How Do Cardiology Practitioners Interpret an Electrocardiogram: An Eye Tracking Study (Preprint)

BACKGROUND Visual expertise refers to advanced visual skills demonstrated when executing domain‐specific visual tasks. Understanding healthcare practitioners’ visual expertise across different levels in the healthcare sector is crucial in clarifying how to acquire accurate interpretations of electrocardiograms (ECGs). OBJECTIVE The study aims to quantify, through the use of eye-tracking, differences in the visual expertise of medical practitioners, such as medical students, cardiology nurses, technicians, fellows, and consultants, when interpreting ECGs. METHODS Sixty-three participants with different healthcare roles participated in an eye-tracking study that consisted of interpreting 10 ECGs with different heart abnormalities. A counterbalanced within-subjects design was employed with one independent variable consisting of the expertise level of the medical practitioners and two measured eye-tracking dependent variables (fixations count and fixations revisitation). Eye-tracking data was assessed according to the accuracy of interpretation and frequency interpreters visited different leads in ECGs. In addition, the median and standard deviation in the interquartile range for the fixations count and the mean and standard deviation for the ECG lead revisitations were calculated. RESULTS Accuracy of interpretation ranged between 98% among consultants and 52% among medical students. Eye-tracking features also reflected this difference in the accuracy of interpretation. The results of the eye fixations count and eye fixations revisitations indicate that the less experienced medical practitioners need to observe various ECG leads more carefully. However, experienced medical practitioners rely on visual pattern recognition to provide their ECG diagnoses. CONCLUSIONS The results show that visual expertise for ECG interpretation is linked to the practitioner’s role within the healthcare system and the number of years of practical experience interpreting ECGs. Medical practitioners focus on different ECG leads and different waveform abnormalities according to their role in the healthcare sector and their expertise levels.

EXPRESS: Music-reading expertise associates with face but not Chinese character processing ability

A growing number of behavioral and neuroimaging studies have investigated the cognitive mechanisms and neural substrates underlying various forms of visual expertise such as face and word processing. However, it remains poorly understood whether and to what extent the acquisition of one form of expertise would be associated with that of another. The current study examined the relationship between music-reading expertise and face and Chinese character processing abilities. In a series of experiments, music experts and novices performed discrimination and recognition tasks of musical notations, faces, and words. Results consistently showed that musical experts responded more accurately to musical notations and faces, but not to words, than did musical novices. More intriguingly, the music expert’s age of training onset could well predict their face but not word processing performance: the earlier musical experts began musical notation reading, the better their face-processing performance. Taken together, our findings provide preliminary and converging evidence that music-reading expertise links with face, but not word, processing, and lend support to the notion that the development of different types of visual expertise may not be independent, but rather interact with each other during their acquisition.

How Visual Expertise Changes Representational Geometry: A Behavioral and Neural Perspective

Many people develop expertise in specific domains of interest, such as chess, microbiology, radiology, and, the case in point in our study: ornithology. It is poorly understood to what extent such expertise alters brain function. Previous neuroimaging studies of expertise have typically focused upon the category level, for example, selectivity for birds versus nonbird stimuli. We present a multivariate fMRI study focusing upon the representational similarity among objects of expertise at the subordinate level. We compare the neural representational spaces of experts and novices to behavioral judgments. At the behavioral level, ornithologists (n = 20) have more fine-grained and task-dependent representations of item similarity that are more consistent among experts compared to control participants. At the neural level, the neural patterns of item similarity are more distinct and consistent in experts than in novices, which is in line with the behavioral results. In addition, these neural patterns in experts show stronger correlations with behavior compared to novices. These findings were prominent in frontal regions, and some effects were also found in occipitotemporal regions. This study illustrates the potential of an analysis of representational geometry to understand to what extent expertise changes neural information processing.

Differences in Visuospatial Expertise between Skeet Shooting Athletes and Non-Athletes

Background: Sports vision is a specialisation of optometry whose objective is to improve and preserve visual function to increase sports performance. The main objective of the present study was to compare the visual expertise of non-athletes to skeet shooting athletes. Methods: Participants underwent an optometric assessment in which all those with severe deviations from normal vision, after compensating for visual abnormalities, were eliminated. After that, the following six visuospatial components were measured: hand–eye coordination, peripheral awareness, fixation disparity, saccadic eye movements, speed of recognition and visual memory. To measure the aforementioned components, the following tests were used: directional arrows, similar and different characters, the dichromatic disparity test, character marking, a tachistoscopic test and tic-tac-toe using COI-vision software. Results: Skeet shooting athletes performed significatively better (p ≤ 0.05) in two out of the six tests: hand–eye coordination and visual memory. Conclusions: Although this study does not support the theory that athletes—in this case, skeet shooting athletes—perform significantly better in most components of the visuospatial tests, visual memory and hand–eye coordination are exceptions. To be more accurate in distinguishing between athletes and non-athletes, specific testing methods that can be used by a wide variety of disciplines should be developed. Training the weakest aspects of athletes can improve their sports performance.

Effects of Experts’ Annotations on Fashion Designers Apprentices’ Gaze Patterns and Verbalisations

Visual expertise is a fundamental proficiency in many vocations and many questions have risen on the topic, with studies looking at experts and novices differences’ in observation (e.g., radiologists) or at ways to help novices achieve visual expertise (e.g., through annotations). However, most of these studies focus on white-collar professions and overlook vocational ones. For example, observing is uttermost important for fashion designers who spend most of their professional time on visual tasks related to creating patterns and garments or performing alterations. Therefore, this study focuses on trying to convey a professional way to look at images by exposing apprentices to images annotated (e.g., circles) by experts and identifying if their gaze (e.g., fixation durations and gaze coverage) and verbalisations (i.e., images descriptions) are affected. The study was conducted with 38 apprentices that were exposed to sequential sets of images depicting shirts, first non-annotated (pre-test), then annotated for the experimental group and non-annotated for the control group (training 1 and training 2), and finally non-annotated (post-test). Also, in the pre and post-test and in training 2 apprentices had to verbally describe each image. Gaze was recorded with the Tobii X2–60 tracker. Results for fixation durations showed that the experimental group looked longer in the annotated part of the shirt in training 1 and in the shirt’s central part at post-test. However, the experimental group did not cover a significantly larger area of the shirt compared to control and verbalisations show no difference between the groups at post-test.

Fostering Apprentice Beauticians’ Visual Expertise Through Annotations: A Design Experiment Using the Platform Realto

Professional beauticians regularly perform skin analyses and should be skilled at observing small skin anomalies and skin damages. However, little is done directly for improving their observation skills at school, during their training. In order to foster apprentices’ observation skills of skin anomalies, a new training scheme exploiting annotations and attention-guiding methods through the use of the platform Realto was developed and tested.A second year class of apprentice beauticians (N=9) was given a pre-test on the visual expertise of skin anomalies. Then, for a semester they attended multiple training sessions where firstly teachers explained skin anomaly images with the help of annotations (attention-guiding) and secondly, students were asked to observe other images of the same anomalies, annotate them, and then provide a textual description of the identified anomaly.At the end of the semester, the trained class completed a post-test and a questionnaire, and group interview have been collected. Another group of apprentices (N=19) of the third year who already completed the skin anomaly course was used as baseline. Results showed that the group who participated in the treatment mentioned almost double the amount of details noticed by the baseline group in the post-test; being trained using annotations and the Realto platform proved effective in developing observation skills, compared to normal lessons. Furthermore, apprentices confirmed, both through the questionnaire and the interviews, that they considered annotations useful for improving their observation skills and that using Realto and its annotation facilities was a good way to achieve this result.

How massed practice improves visual expertise in reading panoramic radiographs in dental students: An eye tracking study

The interpretation of medical images is an error-prone process that may yield severe consequences for patients. In dental medicine panoramic radiography (OPT) is a frequently used diagnostic procedure. OPTs typically contain multiple, diverse anomalies within one image making the diagnostic process very demanding, rendering students’ development of visual expertise a complex task. Radiograph interpretation is typically taught through massed practice; however, it is not known how effective this approach is nor how it changes students’ visual inspection of radiographs. Therefore, this study investigated how massed practice–an instructional method that entails massed learning of one type of material–affects processing of OPTs and the development of diagnostic performance. From 2017 to 2018, 47 dental students in their first clinical semester diagnosed 10 OPTs before and after their regular massed practice training, which is embedded in their curriculum. The OPTs contained between 3 to 26 to-be-identified anomalies. During massed practice they diagnosed 100 dental radiographs without receiving corrective feedback. The authors recorded students’ eye movements and assessed the number of correctly identified and falsely marked low- and high prevalence anomalies before and after massed practice. Massed practice had a positive effect on detecting anomalies especially with low prevalence (p < .001). After massed practice students covered a larger proportion of the OPTs (p < .001), which was positively related to the detection of low-prevalence anomalies (p = .04). Students also focused longer, more frequently, and earlier on low-prevalence anomalies after massed practice (ps < .001). While massed practice improved visual expertise in dental students with limited prior knowledge, there is still substantial room for improvement. The results suggest integrating massed practice with more deliberate practice, where, for example, corrective feedback is provided, and support is adapted to students’ needs.

Visual Experience is not Necessary for the Development of Face Selectivity in the Lateral Fusiform Gyrus

Here we show robust face-selectivity in the lateral fusiform gyrus of congenitally blind participants during haptic exploration of 3D-printed stimuli, indicating that neither visual experience, nor fovea-biased input, nor visual expertise is necessary for face-selectivity to arise in its characteristic location. Similar resting fMRI correlation fingerprints in individual blind and sighted participants suggest a role for long-range connectivity in the specification of the cortical locus of face-selectivity.