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Author: Cagiltay, Nergiz ErcilSubject: surgical training

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    Article
    Citation - WoS: 10
    Citation - Scopus: 12
    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.
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    Conference Object
    Insights From Eye-Movement Events in an Educational Computer-Based Environment (ece) for Endo-Neurosurgery Training Considering Gender, Hand Condition and Scenario Effects
    (Ieee, 2018) Dalveren, Gonca Gokce Menekse; Cagiltay, Nergiz Ercil
    Surgical residents of endo-neurosurgery are required to develop several surgical skills such as eye-hand coordination, ability to use both hand coordination, and depth perception. During the process of gaining these skills, there are several effective factors on the individual performance such as gender, nature of the scenarios and hand condition that can be important to better organize appropriate training programs. Earlier studies show that, surgeons' mental workload show differences according to the difficulty levels of the tasks and hand conditions during the operations. Also there are some evidences showing that male surgeons performing the surgical tasks with a better performance compared to the females. However, in the literature there are not many studies conducted to better understand these effects by analyzing the eye-movements on simulation-based surgical training environments. This study aims to understand the mental workload and gender differences from fixation number and fixation duration eye-movement events. In this study four different computer-based-simulation scenarios which are developed for an Educational Computer-based-simulation Environment (ECE) for endo-neurosurgery training have been performed by 23 (3 female) surgical residents. Participants have performed each scenario in different hand conditions (dominant, non-dominant and both hand). While surgical residents were performing the scenarios their eye-movements were recorded by an eye-tracker. The Binocular Individual Threshold (BIT) classification algorithm was used for eye-movement event classification. According to the results of fixation number and fixation duration events in these four scenarios, hand conditions, scenario fidelity levels and gender are found to be important factors that make changes on mental workload of surgical residents. It can be concluded that, in non-dominant and both hand conditions mental workload increases according to the dominant hand condition. Additionally results show that scenario fidelity levels and gender have an effect on the eye-movements of surgical residents.