Assessing a new teaching method for Point-of-Care Ultrasound

Abstract

Point-of-care ultrasound (POCUS) uses small ultrasound devices that can be used at patients’ bedsides. POCUS can lead to faster diagnoses and treatment but requires extensive training to use effectively. This study evaluated whether eye tracking can differentiate between experts and novice POCUS users to help develop better teaching methods. Ten novices (medical students) and 1 expert (ER physician) had their eye movements recorded while they viewed POCUS lung videos of three different types: Pneumothorax (collapsed lung), Healthy Lung, and Potential False Diagnosis (pseudopneumothorax) to determine the presence of Pneumothorax. The expert had 100% accuracy but the novices’ accuracy did not go above 60%. Novices’ performance was best on the Pneumothorax videos. The expert had high confidence in their decisions while the novices had low to moderate confidence levels. Heat maps showed that the expert had a much more focused gaze on the area of interest (AOI) while novices missed the AOI or had more scattered gaze patterns. This study showed that gaze patterns and accuracy did not always match, where often a participant showed a gaze pattern associated to accuracy but gave an incorrect response, or vice versa. Instead of inferring skill only from gaze, this observation can tell about the specific level of both ultrasound knowledge and visual search strategies, and provide personalized feedback to learners. It also tells expert gaze involves fixating only the correct area, then making the correct diagnostic decision, and novices need training on both to advance towards expertise.