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Proficiency-based pre-training curriculum in phacoemulsification surgery reduces the learning curve of novice trainees on patients

Poster Details

First Author: P.Lee IRELAND

Co Author(s):                  

Abstract Details



Purpose:

To evaluate the effectiveness of a proficiency-based phacoemulsification training curriculum for novice trainees prior to start operating on real patients in the theatre.

Setting:

Royal Victoria Eye And Ear Hospital, Dublin, Ireland

Methods:

Novice trainees, without any previous ophthalmic surgical experiences, underwent a comprehensive, proficiency-based phacoemulsification training curriculum prior to start operating on patients in the theatre. This curriculum includes didactic components and dry lab exercises of all the steps in phacoemulsification surgery. Particular emphasis is made on the instrument handling, the hand-eye-foot coordination and the knowledge potential risks in each step of the surgery. The length of pre-training is dependent on the acquisition of skills rather than the time spent. The trainees have to pass an assessment at the completion of training before they are permitted to operate on real patients in the theatre. The effectiveness of this training methodology is measured by the number of patient required for the trainees to reach their first full case under supervision.

Results:

A total of three novice trainees participated in this study (N=3). The first trainee completed a full case by the 8th patient. The second trainee did the same by the 4th patient and the same for the third trainee by the 9th patient. The average number of patients required for the three trainees to reach their first full case is 7 patients. The average training time needed to reach the required proficiency is 50 hours spread over 6-12 weeks.

Conclusions:

A proficiency-based pre-training curriculum shifts the trainees' learning curve for cataract surgery from patients in theatre to a safe, controlled environment. The trainees can learn the necessary knowledge and skills at their own pace without sacrificing precious theatre time and incurring risk to patients. Pre-training allows the trainees to predominantly demonstrate what they can do instead of discovering what they cannot do when operating on real patients. FINANCIAL INTEREST: NONE

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