Visual Attention in Real‐World Conversation: Gaze Patterns Are Modulated by Communication and Group Size

Attention in hindsight: Using stimulated recall to capture dynamic fluctuations in attentional engagement

Attentional engagement is known to vary on a moment-to-moment basis. However, few self-report methods can effectively capture dynamic fluctuations in attentional engagement over time. In the current paper, we evaluated the utility of stimulated recall, a method wherein individuals are asked to remember their subjective states while using a mnemonic cue, for the measurement of temporal changes in attentional engagement. Participants were asked to watch a video lecture, during which we assessed their in-the-moment levels of attentional engagement using intermittent thought probes. Then, we used stimulated recall by cueing participants with short video clips from the lecture to retrospectively assess the levels of attentional engagement they had experienced when they first watched those clips within the lecture. Experiment 1 assessed the statistical overlap between in-the-moment and video-stimulated ratings. Experiment 2 assessed the generalizability of video-stimulated recall across different types of lectures. Experiment 3 assessed the impact of presenting video-stimulated probe clips in non-chronological order. Experiment 4 assessed the effect of video-stimulated recall on its own. Across all experiments, we found statistically robust correspondence between in-the-moment and video-stimulated ratings of attentional engagement, illustrating a strong convergence between these two methods of assessment. Taken together, our findings indicate that stimulated recall provides a new and practical methodological approach that can accurately capture dynamic fluctuations in subjective attentional states over time.

Nontechnical Skills Assessment in Acute Care Trauma Simulations: A Mixed Methods Approach Using Eye Tracking and Behavioral Marker Systems

INTRODUCTION

The condition of trauma patients and the urgent need for timely resuscitation present unique challenges to trauma teams. These difficulties are exacerbated for military trauma teams in combat environments. Consequently, there is a need for continued improvement of nontechnical skills (NTS) training for trauma teams. However, current approaches to NTS assessment rely on subjective ratings, which can introduce bias. Accordingly, objective methods of NTS evaluation are needed. Eye-tracking (ET) methods have been applied to studying communication, situation awareness, and leadership in many health care settings, and could be applied to studying physicians' NTS during trauma situations. In this study, we aimed to assess the relationship between trauma team leaders' objective gaze patterns and subjective expert NTS ratings during patient care simulations.

MATERIALS AND METHODS

After Institutional Review Board approval, 9 trauma teams from first-year post-graduate general surgery and emergency medicine residents were recruited to participate in 1 of 2 trauma simulations (a difficult airway case and a multi-patient trauma). Each scenario lasted approximately 15 minutes. All team leaders wore a mobile ET system to evaluate gaze metrics-time to first fixation (TTFF), average fixation duration (AFD), and total percentage of the scenario (TPS) focused on Areas of Interest (AOI), which included patient, care team, diagnostic equipment, and patient care equipment. Trained faculty raters completed the Non-Technical Skills for Surgeons (NOTSS) assessment tool and the Trauma Non-Technical Skills (T-NOTECHS) scale. One-way analysis of variance, Kruskal-Wallis, and appropriate post-hoc pairwise comparison tests were run to assess differences between ET metrics across AOI groups. Spearman's Rho tests were used to assess correlations between ET and subjective NTS ratings.

RESULTS

Compared to other NTS domains, trauma teams scored relatively poorly on communication across both T-NOTECHS (3.29$ \pm $0.61, maximum = 5) and NOTSS (2.87$ \pm $0.66, maximum = 4). We found significant differences in trauma team leaders' TTFF between teammates and the patient (Team: 1.56 vs Patient: 29.82 seconds, P < .001). TTFF on the diagnostic equipment was negatively correlated (P < .05) to multiple measures of subjective NTS assessments. There were no significant differences in AFD between AOIs, and AFD on teammates was positively correlated (P < .05) to communication and teamwork. There were significant differences in TPS across most AOI pairs (P < .05), and the average TPS fixated was highest on the patient (32%). Finally, there were several significant correlations between additional ET and NTS metrics.

CONCLUSIONS

This study utilized a mixed methods approach to assess trauma team leaders' NTS in simulated acute care trauma simulations. Our results provide several objective insights into trauma team leaders' NTS behaviors during patient care simulations. Such objective insights provide a more comprehensive understanding of NTS behaviors and can be leveraged to guide NTS training of trauma physicians in the future. More studies are needed to apply these methods to capture NTS from a larger sample of teams in both simulated and real trauma environments.

Interpersonal eye-tracking reveals the dynamics of interacting minds

The human eye is a rich source of information about where, when, and how we attend. Our gaze paths indicate where and what captures our attention, while changes in pupil size can signal surprise, revealing our expectations. Similarly, the pattern of our blinks suggests levels of alertness and when our attention shifts between external engagement and internal thought. During interactions with others, these cues reveal how we coordinate and share our mental states. To leverage these insights effectively, we need accurate, timely methods to observe these cues as they naturally unfold. Advances in eye-tracking technology now enable real-time observation of these cues, shedding light on mutual cognitive processes that foster shared understanding, collaborative thought, and social connection. This brief review highlights these advances and the new opportunities they present for future research.

Sharing and Receiving Eye-Contact Predicts Mate Choice After a 5-Minute Conversation: Evidence from a Speed-Dating Study

In popular narratives, the first date with a potential mate often centers on their gaze as embodiment of interest and attraction. However, evidence is still lacking on the role of eye-contact as a potent signal in human social interaction in the context of dating. In addition, behavioral mechanisms of mate selection are not well understood. In the present study, we therefore examined mutual eye-contact and its influence on mate choice by applying dual mobile eye-tracking during naturalistic speed-dates. A total of 30 male and 30 female subjects attended four speed-dates each (N = 240). Subjects were more likely to choose those dating partners with whom they shared more eye-contact with. In addition, perceived attractiveness played an important role for mate choice. Interestingly, receiving but not giving eye-contact also predicted individual mate choice. Eye-contact thus acts as an important signal of romantic attraction when encountering a dating partner.

A dual mobile eye tracking study on natural eye contact during live interactions

Human eyes convey a wealth of social information, with mutual looks representing one of the hallmark gaze communication behaviors. However, it remains relatively unknown if such reciprocal communication requires eye-to-eye contact or if general face-to-face looking is sufficient. To address this question, while recording looking behavior in live interacting dyads using dual mobile eye trackers, we analyzed how often participants engaged in mutual looks as a function of looking towards the top (i.e., the Eye region) and bottom half of the face (i.e., the Mouth region). We further examined how these different types of mutual looks during an interaction connected with later gaze-following behavior elicited in an individual experimental task. The results indicated that dyads engaged in mutual looks in various looking combinations (Eye-to-eye, Eye-to-mouth, and Mouth-to-Mouth) but proportionately spent little time in direct eye-to-eye gaze contact. However, the time spent in eye-to-eye contact significantly predicted the magnitude of later gaze following response elicited by the partner's gaze direction. Thus, humans engage in looking patterns toward different face parts during interactions, with direct eye-to-eye looks occurring relatively infrequently; however, social messages relayed during eye-to-eye contact appear to carry key information that propagates to affect subsequent individual social behavior.

Early lifetime experience of urban living predicts social attention in real world crowds

More than half of the world's population is currently living in cities, with more and more people moving to densely populated areas. The experience of growing up and living in crowded environments might influence the way we explore our social environment, mainly how we attend to others. Yet, we know little about how urbanicity affects this vital function of our social life. In two studies, we use mobile eye-tracking to measure participants' social attention, while walking through a shopping mall. Results show that social density of participants' native place impacts how frequently they look at passing strangers. People who experienced more city living from birth to early adolescence, attend more to strangers' faces than their rural counterparts. Our findings demonstrate that the early experience of urban upbringing configures social attention in adulthood. The urbanicity-related bias towards social gazing might reflect a more efficient processing of social information in urban natives.

A psychophysiological investigation of mourning: There are two sides to the story

Mourning constitutes an important human emotion, which might cause—among other things—major depressive symptoms when lasting for too long. To date, no study investigated whether mourning is related to specific psychophysiological activation patterns. Therefore, we examined physiological reactions induced by iconographic mourning-related stimuli in comparison to neutral and attachment stimuli in healthy adults (N = 77, mean age: 21.9). We evaluated pupillometric and eye-tracking parameters as well as heart rate variability (HRV) and skin conductance (EDA). Eye-tracking revealed a stronger dilated pupil during mourning in comparison to the neutral, but not to the attachment condition; furthermore, fixation patterns revealed less fixations on mourning stimuli. While HF HRV was reduced during mourning and attachment, we found no differences concerning EDA parameters between conditions. Results suggest specific eye-movement and pupil adaptations during representations of mourning, which might point toward inward cognition or avoidance, but no specific physiological pattern concerning HRV and EDA.

Selective visual attention during public speaking in an immersive context

It has recently become feasible to study selective visual attention to social cues in increasingly ecologically valid ways. In this secondary analysis, we examined gaze behavior in response to the actions of others in a social context. Participants (N = 84) were asked to give a 5-minute speech to a five-member audience that had been filmed in 360° video, displayed in a virtual reality headset containing a built-in eye tracker. Audience members were coached to make movements that would indicate interest or lack of interest (e.g., nodding vs. looking away). The goal of this paper was to analyze whether these actions influenced the speaker's gaze. We found that participants showed reliable evidence of gaze towards audience member actions in general, and towards audience member actions involving their phone specifically (compared with other actions like looking away or leaning back). However, there were no differences in gaze towards actions reflecting interest (like nodding) compared with actions reflecting lack of interest (like looking away). Participants were more likely to look away from audience member actions as well, but there were no specific actions that elicited looking away more or less. Taken together, these findings suggest that the actions of audience members are broadly influential in motivating gaze behaviors in a realistic, contextually embedded (public speaking) setting. Further research is needed to examine the ways in which these findings can be elucidated in more controlled laboratory environments as well as in the real world.

Eye-tracking analyses of physician face gaze patterns in consultations

Face gaze is a fundamental non-verbal behaviour and can be assessed using eye-tracking glasses. Methodological guidelines are lacking on which measure to use to determine face gaze. To evaluate face gaze patterns we compared three measures: duration, frequency and dwell time. Furthermore, state of the art face gaze analysis requires time and manual effort. We tested if face gaze patterns in the first 30, 60 and 120 s predict face gaze patterns in the remaining interaction. We performed secondary analyses of mobile eye-tracking data of 16 internal medicine physicians in consultation with 100 of their patients. Duration and frequency of face gaze were unrelated. The lack of association between duration and frequency suggests that research may yield different results depending on which measure of face gaze is used. Dwell time correlates both duration and frequency. Face gaze during the first seconds of the consultations predicted face gaze patterns of the remaining consultation time (R² 0.26 to 0.73). Therefore, face gaze during the first minutes of the consultations can be used to predict face gaze patterns over the complete interaction. Researchers interested to study face gaze may use these findings to make optimal methodological choices.

Here's looking at you: eye gaze and collaborative recall

In everyday life, we remember together often. Surprisingly, research reliably shows costs of collaboration. People remember less in groups than the same number of individuals remember separately. However, there is evidence that some groups are more successful than others, depending on factors such as group relationship and verbal communication strategies. To understand further the characteristics of more successful vs. less successful collaborative groups, we examined whether non-verbal eye gaze behaviour was associated with group outcomes. We used eye tracking glasses to measure how much collaborating dyads looked at each other during collaborative recall, and examined whether individual differences in eye- and face-directed gaze were associated with collaborative performance. Increased eye- and face-directed gaze was associated with higher collaborative recall performance, more explicit strategy use, more post-collaborative benefits, and increased memory overlap. However, it was also associated with pre-collaborative recall, indicating that gaze during collaboration may at least partially reflect pre-existing abilities. This research helps elucidate individual differences that underlie the outcomes of collaborative recall, and suggests that non-verbal communication differentiates more vs. less successful collaborative groups.