Verbal gaze instruction matches visual gaze guidance in laparoscopic skills training

Novices were trained to perform a unimanual peg transport task in a laparoscopic training box with an illuminated interior displayed on a monitor. Subjects were divided into two groups; one group was verbally instructed to direct their gaze at distant targets, while the other group had their gaze behaviour implicitly manipulated using distant target illumination. Both groups achieved similar task completion times post-training and developed peripheral vision strategies leading to delayed foveation on targets until the instrument was closer to its destination, although the ability to focus on targets earlier during manual movements as done by an expert surgeon was quickly regained by the verbal instruction group post-training. This suggests that care should be taken when employing visual attention cuing methods such as target highlighting for training eye-hand coordination skills, as simple verbal instruction may be sufficient to help trainees to adopt more expert-like gaze behaviours.