Virtual reality simulation and real-life training programs for cataract surgery: a scoping review of the literature.

Autor: Dormegny L; Department of Ophthalmology, Strasbourg University Hospitals, Strasbourg, France. lea.dormegny@chru-strasbourg.fr.; GEPROMED, Education department, Strasbourg, France. lea.dormegny@chru-strasbourg.fr., Lansingh VC; Helpmesee, Jersey City, NJ, United States of America.; Department of Public Health Sciences, Voluntary, University of Miami Miller School of Medicine, Miami, United States of America.; Department of Ophthalmology and Visual Sciences, John A. Moran Eye Center, the University of Utah, Salt Lake City, United States of America.; Director of Research, Instituto Mexicano de Oftalmología, Santiago De Querétaro, Qro, Mexico., Lejay A; GEPROMED, Education department, Strasbourg, France.; Department of Vascular Surgery and Kidney Transplantation, Strasbourg University Hospitals, Strasbourg, France., Chakfe N; GEPROMED, Education department, Strasbourg, France.; Department of Vascular Surgery and Kidney Transplantation, Strasbourg University Hospitals, Strasbourg, France., Yaici R; Department of Ophthalmology, Strasbourg University Hospitals, Strasbourg, France.; GEPROMED, Education department, Strasbourg, France., Sauer A; Department of Ophthalmology, Strasbourg University Hospitals, Strasbourg, France.; GEPROMED, Education department, Strasbourg, France., Gaucher D; Department of Ophthalmology, Strasbourg University Hospitals, Strasbourg, France.; GEPROMED, Education department, Strasbourg, France., Henderson BA; Helpmesee, Jersey City, NJ, United States of America.; Clinical Professor, School of Medicine, Tufts University, Boston, MA, United States of America., Thomsen ASS; Department of Ophthalmology, Rigshospitalet, Golstrup, Denmark.; Copenhagen Academy for Medical Education and Simulation (CAMES), Copenhagen, Denmark.; Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark., Bourcier T; Department of Ophthalmology, Strasbourg University Hospitals, Strasbourg, France.; GEPROMED, Education department, Strasbourg, France.
Jazyk: angličtina
Zdroj: BMC medical education [BMC Med Educ] 2024 Oct 31; Vol. 24 (1), pp. 1245. Date of Electronic Publication: 2024 Oct 31.
DOI: 10.1186/s12909-024-06245-w
Abstrakt: Background: Cataract surgery requires a high level of dexterity and experience to avoid serious intra- and post-operative complications. Proper surgical training and evaluation during the learning phase are crucial to promote safety in the operating room (OR). This scoping review aims to report cataract surgery training efficacy for patient safety and trainee satisfaction in the OR when using virtual reality simulators (EyeSi [Haag-Streit, Heidelberg, Germany] or HelpMeSee [HelpMeSee foundation, Jersey city, New Jersey, United States]) or supervised surgical training on actual patients programs in residents.
Methods: An online article search in the PubMed database was performed to identify studies proposing OR performance assessment after virtual-reality simulation (EyeSi or HelpMeSee) or supervised surgical training on actual patients programs. Outcome assessment was primarily based on patient safety (i.e., intra- and post- operative complications, OR performance, operating time) and secondarily based on trainee satisfaction (i.e., subjective assessment).
Results: We reviewed 18 articles, involving 1515 participants. There were 13 using the EyeSi simulator, with 10 studies conducted in high-income countries (59%). One study used the HelpMeSee simulator and was conducted in India. The four remaining studies reported supervised surgical training on actual patients, mostly conducted in low- middle- income countries. Training programs greatly differed between studies and the level of certainty was considered low. Only four studies were randomized clinical trials. There were 17 studies (94%) proposing patient safety assessments, mainly through intraoperative complication reports (67%). Significant safety improvements were found in 80% of comparative virtual reality simulation studies. All three supervised surgery studies were observational and reported a high amount of cataract surgeries performed by trainees. However, intraoperative complication rates appeared to be higher than in virtual reality simulation studies. Trainee satisfaction was rarely assessed (17%) and did not correlate with training outcomes.
Conclusions: Patient safety assessment in the OR remains a major concern when evaluating the efficacy of a training program. Virtual reality simulation appears to lead to safer outcomes compared to that of supervised surgical training on actual patients alone, which encourages its use prior to performing real cases. However, actual training programs need to be more consistent, while maintaining a balance between financial, cultural, geographical, and accessibility factors.
(© 2024. The Author(s).)
Databáze: MEDLINE
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