The Impact of Simulation-Based Trabeculectomy Training on Resident Core Surgical Skill Competency
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Date
2023Author
Annoh, Roxanne
Buchan, John
Gichuhi, Stephen
Philippin, Heiko
Arunga, Simon
Mukome, Agrippa
Admassu, Fisseha
Karinya, Lewis
Makupa, William
Otiti-Sengeri, Juliet
Kim, Min
MacLeod, David
Burton, Matthew J
Dean, William H
Type
ArticleLanguage
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Prcis: Simulation-based surgical education shows a positive, immediate, and sustained impact on core surgical skill competency in trabeculectomy among resident ophthalmologists in training.
Purpose: To measure the impact of trabeculectomy, surgical simulation training on core surgical skill competency in resident ophthalmologists.
Materials and methods: This is a post hoc analysis of the GLAucoma Simulated Surgery trial, which is a multicenter, multinational randomized controlled trial. Resident ophthalmologists from 6 training centers in sub-Saharan Africa (in Kenya, Uganda, Tanzania, Zimbabwe, and South Africa) were recruited according to the inclusion criteria of having performed zero surgical trabeculectomies and assisted in <5. Participants were randomly assigned to intervention and control arms using allocation concealment. The intervention was a 1-week intensive trabeculectomy surgical simulation course. Outcome measures were mean surgical competency scores in 8 key trabeculectomy surgical skills (scleral incision, scleral flap, releasable suturing, conjunctival suturing, sclerostomy, tissue handling, fluidity, and speed), using a validated scoring tool.
Results: Forty-nine residents were included in the intention-to-treat analysis. Baseline characteristics were balanced between arms. Median baseline surgical competency scores were 2.88/16 [interquartile range (IQR): 1.75-4.17] and 3.25/16 (IQR: 1.83-4.75) in the intervention and control arms, respectively. At primary intervention, median scores increased to 11.67/16 (IQR: 9.58-12.63) and this effect was maintained at 3 months and 1 year ( P =0.0001). Maximum competency scores at primary intervention were achieved in the core trabeculectomy skills of releasable suturing (n=17, 74%), scleral flap formation (n=16, 70%), and scleral incision (n=15, 65%) compared with scores at baseline.
Conclusions: This study demonstrates the positive impact of intensive simulation-based surgical education on core trabeculectomy skill development. The rapid and sustained effect of resident skill acquisition pose strong arguments for its formal integration into ophthalmic surgical education.
Citation
Annoh R, Buchan J, Gichuhi S, Philippin H, Arunga S, Mukome A, Admassu F, Lewis K, Makupa W, Otiti-Sengeri J, Kim M, MacLeod D, Burton MJ, Dean WH. The Impact of Simulation-Based Trabeculectomy Training on Resident Core Surgical Skill Competency. J Glaucoma. 2023 Jan 1;32(1):57-64. doi: 10.1097/IJG.0000000000002114. Epub 2022 Aug 22. PMID: 36001526; PMCID: PMC7614002.Publisher
University of Nairobi
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Attribution-NonCommercial-NoDerivs 3.0 United StatesUsage Rights
http://creativecommons.org/licenses/by-nc-nd/3.0/us/Collections
- Faculty of Health Sciences (FHS) [10378]
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