Expertise under the microscope: processing histopathological slides

Abstract

This study indicates that in the case of intermediates and experts, different visual and cognitive strategies can result in equal levels of diagnostic accuracy. Lessons for training underline the relevance of the distinction between normal and abnormal tissue for novices, especially when the mental rotation of 2-D images is required. Intermediates need to be trained to see deviations in abnormalities. Feedback and an educational design that is specific to these developmental stages might improve training.

Unboxing the Black Box of Visual Expertise in Medicine

“…We fully agree with that, but would like to point towards research not mentioned by these authors, i.e., by Bertram, Helle, Kaakinen, and Svedström (2013) on CT images and our own research on interactive digital pathology slides (Jaarsma et al, 2016;Jaarsma, Jarodzka, Nap, Van Merriënboer, & Boshuizen, 2015;Jaarsma et al, 2014) and on patient-video cases (Balslev et al, 2012). Moreover, the authors mention on several occasions the potential eye tracking has for medical education.…”

“…Manipulation of these hypotheses can lead to the non-recognition of such features (Brooks, LeBlanc, & Norman, 2000;LeBlanc, Brooks, & Norman, 2002;LeBlanc, Dore, Norman, & Brooks, 2004;LeBlanc, Norman, & Brooks, 2001). The alleged superficiality of our own analyses of verbal protocols turned out to reveal aspects of perception and cognition (Jaarsma et al, 2014) that we have never become aware of in earlier research that made use of deep, semantic analyses (see for instance, Boshuizen & Schmidt, 1992). Lack of a professional vocabulary in novice groups seems to be associated with a lack of a repertoire of perceptual features in that domain thus hampering perception and interpretation.…”

“…These analyses could be triangulated with other data. In our own research, we have also investigated the interplay between hand movements as navigations within a pathological digital slide, eye movements on this slide as well as the verbalization about this examination (Jaarsma et al, 2016;Jaarsma et al, 2015;Jaarsma et al, 2014). This approach was also already investigated in a more natural setting with mobile eye tracking, although in the non-medical task of tea making (Tatler et al, 2013).…”

“…In this way, the authors showed that images containing a diffuse disease (i.e., a disease that is spread all over the lungs and cannot be brought down to one location) were visually examined in a broader way, by inducing a higher global/local ration. Similarly, in one of our own studies (Jaarsma, Jarodzka, Nap, Van Merriёnboer, & Boshuizen, 2014), we have investigated how expert pathologists, pathology residents, and medical students visually examine pathological slides. Amongst other, we found that experts and residents diagnosed the slides equally well.…”

Network Consumption and Storage Needs when Working in a Full-Time Routine Digital Environment in a Large Nonacademic Training Hospital

“…For educational purposes, this might be another argument in favor of digital pathology in daily practice. Other studies [7] have shown that registration of eye movements on screen during examination of digital histology slides also reflect the level of experience from the observer. Apparently, digital histology can also play an important role in objectivizing the performance of the apprentice.…”