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Conference Object Citation - Scopus: 2Insights From Eye-Movement Events in an Educational Computer-Based Environment (ece) for Endo-Neurosurgery Training Considering Gender, Hand Condition and Scenario Effects(Institute of Electrical and Electronics Engineers Inc., 2018) Dalveren,G.G.M.; Cagiltay,N.E.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. © 2018 IEEE.Article Citation - WoS: 10Citation - Scopus: 12Distinguishing Intermediate and Novice Surgeons by Eye Movements(Frontiers Media Sa, 2020) Menekse Dalveren, Gonca Gokce; Cagiltay, Nergiz ErcilSurgical 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.Conference Object Neuronavigation Skill Training Through Simulation: Insights From Eye Data(Iated-int Assoc Technology Education A& development, 2016) Cagiltay, N. E.; Topalli, D.; Borcek, A. O.; Tokdemir, G.; Maras, H. H.; Tonbul, G.; Aydin, E.Neuronavigation systems are developed to support the brain surgery operations. Because of its complex anatomical structure, the neurosurgery is a risky and critical operation. The surgeon is required to perform the operation in a very small area with very restricted movements. The neuronavigation systems are developed to help the surgeon during the operation to show the current position of the surgery with respect to the 3D virtual model of the patient. In these systems, the 3D virtual model of the patient is created according to the medical data (MRI/BT) of the patient. Hence these systems work like navigations systems that are used in driving a car. The surgeon uses this system by controlling the system through a software interface and its user interface and correlates the current position of the operation with the 3D patient virtual model. In this way the surgeon checks the critical anatomical structures through this system and eliminates possible risks. Hence surgeons who will perform such operations are required to develop several skills to manage this very complicated environment. They are required to perform the operation according to the information coming from the navigation display. Additionally, in order to reach relevant information from the navigation display they have to control the navigation panel. In order to prepare surgeons to manage this very complicated environment, their required skills need to be improved during the training period. In this study, to better understand the surgeons' behaviours while managing the tasks related to the surgical navigation procedures, a simulation based environment is developed and an experimental study is conducted with 10 people. Their eye data and their performance data is recorded based on the simulated tasks. The results of the study is analysed statistically and descriptively. The results show that it is possible to control a neuronavigation display through eye movements which could be an alternative human-computer interaction option for designing the neuronavigation systems' user interfaces. Secondly, it is shown that performing a task according to the results of a second information source (neuronavigation system) lowers the general performance in terms of travelled distance with the operation tool and camera (endoscope). However the success level while performing each task and the time spent values are similar in both cases. On the other hand the number of errors is higher in the first scenario. Hence, the surgical education programs need to provide appropriate solutions to better understand and measure the skill levels of trainees on such tasks and to improve their skills through virtual practice systems.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 ErcilSurgical 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.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(Institute of Electrical and Electronics Engineers Inc., 2018) Dalveren,G.G.M.; Cagiltay,N.E.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. © 2018 IEEE.
