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Permanent URI for this collectionhttps://hdl.handle.net/20.500.14411/22

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Author: search.filters.author.Cagiltay, Nergiz ErcilWoS Q: search.filters.wosQuartile.Q1

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Now showing 1 - 6 of 6
  • Article
    Citation - WoS: 10
    Citation - Scopus: 13
    Distinguishing Intermediate and Novice Surgeons by Eye Movements
    (Frontiers Media Sa, 2020) Menekse Dalveren, Gonca Gokce; Cagiltay, Nergiz Ercil
    Surgical skill-level assessment is key to collecting the required feedback and adapting the educational programs accordingly. Currently, these assessments for the minimal invasive surgery programs are primarily based on subjective methods, and there is no consensus on skill level classifications. One of the most detailed of these classifications categorize skill levels as beginner, novice, intermediate, sub-expert, and expert. To properly integrate skill assessment into minimal invasive surgical education programs and provide skill-based training alternatives, it is necessary to classify the skill levels in as detailed a way as possible and identify the differences between all skill levels in an objective manner. Yet, despite the existence of very encouraging results in the literature, most of the studies have been conducted to better understand the differences between novice and expert surgical skill levels leaving out the other crucial skill levels between them. Additionally, there are very limited studies by considering the eye-movement behaviors of surgical residents. To this end, the present study attempted to distinguish novice- and intermediate-level surgical residents based on their eye movements. The eye-movement data was recorded from 23 volunteer surgical residents while they were performing four computer-based simulated surgical tasks under different hand conditions. The data was analyzed using logistic regression to estimate the skill levels of both groups. The best results of the estimation revealing a 91.3% recognition rate of predicting novice and intermediate surgical residents on one scenario were selected from four under the dominant hand condition. These results show that the eye-movements can be potentially used to identify surgeons with intermediate and novice skills. However, the results also indicate that the order in which the scenarios are provided, and the design of the scenario, the tasks, and their appropriateness with the skill levels of the participants are all critical factors to be considered in improving the estimation ratio, and hence require thorough assessment for future research.
  • Article
    Citation - WoS: 16
    Citation - Scopus: 15
    Construct and Face Validity of the Educational Computer-Based Environment (ece) Assessment Scenarios for Basic Endoneurosurgery Skills
    (Springer, 2017) Cagiltay, Nergiz Ercil; Ozcelik, Erol; Sengul, Gokhan; Berker, Mustafa
    Background In neurosurgery education, there is a paradigm shift from time-based training to criterion-based model for which competency and assessment becomes very critical. Even virtual reality simulators provide alternatives to improve education and assessment in neurosurgery programs and allow for several objective assessment measures, there are not many tools for assessing the overall performance of trainees. This study aims to develop and validate a tool for assessing the overall performance of participants in a simulation-based endoneurosurgery training environment. Methods A training program was developed in two levels: endoscopy practice and beginning surgical practice based on four scenarios. Then, three experiments were conducted with three corresponding groups of participants (Experiment 1, 45 (32 beginners, 13 experienced), Experiment 2, 53 (40 beginners, 13 experienced), and Experiment 3, 26 (14 novices, 12 intermediate) participants). The results analyzed to understand the common factors among the performance measurements of these experiments. Then, a factor capable of assessing the overall skill levels of surgical residents was extracted. Afterwards, the proposed measure was tested to estimate the experience levels of the participants. Finally, the level of realism of these educational scenarios was assessed. Results The factor formed by time, distance, and accuracy on simulated tasks provided an overall performance indicator. The prediction correctness was very high for the beginners than the one for experienced surgeons in Experiments 1 and 2. When non-dominant hand is used in a surgical procedure-based scenario, skill levels of surgeons can be better predicted. The results indicate that the scenarios in Experiments 1 and 2 can be used as an assessment tool for the beginners, and scenario-2 in Experiment 3 can be used as an assessment tool for intermediate and novice levels. It can be concluded that forming the balance between perceived action capacities and skills is critical for better designing and developing skill assessment surgical simulation tools.
  • Article
    Citation - WoS: 9
    Eye-Hand Coordination Patterns of Intermediate and Novice Surgeons in a Simulation-Based Endoscopic Surgery Training Environment
    (int Group Eye Movement Research, 2018) Topalli, Damla; Cagiltay, Nergiz Ercil
    Endoscopic surgery procedures require specific skills, such as eye-hand coordination to be developed. Current education programs are facing with problems to provide appropriate skill improvement and assessment methods in this field. This study aims to propose objective metrics for hand-movement skills and assess eye-hand coordination. An experimental study is conducted with 15 surgical residents to test the newly proposed measures. Two computer-based both-handed endoscopic surgery practice scenarios are developed in a simulation environment to gather the participants' eye-gaze data with the help of an eye tracker as well as the related hand movement data through haptic interfaces. Additionally, participants' eye-hand coordination skills are analyzed. The results indicate higher correlations in the intermediates' eye-hand movements compared to the novices. An increase in intermediates' visual concentration leads to smoother hand movements. Similarly, the novices' hand movements are shown to remain at a standstill. After the first round of practice, all participants' eye-hand coordination skills are improved on the specific task targeted in this study. According to these results, it can be concluded that the proposed metrics can potentially provide some additional insights about trainees' eye-hand coordination skills and help instructional system designers to better address training requirements.
  • Article
    Citation - WoS: 16
    Citation - Scopus: 16
    Using Eye-Movement Events To Determine the Mental Workload of Surgical Residents
    (int Group Eye Movement Research, 2018) Dalveren, Gonca Gokce Menekse; Cagiltay, Nergiz Ercil
    These days, eye-tracking is one of the promising technologies used in different fields such as aviation, arts, sports, psychology and driving for several purposes. Even though it is being used for health purposes, studies involving eye-tracking are rare in the field of endo-neurosurgery. This study aims to use this technology to promote our understanding of the effect related to computer-based instructional materials on mental workload of endo-neurosurgery residents. Four computer-based simulation scenarios are developed based on skill development requirements of endo-neurosurgery residents. Two of them were designed as general models and the other two as simulated surgical models. During these surgery procedures, in real settings, surgical residents need to use their both hands simultaneously to control the endoscope and the operational tool in a coordinated fashion. Therefore, to shed light on the participants' behaviors, these scenarios are performed with dominant-hand, non-dominant hand and, finally with both-hands using haptic interfaces. Twenty-three residents volunteered in this study. Their eye-movements were recorded while performing the scenarios. According to the results of this study, when performing the simulated surgical models, an increase in the participants' mental workload was recorded when compared to the other scenarios. Accordingly, it can be concluded that the eye-movements of surgical residents can provide insights about the anticipated level of difficulty about the skill-based tasks. This information might be very critical to properly design and organize instructional materials for endo-neurosurgery, and also to better guide and evaluate the progress of trainees in computer simulation-based skill training environments.
  • Article
    Citation - WoS: 6
    Citation - Scopus: 8
    Are Left- and Right-Eye Pupil Sizes Always Equal?
    (int Group Eye Movement Research, 2019) Cagiltay, Nergiz Ercil; Dalveren, Gonca Gokce Menekse
    Eye movements provide very critical information about the cognitive load and behaviors of human beings. Earlier studies report that under normal conditions, the left- and right-eye pupil sizes are equal. For this reason, most studies undertaking eye-movement analysis are conducted by only considering the pupil size of a single eye or taking the average size of both eye pupils. This study attempts to offer a better understanding concerning whether there are any differences between the left- and right-eye pupil sizes of the right-handed surgical residents while performing surgical tasks in a computer-based simulation environment under different conditions (left-hand, right-hand and both hands). According to the results, in many cases, the right-eye pupil sizes of the participants were larger than their left-eye pupil sizes while performing the tasks under right-hand and both hands conditions. However, no significant difference was found in relation to the tasks performed under left-hand condition in all scenarios. These results are very critical to shed further light on the cognitive load of the surgical residents by analyzing their left-eye and right-eye pupil sizes. Further research is required to investigate the effect of the difficulty level of each scenario, its appropriateness with the skill level of the participants, and handedness on the differences between the leftand right-eye pupil sizes.
  • Review
    Citation - WoS: 8
    Citation - Scopus: 9
    A Systematic Review on Classification and Assessment of Surgical Skill Levels for Simulation-Based Training Programs
    (Elsevier Ireland Ltd, 2023) Tonbul, Gokcen; Topalli, Damla; Cagiltay, Nergiz Ercil
    Background: Nowadays, advances in medical informatics have made minimally invasive surgery (MIS) procedures the preferred choice. However, there are several problems with the education programs in terms of surgical skill acquisition. For instance, defining and objectively measuring surgical skill levels is a challenging process. Accordingly, the aim of this study is to conduct a literature review for an investigation of the current approaches for classifying the surgical skill levels and for identifying the skill training tools and measurement methods.Materials and Methods: In this research, a search is conducted and a corpus is created. Exclusion and inclusion criteria are applied by limiting the number of articles based on surgical education, training approximations, hand movements, and endoscopic or laparoscopic operations. To satisfy these criteria, 57 articles are included in the corpus of this study.Results: Currently used surgical skill assessment approaches have been summarized. Results show that various classification approaches for the surgical skill level definitions are being used. Besides, many studies are con-ducted by omitting particularly important skill levels in between. Additionally, some inconsistencies are also identified across the skill level classification studies.Conclusion: In order to improve the benefits of simulation-based training programs, a standardized interdisci-plinary approach should be developed. For this reason, specific to each surgical procedure, the required skills should be identified. Additionally, appropriate measures for assessing these skills, which can be defined in simulation-based MIS training environments, should be refined. Finally, the skill levels gained during the developmental stages of these skills, with their threshold values referencing the identified measures, should be redefined in a standardized manner.