Simultaneous Bilateral Oculoplastic Surgical Simulation

Abstract

PurposeThe current crisis of COVID-19 has reduced training opportunities for many ophthalmology residents. This study describes a model of simultaneous bilateral cadaveric surgical simulation for oculoplastic trainees as means to maximise training outcomes in a time- and resource-limited setting. MethodsA total of fourteen participants were included. Bilateral oculoplastic simulation were performed by two trainees assigned to a human cadaver at the same time. One participant started with transethmoidal endoscopic medial wall decompression over one side while another participant learned transcutaneous lateral wall decompression over the other eye, both under the direct supervision of a single experienced oculoplastic trainer. The number of orbital decompression surgeries performed, and participants’ rating of their learning progress and satisfaction with this simulation model were reported. ResultsThe fourteen participants included five ophthalmic residents (34%) and nine oculoplastic fellows (64%). Each participant completed one endoscopic medial and one lateral wall orbital decompression within 4 hours, hence a total four decompression surgeries was performed per human cadaver. Most (88%) participants agreed that simultaneous bilateral learning was preferred over the conventional and sequential unilateral simulation as it offered more hands-on time especially in a setting of limited time, cadavers and operative instruments. All (100%) would recommend fellow ophthalmic trainees to this type of simulation workshop.ConclusionIn this pilot study, simultaneous bilateral surgical simulation using human cadaver maximises the individual learning opportunity and was well received by all participants. It is an effective and resourceful model especially useful for oculoplastic training.

A scoping review investigating the effects of simulation based training on surgical skills and confidence of Ophthalmology trainees in performing Glaucoma, Oculoplastic and Orbital surgical procedures.

“…Tooley (2020) ran a day entitled 'Ophthalmology Olympics' which involved a short didactic teaching session followed by team based 'challenges' during which trainees had 12 minutes to perform different procedures (for example eyelid margin laceration repair, temporary tarsorrhaphy, lateral canthotomy and cantholysis.) Ma investigated the use of cadaveric simulation to perform endoscopic medial wall decompression and transcutaneous lateral wall decompression (24). Patel investigated a model for goniotomy (25).…”