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Wood TC, Maqsood S, Saunders A, Sancha W, Nanavaty MA, Wearne M, Rajak S. Simulation-based training for intraoperative posterior capsule rupture management: an analysis of nontechnical skills development and the relationship between technical and nontechnical skills. Eye (Lond) 2024:10.1038/s41433-024-03051-y. [PMID: 38575658 DOI: 10.1038/s41433-024-03051-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2023] [Revised: 03/09/2024] [Accepted: 03/28/2024] [Indexed: 04/06/2024] Open
Abstract
OBJECTIVES To analyse development of individual nontechnical skills (NTS) domains after undertaking a previously developed simulation-based training model and analyse the relationship between technical skills (TS) and NTS in ophthalmic surgery. METHODS The simulation-based training model involved a cataract surgery case complicated by intraoperative posterior capsule rupture. Cataract surgeons underwent the simulation twice, separated by a training intervention. Two blinded independent experts assessed participants' NTS using HUFOES, NOn-Technical Skills for Surgeons (NOTSS), and the OSATS global rating scale for TS. Paired t-tests assessed differences in individual NTS domains, with p < 0.05 indicating significance. The Pearson Product Moment Correlation Coefficient was used to assess the correlation between scores from each scoring system. RESULTS All NTS domains within HUFOES and NOTSS demonstrated statistically significant improvements secondary to the training intervention. Positive correlations were demonstrated between HUFOES and OSATS scores in the pre- and post-training simulations, r = 0.870 (p < 0.001) and r = 0.861 (p < 0.001), respectively. Positive correlations were also demonstrated between NOTSS and OSATS scores in pre- and post-training simulations, r = 0.849 (p < 0.001) and r = 0.757 (p = 0.001), respectively. Positive correlations were demonstrated between HUFOES and NOTSS scores; r = 0.979 (p < 0.001) (n = 17) and r = 0.959 (p < 0.001) for pre- and post-training simulations, respectively. CONCLUSION All NTS domains contained within HUFOES and NOTSS demonstrated significant increases following the completion of the simulation-based training model. Positive correlations exist between an ophthalmic surgeon's TS and NTS. This is the first study to report these findings within ophthalmic surgery.
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Affiliation(s)
- Thomas Charles Wood
- Sussex Eye Hospital, University Hospitals Sussex (UHSussex) NHS Trust, Eastern Road, BN2 5BF, Brighton, UK.
| | - Sundas Maqsood
- Sussex Eye Hospital, University Hospitals Sussex (UHSussex) NHS Trust, Eastern Road, BN2 5BF, Brighton, UK
- Department of Ophthalmology, Maidstone and Tunbridge Wells Hospital, Hermitage Lane, ME16 9QQ, Maidstone, Kent, UK
| | - Alexander Saunders
- Resuscitation Services Department, Southpoint Building, Royal Sussex County Hospital, BN2 1HA, Brighton, UK
| | | | - Mayank A Nanavaty
- Sussex Eye Hospital, University Hospitals Sussex (UHSussex) NHS Trust, Eastern Road, BN2 5BF, Brighton, UK
- Brighton and Sussex Medical School, Falmer, BN1 9PX, Brighton, UK
| | - Michael Wearne
- Eastbourne District General Hospital, King's Drive, BN21 2UD, Eastbourne, East Sussex, UK
| | - Saul Rajak
- Sussex Eye Hospital, University Hospitals Sussex (UHSussex) NHS Trust, Eastern Road, BN2 5BF, Brighton, UK
- Brighton and Sussex Medical School, Falmer, BN1 9PX, Brighton, UK
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Rings L, Koechlin L. Strong German Hearts 2023: A Field Report. Thorac Cardiovasc Surg 2023; 71:605-608. [PMID: 37992736 PMCID: PMC10695697 DOI: 10.1055/s-0043-1776293] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2023] [Accepted: 08/08/2023] [Indexed: 11/24/2023]
Abstract
What do the special forces of the Federal Police and heart surgeons have in common? To find out, a team of the German Society for Thoracic and Cardiovascular Surgery (DGTHG) started a pilot project called "Strong German Hearts" with an intensive 36-hour training supported by the special forces of the Federal Police.
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Affiliation(s)
- Laura Rings
- Department of Cardiac Surgery, City Hospital of Zürich – Site Triemli, Zurich, Switzerland
| | - Luca Koechlin
- Department of Cardiac Surgery, University Hospital Basel, Basel, Switzerland
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Non-technical skills simulation-based training model for managing intraoperative posterior capsule rupture during cataract surgery. Eye (Lond) 2023; 37:474-479. [PMID: 35140330 PMCID: PMC9905539 DOI: 10.1038/s41433-022-01962-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2021] [Revised: 01/29/2022] [Accepted: 01/31/2022] [Indexed: 11/09/2022] Open
Abstract
OBJECTIVES To develop and implement a simulation-based training model for the management of posterior capsule rupture (PCR) from a non-technical skills (NTS) perspective, and analyse changes in participant's NTS and technical skills (TS). METHODS The simulation-based training model consisted of two identical PCR simulations with NTS stressors applied, separated by a predominantly NTS focussed training intervention. Participants' TS and NTS were evaluated by two blinded assessors using the Objective Structured Assessment of Technical Skill (OSATS) global rating scale and the HUman Factors in intraoperative Ophthalmic Emergencies Scoring System (HUFOES) respectively. Paired t-tests were used to establish the difference in mean HUFOES and OSATS scores between initial and repeat simulations; p < 0.05 indicated statistical significance. McGaghie's model of translational outcomes for simulation-based learning was used to establish the simulation model's educational status. RESULTS Seventeen cataract surgeons of varying training grades participated in the simulation-based training model. NTS improved with statistical significance; mean HUFOES scores increased from 48.7 ± 16.6 to 59.2 ± 14.8 (p < 0.001). Mean OSATS scores increased without statistical significance from 16.0 ± 7.3 to 17.9 ± 8.3 (p = 0.07). This simulation model achieved Level 1 (internal acceptability) and Level 2 (contained effects) according to McGaghie's model. CONCLUSIONS This novel simulation-based training model was designed to improve the NTS required for managing intraoperative PCR, through the provision of an interactive training session. Statistically significant improvements in participants' NTS in combination with statistically insignificant improvements in TS demonstrate that the simulation-based training model has specificity within the NTS domain.
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Principles of simulation and their role in enhancing cataract surgery training. Eye (Lond) 2022; 36:1529-1531. [PMID: 35368026 PMCID: PMC8976420 DOI: 10.1038/s41433-022-02052-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2022] [Revised: 03/19/2022] [Accepted: 03/22/2022] [Indexed: 12/05/2022] Open
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