Eye tracking in cytotechnology education: “visualizing” students becoming experts

Introduction: This study reports the potential of eye-tracking technology in determining screening skills of cytotechnology (CT) students while examining digital images (DI). Materials and methods: Twenty-five static DI of gynecologic cytology specimens were serially displayed on a computer monitor for evaluation by 16 CT students and 3 cytotechnologists at 3 locations. During evaluation, participant's eye movements were monitored with a Mirametrix S2 eye tracker (iMotions, Boston, MA) and EyeWorks software (Eyetracking, Solana Beach, CA). Students completed the protocol at: Period1 (P1)—4 months, Period2 (P2)—7 months, Period3 (P3)—11 months during their 1-year training; and the cytotechnologists only once. A general linear mixed model was used to analyze the results. Results: The proportion of agreement on interpretations for cytotechnologists, students during P1, and students during P3 were 0.83, 0.62, and 0.70 respectively. The mean task duration in seconds for cytotechnologists, students during P1, and students during P3 were 21.1, 34.6, and 24.9 respectively. The mean number of fixation points for cytotechnologists, students during P1, and students during P3 were 14.5, 52.2, and 35.3, respectively. The mean number of gaze observations of cytotechnologists, students during P1, and students during P3 on region of interest (ROI) 1 were 77.93, 181.12, and 123.83, respectively; and, ROI 2 were 38.90, 142.79, and 92.46, respectively. Conclusions: This study demonstrated that students had decreased time, number of fixation points, gaze observations on ROI, and increased agreement with the reference interpretations at the end of the training program, indicating that their screening skills were progressing towards the level of practicing cytotechnologists.