Effect of wet-laboratory training on resident performed manual small-incision cataract surgery

Ramani, Soumya; Pradeep, Thanuja Gopal; Sundaresh, Divya Dabir

doi:10.4103/ijo.ijo_1041_17

Cited by 33 publications

(26 citation statements)

References 18 publications

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“…In similar studies (8,(22)(23)(24)(25), 80% of the ophthalmology residents stated that the practice and acquisition of the skills required for operation on animal eyes in the wet lab positively contributed to all dimensions of operation on human eyes. When questioned about whether the instruments available at the wet lab were sufficient and appropriate, 60% of the residents stated that goat's eye had many similarities to human's eye.…”

Section: Discussionmentioning

confidence: 93%

“…As the evidence indicates, the pig's eye is used as the most similar eye to the human eye and is regarded as an appropriate reference in wet labs (20)(21). Nevertheless, in a study carried out in India, it was shown that the goat's eye was an appropriate option for practicing purposes in the wet labs (22). In another study performed by Mohammadi in the Eye Research Center in Iran, sheep's eye was suggested as an appropriately similar model to the human eye (23).…”

Section: Methodsmentioning

confidence: 99%

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Impact of practice on goat’s eye on surgical skill development in sophomore ophthalmology residents

et al. 2019

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Introduction: Acquisition of clinical and practical skills is one of the highly critical and sensitive aspects of medical education, particularly in the areas related to surgical specialties. Moreover, one of the most important procedural strategies regarding educational medicine is the acquisition of practical skills in various psychological domains. Regarding this, the present study aimed to delineate the effects of practicing on goat's eye for the residents expected to perform their first surgery on human eyes. Methods: This applied study was conducted on all the sophomore residents (n=8) of the Ophthalmology Department of Isfahan University of Medical Sciences, Isfahan, Iran, using a pre-experimental design. The procedures were instructed to the residents through three stages in the wet lab according to a protocol. After the completion of the second stage, the residents gained their first experience of performing surgery on human eyes in the operating room under the supervision of junior and senior residents and the attending specialist. At this stage, in case further experience was required, the resident could start practicing on goat's eyes in the wet lab upon prior coordination. At the third stage, the residents received instructions and practiced more advanced techniques. After this stage and upon the entrance of the residents to the operating room, the 3 rd and 4 th year residents and the attending specialists were surveyed regarding the performance of the 2 nd year residents in nine fields in accordance with the aims of the study. In addition, the 2 nd year residents completed a self-evaluation checklist. The data were analyzed in SPSS software, version 16. Results: The results revealed that practicing before surgery on the human eye resulted in the reduction of surgical errors (45%), surgical speed and proficiency (20%), and stress and hand tremors (35%) during the first surgical experiences. According to the 3 rd and 4 th year residents, the practices and instructions provided before the wet lab had a positive effect on decreasing the levels of stress and surgical error during the first surgical experiences of the 2 nd year residents. The attending specialists believed that the wet lab experience could have a positive effect on all aspects of surgery, including mental, emotional, and practical factors. Nonetheless, some 3 rd and 4 th year residents believed that the wet lab could not provide circumstances identical to the conditions experienced in the operating room. Therefore, the effects of practicing in the wet lab on surgical speed, proficiency, stress, and surgical error were believed to be less significant. Conclusions: Overall, the study showed that repeated practice sessions on goat's eye in the wet lab under the supervision of 3 rd and 4 th year residents and attending specialists could not only have positive effects on some practical, mental, and attitudinal indices but also improve the knowledge of the residents.

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Section: Discussionmentioning

confidence: 93%

Section: Methodsmentioning

confidence: 99%

Impact of practice on goat’s eye on surgical skill development in sophomore ophthalmology residents

et al. 2019

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“…Wet lab is one such training resource that has been associated with improving technical proficiency of the residents and surgical skill acquisition. In a recent study by Ramani et al, resident-performed manual SICS was in fact associated with significantly decreased intraoperative complication rates and improved postoperative visual outcomes, after implementation of a structured curriculum for wet lab practice 24. Planned training can potentially also result in greater resident comfort level for performing SICS, especially during cases needing conversion from phacoemulsification.…”

Section: Discussionmentioning

confidence: 98%

<p>Outcomes of resident-performed small incision cataract surgery in a university-based practice in the USA</p>

Zafar

Chen

Sikder

et al. 2019

OPTH

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PurposeTo assess outcomes of resident-performed small incision cataract surgery (SICS) at a single academic institute and to determine the availability of SICS-oriented educational resources in residency programs across the USA.Patients and methodsA retrospective chart review was conducted on all patients who underwent SICS performed by postgraduate year 4 residents between January 2014 and January 2018 at the Wilmer Eye Institute, Baltimore, MD, USA. Postoperative visual acuity, intraoperative complications, and postoperative complications were the main outcomes measured. In addition, a survey was administered to all ophthalmology residency program directors in the USA to assess the presence of SICS-related content in their surgical training curriculum.ResultsTwenty-two eyes of 17 patients underwent planned resident-performed SICS, mainly for white cataracts. Intraoperative complications occurred in two (9.1%) eyes. The most common postoperative complication was transient increased intraocular pressure (two eyes, 9.1%). Mean preoperative best-corrected visual acuity (BCVA) was approximately 20/4,000. The large majority (95.2%) of eyes experienced improved BCVA following SICS, with a mean postoperative BCVA of 20/138 over an average follow-up of 4.2 months. Forty-seven programs responded to the survey (40.1% response rate). Residents were trained in SICS in 66.7% of these programs. However, more than half of all the programs did not have SICS-oriented educational resources available for residents.ConclusionResident-performed SICS was found to be a safe and effective technique for cataract management. Considering the limited surgical volume for SICS in the USA, training programs might instead consider implementing SICS-oriented content in their surgical curriculum, including wet labs.

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“…need to be congratulated for such a meticulous study on the effect of wet-laboratory training in this important field. [ 3 ] Residents in many training programs in India, and worldwide, do not get an opportunity to perform enough number of cataract surgeries, under supervision and independently, to groom them into confident and proficient surgeons. [ 1 2 4 ] Fewer opportunities to operate upon cataracts translate into poor proficiency and an inability to deal with the unexpected and poorer visual outcomes, setting up a downward spiral.…”

mentioning

confidence: 99%