Department of Medical Imaging, University of Arizona, Tucson, AZ 85724, USA.
Hum Pathol. 2013 Mar;44(3):357-64. doi: 10.1016/j.humpath.2012.05.024. Epub 2012 Jul 24.
The goal of this study was to examine and characterize changes in the ways that pathology residents examine digital whole slide images as they progress through the residency training. A series of 20 digitized breast biopsy whole slide images (half benign and half malignant biopsies) were individually shown to 4 pathology residents at four points in time--at the beginning of their first, second, third, and fourth years of residency. Their task was to examine each image and select three areas that they would most want to zoom in on in order to view the diagnostic detail at higher resolution. Eye position was recorded as they scanned each whole slide image at low magnification. The data indicate that with each successive year of experience, the residents' search patterns do change. Overall, with time, it takes significantly less time to view an individual slide and decide where to zoom, significantly fewer fixations are generated overall, and there is less examination of nondiagnostic areas. Essentially, the residents' search becomes much more efficient. These findings are similar to those in radiology, and support the theory that an important aspect of the development of expertise is improved pattern recognition (taking in more information during the initial Gestalt or gist view) as well as improved allocation of attention and visual processing resources. Progression in improvements in visual search strategies was similar, but not identical, for the 4 residents.
本研究旨在探讨并描述病理住院医师在接受住院医师培训过程中检查数字全切片图像方式的变化。将一系列 20 张数字化乳腺活检全切片图像（一半良性活检，一半恶性活检）分别在四个时间点展示给 4 名病理住院医师，即他们在住院医师培训的第一年、第二年、第三年和第四年的开始阶段。他们的任务是检查每张图像，并选择三个他们最希望放大的区域，以便以更高的分辨率查看诊断细节。在他们以低倍放大扫描每张全切片图像时记录眼动位置。数据表明，随着每年经验的增加，住院医师的搜索模式确实会发生变化。总体而言，随着时间的推移，查看单个幻灯片并决定放大位置所需的时间明显减少，总的注视次数明显减少，对非诊断区域的检查也减少了。从本质上讲，住院医师的搜索变得更加高效。这些发现与放射学相似，支持了这样一种理论，即专业知识发展的一个重要方面是改进模式识别（在初始的整体或要点视图中获取更多信息）以及改进注意力和视觉处理资源的分配。对于 4 名住院医师来说，视觉搜索策略的改进进展相似但不完全相同。
