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Article Citation - WoS: 6Citation - Scopus: 6Understanding the Effect of Handedness on Both-Handed Task Performance: an Experimental Study Based on a Haptic-Controlled, Simulation-Based Surgical Skill Training Scenario(Taylor & Francis inc, 2019) Topalli, Damla; Eyuboglu, Burak Gokberk; Cagiltay, Nergiz ErcilUnderstanding the performance on both-handed tasks, such as endoscopic surgery, is critical to better organize and develop appropriate instructional systems to improve the necessary skills of surgeons. However, in the literature, only a limited number of studies have investigated the effect of handedness on both-handed task performance. This study aimed to provide an understanding of the participants' performance differences while performing both-handed tasks through a haptic user interface in a simulated virtual environment specifically developed for surgical training purposes. Twenty-four surgeons attending a medical school in Turkey voluntarily participated in the study. The duration, accuracy, and collision measures were automatically recorded by software. The results revealed that the left-handed participants performed the both-handed tasks (camera: nondominant hand, tool: dominant-hand) in a significantly shorter time than the right-handed participants. This study also showed that haptic-controlled simulation-based surgical skill training systems can potentially provide measures for better understanding the individual behaviors and deliver alternative training environments specific to individual requirements.Article A User Task Design Notation for Improved Software Design(Peerj inc, 2021) Ozcan, Eda; Topalli, Damla; Tokdemir, Gul; Cagiltay, Nergiz ErcilSystem design is recognized as one of the most critical components of a software system that bridges system requirements and coding. System design also has a significant impact on testing and maintenance activities, and on further improvements during the lifespan of the software system. Software design should reflect all necessary components of the requirements in a clear and understandable manner by all stakeholders of the software system. To distinguish system elements, separation of concerns in software design is suggested. In this respect, identification of the user tasks, i.e., the tasks that need to be performed by the user, is not currently reflected explicitly in system design documents. Our main assumption in this study is that software quality can be improved significantly by clearly identifying the user tasks from those that need to be performed by the computer system itself. Additionally, what we propose has the potential to better reflect the user requirements and main objectives of the system on the software design and thereby to improve software quality. The main aim of this study is to introduce a novel notation for software developers in the frame of UML Activity Diagram (UML-AD) that enables designers to identify the user tasks and define them separately from the system tasks. For this purpose, an extension of UML-AD, named UML-ADE (UML-Activity Diagram Extended) was proposed. Afterwards, it was implemented in a serious game case for which the specification of user tasks is extremely important. Finally, its effectiveness was analyzed and compared to UML-AD experimentally with 72 participants. The defect detection performance of the participants on both diagrams with two real-life serious game scenarios was evaluated. Results show a higher level of understandability for those using UML-ADE, which in turn may indicate a better design and higher software quality. The results encourage researchers to develop specific design representations dedicated to task design to improve system quality and to conduct further evaluations of the impact of these design on each of the above mentioned potential benefits for the software systems.Review Citation - WoS: 7Citation - Scopus: 7A 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 ErcilBackground: 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.
