A scoping review investigating the effects of simulation based training on surgical skills and confidence of Ophthalmology trainees in performing Glaucoma, Oculoplastic and Orbital surgical procedures.

Abstract

Background: Reduced clinical training opportunities and ethical concerns of trainees newly learning surgical procedures on patients have necessitated consideration of the role of simulation. Simulation allows a standardised training format which is reproducible, but it is not known if it has translational downstream improvements in patient care.Methods: The aim of this review is to assess the effects of simulation based training on surgical skills and confidence of Ophthalmology trainees within the Ophthalmic sub-specialities of Glaucoma, Oculoplastic and Orbital surgery (GOO).Results: This was a scoping review of the literature using MEDLINE and EMBASE to collate models used, outcomes measured and outcomes observed. The Medical Education Research Study Quality Instrument (MERSQI) was used to measure the quality of the studies. Levels of simulation based translational outcomes proposed by McGaghie et al. were used.Discussion: Fifteen studies were included. Simulation based training has high acceptability with subjective reports from participants being overwhelmingly positive in it’s ability to improve confidence in performing surgical procedures related to GOO. With regards to improvements in surgical skills, the results suggest that there are some improvements such as reduction in time taken to perform procedures and improvement in objective skills assessment scores.Conclusion: Simulation based training improves confidence of Ophthalmology trainees in performing surgical procedures related to GOO. Evidence of its effects on downstream processes is lacking, however, such downstream patient-related effects are difficult to associate with a specific educational intervention, as many other factors will be involved over time.