Is there inter-procedural transfer of skills in intraocular surgery?: A randomized controlled trial

Ann Sofia Skou Thomsen; Jens Folke Kiilgaard; Morten la Cour; Ryan Brydges; Lars Konge

doi:10.1111/aos.13434

Is there inter-procedural transfer of skills in intraocular surgery? A randomized controlled trial

Ann Sofia Skou Thomsen, Jens Folke Kiilgaard, Morten la Cour, Ryan Brydges, Lars Konge

Department of Clinical Medicine

11 Citations (Scopus)

Abstract

PURPOSE: To investigate how experience in simulated cataract surgery impacts and transfers to the learning curves for novices in vitreoretinal surgery.

METHODS: Twelve ophthalmology residents without previous experience in intraocular surgery were randomized to (1) intensive training in cataract surgery on a virtual-reality simulator until passing a test with predefined validity evidence (cataract trainees) or to (2) no cataract surgery training (novices). Possible skill transfer was assessed using a test consisting of all 11 vitreoretinal modules on the EyeSi virtual-reality simulator. All participants repeated the test of vitreoretinal surgical skills until their performance curve plateaued. Three experienced vitreoretinal surgeons also performed the test to establish validity evidence. Analysis with independent samples t-tests was performed.

RESULTS: The vitreoretinal test on the EyeSi simulator demonstrated evidence of validity, given statistically significant differences in mean test scores for the first repetition; experienced surgeons scored higher than novices (p = 0.023) and cataract trainees (p = 0.003). Internal consistency for the 11 modules of the test was acceptable (Cronbach's α = 0.73). Our findings did not indicate a transfer effect with no significant differences found between cataract trainees and novices in their starting scores (mean ± SD 381 ± 129 points versus 455 ± 82 points, p = 0.262), time to reach maximum performance level (10.7 ± 3.0 hr versus 8.7 ± 2.8 hr, p = 0.265), or maximum scores (785 ± 162 points versus 805 ± 73 points, p = 0.791).

CONCLUSION: Pretraining in cataract surgery did not demonstrate any measurable effect on vitreoretinal procedural performance. The results of this study indicate that we should not anticipate extensive transfer of surgical skills when planning training programmes in intraocular surgery.

Original language	English
Journal	Acta Ophthalmologica
Volume	95
Issue number	8
Pages (from-to)	845-851
ISSN	1755-375X
DOIs	https://doi.org/10.1111/aos.13434
Publication status	Published - Dec 2017

Keywords

Adult
Clinical Competence
Computer Simulation
Education, Medical, Graduate/methods
Female
Humans
Internship and Residency
Learning Curve
Male
Middle Aged
Ophthalmologic Surgical Procedures/education
Ophthalmology/education
Surgery, Computer-Assisted/education
Transfer (Psychology)

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Cite this

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title = "Is there inter-procedural transfer of skills in intraocular surgery?: A randomized controlled trial",

abstract = "PURPOSE: To investigate how experience in simulated cataract surgery impacts and transfers to the learning curves for novices in vitreoretinal surgery.METHODS: Twelve ophthalmology residents without previous experience in intraocular surgery were randomized to (1) intensive training in cataract surgery on a virtual-reality simulator until passing a test with predefined validity evidence (cataract trainees) or to (2) no cataract surgery training (novices). Possible skill transfer was assessed using a test consisting of all 11 vitreoretinal modules on the EyeSi virtual-reality simulator. All participants repeated the test of vitreoretinal surgical skills until their performance curve plateaued. Three experienced vitreoretinal surgeons also performed the test to establish validity evidence. Analysis with independent samples t-tests was performed.RESULTS: The vitreoretinal test on the EyeSi simulator demonstrated evidence of validity, given statistically significant differences in mean test scores for the first repetition; experienced surgeons scored higher than novices (p = 0.023) and cataract trainees (p = 0.003). Internal consistency for the 11 modules of the test was acceptable (Cronbach's α = 0.73). Our findings did not indicate a transfer effect with no significant differences found between cataract trainees and novices in their starting scores (mean ± SD 381 ± 129 points versus 455 ± 82 points, p = 0.262), time to reach maximum performance level (10.7 ± 3.0 hr versus 8.7 ± 2.8 hr, p = 0.265), or maximum scores (785 ± 162 points versus 805 ± 73 points, p = 0.791).CONCLUSION: Pretraining in cataract surgery did not demonstrate any measurable effect on vitreoretinal procedural performance. The results of this study indicate that we should not anticipate extensive transfer of surgical skills when planning training programmes in intraocular surgery.",

keywords = "Adult, Clinical Competence, Computer Simulation, Education, Medical, Graduate/methods, Female, Humans, Internship and Residency, Learning Curve, Male, Middle Aged, Ophthalmologic Surgical Procedures/education, Ophthalmology/education, Surgery, Computer-Assisted/education, Transfer (Psychology)",

author = "Thomsen, {Ann Sofia Skou} and Kiilgaard, {Jens Folke} and {la Cour}, Morten and Ryan Brydges and Lars Konge",

note = "{\textcopyright} 2017 Acta Ophthalmologica Scandinavica Foundation. Published by John Wiley & Sons Ltd.",

year = "2017",

month = dec,

doi = "10.1111/aos.13434",

language = "English",

volume = "95",

pages = "845--851",

journal = "Acta Ophthalmologica",

issn = "1755-375X",

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TY - JOUR

T1 - Is there inter-procedural transfer of skills in intraocular surgery?

T2 - A randomized controlled trial

AU - Thomsen, Ann Sofia Skou

AU - Kiilgaard, Jens Folke

AU - la Cour, Morten

AU - Brydges, Ryan

AU - Konge, Lars

PY - 2017/12

Y1 - 2017/12

N2 - PURPOSE: To investigate how experience in simulated cataract surgery impacts and transfers to the learning curves for novices in vitreoretinal surgery.METHODS: Twelve ophthalmology residents without previous experience in intraocular surgery were randomized to (1) intensive training in cataract surgery on a virtual-reality simulator until passing a test with predefined validity evidence (cataract trainees) or to (2) no cataract surgery training (novices). Possible skill transfer was assessed using a test consisting of all 11 vitreoretinal modules on the EyeSi virtual-reality simulator. All participants repeated the test of vitreoretinal surgical skills until their performance curve plateaued. Three experienced vitreoretinal surgeons also performed the test to establish validity evidence. Analysis with independent samples t-tests was performed.RESULTS: The vitreoretinal test on the EyeSi simulator demonstrated evidence of validity, given statistically significant differences in mean test scores for the first repetition; experienced surgeons scored higher than novices (p = 0.023) and cataract trainees (p = 0.003). Internal consistency for the 11 modules of the test was acceptable (Cronbach's α = 0.73). Our findings did not indicate a transfer effect with no significant differences found between cataract trainees and novices in their starting scores (mean ± SD 381 ± 129 points versus 455 ± 82 points, p = 0.262), time to reach maximum performance level (10.7 ± 3.0 hr versus 8.7 ± 2.8 hr, p = 0.265), or maximum scores (785 ± 162 points versus 805 ± 73 points, p = 0.791).CONCLUSION: Pretraining in cataract surgery did not demonstrate any measurable effect on vitreoretinal procedural performance. The results of this study indicate that we should not anticipate extensive transfer of surgical skills when planning training programmes in intraocular surgery.

AB - PURPOSE: To investigate how experience in simulated cataract surgery impacts and transfers to the learning curves for novices in vitreoretinal surgery.METHODS: Twelve ophthalmology residents without previous experience in intraocular surgery were randomized to (1) intensive training in cataract surgery on a virtual-reality simulator until passing a test with predefined validity evidence (cataract trainees) or to (2) no cataract surgery training (novices). Possible skill transfer was assessed using a test consisting of all 11 vitreoretinal modules on the EyeSi virtual-reality simulator. All participants repeated the test of vitreoretinal surgical skills until their performance curve plateaued. Three experienced vitreoretinal surgeons also performed the test to establish validity evidence. Analysis with independent samples t-tests was performed.RESULTS: The vitreoretinal test on the EyeSi simulator demonstrated evidence of validity, given statistically significant differences in mean test scores for the first repetition; experienced surgeons scored higher than novices (p = 0.023) and cataract trainees (p = 0.003). Internal consistency for the 11 modules of the test was acceptable (Cronbach's α = 0.73). Our findings did not indicate a transfer effect with no significant differences found between cataract trainees and novices in their starting scores (mean ± SD 381 ± 129 points versus 455 ± 82 points, p = 0.262), time to reach maximum performance level (10.7 ± 3.0 hr versus 8.7 ± 2.8 hr, p = 0.265), or maximum scores (785 ± 162 points versus 805 ± 73 points, p = 0.791).CONCLUSION: Pretraining in cataract surgery did not demonstrate any measurable effect on vitreoretinal procedural performance. The results of this study indicate that we should not anticipate extensive transfer of surgical skills when planning training programmes in intraocular surgery.

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KW - Clinical Competence

KW - Computer Simulation

KW - Education, Medical, Graduate/methods

KW - Female

KW - Humans

KW - Internship and Residency

KW - Learning Curve

KW - Male

KW - Middle Aged

KW - Ophthalmologic Surgical Procedures/education

KW - Ophthalmology/education

KW - Surgery, Computer-Assisted/education

KW - Transfer (Psychology)

U2 - 10.1111/aos.13434

DO - 10.1111/aos.13434

M3 - Journal article

C2 - 28371367

SN - 1755-375X

VL - 95

SP - 845

EP - 851

JO - Acta Ophthalmologica

JF - Acta Ophthalmologica

IS - 8

ER -

Is there inter-procedural transfer of skills in intraocular surgery? A randomized controlled trial

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Keywords

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