competency of both student and teacher

As medical education and credentialing shifts from the traditional experienced-based model to a demonstration of proficiency model, it is imperative that we develop simulation models that permit the valid and reliable assessment of surgical skills,” Dr. Miyazaki stated in a recent paper.

Eye tracking allows experts to record themselves during a task and visually illustrate to students how to complete it. In Dr. Miyazaki’s simulated surgeries, he assesses the skills and competencies of both teacher and student using eye tracking recordings. By reviewing the students’ recording he can assess comprehension and application of the taught technique. In this way he is in the room, even if he is not physically there. Additionally, by reviewing the expert’s initial recording, he can also assess the quality of the teacher.

Benefit 4 — revealing where even experts can improve

Uncovering where experienced professionals could minimize extraneous movements that would otherwise add to total surgical time was an unexpected result revealed by eye tracking. Dr. Miyazaki discovered he adjusted surgical lights 30 different times during a procedure. Each time he looked away took an additional 10 seconds to refocus. Just by keeping his eyes focused on the patient when making these adjustments allowed him to shave minutes off the total length of surgery. This reduction in time is critical as extended surgical times may lead to an increased risk of complications.

Dr. Miyazaki using Tobii Pro Glasses 2 to perform test surgery

Future of eye tracking in field of remote training

Thanks to pioneers like Dr. Miyazaki, the future of eye tracking in healthcare continues to gain traction.

[Eye tracking] is a huge advantage for remote training. If you can have the benefits of hands-on simulation devices combined with remote learning, it will shorten the learning curve, maximize the amount of training available, and make learning more efficient in a shorter timeframe.
Dr. Douglas W. Miyazaki, M.D

According to the Association of American Medical Colleges, “the United States will see a shortage of up to nearly 122,000 physicians by 2032 as demand for physicians continues to grow faster than supply.” Given the barriers to education the recent pandemic has already caused, the medical field needs to consider new approaches to training future medical professionals and reduce further learning gaps. Using eye tracking allows people to see through the surgeon’s eyes in what would otherwise be a limited view situation. This advantage coupled with remote training options may serve the community well as it continues to evolve and adapt to changing times and keep up with ongoing educational demands.

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