Attributes Of Effective Cataract Surgical Trainers: Perspectives Of Uk Trainees In Nhs And Independent Settings

Over the past five years, cataract surgery provision has evolved due to COVID-19 recovery and a shift toward high-efficiency, high-turnover procedures. In this new model of training, integrating surgical education into the independent sector is essential to maintain workforce competency. However, the attributes of effective trainers and the training environment in this sector are less understood than in the NHS. This study aims to identify the key characteristics of effective surgical trainers and assess whether the independent sector provides a supportive, trainee-cantered environment that fosters these attributes.

An anonymised electronic survey was distributed to UK-based ophthalmic specialist trainees (OST) grades ST1-ST7, who had completed a cataract surgery training placement in an NHS Independent sector provider (ISP) between February 2025-August 2025.

A national voluntary survey was developed based on the Faculty of Surgical Trainers (Edinburgh) attributes of excellence and key domains from the Royal College of Ophthalmologists “Teach the Teacher” programme. It was distributed via email in August 2025 to OST trainees on completion of their placement. Responses were fully anonymised prior to analysis. Demographic data collected included trainee grade, gender, training region and number of cataract surgeries performed. Trainees rated desirable and undesirable trainer characteristics using a Likert scale and commented on training environment suitability. Quantitative and qualitative responses were analysed independently. 

Data were analysed from 14 responses (71.4% male, 28.6% female), with surgical experience ranging from 50 to >500 cataract surgeries. Overall satisfaction was high with 85.7% reporting adequate case variety and complexity during independent sector operating. Most valued trainer attributes were being encouraging and positive (31.3%), surgically confident (25%), and a clear communicator (18.8%), with protected time for feedback ranked as the single most desirable trait. The most negative attributes were limiting training opportunities (31.3%), impatience (25%), and providing critical, non-constructive feedback (18.8%). Mean cataract numbers per standard half-day list were higher in the independent sector (5.9) compared with the NHS (4.4).

Effective cataract surgical training requires both technical expertise and strong interpersonal skills. Trainees valued supportive, confident trainers who communicated clearly, provided constructive feedback, and allowed graduated autonomy, while limiting opportunities and non-constructive criticism negatively impacted learning. Although higher case numbers in the independent sector may increase operative exposure, training quality remains dependent on an enabling environment and engaged trainers. Independent sector providers appear to be non inferior to NHS. Optimising trainer attributes and protected feedback time may enhance trainee progression and ultimately patient care across NHS and independent sector settings.