Evaluation Of Simulation Ophthalmic Surgery Training Courses In Sub-Saharan Africa: What Is The Impact Of This Training On Students And Trainers?

Age-standardised prevalence of blindness in sub-Saharan Africa is 0.99%, the highest of the global subregions. This is nearly double the global average of 0.52%. There is only 2.7 ophthalmologists per million population in SSA compared to a global mean of 31.7. Since 2017, the Division of Ophthalmology at the University of Cape Town simulation ophthalmic surgery training programme has provided courses for over 260 surgeons from 22 countries in SSA and beyond. 

Core Question: What is the impact of Simulated Ophthalmic Surgical training undertaken at University of Cape Town on trainees and trainers in sub-Saharan Africa?
Sub Question: What are trainee experience of known surgical training barriers and enablers in sub-Saharan Africa

Online Survey: Any surgical trainee or trainer who has attended University of Cape Town for a Simulated Ophthalmic Surgery training course since November 2017. Courses available include Basical Microsurgical Skills, Manual Small Incision Cataract Surgery, Phacoemulsification, Trabeculectomy, and Pars Planar Vitrectomy.

Study Design

A cross-sectional, anonymous, quantitative survey of all surgical trainees and trainers who attended UCT for one or more Simulatedd Ophthalmic Surgery training courses between November 2017 and June 2024.

Sampling Method
Two questionnaires will be distributed depending on whether participant was a surgical trainer or trainee. Participants will be invited to participate in the survey through email using the existing UCT alumni network.All survey participants will be anonymous upon completion of their survey. 

Data Analysis

Data recorded from questionnaire will be disaggregated for independent courses. Scaled question will be presented as a mean Likert score with 95% confidence intervals.

100 trainee and 18 Trainer respondents:

Trainee Survey Highlights
100% of trainees currently work in SSA  in 20 different countries.

74% of trainees work in non private hospitals.

78% of trainees felt that their complication rate had either decreased or greatly decreased since attending the course.

74% of trainees felt that their post operative visual outcomes had either improved or greatly improved since attending the course.

61% of trainees disagreed that low availability of suitable surgical cases was a barrier to their training.

61% of trainees have not had the opportunity to practice simulation skills since attending the course.

Trainer Survey Highlights

78% of trainers felt their confidence in teaching had improved since attending courses.

This survey provides further support for existing evidence that simulated surgical techniques improve trainee confidence and skill acquisition in early career stage surgeons. Furthermore this research agrees with previous evidence that introduction to surgical skills through simulation reduces surgical complication rates, reducing patient harm. These courses also benefit surgical trainers, creating an unpressured environment to develop teaching skills. Simulation techniques could prove to be a vital tool in helping overcome inequity of eye care in developing countries due to low availability of ophthalmic surgeons. With this evidence we advocate for greater inclusion and provision simulation techiniques into national training curriculum.