Evaluation Of A Pedagogy-Driven High-Volume Modular Cataract Surgery Training Model In The Uk Independent Sector: A Trainee-Reported Outcomes Study

Surgical training in cataract surgery in the UK faces increasing service pressures, reduced theatre time, and variable exposure to high-volume operative experience. Independent sector training environments may offer structured, high-throughput models that facilitate stepwise skill acquisition. This study evaluates trainee-reported outcomes from a modular cataract surgery training programme delivered within a high-volume independent sector setting (Teesside Newmedica, UK), with emphasis on supervision, psychological safety, human factors integration, surgical confidence, and academic development.

Independent sector ophthalmology training centre (Teesside Newmedica), United Kingdom. Teesside Newmedica is a GMC-approved independent sector ophthalmology centre recognised by the School of Ophthalmology for formal ophthalmic training. Seven consecutive trainees rotated through the programme. One trainee per rotation attended a dedicated half-day high-volume cataract surgery list under direct supervision of a GMC-approved clinical supervisor within a structured modular training framework.

An anonymised questionnaire was distributed to ophthalmology trainees completing a modular cataract surgery placement in an independent sector centre. Seven consecutive trainees completed the training programme. Seven trainees responded (100%). Grades ranged from ST2–ST5 (ST2 50%, ST4 17%, ST5 33%). Placement duration was 6–12 months (50%), 3–6 months (33%), and <3 months (17%). Case volume was 50–100 (50%), <50 (33%), and 100–200 (17%). Training followed a previously described competency-based modular model integrating stepwise progression, human factors, and pedagogical theory (Mansoor et al., Clin Ophthalmol 2024). Responses were collected using Likert-scale and categorical measures. Descriptive statistical analysis was performed. 

All trainees (100%) strongly agreed that objectives were clear, high-volume exposure adequate, and theatre flow supportive of training. Stepwise modular progression and systematic teaching of cataract steps were rated 100%, with all progressing when ready. Supervision was appropriate (100%), feedback was “exceptional” (100%), and psychological safety universal. Human factors teaching was rated greater/much greater than traditional training (100%). Confidence improved and anxiety reduced in 100%. All felt ready for catarct surgery with minimal or no supervision. independent practice. Experience was rated excellent and recommended by 100%. The majority would recommend the training model to other trainees.

A structured, high-volume modular cataract surgery programme delivered within an independent sector setting was associated with consistent improvements in trainee confidence, psychological safety, technical progression, and human factors awareness. All trainees reported readiness for independent cataract surgery with minimal or no supervision and strongly endorsed the training model. These findings support real-world implementation of a previously described competency-based modular framework integrating human factors and pedagogical theory, with clear potential for adoption within NHS settings. The model offers a pedagogy-driven, competency-based approach applicable across European and global ophthalmic training systems.