Blink-Based Estimation of Suturing Task Workload and Expertise in Microsurgery

Bednarik, Roman; Koskinen, Jani; Vrzáková, Hana; Bartczak, Piotr; Elomaa, Antti-Pekka

doi:10.1109/cbms.2018.00048

Cited by 4 publications

(5 citation statements)

References 33 publications

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“…In another study, the blink rate was shown to drop to low levels compared to a resting-state rate and be sensitive to the phases of microsurgical suture [164]. In a driving scenario in [163], the eye tracker showed increasing blink rates along with the parallel increase in the difficulty of a -parallel with driving-performed secondary task.…”

Section: Metrics Related To Cognitive Workloadmentioning

confidence: 92%

Review of Eye Tracking Metrics Involved in Emotional and Cognitive Processes

Skaramagkas

Giannakakis

Ktistakis

et al. 2023

IEEE Rev. Biomed. Eng.

119

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Eye behaviour provides valuable information revealing one's higher cognitive functions and state of affect. Although eye tracking is gaining ground in the research community, it is not yet a popular approach for the detection of emotional and cognitive states. In this paper, we present a review of eye and pupil tracking related metrics (such as gaze, fixations, saccades, blinks, pupil size variation, etc.) utilized towards the detection of emotional and cognitive processes, focusing on visual attention, emotional arousal and cognitive workload. Besides, we investigate their involvement as well as the computational recognition methods employed for the reliable emotional and cognitive assessment. The publicly available datasets employed in relevant research efforts were collected and their specifications and other pertinent details are described. The multimodal approaches which combine eye-tracking features with other modalities (e.g. biosignals), along with artificial intelligence and machine learning techniques were also surveyed in terms of their recognition/classification accuracy. The limitations, current open research problems and prospective future research directions were discussed for the usage of eyetracking as the primary sensor modality. This study aims to comprehensively present the most robust and significant eye/pupil metrics based on available literature towards the development of a robust emotional or cognitive computational model.

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Section: Metrics Related To Cognitive Workloadmentioning

confidence: 92%

Review of Eye Tracking Metrics Involved in Emotional and Cognitive Processes

Skaramagkas

Giannakakis

Ktistakis

et al. 2023

IEEE Rev. Biomed. Eng.

119

View full text Add to dashboard Cite

show abstract

“…Lower blink frequency range was associated with higher NASA-TLX ratings during simulated laparoscopic tasks (Zheng et al, 2012). In addition, blink rate was higher for experts than novices during the cutting phase of simulated microsurgery although it did not vary for any of the other phases (Bednarik, Koskinen, Vrzakova, Bartczak, & Elomaa, 2018). However, these studies were limited to basic skills tasks and laparoscopic techniques.…”

Section: Introductionmentioning

confidence: 99%

Eye-Tracking Metrics Predict Perceived Workload in Robotic Surgical Skills Training

Wu¹,

Cha

Sulek

et al. 2019

Hum Factors

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Objective: The aim of this study is to assess the relationship between eye-tracking measures and perceived workload in robotic surgical tasks. Background: Robotic techniques provide improved dexterity, stereoscopic vision, and ergonomic control system over laparoscopic surgery, but the complexity of the interfaces and operations may pose new challenges to surgeons and compromise patient safety. Limited studies have objectively quantified workload and its impact on performance in robotic surgery. Although not yet implemented in robotic surgery, minimally intrusive and continuous eye-tracking metrics have been shown to be sensitive to changes in workload in other domains. Methods: Eight surgical trainees participated in 15 robotic skills simulation sessions. In each session, participants performed up to 12 simulated exercises. Correlation and mixed-effects analyses were conducted to explore the relationships between eye-tracking metrics and perceived workload. Machine learning classifiers were used to determine the sensitivity of differentiating between low and high workload with eye-tracking features. Results: Gaze entropy increased as perceived workload increased, with a correlation of .51. Pupil diameter and gaze entropy distinguished differences in workload between task difficulty levels, and both metrics increased as task level difficulty increased. The classification model using eye-tracking features achieved an accuracy of 84.7% in predicting workload levels. Conclusion: Eye-tracking measures can detect perceived workload during robotic tasks. They can potentially be used to identify task contributors to high workload and provide measures for robotic surgery training. Application: Workload assessment can be used for real-time monitoring of workload in robotic surgical training and provide assessments for performance and learning.

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“…With a custom eye tracker embedded into a surgical microscope, we recorded the blinks and pupil dilations of novice and expert microsurgeons as they performed a set of microsurgical training sutures. In our previous research, 28,29 we found that novices estimated the suturing task to be significantly more demanding than experts and that there are differences in pupil dilations and blink rates between these 2 groups. Here, we extend this research by studying the combined applicability of pupil dilation and blink rate to classify expertise at suture-and segment-level features.…”

Section: Introductionmentioning

confidence: 77%

Combined Gaze Metrics as Stress-Sensitive Indicators of Microsurgical Proficiency

et al. 2020

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Background. Evaluation of microsurgical proficiency is conventionally subjective, time consuming, and unreliable. Eye movement–based metrics have been promising not only in detection of surgical expertise but also in identifying actual cognitive stress and workload. We investigated if pupil dilations and blinks could be utilized in parallel to accurately classify microsurgical proficiency and its moderating features, especially task-related stress. Methods. Participants (n = 11) were divided into groups based on prior experience in microsurgery: novices (n = 6) with no experience and trained microsurgeons (n = 5). All participants conducted standardized suturing tasks with authentic instruments and a surgical microscope. A support vector machine classifier was used to classify features of microsurgical expertise based on percentage changes in pupil size. Results. A total of 109 successful sutures with 1090 segments were recorded. Classification of expertise from sutures achieved accuracies between 74.3% and 76.0%. Classification from individual segments based on these same features was not feasible. Conclusions. Combined gaze metrics are applicable for classifying surgical proficiency during a defined task. Pupil dilation is also sensitive to external stress factors; however, the usefulness of blinks is impaired by low blink rates. The results can be translated to surgical education to improve feedback and should be investigated individually in the context of actual performance and in real patient operations. Combined gaze metrics may be ultimately utilized to help microsurgeons monitor their performance and workload in real time—which may lead to prevention of errors.

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Blink-Based Estimation of Suturing Task Workload and Expertise in Microsurgery

Cited by 4 publications

References 33 publications

Review of Eye Tracking Metrics Involved in Emotional and Cognitive Processes

Review of Eye Tracking Metrics Involved in Emotional and Cognitive Processes

Eye-Tracking Metrics Predict Perceived Workload in Robotic Surgical Skills Training

Combined Gaze Metrics as Stress-Sensitive Indicators of Microsurgical Proficiency

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