title: Quiet eye training improves surgical knot tying more than traditional technical training: a randomized controlled study.
abstract: BACKGROUND
  We examined the effectiveness of technical training (TT) and quiet eye training (QE) on the performance of one-handed square knot tying in surgical residents.
  
  
  METHODS
  Twenty surgical residents were randomly assigned to the 2 groups and completed pretest, training, retention, and transfer tests. Participants wore a mobile eye tracker that simultaneously recorded their gaze and hand movements. Dependent variables were knot tying performance (%), QE duration (%), number of fixations, total movement time (s), and hand movement phase time (s).
  
  
  RESULTS
  The QE training group had significantly higher performance scores, a longer QE duration, fewer fixations, faster total knot tying times, and faster movement phase times compared with the TT group. The QE group maintained performance in the transfer test, whereas the TT group significantly decreased performance from retention to transfer.
  
  
  CONCLUSIONS
  QE training significantly improved learning, retention, and transfer of surgical knot tying compared with a traditional technical approach. Both performance effectiveness (performance outcome) and movement efficiency (hand movement times) were improved using QE modeling, instruction, and feedback.
authors.affiliation: Brain and Behaviour Laboratory, Liverpool John Moores University, Liverpool, UK. Electronic address: j.causer@ljmu.ac.uk.
authors.forename: Joe
authors.initials: J
authors.lastname: Causer
authors.affiliation: Faculty of Medicine, University of Calgary, Calgary, Alberta, Canada.
authors.forename: Adrian
authors.initials: A
authors.lastname: Harvey
authors.affiliation: Faculty of Medicine, University of Calgary, Calgary, Alberta, Canada.
authors.forename: Ryan
authors.initials: R
authors.lastname: Snelgrove
authors.affiliation: Faculty of Kinesiology, University of Calgary, Calgary, Alberta, Canada.
authors.forename: Gina
authors.initials: G
authors.lastname: Arsenault
authors.affiliation: Faculty of Kinesiology, University of Calgary, Calgary, Alberta, Canada.
authors.forename: Joan N
authors.initials: JN
authors.lastname: Vickers
mesh_terms: D000328:Adult; D002983:Clinical Competence; D005260:Female; D005403:Fixation, Ocular / Q000502:physiology*; D013502:General Surgery / Q000193:education*; D006225:Hand / Q000502:physiology; D006801:Humans; D007396:Internship and Residency; D008297:Male; D009068:Movement / Q000502:physiology; D011597:Psychomotor Performance / Q000502:physiology*; D012153:Retention, Psychology; D013536:Suture Techniques / Q000193:education*; D013663:Teaching / Q000379:methods; D055815:Young Adult
keywords: Attention; Expertise; Gaze; Knots; Surgery; Training