Surgeons Learn by Mimicking the Eye Movements of Experts

Trainee surgeons learn technical surgical skills much more quickly and deal better with the stress of the operating theatre if they learn to control their eye movements by mimicking those of experts.

Research at the University of Exeter (United Kingdom), the Royal Devon and Exeter NHS Foundation Trust (United Kingdom), and the University of Hong Kong (SAR China), devised a gaze training program, which taught the novices to copy the visual control patterns of expert surgeons. Subsequently, 30 medical students were divided into three groups, each undertaking a different type of training; gaze training, movement training, and a discovery learning and control group, who were left to their own devices.

The “gaze trained” group of students was shown a video, captured by an eye tracker, displaying the visual control of an experienced surgeon. The footage highlighted exactly where and when the surgeon's eyes were fixed during a simulated surgical task. The students then performed the task themselves, wearing the same eye-tracking device. During the task they were encouraged to adopt the same eye movements as those of the expert surgeon.
After repeating the task a number of times, the students' eye movements soon mimicked those of a far more experienced surgeon, enabling them to learn technical skills more quickly and perform these skills in distracting conditions similar to the operating room. The performance of the students in the other groups, however, broke down when they were put into conditions that simulated the environment of the operating theatre and they needed to multitask. The study was published in the December 2011 issue of Surgical Endoscopy.

“It appears that teaching novices the eye movements of expert surgeons allows them to attain high levels of motor control much quicker than novices taught in a traditional way,” said study coauthor Samuel Vine, MD, of the University of Exeter. “This highlights the important link between the eye and hand in the performance of motor skills. Teaching eye movements rather than the motor skills may have reduced the working memory required to complete the task. This may be why they were able to multitask whilst the other groups were not.”

Successful surgeons “lock” their eyes to a critical location while performing complex movements using surgical instruments; this prevents them from tracking the tip of the surgical tool, helping them to be accurate and avoid distractions. The research team is now analyzing these eye movements to develop a software-training package that will automatically guide trainees to adopt surgeon’s eye movements.

Related Links:
University of Exeter
Royal Devon and Exeter NHS Foundation Trust
University of Hong Kong