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Article Citation - WoS: 12Citation - Scopus: 13The 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 - WoS: 7Citation - Scopus: 7Classification of Intermediate and Novice Surgeons' Skill Assessment Through Performance Metrics(Sage Publications inc, 2019) Topalli, Damla; Cagiltay, Nergiz ErcilBackground. Endoscopic surgeries have become an alternative for open procedures whenever possible. For such types of operations, surgeons are required to gain several skills, whose development needs hands-on practice. Accordingly, gaining these skills today is a challenge for surgical education programs. Despite the development of several technology-enhanced training environments, there are still problems to better integrate these technologies into educational programs. For an appropriate integration, it is critical to assess the skill levels and adapt the training content according to the trainees' requirements. In the literature, there exist several methods for assessing these skill levels. However, there are still problems in practice for objective and repetitive assessment. Methods. The present study aims to estimate the skill levels of participants in surgical training programs in an objective manner by collecting experimental data from residents in an endoscopic surgical simulation environment and gathering performance metrics. Results. It is shown that, by comparing the results of a number of classification algorithms for the best accuracy estimation and feature set, the "novice" and "intermediate" skill levels can be estimated with an accuracy of 86%. Conclusions. The outcomes help surgical educators and instructional system designers to better assess the skill levels of the trainees and guide them accordingly. In addition, objective assessments as highlighted in this study can be beneficial when designing technology-enhanced adaptive learning environments.
