The goal of this study was to examine and characterize changes in the ways that pathology residents examine digital or "virtual" slides as they gain more experience. A series of 20 digitized breast biopsy virtual slides (half benign and half malignant) were shown to 6 pathology residents at three points in time - at the beginning of their first year of residency, at the beginning of the second year, and at the beginning of the third year. Their task was to examine each image and select three areas that they would most want to zoom on in order to view the diagnostic detail at higher resolution. Eye position was recorded as they scanned each image. The data indicate that with each successive year of experience, the residents' search patterns do change. Overall 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 non-diagnostic areas. Essentially, the residents' search becomes much more efficient and after only one year closely resembles that of an expert pathologist. 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.
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