Resident Surgical Practice Patterns for Vitreoretinal Surgery in Ophthalmic Training Programs in the United States

Shah, Vinay; Reddy, Arun; Bonham, Aaron J.; Sabates, Nelson R.; Lee, Andrew G.

doi:10.1016/j.ophtha.2008.11.010

Cited by 28 publications

(19 citation statements)

References 9 publications

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“…Although core competencies and technical skills are described in the Iranian ophthalmology curriculum, it seems most young ophthalmologists have the confidence to manage only the uncomplicated conditions, and it is also possible that the trainer’s learning interests are affected by the fact that some learning fields in ophthalmology are highly related to their future income. However, satisfaction rates of the ophthalmologists about the outpatient and operating room training were comparable to other studies 10,12. Evaluations of learner reactions and learning outcomes also suggested that the programs have positive effects.…”

Section: Discussionsupporting

confidence: 78%

“…For example, due to the high prevalence of diabetes in Iran (9.5%), the ophthalmology curriculum should include special items for the diagnosis and prevention of diabetic retinopathy, which affects more than 37% of the Iranian diabetic population 9. In a similar study in the United States, regarding comfort level, 55.4% of ophthalmology residents, were “fairly satisfied” with vitreous-retinal training 10. On the other hand, in the last Iranian survey on prevalence of glaucoma, only 20% of the patients with glaucoma were aware about their condition.…”

Section: Discussionmentioning

confidence: 99%

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Perceived satisfaction of ophthalmology residents with the current Iranian ophthalmology curriculum

Mostafaei¹,

Hajebrahimi²

2011

OPTH

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ObjectiveTo assess the level of perceived satisfaction with the current Iranian ophthalmology curriculum in ensuring that residents acquire required competencies in various ophthalmology fields.MethodsA closed-ended questionnaire was circulated to 100 residents or recently graduated ophthalmologists in Iran to measure their level of satisfaction about clinical conferences, journal clubs, scientific lectures, wet lab, simulation, evidence-based practice, and outpatient clinic and operating room training. They also cited the main barriers to a successful board exam.ResultsNinety-nine questionnaires were completed and returned. Mean age of the responders was 31 ± 4.56 years. A total of 36 (36.4%) responders expressed an overall satisfaction about the residency program, and 49 (49.5%) did not feel happy about the state of teaching evidence-based decision making. They identified cataract surgery and eyeglass prescription as the most common regularly functioning modalities in their centers. The majority of the participants stated they have received appropriate training in cataract surgery (71%), but only 9% were satisfied with the provided training in glaucoma or vitreous and retinal surgery. Nevertheless, their overall satisfaction with their outpatient skills was good.ConclusionThe ophthalmologists felt quite confident in management of uncomplicated cases, especially cataract surgery at the level of general ophthalmology, but future studies can assess the effect of new practice-based teaching methods on the residents’ clinical training and eventually on patient care.

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Section: Discussionsupporting

confidence: 78%

Section: Discussionmentioning

confidence: 99%

Perceived satisfaction of ophthalmology residents with the current Iranian ophthalmology curriculum

Mostafaei¹,

Hajebrahimi²

2011

OPTH

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“…1 Competence in procedural skills has been recognized as especially valuable. [2][3][4] This growing emphasis is partly related to an increased focus on patient safety along with more rigorous standards in the accreditation of residency programs. 5,6 Furthermore, the importance of adequate procedural experience is highlighted by the significant effect of procedures on inpatient morbidity and mortality.…”

Section: Ré Sumémentioning

confidence: 99%

Emergency medicine procedural skills: what are residents missing?

Petrosoniak¹,

Herold²,

Woolfrey³

2013

CJEM

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Objective: This study sought to establish the current state of procedural skills training in Canadian Royal College emergency medicine (EM) residencies. Methods: A national Web-based survey was administered to residents and program directors of all 13 Canadian-accredited Royal College EM residency programs. Program directors rated the importance and experience required for competence of 45 EM procedural skills. EM residents reported their experience and comfort in performing the same procedural skills. Results: Thirteen program directors and 86 residents responded to the survey (response rate of 100% and 37%, respectively). Thirty-two (70%) procedures were considered important by . 70% of program directors, including all resuscitation and lifesaving airway procedures. Four procedures deemed important by program directors, including cricothyroidotomy, pericardiocentesis, posterior nasal pack for epistaxis, and paraphimosis reduction, had never been performed by the majority of senior residents. Program director opinion was used to categorize each procedure based on performance frequency to achieve competence. Overall, procedural experience correlated positively with comfort levels as indicated by residents. Conclusions: We established an updated needs assessment of procedural skills training for Canadian Royal College EM residency programs. This included program director opinion of important procedures and the performance frequency needed to achieve competence. However, we identified several important procedures that were never performed by most senior residents despite program director opinion regarding the experience needed for competence. Further study is required to better define objective measures for resident competence in procedural skills.

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“…One recent survey of senior ophthalmology residents in the US that the surgical experience at residency programs accredited by the Accreditation Council for Graduate Medical Education was suboptimal for vitreoretinal surgery 17. The training module described herein provides a feasible, cost-effective, and practical model for basic vitreoretinal training.…”

Section: Discussionmentioning

confidence: 99%

Basic training module for vitreoretinal surgery and the Casey Eye Institute Vitrectomy Indices Tool for Skills Assessment

Yeh¹,

Chan-Kai²,

Lauer³

2011

OPTH

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BackgroundThe purpose of this study was to design and implement a vitreoretinal training module that would be useful for ophthalmology residents and fellows to learn the basic maneuvers required in vitreoretinal surgery.MethodsA prospective pilot study evaluating the training module was undertaken in 13 ophthalmology trainees (residents and vitreoretinal fellows) with varying levels of vitreoretinal training experience. A vitreoretinal training module was designed and consisted of a three-port vitrectomy setup (sclerotomy wound construction, infusion placement), intraocular tasks (core vitrectomy, driving the operating microscope, membrane peel, air–fluid exchange), and wound closure. Standard vitrectomy instrumentation, the VitRet eye (Phillips Studio, Bristol, UK) and vitreous-like fluid using dairy creamer and balanced saline were utilized. A five-point Likert scale, ie, the Casey Eye Institute Vitrectomy Indices Tool for Skills Assessment (CEIVITS), was devised to evaluate each component of the module. Vitreoretinal surgical maneuvers were digitally recorded and graded by an attending vitreoretinal surgeon. Linear regression and correlation were performed to evaluate the relationship between prior vitreoretinal experience and CEIVITS performance. The main outcome measures were correlation of vitreoretinal surgical experience and CEIVITS performance on simulated tasks using a basic vitreoretinal training module.ResultsThirteen participants from postgraduate year 2 to postgraduate year 6 levels were evaluated. Nine participants were male and four were female. The median age of participants was 32 (range 30–36) years and surgical experience was 0–410 prior vitreoretinal surgical procedures. A positive correlation (P < 0.05) was observed between vitreoretinal surgical experience and CEIVITS performance on the following tasks: total score (P = 0.021), sclerotomy wound construction (P = 0.047), infusion line placement (P = 0.012), air–fluid exchange (P = 0.004), and wound closure (P = 0.032). Post module surveys showed that the majority of trainees felt that the vitreoretinal training module improved their understanding of vitreoretinal surgery. The nonbiohazardous nature of the setup was advantageous from sanitation and cost perspectives.ConclusionThe implementation of our training module for residency and vitreoretinal fellowship was feasible and the CEIVITS adequately assessed basic vitrectomy maneuvers. Given that ophthalmologic and subspecialty instruction migrates from an apprenticeship to a competency-based model, the face and content validity makes the CEIVITS module a promising one in vitreoretinal surgical instruction.

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Resident Surgical Practice Patterns for Vitreoretinal Surgery in Ophthalmic Training Programs in the United States

Cited by 28 publications

References 9 publications

Perceived satisfaction of ophthalmology residents with the current Iranian ophthalmology curriculum

Perceived satisfaction of ophthalmology residents with the current Iranian ophthalmology curriculum

Emergency medicine procedural skills: what are residents missing?

Basic training module for vitreoretinal surgery and the Casey Eye Institute Vitrectomy Indices Tool for Skills Assessment

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