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Enhancing Transesophageal Echocardiography Training in Cardiac Anesthesia Fellows Using Wearable Eye-Tracking

Benjamin Gorbaty1, Enrique Vergara Escuardo2, Alexander Gherciuc2

  • 1Department of Anesthesiology, Division of Cardiovascular Anesthesiology, University of Minnesota, Minneapolis, MN.

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|May 25, 2025
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Summary

Wearable eye-tracking technology offers objective assessment of transesophageal echocardiography (TEE) skills for Adult Cardiothoracic Anesthesiology (ACTA) fellows. This innovative method tracks gaze patterns, providing insights into visual attention and technical proficiency during TEE examinations.

Keywords:
TEEechoechocardiographyeducationeye-trackingfellowstechnology

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Area of Science:

  • Medical Education
  • Anesthesiology
  • Medical Imaging Technology

Background:

  • Assessing technical proficiency in transesophageal echocardiography (TEE) for Adult Cardiothoracic Anesthesiology (ACTA) fellows is challenging.
  • Traditional evaluation methods often overlook image acquisition techniques and visual attention, focusing mainly on image interpretation.
  • Objective metrics are needed to enhance TEE skill assessment in fellowship training.

Purpose of the Study:

  • To evaluate the feasibility and utility of wearable eye-tracking technology for objectively assessing TEE skills in ACTA fellows.
  • To analyze gaze patterns and visual attention during TEE examinations using eye-tracking data.
  • To establish a benchmark for TEE skill evaluation by comparing fellow performance with an expert.

Main Methods:

  • ACTA fellows utilized Tobii Pro Glasses 3 for real-time video and gaze pattern recording during weekly TEE examinations.
  • Gaze data was analyzed using Tobii Pro Lab Analyzer to generate heat maps and measure time spent on specific TEE views.
  • An expert attending physician also underwent eye-tracking to provide a comparative benchmark.

Main Results:

  • Eye-tracking technology provided valuable insights into fellows' gaze patterns during TEE procedures.
  • Objective measurement of visual focus during TEE examinations was achieved.
  • The study demonstrated the feasibility of using eye-tracking for technical skill evaluation, despite noted limitations.

Conclusions:

  • Wearable eye-tracking technology presents a promising method for refining TEE education and feedback in cardiac anesthesia fellowship.
  • Objective assessment of gaze patterns can enhance the evaluation of technical TEE skills.
  • Further research into metrics like gaze efficiency and image acquisition time is recommended to optimize TEE training.