Expert surgeon's quiet eye and slowing down: expertise differences in performance and quiet eye duration during identification and dissection of the recurrent laryngeal nerve.
BACKGROUND
Long quiet eye (QE) duration is central to expertise in sports, while cognitive "slowing down" has been identified as a perceptual skill possessed by skilled surgeons. Eye-tracking evidence is lacking about the relationship of QE duration to slowing down in surgeons. The aim of this study was to examine QE duration, hand movement time (MT), fixation location, and fixation duration in highly experienced (HE) and less experienced (LE) surgeons.


METHODS
A mobile eye tracker and camera recorded coupled gaze and hand movements. Performance was quantified by blinded review.


RESULTS
HE surgeons were rated higher than LE surgeons but did not differ in operating time or MT. HE and LE surgeons differed in fixation duration on the ligament of Berry during phases 1 and 2 and QE duration on the recurrent laryngeal nerve in phase 2.


CONCLUSIONS
Long-duration fixation on the ligament of Berry and long-duration QE on the recurrent laryngeal nerve combined with no significant differences in MT provide empirical evidence that HE surgeons cognitively slow down more than LE surgeons during critical phases of the operation.
Faculty of Medicine, University of Calgary, Foothills Medical Centre, 1403 29th Street NW, Room 1023 North Tower, Calgary, AB P2N 2T9, Canada.
Adrian
A
Harvey
Faculty of Kinesiology, University of Calgary, Calgary, AB, Canada.
Joan N
JN
Vickers
Faculty of Medicine, University of Calgary, Foothills Medical Centre, 1403 29th Street NW, Room 1023 North Tower, Calgary, AB P2N 2T9, Canada. Electronic address: rsnelgrove@gmail.com.
Ryan
R
Snelgrove
Faculty of Kinesiology, University of Calgary, Calgary, AB, Canada.
Matthew F
MF
Scott
Faculty of Kinesiology, University of Calgary, Calgary, AB, Canada.
Sheila
S
Morrison
D002983:Clinical Competence; D053483:Eye Movement Measurements; D005133:Eye Movements / Q000502:physiology*; D006801:Humans; D010036:Otolaryngology / Q000193:education*; D013517:Otorhinolaryngologic Surgical Procedures / Q000193:education* / Q000592:standards; D010820:Physicians; D011597:Psychomotor Performance; D012009:Recurrent Laryngeal Nerve / Q000601:surgery*; D014743:Videotape Recording
Attention; Expertise; Eye movements; Gaze; Slowing down; Surgical training