Saccadic Eye Movement Metrics Reflect Surgical Residents' Fatigue

Stasi, Leandro L. Di; McCamy, Michael B.; Macknik, Stephen L.; Mankin, James A.; Hooft, Nicole; Catena, Andrés; Martínez-Conde, Susana

doi:10.1097/sla.0000000000000260

Cited by 81 publications

(66 citation statements)

References 66 publications

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“…Specifically, in surgical scenarios, gaze metrics have been used to quantify surgical skills [25][26][27], to study differences between novice and expert surgeons [21,28,29], and to analyze surgeon' scanning behavior [30,31]. Previous studies have also tried to relate surgical task load to gaze metrics using indirect relationships, as those mediated by surgeon's expertise [21] or time-on-task [19]. To date, however, no studies have considered the direct relationship between gaze-based metrics and surgical task load, by manipulating the objective complexity of the task (see Ref.…”

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confidence: 98%

“…When compared with other eye metrics, such as pupil response [21,27,36], gaze entropy offers the advantage that the measured value does not depend on external factors such as environmental light or emotional state [37,38]. Furthermore, unlike other sensitive indices, as saccadic (fastest movement of the eye) velocity [19], gaze entropy does not rely on intrusive and bulky eye tracking systems for the acquisition of its signals [34,39]. Thus, gaze entropy could be measured with mobile and wearable eye trackers (e.g., small-framed glasses eye trackers) which are robust to head movements and changes in ambient illumination, and, most importantly, are easy and comfortable to use.…”

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confidence: 99%

“…Computer-based methods have very limited applicability outside expensive simulation laboratories [16,17]. Thus, the development of objective and feasible systems to assess surgical task load remains a major challenge in the healthcare field [18,19].…”

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Gaze entropy reflects surgical task load

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“…While nine of the included studies showed a detrimental impact of fatigue on technical performance, [17][18][19][20][21][22][23][24][25] nine further studies had findings that showed no impact of fatigue. [26][27][28][29][30][31][32][33][34] A reversed action of fatigue that can lead to improvement in task performance has been described in the literature, 37 so it is interesting to note that the same phenomenon was noted in one of the studies. 28 An exploration of the circumstances that produced this finding, and studying its sustainability may enhance clinicians daily practice.…”

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confidence: 83%

“…Di Stasi et al used the FLS trainer but also aimed to determine if saccadic eye movement metrics would reflect fatigue in surgical residents. 34 To perform the assessment, 12 surgical residents wore a head-mounted video eye tracking device while performing simulated laparoscopic surgery tasks throughout their shifts. The study found that a longer time on duty led to decreased saccadic velocity (P=0.04), but no difference in simulated laparoscopic surgery performance.…”

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Assessment of surgeon fatigue by surgical simulators

Tuwairqi¹,

Selter²,

Sikder³

2015

OAS

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Background:The impact of fatigue on surgical performance and its implications for patient care is a growing concern. While investigators have employed a number of different tools to measure the effect of fatigue on surgical performance, the use of the surgical simulator has been increasingly implemented for this purpose. The goal of this paper is to review the published literature to achieve a better understanding of evaluation of fatigue on performance as studied with surgical simulators. Methods: A PubMed and Cochrane search was conducted using the search terms "simulator", "surgery", and "fatigue". In total, 50 papers were evaluated, and 20 studies were selected after application of exclusion criteria. Articles were excluded if they did not use the simulator to assess the impact of fatigue on surgeon performance. Systematic reviews and case reports were also excluded. Results: Surgeon fatigue led to a consistent decline in cognitive function in six studies. Technical skills were evaluated in 18 studies, and a detrimental impact was reported in nine studies, while the remaining nine studies showed either no change or positive results with regard to surgical skills after experience of fatigue. Two pharmacological intervention studies reversed the detrimental impact of fatigue on cognitive function, but no change or a worsening effect was recognized for technical skills. Conclusion: Simulators are increasingly being used to evaluate the impact of fatigue on the surgeon's performance. With regard to the impact of fatigue in this regard, studies have demonstrated a consistent decline in cognitive function and mixed outcomes for technical skills. Larger studies that relate the simulator's results to real surgical outcomes could help residency programs and policy makers in structuring more efficient training.

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Effect of disparity and viewing ambient illumination on stereoscopic viewing: An eye movement approach

Liu

2018

J Soc Info Display

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Researchers have found that factors related to viewing content and viewing environment could influence viewers' stereoscopic viewing experiences. In this paper, the effect of both disparity and viewing ambient illumination condition on stereoscopic viewing was investigated by using an eye movement approach. The eye movement responses to random dot stereograms (RDS) stimuli in stereoscopic viewing were studied by performing a fusion range measurement experiment involving a judgment task. The fusion ranges under two ambient illumination conditions, eye movement responses to RDS stimuli and effects of disparity on eye movement parameters, were analyzed, respectively. The experimental results showed that fusion range under two ambient illumination conditions were different, and changes of eye movement parameters were different among various disparities when ambient illumination conditions varied. As a result, in order to improve viewers' viewing experiences when viewing different 3D contents, the arrangement of viewing ambient illumination conditions and the selection of disparity should be appropriately considered. The findings in this paper provide guidelines to reasonably arrange the viewing ambient illumination condition and efficiently produce healthy disparity in stereoscopic viewing.

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Saccadic Eye Movement Metrics Reflect Surgical Residents' Fatigue

Cited by 81 publications

References 66 publications

Gaze entropy reflects surgical task load

Gaze entropy reflects surgical task load

Assessment of surgeon fatigue by surgical simulators

Effect of disparity and viewing ambient illumination on stereoscopic viewing: An eye movement approach

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