Scopus İndeksli Yayınlar Koleksiyonu
Permanent URI for this collectionhttps://hdl.handle.net/20.500.12416/8651
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Article A Metaverse-Based Fully Immersive Training for Temporomandibular Joint: A Pilot Study(Wiley, 2026) Ozcelik, Erol; Ekici, Saliha Zerdali; Basmaci, Fulya; Cagiltay, Nergiz Ercil; Kilicarslan, Mehmet AliObjective Understanding the temporomandibular joint (TMJ) can be challenging with conventional methods, as its complex anatomy, comprising the articular disc, mandibular condyle, and temporal bone, requires detailed visualisation. Traditional approaches like textbooks and static images often fall short, whereas modern tools such as 3D modelling and virtual reality (VR) offer more effective alternatives. Metaverse technology further enhances this by creating interactive, immersive and collaborative learning environments that simulate real-world experiences. While VR is increasingly used in dental education, research on fully immersive metaverse-based learning remains limited.Methods In this pilot study, a custom metaverse environment was developed to teach TMJ concepts. Then, the effectiveness of conventional and metaverse-based teaching methods in improving dental students' understanding of the TMJ was evaluated experimentally. A randomised trial was conducted with 120 first-year dental students, divided into three groups: classical lecturing, metaverse-based training and a combination of both.Results Findings indicate that students in the metaverse and combined groups outperformed those in the classical lecturing group, with no significant difference between the two metaverse-involved groups.Conclusions This suggests that for highly complex anatomical structures like the TMJ, metaverse-based training alone may be sufficient, eliminating the need for additional traditional instruction. The study highlights the metaverse's potential to enhance dental education by providing a fully 3D, interactive learning experience.Article Citation - Scopus: 1Randomised Comparison Between Navigation and Non-Navigation Camera Control Performance in a Surgical Simulation Task Using a Haptic Device Interface(Wolters Kluwer Medknow Publications, 2026) Cagiltay, Nergiz Ercil; Topalli, Damla; Tuner, Emre; Berker, MustafaIntroduction:Navigation skills for controlling the camera in the surgical field are critical for many minimally invasive surgery (MIS) procedures. Currently, endoscopes lack integrated navigation aids, making camera control a challenging task. This experimental study aims to investigate the effect of navigation guidance on the performance of beginners.Patients and Methods:A custom computer-based simulation environment was developed for this study, featuring two conditions - one with navigation guidance and one without - focussed on a camera-cleaning task. Participants (64 beginners) were randomly assigned to one of these groups and used two haptic devices to simulate the endoscope and surgical tools.Results:Participants in the guided condition performed significantly better than those in the unguided condition. Notably, female participants completed the task in significantly less time under the guided condition compared to the unguided one.Conclusion:These findings suggest that incorporating navigation aids into endoscope interfaces could improve user performance, especially for beginners. Medical device manufacturers should consider adding navigation features to enhance usability. In addition, simulation-based instructional systems should integrate navigation aids to better support surgical training.Article Citation - WoS: 3Citation - Scopus: 2Evaluation of the Effects of Avatar on Learning Temporomandibular Joint in a Metaverse-Based Training(John Wiley and Sons Inc, 2024) Basmaci, Fulya; Bulut, Ali Can; Ozcelik, Erol; Ekici, Saliha Zerdali; Kilicarslan, Mehmet Ali; Cagiltay, Nergiz Ercil; Zerdali Ekici, SalihaPurposeAvatars, representing users in the digital world, can influence users' behavior and attitudes. This study evaluates the impact of representing dental students receiving temporomandibular joint (TMJ) education in the metaverse via an anonymous or identified avatar.MethodsParticipants included 80 dental students in their fourth and fifth years of study. They were randomly assigned to either the avatar group (identified avatar) or the control group (anonymous avatar). Prior to training, participants completed a demographic questionnaire and a pretraining knowledge assessment. TMJ training was conducted in the metaverse for both groups. Pre- and post-training assessments included the Spielberger State-Trait Anxiety Inventory and a shyness scale to ensure group comparability. A post-test consisting of five questions was administered to both groups after 2 weeks of training.ResultsThere were no significant differences in pretraining scores for prior knowledge (p = 0.67), trait anxiety (p = 0.28), state anxiety (p = 0.92), or shyness (p = 0.42) between the avatar and control groups, indicating comparability at baseline. Post-training analysis revealed significantly higher post-test scores in the avatar group (median = 80) compared to the control group (median = 60) (p = 0.03).ConclusionsMetaverse environments offer various benefits for students, educators, and educational institutions in health education programs. Representing learners and their identities in training environments can enhance learning outcomes.Article Citation - WoS: 3Citation - Scopus: 3Expectancy From, and Acceptance of Augmented Reality in Dental Education Programs: a Structural Equation Model(Wiley, 2024) Toker, Sacip; Akay, Canan; Basmaci, Fulya; Kilicarslan, Mehmet Ali; Mumcu, Emre; Cagiltay, Nergiz ErcilObjectiveDental schools need hands-on training and feedback. Augmented reality (AR) and virtual reality (VR) technologies enable remote work and training. Education programs only partially integrated these technologies. For better technology integration, infrastructure readiness, prior-knowledge readiness, expectations, and learner attitudes toward AR and VR technologies must be understood together. Thus, this study creates a structural equation model to understand how these factors affect dental students' technology use.MethodsA correlational survey was done. Four questionnaires were sent to 755 dental students from three schools. These participants were convenience-sampled. Surveys were developed using validity tests like explanatory and confirmatory factor analyses, Cronbach's alpha, and composite reliability. Ten primary research hypotheses are tested with path analysis.ResultsA total of 81.22% responded to the survey (755 out of 930). Positive AR attitude, expectancy, and acceptance were endogenous variables. Positive attitudes toward AR were significantly influenced by two exogenous variables: infrastructure readiness (B = 0.359, beta = 0.386, L = 0.305, U = 0.457, p = 0.002) and prior-knowledge readiness (B = -0.056, beta = 0.306, L = 0.305, U = 0.457, p = 0.002). Expectancy from AR was affected by infrastructure, prior knowledge, and positive and negative AR attitudes. Infrastructure, prior-knowledge readiness, and positive attitude toward AR had positive effects on expectancy from AR (B = 0.201, beta = 0.204, L = 0.140, U = 0.267, p = 0.002). Negative attitude had a negative impact (B = -0.056, beta = -0.054, L = 0.091, U = 0.182, p = 0.002). Another exogenous variable was AR acceptance, which was affected by infrastructure, prior-knowledge preparation, positive attitudes, and expectancy. Significant differences were found in infrastructure, prior-knowledge readiness, positive attitude toward AR, and expectancy from AR (B = 0.041, beta = 0.046, L = 0.026, U = 0.086, p = 0.054).ConclusionInfrastructure and prior-knowledge readiness for AR significantly affect positive AR attitudes. Together, these three criteria boost AR's potential. Infrastructure readiness, prior-knowledge readiness, positive attitudes toward AR, and AR expectations all increase AR adoption. The study provides insights that can help instructional system designers, developers, dental education institutions, and program developers better integrate these technologies into dental education programs. Integration can improve dental students' hands-on experience and program performance by providing training options anywhere and anytime.Article Citation - WoS: 7Citation - Scopus: 8Quantitative Assessment and Objective Improvement of the Accuracy of Neurosurgical Planning Through Digital Patient-Specific 3d Models(Frontiers Media Sa, 2024) Hanalioglu, Sahin; Gurses, Muhammet Enes; Baylarov, Baylar; Tunc, Osman; Isikay, Ilkay; Cagiltay, Nergiz Ercil; Berker, MustafaObjective Neurosurgical patient-specific 3D models have been shown to facilitate learning, enhance planning skills and improve surgical results. However, there is limited data on the objective validation of these models. Here, we aim to investigate their potential for improving the accuracy of surgical planning process of the neurosurgery residents and their usage as a surgical planning skill assessment tool.Methods A patient-specific 3D digital model of parasagittal meningioma case was constructed. Participants were invited to plan the incision and craniotomy first after the conventional planning session with MRI, and then with 3D model. A feedback survey was performed at the end of the session. Quantitative metrics were used to assess the performance of the participants in a double-blind fashion.Results A total of 38 neurosurgical residents and interns participated in this study. For estimated tumor projection on scalp, percent tumor coverage increased (66.4 +/- 26.2%-77.2 +/- 17.4%, p = 0.026), excess coverage decreased (2,232 +/- 1,322 mm2-1,662 +/- 956 mm2, p = 0.019); and craniotomy margin deviation from acceptable the standard was reduced (57.3 +/- 24.0 mm-47.2 +/- 19.8 mm, p = 0.024) after training with 3D model. For linear skin incision, deviation from tumor epicenter significantly reduced from 16.3 +/- 9.6 mm-8.3 +/- 7.9 mm after training with 3D model only in residents (p = 0.02). The participants scored realism, performance, usefulness, and practicality of the digital 3D models very highly.Conclusion This study provides evidence that patient-specific digital 3D models can be used as educational materials to objectively improve the surgical planning accuracy of neurosurgical residents and to quantitatively assess their surgical planning skills through various surgical scenarios.Article Citation - Scopus: 1A User Task Design Notation for Improved Software Design(Peerj inc, 2021) Topalli, Damla; Tokdemir, Gul; Cagiltay, Nergiz Ercil; Ozcan, EdaSystem 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.Article Citation - WoS: 23Citation - Scopus: 27Insights From Pupil Size To Mental Workload of Surgical Residents: Feasibility of an Educational Computer-Based Surgical Simulation Environment (Ece) Considering the Hand Condition(Sage Publications inc, 2018) Cagiltay, Nergiz Ercil; Ozcelik, Erol; Maras, Hakan; Dalveren, Gonca Gokce Menekse; Menekse Dalveren, Gonca GokceThe advantage of simulation environments is that they present various insights into real situations, where experimental research opportunities are very limited-for example, in endoscopic surgery. These operations require simultaneous use of both hands. For this reason, surgical residents need to develop several motor skills, such as eye-hand coordination and left-right hand coordination. While performing these tasks, the hand condition (dominant, nondominant, both hands) creates different degrees of mental workload, which can be assessed through mental physiological measures-namely, pupil size. Studies show that pupil size grows in direct proportion to mental workload. However, in the literature, there are very limited studies exploring this workload through the pupil sizes of the surgical residents under different hand conditions. Therefore, in this study, we present a computer-based simulation of a surgical task using eye-tracking technology to better understand the influence of the hand condition on the performance of skill-based surgical tasks in a computer-based simulated environment. The results show that under the both-hand condition, the pupil size of the surgical residents is larger than the one under the dominant and nondominant hand conditions. This indicates that when the computer-simulated surgical task is performed with both hands, it is considered more difficult than in the dominant and nondominant hand conditions. In conclusion, this study shows that pupil size measurements are sufficiently feasible to estimate the mental workload of the participants while performing surgical tasks. The results of this study can be used as a guide by instructional system designers of skill-based training programs.Article Citation - WoS: 16Citation - Scopus: 15Construct and Face Validity of the Educational Computer-Based Environment (Ece) Assessment Scenarios for Basic Endoneurosurgery Skills(Springer, 2017) Ozcelik, Erol; Sengul, Gokhan; Berker, Mustafa; Cagiltay, Nergiz ErcilBackground In neurosurgery education, there is a paradigm shift from time-based training to criterion-based model for which competency and assessment becomes very critical. Even virtual reality simulators provide alternatives to improve education and assessment in neurosurgery programs and allow for several objective assessment measures, there are not many tools for assessing the overall performance of trainees. This study aims to develop and validate a tool for assessing the overall performance of participants in a simulation-based endoneurosurgery training environment. Methods A training program was developed in two levels: endoscopy practice and beginning surgical practice based on four scenarios. Then, three experiments were conducted with three corresponding groups of participants (Experiment 1, 45 (32 beginners, 13 experienced), Experiment 2, 53 (40 beginners, 13 experienced), and Experiment 3, 26 (14 novices, 12 intermediate) participants). The results analyzed to understand the common factors among the performance measurements of these experiments. Then, a factor capable of assessing the overall skill levels of surgical residents was extracted. Afterwards, the proposed measure was tested to estimate the experience levels of the participants. Finally, the level of realism of these educational scenarios was assessed. Results The factor formed by time, distance, and accuracy on simulated tasks provided an overall performance indicator. The prediction correctness was very high for the beginners than the one for experienced surgeons in Experiments 1 and 2. When non-dominant hand is used in a surgical procedure-based scenario, skill levels of surgeons can be better predicted. The results indicate that the scenarios in Experiments 1 and 2 can be used as an assessment tool for the beginners, and scenario-2 in Experiment 3 can be used as an assessment tool for intermediate and novice levels. It can be concluded that forming the balance between perceived action capacities and skills is critical for better designing and developing skill assessment surgical simulation tools.Article Citation - WoS: 13Citation - Scopus: 14The 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) Ozcelik, Erol; Isikay, Ilkay; Hanalioglu, Sahin; Suslu, Ahmet E.; Yucel, Taskin; Berker, Mustafa; Cagiltay, Nergiz ErcilToday, 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.