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. 2023 Sep 11;15(1):36.
doi: 10.1186/s13089-023-00333-6.

The association of attentional foci and image interpretation accuracy in novices interpreting lung ultrasound images: an eye-tracking study

Matthew Lee  1 , Janeve Desy  1 , Ana Claudia Tonelli  2 , Michael H Walsh  1 , Irene W Y Ma  3   4
Affiliations

The association of attentional foci and image interpretation accuracy in novices interpreting lung ultrasound images: an eye-tracking study

Matthew Lee et al. Ultrasound J. .

Abstract

It is unclear, where learners focus their attention when interpreting point-of-care ultrasound (POCUS) images. This study seeks to determine the relationship between attentional foci metrics with lung ultrasound (LUS) interpretation accuracy in novice medical learners. A convenience sample of 14 medical residents with minimal LUS training viewed 8 LUS cineloops, with their eye-tracking patterns recorded. Areas of interest (AOI) for each cineloop were mapped independently by two experts, and externally validated by a third expert. Primary outcome of interest was image interpretation accuracy, presented as a percentage. Eye tracking captured 10 of 14 participants (71%) who completed the study. Participants spent a mean total of 8 min 44 s ± standard deviation (SD) 3 min 8 s on the cineloops, with 1 min 14 s ± SD 34 s spent fixated in the AOI. Mean accuracy score was 54.0% ± SD 16.8%. In regression analyses, fixation duration within AOI was positively associated with accuracy [beta-coefficients 28.9 standardized error (SE) 6.42, P = 0.002). Total time spent viewing the videos was also significantly associated with accuracy (beta-coefficient 5.08, SE 0.59, P < 0.0001). For each additional minute spent fixating within the AOI, accuracy scores increased by 28.9%. For each additional minute spent viewing the video, accuracy scores increased only by 5.1%. Interpretation accuracy is strongly associated with time spent fixating within the AOI. Image interpretation training should consider targeting AOIs.

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Conflict of interest statement

The authors declare no competing interests.

Figures

Fig. 1
Fig. 1
Gaze plots of expert (green, top left) and novices (purple) in identifying the presence of a positive spine sign and the pleural effusion. Top right: gaze plot of a novice who scored 0% on the video with minimal gaze on the spine. Bottom left: gaze plot of a different novice who scored 50% on the video. Bottom right: gaze plot of a third novice who correctly identified both findings and scored 100%
Fig. 2
Fig. 2
Scatter plot of image interpretation accuracy score, presented as a precent, vs. total fixation duration within areas of interest (seconds), with fitted line shown in black, and confidence interval for the mean shown in gray
See this image and copyright information in PMC

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