利用眼动追踪技术评估超声引导区域麻醉的操作熟练度
Eye-Tracking Technology to Determine Procedural Proficiency in Ultrasound-Guided Regional Anesthesia.
作者信息
Andrew Wright G, Patel Rahool, Perez-Edgar Koraly, Fu Xiaoxue, Brown Kayla, Adhikary Sanjib, Zurca Adrian
机构信息
is a medical student; is a medical student; is a Professor of Anesthesiology and Perioperative Medicine; is an Associate Professor of Pediatrics at Penn State College of Medicine, Milton S. Hershey Medical Center, Hershey, PA.
is a Professor of Child Studies and Professor of Psychology; is a graduate student in the Developmental Psychology program at The Pennsylvania State University, Department of Psychology, University Park, PA.
出版信息
J Educ Perioper Med. 2022 Jan 1;24(1):E684. doi: 10.46374/volxxiv_issue1_zurca. eCollection 2022 Jan-Mar.
BACKGROUND
Eye-tracking measures attention patterns, which may offer insight into evaluating procedural expertise. The purpose of this study was to determine the feasibility of using eye tracking to assess visual fixation patterns when performing an ultrasound-guided regional anesthesia procedure and to assess for differences between experienced, intermediate, and novice practitioners.
METHODS
Participants performed an ultrasound-guided sciatic nerve block 3 times on a fresh cadaver model while wearing eye-tracking glasses. Gaze fixation and dwell time on each location were compared between participants. Eye-gaze paths were used to derive a measure of entropy, or how often participants switched gaze fixations between locations.
RESULTS
Five attending anesthesiologists, 5 third-year anesthesiology residents with prior ultrasound-guided regional anesthesia experience, and 5 medical students completed the study. Individuals with more experience were more likely to successfully perform the sciatic nerve block (5/5 attendings, 5/5 residents, 0/5 students; = .002) and performed the procedure faster (average: attendings 62.6 seconds, residents 106.4 seconds, students 134.4 seconds; = .089). Participants were progressively faster with practice (Trial 1: 41.8 seconds, Trial 2: 29.2 seconds, Trial 3: 28.9 seconds; = .012), and the average number of eye shifts per trial decreased from 10.8 to 6.5 to 6 ( = .010). Attending physicians spent significantly less time fixating on the ultrasound monitor compared to trainees ( = .035). Average visual entropy progressively decreased from Trial 1 to Trial 3 ( = .03) and with greater experience ( = .15). There was a strong correlation between entropy and time on task (r(16) = 0.826, = .001).
CONCLUSIONS
Experienced providers make fewer back-and-forth visual fixations, spend less time in the procedure, and demonstrate less entropy during ultrasound-guided regional anesthesia procedures. Mobile eye-tracking has the potential to provide additional objective measures of performance that may help not only determine procedural competence but also distinguish between levels of proficiency.
背景
眼动追踪可测量注意力模式，这可能有助于深入了解程序性专业技能的评估。本研究的目的是确定在进行超声引导下区域麻醉操作时使用眼动追踪评估视觉注视模式的可行性，并评估经验丰富、中级和新手从业者之间的差异。
方法
参与者在佩戴眼动追踪眼镜的同时，在新鲜尸体模型上进行3次超声引导下坐骨神经阻滞。比较参与者在每个位置的注视固定和停留时间。眼动路径用于得出熵的测量值，即参与者在不同位置之间切换注视固定的频率。
结果
5名主治麻醉医师、5名有超声引导下区域麻醉经验的三年级麻醉住院医师和5名医学生完成了研究。经验更丰富的个体更有可能成功进行坐骨神经阻滞（5/5名主治医生，5/5名住院医师，0/5名学生；P = 0.002），且操作速度更快（平均：主治医生62.6秒，住院医师106.4秒，学生134.4秒；P = 0.089）。参与者通过练习逐渐加快速度（试验1：41.8秒，试验2：29.2秒，试验3：28.9秒；P = 0.012），每次试验的平均眼动次数从10.8次降至6.5次再降至6次（P = 0.010）。与实习生相比，主治医生在超声监视器上的注视时间明显更短（P = 0.035）。平均视觉熵从试验1到试验3逐渐降低（P = 0.03），且随着经验增加而降低（P = 0.15）。熵与任务时间之间存在很强的相关性（r(16) = 0.826，P = 0.001）。
结论
经验丰富的从业者在超声引导下区域麻醉操作过程中，来回视觉注视次数更少，操作时间更短，熵更低。移动眼动追踪有可能提供额外的客观性能指标，这不仅有助于确定操作能力，还能区分熟练程度。
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