Looks can be deceiving: Gaze pattern differences between novices and experts during placement of central lines

Hong-En Chen; Cheyenne C Sonntag; David F Pepley; Rohan S Prabhu; David C Han; Jason Z Moore; Scarlett R Miller

doi:10.1016/j.amjsurg.2018.11.007

Looks can be deceiving: Gaze pattern differences between novices and experts during placement of central lines

Am J Surg. 2019 Feb;217(2):362-367. doi: 10.1016/j.amjsurg.2018.11.007. Epub 2018 Nov 13.

Authors

Hong-En Chen¹, Cheyenne C Sonntag², David F Pepley³, Rohan S Prabhu³, David C Han⁴, Jason Z Moore³, Scarlett R Miller⁵

Affiliations

¹ Department of Industrial and Manufacturing Engineering, Penn State, University Park, PA, 16802, USA.
² Department of Surgery, Penn State Health Milton S. Hershey Medical Center, Hershey, PA, 17033, USA.
³ Department of Mechanical and Nuclear Engineering, Penn State, University Park, PA, 16802, USA.
⁴ Department of Surgery, Penn State Health Milton S. Hershey Medical Center, Hershey, PA, 17033, USA; Penn State Heart and Vascular Institute, Penn State Health Milton S. Hershey Medical Center, Hershey, PA, 17033, USA.
⁵ Department of Industrial and Manufacturing Engineering, Penn State, University Park, PA, 16802, USA; School of Engineering Design, Technology, and Professional Programs, Penn State, University Park, PA, 16802, USA. Electronic address: scarlettmiller@psu.edu.

Abstract

Background: The objective of this study was to determine whether gaze patterns could differentiate expertise during simulated ultrasound-guided Internal Jugular Central Venous Catheterization (US-IJCVC) and if expert gazes were different between simulators of varying functional and structural fidelity.

Methods: A 2017 study compared eye gaze patterns of expert surgeons (n = 11), senior residents (n = 4), and novices (n = 7) during CVC needle insertions using the dynamic haptic robotic trainer (DHRT), a system which simulates US-IJCVC. Expert gaze patterns were also compared between a manikin and the DHRT.

Results: Expert gaze patterns were consistent between the manikin and DHRT environments (p = 0.401). On the DHRT system, CVC experience significantly impacted the percent of time participants spent gazing at the ultrasound screen (p < 0.0005) and the needle and ultrasound probe (p < 0.0005).

Conclusion: Gaze patterns differentiate expertise during ultrasound-guided IJCVC placement and the fidelity of the simulator does not impact gaze patterns.

Keywords: Central venous catheterization; Eye tracking; Medical training simulation; Residency training.

Publication types

Comparative Study
Research Support, N.I.H., Extramural

MeSH terms

Catheterization, Central Venous*
Clinical Competence*
Education, Medical, Graduate / methods*
Humans
Internship and Residency / methods*
Manikins*
Robotics / education*
Ultrasonography, Interventional*

Grants and funding

R01 HL127316/HL/NHLBI NIH HHS/United States