Impact case study database

Many sectors, from competitive sport to healthcare and the military, continually seek to improve the efficiency and effectiveness with which participants are trained. For complex skills, where visual information needs to be processed to guide precise decisions or movements (e.g., performing delicate surgery or accurate marksmanship), picking up the right visual information at the right time is critical. Acquiring this optimal information pick-up, or the ‘quiet eye’, is thus a goal of many training programmes. But, although proficient at the quiet eye, experts are unable to verbalise precisely how they gain this proficiency. Therefore, training typically requires learners to improve their performance through personal experience (i.e., learning from mistakes), a time-consuming and sometimes ineffective approach, particularly when the taught skills must then be performed under stressful conditions.

Wilson and Vine’s research into the assessment and training of gaze behaviour, or quiet-eye training (QET), has generated an entirely novel approach to training that accelerates the learning process: trainees are provided with information obtained from eye-tracking to attain the quiet eye, enabling them to leapfrog traditional, experience-based stages of learning. Furthermore, QET produces better performance under pressure. First developed in sport, Exeter’s widely applicable research insights are now beneficially impacting training in many other high-performance and safety-critical domains, significantly enhancing participants’ performance. The research has also directly led to the establishment of a commercial company delivering QET to more than a thousand staff across oil, pharmaceutical and healthcare sectors.

Further details of the significance and reach of Exeter’s impact are now outlined.

Creating a new start-up company with benefits for safety training for the oil, pharmaceutical and healthcare sectors.

Wilson and Vine’s research insights underpin the formation and commercial viability of UK start-up Cineon Training ( www.cineon.training). Launched in 2016 as a collaboration between the University of Exeter and Cineon Productions, and supported by an ESRC Impact Acceleration Award, the company provides training for safety critical industries using virtual-reality (VR) simulation tools, and offers solutions co-developed with Wilson and Vine’s research team.

Significance: [text removed for publication] [5.1]. The unique selling point of its VR tools is the incorporation of gaze behaviour assessment and training insights directly informed by Exeter’s research.

Reach: The company is developing training for major customers in several different safety-critical industries. The impact of the Exeter research thus reaches thousands of employees internationally, and is transforming training philosophy, policy and practice across diverse sectors:

• Oil: Concawe (a division of the European Petroleum Refiners Association, representing 40 of the world’s largest oil companies) approached Cineon Training to develop training for improving safety on oil refineries in Europe via virtual-reality QET [5.2]. The training improves hazard awareness skills in operators, reducing accidents and was ranked in the top ten VR experiences of 2019 [5.3]. To date, the training has been adopted by [text removed for publication], reaching an estimated 500 trainees by the end of 2020 [5.1].

• Pharmaceuticals: A VR QET tool developed by Cineon Training for a major pharmaceutical company, [text removed for publication], has been permanently adopted at its Portugal facility which produces 14.6 million vials of medicine per year, each requiring inspection by a trained operator. To date, 65 existing and newly recruited inspectors have received training across two separate phases [5.4].

• Healthcare: Training to support the safe use of personal protective equipment was developed by Cineon, Vine & Wilson for NHS staff during the COVID-19 pandemic, reaching ~500 trainees via an online platform in April 2020 alone, after which it became open access to all health and social care organisations in the U.K. [5.5].

Improving effectiveness and efficiency of Urology Surgery training

Urology was the first branch of surgery to use endoscopic and key-hole techniques and is often a trend-setter for minimally-invasive techniques. The ‘Urology Bootcamp’, an innovative and practical training course which won an education award at the Zenith Global Health Awards 2019, is the UK’s first mandatory training programme for qualified surgeons in any discipline. The Course Director wanted to shorten the time needed for trainees to reach proficiency on fundamental technical surgical skills, and thus improve the overall effectiveness and efficiency of the training camp. Following a presentation of Exeter’s research to the Royal College of Surgeons’ Commission on the “Future of Surgery” (2018) - he invited the Exeter researchers to develop gaze-based training videos for the course [5.6]. Since 2019, trainees now watch the videos – hosted directly on the Bootcamp online environment - ahead of course attendance, to assist in the pre-learning of these key skills, and can access the videos during the module to consolidate their learning.

Significance: As a direct result of Exeter’s work, trainees from the Bootcamp reported ‘ being more aware of controlling gaze to control movements’, ‘ increased feelings of confidence’ and the value of ongoing “practising using the video as a guide”. [5.6]

Reach: Due to the significant benefits offered by Exeter research, the Director has ‘ fully integrated these concepts into our technical skills training module, taken by all urologist trainees in the UK’. [5.6] This impact on training now benefits all 50 to 60 UK urologists who complete the Bootcamp annually, with plans to apply the same training approach to urologists in Belgium, Portugal, and Turkey, as well as to other surgical disciplines in the UK, which are expected to follow urology’s innovative approach [5.6].

Enhancing training infrastructure for [text removed for publication] military training

Since 2012, the Exeter researchers have been commissioned by the Defence Science and Technology Laboratory (DSTL) to develop novel training approaches; a partnership that has been highlighted as a successful case study of ‘Supporting our World-Leading Defence’ in the government’s 2020 UK R&D Roadmap (p16) [5.7]. Much of this work has focused on an element of counter-terrorism training for [text removed for publication], which was hitherto identified as particularly challenging for the Ministry of Defence (MOD).

Significance: [text removed for publication] the benefits of the bespoke QET resources were summarised by the manager of DSTL’s ‘Maximising Human Performance (MHP)’ project, after their first adoption in 2017: ‘ Trainees provided with the gaze training instructions showed a greater increase in their accuracy of execution of the tasks over the course, compared to trainees from a previous cohort who received the standard training. Additionally, both senior officers in charge of managing training, and instructors delivering training were positive about its benefits to them. … the videos simplified initial verbal teaching of the principles of the task, meaning that … more time was available for practice in the training arena.” [5.8] The ongoing significance of Exeter’s contribution to the success of this training programme is revealed in a 2019 Impact Bulletin published for military audiences by DSTL, which states that, ‘ the novel training technique enhances … traditional methods of technical training enabling accelerated skill acquisition … facilitating a winning-edge capability and reduced training costs’ [5.9].

Reach: Exeter’s impact has already been profound within the UK’s [text removed for publication] military regiment, in that all individuals going through selection since September 2017 now receive the new QET-enhanced training programme for counter-terrorism training. [5.8] Additionally, ‘the videos are also being used on a one-to-one basis to assist students who may be struggling with learning the skills.’ [5.8], revealing how the resources have been flexibly embedded within training procedures by the instructors themselves.

Furthermore, the benefits of Exeter’s research are being extended more generally to military capability via the DSTL. In 2017, DSTL noted that “[this work] has benefitted our aims … to provide the MoD, and our partners, with cutting-edge research to support their human capability. The success of these interventions … has impacted significantly upon the strategic planning of DSTL, with future research plans considering the extension and exploitation of this work to other tasks and cohorts’ [5.8]. This exploitation has since begun, with the 2019 DSTL Impact Bulletin reporting that DSTL’s collaboration with the Exeter researchers: “has also generated interest with international partners (via NATO and TTCP), which allows them and the UK to benefit as they exploit this research in alternative contexts.” [5.9].

Improving performance [text removed for publication]

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