A new way to look at simulation-based assessment: the relationship between gaze-tracking and exam performance

Adam Szulewski*, Rylan Egan, Andreas Gegenfurtner, Daniel Howes, Gerhard Dashi, Nick C. J. McGraw, Andrew K. Hall, Damon Dagnone, Jeroen J. G. van Merrienboer

*Corresponding author for this work

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Objective A key task of the team leader in a medical emergency is effective information gathering. Studying information gathering patterns is readily accomplished with the use of gaze-tracking glasses. This technology was used to generate hypotheses about the relationship between performance scores and expert-hypothesized visual areas of interest in residents across scenarios in simulated medical resuscitation examinations. Methods Emergency medicine residents wore gaze-tracking glasses during two simulation-based examinations (n=29 and 13 respectively). Blinded experts assessed video-recorded performances using a simulation performance assessment tool that has validity evidence in this context. The relationships between gaze patterns and performance scores were analyzed and potential hypotheses generated. Four scenarios were assessed in this study: diabetic ketoacidosis, bradycardia secondary to beta-blocker overdose, ruptured abdominal aortic aneurysm and metabolic acidosis caused by antifreeze ingestion. Results Specific gaze patterns were correlated with objective performance. High performers were more likely to fixate on task-relevant stimuli and appropriately ignore task-irrelevant stimuli compared with lower performers. For example, shorter latency to fixation on the vital signs in a case of diabetic ketoacidosis was positively correlated with performance (r=0.70, p

Original languageEnglish
Pages (from-to)129-137
Number of pages9
JournalCanadian Journal of Emergency Medicine
Issue number1
Publication statusPublished - Jan 2019


  • assessment
  • emergency medicine
  • gaze-tracking
  • medical education
  • simulation
  • TOOL


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