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Article Citation - WoS: 8Citation - Scopus: 7The Underlying Reasons of the Navigation Control Effect on Performance in a Virtual Reality Endoscopic Surgery Training Simulator(Taylor & Francis inc, 2019) Cagiltay, Nergiz Ercil; Ozcelik, Erol; Berker, Mustafa; Dalveren, Gonca Gokce MenekseNavigation control skills of surgeons become very critical for surgical procedures. Strategies improving these skills are important for developing higher-quality surgical training programs. In this study, the underlying reasons of the navigation control effect on performance in a virtual reality-based navigation environment are evaluated. The participants' performance is measured in conditions: navigation control display and paper-map display. Performance measures were collected from 45 beginners and experienced residents. The results suggest that navigation display significantly improved performance of the participants. Also, navigation was more beneficial for beginners than experienced participants. The underlying reason of the better performance in the navigation condition was due to lower number of looks to the map, which causes attention shifts between information sources. Accordingly, specific training scenarios and user interfaces can be developed to improve the navigation skills of the beginners considering some strategies to lower their number of references to the information sources.Conference Object Problems of Endoneurosurgery Education: a Case Study in Turkey(Iated-int Assoc Technology Education & development, 2015) Cagiltay, Nergiz Ercil; Berker, Mustafa; Ozcelik, ErolEndoneurosurgery consists of neurological operations performed using an endoscope. Unlike traditional surgery operations, natural body cavities are used as entry points, hence inflicting minimum damage to the patient. These operations are considered as minimal invasive surgeries (or MIS), where surgeons see the operation area in two-dimensional view on the monitor and perform the operation based on that view. Studies show that MIS causes minimal harm to human body and reduces the death risk and that these surgeries are at least as safe as those performed using microscopes. Despite having certain advantages, they also come with certain problems, one of which is that the endoscopic view is two-dimensional, not three; in other words, since endoneurosurgery is performed via the images from the endoscope, the surgeon's perception should enable them to transform those images seen through the endoscope and convert them mentally to their correct anatomical models. In that concern, lack of depth perception can cause serious injuries, even resulting in deaths if not dealt with in advance by training. To be successful in such an environment, the surgeon has to gain critical skills. Hence, the education programs of surgery and endoneurosurgery has unique problems. The main aim of this study is to better understand the problems of endoneurosurgery education in Turkey. For this, a survey study is conducted with 31 participants, who are either currently enrolled in endoneurosurgery education programs in Turkey or experts in the field. Supportively semi-structured individual interviews are also conducted with 5 participants. This data is collected to better understand the methods being used in these programs, their problems and the participants' preferred methods to be used. Additionally, the participants' attitudes towards are also investigated regarding the use of new technologies to enhance the current education programs. The results indicate that, in Turkey, endoneurosurgery training programs are still mostly offered in traditional ways while other educational methods are used in an extremely limited manner. Main problems of integrating new technologies into these education programs are highlighted as: the most widely used educational method for endoneurosurgery in Turkey is the traditional one, see one-do one-teach one, provided in the operating theatre on real patients with an extremely limited practice alternative for the assistants. To improve the practice educators and trainees are willing to use alternative education environments, such as virtual reality and box training. However, they are not available and there are no curriculum integration models for these technologies.Article Citation - WoS: 12Citation - Scopus: 13The Effect of Training, Used-Hand, and Experience on Endoscopic Surgery Skills in an Educational Computer-Based Simulation Environment (ece) for Endoneurosurgery Training(Sage Publications inc, 2019) Cagiltay, Nergiz Ercil; Ozcelik, Erol; Isikay, Ilkay; Hanalioglu, Sahin; Suslu, Ahmet E.; Yucel, Taskin; Berker, MustafaToday, virtual simulation environments create alternative hands-on practice opportunities for surgical training. In order to increase the potential benefits of such environments, it is critical to understand the factors that influence them. This study was conducted to determine the effects of training, used-hand, and experience, as well as the interactions between these variables, on endoscopic surgery skills in an educational computer-based surgical simulation environment. A 2-hour computer-based endoneurosurgery simulation training module was developed for this study. Thirty-one novice- and intermediate-level resident surgeons from the departments of neurosurgery and ear, nose, and throat participated in this experimental study. The results suggest that a 2-hour training during a 2-month period through computer-based simulation environment improves the surgical skills of the residents in both-hand tasks, which is necessary for endoscopic surgical procedures but not in dominant hand tasks. Based on the results of this study, it can be concluded that computer-based simulation environments potentially improve surgical skills; however, the scenarios for such training modules need to consider especially the bimanual coordination of hands and should be regularly adapted to the individual skill levels and progresses.Conference Object Simulations for Surgical Education: a Case Study for Endoneurosurgery(Iated-int Assoc Technology Education A& development, 2015) Berker, Mustafa; Cagiltay, Nergiz Ercil; Isikay, IlkayToday, introduction of the microscope and later the extensive use of the video camera have changed the way operations are performed which have replaced the direct vision by a video image. These types of surgical techniques are generally called as minimal invasive surgery (MIS). Laparoscopic surgery and endoscopic surgery fall in this category. These new technologies require some additional skills to be gained during the surgical education and training programs. Most of the traditional surgical training takes place in the operating theater under the supervision of an experienced surgeon which does not allow any try-and-error type of learning, and does not tolerate errors. Hence, alternative educational methods by providing try-and-error type of learning are a critical for medical education. This study presents a simulation environment developed specifically for the pituitary surgery operations. The simulation environment composed of two main parts: the skill-based education and the procedure-based education for the novice surgeons. This study shows the design and implementation of educational modules developed to provide try-and-error type of educational environments as a case study on pituitary surgery operations.Article Citation - WoS: 15Citation - Scopus: 15Construct 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, MustafaBackground 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.
