title: E-tutorial improves students' ability to detect lesions.
abstract: OBJECTIVE
  This Australian study explores the effects of an educational intervention on first-year medical radiation sciences (MRS) students by examining eye-tracking metrics while they attempted to detect breast lesions on radiologic images before and after an e-learning tutorial. The study also analyzes performance using receiver operating characteristic methodology.
  
  
  METHODS
  Fourteen first-year MRS students were equally and randomly assigned to a control or experiment group to participate in 2 image-detection sessions. The experiment group completed an online e-learning tutorial between sessions. Eighty mammographic breast images from 20 cases were obtained from a validated online image bank. Of those 20 cases, 30% were normal and 70% demonstrated a single-lesion abnormality.
  
  
  RESULTS
  The experiment group demonstrated a 45% increase in the mean number of fixations per case (P = .047), with a 30% increase in sensitivity (P = .022) following the tutorial. The experiment group also demonstrated improved lesion detection overall and a 49% decrease in mean time to first fixation on the lesion (P = .016).
  
  
  CONCLUSIONS
  This study demonstrates that increased lesion detection is possible after a brief e-learning tutorial. Early changes in the viewing patterns of less-experienced technologists are intriguing, and explanation may be gained from our current understanding of radiologic perception and cognitive neuroscience. The task for the first-year MRS students in this study was only to positively detect a lesion, and we recognize that a higher level of visual processing would be required to critique image quality. Exposure to the brief tutorial, however, might have triggered some learning-related neural changes at an early level of visual processing, representing stimuli relating to task performance.
  
  
  CONCLUSIONS
  Participants in the experiment group improved their ability to identify breast lesions, which coincided with changes in eye position metrics and error type analysis. The data presented here suggest that the intervention resulted in a significant improvement in detection by the experiment group.
authors.forename: BaoLin Pauline
authors.initials: BP
authors.lastname: Soh
authors.forename: Warren Michael
authors.initials: WM
authors.lastname: Reed
authors.forename: Ann
authors.initials: A
authors.lastname: Poulos
authors.forename: Patrick C
authors.initials: PC
authors.lastname: Brennan
mesh_terms: D001315:Australia; D001943:Breast Neoplasms / Q000000981:diagnostic imaging*; D003194:Computer-Assisted Instruction / Q000706:statistics & numerical data*; D004521:Educational Measurement; D005260:Female; D006801:Humans; D008297:Male; D015588:Observer Variation; D011859:Radiography; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D013337:Students, Medical / Q000706:statistics & numerical data*; D013647:Task Performance and Analysis