Hazard Perception Video Training For Cataract Surgery - A New Safety Initiative.

Driving hazard perception tests are frequently used to train and assess drivers, and improve road safety.  We wished to explore whether hazard perception principles could be applied to cataract surgery training, and improve patient safety.

University teaching hospital in Scotland, UK. 

A series of video segments from real life surgery demonstrating surgical hazards were collected. Surgeons with a range of experience were invited to watch the videos and identified hazards. We then instigated a brief hazard perception educational intervention, reviewed the earlier videos with teaching commentary, and then asked participants to assessed 5 further videos for hazards. A composite score of correctly identified hazards was calculated for each participant before and after the itnervention. Participants confidence at detecting hazards were measured on a likert scale (1=very confident, 5=not confident at all) before and after teaching intervention.

Of the 26 participants, 9 were junior trainees (year 1-3, 0-300 completed cataract procedures), 11 senior trainees (year 4-7, 200-1000+) and 6 consultants (1000+). Hazards were identified accurately 33% before vs 52% (p<0.01) following teaching intervention. Every groups performance improved; juniors 19% vs 44% (p=0.02), seniors 48% vs 63% (p=0.02), and consultants 33% vs 44% (p=0.04). There was statistically significantly difference between junior and senior trainees performance before the intervention (p=0.01) but not afterwards (p=0.15).

Confidence scores at detecting hazards were unchanged before and after training intervention (2.5 versus 2.4 respective, p>0.5).

Cataract hazard perception video training improved junior and experienced surgeons ability to detect surgical hazards. Confidence to detect hazards did not improve following the training intervention, indicating that more in-depth hazard perception training may be of benefit.