The role of eye tracker in teaching video-assisted thoracoscopic surgery: the differences in visual strategies between novice and expert surgeons in thoracoscopic surgery

BACKGROUND: In light of continued advances in surgical techniques, it is essential to improve the efficacy of training young thoracic surgeons. Increasingly, the feedback of visual information is believed to be a crucial teaching tool. When surgeons are looking at surgical teaching videos, eye gaze technology can be used to record the gaze movement to examine the stages of information access. METHODS: A total of 8 novice surgeons and 8 expert surgeons were recruited to watch an instructional video of surgery while Tobii Pro Fusion was used to recorded their movement trajectory. Another 36 novice surgeons were recruited and divided into two groups. One group watched the video following the trajectory of the senior thoracic surgeons’ eye movements and the other group watched the raw video. All 36 novice surgeons subsequently underwent a post-test which was conducted via a questionnaire. RESULTS: The differences in eye fixation patterns and search strategies between novices and experts were assessed using 4 indexes, including total duration of fixation, time to entry saccade, number of saccades, and peak velocity of saccade. The results were compared using independent-sample t-tests and repeated-measures analysis. When experts watched the videos, there was a 67.8% overlap of eye gaze compared to a 51.4% overlap in novices (P≤0.001). The post-test showed that novice surgeons who watched the video marked with the senior thoracic surgeon’s eye movements had a better understanding of the key points of the operation. CONCLUSIONS: Novice and expert surgeons have different eye fixation patterns and search strategies when watching videos of thoracoscopic surgery. Watching surgical videos marked with expert eye movement trajectories is conducive to novice surgeons to master operative skills.