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Alder DB, Ford PR, Causer J, Williams AM. The effect of anxiety on anticipation, allocation of attentional resources, and visual search behaviours. Hum Mov Sci 2018; 61:81-89. [PMID: 30036797 DOI: 10.1016/j.humov.2018.07.002] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2016] [Revised: 07/02/2018] [Accepted: 07/02/2018] [Indexed: 11/25/2022]
Abstract
Successful sports performance requires athletes to be able to mediate any detrimental effects of anxiety whilst being able to complete tasks simultaneously. In this study, we examine how skill level influences the ability to mediate the effects of anxiety on anticipation performance and the capacity to allocate attentional resources to concurrent tasks. We use a counterbalanced, repeated measures design that required expert and novice badminton players to complete a film-based anticipation test in which they predicted serve direction under high- and low-anxiety conditions. On selected trials, participants completed an auditory secondary task. Visual search data were recorded and the Mental Readiness Form v-3 was used to measure cognitive anxiety, somatic anxiety and self-confidence. The Rating Scale of Mental Effort was used to measure mental effort. The expert players outperformed their novice counterparts on the anticipation task across both anxiety conditions, with both groups anticipation performance deteriorating under high- compared to low-anxiety. This decrease across anxiety conditions was significantly greater in the novice compared to the expert group. High-anxiety resulted in a shorter final visual fixation duration for both groups when compared to low-anxiety. Anxiety had a negative impact on secondary task performance for the novice, but not the expert group. Our findings suggest that expert athletes more effectively allocated attentional resources during performance under high-anxiety conditions. In contrast, novice athletes used more attentional resources when completing the primary task and, therefore, were unable to maintain secondary task performance under high-anxiety.
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Affiliation(s)
- D B Alder
- Carnegie School of Sport, Leeds Beckett University, Leeds, United Kingdom.
| | - P R Ford
- Sport and Service Management, University of Brighton, Brighton, United Kingdom
| | - J Causer
- Research Institute for Sport and Exercise Sciences, Liverpool John Moores University, Liverpool, United Kingdom
| | - A M Williams
- Psychology Department, University of Utah, Salt Lake City, USA
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Jie LJ, Kleynen M, Meijer K, Beurskens A, Braun S. The Effects of Implicit and Explicit Motor Learning in Gait Rehabilitation of People After Stroke: Protocol for a Randomized Controlled Trial. JMIR Res Protoc 2018; 7:e142. [PMID: 29793902 PMCID: PMC5992456 DOI: 10.2196/resprot.9595] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2017] [Revised: 03/30/2018] [Accepted: 03/31/2018] [Indexed: 11/17/2022] Open
Abstract
Background A significant part of neurological rehabilitation focuses on facilitating the learning of motor skills. Training can adopt either (more) explicit or (more) implicit forms of motor learning. Gait is one of the most practiced motor skills within rehabilitation in people after stroke because it is an important criterion for discharge and requirement for functioning at home. Objective The aim of this study was to describe the design of a randomized controlled study assessing the effects of implicit motor learning compared with the explicit motor learning in gait rehabilitation of people suffering from stroke. Methods The study adopts a randomized, controlled, single-blinded study design. People after stroke will be eligible for participation when they are in the chronic stage of recovery (>6 months after stroke), would like to improve walking performance, have a slow walking speed (<1 m/s), can communicate in Dutch, and complete a 3-stage command. People will be excluded if they cannot walk a minimum of 10 m or have other additional impairments that (severely) influence gait. Participants will receive 9 gait-training sessions over a 3-week period and will be randomly allocated to an implicit or explicit group. Therapists are aware of the intervention they provide, and the assessors are blind to the intervention participants receive. Outcome will be assessed at baseline (T0), directly after the intervention (T1), and after 1 month (T2). The primary outcome parameter is walking velocity. Walking performance will be assessed with the 10-meter walking test, Dynamic Gait Index, and while performing a secondary task (dual task). Self-reported measures are the Movement Specific Reinvestment Scale, verbal protocol, Stroke and Aphasia Quality of Life Scale, and the Global Perceived Effect scale. A process evaluation will take place to identify how the therapy was perceived and identify factors that may have influenced the effectiveness of the intervention. Repeated measures analyses will be conducted to determine significant and clinical relevant differences between groups and over time. Results Data collection is currently ongoing and results are expected in 2019. Conclusions The relevance of the study as well as the advantages and disadvantages of several aspects of the chosen design are discussed, for example, the personalized approach and choice of measurements. Trial Registration Netherlands Trial Register NTR6272; http://www.trialregister.nl/trialreg/admin/rctview.asp?TC=6272 (Archived by WebCite http://www.webcitation.org/6ytA937m5) Registered Report Identifier RR1-10.2196/9595
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Affiliation(s)
- Li-Juan Jie
- Research Center of Nutrition, Lifestyle and Exercise, Faculty of Health, Heerlen, Netherlands.,Caphri School for Public Health and Primary care, Maastricht University, Maastricht, Netherlands.,Nutrim School for Nutrition and Translational Research in Metabolism, Department of Nutrition and Movement Sciences, Maastricht University, Maastricht, Netherlands
| | - Melanie Kleynen
- Research Center of Nutrition, Lifestyle and Exercise, Faculty of Health, Heerlen, Netherlands.,Caphri School for Public Health and Primary care, Maastricht University, Maastricht, Netherlands
| | - Kenneth Meijer
- Nutrim School for Nutrition and Translational Research in Metabolism, Department of Nutrition and Movement Sciences, Maastricht University, Maastricht, Netherlands
| | - Anna Beurskens
- Caphri School for Public Health and Primary care, Maastricht University, Maastricht, Netherlands.,Research Centre for Autonomy and Participation of Persons with a Chronic Illness, Zuyd University of Applied Sciences, Heerlen, Netherlands
| | - Susy Braun
- Research Center of Nutrition, Lifestyle and Exercise, Faculty of Health, Heerlen, Netherlands.,Caphri School for Public Health and Primary care, Maastricht University, Maastricht, Netherlands
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Feng Y, McGowan H, Semsar A, Zahiri HR, George IM, Turner T, Park A, Kleinsmith A, Mentis HM. A virtual pointer to support the adoption of professional vision in laparoscopic training. Int J Comput Assist Radiol Surg 2018; 13:1463-1472. [PMID: 29796835 DOI: 10.1007/s11548-018-1792-9] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2018] [Accepted: 05/09/2018] [Indexed: 10/16/2022]
Abstract
PURPOSE To assess a virtual pointer in supporting surgical trainees' development of professional vision in laparoscopic surgery. METHODS We developed a virtual pointing and telestration system utilizing the Microsoft Kinect movement sensor as an overlay for any imagine system. Training with the application was compared to a standard condition, i.e., verbal instruction with un-mediated gestures, in a laparoscopic training environment. Seven trainees performed four simulated laparoscopic tasks guided by an experienced surgeon as the trainer. Trainee performance was subjectively assessed by the trainee and trainer, and objectively measured by number of errors, time to task completion, and economy of movement. RESULTS No significant differences in errors and time to task completion were obtained between virtual pointer and standard conditions. Economy of movement in the non-dominant hand was significantly improved when using virtual pointer ([Formula: see text]). The trainers perceived a significant improvement in trainee performance in virtual pointer condition ([Formula: see text]), while the trainees perceived no difference. The trainers' perception of economy of movement was similar between the two conditions in the initial three runs and became significantly improved in virtual pointer condition in the fourth run ([Formula: see text]). CONCLUSIONS Results show that the virtual pointer system improves the trainer's perception of trainee's performance and this is reflected in the objective performance measures in the third and fourth training runs. The benefit of a virtual pointing and telestration system may be perceived by the trainers early on in training, but this is not evident in objective trainee performance until further mastery has been attained. In addition, the performance improvement of economy of motion specifically shows that the virtual pointer improves the adoption of professional vision- improved ability to see and use laparoscopic video results in more direct instrument movement.
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Affiliation(s)
- Yuanyuan Feng
- Department of Information Systems, University of Maryland, Baltimore County, 1000 Hilltop Circle, Baltimore, MD, 21250, USA.
| | - Hannah McGowan
- Department of Information Systems, University of Maryland, Baltimore County, 1000 Hilltop Circle, Baltimore, MD, 21250, USA
| | - Azin Semsar
- Department of Information Systems, University of Maryland, Baltimore County, 1000 Hilltop Circle, Baltimore, MD, 21250, USA
| | - Hamid R Zahiri
- Department of Surgery, Anne Arundel Medical Center, 2001 Medical Pkwy, Annapolis, MD, 21401, USA
| | - Ivan M George
- Department of Surgery, Anne Arundel Medical Center, 2001 Medical Pkwy, Annapolis, MD, 21401, USA
| | - Timothy Turner
- Department of Surgery, Anne Arundel Medical Center, 2001 Medical Pkwy, Annapolis, MD, 21401, USA
| | - Adrian Park
- Department of Surgery, Anne Arundel Medical Center, 2001 Medical Pkwy, Annapolis, MD, 21401, USA
| | - Andrea Kleinsmith
- Department of Information Systems, University of Maryland, Baltimore County, 1000 Hilltop Circle, Baltimore, MD, 21250, USA
| | - Helena M Mentis
- Department of Information Systems, University of Maryland, Baltimore County, 1000 Hilltop Circle, Baltimore, MD, 21250, USA
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von Strauss Und Torney M, Aghlmandi S, Zeindler J, Nowakowski D, Nebiker CA, Kettelhack C, Rosenthal R, Droeser RA, Soysal SD, Hoffmann H, Mechera R. High-resolution standardization reduces delay due to workflow disruptions in laparoscopic cholecystectomy. Surg Endosc 2018; 32:4763-4771. [PMID: 29785458 DOI: 10.1007/s00464-018-6224-y] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2018] [Accepted: 05/09/2018] [Indexed: 01/01/2023]
Abstract
BACKGROUND Optimal resource utilization in high-cost environments like operating theatres is fundamental in today's cost constrained health care systems. Interruptions of the surgical workflow, i.e. microcomplications (MC), lead to prolonged procedure times and higher costs and can be indicative of surgical mistakes. Reducing MC can improve operating room efficiency and prevent intraoperative complications. We, therefore, aimed to evaluate the impact of a high-resolution standardized laparoscopic cholecystectomy protocol (HRSL) on operative time and intraoperative interruptions in a teaching hospital. METHODS HRSL consisted of a detailed stepwise protocol for the procedure, supported by a teaching video, both to be reviewed as mandatory preparation by each team member before surgery. Audio-video records of laparoscopic cholecystectomies were reviewed regarding type, frequency and duration of MC before and after implementation of HRSL. RESULTS Thirty-nine (20 control and 19 HRSL) audio-video records of laparoscopic cholecystectomies with a total duration of 51.36 h (28.92 pre 22.44 post) were reviewed. The majority of operations (86%) were performed by teams who had completed less than 10 procedures together previously. Communication-related interruptions and instrument changes accounted for the majority of MC. Median frequency and duration of MC were 95 events/h and 15.6 min/h, respectively, of surgery pre-intervention. With HRSL this was reduced to 76 events/h and 10.6 min/h of operating. In multivariable analysis, HRSL was an independent predictor for shorter delay and lower frequency of MC [percentage decrease 27% (95% CI 18-35%), resp. 30% (95% CI 19-40%)]. Procedure-related risk factors for the longer delay due to MC in multivariable analysis were less experience of the surgeon and intraoperative adhesiolysis. CONCLUSIONS HRSL is effective in reducing delays due to MC in a teaching institution with limited team experience. These findings should be tested in larger potentially cluster-randomized controlled trials. The trial has been registered with clinicaltrials.gov: NCT03329859.
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Affiliation(s)
| | - Sohelia Aghlmandi
- Basel Institute for Clinical Epidemiology and Biostatistics, University Hospital Basel, University of Basel, Basel, Switzerland
| | - Jasmin Zeindler
- Department of General and Visceral Surgery, University Hospital Basel, Basel, Switzerland
| | - Debora Nowakowski
- Department of General and Visceral Surgery, University Hospital Basel, Basel, Switzerland
| | - Christian A Nebiker
- Department of General and Visceral Surgery, University Hospital Basel, Basel, Switzerland.,Department of Surgery, Cantonal Hospital of Aarau, Aarau, Switzerland
| | - Christoph Kettelhack
- Department of General and Visceral Surgery, University Hospital Basel, Basel, Switzerland
| | - Rachel Rosenthal
- Department of General and Visceral Surgery, University Hospital Basel, Basel, Switzerland
| | - Raoul A Droeser
- Department of General and Visceral Surgery, University Hospital Basel, Basel, Switzerland
| | - Savas D Soysal
- Department of General and Visceral Surgery, University Hospital Basel, Basel, Switzerland
| | - Henry Hoffmann
- Department of General and Visceral Surgery, University Hospital Basel, Basel, Switzerland
| | - Robert Mechera
- Department of General and Visceral Surgery, University Hospital Basel, Basel, Switzerland
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Borg LK, Harrison TK, Kou A, Mariano ER, Udani AD, Kim TE, Shum C, Howard SK. Preliminary Experience Using Eye-Tracking Technology to Differentiate Novice and Expert Image Interpretation for Ultrasound-Guided Regional Anesthesia. JOURNAL OF ULTRASOUND IN MEDICINE : OFFICIAL JOURNAL OF THE AMERICAN INSTITUTE OF ULTRASOUND IN MEDICINE 2018; 37:329-336. [PMID: 28777464 DOI: 10.1002/jum.14334] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/22/2017] [Accepted: 04/24/2017] [Indexed: 06/07/2023]
Abstract
OBJECTIVES Objective measures are needed to guide the novice's pathway to expertise. Within and outside medicine, eye tracking has been used for both training and assessment. We designed this study to test the hypothesis that eye tracking may differentiate novices from experts in static image interpretation for ultrasound (US)-guided regional anesthesia. METHODS We recruited novice anesthesiology residents and regional anesthesiology experts. Participants wore eye-tracking glasses, were shown 5 sonograms of US-guided regional anesthesia, and were asked a series of anatomy-based questions related to each image while their eye movements were recorded. The answer to each question was a location on the sonogram, defined as the area of interest (AOI). The primary outcome was the total gaze time in the AOI (seconds). Secondary outcomes were the total gaze time outside the AOI (seconds), total time to answer (seconds), and time to first fixation on the AOI (seconds). RESULTS Five novices and 5 experts completed the study. Although the gaze time (mean ± SD) in the AOI was not different between groups (7 ± 4 seconds for novices and 7 ± 3 seconds for experts; P = .150), the gaze time outside the AOI was greater for novices (75 ± 18 versus 44 ± 4 seconds for experts; P = .005). The total time to answer and total time to first fixation in the AOI were both shorter for experts. CONCLUSIONS Experts in US-guided regional anesthesia take less time to identify sonoanatomy and spend less unfocused time away from a target compared to novices. Eye tracking is a potentially useful tool to differentiate novices from experts in the domain of US image interpretation.
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Affiliation(s)
- Lindsay K Borg
- Department of Anesthesiology, Perioperative, and Pain Medicine, Stanford University School of Medicine, Stanford, California, USA
| | - T Kyle Harrison
- Department of Anesthesiology, Perioperative, and Pain Medicine, Stanford University School of Medicine, Stanford, California, USA
- Anesthesiology and Perioperative Care Service, VA Palo Alto Health Care System, Palo Alto, California, USA
| | - Alex Kou
- Department of Anesthesiology, Perioperative, and Pain Medicine, Stanford University School of Medicine, Stanford, California, USA
- Anesthesiology and Perioperative Care Service, VA Palo Alto Health Care System, Palo Alto, California, USA
| | - Edward R Mariano
- Department of Anesthesiology, Perioperative, and Pain Medicine, Stanford University School of Medicine, Stanford, California, USA
- Anesthesiology and Perioperative Care Service, VA Palo Alto Health Care System, Palo Alto, California, USA
| | - Ankeet D Udani
- Department of Anesthesiology, Perioperative, and Pain Medicine, Stanford University School of Medicine, Stanford, California, USA
- Department of Anesthesiology, Duke University School of Medicine, Durham, North Carolina, USA
| | - T Edward Kim
- Department of Anesthesiology, Perioperative, and Pain Medicine, Stanford University School of Medicine, Stanford, California, USA
- Anesthesiology and Perioperative Care Service, VA Palo Alto Health Care System, Palo Alto, California, USA
| | - Cynthia Shum
- Anesthesiology and Perioperative Care Service, VA Palo Alto Health Care System, Palo Alto, California, USA
| | - Steven K Howard
- Department of Anesthesiology, Perioperative, and Pain Medicine, Stanford University School of Medicine, Stanford, California, USA
- Anesthesiology and Perioperative Care Service, VA Palo Alto Health Care System, Palo Alto, California, USA
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Ashraf H, Sodergren MH, Merali N, Mylonas G, Singh H, Darzi A. Eye-tracking technology in medical education: A systematic review. MEDICAL TEACHER 2018; 40:62-69. [PMID: 29172823 DOI: 10.1080/0142159x.2017.1391373] [Citation(s) in RCA: 68] [Impact Index Per Article: 11.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/24/2023]
Abstract
BACKGROUND Eye-tracking technology is an established research tool within allied industries such as advertising, psychology and aerospace. This review aims to consolidate literature describing the evidence for use of eye-tracking as an adjunct to traditional teaching methods in medical education. METHODS A systematic literature review was conducted in line with STORIES guidelines. A search of EMBASE, OVID MEDLINE, PsycINFO, TRIP database, and Science Direct was conducted until January 2017. Studies describing the use of eye-tracking in the training, assessment, and feedback of clinicians were included in the review. RESULTS Thirty-three studies were included in the final qualitative synthesis. Three studies were based on the use of gaze training, three studies on the changes in gaze behavior during the learning curve, 17 studies on clinical assessment and six studies focused on the use of eye-tracking methodology as a feedback tool. The studies demonstrated feasibility and validity in the use of eye-tracking as a training and assessment method. CONCLUSIONS Overall, eye-tracking methodology has contributed significantly to the training, assessment, and feedback practices used in the clinical setting. The technology provides reliable quantitative data, which can be interpreted to give an indication of clinical skill, provide training solutions and aid in feedback and reflection. This review provides a detailed summary of evidence relating to eye-tracking methodology and its uses as a training method, changes in visual gaze behavior during the learning curve, eye-tracking methodology for proficiency assessment and its uses as a feedback tool.
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Affiliation(s)
- Hajra Ashraf
- a Department of Surgery and Cancer , Imperial College, St Mary's Hospital , London , UK
| | - Mikael H Sodergren
- a Department of Surgery and Cancer , Imperial College, St Mary's Hospital , London , UK
| | | | - George Mylonas
- a Department of Surgery and Cancer , Imperial College, St Mary's Hospital , London , UK
| | - Harsimrat Singh
- a Department of Surgery and Cancer , Imperial College, St Mary's Hospital , London , UK
| | - Ara Darzi
- a Department of Surgery and Cancer , Imperial College, St Mary's Hospital , London , UK
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Abstract
The aim of this review was to amalgamate literature on the use of eye tracking methodology as an adjunct to surgical training. The PRISMA Guidelines were used to undertake this systematic review. Our review studies has shown that recording a surgeon's eye movements; time to first fixation and gaze pattern through the use of eye tracking technology would be beneficial for surgical training.
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Affiliation(s)
- Nabeel Merali
- Frimley Park Hospital, Frimley Health NHS Trust , United Kingdom
| | | | - Sukhpal Singh
- Frimley Park Hospital, Frimley Health NHS Trust , United Kingdom
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58
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Can biological motion research provide insight on how to reduce friendly fire incidents? Psychon Bull Rev 2017; 23:1429-1439. [PMID: 26850024 DOI: 10.3758/s13423-016-1006-9] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
The ability to accurately detect, perceive, and recognize biological motion can be associated with a fundamental drive for survival, and it is a significant interest for perception researchers. This field examines various perceptual features of motion and has been assessed and applied in several real-world contexts (e.g., biometric, sport). Unexplored applications still exist however, including the military issue of friendly fire. There are many causes and processes leading to friendly fire and specific challenges that are associated with visual information extraction during engagement, such as brief glimpses, low acuity, camouflage, and uniform deception. Furthermore, visual information must often be processed under highly stressful (potentially threatening), time-constrained conditions that present a significant problem for soldiers. Biological motion research and anecdotal evidence from experienced combatants suggests that intentions, emotions, identities of human motion can be identified and discriminated, even when visual display is degraded or limited. Furthermore, research suggests that perceptual discriminatory capability of movement under visually constrained conditions is trainable. Therefore, given the limited military research linked to biological motion and friendly fire, an opportunity for cross-disciplinary investigations exists. The focus of this paper is twofold: first, to provide evidence for the possible link between biological motion factors and friendly fire, and second, to propose conceptual and methodological considerations and recommendations for perceptual-cognitive training within current military programs.
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60
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Harris DJ, Vine SJ, Wilson MR, McGrath JS, LeBel ME, Buckingham G. The effect of observing novice and expert performance on acquisition of surgical skills on a robotic platform. PLoS One 2017; 12:e0188233. [PMID: 29141046 PMCID: PMC5687728 DOI: 10.1371/journal.pone.0188233] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2017] [Accepted: 11/02/2017] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Observational learning plays an important role in surgical skills training, following the traditional model of learning from expertise. Recent findings have, however, highlighted the benefit of observing not only expert performance but also error-strewn performance. The aim of this study was to determine which model (novice vs. expert) would lead to the greatest benefits when learning robotically assisted surgical skills. METHODS 120 medical students with no prior experience of robotically-assisted surgery completed a ring-carrying training task on three occasions; baseline, post-intervention and at one-week follow-up. The observation intervention consisted of a video model performing the ring-carrying task, with participants randomly assigned to view an expert model, a novice model, a mixed expert/novice model or no observation (control group). Participants were assessed for task performance and surgical instrument control. RESULTS There were significant group differences post-intervention, with expert and novice observation groups outperforming the control group, but there were no clear group differences at a retention test one week later. There was no difference in performance between the expert-observing and error-observing groups. CONCLUSIONS Similar benefits were found when observing the traditional expert model or the error-strewn model, suggesting that viewing poor performance may be as beneficial as viewing expertise in the early acquisition of robotic surgical skills. Further work is required to understand, then inform, the optimal curriculum design when utilising observational learning in surgical training.
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Affiliation(s)
- David J. Harris
- Department of Sport and Health Sciences, University of Exeter, Exeter, United Kingdom
| | - Samuel J. Vine
- Department of Sport and Health Sciences, University of Exeter, Exeter, United Kingdom
| | - Mark R. Wilson
- Department of Sport and Health Sciences, University of Exeter, Exeter, United Kingdom
| | - John S. McGrath
- Exeter Surgical Health Services Research Unit, RD&E Hospital, Exeter, United Kingdom
- University of Exeter Medical School, Exeter, United Kingdom
| | - Marie-Eve LeBel
- Division of Orthopaedic Surgery, University of Western Ontario, London, Canada
| | - Gavin Buckingham
- Department of Sport and Health Sciences, University of Exeter, Exeter, United Kingdom
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Effectiveness of above real-time training on decision-making in elite football: A dose-response investigation. PROGRESS IN BRAIN RESEARCH 2017. [PMID: 29031459 DOI: 10.1016/bs.pbr.2017.08.007] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register]
Abstract
We examined the effects of video-based training in elite footballers' decision-making by presenting videos with training and testing scenarios at above real-time speeds. We also examined different training protocols to establish how much training is beneficial. We found that above real-time training improved accuracy and response time in football decision-making. In terms of scheduling, we found that the benefits were short lasting and did not last beyond 2 weeks.
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Parr JVV, Vine SJ, Harrison NR, Wood G. Examining the Spatiotemporal Disruption to Gaze When Using a Myoelectric Prosthetic Hand. J Mot Behav 2017; 50:416-425. [PMID: 28925815 DOI: 10.1080/00222895.2017.1363703] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
The aim of this study was to provide a detailed account of the spatial and temporal disruptions to eye-hand coordination when using a prosthetic hand during a sequential fine motor skill. Twenty-one able-bodied participants performed 15 trials of the picking up coins task derived from the Southampton Hand Assessment Procedure with their anatomic hand and with a prosthesis simulator while wearing eye-tracking equipment. Gaze behavior results revealed that when using the prosthesis, performance detriments were accompanied by significantly greater hand-focused gaze and a significantly longer time to disengage gaze from manipulations to plan upcoming movements. The study findings highlight key metrics that distinguish disruptions to eye-hand coordination that may have implications for the training of prosthesis use.
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Affiliation(s)
- J V V Parr
- a School of Health Sciences , Liverpool Hope University , United Kingdom
| | - S J Vine
- b College of Life & Environmental Sciences , University of Exeter , United Kingdom
| | - N R Harrison
- c Department of Psychology , Liverpool Hope University , United Kingdom
| | - G Wood
- d Centre for Health, Exercise and Active Living , Manchester Metropolitan University , United Kingdom
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Gaze-based Technology as a Tool for Surgical Skills Assessment and Training in Urology. Urology 2017; 107:26-30. [DOI: 10.1016/j.urology.2017.06.030] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2017] [Revised: 05/05/2017] [Accepted: 06/19/2017] [Indexed: 01/02/2023]
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Pernek I, Ferscha A. A survey of context recognition in surgery. Med Biol Eng Comput 2017; 55:1719-1734. [DOI: 10.1007/s11517-017-1670-6] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2016] [Accepted: 06/15/2017] [Indexed: 11/30/2022]
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Roach VA, Fraser GM, Kryklywy JH, Mitchell DGV, Wilson TD. Different perspectives: Spatial ability influences where individuals look on a timed spatial test. ANATOMICAL SCIENCES EDUCATION 2017; 10:224-234. [PMID: 27706927 DOI: 10.1002/ase.1654] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/29/2016] [Revised: 08/02/2016] [Accepted: 09/03/2016] [Indexed: 06/06/2023]
Abstract
Learning in anatomy can be both spatially and visually complex. Pedagogical investigations have begun exploration as to how spatial ability may mitigate learning. Emerging hypotheses suggests individuals with higher spatial reasoning may attend to images differently than those who are lacking. To elucidate attentional patterns associated with different spatial ability, eye movements were measured in individuals completing a timed electronic mental rotation test (EMRT). The EMRT was based on the line drawings of Shepherd and Metzler. Individuals deduced whether image pairs were rotations (same) or mirror images (different). It was hypothesized that individuals with high spatial ability (HSA) would demonstrate shorter average fixation durations during problem solving and attend to different features of the EMRT than low spatial ability (LSA) counterparts. Moreover, question response accuracy would be associated with fewer fixations and shorter average response times, regardless of spatial reasoning ability. Average fixation duration in the HSA group was shorter than LSA (F(1,8) = 7.99; P = 0.022). Importantly, HSA and LSA individuals looked to different regions of the EMRT images (Fisher Exact Test: 12.47; P = 0.018); attending to the same locations only 34% of the time. Correctly answered questions were characterized by fewer fixations per question (F(1, 8) = 18.12; P = 0.003) and shorter average response times (F(1, 8) = 23.89; P = 0.001). The results indicate that spatial ability may influence visual attention to salient areas of images and this may be key to problem solving processes for low spatial individuals. Anat Sci Educ 10: 224-234. © 2016 American Association of Anatomists.
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Affiliation(s)
- Victoria A Roach
- Department of Biomedical Sciences, William Beaumont School of Medicine, Oakland University, Rochester, Michigan
| | - Graham M Fraser
- Department of Medical Biophysics, Schulich School of Medicine and Dentistry, The University of Western Ontario, London, Ontario, Canada
| | - James H Kryklywy
- Department of Psychiatry, Brain and Mind Institute, Schulich School of Medicine and Dentistry, The University of Western Ontario, London, Ontario, Canada
| | - Derek G V Mitchell
- Department of Psychiatry, Brain and Mind Institute, Schulich School of Medicine and Dentistry, The University of Western Ontario, London, Ontario, Canada
- Department of Anatomy and Cell Biology, Corps for Research of Instructional and Perceptual Technologies, Schulich School of Medicine and Dentistry, The University of Western Ontario, London, Ontario, Canada
| | - Timothy D Wilson
- Department of Anatomy and Cell Biology, Corps for Research of Instructional and Perceptual Technologies, Schulich School of Medicine and Dentistry, The University of Western Ontario, London, Ontario, Canada
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Gallagher-Mitchell T, Simms V, Litchfield D. Learning from where 'eye' remotely look or point: Impact on number line estimation error in adults. Q J Exp Psychol (Hove) 2017; 71:1526-1534. [PMID: 28540753 DOI: 10.1080/17470218.2017.1335335] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
In this article, we present an investigation into the use of visual cues during number line estimation and their influence on cognitive processes for reducing number line estimation error. Participants completed a 0-1000 number line estimation task before and after a brief intervention in which they observed static-visual or dynamic-visual cues (control, anchor, gaze cursor, mouse cursor) and also made estimation marks to test effective number-target estimation. Results indicated that a significant pre-test to post-test reduction in estimation error was present for dynamic-visual cues of modelled eye-gaze and mouse cursor. However, there was no significant performance difference between pre- and post-test for the control or static anchor conditions. Findings are discussed in relation to the extent to which anchor points alone are meaningful in promoting successful segmentation of the number line and whether dynamic cues promote the utility of these locations in reducing error through attentional guidance.
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Affiliation(s)
- Thomas Gallagher-Mitchell
- 1 Department of Psychology, Edge Hill University, Ormskirk, UK.,2 Department of Psychology, Liverpool Hope University, Liverpool, UK
| | - Victoria Simms
- 3 School of Psychology, Ulster University, Coleraine, UK
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Wood G, Hartley G, Furley P, Wilson M. Working Memory Capacity, Visual Attention and Hazard Perception in Driving. JOURNAL OF APPLIED RESEARCH IN MEMORY AND COGNITION 2016. [DOI: 10.1016/j.jarmac.2016.04.009] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Battah M, McKendrick M, Kean D, Obregon M. Eye-tracking as a measure of trainee progress in laparoscopic training. Eur J Obstet Gynecol Reprod Biol 2016. [DOI: 10.1016/j.ejogrb.2016.07.064] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Roach VA, Fraser GM, Kryklywy JH, Mitchell DGV, Wilson TD. The eye of the beholder: Can patterns in eye movement reveal aptitudes for spatial reasoning? ANATOMICAL SCIENCES EDUCATION 2016; 9:357-366. [PMID: 26599398 DOI: 10.1002/ase.1583] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/12/2015] [Revised: 10/02/2015] [Accepted: 10/27/2015] [Indexed: 06/05/2023]
Abstract
Mental rotation ability (MRA) is linked to academic success in the spatially complex Science, Technology, Engineering, Medicine, and Mathematics (STEMM) disciplines, and anatomical sciences. Mental rotation literature suggests that MRA may manifest in the movement of the eyes. Quantification of eye movement data may serve to distinguish MRA across individuals, and serve as a consideration when designing visualizations for instruction. It is hypothesized that high-MRA individuals will demonstrate fewer eye fixations, conduct shorter average fixation durations (AFD), and demonstrate shorter response times, than low-MRA individuals. Additionally, individuals with different levels of MRA will attend to different features of the block-figures presented in the electronic mental rotations test (EMRT). All participants (n = 23) completed the EMRT while metrics of eye movement were collected. The test required participants view pairs of three-dimensional (3D) shapes, and identify if the pair is rotated but identical, or two different structures. Temporal analysis revealed no significant correlations between response time, average fixation durations, or number of fixations and mental rotation ability. Further analysis of within-participant variability yielded a significant correlation for response time variability, but no correlation between AFD variability and variability in the number of fixations. Additional analysis of salience revealed that during problem solving, individuals of differing MRA attended to different features of the block images; suggesting that eye movements directed at salient features may contribute to differences in mental rotations ability, and may ultimately serve to predict success in anatomy. Anat Sci Educ 9: 357-366. © 2015 American Association of Anatomists.
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Affiliation(s)
- Victoria A Roach
- Department of Anatomy and Cell Biology, Corps for Research of Instructional and Perceptual Technologies, Schulich School of Medicine and Dentistry, Western University, London, Ontario, Canada
| | - Graham M Fraser
- Department of Medical Biophysics, Schulich School of Medicine and Dentistry, Western University, London, Ontario, Canada
| | - James H Kryklywy
- Departments of Psychiatry and Psychology, The Brain and Mind Institute, Schulich School of Medicine and Dentistry, Western University, London, Ontario, Canada
| | - Derek G V Mitchell
- Department of Anatomy and Cell Biology, Corps for Research of Instructional and Perceptual Technologies, Schulich School of Medicine and Dentistry, Western University, London, Ontario, Canada
- Departments of Psychiatry and Psychology, The Brain and Mind Institute, Schulich School of Medicine and Dentistry, Western University, London, Ontario, Canada
| | - Timothy D Wilson
- Department of Anatomy and Cell Biology, Corps for Research of Instructional and Perceptual Technologies, Schulich School of Medicine and Dentistry, Western University, London, Ontario, Canada
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Browning M, Cooper S, Cant R, Sparkes L, Bogossian F, Williams B, O'Meara P, Ross L, Munro G, Black B. The use and limits of eye-tracking in high-fidelity clinical scenarios: A pilot study. Int Emerg Nurs 2016; 25:43-7. [DOI: 10.1016/j.ienj.2015.08.002] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2015] [Revised: 07/30/2015] [Accepted: 08/04/2015] [Indexed: 11/16/2022]
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White C, Rodger MWM, Tang T. Current understanding of learning psychomotor skills and the impact on teaching laparoscopic surgical skills. ACTA ACUST UNITED AC 2016. [DOI: 10.1111/tog.12255] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
Affiliation(s)
- Colette White
- Royal Jubilee Maternity Services; Belfast Health and Social Care Trust; 274 Grosvenor Road Belfast BT12 6BA UK
| | - Matthew WM Rodger
- Department of Psychology; Queen's University Belfast; Belfast BT9 5BN UK
| | - Thomas Tang
- Regional Fertility Centre; Royal Jubilee Maternity Services; Belfast Health and Social Care Trust; Belfast BT12 6BA UK
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Klostermann A, Vater C, Kredel R, Hossner EJ. Perceptual Training in Beach Volleyball Defence: Different Effects of Gaze-Path Cueing on Gaze and Decision-Making. Front Psychol 2015; 6:1834. [PMID: 26648894 PMCID: PMC4664622 DOI: 10.3389/fpsyg.2015.01834] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2015] [Accepted: 11/12/2015] [Indexed: 11/13/2022] Open
Abstract
For perceptual-cognitive skill training, a variety of intervention methods has been proposed, including the so-called "color-cueing method" which aims on superior gaze-path learning by applying visual markers. However, recent findings challenge this method, especially, with regards to its actual effects on gaze behavior. Consequently, after a preparatory study on the identification of appropriate visual cues for life-size displays, a perceptual-training experiment on decision-making in beach volleyball was conducted, contrasting two cueing interventions (functional vs. dysfunctional gaze path) with a conservative control condition (anticipation-related instructions). Gaze analyses revealed learning effects for the dysfunctional group only. Regarding decision-making, all groups showed enhanced performance with largest improvements for the control group followed by the functional and the dysfunctional group. Hence, the results confirm cueing effects on gaze behavior, but they also question its benefit for enhancing decision-making. However, before completely denying the method's value, optimisations should be checked regarding, for instance, cueing-pattern characteristics and gaze-related feedback.
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Affiliation(s)
| | - Christian Vater
- Institute of Sport Science, University of Bern Bern, Switzerland
| | - Ralf Kredel
- Institute of Sport Science, University of Bern Bern, Switzerland
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74
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Leff DR, James DRC, Orihuela-Espina F, Kwok KW, Sun LW, Mylonas G, Athanasiou T, Darzi AW, Yang GZ. The impact of expert visual guidance on trainee visual search strategy, visual attention and motor skills. Front Hum Neurosci 2015; 9:526. [PMID: 26528160 PMCID: PMC4604246 DOI: 10.3389/fnhum.2015.00526] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2015] [Accepted: 09/10/2015] [Indexed: 11/13/2022] Open
Abstract
Minimally invasive and robotic surgery changes the capacity for surgical mentors to guide their trainees with the control customary to open surgery. This neuroergonomic study aims to assess a "Collaborative Gaze Channel" (CGC); which detects trainer gaze-behavior and displays the point of regard to the trainee. A randomized crossover study was conducted in which twenty subjects performed a simulated robotic surgical task necessitating collaboration either with verbal (control condition) or visual guidance with CGC (study condition). Trainee occipito-parietal (O-P) cortical function was assessed with optical topography (OT) and gaze-behavior was evaluated using video-oculography. Performance during gaze-assistance was significantly superior [biopsy number: (mean ± SD): control = 5.6 ± 1.8 vs. CGC = 6.6 ± 2.0; p < 0.05] and was associated with significantly lower O-P cortical activity [ΔHbO2 mMol × cm [median (IQR)] control = 2.5 (12.0) vs. CGC 0.63 (11.2), p < 0.001]. A random effect model (REM) confirmed the association between guidance mode and O-P excitation. Network cost and global efficiency were not significantly influenced by guidance mode. A gaze channel enhances performance, modulates visual search, and alleviates the burden in brain centers subserving visual attention and does not induce changes in the trainee's O-P functional network observable with the current OT technique. The results imply that through visual guidance, attentional resources may be liberated, potentially improving the capability of trainees to attend to other safety critical events during the procedure.
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Affiliation(s)
- Daniel R Leff
- Hamlyn Centre for Robotic Surgery, Imperial College London London, UK
| | - David R C James
- Hamlyn Centre for Robotic Surgery, Imperial College London London, UK
| | - Felipe Orihuela-Espina
- Hamlyn Centre for Robotic Surgery, Imperial College London London, UK ; National Institute for Astrophysics, Optics and Electronics (INAOE) Tonantzintla, Mexico
| | - Ka-Wai Kwok
- Hamlyn Centre for Robotic Surgery, Imperial College London London, UK
| | - Loi Wah Sun
- Hamlyn Centre for Robotic Surgery, Imperial College London London, UK
| | - George Mylonas
- Hamlyn Centre for Robotic Surgery, Imperial College London London, UK
| | - Thanos Athanasiou
- Hamlyn Centre for Robotic Surgery, Imperial College London London, UK
| | - Ara W Darzi
- Hamlyn Centre for Robotic Surgery, Imperial College London London, UK
| | - Guang-Zhong Yang
- Hamlyn Centre for Robotic Surgery, Imperial College London London, UK
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Bogdanova R, Boulanger P, Zheng B. Three-Dimensional Eye Tracking in a Surgical Scenario. Surg Innov 2015; 22:522-527. [DOI: 10.1177/1553350615573581] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/30/2023]
Abstract
Introduction. Eye tracking has been widely used in studying the eye behavior of surgeons in the past decade. Most eye-tracking data are reported in a 2-dimensional (2D) fashion, and data for describing surgeons’ behaviors on stereoperception are often missed. With the introduction of stereoscopes in laparoscopic procedures, there is an increasing need for studying the depth perception of surgeons under 3D image-guided surgery. Methods. We developed a new algorithm for the computation of convergence points in stereovision by measuring surgeons’ interpupillary distance, the distance to the view target, and the difference between gaze locations of the 2 eyes. To test the feasibility of our new algorithm, we recruited 10 individuals to watch stereograms using binocular disparity and asked them to develop stereoperception using a cross-eyed viewing technique. Participants’ eye motions were recorded by the Tobii eye tracker while they performed the trials. Convergence points between normal and stereo-viewing conditions were computed using the developed algorithm. Results. All 10 participants were able to develop stereovision after a short period of training. During stereovision, participants’ eye convergence points were 14 ± 1 cm in front of their eyes, which was significantly closer than the convergence points under the normal viewing condition (77 ± 20 cm). Conclusion. By applying our method of calculating convergence points using eye tracking, we were able to elicit the eye movement patterns of human operators between the normal and stereovision conditions. Knowledge from this study can be applied to the design of surgical visual systems, with the goal of improving surgical performance and patient safety.
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Affiliation(s)
| | | | - Bin Zheng
- University of Alberta,Edmonton, AB, Canada
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Uemura M, Jannin P, Yamashita M, Tomikawa M, Akahoshi T, Obata S, Souzaki R, Ieiri S, Hashizume M. Procedural surgical skill assessment in laparoscopic training environments. Int J Comput Assist Radiol Surg 2015; 11:543-52. [PMID: 26253582 DOI: 10.1007/s11548-015-1274-2] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2015] [Accepted: 07/21/2015] [Indexed: 11/26/2022]
Abstract
PURPOSE This study aimed to identify detailed differences in laparoscopic surgical processes between expert and novice surgeons in a training environment and demonstrate that surgical process modeling can be used for such detailed analysis. METHODS Eleven expert surgeons each of whom had performed [Formula: see text] laparoscopic procedures were compared with 10 young surgeons each of whom had performed [Formula: see text] laparoscopic procedures, and five medical students. Each examinee performed a specific skill assessment task. During tasks, instrument motion was monitored using a video capture system. From the video, the corresponding workflow was recorded by labeling the surgeons' activities according to a predefined terminology. Activities represented manual work steps performed during the task, described by a combination of a verb (representing the action), a tool, and the involved structure. The results were described as the number of occurrences (times), average duration (seconds), total duration (seconds), minimal duration (seconds), maximal duration (seconds), and occupancy percentage (%). RESULTS The terminology for describing the processes of this task included 10 actions, six tools, four structures, and three events for each hand. There were 63 combinations of different possible activities; significant differences in 12 activities were observed between the expert and novice groups (young surgeons and medical students). The expert group performed the task with fewer occurrences and shorter duration than did the novice group in the left hand. CONCLUSIONS We identified differences in surgical process between experts and novices in laparoscopic surgical simulation. Our proposed method would be useful for education and training in laparoscopic surgery.
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Affiliation(s)
- Munenori Uemura
- Department of Advanced Medical Initiatives, Graduate School of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka, 812-8582, Japan.
| | - Pierre Jannin
- INSERM, U1099, 35000, Rennes, France
- LTSI, Université de Rennes 1, 35000, Rennes, France
| | - Makoto Yamashita
- Department of Advanced Medical Initiatives, Graduate School of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka, 812-8582, Japan
| | - Morimasa Tomikawa
- Department of Advanced Medicine and Innovative Technology, Kyushu University Hospital, Fukuoka, Japan
| | - Tomohiko Akahoshi
- Department of Advanced Medical Initiatives, Graduate School of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka, 812-8582, Japan
| | - Satoshi Obata
- Department of Advanced Medicine and Innovative Technology, Kyushu University Hospital, Fukuoka, Japan
| | - Ryota Souzaki
- Department of Advanced Medicine and Innovative Technology, Kyushu University Hospital, Fukuoka, Japan
| | - Satoshi Ieiri
- Department of Advanced Medicine and Innovative Technology, Kyushu University Hospital, Fukuoka, Japan
| | - Makoto Hashizume
- Department of Advanced Medical Initiatives, Graduate School of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka, 812-8582, Japan
- Department of Advanced Medicine and Innovative Technology, Kyushu University Hospital, Fukuoka, Japan
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Moore LJ, Wilson MR, Waine E, McGrath JS, Masters RSW, Vine SJ. Robotically assisted laparoscopy benefits surgical performance under stress. J Robot Surg 2015; 9:277-84. [DOI: 10.1007/s11701-015-0527-y] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2015] [Accepted: 07/17/2015] [Indexed: 01/08/2023]
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Bongers PJ, Diederick van Hove P, Stassen LPS, Dankelman J, Schreuder HWR. A new virtual-reality training module for laparoscopic surgical skills and equipment handling: can multitasking be trained? A randomized controlled trial. JOURNAL OF SURGICAL EDUCATION 2015; 72:184-191. [PMID: 25439179 DOI: 10.1016/j.jsurg.2014.09.004] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/25/2014] [Revised: 08/28/2014] [Accepted: 09/09/2014] [Indexed: 06/04/2023]
Abstract
OBJECTIVE During laparoscopic surgery distractions often occur and multitasking between surgery and other tasks, such as technical equipment handling, is a necessary competence. In psychological research, reduction of adverse effects of distraction is demonstrated when specifically multitasking is trained. The aim of this study was to examine whether multitasking and more specifically task-switching can be trained in a virtual-reality (VR) laparoscopic skills simulator. DESIGN After randomization, the control group trained separately with an insufflator simulation module and a laparoscopic skills exercise module on a VR simulator. In the intervention group, insufflator module and VR skills exercises were combined to develop a new integrated training in which multitasking was a required competence. At random moments, problems with the insufflator appeared and forced the trainee to multitask. During several repetitions of a different multitask VR skills exercise as posttest, performance parameters (laparoscopy time, insufflator time, and errors) were measured and compared between both the groups as well with a pretest exercise to establish the learning effect. A face-validity questionnaire was filled afterward. SETTING University Medical Centre Utrecht, The Netherlands. PARTICIPANTS Medical and PhD students (n = 42) from University Medical Centre Utrecht, without previous experience in laparoscopic simulation, were randomly assigned to either intervention (n = 21) or control group (n = 21). RESULTS All participants performed better in the posttest exercises without distraction of the insufflator compared with the exercises in which multitasking was necessary to solve the insufflator problems. After training, the intervention group was significantly quicker in solving the insufflator problems (mean = 1.60Log(s) vs 1.70Log(s), p = 0.02). No significant differences between both the groups were seen in laparoscopy time and errors. CONCLUSION Multitasking has negative effects on the laparoscopic performance. This study suggests an additional learning effect of training multitasking in VR laparoscopy simulation, because the trainees are able to handle a secondary task (solving insufflator problems) quicker. These results may aid the development of laparoscopy VR training programs in approximating real-life laparoscopic surgery.
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Affiliation(s)
- Pim J Bongers
- Department of Reproductive Medicine and Gynaecology, University Medical Centre Utrecht, Utrecht, The Netherlands
| | | | - Laurents P S Stassen
- Department of Surgery, Maastricht University Medical Centre, Maastricht, The Netherlands
| | - Jenny Dankelman
- Department of BioMechanical Engineering, Delft University of Technology, Delft, The Netherlands
| | - Henk W R Schreuder
- Department of Reproductive Medicine and Gynaecology, University Medical Centre Utrecht, Utrecht, The Netherlands.
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Moore LJ, Wilson MR, Waine E, Masters RSW, McGrath JS, Vine SJ. Robotic technology results in faster and more robust surgical skill acquisition than traditional laparoscopy. J Robot Surg 2014; 9:67-73. [PMID: 26530974 DOI: 10.1007/s11701-014-0493-9] [Citation(s) in RCA: 45] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2014] [Accepted: 12/11/2014] [Indexed: 01/23/2023]
Abstract
Technical surgical skills are said to be acquired quicker on a robotic rather than laparoscopic platform. However, research examining this proposition is scarce. Thus, this study aimed to compare the performance and learning curves of novices acquiring skills using a robotic or laparoscopic system, and to examine if any learning advantages were maintained over time and transferred to more difficult and stressful tasks. Forty novice participants were randomly assigned to either a robotic- or laparoscopic-trained group. Following one baseline trial on a ball pick-and-drop task, participants performed 50 learning trials. Participants then completed an immediate retention trial and a transfer trial on a two-instrument rope-threading task. One month later, participants performed a delayed retention trial and a stressful multi-tasking trial. The results revealed that the robotic-trained group completed the ball pick-and-drop task more quickly and accurately than the laparoscopic-trained group across baseline, immediate retention, and delayed retention trials. Furthermore, the robotic-trained group displayed a shorter learning curve for accuracy. The robotic-trained group also performed the more complex rope-threading and stressful multi-tasking transfer trials better. Finally, in the multi-tasking trial, the robotic-trained group made fewer tone counting errors. The results highlight the benefits of using robotic technology for the acquisition of technical surgical skills.
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Affiliation(s)
- Lee J Moore
- Faculty of Applied Sciences, University of Gloucestershire, Gloucester, UK
| | - Mark R Wilson
- Sport and Health Sciences, College of Life and Environmental Sciences, University of Exeter, St Luke's Campus, Heavitree Road, Exeter, Devon, EX1 2LU, UK
| | - Elizabeth Waine
- Royal Devon and Exeter NHS Trust, Health Services Research Unit, Exeter, UK
| | - Rich S W Masters
- Department of Sport and Leisure Studies, University of Waikato, Hamilton, New Zealand
- Institute of Human Performance, University of Hong Kong, Pok Fu Lam, Hong Kong
| | - John S McGrath
- Royal Devon and Exeter NHS Trust, Health Services Research Unit, Exeter, UK
| | - Samuel J Vine
- Sport and Health Sciences, College of Life and Environmental Sciences, University of Exeter, St Luke's Campus, Heavitree Road, Exeter, Devon, EX1 2LU, UK.
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Moore LJ, Wilson MR, McGrath JS, Waine E, Masters RSW, Vine SJ. Surgeons’ display reduced mental effort and workload while performing robotically assisted surgical tasks, when compared to conventional laparoscopy. Surg Endosc 2014; 29:2553-60. [DOI: 10.1007/s00464-014-3967-y] [Citation(s) in RCA: 36] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2014] [Accepted: 10/24/2014] [Indexed: 11/28/2022]
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82
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Performing under pressure: Quiet eye training improves surgical knot-tying performance. Surgery 2014; 156:1089-96. [DOI: 10.1016/j.surg.2014.05.004] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2013] [Accepted: 05/12/2014] [Indexed: 11/22/2022]
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83
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An evaluation of eye tracking technology in the assessment of 12 lead electrocardiography interpretation. J Electrocardiol 2014; 47:922-9. [DOI: 10.1016/j.jelectrocard.2014.08.008] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2014] [Indexed: 01/08/2023]
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Giovinco NA, Sutton SM, Miller JD, Rankin TM, Gonzalez GW, Najafi B, Armstrong DG. A passing glance? Differences in eye tracking and gaze patterns between trainees and experts reading plain film bunion radiographs. J Foot Ankle Surg 2014; 54:382-91. [PMID: 25441848 DOI: 10.1053/j.jfas.2014.08.013] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/02/2014] [Indexed: 02/03/2023]
Abstract
Eye tracking and gaze pattern studies have been used to evaluate human behavior for decades. This is because of its ability to reveal conscious and subconscious behaviors when subjects are tasked with observation, decision making, and surgical performance. Many have popularized the use of this technology for radiographic assessment while evaluating radiologist behaviors, but little has been described for surgeon behavior patterns when evaluating preoperative deformities by radiograph. Because the radiographic assessment strongly influences surgical selection, the present study was designed to evaluate the differences between groups of novice and experienced surgeons' gaze patterns when tasked to describe hallux valgus deformities. The subjects were asked to rate the deformity as "none," "mild," "moderate," or "severe." Using an externally mounted eye tracking system, our study assessed saccades, fixations, overall time spent per radiograph, and the subjects' chosen bunion rating. Both the novice and advanced groups of foot and ankle surgeons were tasked to evaluate 25 total anteroposterior radiographs from patients who presented with a primary complaint of bunion pain. These patients were chosen at random, such that all participating surgeons had no previous patient familiarization. Statistically significant differences were observed with regard to the activity and rating of the moderate bunion films. The experience of surgeons does appear to modify gaze behavior with respect to time and attention, such that less overall time spent per image is needed by the advanced group, with improved efficiency. Future academic curriculum and training techniques could be developed to reflect these potential technical differences in search behavior, diagnostic technique, and surgical selection strategy.
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Affiliation(s)
- Nicholas A Giovinco
- Director of Education, Southern Arizona Limb Salvage Alliance, University of Arizona, Tucson, AZ; Member, Interdisciplinary Consortium of Advanced Motion Performance (iCAMP), University of Arizona, Tucson, AZ; Member, Board of Directors, Freeside Atlanta Technology Space, Atlanta, GA; and Faculty, The Podiatry Institute, Decatur, GA.
| | | | - John D Miller
- Research Associate, Southern Arizona Limb Salvage Alliance, University of Arizona, Tucson, AZ
| | - Timothy M Rankin
- Resident, Southern Arizona Limb Salvage Alliance, University of Arizona, Tucson, AZ
| | | | - Bijan Najafi
- Director of Education, Southern Arizona Limb Salvage Alliance, University of Arizona, Tucson, AZ; Member, Interdisciplinary Consortium of Advanced Motion Performance (iCAMP), University of Arizona, Tucson, AZ; Member, Board of Directors, Freeside Atlanta Technology Space, Atlanta, GA; and Faculty, The Podiatry Institute, Decatur, GA
| | - David G Armstrong
- Member, Interdisciplinary Consortium of Advanced Motion Performance (iCAMP), University of Arizona, Tucson, AZ; and Director of Education, Southern Arizona Limb Salvage Alliance, University of Arizona, Tucson, AZ
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Abstract
INTRODUCTION Laparoscopic tissue handling is quite difficult to measure using virtual-reality laparoscopic simulators and box-trainer exercises, and therefore, completion time is the predominant performance measure for simulation-based laparoscopic training exercises. The purpose of this study was to evaluate the construct validity of a training and assessment model for precise laparoscopic handling of delicate tissue. METHODS Participants (n = 35) completed 2 progressively challenging laparoscopic tissue translocation exercises using delicate foam pieces and templates. Deidentified performances were scored using objective measures for tissue damage, accuracy, percentage complete, and completion time. Evaluation included multiple analysis of variance with repeated measures among the 3 groups as follows: medical students, residents and faculty who perform laparoscopic surgery less than once per week, and faculty members who perform laparoscopic surgery at least once per week. RESULTS The model demonstrated significant construct validity by discriminating performances between the types of shapes and templates and across the levels of surgical experience on all dimensions. A significant interaction effect between the level of expertise and the difficulty of the exercise revealed excellent discrimination between experienced laparoscopic surgeons and others. DISCUSSION This low-cost model provides an alternative or adjunct platform for laparoscopic training and assessment that requires precise and measurable handling of a delicate tissue.
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86
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Differences in gaze behaviour of expert and junior surgeons performing open inguinal hernia repair. Surg Endosc 2014; 29:405-13. [DOI: 10.1007/s00464-014-3683-7] [Citation(s) in RCA: 50] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2014] [Accepted: 06/01/2014] [Indexed: 10/24/2022]
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87
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Causer J, Harvey A, Snelgrove R, Arsenault G, Vickers JN. Quiet eye training improves surgical knot tying more than traditional technical training: a randomized controlled study. Am J Surg 2014; 208:171-7. [DOI: 10.1016/j.amjsurg.2013.12.042] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2013] [Revised: 12/11/2013] [Accepted: 12/22/2013] [Indexed: 11/25/2022]
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88
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Jiang X, Zheng B, Atkins MS. Video processing to locate the tooltip position in surgical eye-hand coordination tasks. Surg Innov 2014; 22:285-93. [PMID: 25049318 DOI: 10.1177/1553350614541859] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
INTRODUCTION Trajectories of surgical instruments in laparoscopic surgery contain rich information about surgeons' performance. In a simulation environment, instrument trajectories can be taken by motion sensors attached to the instruments. This method is not accepted by surgeons working in the operating room due to safety concerns. In this study, a novel approach of acquiring instrument trajectories from surgical videos is reported. METHODS A total of 12 surgical videos were obtained for this study. The videos were captured during simulated laparoscopic procedures where subjects were required to pick up and transport an object over 3 different targets using a laparoscopic grasper. An algorithm was developed to allow the computer to identify the tip of the grasper on each frame of video, and then compute the trajectories of grasper movement. RESULTS The newly developed algorithm successfully identified tool trajectories from all 12 surgical videos. To validate the accuracy of this algorithm, the location of the tooltip in these videos were also manually labeled. The rate of accurate matching between these 2 methods was 98.4% of all video frames. DISCUSSION Identifying tool movement from surgical videos creates an effective way to track instrument trajectories. This builds up the foundation for assessing psychomotor performance of surgeons in the operating room without jeopardizing patient safety.
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Affiliation(s)
- Xianta Jiang
- Zhejiang University, Hangzhou, Zhejiang, China Simon Fraser University, Burnaby, British Columbia, Canada
| | - Bin Zheng
- University of Alberta, Edmonton, Alberta, Canada
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89
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Bright E, Vine SJ, Dutton T, Wilson MR, McGrath JS. Visual control strategies of surgeons: a novel method of establishing the construct validity of a transurethral resection of the prostate surgical simulator. JOURNAL OF SURGICAL EDUCATION 2014; 71:434-439. [PMID: 24797862 DOI: 10.1016/j.jsurg.2013.11.006] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/09/2013] [Revised: 11/16/2013] [Accepted: 11/20/2013] [Indexed: 06/03/2023]
Abstract
OBJECTIVE To examine novice and expert differences in visual control strategies while performing a virtual reality transurethral resection of the prostate (TURP) task and to determine if these differences could provide a novel method for assessing construct validity of the simulator. SUBJECTS AND METHODS A total of 11 novices (no TURP experience) and 7 experts (>200 TURPs) completed a virtual reality prostate resection task on the TURPsim (Simbionix USA Corp, Cleveland, OH) while wearing an eye tracker (ASL, Bedford, MA). Performance parameters and the surgeon's visual control strategy were measured and compared between the 2 groups. RESULTS Experts resected a greater percentage of prostate than novices (p < 0.01) and had less active diathermy time without tissue contact (p < 0.01). Experts adopted a target-locking visual strategy, employing fewer visual fixations (p < 0.05) with longer mean fixation duration (p < 0.005). With multiple learning trials, novices' performance improved and the adoption of a more expertlike gaze strategy was observed. CONCLUSION Significant differences between experts and novices in both performance and visual control strategy were observed. The study of visual control strategies may be a useful adjunct, alongside measurements of motor performance, providing a novel method of assessing the construct validity of surgical simulators.
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Affiliation(s)
- Elizabeth Bright
- Exeter Surgical Health Services Research Unit, Royal Devon & Exeter NHS Foundation Trust, Devon, United Kingdom.
| | - Samuel J Vine
- College of Life and Environmental Sciences, University of Exeter, St Luke's Campus, Devon, United Kingdom
| | - Thomas Dutton
- Exeter Surgical Health Services Research Unit, Royal Devon & Exeter NHS Foundation Trust, Devon, United Kingdom
| | - Mark R Wilson
- College of Life and Environmental Sciences, University of Exeter, St Luke's Campus, Devon, United Kingdom
| | - John S McGrath
- Exeter Surgical Health Services Research Unit, Royal Devon & Exeter NHS Foundation Trust, Devon, United Kingdom
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90
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Tien T, Pucher PH, Sodergren MH, Sriskandarajah K, Yang GZ, Darzi A. Eye tracking for skills assessment and training: a systematic review. J Surg Res 2014; 191:169-78. [PMID: 24881471 DOI: 10.1016/j.jss.2014.04.032] [Citation(s) in RCA: 95] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2014] [Revised: 01/26/2014] [Accepted: 04/16/2014] [Indexed: 11/24/2022]
Abstract
BACKGROUND The development of quantitative objective tools is critical to the assessment of surgeon skill. Eye tracking is a novel tool, which has been proposed may provide suitable metrics for this task. The aim of this study was to review current evidence for the use of eye tracking in training and assessment. METHODS A systematic literature review was conducted in line with PRISMA guidelines. A search of EMBASE, OVID MEDLINE, Maternity and Infant Care, PsycINFO, and Transport databases was conducted, till March 2013. Studies describing the use of eye tracking in the execution, training or assessment of a task, or for skill acquisition were included in the review. RESULTS Initial search results returned 12,051 results. Twenty-four studies were included in the final qualitative synthesis. Sixteen studies were based on eye tracking in assessment and eight studies were on eye tacking in training. These demonstrated feasibility and validity in the use of eye tracking metrics and gaze tracking to differentiate between subjects of varying skill levels. Several training methods using gaze training and pattern recognition were also described. CONCLUSIONS Current literature demonstrates the ability of eye tracking to provide reliable quantitative data as an objective assessment tool, with potential applications to surgical training to improve performance. Eye tracking remains a promising area of research with the possibility of future implementation into surgical skill assessment.
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Affiliation(s)
- Tony Tien
- Department of Surgery and Cancer, St Mary's Hospital, Imperial College London, London, UK
| | - Philip H Pucher
- Department of Surgery and Cancer, St Mary's Hospital, Imperial College London, London, UK
| | - Mikael H Sodergren
- Department of Surgery and Cancer, St Mary's Hospital, Imperial College London, London, UK; Hamlyn Centre for Robotic Surgery, Imperial College London, London, UK.
| | - Kumuthan Sriskandarajah
- Department of Surgery and Cancer, St Mary's Hospital, Imperial College London, London, UK; Hamlyn Centre for Robotic Surgery, Imperial College London, London, UK
| | - Guang-Zhong Yang
- Hamlyn Centre for Robotic Surgery, Imperial College London, London, UK
| | - Ara Darzi
- Department of Surgery and Cancer, St Mary's Hospital, Imperial College London, London, UK; Hamlyn Centre for Robotic Surgery, Imperial College London, London, UK
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91
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Harvey A, Vickers JN, Snelgrove R, Scott MF, Morrison S. Expert surgeon's quiet eye and slowing down: expertise differences in performance and quiet eye duration during identification and dissection of the recurrent laryngeal nerve. Am J Surg 2014; 207:187-93. [DOI: 10.1016/j.amjsurg.2013.07.033] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2013] [Revised: 06/20/2013] [Accepted: 07/11/2013] [Indexed: 10/26/2022]
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92
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Wood G, Batt J, Appelboam A, Harris A, Wilson MR. Exploring the Impact of Expertise, Clinical History, and Visual Search on Electrocardiogram Interpretation. Med Decis Making 2013; 34:75-83. [DOI: 10.1177/0272989x13492016] [Citation(s) in RCA: 36] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Background: The primary aim of this study is to understand more about the perceptual-cognitive mechanisms underpinning the expert advantage in electrocardiogram (ECG) interpretation. While research has examined visual search processes in other aspects of medical decision making (e.g., radiology), this is the first study to apply the paradigm to ECG interpretation. The secondary aim is to explore the role that clinical history plays in influencing visual search behavior and diagnostic decision making. While clinical history may aid diagnostic decision making, it may also bias the visual search process. Methods: Ten final-year medical students and 10 consultant emergency medics were presented with 16 ECG traces (8 with clinical history that was not manipulated independently of case) while wearing eye tracking equipment. The ECGs represented common abnormalities encountered in emergency departments and were among those taught to final-year medical students. Participants were asked to make a diagnosis on each presented trace and report their level of diagnostic confidence. Results: Experts made significantly faster, more accurate, and more confident diagnoses, and this advantage was underpinned by differences in visual search behavior. Specifically, experts were significantly quicker at locating the leads of critical importance. Contrary to our hypothesis, clinical history had no significant effect on the readers’ ability to detect the abnormality or make an accurate diagnosis. Conclusions: Accurate ECG interpretation appears dependent on the perceptual skill of pattern recognition and specifically the time to fixate the critical lead(s). Therefore, there is potential clinical utility in developing perceptual training programs to train novices to detect abnormalities more effectively.
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Affiliation(s)
- Greg Wood
- College of Life and Environmental Sciences, University of Exeter, Exeter, UK (GW, JB, MRW)
- Emergency Department, Royal Devon and Exeter NHS Foundation Trust, UK (AA, AH)
| | - Jeremy Batt
- College of Life and Environmental Sciences, University of Exeter, Exeter, UK (GW, JB, MRW)
- Emergency Department, Royal Devon and Exeter NHS Foundation Trust, UK (AA, AH)
| | - Andrew Appelboam
- College of Life and Environmental Sciences, University of Exeter, Exeter, UK (GW, JB, MRW)
- Emergency Department, Royal Devon and Exeter NHS Foundation Trust, UK (AA, AH)
| | - Adrian Harris
- College of Life and Environmental Sciences, University of Exeter, Exeter, UK (GW, JB, MRW)
- Emergency Department, Royal Devon and Exeter NHS Foundation Trust, UK (AA, AH)
| | - Mark R. Wilson
- College of Life and Environmental Sciences, University of Exeter, Exeter, UK (GW, JB, MRW)
- Emergency Department, Royal Devon and Exeter NHS Foundation Trust, UK (AA, AH)
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93
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Vine SJ, Chaytor RJ, McGrath JS, Masters RSW, Wilson MR. Gaze training improves the retention and transfer of laparoscopic technical skills in novices. Surg Endosc 2013; 27:3205-13. [PMID: 23479253 DOI: 10.1007/s00464-013-2893-8] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2012] [Accepted: 02/14/2013] [Indexed: 11/30/2022]
Abstract
BACKGROUND Gaze training is an effective way of training basic laparoscopic skills, resulting in faster acquisition periods and more robust subsequent performance under pressure. The current study is a randomized control trial which examines whether the performance benefits of gaze training stand the test of time (delayed retention) and transfer to more complex skills. METHODS Thirty-six medical students were trained to proficiency (50 trials) on a one-handed laparoscopic task (picking and dropping balls) in either a discovery learning (DL) or gaze training (GT) group. Both groups performed the one-handed task in baseline, retention and delayed retention (1 month) tests. They also performed baseline, retention and delayed retention tests of a two-handed task (grasping and cutting). Performance (completion time) and gaze control (target locking) were assessed throughout. RESULTS For the one-handed task, the GT group displayed superior performance at retention (p < .001), underpinned by more expert-like gaze control (p < .05). The GT group also displayed superior performance in the one-handed task at delayed retention (p < .005), underpinned by more expert-like gaze control strategies (p < .001). Although the DL group's performance fell to 84% of performance at retention, the GT group maintained performance at 100% of retention. There were no differences between the groups for the two-handed task at retention (p = .140); however, at delayed retention, the GT group outperformed the DL group (p < .005) and displayed more expert-like gaze control (p < .001). CONCLUSIONS Novices trained to adopt an expert-like gaze control strategy were able to attain higher levels of performance more quickly than novices who learned by discovery alone. Furthermore, these skills were more durable over time and were transferable to more complex skills. Gaze training is a beneficial intervention to aid the acquisition of the basic motor skills required for laparoscopy.
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Affiliation(s)
- Samuel J Vine
- College of Life and Environmental Sciences, University of Exeter, Exeter, UK.
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94
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Ryu D, Abernethy B, Mann DL, Poolton JM, Gorman AD. The Role of Central and Peripheral Vision in Expert Decision Making. Perception 2013; 42:591-607. [DOI: 10.1068/p7487] [Citation(s) in RCA: 37] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
The purpose of this study was to investigate the role of central and peripheral vision in expert decision making. A gaze-contingent display was used to selectively present information to the central and peripheral areas of the visual field while participants performed a decision-making task. Eleven skilled and eleven less-skilled male basketball players watched video clips of basketball scenarios in three different viewing conditions: full-image control, moving window (central vision only), and moving mask (peripheral vision only). At the conclusion of each clip participants were required to decide whether it was more appropriate for the ball-carrier to pass the ball or to drive to the basket. The skilled players showed significantly higher response accuracy and faster response times compared with their lesser-skilled counterparts in all three viewing conditions, demonstrating superiority in information extraction that held irrespective of whether they were using central or peripheral vision. The gaze behaviour of the skilled players was less influenced by the gaze-contingent manipulations, suggesting they were better able to use the remaining information to sustain their normal gaze behaviour. The superior capacity of experts to interpret dynamic visual information is evident regardless of whether the visual information is presented across the whole visual field or selectively to either central or peripheral vision alone.
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Affiliation(s)
- Donghyun Ryu
- Institute of Human Performance, The University of Hong Kong, 5 Sassoon Road, Pokfulam, Hong Kong
| | - Bruce Abernethy
- Institute of Human Performance, The University of Hong Kong, 5 Sassoon Road, Pokfulam, Hong Kong
- School of Human Movement Studies, The University of Queensland, Brisbane, Australia
| | - David L Mann
- Institute of Human Performance, The University of Hong Kong, 5 Sassoon Road, Pokfulam, Hong Kong
- Research Institute MOVE Amsterdam, Faculty of Human Movement Sciences, VU University, Amsterdam, The Netherlands
| | - Jamie M Poolton
- Institute of Human Performance, The University of Hong Kong, 5 Sassoon Road, Pokfulam, Hong Kong
| | - Adam D Gorman
- School of Human Movement Studies, The University of Queensland, Brisbane, Australia
- Movement Science—Skill Acquisition, Australian Institute of Sport, Canberra, Australia
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95
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Vine SJ, Masters RSW, McGrath JS, Bright E, Wilson MR. You can't beat experience, but you can cheat it. Surgery 2012; 153:300. [PMID: 23218884 DOI: 10.1016/j.surg.2012.10.002] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2012] [Accepted: 10/04/2012] [Indexed: 10/27/2022]
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96
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Nieuwenhuys A, Oudejans RRD. Anxiety and perceptual-motor performance: toward an integrated model of concepts, mechanisms, and processes. PSYCHOLOGICAL RESEARCH 2012; 76:747-59. [PMID: 22038472 PMCID: PMC3470682 DOI: 10.1007/s00426-011-0384-x] [Citation(s) in RCA: 93] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2011] [Accepted: 10/11/2011] [Indexed: 12/02/2022]
Abstract
Under anxiety, people sometimes perform poorly. This concerns cognitive performance (e.g., taking an important exam) as well as perceptual-motor performance (e.g., picking up a cup from a table). There is still much debate about how anxiety affects perceptual-motor performance. In the current paper we review the experimental literature on anxiety and perceptual-motor performance, thereby focusing on how anxiety affects the perception, selection, and realization of action possibilities. Based on this review we discuss the merits of two opposing theoretical explanations and build on existing frameworks of anxiety and cognitive performance to develop an integrated model that explains the various ways in which anxiety may specifically affect perceptual-motor performance. This model distinguishes between positive and negative effects of anxiety and, moving beyond previous approaches, recognizes three operational levels (i.e., attentional, interpretational, and behavioral) at which anxiety may affect different aspects of goal-directed action. Finally, predictions are formulated and directions for future research suggested.
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Affiliation(s)
- Arne Nieuwenhuys
- Research Institute MOVE, Faculty of Human Movement Sciences, VU University Amsterdam, Van der Boechorstraat 9, 1081 BT Amsterdam, The Netherlands
| | - Raôul R. D. Oudejans
- Research Institute MOVE, Faculty of Human Movement Sciences, VU University Amsterdam, Van der Boechorstraat 9, 1081 BT Amsterdam, The Netherlands
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97
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Khan RSA, Tien G, Atkins MS, Zheng B, Panton ONM, Meneghetti AT. Analysis of eye gaze: Do novice surgeons look at the same location as expert surgeons during a laparoscopic operation? Surg Endosc 2012; 26:3536-40. [DOI: 10.1007/s00464-012-2400-7] [Citation(s) in RCA: 63] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2012] [Accepted: 05/15/2012] [Indexed: 11/28/2022]
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98
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Atkins MS, Tien G, Khan RSA, Meneghetti A, Zheng B. What do surgeons see: capturing and synchronizing eye gaze for surgery applications. Surg Innov 2012; 20:241-8. [PMID: 22696024 DOI: 10.1177/1553350612449075] [Citation(s) in RCA: 40] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Recording eye motions in surgical environments is challenging. This study describes the authors' experiences with performing eye-tracking for improving surgery training, both in the laboratory and in the operating room (OR). Three different eye-trackers were used, each with different capabilities and requirements. For monitoring eye gaze shifts over the room scene in a simulated OR, a head-mounted system was used. The number of surgeons' eye glances on the monitor displaying patient vital signs was successfully captured by this system. The resolution of the head-mounted eye-tracker was not sufficient to obtain the gaze coordinates in detail on the surgical display monitor. The authors then selected a high-resolution eye-tracker built in to a 17-inch computer monitor that is capable of recording gaze differences with resolution of 1° of visual angle. This system enables one to investigate surgeons' eye-hand coordination on the surgical monitor in the laboratory environment. However, the limited effective tracking distance restricts the use of this system in the dynamic environment in the real OR. Another eye-tracker system was found with equally high level of resolution but with more flexibility on the tracking distance, as the eye-tracker camera was detached from the monitor. With this system, the surgeon's gaze during 11 laparoscopic procedures in the OR was recorded successfully. There were many logistical challenges with unobtrusively integrating the eye-tracking equipment into the regular OR workflow and data processing issues in the form of image compatibility and data validation. The experiences and solutions to these challenges are discussed.
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99
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Vine SJ, Moore LJ, Wilson MR. Quiet eye training: the acquisition, refinement and resilient performance of targeting skills. Eur J Sport Sci 2012; 14 Suppl 1:S235-42. [PMID: 24444212 DOI: 10.1080/17461391.2012.683815] [Citation(s) in RCA: 62] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Abstract
How we learn and refine motor skills in the most effective manner and how we prevent performance breakdown in pressurised or demanding circumstances are among the most important questions within the sport psychology and skill acquisition literature. The quiet eye (QE) has emerged as a characteristic of highly skilled perceptual and motor performance in visually guided motor tasks. Defined as the final fixation that occurs prior to a critical movement, over 70 articles have been published in the last 15 years probing the role that the QE plays in underpinning skilled performance. The aim of this review is to integrate research findings from studies examining the QE as a measure of visuomotor control in the specific domain of targeting skills; motor skills requiring an object to be propelled to a distant target. Previous reviews have focused primarily on the differences in QE between highly skilled performers and their less skilled counterparts. The current review aims to discuss contemporary findings relating to 1. The benefits of QE training for the acquisition and refinement of targeting skills; 2. The effects of anxiety upon the QE and subsequent targeting skill performance and 3. The benefits of QE training in supporting resilient performance under elevated anxiety. Finally, potential processes through which QE training proffers this advantage, including improved attentional control, response programming and external focus, will be discussed and directions for future research proposed.
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Affiliation(s)
- Samuel J Vine
- a Department of Sport and Health Sciences , University of Exeter , Exeter , UK
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100
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Vine SJ, Masters RSW, McGrath JS, Bright E, Wilson MR. Cheating experience: Guiding novices to adopt the gaze strategies of experts expedites the learning of technical laparoscopic skills. Surgery 2012; 152:32-40. [PMID: 22464048 DOI: 10.1016/j.surg.2012.02.002] [Citation(s) in RCA: 83] [Impact Index Per Article: 6.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2011] [Accepted: 02/09/2012] [Indexed: 11/30/2022]
Abstract
BACKGROUND Previous research has demonstrated that trainees can be taught (via explicit verbal instruction) to adopt the gaze strategies of expert laparoscopic surgeons. The current study examined a software template designed to guide trainees to adopt expert gaze control strategies passively, without being provided with explicit instructions. METHODS We examined 27 novices (who had no laparoscopic training) performing 50 learning trials of a laparoscopic training task in either a discovery-learning (DL) group or a gaze-training (GT) group while wearing an eye tracker to assess gaze control. The GT group performed trials using a surgery-training template (STT); software that is designed to guide expert-like gaze strategies by highlighting the key locations on the monitor screen. The DL group had a normal, unrestricted view of the scene on the monitor screen. Both groups then took part in a nondelayed retention test (to assess learning) and a stress test (under social evaluative threat) with a normal view of the scene. RESULTS The STT was successful in guiding the GT group to adopt an expert-like gaze strategy (displaying more target-locking fixations). Adopting expert gaze strategies led to an improvement in performance for the GT group, which outperformed the DL group in both retention and stress tests (faster completion time and fewer errors). CONCLUSION The STT is a practical and cost-effective training interface that automatically promotes an optimal gaze strategy. Trainees who are trained to adopt the efficient target-locking gaze strategy of experts gain a performance advantage over trainees left to discover their own strategies for task completion.
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Affiliation(s)
- Samuel J Vine
- College of Life and Environmental Sciences, University of Exeter, Exeter, UK.
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