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‘Cheese, Ketchup and Grapes’: medical student feedback on remote learning using a cataract surgery practical simulation with household items versus a cataract procedure video during the Covid-19 pandemic

Poster Details

First Author: C. Norbury UK

Co Author(s):                        

Abstract Details


The Royal College of Ophthalmologists guidance includes; the anatomy of the lens, symptoms and management of a cataract as core knowledge expected to be included in all UK medical school curricula. Despite cataracts being common amongst the general population and cataract surgery remaining one of the most common operations performed worldwide, many medical students are unaware of what a cataract is or how they are managed. The Covid-19 pandemic has had major implications on medical student education with many opportunities including theatre sessions being withdrawn. As a result, it is imperative that alternative socially distanced learning opportunities are developed.


This research was conducted at a small district general hospital with third and fourth year medical students completing a week long speciality attachment on ophthalmology, following social distancing recommendations provided by the Welsh government.


As part of a rotation in ophthalmology, 20 students undertook a wet lab, simulation based exercise where they performed the steps of cataract surgery using readily available household items including cheese, ketchup and grapes, without the need of an operating microscope or microsurgical instruments. The same group of 20 students were provided with a publicly available 7-minute instructional video on phacoemulsification cataract surgery accessed via the YouTubeᆴ platform. Following this, students were invited to participate in a focus group discussion about their experience and advantages and disadvantages of each method of learning. Interpretative phenomenological analysis (IPA) was used for analysis.


All 20 students consented to be included in the research. Using IPA, key themes were identified for each remote learning activity. A number of key themes were identified for both learning activities. Engagement was a key theme and students found that the simulation session was more engaging. Educational value was found to be another theme with students unanimously finding that a practical hands-on simulation session with an instructor helped with understanding, knowledge retention and improving dexterity. Limitations of a simulation exercise was a lack of experience of the theatre environment or observing microsurgical techniques.


As a result of the Covid-19 pandemic alternative methods of medical student education have become more important than ever. We developed a simulation exercise using readily available household items and compared it to video learning which would closely resemble what students would observe on an audio-visual screen in a theatre environment. We found, from focus group discussions, that students found the simulation exercise much more educationally beneficial and engaging than watching a video. Our results show that a simple simulation exercise could provide an improved learning opportunity for medical students than the traditional observational role in theatre.

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