Eye-tracking technology in medical education: A systematic review

Abstract

Background: Eye-tracking technology is an established research tool within allied industries such as advertising, psychology and aerospace. This review aims to consolidate literature describing the evidence for use of eye-tracking as an adjunct to traditional teaching methods in medical education.

Methods: A systematic literature review was conducted in line with STORIES guidelines. A search of EMBASE, OVID MEDLINE, PsycINFO, TRIP database, and Science Direct was conducted until January 2017. Studies describing the use of eye-tracking in the training, assessment, and feedback of clinicians were included in the review.

Results: Thirty-three studies were included in the final qualitative synthesis. Three studies were based on the use of gaze training, three studies on the changes in gaze behavior during the learning curve, 17 studies on clinical assessment and six studies focused on the use of eye-tracking methodology as a feedback tool. The studies demonstrated feasibility and validity in the use of eye-tracking as a training and assessment method.

Conclusions: Overall, eye-tracking methodology has contributed significantly to the training, assessment, and feedback practices used in the clinical setting. The technology provides reliable quantitative data, which can be interpreted to give an indication of clinical skill, provide training solutions and aid in feedback and reflection. This review provides a detailed summary of evidence relating to eye-tracking methodology and its uses as a training method, changes in visual gaze behavior during the learning curve, eye-tracking methodology for proficiency assessment and its uses as a feedback tool.

Disclosure statement

The authors report no conflicts of interest. The authors alone are responsible for the content and writing of the article.

Glossary

Fixation: The point between any two saccades, during which eyes are relatively stationary and virtually all visual input occurs. A dwell time between 200 and 250 ms is also used to characterize a fixation.

Saccade: The rapid motion of the eye from one fixation to another.

Dwell time: The sum of all fixation and saccade durations within one area of interest.

Notes on contributors

Hajra Ashraf, MBBS, is a PhD Student at the Department of Surgery and Cancer, Imperial College, St Mary's Hospital, London, United Kingdom.

Nabeel Merali, MBBS, MSc, MRCS, is a Specialist Registrar, Frimley NHS Trust, Surrey, United Kingdom.

Mikael Sodergren, MBChB, DIC, PhD, FRCS, is a Clinical lecturer and co-supervisor to Hajra Ashraf, Department of Surgery and Cancer, Imperial College, St Mary's Hospital, London, United Kingdom.

George Mylonas, BEng, MSc, PhD, is a Clinical lecturer and co-supervisor to Hajra Ashraf, Department of Surgery and Cancer, Imperial College, St Mary's Hospital, London, United Kingdom.

Harsimrat Singh, BTech, MTech, PhD, is a Data Analyst at the Big Data Unit, Department of Surgery and Cancer, Imperial College, St Mary's Hospital, London, United Kingdom.

Ara Darzi, OM, KBE, PC, FRS, FMedSci, FRCSI, FRCS, FRCSE, FRCPGlas, FACS, FRCP, FREng, is a Professor of surgery and supervisor to Hajra Ashraf, Department of Surgery and Cancer, Imperial College, St Mary's Hospital, London, United Kingdom.