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Article Citation - WoS: 9Citation - 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.Article Citation - WoS: 13Citation - Scopus: 14The 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.Article Citation - Scopus: 1Randomised Comparison Between Navigation and Non-Navigation Camera Control Performance in a Surgical Simulation Task Using a Haptic Device Interface(Wolters Kluwer Medknow Publications, 2026) Cagiltay, Nergiz Ercil; Topalli, Damla; Tuner, Emre; Berker, MustafaIntroduction:Navigation skills for controlling the camera in the surgical field are critical for many minimally invasive surgery (MIS) procedures. Currently, endoscopes lack integrated navigation aids, making camera control a challenging task. This experimental study aims to investigate the effect of navigation guidance on the performance of beginners.Patients and Methods:A custom computer-based simulation environment was developed for this study, featuring two conditions - one with navigation guidance and one without - focussed on a camera-cleaning task. Participants (64 beginners) were randomly assigned to one of these groups and used two haptic devices to simulate the endoscope and surgical tools.Results:Participants in the guided condition performed significantly better than those in the unguided condition. Notably, female participants completed the task in significantly less time under the guided condition compared to the unguided one.Conclusion:These findings suggest that incorporating navigation aids into endoscope interfaces could improve user performance, especially for beginners. Medical device manufacturers should consider adding navigation features to enhance usability. In addition, simulation-based instructional systems should integrate navigation aids to better support surgical training.Article Citation - WoS: 16Citation - 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.Article Citation - WoS: 3Citation - Scopus: 5Technology-Enhanced Surgical Education: Attitudes and Perceptions of the Endoscopic Surgery Community in Turkey(Bmj Publishing Group, 2019) Cagiltay, Nergiz Ercil; Berker, MustafaThe education programme of surgery has unique problems. In this study, first, a literature review is conducted to cover the studies found in the literature reporting on the problems of surgical education. Additionally, a survey study is conducted with 31 participants, who are either currently enrolled in endoscopic surgery education programmes in Turkey or are experts in the field. Supportively semistructured individual interviews are also conducted with five participants. These data are collected to better understand the instructional methods being used, their problems and the participants' preferred methods to be used. Additionally, the participants' attitudes are also investigated regarding the use of new technologies to enhance the current education programmes. The results indicate that, in Turkey, surgical education programmes are still mostly offered in traditional ways while other educational methods are used in an extremely limited manner. In general, the authors emphasise that more research needs to be conducted to better understand the characteristics of the medical students and develop standards for surgical education programmes, educational tools specific for related surgical domains and guidelines for the curriculum integration. The results of this study aimed to guide the instructional system designers for the endoscopic surgery education programmes.
