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Dormegny L, Neumann N, Lejay A, Sauer A, Gaucher D, Proust F, Chakfe N, Bourcier T. Multiple metrics assessment method for a reliable evaluation of corneal suturing skills. Sci Rep 2023; 13:2920. [PMID: 36806319 PMCID: PMC9941077 DOI: 10.1038/s41598-023-29555-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2022] [Accepted: 02/06/2023] [Indexed: 02/22/2023] Open
Abstract
This study aimed to evaluate the efficiency of a multiple metrics assessment method to differentiate between surgeons of differing experience while performing a corneal suturing task. Volunteer ophthalmologists were assigned to three groups (senior [SG], junior [JG] and novice [NG]) according to their experience in corneal suturing. All participants performed three sessions of corneal wound closure by three stitches. Suturing and participant posture were recorded with cameras, and assessed by two blind assessors for stitch quality (using Zhang score) and ergonomics (using Rapid Upper Limb Assessment [RULA] score). Task duration was recorded. Objective analyses of stitches geometry and instrument position were carried out. We included 24 participants: 5 in the SG, 8 in the JG and 11 in the NG. Stitch quality was significantly better and time to perform the procedure significantly lower in more experienced groups (p < 0.001 and p = 0.002, respectively). SG participants better respected regular distance and parallelism between stitches compared to others (p = 0.01). Instrument position was similar between groups, although SG participants minimized their back-and-forth movements compared to NG participants. Ergonomics assessment was similar. Multiple metrics assessment efficiently determined how to differentiate between novices and experienced surgeons on corneal suturing skills, providing hints for future training studies.
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Affiliation(s)
- Lea Dormegny
- GEPROMED, Strasbourg, France.
- Department of Ophthalmology, Nouvel Hôpital Civil, Strasbourg University Hospital, BP426, 67091, Strasbourg Cedex, France.
- UNISIMES (UNIté de SIMulation Européenne en Santé), Strasbourg University Hospital, Faculty of Medicine, Strasbourg, France.
| | | | - Anne Lejay
- GEPROMED, Strasbourg, France
- UNISIMES (UNIté de SIMulation Européenne en Santé), Strasbourg University Hospital, Faculty of Medicine, Strasbourg, France
- Department of Vascular Surgery and Kidney Transplantation, Strasbourg University Hospital, Strasbourg, France
| | - Arnaud Sauer
- GEPROMED, Strasbourg, France
- Department of Ophthalmology, Nouvel Hôpital Civil, Strasbourg University Hospital, BP426, 67091, Strasbourg Cedex, France
- UNISIMES (UNIté de SIMulation Européenne en Santé), Strasbourg University Hospital, Faculty of Medicine, Strasbourg, France
| | - David Gaucher
- GEPROMED, Strasbourg, France
- Department of Ophthalmology, Nouvel Hôpital Civil, Strasbourg University Hospital, BP426, 67091, Strasbourg Cedex, France
- UNISIMES (UNIté de SIMulation Européenne en Santé), Strasbourg University Hospital, Faculty of Medicine, Strasbourg, France
| | - François Proust
- GEPROMED, Strasbourg, France
- UNISIMES (UNIté de SIMulation Européenne en Santé), Strasbourg University Hospital, Faculty of Medicine, Strasbourg, France
- Department of Neurosurgery, Strasbourg University Hospital, Strasbourg, France
| | - Nabil Chakfe
- GEPROMED, Strasbourg, France
- UNISIMES (UNIté de SIMulation Européenne en Santé), Strasbourg University Hospital, Faculty of Medicine, Strasbourg, France
- Department of Vascular Surgery and Kidney Transplantation, Strasbourg University Hospital, Strasbourg, France
| | - Tristan Bourcier
- GEPROMED, Strasbourg, France
- Department of Ophthalmology, Nouvel Hôpital Civil, Strasbourg University Hospital, BP426, 67091, Strasbourg Cedex, France
- UNISIMES (UNIté de SIMulation Européenne en Santé), Strasbourg University Hospital, Faculty of Medicine, Strasbourg, France
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Bhullar PK, Venkateswaran N. Ophthalmology Residency in the United States: The Case for a National Curriculum. Semin Ophthalmol 2023; 38:167-177. [PMID: 36653736 DOI: 10.1080/08820538.2022.2152713] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/20/2023]
Abstract
To identify strategies for effective curriculum development and implementation in United States (US) ophthalmology residency training programs. A literature review was conducted for all English-language PubMed/Medline articles relating to ophthalmology residency education or curriculum/curricula. Despite ACGME-defined program requirements outlining curricular goals for US ophthalmology residency training programs, there is no comprehensive, national curriculum with detailed plans for instruction of necessary topics within the 36-month residency training period. Several articles identify a need for detailed curricula on various topics, propose ideas on how residency programs could create curricula, and explore ways of assessing resident competence. There is a paucity of literature evaluating how ophthalmology residents best learn various ophthalmology topics. We need to develop an intentional, comprehensive, and timely national curriculum for ophthalmology residency programs in the US, with detailed plans on how to meet curricular objectives and consideration of the most effective teaching strategies for different ophthalmology concepts.
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Bentes LGDB, Costa LVPD, Pimentel ALJC, Tramontin DF, Lemos RS, Vasconcelos MEDSL, Santos DRD. What came first: the egg or the microsurgery training? An ophthalmic model for developing basic skills in microsurgery. REVISTA BRASILEIRA DE OFTALMOLOGIA 2022. [DOI: 10.37039/1982.8551.20220040] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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Ramani S, Pradeep TG, Sundaresh DD. An update on the novel approaches towards skills assessment of ophthalmology residents in the Indian scenario. Indian J Ophthalmol 2022; 70:1092-1098. [PMID: 35325993 PMCID: PMC9240543 DOI: 10.4103/ijo.ijo_1034_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
An essential part of the teaching-learning paradigm is assessment. It is one of the ways to achieve feedback for the various methods that have been used to impart a particular skill. This is true of ophthalmology training, where various clinical and surgical skills are learned as part of the residency program. In preparation for residents to become proficient ophthalmologists, both formative and summative assessments are of paramount importance. At present, assessment is primarily summative in the form of a university examination, including theory and practical examinations that are conducted at the end of the three years of residency. A formative assessment can make course corrections early on, allowing for an improved understanding of the subject and the acquisition of clinical and surgical skills. Formative assessments also allow us to customize the teaching methodology considering individual residents’ learning capabilities. In addition, formative assessments have the advantage of alleviating the stress of a “final” examination, which could sometimes result in a less-than-optimum performance by the residents. The COVID-19 pandemic has forced us to adopt new teaching methods, which has led to the adoption of changes in assessment. In this regard, we discuss the different assessment tools available, their pros and cons, and how best these tools can be made applicable in the setting of an ophthalmology residency program.
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Affiliation(s)
- Soumya Ramani
- Department of Ophthalmology, M.S. Ramaiah Medical College, Bangalore, Karnataka, India
| | - Thanuja G Pradeep
- Department of Ophthalmology, M.S. Ramaiah Medical College, Bangalore, Karnataka, India
| | - Divya D Sundaresh
- Department of Ophthalmology, M.S. Ramaiah Medical College, Bangalore, Karnataka, India
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Murai Y, Ishisaka E, Tsukiyama A, Kubota A, Yamaguchi M, Matano F, Tamaki T, Mizunari T, Morita A. Contest-style evaluation for the objective assessment of microsurgical techniques: an observational study. J NIPPON MED SCH 2022; 89:405-411. [DOI: 10.1272/jnms.jnms.2022_89-407] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Affiliation(s)
- Yasuo Murai
- Department of Neurological Surgery, Nippon Medical School Hospital
| | - Eitaro Ishisaka
- Department of Neurological Surgery, Nippon Medical School Hospital
| | | | - Asami Kubota
- Department of Neurological Surgery, Nippon Medical School Hospital
| | - Masahiro Yamaguchi
- Department of Neurosurgery, Nippon Medical School Chiba Hokusoh Hospital
| | - Fumihiro Matano
- Department of Neurological Surgery, Nippon Medical School Hospital
| | - Tomonori Tamaki
- Department of Neurological Surgery, Nippon Medical School Hospital
| | - Takayuki Mizunari
- Department of Neurosurgery, Nippon Medical School Chiba Hokusoh Hospital
| | - Akio Morita
- Department of Neurological Surgery, Nippon Medical School Hospital
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Dormegny L, Neumann N, Lejay A, Sauer A, Gaucher D, Chakfe N, Bourcier T. Resident Skills Assessment in Corneal Suturing: A Comprehensive Review of Currently Proposed Educational Programs and Evaluation Tools. JOURNAL OF ACADEMIC OPHTHALMOLOGY 2021. [DOI: 10.1055/s-0041-1740065] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022] Open
Abstract
Abstract
Purpose This study aimed to perform a comprehensive review of publications proposing educational programs for resident skills assessment in corneal suturing.
Methods An extensive online article search in PubMed following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PISMA) reporting guidelines was performed to identify prospective comparative studies or prospective before/after studies published up to March 2021 and reporting the assessment of ophthalmology residents' skills in corneal suturing during dedicated training sessions.
Results Three studies were identified for review. The first reported the efficiency of an electromagnetic tracking system placed on the surgeon's fingers coupled with a computer analysis of movements and time to identify surgeons with different backgrounds in corneal suturing. The second reported the efficiency of the reference system in assessing the improvement of corneal suturing conducted by residents after a training session, with video-based assessment for economy and confidence of movement, limiting tissue damage and precision of operative technique, reviewed by blind assessors. The third proposed an innovative remote corneal suturing training method using Zoom for direct feedback to the residents. The stitch quality was assessed for length, depth, radiality, and tension. The results were similar when compared with a group of residents without feedback.
Conclusion This review underlines the rarity and disparity of available tools for corneal suturing assessment, justifying the need for more complete models to be designed. These should consider body ergonomics and stitch quality and time. Comparative studies involving novices and attendings may provide reliable evaluation of existing gaps and specific metrics to target, helping residents to approach their superiors' experience.
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Affiliation(s)
- Lea Dormegny
- Department of Ophthalmology, New Civil Hospital, Strasbourg University Hospital, Strasbourg, France
- GEPROVAS (Groupe Européen de Recherche sur les Prothèses Appliquées à la Chirurgie Vasculaire), Department of Anesthesiology, Civil Hospital, Strasbourg, France
| | - Nicole Neumann
- GEPROVAS (Groupe Européen de Recherche sur les Prothèses Appliquées à la Chirurgie Vasculaire), Department of Anesthesiology, Civil Hospital, Strasbourg, France
| | - Anne Lejay
- GEPROVAS (Groupe Européen de Recherche sur les Prothèses Appliquées à la Chirurgie Vasculaire), Department of Anesthesiology, Civil Hospital, Strasbourg, France
- Department of Vascular Surgery and Kidney Transplantation, Strasbourg University Hospital, France
| | - Arnaud Sauer
- Department of Ophthalmology, New Civil Hospital, Strasbourg University Hospital, Strasbourg, France
- GEPROVAS (Groupe Européen de Recherche sur les Prothèses Appliquées à la Chirurgie Vasculaire), Department of Anesthesiology, Civil Hospital, Strasbourg, France
| | - David Gaucher
- Department of Ophthalmology, New Civil Hospital, Strasbourg University Hospital, Strasbourg, France
- GEPROVAS (Groupe Européen de Recherche sur les Prothèses Appliquées à la Chirurgie Vasculaire), Department of Anesthesiology, Civil Hospital, Strasbourg, France
| | - Nabil Chakfe
- GEPROVAS (Groupe Européen de Recherche sur les Prothèses Appliquées à la Chirurgie Vasculaire), Department of Anesthesiology, Civil Hospital, Strasbourg, France
- Department of Vascular Surgery and Kidney Transplantation, Strasbourg University Hospital, France
| | - Tristan Bourcier
- Department of Ophthalmology, New Civil Hospital, Strasbourg University Hospital, Strasbourg, France
- GEPROVAS (Groupe Européen de Recherche sur les Prothèses Appliquées à la Chirurgie Vasculaire), Department of Anesthesiology, Civil Hospital, Strasbourg, France
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Zhang Z, Qian T, Zhu B, Liu H, Sun X, Xu X. Development of a valid and reliable pterygium surgery assessment scale for ophthalmology residents. BMC MEDICAL EDUCATION 2021; 21:511. [PMID: 34579726 PMCID: PMC8477497 DOI: 10.1186/s12909-021-02934-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 02/07/2021] [Accepted: 09/08/2021] [Indexed: 06/13/2023]
Abstract
BACKGROUND Microsurgery training has become an important part of ophthalmology teaching and one of the main topics of examination. Accurate and effective evaluation of microsurgery skills is vital for the training and teaching of residents. In this study, we aimed to establish a pterygium surgery assessment scale for use by ophthalmic residents and evaluate its reliability and validity. METHODS Based on a literature search, experienced pterygium surgeons developed the preliminary scale according to the standard surgical procedure. The preliminary scale and a questionnaire were sent to teaching and research experts in the field for feedback. Face and content validity and reliability of the scale were determined by rounds of modifications based on expert feedback. For construct validity, existing assessment scales were obtained and a range of factors were tested. RESULTS Nineteen expert surgeons completed the questionnaire and modifications were made until all surgeons agreed on the final scale. Good construct validity was found by evaluation against 257 existing scales. For reliability, 280 evaluation scales were completed. Inter- and intra-rater reliability analysis both found Intraclass Correlation Coefficient (ICC) > 0.8 for all items and total scores. CONCLUSION The pterygium surgery assessment scale developed in this study has good reliability and validity, and is an effective measurement tool for the evaluation of ophthalmology residents' pterygium surgical skills.
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Affiliation(s)
- Zhihua Zhang
- Department of Ophthalmology, Shanghai General Hospital, Shanghai Jiao Tong University, 100 Haining Road, Hongkou District, 200080, Shanghai, China
- National Clinical Research Center for Eye Diseases, Shanghai, China
- Shanghai Key Laboratory of Ocular Fundus Diseases, Shanghai, China
- Shanghai Engineering Center for Visual Science and Photomedicine, Shanghai, China
- Shanghai Engineering Center for Precise Diagnosis and Treatment of Eye Disease, Shanghai, China
| | - Tianwei Qian
- Department of Ophthalmology, Shanghai General Hospital, Shanghai Jiao Tong University, 100 Haining Road, Hongkou District, 200080, Shanghai, China
- National Clinical Research Center for Eye Diseases, Shanghai, China
- Shanghai Key Laboratory of Ocular Fundus Diseases, Shanghai, China
- Shanghai Engineering Center for Visual Science and Photomedicine, Shanghai, China
- Shanghai Engineering Center for Precise Diagnosis and Treatment of Eye Disease, Shanghai, China
| | - Bijun Zhu
- Department of Ophthalmology, Shanghai General Hospital, Shanghai Jiao Tong University, 100 Haining Road, Hongkou District, 200080, Shanghai, China
- National Clinical Research Center for Eye Diseases, Shanghai, China
- Shanghai Key Laboratory of Ocular Fundus Diseases, Shanghai, China
- Shanghai Engineering Center for Visual Science and Photomedicine, Shanghai, China
- Shanghai Engineering Center for Precise Diagnosis and Treatment of Eye Disease, Shanghai, China
| | - Haiyun Liu
- Department of Ophthalmology, Shanghai General Hospital, Shanghai Jiao Tong University, 100 Haining Road, Hongkou District, 200080, Shanghai, China.
- National Clinical Research Center for Eye Diseases, Shanghai, China.
- Shanghai Key Laboratory of Ocular Fundus Diseases, Shanghai, China.
- Shanghai Engineering Center for Visual Science and Photomedicine, Shanghai, China.
- Shanghai Engineering Center for Precise Diagnosis and Treatment of Eye Disease, Shanghai, China.
| | - Xiaodong Sun
- Department of Ophthalmology, Shanghai General Hospital, Shanghai Jiao Tong University, 100 Haining Road, Hongkou District, 200080, Shanghai, China
- National Clinical Research Center for Eye Diseases, Shanghai, China
- Shanghai Key Laboratory of Ocular Fundus Diseases, Shanghai, China
- Shanghai Engineering Center for Visual Science and Photomedicine, Shanghai, China
- Shanghai Engineering Center for Precise Diagnosis and Treatment of Eye Disease, Shanghai, China
| | - Xun Xu
- Department of Ophthalmology, Shanghai General Hospital, Shanghai Jiao Tong University, 100 Haining Road, Hongkou District, 200080, Shanghai, China
- National Clinical Research Center for Eye Diseases, Shanghai, China
- Shanghai Key Laboratory of Ocular Fundus Diseases, Shanghai, China
- Shanghai Engineering Center for Visual Science and Photomedicine, Shanghai, China
- Shanghai Engineering Center for Precise Diagnosis and Treatment of Eye Disease, Shanghai, China
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Wang YE, Zhang C, Chen AC, Pineles S, Hou J. Current Status of Ophthalmology Residency Training in China: The Experience From Well-Structured Centers Around the Country. Asia Pac J Ophthalmol (Phila) 2020; 9:369-373. [PMID: 32501893 DOI: 10.1097/apo.0000000000000284] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023] Open
Abstract
Chinese ophthalmology residency training is continuously evolving with an emphasis on standardization. In this article, we assess the current status of ophthalmology residency training in China compared with that in the United States through analysis of literature review and onsite data collection. We comprehensively review various aspects of the residency training structure in China, including accreditation, resident selection, clinical and surgical curricula, research requirements, and evaluation. Our report demonstrates significant regional differences among training programs due to the lack of a national standard, resulting in varying competencies of graduating Chinese ophthalmology residents. The Chinese ophthalmology community is determined to improve the standardization process and quality of training for their ophthalmologists, an important goal that will facilitate international fellowship studies, exchange scholars, and research collaboration.
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Affiliation(s)
- Ye Elaine Wang
- Stein Eye Institute, UCLA Department of Ophthalmology, Los Angeles, CA
- Bascom Palmer Eye Institute, University of Miami, Coral Gables, FL
- Harvard Eye Associates, Laguna Hills, CA
| | - Chuan Zhang
- Department of Ophthalmology, People's Hospital, Peking University, Beijing, China
| | | | - Stacy Pineles
- Stein Eye Institute, UCLA Department of Ophthalmology, Los Angeles, CA
- UCLA GSM
| | - Jing Hou
- Department of Ophthalmology, People's Hospital, Peking University, Beijing, China
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