The Use of Task-Evoked Pupillary Response as an Objective Measure of Cognitive Load in Novices and Trained Physicians

Abstract

Novices require more mental effort to answer clinical questions than trained physicians, even when both respond correctly. Measuring TEPRs has the potential to be a valuable assessment tool by providing objective measures of expertise and is worthy of further study.

Pupillometry as a Tool to Study Expertise in Medicine

“…Essentially, the group with the lower intelligence had to "think harder" to achieve the same correct response as the group with higher intelligence. Moving away from intelligence defined by standardized testing, a study by Szulewski et al (2015) found similar results in novices and trained physicians as they answered clinically-based multiple choice questions. The participant groups in this study were divided not by intelligence, but by clinical experience.…”

“…Anecdotally, cognitive efficiency seems to evolve with experience. The "anatomy" of working memory is thought to change with the development of expertise and it is likely that certain clinical tasks cognitively load experts and novices in different ways (Szulewski et al, 2015). This evolution of the thinking process is tied to expertise development.…”

“…Ongoing work in this area now suggests that with experience, experts are able to expand working memory capacity by having developed methods for storage and retrieval of domain-specific information in long-term memoryso called long-term working memory (Ericsson & Kintsch, 1995). This is accomplished, in part, by pattern recognition and schema development, and a resultant relative decrease in the cognitive load that a problem or situation imposes as an individual becomes more expert-like (Szulewski, Roth, & Howes, 2015).…”

Before your very eyes: the value and limitations of eye tracking in medical education

“…It has recently been applied in medical education: Szulewski et al 30 showed that pupil dilation was greater when emergency medicine trainees answered difficult clinical questions as compared with easier questions. Pupil dilation, however, is much more sensitive to ambient lighting conditions than it is to cognitive load.…”

Visual expertise and the Quiet Eye in sports – comment on Vickers

“…For example, we use an eye tracker to define constantly occurring micro-movements of our eyes as a singular "fixation" and then study the frequency of fixations, their durations, or the time between fixation onset and the initiation of a movement (Panchuk, Vine, & Vickers, 2015). The underlying assumption is that visual expertise is an individual capacity that resides inside the mind or brain of an elite performer (Gruber, Jansen, Marienhagen, & Altenmueller, 2010; Seppänen & Gegenfurtner, 2012;Szulewski, Roth, & Howes, 2015). In recent years, there has been an increasing interest in studying the social and cultural sources that correspond with individual displays of expert performance (Gegenfurtner, Siewiorek, Lehtinen, & Säljö, 2013;Stoeger & Gruber, 2014).…”