Optimizing surgical training in paediatric ophthalmology: perspectives from a major tertiary metropolitan teaching centre in Australia

Abstract

Aim A core competency in ophthalmology training programs is paediatric strabismus surgery. Surgical teaching in this area has not yet been evaluated. To quantitatively evaluate paediatric strabismus teaching over a 5-year period. Materials and methods A consecutive, retrospective review of strabismus surgery performed by all surgeons at The Royal Children’s Hospital Melbourne, from Jan 2018 to Dec 2022. Results Five aspects relevant to surgical teaching: i). the pandemic adversely affected training ii). operating time for a trainee was: 57.8mins +/- 16mins per case iii). Surgical alignment outcomes were excellent in 34.1 to 43.4% cases and poor in 4 to 6% of cases. iv). Significantly higher incidence of adverse events among junior trainees compared to Fellows (71.4% vs. 46.7%, p = 0.003) v). Most adverse events were minor Discussion Surgical operating time is impacted by case selection and reinforces the need for supervisors to be mindful of the trainee’s competency level when preparing surgical lists. The majority of cases performed by trainees had an adequate outcome. The high incidence of adverse events among junior trainees highlights the need to focus our teaching on common pitfall areas using didactic teaching methods including technology-based teaching such as virtual simulators.