Operating Room Performance Improves after Proficiency-Based Virtual Reality Cataract Surgery Training

TY - JOUR

T1 - Operating Room Performance Improves after Proficiency-Based Virtual Reality Cataract Surgery Training

AU - Thomsen, Ann Sofia Skou

AU - Bach-Holm, Daniella

AU - Kjærbo, Hadi

AU - Højgaard-Olsen, Klavs

AU - Subhi, Yousif

AU - Saleh, George M

AU - Park, Yoon Soo

AU - la Cour, Morten

AU - Konge, Lars

N1 - Copyright © 2017 American Academy of Ophthalmology. Published by Elsevier Inc. All rights reserved.

PY - 2017/4/1

Y1 - 2017/4/1

N2 - 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.

AB - 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.

KW - Clinical Competence/standards

KW - Computer Simulation

KW - Computer-Assisted Instruction/methods

KW - Double-Blind Method

KW - Education, Medical, Graduate/standards

KW - Educational Measurement

KW - Female

KW - Humans

KW - Internship and Residency

KW - Male

KW - Middle Aged

KW - Operating Rooms/standards

KW - Ophthalmology/education

KW - Phacoemulsification/education

KW - Prospective Studies

KW - Task Performance and Analysis

KW - Video Recording

KW - Visual Acuity

U2 - 10.1016/j.ophtha.2016.11.015

DO - 10.1016/j.ophtha.2016.11.015

M3 - Journal article

C2 - 28017423

SN - 0161-6420

VL - 124

SP - 524

EP - 531

JO - Ophthalmology

JF - Ophthalmology

IS - 4

ER -