A Science Education Study Using Visual Cognition and Eye Tracking to Explore Medication Selection in the Novice Versus Expert Nurse Anesthetist

The purpose of this science education study is to explore visual cognition and eye tracking during medication selection in the student nurse anesthetist (first year and second year students) and the expert nurse anesthetist. The first phase of this study consisted of the selection of a specific medication (target) from an array of medications via computer simulation. Various dependent variables were recorded to examine performance (reaction time and accuracy), and the allocation of visual attention was measured with eye tracking (dwell proportion, verification, and guidance). The second phase of this study included the administration of a demographic and post experiment questionnaire to capture additional quantitative and qualitative data. Results demonstrate that similar distractors attract attention during search as evidenced by longer reaction times when similar distractors are present, most significantly in expert participants. Additionally, all participants spent a greater amount of time looking at the similar distractor as compared to randomly chosen non-similar distractors when a similar distractor was present. However, the presence of similar distractors in target present trials increased performance in experts, decreased performance in second year students, and had no effect on first year students’ performance. Expertise effects were further demonstrated, as expert participants were significantly slower than both first and second years during target verification. The post experiment questionnaire included both open-ended and close-ended questions, to allow for themes to emerge related the participants’ beliefs related to visual search and medication selection. The results reinforced the eye tracking results reported above, with most participants identifying “color” and “medication label” as the most difficult medication features to distinguish during visual search. Additionally, the majority of participants who responded they had committed a medication error, identified “similarity” as the most common factor that led to the medication error