The Development of the Eye-movement Response in the Trainee Radiologist

In order to explore the initial response of the visual system to radiological images in groups of individuals with increasing degrees of radiological training and experience, the locations of fixations made during visual inspection of digitised chest radiographs were examined for 4 groups of observers: 10 experienced radiologists, 9 first-year “novice” radiologists, 11 “trainee” radiologists in the second and third years of their training, and 7 naive controls. Each observer viewed 12 digitised chest radiographs (6 normal and 6 showing some abnormality) on a VDU for 8s each. Eye movements were recorded throughout and observers indicated via a button box whether they thought the radiograph to be normal or abnormal. A least squares index was utilised in order to quantify the similarity in fixation location between pairs of eye movement traces over the first 1.5 and 3 seconds of an inspection. The similarities thus produced were then averaged to give intraand intergroup similarities in fixation location. The fixation locations of experienced radiologists were found to be highly similar as a group, as were those of the novices. While the fixation locations of controls showed less similarity, it was the fixations of trainees which were the least similar (i.e. showed the most variability) within their group. The fixation locations of novices showed a greater similarity to those of radiologists than those of controls, and a decreased similarity to those of controls than those of the controls themselves. However, rather than showing that the fixation locations of individuals become increasing similar to those of radiologists as training progresses, the data show that the more variable fixation locations of trainees are the least similar to those of radiologists than those of any of the groups, even the controls. Control observers examine every day images in a similar way and this is also true of radiological images. Experienced radiologists view radiological images in a similar way to each other, but their training has resulted in differences between them and controls. In becoming experienced radiologists, it appears that trainees may move through a developmental phase characterised by more idiosyncratic eye movements; their eye movements becoming less similar to controls or experienced radiologists than they were. With experience the eye movements of trainee radiologists may become more similar to both groups, but the transition of the trainee from novice to experienced radiologist is not a simple one: the change involves a period of some disorder.