Changes in Gaze Behavior during the Learning of the Epidural Technique with a Simulator in Anesthesia Novices (Preprint)

Abstract

BACKGROUND Current literature demonstrates the ability of eye tracking to provide reliable quantitative data as an objective assessment tool, with potential applications to medical and surgical training to improve performance. OBJECTIVE The aim of this study was to evaluate the changes in gaze behavior in anesthesia novice trainees when performing a simulated epidural technique before and after a hands-on training on the epidural simulator. METHODS We enrolled 48 novice trainees who had never previously performed an epidural block. After a standardized learning module, each trainee practiced the epidural procedure on the epidural simulator while wearing a pair of eye tracking glasses (Tobii Pro Glasses 50 Hz wearable wireless eye tracker). After this baseline recording, each trainee spent two hours practicing with the epidural simulator and afterwards once again performed the eye tracking epidural procedure. Eye tracking metrics and epidural learning (duration of the procedure and number of attempts) before and after the simulated practice were recorded. RESULTS The duration of the epidural procedure was shorter and the number of epidural attempts reduced after the tutorial. Before the tutorial, during needle insertion. the eye tracking metrics showed more visit counts of shorter duration and after the tutorial less visit counts (P=.05) but of longer duration (P=.03). A significant correlation was observed between the number of epidural needle insertions (additional attempts) and the number (OR=2.02 (0.23-1.27; P=.008)) and duration (OR=0.65 (-0.93-0.02; P=.05)) of visits. CONCLUSIONS In novice anesthesia trainees who had never previously performed an epidural block, we observed significant changes in gaze behavior associated with increased performance during the initial phase of epidural technique learning with a simulator. These results may create a prototype for future studies on eye tracking technique as a teaching and evaluating tool in simulation. CLINICALTRIAL Not necessary