Ophthalmology Resident Surgical Competency

Binenbaum, Gil; Volpe, Nicholas J.

doi:10.1016/j.ophtha.2006.03.026

Cited by 86 publications

(66 citation statements)

References 30 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…[17][18][19] However, it was estimated by the programme directors that about 10% of the residents in the United States were still labelled as having trouble mastering surgical skills by the end of their residency. 20 Individual variation in surgical skill among residents of a same level was also a common problem in phacoemulsification training. 4 Therefore, knowing how to verify each resident's current status in his or her learning process is essential for the supervisors to arrange a timely and suitable adjustment of the training programme.…”

Section: Discussionmentioning

confidence: 99%

A different approach to assess resident phacoemulsification learning curve: analysis of both completion and complication rates

Hou

Yang

et al. 2008

Eye

View full text Add to dashboard Cite

Purpose To assess phacoemulsification learning curve by analysing residents' surgical completion and complication rates. Methods This prospective study included 226 cases of phacoemulsification performed by 11 senior residents under a single supervisor during a 27-month period. Both completion and complication rates were collected to assess their surgical results. 'Short-term completion rate (STCR)', the frequency of the surgeries completed exclusively by the residents during every five consecutive cases, was used in the evaluation of the learning curve parameter. Results These residents could complete phacoemulsification independently in 101 surgeries (44.7%). Intraoperative complications occurred in 62 cases (27.4%), of which 11 cases were complicated with vitreous loss (4.9%). By tracing different residents' individual STCRs, we found that the learning curve for phacoemulsification surgery to be of an exponential pattern, and the first STCR of 60% to be a good representation of the exponential point. Before the residents' first STCR of 60%, their average completion rate was only 16.7% and complication rate was as high as 39.2%. While after that point, the average completion rate accelerated to 76.4% and complication rate decreased to 14.2%. Conclusion The learning curve of phacoemulsification is of an exponential pattern and the trainees' STCR can be a useful parameter to evaluate their surgical performance.

show abstract

Section: Discussionmentioning

confidence: 99%

A different approach to assess resident phacoemulsification learning curve: analysis of both completion and complication rates

Hou

Yang

et al. 2008

Eye

View full text Add to dashboard Cite

show abstract

“…The minimum average number of cataract operations that a residency programme must provide to gain accreditation is 45 (defined by the Residency Review Committee responsible for accrediting residency programmes), even if the actual average cataract numbers of surgeries performed in US residency programmes is more than double this figure. 17 It is generally accepted that the UK National Cataract Surgery Survey 11 published in 1999, which found a PCR with vitreous loss rate for phacoemulsification of 4.4%, is no longer an acceptable benchmark for audit of surgical complications. With the evolution of the machines, the techniques, and the surgeons themselves, better results should now be expected.…”

Section: Audit Benchmarkmentioning

confidence: 99%

Determinants of cataract surgical opportunities and complication rates in UK higher specialist training

Cassels-Brown

2008

Eye

View full text Add to dashboard Cite

Purpose The volume of cataract surgery performed by trainee ophthalmologists in the UK, and the complication rates experienced by those trainees is unknown. As a result, no appropriate audit benchmark exists for trainees or their trainers. This study describes the surgical opportunities and rates of posterior capsule rupture (PCR) experienced by higher specialist trainees in one UK training region and explores influencing factors. Methods Number of cataract operations and episodes of PCR in each calendar month were recorded from surgical logbooks for all Specialist Registrars (SpRs) who had completed at least 6 months of training by January 2007. Dates and details of the posts in which the surgery was performed were also recorded. Results Data from 475 completed months were collected from 19 trainees including 4322 cataract operations and 99 episodes of PCR. Trainees performed a mean 9.1 operations per month. This varied significantly between different subspeciality posts; the fewest cataracts were on paediatric and oculo-plastic firms. District General Hospitals offered more surgery than Teaching Hospitals; mean 10.9 vs 8.5 cataracts per month (P ¼ 0.005). No difference in surgical opportunity was found between male and female trainees. An overall PCR rate of 2.3% (95% CI 2.25-2.33%) was found, which decreased significantly with increasing experience (Po0.01). Conclusion SpRs in Yorkshire expect to complete around 500 cataract operations in their 4.5 years of training. A PCR rate of 2.3% was found for trainees with a mean of 25 months higher specialist training which compares favourably with published series of trainees from other countries.

show abstract

“…On the one hand, it is desirable to the surgeon to have previously experience in micro and intraocular surgery. On the other hand, up to 10% of the residents may experience troubles in developing surgical skills (3) and the later the training, less the time to specially training and supervise distressed surgeons.…”

Section: Introductionmentioning

confidence: 99%