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

Abstract

Background This study assessed the impact of distance cataract surgical wet laboratory training on surgical competency of ophthalmology residents at a tertiary-level ophthalmic training center in Trujillo, Peru. Methods Three five-week distance wet lab courses were administered through Cybersight, Orbis International’s telemedicine platform. Weekly lectures and demonstrations addressed specific steps in phacoemulsification surgery. Each lecture had two accompanying wet lab assignments, which residents completed and recorded in their institution’s wet lab and uploaded to Cybersight for grading. Competency was assessed through anonymous grading of pre- and post-training surgical simulation videos, masked as to which occurred before and after training, using a standardized competency rubric adapted from the Ophthalmology Surgical Competency Assessment Rubric (OSCAR, scale of 0–32). Day one best-corrected post-operative visual acuity (BVCA) was assessed in the operative eye on the initial consecutive 4–6 surgeries conducted by the residents as per the norms of their residency training. An anonymous post-training satisfaction survey was administered to trainees’. Results In total, 21 ophthalmic residents participated in the courses, submitting a total of 210 surgical videos. Trainees’ average competency score increased 6.95 points (95%CI [4.28, 9.62], SD = 5.01, p < 0.0001, two sample t-test) from 19.3 (95%CI [17.2, 21.5], SD = 4.04) to 26.3 (95%CI [24.2, 28.3], SD = 3.93). Visual acuity for 92% of post-training resident surgeries (n = 100) was ≥20/60, meeting the World Health Organization’s criterion for good quality. Conclusions Structured distance wet lab courses in phacoemulsification resulted in significantly improved cataract surgical skills. This model could be applicable to locations where there are obstacles to traditional in-person training, such as the current COVID-19 pandemic.

Implementation and Methodology of a Pilot, Localized Video Library of Cataract Surgeries for Residency Training in a Tertiary Philippine Eye Institute

“…Another study done in 2017, used wet lab training for cataract surgery using online instructional videos, and showed improvement in trainee competency scores after the course. 12 Such studies show that video-based learning is an acceptable tool to address limitations in surgical education at this time.…”

Surgical education in the post-COVID era: an EAES DELPHI-study

“…Hands-on training resources, i.e. wet labs and dry labs, provide valuable training opportunities for surgical residents outside of the clinic and have been validated across a range of surgical specialties[ 14 – 17 ]. Unsurprisingly, respondents in the current study reached consensus on the need to use these resources both for their own merit, and as compensation for missed/limited OR training.…”

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

“…Module 1 was completed in Week 1 of on-site training, which had wet-lab training and group discussions. Wet-lab training included 5 days of intensive wet-lab course with the grading of the cases with OSSCAR score (Ophthalmology Simulated Surgical Competency Assessment Rubric) score[ 9 ] and formative feedback–assisted training wherein repeat wet-lab cases were done if the trainee did not achieve the designated score. The trainee also underwent online theoretical sessions along with group discussion on incisions and wound construction, capsulorrhexis, phacodynamics, and complications of surgery.…”