Impact of virtual reality simulation on learning barriers of phacoemulsification perceived by residents

Abstract

ObjectiveTo identify residents’ perceived barriers to learning phacoemulsification surgical procedures and to evaluate whether virtual reality simulation training changed these perceptions.DesignThe ophthalmology residents undertook a simulation phacoemulsification course and proficiency assessment on the Eyesi system using the previously validated training modules of intracapsular navigation, anti-tremor, capsulorrhexis, and cracking/chopping. A cross-sectional, multicenter survey on the perceived difficulties in performing phacoemulsification tasks on patients, based on the validated International Council of Ophthalmology’s Ophthalmology Surgical Competency Assessment Rubric (ICO-OSCAR), using a 5-point Likert scale (1 = least and 5 = most difficulty), was conducted among residents with or without prior simulation training. Mann–Whitney U tests were carried out to compare the mean scores, and multivariate regression analyses were performed to evaluate the association of lower scores with the following potential predictors: 1) higher level trainee, 2) can complete phacoemulsification most of the time (>90%) without supervisor’s intervention, and 3) prior simulation training.SettingThe study was conducted in ophthalmology residency training programs in five regional hospitals in Hong Kong.ResultsOf the 22 residents, 19 responded (86.3%), of which 13 (68.4%) had completed simulation training. Nucleus cracking/chopping was ranked highest in difficulty by all respondents followed by capsulorrhexis completion and nucleus rotation/manipulation. Respondents with prior simulation training had significantly lower difficulty scores on these three tasks (nucleus cracking/chopping 3.85 vs 4.75, P = 0.03; capsulorrhexis completion 3.31 vs 4.40, P = 0.02; and nucleus rotation/manipulation 3.00 vs 4.75, P = 0.01). In multivariate analyses, simulation training was significantly associated with lower difficulty scores on these three tasks.ConclusionResidents who had completed Eyesi simulation training had higher confidence in performing the most difficult tasks perceived during phacoemulsification.

Usefulness of virtual reality-based training to diagnose strabismus

“…McCannel et al 15 presented that VR simulation could reduce the rate of errant capsulorhexis. Ng et al 16 reported that residents who had completed the VR training had greater confidence in performing phacoemulsification. In addition to surgical training, Wilson et al 8 reported that the VR ophthalmoscope training could successfully simulate performing eye examinations.…”

The impact of distance cataract surgical wet laboratory training on cataract surgical competency of ophthalmology residents

“…The use of the virtual reality cataract surgical simulator Eyesi (VRmagic, Mannheim, Germany) has also shown improved performance among cataract surgery trainees [ 27 ]. Eyesi cataract simulation training has shown improvements in resident ophthalmologists’ confidence in performing phacoemulsification [ 28 ]. A Royal College of Ophthalmologists’ National Ophthalmology database study of nearly 18,000 cases performed by first- and second-year residents showed a 38% reduction in posterior capsule rupture rates for residents who’d undergone simulation training compared to trainees who did not receive this form of simulation training [ 29 ].…”

Validez de constructo del uso de realidad virtual en la cirugía de cataratas: revisión sistemática

“…La adición del entrenamiento de simulación quirúrgica se asoció con una tasa significativamente reducida de complicaciones, incluyendo desgarros de la cápsula posterior y prolapso vítreo Siu-Chung et al 2018 21 Estudio prospectivo, transversal, multicéntrico (ICO-OSCAR) Eyesi Catarata…”

“…Siu-Chung y colaboradores descubrieron que aquellos residentes que se entrenaron con realidad virtual y que completaron el entrenamiento de simulación Eyesi tenían mayor confianza en la realización de las tareas más difíciles durante la facoemulsificación. 21 PhacoVision es un simulador de realidad virtual para la técnica de cirugía de cataratas usando facoemulsificación. Algunos de los estudios realizados para este simulador destacan el desarrollo de índices integrados para monitorear el desempeño de los usuarios durante el entrenamiento en cirugía de cataratas.…”