Effects of eye movement modeling examples on adaptive expertise in medical image diagnosis

Research indicates that expert performance is domain specific and hardly transfers to novel tasks or domains. However, due to technological changes in dynamic work settings, experts sometimes need to adapt and transfer their skills to new task affordances. The present mixed method study investigates whether eye movement modeling examples (EMME) can promote adaptive expertise in medical image diagnosis. Performance, eye tracking, and think-aloud protocol data were obtained from nine medical experts and fourteen medical students. Participants interpreted dynamic visualizations before (baseline) and after (retention, transfer) viewing an expert model's eye movements. Findings indicate that studying eye movement modeling examples had positive effects on performance, task-relevant fixations, and the use of cognitive and metacognitive comprehension strategies. Effects were stronger for the retention than for the transfer task. Medical experts benefitted more from the modeling examples than did medical students. Directions for future research and implications for related domains are discussed.

[1]  Lúcia Pombo,et al.  Academic domains as political battlegrounds , 2017 .

[2]  Damien Litchfield,et al.  Worth a quick look? Initial scene previews can guide eye movements as a function of domain-specific expertise but can also have unforeseen costs. , 2016, Journal of experimental psychology. Human perception and performance.

[3]  Mitsuru Ikeda,et al.  Interactions of perceptual and conceptual processing: Expertise in medical image diagnosis , 2008, Int. J. Hum. Comput. Stud..

[4]  Daniel L. Schwartz,et al.  EFFICIENCY AND INNOVATION IN TRANSFER , 2005 .

[5]  Anna Siewiorek,et al.  Leading to win: the influence of leadership styles on team performance during a computer game training , 2010, ICLS.

[6]  Halszka Jarodzka,et al.  In my mind: how situation awareness can facilitate expert performance and foster learning , 2015, Medical education.

[7]  K. Hakkarainen,et al.  Understanding Learning for the Professions: How Theories of Learning Explain Coping with Rapid Change , 2014 .

[8]  R. Säljö,et al.  Assessing the Quality of Expertise Differences in the Comprehension of Medical Visualizations , 2013 .

[9]  Jan-Willem Strijbos,et al.  Content analysis: What are they talking about? , 2006, Comput. Educ..

[10]  Richard E. Mayer,et al.  Cognitive Theory of Multimedia Learning , 2021, The Cambridge Handbook of Multimedia Learning.

[11]  Mark R. Wilson,et al.  Psychomotor control in a virtual laparoscopic surgery training environment: gaze control parameters differentiate novices from experts , 2010, Surgical Endoscopy.

[12]  E. Krupinski,et al.  Computer-displayed eye position as a visual aid to pulmonary nodule interpretation. , 1990, Investigative radiology.

[13]  Andreas Gegenfurtner,et al.  Transfer of expertise: An eye tracking and think aloud study using dynamic medical visualizations , 2013, Comput. Educ..

[14]  Andreas Gegenfurtner,et al.  The challenges of studying visual expertise in medical image diagnosis , 2017, Medical education.

[15]  G. Hatano,et al.  TWO COURSES OF EXPERTISE , 1984 .

[16]  T. Gog,et al.  Learning to see: Guiding students' attention via a Model's eye movements fosters learning , 2013 .

[17]  H. Gruber,et al.  Eye tracking in Educational Science: Theoretical frameworks and research agendas. , 2017, Journal of eye movement research.

[18]  Richard E. Mayer,et al.  The Cambridge Handbook of Multimedia Learning: Cognitive Theory of Multimedia Learning , 2005 .

[19]  Kevin W. Eva,et al.  The Cambridge Handbook of Expertise and Expert Performance: Expertise in Medicine and Surgery , 2006 .

[20]  Richard E. Mayer,et al.  Problem-solving transfer. , 1996 .

[21]  Marko Seppanen Modern imaging of multiple myeloma. , 2008, Acta radiologica.

[22]  M. McHugh Interrater reliability: the kappa statistic , 2012, Biochemia medica.

[23]  Andreas Gegenfurtner,et al.  Visual expertise and the Quiet Eye in sports – comment on Vickers , 2016 .

[24]  K. A. Ericsson,et al.  Long-term working memory. , 1995, Psychological review.

[25]  Andreas Gegenfurtner,et al.  Neural correlates of visual perceptual expertise: Evidence from cognitive neuroscience using functional neuroimaging , 2017 .

[26]  Marko Seppänen,et al.  Modern imaging of multiple myeloma , 2008 .

[27]  Andreas Gegenfurtner,et al.  Digital simulation-based training: A meta-analysis , 2014, Br. J. Educ. Technol..

[28]  Paul J. Feltovich,et al.  Expertise in context: human and machine , 1997 .

[29]  J. V. van Merriënboer,et al.  Expertise in clinical pathology: combining the visual and cognitive perspective , 2015, Advances in health sciences education : theory and practice.

[30]  Andreas Gegenfurtner,et al.  Reflections on Empirical and Methodological Accounts of Agency at Work , 2017 .

[31]  Andreas Gegenfurtner,et al.  Toward a unified model of motivation for training transfer: a phase perspective , 2015 .

[32]  T. Crawford,et al.  Viewing another person's eye movements improves identification of pulmonary nodules in chest x-ray inspection. , 2010, Journal of experimental psychology. Applied.

[33]  Kenneth Holmqvist,et al.  Visual expertise in paediatric neurology. , 2012, European journal of paediatric neurology : EJPN : official journal of the European Paediatric Neurology Society.

[34]  H. Jarodzka,et al.  Expertise under the microscope: processing histopathological slides , 2014, Medical education.

[35]  R. Säljö,et al.  Traditional microscopy instruction versus process-oriented virtual microscopy instruction: a naturalistic experiment with control group , 2011, Diagnostic pathology.

[36]  Elizabeth A Krupinski,et al.  Current perspectives in medical image perception , 2010, Attention, perception & psychophysics.

[37]  Andreas Gegenfurtner,et al.  Measuring physician cognitive load: validity evidence for a physiologic and a psychometric tool , 2016, Advances in Health Sciences Education.

[38]  Tamara van Gog,et al.  Example-based learning: effects of model expertise in relation to student expertise. , 2010, The British journal of educational psychology.

[39]  Ellen M. Kok Developing visual expertise: from shades of grey to diagnostic reasoning in radiology , 2016 .

[40]  Andreas Gegenfurtner,et al.  Motivation to transfer revisited , 2010, ICLS.

[41]  Andreas Gegenfurtner,et al.  Capturing Individual and Institutional Change: Exploring Horizontal versus Vertical Transitions in Technology-Rich Environments , 2009, EC-TEL.

[42]  Eckart Altenmüller,et al.  Adaptations During the Acquisition of Expertise , 2010 .

[43]  Ulrike Cress,et al.  Learning in the Synergy of Multiple Disciplines, 4th European Conference on Technology Enhanced Learning, EC-TEL 2009, Nice, France, September 29 - October 2, 2009, Proceedings , 2009, EC-TEL.

[44]  A. Gegenfurtner,et al.  Voluntary or Mandatory Training Participation as a Moderator in the Relationship between Goal Orientations and Transfer of Training , 2016 .

[45]  Slava Kalyuga,et al.  The Expertise Reversal Effect is a Variant of the More General Element Interactivity Effect , 2017 .

[46]  Jenny Gavriel Cognitive apprenticeship , 2015, Education for primary care : an official publication of the Association of Course Organisers, National Association of GP Tutors, World Organisation of Family Doctors.

[47]  Andreas Gegenfurtner,et al.  Seeing through a teacher’s eyes improves students’ imaging interpretation , 2012, Medical education.

[48]  Tom Fawcett,et al.  An introduction to ROC analysis , 2006, Pattern Recognit. Lett..

[49]  Raymond Bertram,et al.  The Effect of Expertise on Eye Movement Behaviour in Medical Image Perception , 2013, PloS one.

[50]  T. Gog,et al.  In the eyes of the beholder: How experts and novices interpret dynamic stimuli , 2010 .

[51]  B. Velichkovsky Communicating attention: Gaze position transfer in cooperative problem solving , 1995 .

[52]  R. Säljö,et al.  Expertise Differences in the Comprehension of Visualizations: a Meta-Analysis of Eye-Tracking Research in Professional Domains , 2011 .

[53]  P. Feltovich,et al.  Issues of expert flexibility in contexts characterized by complexity and change , 1997 .

[54]  H. Haider,et al.  Eye movement during skill acquisition: More evidence for the information-reduction hypothesis , 1999 .

[55]  Andreas Gegenfurtner Transitions of Expertise , 2013 .

[56]  K. Scheiter,et al.  Conveying clinical reasoning based on visual observation via eye-movement modelling examples , 2012, Instructional Science.

[57]  K. A. Ericsson,et al.  Deliberate practice and the acquisition and maintenance of expert performance in medicine and related domains. , 2004, Academic medicine : journal of the Association of American Medical Colleges.

[58]  A. Gegenfurtner,et al.  Transfer of training: New conceptualizations through integrated research perspectives , 2013 .

[59]  Katharina Scheiter,et al.  Attention guidance during example study via the model's eye movements , 2009, Comput. Hum. Behav..

[60]  Andreas Gegenfurtner,et al.  Methodologies for Studying Visual Expertise , 2017 .

[61]  Lieven Verschaffel,et al.  Design of the Game-Based Learning Environment “Dudeman & Sidegirl: Operation Clean World,” a Numerical Magnitude Processing Training , 2015 .

[62]  Anand K. Gramopadhye,et al.  Evaluation of the effect of feedforward training displays of search strategy on visual search performance , 2006 .

[63]  Erno Lehtinen,et al.  Describing and Studying Domain-Specific Serious Games: Introduction , 2015 .

[64]  Anna Siewiorek,et al.  The effects of computer-simulation game training on participants' opinions on leadership styles , 2013, Br. J. Educ. Technol..

[65]  Patrik Pluchino,et al.  Eye-movement modeling of integrative reading of an illustrated text: Effects on processing and learning , 2015 .

[66]  Alan Kennedy,et al.  Book Review: Eye Tracking: A Comprehensive Guide to Methods and Measures , 2016, Quarterly journal of experimental psychology.