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Training dexterity in dominant and non-dominant hands by ophthlamic surgical simulation: results from a pilot study

Poster Details

First Author: M.Daly USA

Co Author(s):    L. Gonzalez-Gonzalez              

Abstract Details



Purpose:

Ophthalmic surgery is inherently bimanual and requires surgeons to use their dominant and non-dominant hand. Virtual surgical simulation has been incorporated into training programs in the aim of improving dexterity. To date, there is no recommendation or requirement for teaching programs to offer structured curricula targeted at improving dexterity in the non-dominant hand. We hypothesize that a structured training program using the validated EYESI surgical simulator may improve dexterity in non-dominant hands.

Setting:

Non-randomized, prospective study, at an academic institution, Veterans Administration Boston Healthcare System, Boston, Massachusetts.

Methods:

Fourteen subjects were asked to complete three sessions of simulated capsulorrhexis with their dominant and non-dominant hand. A baseline performance was recorded for each, followed by a series of abstract training tasks and an evaluation test at the end of each session. We compared the average overall scores at baseline and at the end of the study adjusting for level of training. Demographic data and hand preference were collected prior to the simulation sessions. Wilcoxon rank sum and singed-rank tests were performed for statistical analysis using JMP® by SAS.

Results:

Of the 14 participants, four (28.6%) were attending physician, eight (57.1%) were medical students and two (14.3%) were residents. One participant was left-handed (7.1%). The average baseline scores were 33.4 ± 24.3 and 28.9 ± 24.3 and the average final scores were 46.5 ± 24.3 and 47.7 ± 24.8, for the dominant and non-dominant hand, respectively (p=0.68, p=0.81). We found a statistically significant difference at baseline and final scores in the non-dominant hand (p=0.04), but no difference between scores in the dominant hand (p=0.12). We observed a trend toward improvement in both hands, more marked in the non-dominant hand. When analyzing the data across groups, there was a significant difference in the improvement between the dominant and non-dominant hand (p=0.013).

Conclusions:

We found a statistically significant improvement in dexterity in the non-dominant hand after the three training session program. We also observed a trend to improvement in the performance with the dominant hand; but this trend was not statistically significant. Perhaps, the higher scores at baseline in the dominant hand may result in less improvement relative to that observed in the non-dominant hand. The results of this pilot study suggest that a more elaborate, structured curriculum that targets teaching dexterity in both dominant and non-dominant hand may result in better performance as measured by validated, simulated training protocols. A larger, longer study that also evaluates the impact of simulated training in the real clinical scenario is warranted. FINANCIAL INTEREST: NONE

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