Eye gaze patterns differentiate novice and experts in a virtual laparoscopic surgery training environment

Visual information is important in surgeons' manipulative performance especially in laparoscopic surgery where tactual feedback is less than in open surgery. The study of surgeons' eye movements is an innovative way of assessing skill, in that a comparison of the eye movement strategies between expert surgeons and novices may show important differences that could be used in training. We conducted a preliminary study comparing the eye movements of 5 experts and 5 novices performing a one-handed aiming task on a computer-based laparoscopic surgery simulator. The performance results showed that experts were quicker and generally committed fewer errors than novices. We investigated eye movements as a possible factor for experts performing better than novices. The results from eye gaze analysis showed that novices needed more visual feedback of the tool position to complete the task than did experts. In addition, the experts tended to maintain eye gaze on the target while manipulating the tool, whereas novices were more varied in their behaviours. For example, we found that on some trials, novices tracked the movement of the tool until it reached the target.