EP.TH.589Comparison of Surgeon Gaze Behaviour Against Objective Skill Assessment in Open Inguinal Hernia Repair – A Pilot Study

Abstract Aims Technical skill is associated with improved postoperative outcomes. Adoption of a formalised high-stakes assessment of surgical skill is technically challenging and limited by the financial and human resources available. We aimed to assess the ability to adopt gaze behaviour analysis as an assessment of surgical skill within live open inguinal herniorrhaphy. Methods Surgeons’ gaze was measured with Tobii Pro eye-tracking Glasses 2 (Tobii AB). All grades of surgeons were included. Primary outcomes were dwell time (%) and fixation frequency (count/s), as markers of cognition, on areas of interest correlated to mean Objective Skill Assessment of Technical Skill score. Secondary outcomes assessed effort and concentration levels through maximum pupil diameter (mm) and rate of pupil change (mm/s) correlated to perceived workload (SURG-TLX). Three operative segments underwent analysis: mesh preparation, fixation and muscle closure. Spearman’s and Pearson’s correlation were performed with significance set at p < 0.05. Results 5 cases were analysed, totalling 270 minutes of video footage. All participants were senior surgical trainees and right-hand-dominant. The median number of hernia operations performed was 160 (range:100-500). The median ASA score of each patient participant was 2 (range:1-2). The median operation length was 45 mins (range:40-90 mins). There were no statistically significant primary outcomes from this pilot data (p > 0.05). Conclusions This pilot study demonstrated the feasibility of recording gaze behaviours for comparison against formal skills assessment to determine the role of eye tracking in live high stakes technical skills assessment. A full study will now commence based on formal power calculation.

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Comparison of surgeon gaze behaviour against objective skill assessment in laparoscopic cholecystectomy-a prospective cohort study

International Journal of Surgery ◽

10.1016/j.ijsu.2020.08.006 ◽

2020 ◽

Vol 82 ◽

pp. 149-155

Author(s):

Keane Evans-Harvey ◽

Simon Erridge ◽

Urvi Karamchandani ◽

Sala Abdalla ◽

Jasmine Winter Beatty ◽

...

Keyword(s):

Cohort Study ◽

Laparoscopic Cholecystectomy ◽

Prospective Cohort Study ◽

Prospective Cohort ◽

Skill Assessment ◽

Objective Skill Assessment ◽

Gaze Behaviour

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Eye movements in surgery : A literature review

Journal of Eye Movement Research ◽

10.16910/jemr.6.4.4 ◽

2013 ◽

Vol 6 (4) ◽

Cited By ~ 3

Author(s):

Frouke Hermens ◽

Rhona Flin ◽

Irfan Ahmed

Keyword(s):

Eye Movements ◽

Literature Review ◽

Eye Tracking ◽

Surgical Training ◽

Skill Assessment ◽

Surgical Skill ◽

Surgical Residents ◽

Methodological Aspects ◽

Tracking Technology

h recent advances in eye tracking technology, it is now possible to track surgeons’ eye movements while engaged in a surgical task or when surgical residents practice their surgical skills. Several studies have compared eye movements of surgical experts and novices, developed techniques to assess surgical skill on the basis of eye movements, and examined the role of eye movements in surgical training. We here provide an overview of these studies with a focus on the methodological aspects. We conclude that the different studies of eye movements in surgery suggest that the recording of eye movements may be beneficial both for skill assessment.

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Eye movements in sports research and practice: Immersive technologies as optimal environments for the study of gaze behaviour

10.31234/osf.io/fbwvk ◽

2020 ◽

Author(s):

David Harris ◽

Mark Wilson ◽

Tim Holmes ◽

Toby de Burgh ◽

Samuel James Vine

Keyword(s):

Virtual Reality ◽

Eye Movements ◽

Eye Tracking ◽

Visual Information ◽

Successful Performance ◽

Experimental Control ◽

Research And Practice ◽

Gaze Behaviour ◽

Immersive Technologies

Head-mounted eye tracking has been fundamental for developing an understanding of sporting expertise, as the way in which performers sample visual information from the environment is a major determinant of successful performance. There is, however, a long running tension between the desire to study realistic, in-situ gaze behaviour and the difficulties of acquiring accurate ocular measurements in dynamic and fast-moving sporting tasks. Here, we describe how immersive technologies, such as virtual reality, offer an increasingly compelling approach for conducting eye movement research in sport. The possibility of studying gaze behaviour in representative and realistic environments, but with high levels of experimental control, could enable significant strides forward for eye tracking in sport and improve understanding of how eye movements underpin sporting skills. By providing a rationale for virtual reality as an optimal environment for eye tracking research, as well as outlining practical considerations related to hardware, software and data analysis, we hope to guide researchers and practitioners in the use of this approach.

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Investigating Gaze Behaviour of Children Diagnosed with Autism Spectrum Disorders in a Classroom Setting

Journal of Autism and Developmental Disorders ◽

10.1007/s10803-021-04906-z ◽

2021 ◽

Author(s):

Aideen McParland ◽

Stephen Gallagher ◽

Mickey Keenan

Keyword(s):

Eye Tracking ◽

Autism Spectrum ◽

Classroom Setting ◽

Typically Developing ◽

Training Tool ◽

Gaze Behaviour ◽

Promising Application ◽

Spectrum Disorders ◽

Face Stimuli ◽

Operant Training

AbstractA defining feature of ASD is atypical gaze behaviour, however, eye-tracking studies in ‘real-world’ settings are limited, and the possibility of improving gaze behaviour for ASD children is largely unexplored. This study investigated gaze behaviour of ASD and typically developing (TD) children in their classroom setting. Eye-tracking technology was used to develop and pilot an operant training tool to positively reinforce typical gaze behaviour towards faces. Visual and statistical analyses of eye-tracking data revealed different gaze behaviour patterns during live interactions for ASD and TD children depending on the interaction type. All children responded to operant training with longer looking times observed on face stimuli post training. The promising application of operant gaze training in ecologically valid settings is discussed.

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Validating scoring systems for fracture healing in infants and young children: pilot study

Pediatric Radiology ◽

10.1007/s00247-021-05038-3 ◽

2021 ◽

Author(s):

Samuel Crompton ◽

Fabrizio Messina ◽

Gillian Klafkowski ◽

Christine Hall ◽

Amaka C. Offiah

Keyword(s):

Pilot Study ◽

Young Children ◽

Fracture Healing ◽

Callus Formation ◽

Femoral Fractures ◽

Scoring Systems ◽

Power Calculation ◽

Small Pilot Study ◽

Fractures In Children ◽

Infants And Young Children

Abstract Background Recent studies have analysed birth-related clavicular fractures to propose time frames for healing that could be applied to dating of all fractures in cases of suspected child abuse. Objective To assess differences in healing rates between femoral fractures and birth-related clavicular fractures in infants and young children. Materials and methods A retrospective 5-year pilot study of femoral fractures in children younger than 3 years of age was performed. Anonymised radiographs were independently scored by two radiologists for stages of fracture healing. In cases of reader disagreement, radiographs were independently scored by a third radiologist. Results In total, 74 radiographs (30 children) met the inclusion criteria. Fracture healing evolved over time with subperiosteal new bone formation (SPNBF) appearing first, followed by callus then remodelling. A power calculation for a single proportion, with a level of confidence of 95% and a margin of error of 5%, showed that in a definitive study, 359 radiographs would be required. Conclusion Although the overall pattern of healing is similar, in this small pilot study, the earliest times for SPNBF and callus formation in femoral fractures appeared to lag behind healing of birth-related clavicular fractures. Remodelling appeared earlier than remodelling of clavicular fractures. A power calculation has determined numbers of femoral radiographs (359) required for a definitive study.

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Validity of robotic simulation for high-stakes examination: a pilot study

Journal of Robotic Surgery ◽

10.1007/s11701-021-01258-9 ◽

2021 ◽

Author(s):

Adrienne Jarocki ◽

David Rice ◽

Michael Kent ◽

Daniel Oh ◽

Jules Lin ◽

...

Keyword(s):

Pilot Study ◽

High Stakes ◽

Robotic Simulation

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Correction to: Eye-tracking-aided characterization of saccades and antisaccades in SYNE1 ataxia patients: a pilot study

BMC Neuroscience ◽

10.1186/s12868-021-00621-8 ◽

2021 ◽

Vol 22 (1) ◽

Author(s):

Laszlo Szpisjak ◽

Gabor Szaraz ◽

Andras Salamon ◽

Viola L. Nemeth ◽

Noemi Szepfalusi ◽

...

Keyword(s):

Pilot Study ◽

Eye Tracking

An amendment to this paper has been published and can be accessed via the original article.

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Automation of surgical skill assessment using a three-stage machine learning algorithm

Scientific Reports ◽

10.1038/s41598-021-84295-6 ◽

2021 ◽

Vol 11 (1) ◽

Author(s):

Joël L. Lavanchy ◽

Joel Zindel ◽

Kadir Kirtac ◽

Isabell Twick ◽

Enes Hosgor ◽

...

Keyword(s):

Machine Learning ◽

Learning Algorithm ◽

Surgical Skills ◽

Adverse Outcomes ◽

Machine Learning Algorithms ◽

Surgical Instruments ◽

Skill Assessment ◽

Surgical Skill ◽

Surgical Skill Assessment ◽

Motion Features

AbstractSurgical skills are associated with clinical outcomes. To improve surgical skills and thereby reduce adverse outcomes, continuous surgical training and feedback is required. Currently, assessment of surgical skills is a manual and time-consuming process which is prone to subjective interpretation. This study aims to automate surgical skill assessment in laparoscopic cholecystectomy videos using machine learning algorithms. To address this, a three-stage machine learning method is proposed: first, a Convolutional Neural Network was trained to identify and localize surgical instruments. Second, motion features were extracted from the detected instrument localizations throughout time. Third, a linear regression model was trained based on the extracted motion features to predict surgical skills. This three-stage modeling approach achieved an accuracy of 87 ± 0.2% in distinguishing good versus poor surgical skill. While the technique cannot reliably quantify the degree of surgical skill yet it represents an important advance towards automation of surgical skill assessment.

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