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Article Citation - WoS: 16Citation - Scopus: 15Using Eye-Movement Events To Determine the Mental Workload of Surgical Residents(int Group Eye Movement Research, 2018) Dalveren, Gonca Gokce Menekse; Cagiltay, Nergiz ErcilThese 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: 6Citation - Scopus: 7Are Left- and Right-Eye Pupil Sizes Always Equal?(int Group Eye Movement Research, 2019) Cagiltay, Nergiz Ercil; Dalveren, Gonca Gokce MenekseEye 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.Article Citation - WoS: 8Eye-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 ErcilEndoscopic 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.

