title: Eye tracking for skills assessment and training: a systematic review.
abstract: BACKGROUND
  The development of quantitative objective tools is critical to the assessment of surgeon skill. Eye tracking is a novel tool, which has been proposed may provide suitable metrics for this task. The aim of this study was to review current evidence for the use of eye tracking in training and assessment.
  
  
  METHODS
  A systematic literature review was conducted in line with PRISMA guidelines. A search of EMBASE, OVID MEDLINE, Maternity and Infant Care, PsycINFO, and Transport databases was conducted, till March 2013. Studies describing the use of eye tracking in the execution, training or assessment of a task, or for skill acquisition were included in the review.
  
  
  RESULTS
  Initial search results returned 12,051 results. Twenty-four studies were included in the final qualitative synthesis. Sixteen studies were based on eye tracking in assessment and eight studies were on eye tacking in training. These demonstrated feasibility and validity in the use of eye tracking metrics and gaze tracking to differentiate between subjects of varying skill levels. Several training methods using gaze training and pattern recognition were also described.
  
  
  CONCLUSIONS
  Current literature demonstrates the ability of eye tracking to provide reliable quantitative data as an objective assessment tool, with potential applications to surgical training to improve performance. Eye tracking remains a promising area of research with the possibility of future implementation into surgical skill assessment.
authors.affiliation: Department of Surgery and Cancer, St Mary's Hospital, Imperial College London, London, UK.
authors.forename: Tony
authors.initials: T
authors.lastname: Tien
authors.affiliation: Department of Surgery and Cancer, St Mary's Hospital, Imperial College London, London, UK.
authors.forename: Philip H
authors.initials: PH
authors.lastname: Pucher
authors.affiliation: Department of Surgery and Cancer, St Mary's Hospital, Imperial College London, London, UK; Hamlyn Centre for Robotic Surgery, Imperial College London, London, UK. Electronic address: m.sodergren@imperial.ac.uk.
authors.forename: Mikael H
authors.initials: MH
authors.lastname: Sodergren
authors.affiliation: Department of Surgery and Cancer, St Mary's Hospital, Imperial College London, London, UK; Hamlyn Centre for Robotic Surgery, Imperial College London, London, UK.
authors.forename: Kumuthan
authors.initials: K
authors.lastname: Sriskandarajah
authors.affiliation: Hamlyn Centre for Robotic Surgery, Imperial College London, London, UK.
authors.forename: Guang-Zhong
authors.initials: GZ
authors.lastname: Yang
authors.affiliation: Department of Surgery and Cancer, St Mary's Hospital, Imperial College London, London, UK; Hamlyn Centre for Robotic Surgery, Imperial College London, London, UK.
authors.forename: Ara
authors.initials: A
authors.lastname: Darzi
mesh_terms: D004503:Education, Medical, Graduate / Q000379:methods*; D004521:Educational Measurement / Q000379:methods*; D005133:Eye Movements; D013502:General Surgery / Q000193:education*; D006801:Humans
keywords: Education; Eye tracking; Learning; Training