Training focal lung pathology detection using an eye movement modeling example.

Purpose: Published reports suggest that nonoptimal visual search behavior is associated with false negatives in chest x-ray interpretation. Eye movement modeling example (EMME)-based training interventions, that is, interventions showing models of visual search to trainees, have been shown to improve visual search as well as task accuracy. Approach: We examined the detection of focal lung pathology on chest x-rays before and after two different EMME training interventions that have been shown to be efficient: (i) an EMME showing moving fixations on a blurred background (spotlight group) and (ii) an EMME showing moving fixations on a nonblurred background (circle group). These two experimental groups were compared to a control group that was only provided with the correct location of pathologies on the chest x-rays. Results: Performance outcomes showed improved detection sensitivity and specificity in all groups (also the control group). It appears that repetitive exposure to pathologies on chest x-rays with feedback resulted in enhanced pattern recognition. In addition, visual search strategies became more efficient during post-tests. Conclusion: Repetitive exposure to a focal lung pathology detection task with feedback improves overall performance. However, the specific EMME training interventions did not add any further advantages. Similar training interventions can be provided online to assess feasibility and reproducibility of such (or similar) training formats. Such training can, for example, reduce the number of false negative errors, especially for novices.

Gaze Behavior of Referees in Sport-A Review.

The purpose of this review was to examine the literature on gaze behavior in referees. A literature search found only 12 relevant studies. Five of those studies were conducted on referees in association football (soccer), three on judges in gymnastics, one on softball umpires, and one each on referees in team handball, rugby, and ice hockey. Seven studies reported differences in gaze behavior between referees of a higher skill level and those of a lower skill level, while four studies found no differences. In addition, five studies reported differences between referees of different skill levels in both gaze behavior and performance, while four studies found differences in performance only. A number of methodological concerns arise from the current review. Among them are the lack of studies conducted in ecologically valid conditions, the lack of studies on peripheral vision, and the lack of data on referees who are working together as teams. Based on this review, we conclude that additional research is needed to clarify the relationships between gaze behavior and performance in refereeing. Practitioners who work with referees should be cautious when adopting gaze training strategies to improve selective attention, since the data on their effectiveness are scarce and sometimes contradictory.

Focal lung pathology detection in radiology: Is there an effect of experience on visual search behavior?

In radiology, 60% to 80% of diagnostic errors are perceptual. The use of more efficient visual search behaviors is expected to reduce these errors. We collected eye-tracking data from participants with different levels of experience when interpreting chest X-rays during the completion of a pathology-detection task. Eye-tracking measures were assessed in the context of three existing visual search theories from the literature to understand the association between visual search behavior and underlying processes: the long-term working memory theory, the information-reduction hypothesis, and the holistic model of image perception. The most experienced participants (radiology residents) showed the highest level of performance, albeit their visual search behaviors did not differ from the intermediate group. This suggests that radiology residents better processed the represented information on the X-ray, using a visual search strategy similar to the intermediate group. Since similar visual search resulted in more information extraction in the radiology residents compared with the intermediates, we suggest that this result might support the long-term working memory theory. Furthermore, compared with novices, intermediates and radiology residents fixated longer on areas that were more important to avoid missing any pathology, which possibly confirms the information-reduction hypothesis. Finally, the larger distances between fixations observed in more experienced participants could support the holistic model of image perception. In addition, measures of generic skills were related to a lower time cost for switching between global and local information processing. Our findings suggest that the three theories may be complementary in chest X-ray interpretation. Therefore, a unified theory explaining perceptual-cognitive superiority in radiology is considered.

The relationship between gaze behavior, expertise, and performance: A systematic review.

Perceptual-cognitive skills enable an individual to integrate environmental information with existing knowledge to be able to process stimuli and execute appropriate responses on complex tasks. Various underlying processes could explain how perceptual-cognitive skills impact on expert performance, as articulated in three theoretical accounts: (a) the long-term working memory theory, which argues that experts are able to encode and retrieve visual information from long-term working memory more than less experienced counterparts; (b) the information-reduction hypothesis, which suggests that experts can optimize the amount of information processed by selectively allocating their attentional resources to task relevant stimuli and ignore irrelevant stimuli; and (c) the holistic model of image perception, which proposes that experts are able to extract visual information from distal and para-foveal regions, allowing more efficient global-local processing of the scene. In this systematic review, we examine the validity of the aforementioned theories based on gaze features associated with the proposed processes. The information-reduction hypothesis was supported in most studies, except in medicine where the holistic model of image perception garners stronger support. These results indicate that selectively allocating attention toward important task-related information is the most important skill developed in experts across domains, whereas expertise in medicine is reflected more in an extended visual span. Large discrepancies in the outcomes of the papers reviewed suggest that there is not one theory that fits all domains of expertise. The review provides some essential building blocks, however, to help synthesize theoretical concepts across expertise domains. (PsycINFO Database Record (c) 2019 APA, all rights reserved).

Does effective gaze behavior lead to enhanced performance in a complex error-detection cockpit task?

The purpose of the current study was to examine the relationship between expertise, performance, and gaze behavior in a complex error-detection cockpit task. Twenty-four pilots and 26 non-pilots viewed video-clips from a pilot's viewpoint and were asked to detect malfunctions in the cockpit instrument panel. Compared to non-pilots, pilots detected more malfunctioning instruments, had shorter dwell times on the instruments, made more transitions, visited task-relevant areas more often, and dwelled longer on the areas between the instruments. These results provide evidence for three theories that explain underlying processes for expert performance: The long-term working memory theory, the information-reduction hypothesis, and the holistic model of image perception. In addition, the results for generic attentional skills indicated a higher capability to switch between global and local information processing in pilots compared to non-pilots. Taken together, the results suggest that gaze behavior as well as other generic skills may provide important information concerning underlying processes that can explain successful performance during flight in expert pilots.

To mirror or not to mirror upon mutual gaze, oxytocin can pave the way: A cross-over randomized placebo-controlled trial.

The eyes constitute a highly salient cue to communicate social intent. Previous research showed that direct eye contact between two individuals can readily evoke an increased propensity to 'mirror' other peoples' actions. Considering the implicated role of the prosocial neuropeptide oxytocin (OXT) in enhancing the saliency of social cues and modulating approach/avoidance motivational tendencies, the current study adopted the non-invasive brain stimulation technique transcranial magnetic stimulation (TMS) to explore whether a single dose of intranasal OXT (24 IU) modulated (enhanced) a person's propensity to show heightened mirroring or motor resonance upon salient social cues, such as eye contact. The study involved a double-blind, placebo-controlled, cross-over trial with twenty-seven healthy adult men (19-32 y). By applying single-pulse TMS over the primary motor cortex during movement observation, it was shown that motor resonance was significantly higher when movement observation was accompanied by direct, compared to averted gaze, but that a single dose of OXT did not uniformly enhance this effect. Significant moderations of the treatment effect were noted however, indicating that participants with high self-reports of attachment avoidance displayed a stronger OXT-treatment effect (enhancement of motor resonance upon direct eye contact), compared to participants with low attachment avoidance. Particularly, while participants with high attachment avoidance initially displayed a reduced propensity to increase their motor resonance upon direct eye contact, a single dose of OXT was able to promote an otherwise avoidant individual's propensity to engage in motor resonance upon a salient social cue such as eye contact.