Training focal lung pathology detection using an eye movement modeling example

Purpose: Published reports suggest that nonoptimal visual search behavior is associated with false negatives in chest x-ray interpretation. Eye movement modeling example (EMME)-based training interventions, that is, interventions showing models of visual search to trainees, have been shown to improve visual search as well as task accuracy. Approach: We examined the detection of focal lung pathology on chest x-rays before and after two different EMME training interventions that have been shown to be efficient: (i) an EMME showing moving fixations on a blurred background (spotlight group) and (ii) an EMME showing moving fixations on a nonblurred background (circle group). These two experimental groups were compared to a control group that was only provided with the correct location of pathologies on the chest x-rays. Results: Performance outcomes showed improved detection sensitivity and specificity in all groups (also the control group). It appears that repetitive exposure to pathologies on chest x-rays with feedback resulted in enhanced pattern recognition. In addition, visual search strategies became more efficient during post-tests. Conclusion: Repetitive exposure to a focal lung pathology detection task with feedback improves overall performance. However, the specific EMME training interventions did not add any further advantages. Similar training interventions can be provided online to assess feasibility and reproducibility of such (or similar) training formats. Such training can, for example, reduce the number of false negative errors, especially for novices.