Catarant: Development Of A Novel Postoperative Surgical Feedback Tool.

The learning curve for intraocular surgery is steep. Timely and structured feedback of surgical cases has the great potential to increase knowledge transfer between surgical mentor and mentee, resulting in sequential improvements in intraoperative performance and a flattening of the learning curve. Despite these benefits demonstrated in other surgical specialties, there are no structured feedback or debrief tools in cataract surgery. Our goal was to create a novel feedback tool for resident education in cataract surgery.

A prospective qualitative medical education study applying iterative thematic analysis to one-to-one interviews of cataract surgical trainers at two large tertiary ophthalmology units in London and Sussex.

A novel feedback tool was developed employing adult learning theory and the Stanford design process. This involved a 1-month period of biweekly theatre observation and semi-structured interviews with cataract surgical trainers. ‘CataRANT’ was coined, which encompassed the Context of the surgical case, Analysis of the surgical video, Teaching from the cataract trainer, and Application to sequential procedures. The feedback process ended with an informal conversation - labelled ‘rant’ - to further foster a positive mentor-mentee relationship. Data was reported using simple descriptive statistics and iterative thematic analysis was applied to transcribed interviews.

16 theatre sessions were observed and 18.75% (3/16) had a formal debrief between surgical trainee and trainer. 87.5% (14/16) of theatre sessions had a formal debrief between members of the surgical team. 10 one-to-one interviews were conducted with senior surgical trainers, each trainer previously having supervised at least three junior cataract surgeons. 89 minutes of interview material underwent iterative thematic analysis. Four recurrent themes were generated, including implementation in surgical curriculum, timing of feedback, target audience and surgical education.

Timely and structured feedback is pivotal to cataract surgery education. CataRANT is a unique, formal and memorable surgical feedback tool that can be used to standardise surgical education, and democratise knowledge transfer between cataract trainers and ophthalmology residents.