Surgeons working on a patient

Customer story

Improving thoracoscopic surgery training using eye tracking technology

Resource Details

  • Written by

    Murphy Wang

  • Reading time

    5 min

Associate Professor Jingxi Chen of Tongji University and Dr. Liang Zhao of the Department of Thoracic Surgery at the Cancer Hospital of the Chinese Academy of Medical Sciences have formed an innovative research team dedicated to studying skill transfer in medical contexts. They have improved medical schools’ thoracoscopic surgery training by combining medical expertise with eye tracking. In their latest study, the team used the Tobii Pro Fusion and Tobii Pro Lab to investigate the significance of eye movement metrics as an objective testing standard for thoracic surgery training.

Nowadays, more than 90 percent of all thoracic surgeries are performed under a thoracoscope – a tiny, flexible tube with a camera on end, which allows surgeons to view inside the chest cavity. Thoracoscopic surgery presents new challenges to novice surgeons compared to the traditional open surgical approach. In thoracoscopic surgery, the tactile feedback from a hand or instrument is limited, and only visual feedback captured in a video by a thoracoscopic lens is available. In addition, most surgical skills training is based on the subjective judgment of the teaching surgeon and lacks objective assessment tools. All these factors adversely affect the training of novice thoracic surgeons.

Surgery training using eye tracking

Eye tracking reveals visual strategies in novice and expert surgeons

Eye tracking can effectively capture an individual’s visual attention and various cognitive processes. By recording eye movements in specific scenarios, the data obtained through eye tracking becomes a valuable source of information, shedding light on how an individual perceives their environment, processes information, and applies knowledge and skills. Eye tracking technology stands out as an innovative tool, enabling the training of new doctors through cued video training and offering a possibility for objective, instructional feedback throughout the learning process.

…you don't want your eye tracking equipment to be too heavy. While maintaining satisfactory data quality, the Tobii Pro Fusion is so easy to carry that it fits into any standard backpack, which saves us a lot of time and effort.
Jingxi Chen, Associate Professor, Director of Health Communication Research Center, College of Arts and Media, Tongji University;the Deputy Secretary-general of the Health Communication Division of the Chinese Association for History of Journalism and Communication( School of Language and Communication Studies,Beijing Jiaotong University)
Tobii-Pro-Fusion
Tobii Pro Fusion eye tracker used in the research study

In the present study, the researchers wanted to know whether observing and replicating the expert surgeon’s eye movements in a thoracoscopic surgery video would enhance the learning process of novice surgeons. To address this question, the scientist performed a two-phase eye tracking study. They used the Tobii Pro Fusion eye tracker and Tobii Pro Lab for stimulus presentation, data collection, and analysis.

In the first experiment phase, the researchers tracked expert and novice surgeons’ eye movements while watching a thoracoscopic dissection video. In the analysis, the researchers looked into two main types of eye movement metrics within the specific areas of interest (AOI) and times of interest (TOI):

  • Saccade-based metrics, which reflect the areas of cognitive processing and information acquisition.
  • Fixation-based metrics, which allow gaining insight into the area of attention allocation, cognitive processing, and learning efficiency.

The study results revealed significant differences in gaze patterns between the two groups while watching the surgical video. While expert doctors focused longer on critical details in the video and paid attention to key anatomical structures, novice doctors tended to deviate their attention from the key regions and spent more time fixating on unrelated areas.

In the study’s second phase, a new cohort of novice surgeons was divided into two groups to watch the original surgical video (control group) and the same video with the expert’s eye movement trajectory attached (experimental group). Post-tests showed that the experimental group better understood the surgical procedure details, significantly improving their learning.

Eye tracking technology can provide real-time workflow videos overlaid with eye-movement data and using this resource to analyze experts' visual attention distribution, hand-eye coordination, and workflow enables researchers to extract key operational steps and attention details to optimize the training process.
Jingxi Chen, Associate Professor, Director of Health Communication Research Center, College of Arts and Media, Tongji University;the Deputy Secretary-general of the Health Communication Division of the Chinese Association for History of Journalism and Communication( School of Language and Communication Studies,Beijing Jiaotong University)

Publication

Ji, Y., Kong, Z., Deng, Y., Chen, J., Liu, Y., & Zhao, L. (2022). The role of eye tracker in teaching video-assisted thoracoscopic surgery: the differences in visual strategies between novice and expert surgeons in thoracoscopic surgery. Annals of Translational Medicine, 10(10), 592–592. 

Resource Details

  • Written by

    Murphy Wang

  • Reading time

    5 min

    Resource type

    • Customer story

    Tagged products

    • Eye trackers
    • Software

    Tagged solutions

    • Scientific research
    • Training and skills assessment
    • Healthcare

Author

  • Murphy Wang

    Murphy Wang

    Knowledge Consultant, Tobii

    As a knowledge consultant for Tobii China, I popularize eye tracking technology among our nation's scientists and partners in their eye tracking journeys. My vision is to promote the widespread integration of eye tracking technology into the advancement of science.

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