Phacoemulsification skills training and assessment.

Specialist Trainee, South Thames Rotation, 34 Ashgrove House, 28 Lindsay Square, London SW1V 2HW, UK.
The British journal of ophthalmology (Impact Factor: 2.92). 08/2009; 94(5):536-41. DOI: 10.1136/bjo.2009.159715
Source: PubMed

ABSTRACT BACKGROUND The quality of ophthalmic surgical training is increasingly challenged by an untimely convergence of several factors. This article reviews the tools currently available for training and assessment in phacoemulsification surgery. METHODS Medline searches were performed to identify articles with combinations of the following words: phacoemulsification, training, curriculum, virtual reality and assessment. Further articles were obtained by manually searching the reference lists of identified papers. RESULTS Thus far phacoemulsification training outside the operating room include wet labs and micro-surgical skills courses. These methods have been criticised for being unrealistic, inaccurate and inconsistent. Virtual reality simulators have the ability to teach phacoemulsification psychomotor skills, as well as to carry out objective assessment. Other ophthalmic surgical skill assessment tools such as Objective Assessment of Skills in Intraocular Surgery (OASIS) and Global Rating Assessment of Skills in Intraocular Surgery (GRASIS) are emerging. Assessor bias is minimised by using video-based assessments, which have been shown to reduce subjectivity. Dexterity analysis technology such as the Imperial College Surgical Assessment Device (ICSAD) and virtual reality simulators can be used as objective assessment devices. CONCLUSION Improvements in technology can be utilised in ophthalmology and will help to address the increasingly limited opportunities for training and assessment during training and throughout a subsequent career (re-training and re-validation). This will inevitably translate into enhanced patient care.

  • [Show abstract] [Hide abstract]
    ABSTRACT: After publication of the Accreditation Council for Graduate Medical Education's required competencies for residency training programs, ophthalmology training programs began developing objective assessments to measure resident surgical skill. The application of these evaluation tools represents a move toward standardization in the resident educational process. This review of the assessment tools found that the evaluation rubrics for cataract surgery vary in their level of reliability and validity. Currently, variations in reliability and validity are the only measure of true differences in the evaluation rubrics. Future studies will determine which of the assessment tools is the most practical and efficient for resident training. Neither author has a financial or proprietary interest in any material or method mentioned.
    Journal of Cataract and Refractive Surgery 02/2014; · 2.75 Impact Factor
  • [Show abstract] [Hide abstract]
    ABSTRACT: Zahlreiche Studien haben nachgewiesen, dass strukturiertes und betreutes ophthalmologisches Simulatortraining zur Verbesserung der ophthalmochirurgischen Ausbildung beiträgt und damit das Lernen beschleunigt. Um die Sicherheit der Patienten zu erhöhen, sollte man die Operationssimulatoren in die traditionelle Ausbildung einführen. Die vorliegende Übersichtsarbeit versucht unser derzeitiges Wissen über ophthalmochirurgische Operationssimulatoren als Trainings- und Bewertungssystem in der ophthalmologischen Aus- und Weiterbildung zusammenzufassen.
    Spektrum der Augenheilkunde 12/2013; 27(6). · 0.18 Impact Factor
  • [Show abstract] [Hide abstract]
    ABSTRACT: PurposeTo establish and evaluate a systematic training programme to be included into the ophthalmologic resident curriculum. Methods Medical students (n = 20) within a year from graduation and with no previous ophthalmic experience were included in this prospective study and randomized into two groups. Group A (n = 10) completed the Eyesi cataract simulator training programme once a week for 4 weeks, while Group B (n = 10) completed it once a week at the first and the last week. Two cataract surgeons were used to determine two different levels of reference scores. Score per analysed module [two different levels of Capsulorhexis (A and B), Hydromaneuver, Phaco divide and conquer], Overall score, Total time, Cornea injury, Capsule rupture and Capsule damage by ultrasound were recorded. ResultsGroup A outperformed Group B in several modules, reached a significant higher number of reference scores (p < 0.01) and caused fewer complications with regard to Capsule rupture (p = 0.01) and Capsule damage by ultrasound (p < 0.05). Both Groups A and B improved their performance and also became more time efficient (p < 0.01 for both groups). Group A showed positive learning curves for Overall score (p < 0.01), Capsulorhexis A (p < 0.01), Capsulorhexis B (p < 0.01) and Hydromaneuver (p = 0.01). Group B showed a significant improvement for Overall score (p < 0.01), Hydromaneuver (p = 0.02) and Phaco divide and conquer (p < 0.01). Conclusion Repetitive training with a systematic training programme, based on validated modules in the Eyesi simulator, was shown to improve simulated cataract surgery skills. Higher level of skills and more reference scores were reached with more training. Furthermore, the programme was optimized to be applied into the standard ophthalmological curriculum for cataract surgery training.
    Acta ophthalmologica 03/2014; · 2.44 Impact Factor

Full-text (2 Sources)

Available from
May 27, 2014