Ann Sofia Skou Thomsen1, Daniella Bach-Holm2, Hadi Kjærbo2, Klavs Højgaard-Olsen2, Yousif Subhi3, George M Saleh4, Yoon Soo Park5, Morten la Cour2, Lars Konge3. 1. Department of Ophthalmology, Rigshospitalet, Glostrup, Denmark; Copenhagen Academy for Medical Education and Simulation, Centre for HR, Copenhagen, Capital Region of Denmark, Denmark. Electronic address: skouthomsen@dadlnet.dk. 2. Department of Ophthalmology, Rigshospitalet, Glostrup, Denmark. 3. Copenhagen Academy for Medical Education and Simulation, Centre for HR, Copenhagen, Capital Region of Denmark, Denmark. 4. National Institute for Health Research, Biomedical Research Centre at Moorfields Eye Hospital and the UCL Institute of Ophthalmology, Moorfields Eye Hospital, London, United Kingdom. 5. Department of Medical Education, College of Medicine, University of Illinois, Chicago, Illinois.
Abstract
PURPOSE: To investigate the effect of virtual reality proficiency-based training on actual cataract surgery performance. The secondary purpose of the study was to define which surgeons benefit from virtual reality training. DESIGN: Multicenter masked clinical trial. PARTICIPANTS: Eighteen cataract surgeons with different levels of experience. METHODS:Cataract surgical training on a virtual reality simulator (EyeSi) until a proficiency-based test was passed. MAIN OUTCOME MEASURES: Technical performance in the operating room (OR) assessed by 3 independent, masked raters using a previously validated task-specific assessment tool for cataract surgery (Objective Structured Assessment of Cataract Surgical Skill). Three surgeries before and 3 surgeries after the virtual reality training were video-recorded, anonymized, and presented to the raters in random order. RESULTS: Novices (non-independently operating surgeons) and surgeons having performed fewer than 75 independent cataract surgeries showed significant improvements in the OR-32% and 38%, respectively-after virtual reality training (P = 0.008 and P = 0.018). More experienced cataract surgeons did not benefit from simulator training. The reliability of the assessments was high with a generalizability coefficient of 0.92 and 0.86 before and after the virtual reality training, respectively. CONCLUSIONS: Clinically relevant cataract surgical skills can be improved by proficiency-based training on a virtual reality simulator. Novices as well as surgeons with an intermediate level of experience showed improvement in OR performance score.
RCT Entities:
PURPOSE: To investigate the effect of virtual reality proficiency-based training on actual cataract surgery performance. The secondary purpose of the study was to define which surgeons benefit from virtual reality training. DESIGN: Multicenter masked clinical trial. PARTICIPANTS: Eighteen cataract surgeons with different levels of experience. METHODS:Cataract surgical training on a virtual reality simulator (EyeSi) until a proficiency-based test was passed. MAIN OUTCOME MEASURES: Technical performance in the operating room (OR) assessed by 3 independent, masked raters using a previously validated task-specific assessment tool for cataract surgery (Objective Structured Assessment of Cataract Surgical Skill). Three surgeries before and 3 surgeries after the virtual reality training were video-recorded, anonymized, and presented to the raters in random order. RESULTS: Novices (non-independently operating surgeons) and surgeons having performed fewer than 75 independent cataract surgeries showed significant improvements in the OR-32% and 38%, respectively-after virtual reality training (P = 0.008 and P = 0.018). More experienced cataract surgeons did not benefit from simulator training. The reliability of the assessments was high with a generalizability coefficient of 0.92 and 0.86 before and after the virtual reality training, respectively. CONCLUSIONS: Clinically relevant cataract surgical skills can be improved by proficiency-based training on a virtual reality simulator. Novices as well as surgeons with an intermediate level of experience showed improvement in OR performance score.
Authors: Marina Roizenblatt; Vitor Dias Gomes Barrios Marin; Alex Treiger Grupenmacher; Felipe Muralha; Jean Faber; Kim Jiramongkolchai; Peter Louis Gehlbach; Michel Eid Farah; Rubens Belfort; Mauricio Maia Journal: JAMA Ophthalmol Date: 2020-08-01 Impact factor: 7.389
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Authors: Morten la Cour; Ann Sofia Skou Thomsen; Mark Alberti; Lars Konge Journal: Graefes Arch Clin Exp Ophthalmol Date: 2019-01-15 Impact factor: 3.117
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