Learning curves of novice residents on cataract surgery simulator: the E3CAPS pedagogic study.

Autor: Ducloyer JB; CHU Nantes, Ophthalmology Department, Nantes University, Nantes, France. Jean-Baptiste.Ducloyer@univ-nantes.fr.; CHU Nantes, Inserm, CIC 1413, Nantes University, Nantes, France. Jean-Baptiste.Ducloyer@univ-nantes.fr., Poinas A; CHU Nantes, Inserm, CIC 1413, Nantes University, Nantes, France., Duchesne L; CHU Nantes, Public Health Department, Nantes University, Nantes, France., Caillet P; CHU Nantes, Public Health Department, Nantes University, Nantes, France., Lejus-Bourdeau C; CHU Nantes, Department of Anesthesia and Intensive Care, Nantes University, Nantes, France., Le Meur G; CHU Nantes, Ophthalmology Department, Nantes University, Nantes, France.; CHU Nantes, Inserm, CIC 1413, Nantes University, Nantes, France., Weber M; CHU Nantes, Ophthalmology Department, Nantes University, Nantes, France.; CHU Nantes, Inserm, CIC 1413, Nantes University, Nantes, France., Ivan C; CHU Nantes, Ophthalmology Department, Nantes University, Nantes, France.; CHU Nantes, Inserm, CIC 1413, Nantes University, Nantes, France., Limousin N; Department of Neurology and Clinical Neurophysiology, University Hospital Bretonneau, Tours, France., Desmidt T; UMR 1253, IBraiN, Université de Tours, Inserm, Tours, France.; CHU de Tours, Tours, France., Pladys P; CHU Rennes, Inserm, LTSI-UMR 1099, University Rennes, Rennes, France., Pisella PJ; Department of Ophthalmology, Centre Hospitalier Regional Universitaire de Tours, Bretonneau Hospital, Tours, 37000, France., Bernard A; Department of Cardiology, Tours University Hospital, Tours, France., Lardy H; Division of Pediatric Surgery, CHU-Centre de Pédiatrie de Clocheville, Tours, France., Gohier P; Department of Ophthalmology, CHU de Angers, Angers, 49100, France., Martin L; All'Sims Centre for Healthcare Simulation, Angers University Hospital, Angers, France., Mouriaux F; Department of Ophthalmology, CHU Rennes, Université Rennes 1, Rennes, France., Lebranchu P; CHU Nantes, Ophthalmology Department, Nantes University, Nantes, France.; CHU Nantes, Inserm, CIC 1413, Nantes University, Nantes, France., Khanna RK; Department of Ophthalmology, Bretonneau University Hospital of Tours, Tours, France.
Jazyk: angličtina
Zdroj: BMC medical education [BMC Med Educ] 2024 Sep 30; Vol. 24 (1), pp. 1078. Date of Electronic Publication: 2024 Sep 30.
DOI: 10.1186/s12909-024-06064-z
Abstrakt: Introduction: Training novice ophthalmology residents on the EyeSi ® simulator increases cataract surgery safety. However, there is no consensus regarding how much training residents should perform before their first time on patients. We evaluated the French national training program through the analysis of the learning curves of novice residents.
Methods: This prospective multicentric pedagogic study was conducted with French novice residents. Each resident completed the recommended four two-hour training sessions and performed a standardized assessment simulating standard cataract surgery before the first session (A0), at the end of the first (A1), second (A2), third (A3) and fourth (A4) sessions. For each surgical step of each attempt, the following data were collected: score, odometer, completion time, posterior capsular rupture and cumulative energy delivered (ultrasounds) during phacoemulsification. A performance threshold was set at a score of 80/100 for each surgical step, 400/500 for the overall procedure. Only descriptive statistics were employed.
Results: Sixteen newly nominated ophthalmology residents were included. Median score progressively increased from 95 [IQR 53; 147]) at A0 to 425 [IQR 411; 451] at A4. Despite a significant progression, the "emulsification" step had the lowest A4 scores 86 [IQR 60; 94] without reduction in completion time, odometer or ultrasounds delivered. The rate of posterior capsular rupture decreased linearly from 75% at A0 to 13% at A4 during "emulsification" and from 69 to 0% during "irrigation and aspiration". At A4, only 25% [8; 53] of residents had > 80 at each step and only 75% [47; 92] had > 400/500 overall.
Conclusion: A training program consisting of four two-hour sessions on the EyeSi simulator over four consecutive days effectively enhances the surgical skills of novice ophthalmology residents. Undergoing more training sessions may improve scores and decrease the incidence of surgical complications, particularly at the emulsification step of cataract surgery. The learning curves presented here can reassure residents who are progressing normally and help identify those who need a further personalized training program.  TRIAL REGISTRATION: ClinicalTrials registration number: NCT05722080 (first submitted 22/12/2022, first posted 10/02/2023).
(© 2024. The Author(s).)
Databáze: MEDLINE
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