Influences of medical expertise on visual diagnosis in pathology

Visual expertise is becoming more and more a crucial part of medical expertise. The amount of medical images has grown tremendously and the last decades have welcomed several new and increasingly dynamic imaging techniques (Krupinski, 2010). Nevertheless, visual expertise has so far mainly been studied in domains using static images, such as X-ray images (Reingold & Sheridan, 2011). This is also true for the domain of clinical pathology, where, in their natural context, pathologists interactively navigate and zoom within microscopic slides. Research in this domain either restricted these navigation possibilities (Krupinski et al., 2006; Tiersma, Peters, Mooij, & Fleuren, 2003) or neglected the visual processes (Crowley, Naus, Stewart, & Friedman, 2003). Hence, not much is known on visual expertise in domains that deal with interactive, medical images. In this study, 38 clinical pathologists with three different expertise levels, performed diagnostic tasks on a virtual microscope (i.e., computer software displaying scanned tissue samples in a similar way as a light microscope). By measuring eye movements, microscope navigation and thinking aloud, insight in both visual and cognitive expertise was gained. Each participant viewed seven interactive slides, representing different diseases of the colon. At the time of writing this submission, the analysis was not fully completed, yet. However, both literature and a previous study in this project, using static images only, revealed that novices spent less time and fixations in diagnostically relevant areas. This study will contribute to the understanding of visual expertise by developing a methodology which is fit for the study of interactive images.