Visual scan behavior of new and experienced clinicians assessing panoramic radiographs

Objective: The aim of this study was to examine and compare the visual scan behavior of clinicians with different levels of experience during assessment of panoramic radiographs. Methods: The visual scan paths of 20 dentists, 10 with 5 years of clinical experience or less (new clinicians) and 10 with more than 5 years of clinical experience (experienced clinicians), were recorded as they assessed five panoramic radiographs. Differences between groups were tested for statistical significance, and associations between level of clinical experience, viewing time, completeness, and detection of abnormality were computed. Results: Experienced clinicians were significantly quicker (P < 0.001) and, more often than new clinicians, had a discernible scanning pattern. New clinicians often had no pattern to radiograph assessment, but they scanned the radiographs significantly more completely (P < 0.001), and their gaze scan paths entered more areas of abnormality. There were significant positive correlations between viewing time and completeness (P < 0.001), and between viewing time and detection of abnormality (P = 0.042) but not between level of clinical experience and detection of abnormality (P = 0.054). Conclusions: Experienced clinicians have a faster and more systematic approach to panoramic radiograph assessment but tend to be less complete than new clinicians.