Surgeons now have a really good excuse to be out on the golf course. Researchers have shown that the same training technique that will improve their putting can also improve their operating skills. Dr Samuel Vine and Dr Mark Wilson, from Sport and Health Sciences at the University of Exeter, tested both elite golfers and surgical residents in two separate experiments using the gaze control technique known as the “Quiet Eye.”
First, they divided 22 elite golfers, (handicaps less than 6), into two groups after their baseline putting performance was measured. The control group received no additional training while the experimental group participated in Quiet Eye (QE) training, a method first developed by Dr. Joan Vickers of the University of Calgary. They were instructed to follow these steps:
1. Assume your stance and align the club so your gaze is on the back of the ball.
2. After setting up over the ball, fix your gaze on the hole. Fixations toward the hole should be made no more than 3 times.
3. The final fixation should be a QE on the back of the ball. The onset of the QE should occur before the stroke begins and last for 2 to 3 seconds.
4. No gaze should be directed to the clubhead during the backswing or foreswing.
5. The QE should remain on the green for 200 to 300 ms after the club contacts the ball.
While several earlier studies have shown the effectiveness of using QE in lab-based putting experiments, Vine and Wilson wanted to add two additional tests. Would the golfers not only putt better in the lab, but also retain that performance under induced stress and in real world, golf course conditions?
The stress was added by telling the golfers that they were playing for a $50 prize as well as having their final scores posted at their home golf courses. Even though the two groups showed no difference at the pre-training baseline testing, the QE group had significantly better putting scores than the control group in all three scenarios, including a decrease of two putts per round.
So, QE will help a surgeon on the green but what about in the operating room? Knowing the positive results that athletes have seen, Vine and Wilson wondered if gaze control could help other professions, especially medicine. Working in collaboration with the University of Hong Kong, the Royal Devon and Exeter NHS Foundation Trust and the Horizon training centre Torbay, the University of Exeter team brought thirty medical students together to find out.
Part of the quiet eye training feedback involves wearing a gaze control eye tracker. Its a set of glasses with one camera recording what the person is looking at and one camera looking at their eyeball movement. By combining the two feeds, the point of focus or gaze can be tracked. The trainee can then view their own gaze history and be instructed on the gap between where they are focusing and where they should be focused, based on the gaze of experts in the same field.
For the experiment, one group received no instruction on how to do a surgical procedure in a simulator (no human patients), another group received some verbal instruction while the last group watched a video that included the gaze history of expert surgeons doing the same simulated procedure. The students were told to try to copy the same point of focus that the experienced surgeons used when doing the procedure.
Dr. Vine describes the positive results, “It appears that teaching novices the eye movements of expert surgeons allows them to attain high levels of motor control much quicker than novices taught in a traditional way. This highlights the important link between the eye and hand in the performance of motor skills. These individuals were also able to successfully multi-task without their technical skills breaking down, something that we know experienced surgeons are capable of doing in the operating theatre. Teaching eye movements rather than the motor skills may have reduced the working memory required to complete the task. This may be why they were able to multi-task whilst the other groups were not.”
Vine hopes that this new training technique will speed up the time needed to get surgical students to a level of competency. “Focusing on surgeons’ eye movements has resulted in a reduction in the time taken to learn specific procedures and, more importantly, demonstrated that their skills are less likely to break down under pressure,” Vine concluded.
Whether they get their QE training at the hospital or the clubhouse, aspiring surgeons can kill two birds with one stone… or is that two birdies with one stroke?