Changes in gaze behaviors during psychomotor skill training in laparoscopic surgery: A longitudinal eye tracking study.

Eye metrics have been widely used to differentiate laparoscopic skill levels between novice and expert surgeons. However, surgical expertise develops over time and little is known about how gaze behavior evolves during this skill progression. This study investigated how visual attention changes with practice and how it differs across learners with varying rates of skill acquisition for the peg transfer task from the Fundamentals of Laparoscopic Surgery curriculum. Eye gaze data were collected from twenty-nine novice participants as they practiced the peg transfer task until reaching proficiency or completing six training sessions. Results showed that practice led to increased visual focus on task-critical areas and more frequent gaze toward future target locations. Notably, faster learners adopted feedforward gaze behaviors earlier and more consistently than others. These findings suggest that the early development of efficient visual control is closely associated with accelerated psychomotor skill acquisition, providing the basis for using eye metrics as an objective tool for surgical skill assessment and training.