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Visual gaze patterns in trainee endoscopists - a novel assessment tool.

Urvi Karamchandani1, Simon Erridge1, Keane Evans-Harvey1

  • 1Department of Surgery and Cancer, Imperial College London, St Mary's Hospital, London, UK.

Scandinavian Journal of Gastroenterology
|April 22, 2022
PubMed
Summary

Eye-tracking reveals that trainee endoscopists focusing on bowel mucosa during colonoscopy correlates with higher proficiency. This visual search strategy analysis offers a novel method for assessing and guiding colonoscopy trainees.

Keywords:
Visual gaze patterncolonoscopy trainingeye-tracking

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Area of Science:

  • Medical Education
  • Gastroenterology
  • Ophthalmology

Background:

  • Colonoscopy skill acquisition is crucial for proficiency.
  • Current assessment methods lack evaluation of visual search strategies.
  • Eye-tracking shows potential for automated assessment of endoscopists.

Purpose of the Study:

  • To assess the feasibility of eye-tracking as a novel assessment tool for colonoscopy trainees.
  • To correlate visual gaze patterns (VGPs) with objective performance scores.

Main Methods:

  • Eye-tracking glasses recorded 26 colonoscopies from 12 trainees.
  • Trainees were assessed using directly observed procedural scores (DOPS) and visual analogue scores.
  • Fixation duration (FixD) and frequency (FixF) were analyzed in relation to bowel surface and lumen areas of interest (AOIs).

Main Results:

  • Significant positive correlation between total weighted procedure score (TWPS) and FixD/FixF in bowel mucosa peripheries (p<.0001).
  • Significant negative correlation between TWPS and bowel lumen fixation (p=.004 for FixD, p=.002 for FixF).
  • Higher objective performance linked to VGPs focusing on bowel mucosa.

Conclusions:

  • Visual gaze patterns focusing on bowel mucosa correlate with higher colonoscopy performance.
  • Eye-tracking analysis of VGPs shows potential for training and assessment in colonoscopy.
  • This technology may offer objective feedback for trainee improvement.