Gaze patterns of gross anatomy students change with classroom learning

Numerous studies have documented that experts exhibit more efficient gaze patterns than those of less experienced individuals. In visual search tasks, experts use fewer, longer fixations to fixate for relatively longer on salient regions of the visual field while less experienced observers spend more time examining nonsalient regions. This study investigates whether changes in gaze patterns reflect learning by students in a medical gross anatomy course. Students were asked to examine photographs of dissections similar to those they experienced in class and to identify the tagged structure in each image. We postulated that, compared to naive behavior (behavior at baseline and when examining unfamiliar content) students would examine familiar content for longer and would direct proportionally more fixation time on cognitively salient regions of the images while using fewer, longer duration fixations. Our students examined familiar images for significantly longer than they did at baseline (P < 0.0001) or for unfamiliar images (P < 0.0001). They also spent significantly longer examining cognitively salient regions of familiar images, as compared to examining those regions at baseline (P < 0.0001) and on unfamiliar images (P < 0.0001). However, these gaze patterns were characterized by more numerous fixations rather than fewer, longer fixations. These individuals are successful learners in a challenging gross anatomy course, but are not experts in anatomy. Therefore we speculate that the gaze pattern they exhibit characterizes an earlier stage of the learning process than has previously been documented in studies of expertise, which have primarily focused on the gaze patterns of true experts.