1
|
Rice J, Steffan J. Vitreoretinal surgery: an introduction to simulation training. COMMUNITY EYE HEALTH 2023; 36:12-14. [PMID: 38178821 PMCID: PMC10762712] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Figures] [Subscribe] [Scholar Register] [Indexed: 01/06/2024]
|
2
|
Nagamoto T, Kubono H, Kawamura M, Suzuki K. A custom-made vitreoretinal surgical simulator using a silicone mold. BMC Ophthalmol 2023; 23:311. [PMID: 37434127 DOI: 10.1186/s12886-023-03070-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2022] [Accepted: 07/05/2023] [Indexed: 07/13/2023] Open
Abstract
PURPOSE We constructed a custom-made vitreoretinal surgical simulator using a silicone mold and described its practicality. METHODS We obtained spherical silicone molds, mannequins, and spray material from an internet-based vendor and combined them with expired surgical instruments to complete the simulator. Vitreoretinal experts confirmed the practicality of the simulator after simulated vitrectomy, and the results of the questionnaires were confirmed by nonvitreoretinal experts. RESULTS Vitreoretinal experts observed that the simulated eyeball and the actual eyeball were similar in size and rigidity and that the intraocular practice swing seemed to be useful for the prevention of complications. The semitransparency and open-sky structure of the silicone material ensured visibility. The simulated membrane, which was spray glue, provided an excellent peeling sensation. In the results of the nonvitreoretinal experts' questionnaires, the average scores of all items were generally high, which supported the claims of the simulator's usefulness. CONCLUSION This report describes the simplicity and cost-effectiveness of our custom-made simulator and its contribution in creating an ideal training environment that does not necessitate travel to special facilities that offer a large number of pig eyes and vitreous surgical machines. The simple shape seems to allow many possibilities, and further verification at multiple facilities is necessary.
Collapse
Affiliation(s)
- Takashi Nagamoto
- Department of Ophthalmology, Keiyu Hospital, 3-7-3 Minatomirai, Nishi-ku, Yokohama-city, 220-8521, Kanagawa, Japan.
- Department of Ophthalmology, Keio University School of Medicine, Tokyo, Japan.
| | - Hirohisa Kubono
- Department of Ophthalmology, Keiyu Hospital, 3-7-3 Minatomirai, Nishi-ku, Yokohama-city, 220-8521, Kanagawa, Japan
| | - Mari Kawamura
- Department of Ophthalmology, Keiyu Hospital, 3-7-3 Minatomirai, Nishi-ku, Yokohama-city, 220-8521, Kanagawa, Japan
| | - Kotaro Suzuki
- Department of Ophthalmology, Keiyu Hospital, 3-7-3 Minatomirai, Nishi-ku, Yokohama-city, 220-8521, Kanagawa, Japan
| |
Collapse
|
3
|
Lowater SJ, Grauslund J, Vergmann AS. Modern Educational Simulation-Based Tools Among Residents of Ophthalmology: A Narrative Review. Ophthalmol Ther 2022; 11:1961-1974. [PMID: 36001249 PMCID: PMC9587160 DOI: 10.1007/s40123-022-00559-y] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2022] [Accepted: 08/03/2022] [Indexed: 11/29/2022] Open
Abstract
INTRODUCTION With no specific overview on simulation-based training for educational purposes among residents in ophthalmology, this narrative review attempts to highlight the current literature on modern educational simulation-based tools used to educate residents in ophthalmology. METHODS We searched databases Web of Science and PubMed between March 15 and July 21, 2022. Relevant and accessible articles and abstracts published after 2006 and in English only were included. RESULTS Simulation-based cataract surgery is associated with better outcomes in the operating room and faster surgeries. Construct validity has been established across different procedures and levels in simulation-based cataract surgery and simulation-based vitreoretinal surgery. Other simulation-based procedures indicate promising results but in general lack evidence-based validity. DISCUSSION This narrative review highlights and evaluates the current and relevant literature of modern educational simulation-based tools to train ophthalmology residents in different fundamental skills like simulation-based ophthalmoscopy and complex surgical procedures like simulation-based cataract surgery and vitreoretinal surgery. Some studies attempt to develop simulators for the use in education of ophthalmology residents. Other studies strive to establish validity of the respective procedures or modern education tools and some studies investigate the effect of simulation-based training. The most validated modern educational simulation-based tool is the Eyesi Surgical Simulator (VRmagic, Germany). However, other modern educational simulation-based tools have also been evaluated, including the HelpMeSee Eye Surgery Simulator (HelpMeSee Inc., New York, USA) and the MicroVisTouch Surgical Simulator (ImmersiveTouch, USA). CONCLUSION Simulation-based training has already been established for residents in ophthalmology to benefit the most from skill-demanding procedures resulting in better learning and better patient handling. Future studies should aim to validate more simulation-based procedures for the teaching of ophthalmology residents so that the evidence is kept at a high standard.
Collapse
Affiliation(s)
- Simon J Lowater
- Research Unit of Ophthalmology, Department of Ophthalmology, Odense University Hospital, J. B. Winsløws Vej 4, 5000, Odense C, Denmark.
| | - Jakob Grauslund
- Research Unit of Ophthalmology, Department of Ophthalmology, Odense University Hospital, J. B. Winsløws Vej 4, 5000, Odense C, Denmark
- Department of Clinical Research, University of Southern Denmark, Odense, Denmark
| | - Anna S Vergmann
- Research Unit of Ophthalmology, Department of Ophthalmology, Odense University Hospital, J. B. Winsløws Vej 4, 5000, Odense C, Denmark
| |
Collapse
|
4
|
Lucatto LFA, Prazeres JMB, Guerra RLL, Arantes R, Barbosa GCS, Badaró E, Lima LH, Rodrigues E. Evaluation of quality and utility of YouTube vitreoretinal surgical videos. Int J Retina Vitreous 2022; 8:9. [PMID: 35109918 PMCID: PMC8812238 DOI: 10.1186/s40942-022-00360-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2021] [Accepted: 01/18/2022] [Indexed: 11/10/2022] Open
Abstract
Background We evaluated the utility and quality of surgical videos posted on the main retinal YouTube channels by surgeons at different career stages and assessed how well the steps of the vitrectomy videos conformed to the parameters in the Casey Eye Institute Vitrectomy Indices Tool for Skills assessment (CEIVITS) scale. Methods Forty-five videos were included from nine retinal YouTube channels posted from 2011 to 2021. For each surgeon, 10 videos were randomized and the utility, quality, and educational content were assessed. For each video, the surgeons also assessed how the validated CEIVITS items were presented in the videos. The surgeons were divided based on years of experience: fellows (0–3 years), young surgeons (4–10 years), and senior surgeons (more than 10 years). Results The video image quality was rated as good in 63.52% of evaluations, moderate in 30.37%, and poor in 6.11%. The quality assessment of the videos among the groups did not differ. The fellows rated the use of the videos as educational tools higher (3.99) than the young (3.87) and senior surgeons (3.47) (p < 0.0002, Kruskal–Wallis test); 34.76% of the fellows reported learning something new from the videos compared with 19.17% of the senior surgeons (p < 0.05). The CEIVITS scale item that was seen more frequently was related to core vitrectomies (72.29%) and the least represented was about checking infusion lines (80.17%). Conclusions Vitreoretinal surgical videos are useful educational tools during all stages of surgeons’ careers, and the evaluation of the quality of the images did not differ significantly among the groups, however, surgeons with expertise shorter than 10 years report significantly greater use of videos than experienced surgeons. Videos posted to the public domain on different social media, most often YouTube, are widespread and unregulated for providing complimentary surgical education. Retinal societies should formulate guidelines and improve the educational value of the surgical videos posted on the Internet. Trial Registration The Federal University of São Paulo institution’s Research Ethics Committee reviewed and approved this study protocol (Approval Number, 4.726.589). Supplementary Information The online version contains supplementary material available at 10.1186/s40942-022-00360-w.
Collapse
Affiliation(s)
- Luiz Filipe Adami Lucatto
- Ophthalmology Department, Federal University of São Paulo (UNIFESP/EPM), R. Botucatu-822, São Paulo, SP, 04023-900, Brazil.
| | - Juliana Moura Bastos Prazeres
- Ophthalmology Department, Federal University of São Paulo (UNIFESP/EPM), R. Botucatu-822, São Paulo, SP, 04023-900, Brazil
| | | | - Rafael Arantes
- Ophthalmology Department, Federal University of São Paulo (UNIFESP/EPM), R. Botucatu-822, São Paulo, SP, 04023-900, Brazil
| | | | - Emmerson Badaró
- Ophthalmology Department, Federal University of São Paulo (UNIFESP/EPM), R. Botucatu-822, São Paulo, SP, 04023-900, Brazil
| | - Luiz H Lima
- Ophthalmology Department, Federal University of São Paulo (UNIFESP/EPM), R. Botucatu-822, São Paulo, SP, 04023-900, Brazil
| | - Eduardo Rodrigues
- Ophthalmology Department, Saint Louis University Eye Institute (SLUEI), St. Louis, MO, USA
| |
Collapse
|
5
|
Lee R, Raison N, Lau WY, Aydin A, Dasgupta P, Ahmed K, Haldar S. A systematic review of simulation-based training tools for technical and non-technical skills in ophthalmology. Eye (Lond) 2020; 34:1737-1759. [PMID: 32203241 PMCID: PMC7609318 DOI: 10.1038/s41433-020-0832-1] [Citation(s) in RCA: 71] [Impact Index Per Article: 17.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2019] [Revised: 11/23/2019] [Accepted: 01/05/2020] [Indexed: 12/27/2022] Open
Abstract
To evaluate all simulation models for ophthalmology technical and non-technical skills training and the strength of evidence to support their validity and effectiveness. A systematic search was performed using PubMed and Embase for studies published from inception to 01/07/2019. Studies were analysed according to the training modality: virtual reality; wet-lab; dry-lab models; e-learning. The educational impact of studies was evaluated using Messick's validity framework and McGaghie's model of translational outcomes for evaluating effectiveness. One hundred and thirty-one studies were included in this review, with 93 different simulators described. Fifty-three studies were based on virtual reality tools; 47 on wet-lab models; 26 on dry-lab models; 5 on e-learning. Only two studies provided evidence for all five sources of validity assessment. Models with the strongest validity evidence were the Eyesi Surgical, Eyesi Direct Ophthalmoscope and Eye Surgical Skills Assessment Test. Effectiveness ratings for simulator models were mostly limited to level 2 (contained effects) with the exception of the Sophocle vitreoretinal surgery simulator, which was shown at level 3 (downstream effects), and the Eyesi at level 5 (target effects) for cataract surgery. A wide range of models have been described but only the Eyesi has undergone comprehensive investigation. The main weakness is in the poor quality of study design, with a predominance of descriptive reports showing limited validity evidence and few studies investigating the effects of simulation training on patient outcomes. More robust research is needed to enable effective implementation of simulation tools into current training curriculums.
Collapse
Affiliation(s)
- Roxanne Lee
- GKT School of Medical Education, King's College London, London, UK
| | - Nicholas Raison
- MRC Centre for Transplantation, King's College London, London, UK
| | - Wai Yan Lau
- School of Medicine, St George's, University of London, London, UK
| | - Abdullatif Aydin
- MRC Centre for Transplantation, King's College London, London, UK
| | - Prokar Dasgupta
- MRC Centre for Transplantation, King's College London, London, UK
| | - Kamran Ahmed
- MRC Centre for Transplantation, King's College London, London, UK
| | - Shreya Haldar
- Department of Ophthalmology, Stoke Mandeville Hospital, Aylesbury, UK.
| |
Collapse
|
6
|
Pujari A, Kumar S, Markan A, Chawla R, Damodaran S, Kumar A. Buckling surgery on a goat's eye: A simple technique to enhance residents' surgical skill. Indian J Ophthalmol 2019; 67:1327-1328. [PMID: 31332123 PMCID: PMC6677078 DOI: 10.4103/ijo.ijo_1779_18] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
Buckling surgery is one of the common procedures performed by the retinal surgeons for visual rehabilitation at the earliest in cases of retinal detachment. The optimal surgical skill in this section can only be achieved with repeated practices and clinical experiences. Here, we describe an easy and inexpensive way to perform, practice, and refine surgical skills by demonstrating this complicated surgery in a simple manner on goat's eyes. The advantages of this technique are real-tissue handling experiences and repeatability of the procedure with almost similar practical implications. Thus, whenever feasible, every attempt should be made to refine the residents or budding ophthalmologists surgical skills by undertaking this technique in their routine curriculum.
Collapse
Affiliation(s)
- Amar Pujari
- Dr. Rajendra Prasad Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, New Delhi, India
| | - Suneel Kumar
- Dr. Rajendra Prasad Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, New Delhi, India
| | - Ashish Markan
- Dr. Rajendra Prasad Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, New Delhi, India
| | - Rohan Chawla
- Dr. Rajendra Prasad Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, New Delhi, India
| | - Sourav Damodaran
- Dr. Rajendra Prasad Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, New Delhi, India
| | - Atul Kumar
- Dr. Rajendra Prasad Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, New Delhi, India
| |
Collapse
|
7
|
Pujari A, Sharma N, Chaniyara MH, Urkude J, Singh R, Yadav S, Mukhija R, Asif MI, Sidhu N. Optimal refinement of residents' surgical skills by training on induced goat's eye corneoscleral perforation. Indian J Ophthalmol 2019; 67:547-548. [PMID: 30900593 PMCID: PMC6446649 DOI: 10.4103/ijo.ijo_1474_18] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022] Open
Abstract
Surgical skill enhancement for the residents under training can be performed through various efforts. Here in this report, the authors describe a technique of corneoscleral perforation repair on goat's eye, as the tissue resemblance and the reality of experience while performing crucial steps are similar to human eyes. Beginning from tissue handling, optimal suture placement was taught with an intention to impart quality techniques of traumatic globe injury repair. Therefore, rather than training on expensive artificial eye model, training budding surgeons on goat's eye gives much more realistic tissue handling experiences in the presence of constant challenges almost similar to human eyes.
Collapse
Affiliation(s)
- Amar Pujari
- Dr. Rajendra Prasad Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, New Delhi, India
| | - Namrata Sharma
- Dr. Rajendra Prasad Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, New Delhi, India
| | | | - Jayanand Urkude
- Dr. Rajendra Prasad Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, New Delhi, India
| | - Rashmi Singh
- Dr. Rajendra Prasad Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, New Delhi, India
| | - Saumya Yadav
- Dr. Rajendra Prasad Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, New Delhi, India
| | - Ritika Mukhija
- Dr. Rajendra Prasad Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, New Delhi, India
| | - Mohamed Ibrahime Asif
- Dr. Rajendra Prasad Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, New Delhi, India
| | - Navneet Sidhu
- Dr. Rajendra Prasad Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, New Delhi, India
| |
Collapse
|
8
|
Rasmussen RC, Grauslund J, Vergmann AS. Simulation training in vitreoretinal surgery: a systematic review. BMC Ophthalmol 2019; 19:90. [PMID: 30975112 PMCID: PMC6460826 DOI: 10.1186/s12886-019-1098-x] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2018] [Accepted: 03/28/2019] [Indexed: 11/10/2022] Open
Abstract
Background The purpose of this study was to perform a systematic review of the current literature on simulator-based training in vitreoretinal surgery (VRS). We examined the results regarding simulated VRS and provided an overview of how the current results may be employed in VRS training. Lastly, we evaluated the quality of these results. Methods The databases of Pubmed, Embase and Cochrane Library were searched for articles in English involving simulated VRS training. A qualitative analysis was performed, since the studies which met our inclusion criteria did not allow for a quantitative meta-analysis. Results We identified 203 articles of which seven met the inclusion criteria. Of these, six studies investigated simulation with EyeSi® Surgical (VRMagic, Mannheim, Germany). Six studies reported positive performance curves. Four studies showed construct validity. One study attempted to show skill transfer from simulator to vitrectomies performed on cadavers. Methodological quality of the included studies was moderate but lacking in instrument validation. Conclusion Simulator-based training in VRS can assess and possibly assist acquisition of a variety of VRS skills. Further research is needed to support transfer from simulator to operating room. Future studies should strive to follow established validation frameworks and streamline study designs. Electronic supplementary material The online version of this article (10.1186/s12886-019-1098-x) contains supplementary material, which is available to authorized users.
Collapse
Affiliation(s)
- Rasmus Christian Rasmussen
- Department of Ophthalmology, Odense University Hospital, J.B. Winsløws Vej 4, DK-5000, Odense C, Denmark.
| | - Jakob Grauslund
- Department of Ophthalmology, Odense University Hospital, J.B. Winsløws Vej 4, DK-5000, Odense C, Denmark.,Department of Clinical Research, University of Southern Denmark, Winløwsparken 19, DK-5000, Odense C, Denmark
| | - Anna Stage Vergmann
- Department of Ophthalmology, Odense University Hospital, J.B. Winsløws Vej 4, DK-5000, Odense C, Denmark.,Department of Clinical Research, University of Southern Denmark, Winløwsparken 19, DK-5000, Odense C, Denmark
| |
Collapse
|
9
|
Al-Salem KM, Al-Sarayra FA, Abu Al-Dabaat M, Shihadeh W, Al-Salem MM, Al-Salem MK, Schaal S. Ophthalmology residency training in Jordan: an evaluation of quality and comparison with international standards. Int J Ophthalmol 2014; 7:898-904. [PMID: 25349813 DOI: 10.3980/j.issn.2222-3959.2014.05.28] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2013] [Accepted: 11/25/2013] [Indexed: 11/02/2022] Open
Abstract
AIM To evaluate Jordanian ophthalmology residency programs in achieving competencies outlined by the International Council of Ophthalmology (ICO) and residents' satisfaction with available training programs in Jordan, and to highlight weakness points that may be improved and strengthened. METHODS A closed-ended questionnaire was circulated to all ophthalmologists who completed their training in Jordanian institutions between 2006 and 2011, to measure the quality of residency training and satisfaction level with regards to clinical conferences, journal clubs, scientific lectures, wet lab sessions, simulations, outpatient clinics and operating room training. Barriers to a successful board exam were cited. All ophthalmologists had official residency training in Jordanian Hospitals; this includes military, university, governmental and private sector hospitals. RESULTS Sixty-one questionnaires completed out of 69 circulated. Males (75.4%) were more than females. Mean age was 32.5±3.27y. A total 21 (34.4%) responders expressed an overall satisfaction, 38 (62.3%) were dissatisfied and 2 (3.3%) were equivocal. Respondents reported insufficient exposure to low-vision rehabilitation 57 (93.4%), or refraction and glasses prescription 34 (55.7%). Regarding operative experiences, the mean cataract extraction per-resident was 43 cataracts; the number of phacoemulsification surgery was 2.96 per-resident, 46 (75.4%) of responders never did a single phacoemulsification during residency. Nine (14.8%) had training in refractive surgery, and 15 (24.6%) assisted orbital surgery. Forty-four (72.1%) never assisted in vitreoretinal surgery. Among The graduates surveyed, 14 (23.0%) passed Jordanian licensing board exam at the first attempt, and felt that their residency programs adequately prepared them for the examinations. CONCLUSION Around two thirds (62.3%) of ophthalmologists expressed dissatisfaction with residency training at Jordanian programs, further study is required to assess each program separately and evaluate the system of accreditation in Jordanian residency programs.
Collapse
Affiliation(s)
- Khalil M Al-Salem
- Department of Ophthalmology, Mutah University, AL-Karak 61710, Jordan
| | | | | | - Wisam Shihadeh
- Department of Ophthalmology, Jordan University of Science & Technology, Irbid 22110, Jordan
| | - Mohammad M Al-Salem
- Department of Ophthalmology, Jordan University of Science & Technology, Irbid 22110, Jordan
| | - Mahmoud K Al-Salem
- Department of Ophthalmology, Jordan University of Science & Technology, Irbid 22110, Jordan
| | - Shlomit Schaal
- Department of Ophthalmology and Visual Sciences University of Louisville, Louisville, KY 47130, USA
| |
Collapse
|