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Dean W, Patel D, Venkatesh R, Wolvaardt E. Learning surgical skills for eye care. COMMUNITY EYE HEALTH 2023; 36:1-3. [PMID: 38178824 PMCID: PMC10762705] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Figures] [Subscribe] [Scholar Register] [Indexed: 01/06/2024]
Affiliation(s)
- William Dean
- Assistant Clinical Professor: ICEH, LSHTM, London, UK
| | | | | | - Elmien Wolvaardt
- Editor-in-Chief: Community Eye Health Journal, ICEH, LSHTM, London, UK
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Zhang Z, Li S, Sun L, Yan W, Huang L, Lu J, Wang Q, Li M, Zheng D, Liu Y, Ding X. Skills assessment after a grape-based microsurgical course for ophthalmology residents: randomised controlled trial. Br J Ophthalmol 2023; 107:1395-1402. [PMID: 35701080 PMCID: PMC10447371 DOI: 10.1136/bjophthalmol-2022-321135] [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: 01/17/2022] [Accepted: 05/19/2022] [Indexed: 11/04/2022]
Abstract
AIMS To introduce and assess a course using grapes as training models for ophthalmology residents to acquire basic microsurgical skills. METHODS Ophthalmology residents who were novices at microsurgery were included. Participants were randomised into a 1:1 ratio to a 4-hour training programme based on fruit models (group A) or virtual reality (VR) modulator and silicone suture pads (group B), respectively. Before and after training, questionnaires were designed to measure their self-confidence with ophthalmic operations and with their coming role as surgical assistants. After training, each participant provided their interest in further studying microsurgery and was assessed for their general competence of ophthalmic microsurgery on porcine eyes. RESULTS Eighty-three participants were included, with 42 ones in group A and 41 ones in group B. After training, participants in group A performed better in the uniformities of the suture span (p<0.05), suture thickness (p<0.05) and tissue protection (p<0.05) during the corneal suturing assessment. The overall scores of corneal suturing and circular capsulorhexis in the porcine eye in group A were comparable to those in group B (p=0.26 and 0.87, respectively). Group A showed a more positive attitude to withstand the training for more than 4 hours (p<0.001), as well as a higher willingness to receive more times of the training in the future (p<0.001). CONCLUSIONS Training models based on grapes are equal to VR simulators and silicon suture pads to provide solid training tasks for ophthalmology residents to master basic microsurgical skills, and might have advantages in lower economic cost, and easy availability. TRIAL REGISTRATION NUMBER ChiCTR2000040439.
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Affiliation(s)
- Zhaotian Zhang
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Guangdong Provincial Clinical Research Center for Ocular Diseases, Guangzhou, China
| | - Songshan Li
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Guangdong Provincial Clinical Research Center for Ocular Diseases, Guangzhou, China
| | - Limei Sun
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Guangdong Provincial Clinical Research Center for Ocular Diseases, Guangzhou, China
| | - Wenjia Yan
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Guangdong Provincial Clinical Research Center for Ocular Diseases, Guangzhou, China
| | - Li Huang
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Guangdong Provincial Clinical Research Center for Ocular Diseases, Guangzhou, China
| | - Jinglin Lu
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Guangdong Provincial Clinical Research Center for Ocular Diseases, Guangzhou, China
| | - Qiong Wang
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Guangdong Provincial Clinical Research Center for Ocular Diseases, Guangzhou, China
| | - Mengke Li
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Guangdong Provincial Clinical Research Center for Ocular Diseases, Guangzhou, China
| | - Danying Zheng
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Guangdong Provincial Clinical Research Center for Ocular Diseases, Guangzhou, China
| | - Yizhi Liu
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Guangdong Provincial Clinical Research Center for Ocular Diseases, Guangzhou, China
| | - Xiaoyan Ding
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Guangdong Provincial Clinical Research Center for Ocular Diseases, Guangzhou, China
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Cheema M, Anderson S, Hanson C, Solarte C. Surgical simulation in Canadian ophthalmology programs: a nationwide questionnaire. CANADIAN JOURNAL OF OPHTHALMOLOGY 2023; 58:e11-e13. [PMID: 35623410 DOI: 10.1016/j.jcjo.2022.05.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/06/2021] [Revised: 04/19/2022] [Accepted: 05/02/2022] [Indexed: 11/16/2022]
Affiliation(s)
- Marvi Cheema
- Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Alta
| | - Scott Anderson
- Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Alta
| | | | - Carlos Solarte
- Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Alta..
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Annoh R, Buchan J, Gichuhi S, Philippin H, Arunga S, Mukome A, Admassu F, Lewis K, Makupa W, Otiti-Sengeri J, Kim M, MacLeod D, Burton MJ, Dean WH. The Impact of Simulation-Based Trabeculectomy Training on Resident Core Surgical Skill Competency. J Glaucoma 2023; 32:57-64. [PMID: 36001526 PMCID: PMC7614002 DOI: 10.1097/ijg.0000000000002114] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2021] [Accepted: 07/27/2022] [Indexed: 02/08/2023]
Abstract
PRCIS Simulation-based surgical education shows a positive, immediate, and sustained impact on core surgical skill competency in trabeculectomy among resident ophthalmologists in training. PURPOSE To measure the impact of trabeculectomy, surgical simulation training on core surgical skill competency in resident ophthalmologists. MATERIALS AND METHODS This is a post hoc analysis of the GLAucoma Simulated Surgery trial, which is a multicenter, multinational randomized controlled trial. Resident ophthalmologists from 6 training centers in sub-Saharan Africa (in Kenya, Uganda, Tanzania, Zimbabwe, and South Africa) were recruited according to the inclusion criteria of having performed zero surgical trabeculectomies and assisted in <5. Participants were randomly assigned to intervention and control arms using allocation concealment. The intervention was a 1-week intensive trabeculectomy surgical simulation course. Outcome measures were mean surgical competency scores in 8 key trabeculectomy surgical skills (scleral incision, scleral flap, releasable suturing, conjunctival suturing, sclerostomy, tissue handling, fluidity, and speed), using a validated scoring tool. RESULTS Forty-nine residents were included in the intention-to-treat analysis. Baseline characteristics were balanced between arms. Median baseline surgical competency scores were 2.88/16 [interquartile range (IQR): 1.75-4.17] and 3.25/16 (IQR: 1.83-4.75) in the intervention and control arms, respectively. At primary intervention, median scores increased to 11.67/16 (IQR: 9.58-12.63) and this effect was maintained at 3 months and 1 year ( P =0.0001). Maximum competency scores at primary intervention were achieved in the core trabeculectomy skills of releasable suturing (n=17, 74%), scleral flap formation (n=16, 70%), and scleral incision (n=15, 65%) compared with scores at baseline. CONCLUSIONS This study demonstrates the positive impact of intensive simulation-based surgical education on core trabeculectomy skill development. The rapid and sustained effect of resident skill acquisition pose strong arguments for its formal integration into ophthalmic surgical education.
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Affiliation(s)
- Roxanne Annoh
- International Centre for Eye Health, Department of Clinical Research, London School of Hygiene and Tropical Medicine, London, UK
| | - John Buchan
- International Centre for Eye Health, Department of Clinical Research, London School of Hygiene and Tropical Medicine, London, UK
| | | | - Heiko Philippin
- International Centre for Eye Health, Department of Clinical Research, London School of Hygiene and Tropical Medicine, London, UK
- Eye Centre, Medical Centre, Faculty of Medicine, University of Freiburg, Germany
| | - Simon Arunga
- International Centre for Eye Health, Department of Clinical Research, London School of Hygiene and Tropical Medicine, London, UK
- Mbarara University & Referral Hospital Eye Centre (MURHEC), Mbarara University of Science and Technology, Mbarara, Uganda
| | - Agrippa Mukome
- Department of Ophthalmology, Parirenyatwa Hospitals, University of Zimbabwe, Harare
| | | | - Karinya Lewis
- Ophthalmology Department, Salisbury Hospitals NHS Foundation Trust, UK
- Eye Foundation Hospitals, Lagos, Nigeria
| | | | - Juliet Otiti-Sengeri
- Department of Ophthalmology, School of Medicine, Makerere University, Kampala, Uganda
| | - Min Kim
- Tropical Epidemiology Group, Faculty of Infectious Disease Epidemiology, London School of Hygiene and Tropical Medicine, London; UK
| | - David MacLeod
- Tropical Epidemiology Group, Faculty of Infectious Disease Epidemiology, London School of Hygiene and Tropical Medicine, London; UK
| | - Matthew J. Burton
- International Centre for Eye Health, Department of Clinical Research, London School of Hygiene and Tropical Medicine, London, UK
- National Institute for Health Research Biomedical Research Centre for Ophthalmology at Moorfields Eye Hospital NHS Foundation Trust and UCL Institute of Ophthalmology, United Kingdom
| | - William H. Dean
- International Centre for Eye Health, Department of Clinical Research, London School of Hygiene and Tropical Medicine, London, UK
- Division of Ophthalmology, University of Cape Town, South Africa
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Song SL, Yu ZZ, Pavlech L, Scott IU, Greenberg PB. Theoretical Frameworks in Medical Education: Using a Systematic Review of Ophthalmology Education Research to Create a Theory of Change Model. J Grad Med Educ 2022; 14:568-582. [PMID: 36274766 PMCID: PMC9580314 DOI: 10.4300/jgme-d-22-00115.1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/07/2022] [Revised: 05/25/2022] [Accepted: 07/22/2022] [Indexed: 11/06/2022] Open
Abstract
BACKGROUND Theoretical frameworks provide a lens to examine questions and interpret results; however, they are underutilized in medical education. OBJECTIVE To systematically evaluate the use of theoretical frameworks in ophthalmic medical education and present a theory of change model to guide educational initiatives. METHODS Six electronic databases were searched for peer-reviewed, English-language studies published between 2016 and 2021 on ophthalmic educational initiatives employing a theoretical framework. Quality of studies was assessed using the Grading of Recommendations, Assessment, Development, and Evaluations (GRADE) approach; risk of bias was evaluated using the Medical Education Research Study Quality Instrument (MERSQI) and the Accreditation Council for Graduate Medical Education (ACGME) guidelines for evaluation of assessment methods. Abstracted components of the included studies were used to develop a theory of change model. RESULTS The literature search yielded 1661 studies: 666 were duplicates, 834 studies were excluded after abstract review, and 132 after full-text review; 29 studies (19.2%) employing a theoretical framework were included. The theories used most frequently were the Dreyfus model of skill acquisition and Messick's contemporary validity framework. GRADE ratings were predominantly "low," the average MERSQI score was 10.04, and the ACGME recommendation for all assessment development studies was the lowest recommendation. The theory of change model outlined how educators can select, apply, and evaluate theory-based interventions. CONCLUSIONS Few ophthalmic medical education studies employed a theoretical framework; their overall rigor was low as assessed by GRADE, MERSQI, and ACGME guidelines. A theory of change model can guide integration of theoretical frameworks into educational initiatives.
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Affiliation(s)
- Sophia L. Song
- Sophia L. Song, ScB, is a Medical Student, Warren Alpert Medical School, Brown University
| | - Zane Z. Yu
- Zane Z. Yu, AB, is a Medical Student, Warren Alpert Medical School, Brown University
| | - Laura Pavlech
- Laura Pavlech, DVM, MSLS, is a Research Librarian, University of Maryland School of Pharmacy and University of Maryland Health and Human Services Library
| | - Ingrid U. Scott
- Ingrid U. Scott, MD, MPH, is a Professor of Ophthalmology and Public Health Sciences, Penn State College of Medicine
| | - Paul B. Greenberg
- Paul B. Greenberg, MD, MPH, is Deputy Chief Academic Affiliations Officer, Office of Academic Affiliations, United States Department of Veterans Affairs, and Professor of Surgery (Ophthalmology), Warren Alpert Medical School, Brown University
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Angle Examination Gonioscopy and Minimally Invasive Glaucoma Surgical Training on Human Eyes in Wet Lab. J Glaucoma 2022; 31:839-845. [PMID: 35882034 DOI: 10.1097/ijg.0000000000002075] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2021] [Accepted: 06/12/2022] [Indexed: 11/26/2022]
Abstract
PURPOSE To understand the feasibility, utility and efficacy of a low-cost model for performing anterior chamber angle gonioscopy and micro-surgery on human corneo-scleral tissues in wet lab on resident skill enhancement. METHODS Post-keratoplasty residual corneo-scleral rims and/or the expired donor corneo-scleral buttons were included for the purpose of this study. Initially, inverted rims were used to demonstrate the basic angle anatomy on a slit lamp bio-microscope. Central hazy cornea was then replaced with an artificial cornea and an artificial anterior chamber to simulate indirect gonioscopy, direct gonioscopy, goniotomy and other angle-based surgeries. Direct gonioscopy and goniotomy exercises (as a means to simulate intra-operative gonioscopy and other angle-based surgeries respectively) were evaluated quantitatively, and the rest qualitatively. RESULTS A total of 65 residents were included in the exercise. The mean age was 26.69±1.74 years. Amongst these, 55 ophthalmology residents performed the basic examination, that is, slit lamp mounted angle anatomy examination (n=55) and artificial chamber mounted indirect gonioscopic examination through artificial cornea (n=55). In the second exercise, 10 glaucoma fellows performed the direct gonioscopic and the goniotomy exercises on artificial chamber. The fellows demonstrated a statistically significant improvement in interpretation and surgical skill enhancement concurrent with reduction in time taken with increasing number of attempts (P<0.05). In the third simulation exercise, micro-stent placement within the Schlemm's canal, sub-conjunctival space, and the supra-choroidal space was re-produced successfully on multiple occasions. CONCLUSIONS The residual human corneo-scleral rims proved to be an important resource for teaching both the basic examination skills as well as those required for transitioning to advanced intraoperative gonioscopy and goniotomy skills. These low cost, easy to adapt models can be incorporated within the curriculum for improved glaucoma training of both the residents and the glaucoma fellows.
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Surgical Competency Assessment in Ophthalmology Residency. CURRENT SURGERY REPORTS 2022. [DOI: 10.1007/s40137-022-00309-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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Tripathi S, Bhadauria M, Paul C, Ariga M. Glauco skills for the millennial glaucoma specialist. TNOA JOURNAL OF OPHTHALMIC SCIENCE AND RESEARCH 2022. [DOI: 10.4103/tjosr.tjosr_24_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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Annoh R, Banks LM, Gichuhi S, Buchan J, Makupa W, Otiti J, Mukome A, Arunga S, Burton MJ, Dean WH. Experiences and Perceptions of Ophthalmic Simulation-Based Surgical Education in Sub-Saharan Africa. JOURNAL OF SURGICAL EDUCATION 2021; 78:1973-1984. [PMID: 33985925 PMCID: PMC8668871 DOI: 10.1016/j.jsurg.2021.04.005] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/23/2020] [Revised: 03/19/2021] [Accepted: 04/12/2021] [Indexed: 06/12/2023]
Abstract
BACKGROUND Simulation-based surgical education (SBSE) can positively impact trainee surgical competence. However, a detailed qualitative study of the role of simulation in ophthalmic surgical education has not previously been conducted. OBJECTIVE To explore the experiences of trainee ophthalmologists and ophthalmic surgeon educators' use of simulation, and the perceived challenges in surgical training. METHODS A multi-center, multi-country qualitative study was conducted between October 2017 and August 2020. Trainee ophthalmologists from six training centers in sub-Saharan Africa (SSA) (in Kenya, Uganda, Tanzania, Zimbabwe and South Africa) participated in semi-structured interviews, before and after an intense simulation training course in intraocular surgery. Semi-structured interviews were also conducted with experienced ophthalmic surgeon educators. Interviews were anonymized, recorded, transcribed and coded. An inductive, bottom-up, constant comparative method was used for thematic analysis. RESULTS Twenty-seven trainee ophthalmologists and 12 ophthalmic surgeon educators were included in the study and interviewed. The benefits and challenges of conventional surgical teaching, attributes of surgical educators, value of simulation in training and barriers to implementing ophthalmic surgical simulation were identified as major themes. Almost all trainees and trainers reported patient safety, a calm environment, the possibility of repetitive practice, and facilitation of reflective learning as beneficial aspects of ophthalmic SBSE. Perceived barriers in surgical training included a lack of surgical cases, poor supervision and limited simulation facilities. CONCLUSIONS Simulation is perceived as an important and valuable model for education amongst trainees and ophthalmic surgeon educators in SSA. Advocating for the expansion and integration of educationally robust simulation surgical skills centers may improve the delivery of ophthalmic surgical education throughout SSA.
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Affiliation(s)
- Roxanne Annoh
- International Centre for Eye Health, Department of Clinical Research, London School of Hygiene and Tropical Medicine, London, United Kingdom.
| | - Lena Morgon Banks
- International Centre for Evidence in Disability, Department of Clinical Research, London School of Hygiene & Tropical Medicine, London, United Kingdom
| | | | - John Buchan
- International Centre for Eye Health, Department of Clinical Research, London School of Hygiene and Tropical Medicine, London, United Kingdom
| | | | - Juliet Otiti
- Department of Ophthalmology, School of Medicine, Makerere University, Kampala, Uganda
| | - Agrippa Mukome
- Department of Ophthalmology, Parirenyatwa Hospitals, University of Zimbabwe, Harare
| | - Simon Arunga
- Mbarara University & Referral Hospital Eye Centre, Mbarara University of Science and Technology, Mbarara, Uganda
| | - Matthew J Burton
- International Centre for Eye Health, Department of Clinical Research, London School of Hygiene and Tropical Medicine, London, United Kingdom; National Institute for Health Research Biomedical Research Centre for Ophthalmology at Moorfields Eye Hospital NHS Foundation Trust and UCL Institute of Ophthalmology, United Kingdom
| | - William H Dean
- International Centre for Eye Health, Department of Clinical Research, London School of Hygiene and Tropical Medicine, London, United Kingdom; Division of Ophthalmology, University of Cape Town, South Africa
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Damagatla M, Krishnamurthy R, Senthil S. Surgical skill assessment rubric for Ahmed glaucoma valve implantation surgery. Indian J Ophthalmol 2021; 69:1008-1013. [PMID: 33727486 PMCID: PMC8012929 DOI: 10.4103/ijo.ijo_2392_20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Affiliation(s)
- Manikanta Damagatla
- Academy of Eye Education, L V Prasad Eye Institute; VST Centre for Glaucoma Care, L V Prasad Eye Institute L V Prasad Marg, Banjara Hills, Hyderabad, Telangana, India
| | - Rashmi Krishnamurthy
- VST Centre for Glaucoma Care, L V Prasad Eye Institute L V Prasad Marg, Banjara Hills, Hyderabad, Telangana, India
| | - Sirisha Senthil
- VST Centre for Glaucoma Care, L V Prasad Eye Institute L V Prasad Marg, Banjara Hills, Hyderabad, Telangana, India
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Dean WH, Buchan J, Gichuhi S, Philippin H, Arunga S, Mukome A, Admassu F, Lewis K, Makupa W, Otiti J, Kim MJ, Macleod D, Cook C, Burton MJ. Simulation-based surgical education for glaucoma versus conventional training alone: the GLAucoma Simulated Surgery (GLASS) trial. A multicentre, multicountry, randomised controlled, investigator-masked educational intervention efficacy trial in Kenya, South Africa, Tanzania, Uganda and Zimbabwe. Br J Ophthalmol 2021; 106:863-869. [PMID: 33495158 PMCID: PMC9132848 DOI: 10.1136/bjophthalmol-2020-318049] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2020] [Revised: 12/05/2020] [Accepted: 01/04/2021] [Indexed: 12/26/2022]
Abstract
Background/Aim Glaucoma accounts for 8% of global blindness and surgery remains an important treatment. We aimed to determine the impact of adding simulation-based surgical education for glaucoma. Methods We designed a randomised controlled, parallel-group trial. Those assessing outcomes were masked to group assignment. Fifty-one trainee ophthalmologists from six university training institutions in sub-Saharan Africa were enrolled by inclusion criteria of having performed no surgical trabeculectomies and were randomised. Those randomised to the control group received no placebo intervention, but received the training intervention after the initial 12-month follow-up period. The intervention was an intense simulation-based surgical training course over 1 week. The primary outcome measure was overall simulation surgical competency at 3 months. Results Twenty-five were assigned to the intervention group and 26 to the control group, with 2 dropouts from the intervention group. Forty-nine were included in the final intention-to-treat analysis. Surgical competence at baseline was comparable between the arms. This increased to 30.4 (76.1%) and 9.8 (24.4%) for the intervention and the control group, respectively, 3 months after the training intervention for the intervention group, a difference of 20.6 points (95% CI 18.3 to 22.9, p<0.001). At 1 year, the mean surgical competency score of the intervention arm participants was 28.6 (71.5%), compared with 11.6 (29.0%) for the control (difference 17.0, 95% CI 14.8 to 19.4, p<0.001). Conclusion These results support the pursuit of financial, advocacy and research investments to establish simulation surgery training units and courses including instruction, feedback, deliberate practice and reflection with outcome measurement to enable trainee glaucoma surgeons to engage in intense simulation training for glaucoma surgery. Trial registration number PACTR201803002159198.
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Affiliation(s)
- William H Dean
- International Centre for Eye Health, Department of Clinical Research, London School of Hygiene and Tropical Medicine, London, UK .,Ophthalmology, University of Cape Town Faculty of Health Sciences, Observatory, Western Cape, South Africa
| | - John Buchan
- International Centre for Eye Health, Department of Clinical Research, London School of Hygiene and Tropical Medicine, London, UK
| | - Stephen Gichuhi
- Ophthalmology, University of Nairobi College of Health Sciences, Nairobi, Kenya
| | - Heiko Philippin
- International Centre for Eye Health, Department of Clinical Research, London School of Hygiene and Tropical Medicine, London, UK.,Eye Centre, Faculty of Medicine, University of Freiburg, Freiburg im Breisgau, Baden-Württemberg, Germany
| | - Simon Arunga
- International Centre for Eye Health, Department of Clinical Research, London School of Hygiene and Tropical Medicine, London, UK.,Ophthalmology, Mbarara University of Science and Technology, Mbarara, Uganda
| | - Agrippa Mukome
- University of Zimbabwe College of Health Sciences, Harare, Zimbabwe
| | - Fisseha Admassu
- Department of Ophthalmology, University of Gondar, Gondar, Ethiopia
| | - Karinya Lewis
- Ophthalmology, Salisbury Hospital NHS Foundation Trust, Salisbury, Wiltshire, UK
| | - William Makupa
- Ophthalmology, Kilimanjaro Christian Medical Centre, Moshi, Tanzania, United Republic of
| | - Juliet Otiti
- Ophthalmology, Makerere University Faculty of Medicine, Kampala, Uganda
| | - Min J Kim
- Tropical Epidemiology Group, Faculty of Infectious Disease Epidemiology, London School of Hygiene and Tropical Medicine, London, UK
| | - David Macleod
- Tropical Epidemiology Group, Faculty of Infectious Disease Epidemiology, London School of Hygiene and Tropical Medicine, London, UK
| | - Colin Cook
- Ophthalmology, University of Cape Town Faculty of Health Sciences, Observatory, Western Cape, South Africa
| | - Matthew J Burton
- International Centre for Eye Health, Department of Clinical Research, London School of Hygiene and Tropical Medicine, London, UK.,Moorfields Eye Hospital NHS Foundation Trust, London, UK
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Swift A, Waldner D, Gorner A, Chung H, Ahmed Y, Docherty G, Gooi P. Face and content validity of an artificial eye model for Ab-Interno Goniotomy. Eur J Ophthalmol 2020; 31:2418-2423. [PMID: 32967453 DOI: 10.1177/1120672120959558] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
PURPOSE To determine the face and content validity of an artificial eye model for ab-interno goniotomy (SimulEYE KDB model, InsEYEt, Westlake Village, CA) by surveying ophthalmologists with varying experience using a Kahook Dual Blade (KDB; New World Medical, Rancho Cucamonga, CA, USA) following a 90-min wet-lab course using the model. PARTICIPANTS Overall 13 ophthalmologists participated following a surgical simulation session on goniotomy using the goniotomy blade at the 2019 Canadian Ophthalmological Society annual meeting. METHODS A 17-question survey to assess the face and content validity of the model was given immediately following the surgical simulation session on goniotomy using the goniotomy blade. Responses to each survey question were recorded on a 5-point Likert scale ranging from (1) strongly agree to (5) strongly disagree. RESULTS Respondents rated statements regarding the model with a median response of 1 (Strongly Agree) to 3 (Neither agree or disagree). Mann-Whitney U nonparametric analysis revealed no significant difference in responses between instructor vs. non-instructor or between prior experience vs. no prior experience for any of the survey statements. The model received highest survey ratings for utility in training residents, acquisition of surgical skills, accessibility, and higher likelihood of success with the procedure than theory and observation alone. Lowest ratings were for realism of the model compared to a human cadaveric eye. CONCLUSION Our results suggest the SimulEYE KDB model is a reasonably cost-effective solution for simulating angle-based surgeries. Additionally, our project shows that experienced ophthalmologists found the artificial eye models useful and helpful for angle-based surgery training.
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Affiliation(s)
- Andrew Swift
- University of Calgary Cumming School of Medicine, Calgary, AB, Canada
| | - Derek Waldner
- University of Calgary Cumming School of Medicine, Calgary, AB, Canada
| | - Adam Gorner
- University of Calgary Cumming School of Medicine, Calgary, AB, Canada
| | | | - Yusuf Ahmed
- University of Toronto Faculty of Medicine, Toronto, ON, Canada
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National access to Eyesi® and anterior vitrectomy simulation. Eye (Lond) 2020; 35:2051-2052. [PMID: 32719523 DOI: 10.1038/s41433-020-1107-6] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2020] [Revised: 07/12/2020] [Accepted: 07/15/2020] [Indexed: 11/09/2022] Open
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