This paper presents a new method of knowledge gathering for decision support in image understanding based on information extracted from the dynamics of saccadic eye movements. The framework involves the construction of a generic image feature extraction library, from which the feature extractors that are most relevant to the visual assessment by domain experts are determined automatically through factor analysis. The dynamics of the visual search are analyzed by using the Markov model for providing training information to novices on how and where to look for image features. The validity of the framework has been evaluated in a clinical scenario whereby the pulmonary vascular distribution on Computed Tomography images was assessed by experienced radiologists as a potential indicator of heart failure. The performance of the system has been demonstrated by training four novices to follow the visual assessment behavior of two experienced observers. In all cases, the accuracy of the students improved from near random decision making (33%) to accuracies ranging from 50% to 68%.