Insights from Eye-movement Events in an Educational Computer-based-simulation Environment (ECE) for Endo-neurosurgery Training Considering Gender, Hand Condition and Scenario Effects

Abstract

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.