Cost analysis of virtual-reality phacoemulsification simulation in ophthalmology training programs

Lowry, Eugene A.; Porco, Travis C.; Naseri, Ayman

doi:10.1016/j.jcrs.2013.08.015

Cited by 23 publications

(25 citation statements)

References 6 publications

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“…A limitation to using the EyeSi simulator as an assessment tool in all residency programmes is cost. However, Lowry et al (2013) found that purchase of the EyeSi simulator was related to a wide range of cost reductions between residency programmes with number of residents being a major predictor. This in spite of the fact that only a decrease in operating time after training on the EyeSi simulator was included in the equation.…”

Section: Discussionmentioning

confidence: 99%

High correlation between performance on a virtual‐reality simulator and real‐life cataract surgery

Thomsen

Smith

Subhi

et al. 2016

Acta Ophthalmologica

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Purpose: To investigate the correlation in performance of cataract surgery between a virtualreality simulator and real-life surgery using two validated, objective assessment tools.Methods: Cataract surgeons with varying levels of experience were included in the study. All participants performed and video-recorded three standard cataract surgeries before completing a proficiency-based test on the EyeSi virtual-reality simulator. Standard cataract surgeries were defined as: 1) surgery performed under local anaesthesia, 2) patient age > 60 years, and 3) visual acuity > 1/60 pre-operatively. A motion-tracking score was calculated by multiplying average path length and average number of movements from the three real-life surgical videos of full procedures. The EyeSi test consisted of five abstract and two procedural modules: intracapsular navigation, antitremor training, intracapsular antitremor training, forceps training, bimanual training, capsulorhexis, and phaco divide and conquer. Results: Eleven surgeons were enrolled. After a designated warm-up period, the proficiency-based test on the EyeSi simulator was strongly correlated to real-life performance measured by motion-tracking software of cataract surgical videos with a Pearson correlation coefficient of -0.70(p=0.017). Conclusion: Performance on the EyeSi simulator is significantly and highly correlated to real-life surgical performance. However, it is recommended that performance assessments are made using multiple data sources

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Section: Discussionmentioning

confidence: 99%

High correlation between performance on a virtual‐reality simulator and real‐life cataract surgery

Thomsen

Smith

Subhi

et al. 2016

Acta Ophthalmologica

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“…Furthermore, an associated cost reduction in residency programmes has been shown (Lowry et al. ). Indeed, there is a need for an assessment tool and an associated criterion, which objectively and in a standardized manner assesses when the trainee has achieved proficiency within the area.…”

Section: Discussionmentioning

confidence: 99%

Simulation‐based certification for cataract surgery

Thomsen

Kiilgaard

Kjærbo

et al. 2015

Acta Ophthalmologica

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ABSTRACT.Purpose: To evaluate the EyeSi TM simulator in regard to assessing competence in cataract surgery. The primary objective was to explore all simulator metrics to establish a proficiency-based test with solid evidence. The secondary objective was to evaluate whether the skill assessment was specific to cataract surgery. Methods: We included 26 ophthalmic trainees (no cataract surgery experience), 11 experienced cataract surgeons (>4000 cataract procedures) and five vitreoretinal surgeons. All subjects completed 13 different modules twice. Simulator metrics were used for the assessments. Results: Total module score on seven of 13 modules showed significant discriminative ability between the novices and experienced cataract surgeons. The intermodule reliability coefficient was 0.76 (p < 0.001). A pass/fail level was defined from the total score on these seven modules using the contrasting-groups method. The test had an overall ability to discriminate between novices and experienced cataract surgeons, as 21 of 26 novices (81%) versus one of 11 experienced surgeons (9%) did not pass the test. The vitreoretinal surgeons scored significantly higher than the novices (p = 0.006), but not significantly lower than the experienced cataract surgeons (p = 0.32). Conclusion: We have established a performance test, consisting of seven modules on the EyeSi TM simulator, which possess evidence of validity. The test is a useful and reliable tool for assessment of both cataract surgical and general microsurgical skills in vitro.

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“…Two separate preliminary analyses on cost effectiveness were carried out in 2013, both suggested that the cost to benefit ratio was unfavourable. One study predicted, on the basis of cost modelling, that residency programmes would not be able to recoup the costs of purchasing one Eyesi model within 10 years under the most optimistic scenario [ 149 ]. The other study suggested that, realistically, it would take 34 years to make a cost recovery [ 150 ].…”

Section: Discussionmentioning

confidence: 99%

A systematic review of simulation-based training tools for technical and non-technical skills in ophthalmology

Lee

Raison

Lau

et al. 2020

Eye

100

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To evaluate all simulation models for ophthalmology technical and non-technical skills training and the strength of evidence to support their validity and effectiveness. A systematic search was performed using PubMed and Embase for studies published from inception to 01/07/2019. Studies were analysed according to the training modality: virtual reality; wet-lab; dry-lab models; e-learning. The educational impact of studies was evaluated using Messick’s validity framework and McGaghie’s model of translational outcomes for evaluating effectiveness. One hundred and thirty-one studies were included in this review, with 93 different simulators described. Fifty-three studies were based on virtual reality tools; 47 on wet-lab models; 26 on dry-lab models; 5 on e-learning. Only two studies provided evidence for all five sources of validity assessment. Models with the strongest validity evidence were the Eyesi Surgical, Eyesi Direct Ophthalmoscope and Eye Surgical Skills Assessment Test. Effectiveness ratings for simulator models were mostly limited to level 2 (contained effects) with the exception of the Sophocle vitreoretinal surgery simulator, which was shown at level 3 (downstream effects), and the Eyesi at level 5 (target effects) for cataract surgery. A wide range of models have been described but only the Eyesi has undergone comprehensive investigation. The main weakness is in the poor quality of study design, with a predominance of descriptive reports showing limited validity evidence and few studies investigating the effects of simulation training on patient outcomes. More robust research is needed to enable effective implementation of simulation tools into current training curriculums.

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Cost analysis of virtual-reality phacoemulsification simulation in ophthalmology training programs

Cited by 23 publications

References 6 publications

High correlation between performance on a virtual‐reality simulator and real‐life cataract surgery

High correlation between performance on a virtual‐reality simulator and real‐life cataract surgery

Simulation‐based certification for cataract surgery

A systematic review of simulation-based training tools for technical and non-technical skills in ophthalmology

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