The Influence of Experience on Gazing Patterns during Endovascular Treatment: Eye-Tracking Study

Objective: In various fields, differences in eye-gazing patterns during tasks between experts and novices have been evaluated. The aim of this study was to investigate gazing patterns during neuro-endovascular treatment using an eyetracking device and assess whether gazing patterns depend on the physician's experience or skill. Methods: Seven physicians performed coil embolization for a cerebral aneurysm in a silicone vessel model under biplane X-ray fluoroscopy, and their gazing patterns were recorded using an eye-tracking device. The subjects were divided into three groups according to experience, highly experienced (Expert) group, intermediately experienced (Trainee) group, and less experienced (Novice) group. The duration of fixation on the anterior-posterior (AP) view screen, lateral (LR) view, and out-of-screen were compared between each group. Results: During microcatheter navigation, the Expert and Trainee groups spent a long time on fixation to AP, while the Novice group split their attention between each location. In coil insertion, the Expert group gazed at both the AP and the LR views with more saccades between screens. In contrast, the Trainee group spent most of their time only on the AP view screen and the Novice group spent longer out-of-screen. Conclusion: An eye-tracking device can detect different gazing patterns among physicians with several experiences and skill levels of neuroendovascular treatment. Learning the gazing patterns of experts using eye tracking may be a good educational tool for novices and trainees.