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Novice and Expert Anesthesiologists’ Eye-Tracking Metrics During Simulated Epidural Block: A Preliminary, Brief Observational Report

Authors Capogna E, Salvi F, Delvino L, Di Giacinto A, Velardo M

Received 15 June 2020

Accepted for publication 6 August 2020

Published 21 August 2020 Volume 2020:13 Pages 105—109


Checked for plagiarism Yes

Review by Single anonymous peer review

Peer reviewer comments 2

Editor who approved publication: Dr Stefan Wirz

Emanuele Capogna,1 Francesco Salvi,1 Lorena Delvino,2 Andrea Di Giacinto,2 Matteo Velardo1

1EESOA Maternal Neonatal Simulation Center, European School of Obstetric Anesthesia, Rome, Italy; 2SrLabs, Milan, Italy

Correspondence: Emanuele Capogna
EESOA Maternal Neonatal Simulation Center, European School of Obstetric Anesthesia, Via Giulia di Gallese 15, Rome 00151, Italy

Introduction: Eye tracking is the process of measuring an individual’s eye movements to register their attentional behavior by using a device called an eye-tracker. Studies conducted using eye-tracking techniques have demonstrated a number of differences in eye movement parameters and patterns between experts and novices. The aim of this preliminary study was to evaluate if there are any differences in eye-tracking metrics between novice and expert anesthesiologists during the performance of an epidural block using an epidural simulator.
Methods: Seven experts and seven novices who gave their consent to this preliminary study were asked to perform an epidural technique using an epidural simulator while wearing a pair of Tobii Pro glasses. Number of fixations, fixation duration, heat maps and scan-paths were examined by Tobii Pro Lab Software. Duration of the procedure was also recorded.
Results: The observation of the attentional heat map and gaze plot showed different gaze dispersion between experts and novices. The mean total duration of fixations during needle insertion and advancement and catheter introduction was lower in experts than trainees (respectively, 0.18 vs 3.56 sec; P< 0.05 and 0.73 vs 2.48 sec; P< 0.05). The mean fixation count was greater in experts vs trainees (5 vs 2; P< 0.05). The mean duration of the epidural procedure was 104.16 (41) (trainees) vs 65.3 (32.6) seconds (experts) (P< 0.05). Expert anesthesiologists spent more time fixating a more specific target location (eg, the point of the epidural needle rather than the syringe’s barrel) whilst novices split their attention between tracking their tools and the target location.
Discussion: Eye tracking may have interesting implications for the creation of assessment programs, which distinguish skill level through the use of gaze behavior, and may be a promising tool for monitoring training progress towards the development of expertise.

Keywords: simulation, epidural technique, eye tracking

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