title: Dynamic Patterns of Expertise: The Case of Orthopedic Medical Diagnosis.
abstract: The aim of this study was to analyze dynamic patterns for scanning femoroacetabular impingement (FAI) radiographs in orthopedics, in order to better understand the nature of expertise in radiography. Seven orthopedics residents with at least two years of expertise and seven board-certified orthopedists participated in the study. The participants were asked to diagnose 15 anteroposterior (AP) pelvis radiographs of 15 surgical patients, diagnosed with FAI syndrome. Eye tracking data were recorded using the SMI desk-mounted tracker and were analyzed using advanced measures and methodologies, mainly recurrence quantification analysis. The expert orthopedists presented a less predictable pattern of scanning the radiographs although there was no difference between experts and non-experts in the deterministic nature of their scan path. In addition, the experts presented a higher percentage of correct areas of focus and more quickly made their first comparison between symmetric regions of the pelvis. We contribute to the understanding of experts' process of diagnosis by showing that experts are qualitatively different from residents in their scanning patterns. The dynamic pattern of scanning that characterizes the experts was found to have a more complex and less predictable signature, meaning that experts' scanning is simultaneously both structured (i.e. deterministic) and unpredictable.
authors.affiliation: Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.
authors.forename: Dan
authors.identifier: http://orcid.org/0000-0003-2496-4253
authors.initials: D
authors.lastname: Assaf
authors.affiliation: Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.|Orthopedics Division, Tel Aviv Sourasky Medical Center, 6 Weizmann Street, Tel Aviv, Israel.
authors.forename: Eyal
authors.initials: E
authors.lastname: Amar
authors.affiliation: Potsdam Institute for Climate Impact Research, Potsdam, Germany.
authors.forename: Norbert
authors.initials: N
authors.lastname: Marwan
authors.affiliation: Department of Education, Homeland Security Institute, Center for the Study of Conversion and Inter-Religious Encounters, Ben-Gurion University of the Negev, Beer-Sheva, Israel.
authors.forename: Yair
authors.initials: Y
authors.lastname: Neuman
authors.affiliation: Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.|Orthopedics Division, Tel Aviv Sourasky Medical Center, 6 Weizmann Street, Tel Aviv, Israel.
authors.forename: Moshe
authors.initials: M
authors.lastname: Salai
authors.affiliation: Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.|Orthopedics Division, Tel Aviv Sourasky Medical Center, 6 Weizmann Street, Tel Aviv, Israel.
authors.forename: Ehud
authors.initials: E
authors.lastname: Rath
mesh_terms: D000328:Adult; D002983:Clinical Competence / Q000592:standards / Q000706:statistics & numerical data*; D053483:Eye Movement Measurements; D057925:Femoracetabular Impingement / Q000175:diagnosis / Q000000981:diagnostic imaging*; D006801:Humans; D007396:Internship and Residency / Q000592:standards / Q000706:statistics & numerical data; D008297:Male; D000072161:Orthopedic Surgeons / Q000193:education / Q000523:psychology / Q000592:standards / Q000706:statistics & numerical data*; D010818:Practice Patterns, Physicians' / Q000592:standards / Q000706:statistics & numerical data*; D011859:Radiography / Q000523:psychology / Q000592:standards / Q000706:statistics & numerical data*