Standardized approach to training for cataract surgery skill evaluation

Pittner, Andrew; Nolan, Michael; Traish, Aisha S.; Farooq, Asim V.; Feder, Robert S.; Hill, Geoff; Dwarakanathan, Surendar; McGaghie, William C.; Bouchard, Charles S.

doi:10.1016/j.jcrs.2016.03.031

Cited by 12 publications

(5 citation statements)

References 8 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…In the future, assessment tools might be further modified to standardize resident education toward the goal of more uniform surgical skills in the wet-lab curriculum. Learning to accurately evaluate the performance of cataract surgery by reviewing videos is an integral part of ophthalmology residency education [23][24] . Trainees are expected to make rigorous self-evaluations as an index of professional competence [25] .…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Utility of real-time 3D visualization system in the early stage of phacoemulsification training

Xu,

Feng

et al. 2024

Int J Ophthalmol

View full text Add to dashboard Cite

AIM: To determine the teaching effects of a real-time three dimensional (3D) visualization system in the operating room for early-stage phacoemulsification training. METHODS: A total of 10 ophthalmology residents of the first-year postgraduate were included. All the residents were novices to cataract surgery. Real-time cataract surgical observations were performed using a custom-built 3D visualization system. The training lasted 4wk (32h) in all. A modified International Council of Ophthalmology’s Ophthalmology Surgical Competency Assessment Rubric (ICO-OSCAR) containing 4 specific steps of cataract surgery was applied. The self-assessment (self) and expert-assessment (expert) were performed through the microsurgical attempts in the wet lab for each participant. RESULTS: Compared with pre-training assessments (self 3.2±0.8, expert 2.5±0.6), the overall mean scores of post-training (self 5.2±0.4, expert 4.7±0.6) were significantly improved after real-time observation training of 3D visualization system (P<0.05). Scores of 4 surgical items were significantly improved both self and expert assessment after training (P<0.05). CONCLUSION: The 3D observation training provides novice ophthalmic residents with a better understanding of intraocular microsurgical techniques. It is a useful tool to improve teaching efficiency of surgical education.

show abstract

Section: Discussionmentioning

confidence: 99%

“…Incorrect assessment at any stage will introduce unwanted error variance. Thus, residents must assess their performance accurately for surgical improvement [23] .…”

Section: Discussionmentioning

confidence: 99%

Utility of real-time 3D visualization system in the early stage of phacoemulsification training

Xu,

Feng

et al. 2024

Int J Ophthalmol

View full text Add to dashboard Cite

show abstract

“…Trainees are expected to perform rigorous self-evaluation of their surgical skills as an index of professional competence. [ 1 ] It benefits a trainee to smoothly transition from phacoemulsification step surgery to complete independent surgeries with supervisory discussions. Observational learning is an effective method for learning surgical skills.…”

Section: Discussionmentioning

confidence: 99%

“…Cataract surgery is one of the most frequently performed surgical procedures worldwide. [ 1 ] Phacoemulsification is the preferred technique for performing a cataract surgery as it gives better uncorrected visual acuity in a larger proportion of patients at 6 weeks as compared with the manual small-incision cataract surgery[ 2 ] and has lower surgically induced astigmatism. [ 3 ] The residency training program in the majority of the medical schools across India offers minimal or no exposure to phacoemulsification surgery techniques.…”

mentioning

confidence: 99%

Impact of a structured training program to enhance skills in phacoemulsification surgery

Bhatt

Dole²,

Deshpande³

et al. 2021

Indian Journal of Ophthalmology

View full text Add to dashboard Cite

Purpose: The aim of this study was to determine whether the introduction of a structured short-term phacoemulsification training program improved the ICO-OSCAR (International Council of Ophthalmology’s Ophthalmology Surgical Competency Assessment Rubric) score and the learning curve of the trainees and decreased the complication rates of the cases. Methods: This study was a retrospective, observational study conducted in a tertiary eye care hospital in India. The study was conducted from March 2018 to October 2019 based on a structured phacoemulsification training program introduced in January 2019. The trainees enrolled in the phacoemulsification training program were divided into two groups: Group 1 ( n = 33), who underwent training before the introduction of the structured program, and Group 2 ( n = 29), who underwent the training after the introduction of the structured training program. Each trainee performed 20 cases. Group 1 training consisted of wet-lab and phacoemulsification surgeries. Group 2 training program comprised three modules over 5 weeks and a preassessment examination. Premodule 1 imparted cognitive skills; Module 1 was on structured wet-lab, Module 2 was about phacoemulsification step surgery, and Module 3 had independent complete surgeries. Group 2 also underwent compulsory Observation of cases being performed in the operation theater, surgical video recording review, and formative feedback. Mean OSCAR score comparison was done for both the groups. The OSCAR score was also calculated case-wise to obtain the learning curve with respect to the entry and exit levels, by classifying the trainees in each group as Novice, Beginner, Advanced Beginner, or Competent. A comparison of the posterior capsular rupture (PCR) rates and vision at discharge of all the cases was done. Results: Group 2 had a significantly better mean OSCAR score than Group 1 (4.03 and 3.43, respectively; P < 0.001). The PCR rate of the cases was significantly lower in Group 2 than in Group 1 (9.14% and 20.30%, respectively; P < 0.001). Group 2 had a significantly better visual acuity outcome of the cases than Group 1. Group 1 started as Novice (OSCAR score: 2), whereas Group 2 started as Beginner (OSCAR score: 3). Group 2 reached the Advanced Beginner level eight to 10 cases prior to Group 1. Conclusion: A structured training curriculum can make a significant difference in the training experience of the trainees and enable better surgical outcomes and a decrease in the complication rates.

show abstract

“…Worldwide Cataract is a major cause of blindness followed by refractive error with phacoemulsification being the preferred technique for cataract surgery. [ 1 , 2 ] Postoperative assessment after a cataract surgery is a vital step in the management of the patient as it documents the outcome of surgery and enables earlier identification of complications if any. [ 3 ] Postoperative follow-up among these patients is quite challenging due to commuting problem and the requirement of the attendant as cataract mainly affects geriatric population which increases indirect cost of follow-up.…”

Section: Introductionmentioning

confidence: 99%

A comparative clinical study of postoperative care by teleophthalmology and in-person consultation at hospital outpatient department after an uncomplicated cataract surgery

Pakhale,

Dole,

Gandhi

et al. 2023

Oman J Ophthalmol

View full text Add to dashboard Cite

BACKGROUND: Teleophthalmology provides an opportunity to conduct consultations in far-flung and remote areas that have no access to specialized eye care. However, there is a paucity of studies to assess the effect of missing in-person follow-up on initial postoperative visits. The study thus aims to compare postoperative satisfaction and uncorrected distance visual activity after an uneventful phacoemulsification cataract surgery in patients with teleconsultation approach to those with hospital visit. MATERIALS AND METHODS: The prospective observation study ( n = 240) was conducted in patients who underwent surgery for cataract. Pre- and post-operative data were collected and divided into two groups based on the type of postoperative follow-up. All patients were scheduled for ophthalmic reviews in the hospital on day 1, day 7, and day 30–40 (hospital visit group) or through teleconsultation on days 1 and 7 followed by a hospital visit on days 30–40 (teleconsultation group). Outcomes evaluated in both groups were complications, patient satisfaction, and uncorrected distance visual acuity. RESULTS: Most patients in both groups were in the age group of 51–70 years. Overall satisfaction was comparable in teleconsultation and hospital visit groups (3.74 ± 0.23 vs. 3.72 ± 0.27; P = 0.22). The majority of patients had visual acuity 6/18-6/6 on postoperative day 1, day 7, and day 30–40 in both groups. Lid edema, pain, redness, watering, and congestion complications were more in the hospital visit group on postoperative day 1. CONCLUSION: The study concludes that patients with no preexisting ocular and systemic comorbidity undergoing an uneventful phacoemulsification cataract surgery teleconsultation approach can be used for follow-up without any impact on the postoperative visual outcome and patient satisfaction, thereby increasing the efficiency and productivity of health-care system.

show abstract

Standardized approach to training for cataract surgery skill evaluation

Abstract: None of the authors has a financial or proprietary interest in any material or method mentioned.

Cited by 12 publications

References 8 publications

Utility of real-time 3D visualization system in the early stage of phacoemulsification training

Utility of real-time 3D visualization system in the early stage of phacoemulsification training

Impact of a structured training program to enhance skills in phacoemulsification surgery

A comparative clinical study of postoperative care by teleophthalmology and in-person consultation at hospital outpatient department after an uncomplicated cataract surgery

Contact Info

Product

Resources

About