Assessing Medical Student Attentional Bias in Unicoronal Craniosynostosis: An Eye-Tracking Study

Objective: Using a well-established measure of attention, we aimed to objectively identify medical students' gaze patterns when assessing children with/without unicoronal craniosynostosis (UCS) and identify potential diagnostic and educational gaps in their assessment. Design: Medical student participants viewed a series of images of children with/without UCS. Eye movements were recorded using a table-mounted eye-tracking device. Dwell times for 8 interest areas (forehead, brow, eyes, nose, lower face, mouth, left ear, right ear) were compared. Participants: Thirty medical students (21 males, 9 females, mean age = 29.9 years old) were recruited from the local medical school. Main Outcome Measure: The main outcome measure was the cumulative dwell times (milliseconds) participants spent within the 8 facial regions (forehead, brow, eyes, nose, lower face, mouth, left ear, right ear). Results: Participants spent significantly more time on the brow region (P < 0.001) and less on the nose region (P < 0.05) when viewing UCS images. Furthermore, there were significantly longer dwell times to the side of the forehead contralateral to the fused suture in UCS images (P < 0.05). In control images, participants focused more on the right side of the mouth (P < 0.05). No other significant differences in dwell times were observed. Conclusion: This study demonstrates that medical students exhibit attentional biases when viewing children with UCS and focus on only some of the asymmetries seen in UCS. These findings highlight potential educational gaps emphasizing the need for targeted training in craniofacial assessment.