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The effects of gaze-display feedback on medical students’ self-monitoring and learning in radiology

Kok, Ellen M. ; Niehorster, Diederick C. LU orcid ; van der Gijp, Anouk ; Rutgers, Dirk R. ; Auffermann, William F. ; van der Schaaf, Marieke ; Kester, Liesbeth and van Gog, Tamara (2024) In Advances in Health Sciences Education
Abstract

Self-monitoring is essential for effectively regulating learning, but difficult in visual diagnostic tasks such as radiograph interpretation. Eye-tracking technology can visualize viewing behavior in gaze displays, thereby providing information about visual search and decision-making. We hypothesized that individually adaptive gaze-display feedback improves posttest performance and self-monitoring of medical students who learn to detect nodules in radiographs. We investigated the effects of: (1) Search displays, showing which part of the image was searched by the participant; and (2) Decision displays, showing which parts of the image received prolonged attention in 78 medical students. After a pretest and instruction, participants... (More)

Self-monitoring is essential for effectively regulating learning, but difficult in visual diagnostic tasks such as radiograph interpretation. Eye-tracking technology can visualize viewing behavior in gaze displays, thereby providing information about visual search and decision-making. We hypothesized that individually adaptive gaze-display feedback improves posttest performance and self-monitoring of medical students who learn to detect nodules in radiographs. We investigated the effects of: (1) Search displays, showing which part of the image was searched by the participant; and (2) Decision displays, showing which parts of the image received prolonged attention in 78 medical students. After a pretest and instruction, participants practiced identifying nodules in 16 cases under search-display, decision-display, or no feedback conditions (n = 26 per condition). A 10-case posttest, without feedback, was administered to assess learning outcomes. After each case, participants provided self-monitoring and confidence judgments. Afterward, participants reported on self-efficacy, perceived competence, feedback use, and perceived usefulness of the feedback. Bayesian analyses showed no benefits of gaze displays for post-test performance, monitoring accuracy (absolute difference between participants’ estimated and their actual test performance), completeness of viewing behavior, self-efficacy, and perceived competence. Participants receiving search-displays reported greater feedback utilization than participants receiving decision-displays, and also found the feedback more useful when the gaze data displayed was precise and accurate. As the completeness of search was not related to posttest performance, search displays might not have been sufficiently informative to improve self-monitoring. Information from decision displays was rarely used to inform self-monitoring. Further research should address if and when gaze displays can support learning.

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author
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organization
publishing date
type
Contribution to journal
publication status
in press
subject
keywords
Eye tracking, Feedback, Gaze display, Medical image perception, Radiograph interpretation, Self-monitoring
in
Advances in Health Sciences Education
publisher
Springer
external identifiers
  • pmid:38555550
  • scopus:85188991948
ISSN
1382-4996
DOI
10.1007/s10459-024-10322-6
language
English
LU publication?
yes
additional info
Publisher Copyright: © The Author(s) 2024.
id
5d06141e-b2cd-48dc-9a7f-c96dcbb5c299
date added to LUP
2024-04-06 19:41:55
date last changed
2024-04-20 22:13:13
@article{5d06141e-b2cd-48dc-9a7f-c96dcbb5c299,
  abstract     = {{<p>Self-monitoring is essential for effectively regulating learning, but difficult in visual diagnostic tasks such as radiograph interpretation. Eye-tracking technology can visualize viewing behavior in gaze displays, thereby providing information about visual search and decision-making. We hypothesized that individually adaptive gaze-display feedback improves posttest performance and self-monitoring of medical students who learn to detect nodules in radiographs. We investigated the effects of: (1) Search displays, showing which part of the image was searched by the participant; and (2) Decision displays, showing which parts of the image received prolonged attention in 78 medical students. After a pretest and instruction, participants practiced identifying nodules in 16 cases under search-display, decision-display, or no feedback conditions (n = 26 per condition). A 10-case posttest, without feedback, was administered to assess learning outcomes. After each case, participants provided self-monitoring and confidence judgments. Afterward, participants reported on self-efficacy, perceived competence, feedback use, and perceived usefulness of the feedback. Bayesian analyses showed no benefits of gaze displays for post-test performance, monitoring accuracy (absolute difference between participants’ estimated and their actual test performance), completeness of viewing behavior, self-efficacy, and perceived competence. Participants receiving search-displays reported greater feedback utilization than participants receiving decision-displays, and also found the feedback more useful when the gaze data displayed was precise and accurate. As the completeness of search was not related to posttest performance, search displays might not have been sufficiently informative to improve self-monitoring. Information from decision displays was rarely used to inform self-monitoring. Further research should address if and when gaze displays can support learning.</p>}},
  author       = {{Kok, Ellen M. and Niehorster, Diederick C. and van der Gijp, Anouk and Rutgers, Dirk R. and Auffermann, William F. and van der Schaaf, Marieke and Kester, Liesbeth and van Gog, Tamara}},
  issn         = {{1382-4996}},
  keywords     = {{Eye tracking; Feedback; Gaze display; Medical image perception; Radiograph interpretation; Self-monitoring}},
  language     = {{eng}},
  month        = {{03}},
  publisher    = {{Springer}},
  series       = {{Advances in Health Sciences Education}},
  title        = {{The effects of gaze-display feedback on medical students’ self-monitoring and learning in radiology}},
  url          = {{http://dx.doi.org/10.1007/s10459-024-10322-6}},
  doi          = {{10.1007/s10459-024-10322-6}},
  year         = {{2024}},
}