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Exploring the Relationship Between Eye Metrics and Surgical Performance: A Study on Orthopedic Surgeons in Simulated
Andreas Ladurner1, Meghan McConnell2
1Master of Medical Education Program (MME), Institute for Medical Education (IML), University of Bern, Bern, Switzerland; Department of Orthopaedics, Hand and Trauma Surgery, Stadtspital Zürich, Zurich, Switzerland.
Eye-tracking metrics in arthroscopic surgery simulation revealed differences in visual attention strategies between surgical experts and trainees. While helpful for assessing attentional efficiency, these metrics do not reliably indicate technical skill alone.
Area of Science:
- Medical Education
- Surgical Simulation
- Human Factors Engineering
Background:
- Assessing surgical expertise is crucial for patient safety and effective training.
- Traditional performance metrics in surgical simulation may not fully capture cognitive aspects of skill.
Purpose of the Study:
- To determine if eye-tracking metrics differentiate surgical expertise levels in simulated arthroscopy.
- To evaluate associations between eye-tracking, simulator performance, and perceived workload.
Main Methods:
- Observational educational study using mixed-reality arthroscopy simulation.
- Integrated eye-tracking and workload assessment (NASA-TLX) in 26 orthopaedic surgeons.
- Performed 6 standardized arthroscopic tasks of increasing complexity.
Main Results:
- Eye-tracking showed experience-related differences (fewer fixations, longer fixation durations in consultants).
- Simulator performance metrics did not consistently differentiate residents from consultants.
- Weak correlations observed between workload, simulator performance, and eye-tracking metrics.
Conclusions:
- Eye-tracking metrics in arthroscopic simulation reflect visual attention differences related to experience, not solely technical performance.
- Fixation-based eye-tracking may offer insights into attentional efficiency and cognitive workload.
- Eye-tracking provides complementary data when integrated with performance and workload assessments for surgical expertise evaluation.