Eye tracking metrics of orthopedic surgeons with different competency levels who practice simulation-based hip arthroscopic procedures

Objective: This study aimed to investigate the feasibility of using eye tracking data to identify orthopedic trainees' technical proficiency in hip arthroscopic procedures during simulation-based training. Design: A cross sectional study.Setting: A simulation-based training session for hip arthroscopy was conducted. Eye tracking devices were used to record participants' eye movements while performing simulated operations. The NASA Task Load Index survey was then used to measure subjective opinions on the perceived workload of the training. Statistical analyses were performed to determine the significance of the eye metrics and survey data.Participants: A total of 12 arthroscopic trainees, including resident doctors, junior specialist surgeons, and consultant surgeons from the Department of Orthopedics in five hospitals, participated in this study. They were divided into three subgroups based on their prior clinical experience.Results: Significant differences, including those for dwell time, number of fixations, number of saccades, saccade duration, peak velocity of the saccade, and pupil entropy, were observed among the three subgroups. Addi-tionally, there were clear trends in the perceived workload of the simulation-based training based on feedback from the participants.Conclusion: Based on this preliminary study, a correlation was identified between the eye tracking metrics and participants' experience levels. Hence, it is feasible to apply eye tracking data as a supplementary objective assessment tool to benchmark the technical proficiency of surgical trainees in hip arthroscopy, and enhance simulation-based training.