Abstract
ABSTRACT Background: Cataract surgery and surgical training has undergone extensive revolution over years. Phacoemulsification is the surgery of choice. However, in developing countries, residents begin surgical training with small incision cataract surgery (SICS). SICS is a stepping stone to acquire good intraocular awareness and eventually perform phacoemulsification surgeries. Through this study we emphasize the need for one-to-one monitoring of surgeries performed by residents. The objective analysis of their surgical performance was based on the International Council of Ophthalmology Ophthalmology Surgical Competency Assessment Rubrics (ICO OSCAR). Aims and Objectives: Primary objective: To improvise the ophthalmic surgical training of the residents by one to one monitoring of the first 20 surgeries performed by the trainee. Secondary objective: To ensure the best possible outcome with the least number of complications in the resident surgical cases. Materials and Methods: It was a cross sectional, observational study done in the tertiary care eye hospital in South Bengaluru from May 2023 to August 2023. Six residents, who were to begin their surgical training in our institute, were observed by three senior skilled faculty surgeons. At the end of each surgery, ICO OSCAR structured questionnaire was given to each resident for self evaluation, and the assessment made by the resident was re analysed by the observing faculty on the postoperative day one based on the outcomes of surgery. Results: The significant observations made by senior skilled faculty surgeons has been summarized as verbatim quotes. We describe the performance of the candidate during surgery as per ICO-OSCAR scoring, 2-novice; 3-beginner; 4-advanced beginner, 5-competent. This structured procedure of candidate observation and assessment was followed for the first twenty surgeries performed by the residents who have enrolled in the study. The data was entered in Microsoft-EXCEL version 10 and analysed. Conclusion: We conclude that one is to one monitoring by the senior faculty surgeon during the initial few cases plays a pivotal role in the surgical learning curve of the residents and observations of our study can be used for future modifications to improvise the postgraduate training program in ophthalmology.
Published Version
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