Group Supervision Research Articles

Evaluation and Supervision of The Learning Process as An Effort to Improve Teacher Professionalism in Schools

The purpose of this study was to examine the evaluation and supervision of the learning process as an effort to increase teacher professionalism in schools. The method used is a qualitative research method with a type of field research. The research locations in this study were MA Darul Hikmah Jember, MA Fatihul Ulum Al Mahfudz, MAN 1 Jember, and MAN 2 Jember. The findings in this study are that, in general, the implementation of academic supervision at MA Darul Hikmah Jember, MA Fatihul Ulum Al Mahfudz, MAN 1 Jember, and MAN 2 Jember has been going well. School supervisors have an adequate understanding of academic supervision and can carry out their supervisory duties and functions properly. Second, there are still limitations in the aspects targeted for academic supervision by Madrasah supervisors at MA Darul Hikmah Jember, MA Fatihul Ulum Al Mahfudz. Not all aspects of academic supervision are the focus of school supervisors. Whereas in MAN 1 Jember and MAN 2 Jember, all aspects have been carried out by the madrasa supervisor. Supervised aspects include lesson planning, teaching and learning implementation, class management, and follow-up on learning outcomes. Third, Madrasa supervisors have developed various academic supervision techniques that are quite varied at MA Darul Hikmah Jember, MA Fatihul Ulum Al Mahfudz, MAN 1 Jember, and MAN 2 Jember. The techniques used include individual supervision, such as class visits, observations, and individual meetings; group supervision, such as teacher meetings/supervision meetings, committees, and group work, as in the MGMP. The approaches used in supervision activities include the official, partner, and family approaches.

Factors influencing the selection of oral healthcare providers in multidisciplinary Nutrition Support Team for malnourished inpatients: A cross-sectional study.

Oral health management involving dental professionals in a multidisciplinary Nutritional Support Team (NST) is effective collaborative care. However, the indicators for the triage of oral health management requirements and selection of oral healthcare providers remain unclear. This cross-sectional study included inpatients with malnutrition and aimed to investigate the factors associated with determining the need for oral health management involving dental professionals and selecting primary oral healthcare providers when needed. Participants included 255 inpatients (154 males and 101 females, mean age 69.7 ± 14.4 years) aged ≥20 years who underwent oral assessment by the NST between April 2016 and July 2019. Participants were assigned to the following groups: good oral health group, oral health management by nurses under the supervision of dental professionals group, and oral health management by dental professionals group. The comprehensive oral health status was investigated using the Oral Health Assessment Tool (OHAT). The total OHAT score ranges from 0 to 16, with a higher score indicating a poorer oral environment. The total OHAT score had a significant correlation with the need for oral health management by dental professionals. Inpatients with denture problems required oral health management from dental professionals. The optimal cutoff value of the total OHAT score for determining the need for oral health management was four. The need for oral health management by dental professionals increased with worsening oral health status, especially denture problems. The OHAT score could be used to triage inpatients who require oral health management collaborated with dental professionals.

The association of feeding difficulties and generic health-related quality of life among children born with esophageal atresia

BackgroundChildren born with esophageal atresia experience feeding difficulties. This study investigates the association of feeding difficulties and generic health-related quality of life among children aged 2–7 and 8–17 years, born with esophageal atresia.Methods108 families (n = 36 aged 2–7 years; n = 72 aged 8–17) answered a survey regarding difficulties in their child’s mealtimes and a validated generic health-related quality of life instrument(PedsQL 4.0). Clinical data was collected from hospital records. The association of feeding difficulties and health-related quality of life was analysed trough Mann-Whitney U-test. Linear regression determined whether the number of concurrent feeding difficulties in the child decreased the health-related quality of life scores. P < 0.05 was considered significant.ResultsIn children aged 2–7 and 8–17 years, to have a gastrostomy, to use a food infusion pump, need for energy-enriched food and eating small portions were respectively significantly associated with lower total health-related quality of life scores in the parent-reports (p < 0.05). Most of the feeding difficulties had a negative significant relationship with the domains of physical and social functioning. Additionally, in the older age group, long mealtimes and adult mealtime supervision were associated with lower scores in both child and parent reports. In both age groups, an increased number of feeding difficulties in the child decreased the total generic health-related quality of life scores (p < 0.01).ConclusionSpecific feeding difficulties are associated with low health-related quality of life among children with esophageal atresia. An increasing number of feeding difficulties is associated to decreasing health-related quality of life-scores. Further research is needed to understand these associations.

The psychological safety of specialists involved in the organization and provision of psychological assistance in war conditions

The aim. To provide an analysis of the theoretical foundations and practical approaches to addressing the issue of psychological safety for specialists involved in the organization and provision of psychological assistance in war conditions.&#x0D; Materials and methods. The research employed the bibliographic method, method of analysis, and synthesis of scientific materials from academic sources.&#x0D; Results and discussion. A detailed analysis of several scientific studies revealed that among the main prerequisites for the emergence of emotional burnout in helping professionals, two directions are traditionally identified: the characteristics of professional activities and the psychological characteristics of the specialist.&#x0D; In the context of the question about the psychological changes that can occur in professionals during their professional activities, we have examined the phenomenon of secondary trauma or secondary traumatic stress, which refers to the trauma experienced by a professional while providing psychological assistance. In the literature on crisis psychology, the phenomenon of burnout is often equated with the phenomenon of secondary trauma due to the following reasons: 1) both states tend to accumulate over time, and 2) they have similar consequences (insomnia, depressed mood, impaired communication with social environment and family).However, a detailed analysis of these phenomena indicates the presence of differences, primarily in the characteristics of their emergence.&#x0D; Conclusion. &#x0D; The main safety rules for assisting specialists, compliance with which is necessary to maintain their professional well-being, include: awareness of one's abilities and the limits of one's competence;having an understanding of one's vulnerabilities and assessing one's capabilities and risks when working with cases that involve heightened emotional sensitivity; tracking changes in one's emotional and physical state, as well as changes in behavior; seeking help from superiors when needed;when dealing with challenging crisis events and their aftermath, working better in pairs with colleagues. This is necessary for maintaining emotional balance for each specialist working in a pair and for the ability to rely on each other during consultations or group psychological work;participating periodically in supervision groups or receiving supervision.Following these rules is essential for preserving the emotional well-being of each specialist and enables them to rely on support systems such as working in pairs and seeking supervision or consultation when needed.

Supporting Relational, Trauma-Informed Social Care Work with Autistic Adults: Evaluation of a Reflective Supervision Group Pilot

Abstract There is a growing body of literature highlighting the need for reflective supervision to support the often complex and challenging practice of social care workers. The current study aimed to explore an Irish social care team’s experience of a pilot reflective supervision group. The study participants were six male social care workers supporting autistic adults in the community. The team met for four one-monthly group supervision sessions, facilitated by an external supervisor. A reflective, relational approach was taken to the supervisory work, using role-play, free association and the Seven-Eyed model of supervision. At the end of the four-month pilot, participants completed a brief questionnaire to evaluate the supervision group experience. Thematic analysis of the participants’ open responses revealed the following themes: (i) increased insight/empathy; (ii) experiential learning; (iii) enhanced awareness/skills in relational practice; (iv) personal resilience; (v) team resilience; and (vi) emotional challenges. The study results suggest the potential importance of reflective supervision in boosting resilience, motivation and emotional insight when supporting people with unique relational needs.

Clarifying the Stages of Group Supervision through Action Research

This study aimed to clarify the stages of group supervision carried out in the field of clinical supervision. We used the action research design in the study. Accordingly, we followed a cycle of defining the focus area, collecting data, analyzing and interpreting the data, and developing an action plan. The participants consisted of four graduate supervisees studying in a state university's Counseling and Guidance Program in Turkey. We obtained the data from observations, interviews, validation committee meetings reports, and the researcher's and participants' journals. The study results revealed that the 14-session group supervision, in which the Discrimination Model was followed in the Participative Group Supervision format, consisted of four stages: beginning, transition, working, and termination. The results revealed that there were dynamics based on the problem of belonging to and trusting in the group, incompetence, uncertainty, and anxiety in the first stage, which was the beginning stage. The study showed that the second stage of the group supervision process was the transition stage and that the group dynamics that defined this stage were the dynamics based on dissatisfaction, conflict, grouping, competition, and resistance. The results, which revealed that the third stage of the group supervision process involved the working stage, showed that the dynamics at this stage were based on having a sense of belonging to and trust in the group, focusing on development, and tending to receive and provide peer support. The results revealed that the final stage of the group supervision process was the termination stage and that the group dynamics that defined this stage were based on having dual feelings such as relaxation and sadness, self-evaluation, individualization, and dependence on the supervisor. The study results revealed that the supervisor exhibiting the roles of teacher, counselor, and consultant and ensuring peer participation could be functional in coping with the dynamics that emerged in the process. Furthermore, the study results showed that the stages of the group supervision process could be clarified based on the action research method.

Principal Supervision in Improving Teacher Pedagogic Competence in Elementary Schools in Pidie District

Supervision is an activity to assist teachers in developing their ability to manage learning to achieve the expected goals in learning. Supervision aims to provide services and assistance to improve the quality of teaching and learning for teachers in the classroom, in turn to produce quality student learning. The aim of the research was to find out how the principal's supervision improves the pedagogical competence of teachers in elementary schools in Pidie District. This research uses a qualitative approach with descriptive methods. Data collection techniques are carried out through observation, interviews, and documentation. Data analysis techniques, namely by collecting data, reducing data, presenting data, and drawing conclusions. The research subjects were school principals, teachers, staff, students, and parents in Pidie District. The results of the study found: (1) the program planned by the principal to develop teachers was a supervision program; (2) The implementation of supervision is carried out by the principal to help teachers improve their competence, provide directions, and help teachers find joint solutions to the constraints being faced. The supervision techniques used are individual supervision techniques and group supervision techniques; (3) Evaluation is carried out at the end of the odd semester and the end of the even semester. Follow-up is carried out to find solutions to the problems being faced; (4) The supporting factors of the academic supervision program include a conducive school culture; (5) The inhibiting factor for supervision activities is the teacher's readiness when supervised, the teacher still considers supervision as a scourge, not a need for good.

Imperial statehood as the basis for successful national development of Russia (ending)

This article is devoted to the study of imperial statehood as a traditional form of statehood for Russia and the Russian people. The author of the article notes that in the minds of most “Russians” and residents of the Earth, the term “empire” is perceived with a pronounced negative connotation, which is a consequence of the dominant in science and mass consciousness, thanks to the activities of the media and propaganda, certain myths about empire and ideological attitudes.Imperial states are usually identified either with a large power in their territorial possessions, or with a special type of state entities seeking constant territorial expansion, coupled with the merciless exploitation of “enslaved” peoples, i.e. with colonial powers, often to raise their status calling themselves “empires”.Meanwhile, such ideas have nothing to do with reality. Classical empires are a special type of state entity dominated by the idea of ​ ​ unity of society in the name of the common good. Different ethnic groups coexist peacefully in culture and customs, coexisting under the patronage and supervision of the core imperial ethnic group, while maintaining their traditional way of life, economic structures, the system of local self-government and often statehood.The study of the phenomenon of “empire” is very important at present in the light of determining the prospects and vector for the further development of the Russian world, Russian society and statehood. For, as history shows, the fate of the empire is inseparable from the fate of the core imperial ethnic group, i.e. the Russian people. And in this sense, the empire is not only a tradition, but also the fate of Russia.

Using Video Enhanced Reflective Practice (VERP) for the continuing professional development of a team of music therapists: Evaluation and reflections

In 2018, six music therapists undertook a short course on Video Enhanced Reflective Practice (VERP). A group goal was co-constructed for team development as part of the project, with application for individual casework. The training course was held over two 1.5-hour sessions where the principles for developing attunement were explained, individual goals for each practitioner’s development were decided upon, and casework discussion took place. The process for recording and analysing short film clips ahead of group supervision was also discussed. Target Monitoring and Evaluation (TME) was used to quantify the impact of the goals pre- and post-project. Other measures used included a self-rating scale of the Communication Principles before and after, and open ended questions on evaluation forms. TME data revealed a positive shift of 3 points for the group goal pre- and post-project, and an average shift of 3.6 points in a positive direction for individual goals. Furthermore, the self-rating scales of individual practitioners also showed increased frequency in their use of the Communication Principles in their interactions with children. This project builds on research that VERP is a professional development tool that enhances practitioner’s self-belief and agency through self-awareness and knowledge of skills used in everyday clinical practice. Additionally, it provided a mechanism for a team to think and work creatively and therapeutically together.

Pilot study of a group clinical supervision model for medical students.

To trial a clinical supervision model with medical students, co-designed by students and clinicians, and evaluate its feasibility, acceptability, and perceived benefits. Two clinical supervision groups, one online and one face-to-face, were conducted for six one-hour sessions, over 12 weeks. Clinical supervision was evaluated through mixed methods including attendance levels, focus groups, and quantitative surveys. Thirteen students participated, including one rural and one regional group, each with a clinical supervisor. Attendance was 100%. Students viewed clinical supervision as a safe time for reflection on clinical experiences, validation from senior clinicians and peers, and connection to the medical community. Themes that emerged included strategies to prevent moral injury, self-care, and the need for a trusted clinical supervisor. The clinical supervision model received positive medical student evaluations and 100% attendance. This shows promise as an avenue to professionally support medical students as they navigate complex clinical training.

집단 수퍼비전에서 초심 수퍼바이저의 경험과 인식

Objectives This study aimed to explore the perception and experience of novice supervisors performing teaching functions in group supervision and to analyze their meaning.&#x0D; Methods The purposes of this study were four novice supervisors who conducted group supervision with graduate students majoring in counseling psychology at A University. Data were collected through in-depth interviews conducted from November 2021 to January 2022, as well as personal records and session reports, and analyzed using phenomenological research methods.&#x0D; Results The analysis resulted in three top-level components, namely “anxiety of novice supervisors,” “unconditional support and encouragement,” and “demand for counseling expertise,” along with six subcategories and twelve units of meaning.&#x0D; Conclusions This study aims to explore the perception and meaning of novice supervisors performing teaching functions in group supervision with novice supervisees. It is expected that this study will provide valuable insights for novice counselors to grow into experts in the counseling field through the two significant roles they experience in the process of becoming novice supervisors and novice supervisees.

What ethical requirements should be considered in language classroom assessment? insights from high school students

There has been a growing call for listening to test-takers’ voices across diverse assessment contexts. Within classroom assessment (CA), however, test-takers’ voices on ethics are under-researched in the high school context of Iran. Hence, this study purported to disclose Iranian high school test-takers’ (n = 15) perceptions of the ethical requirements in CA. For this purpose, a systematic thematic coding approach (constant-comparative method) was used to analyze the participants’ perceptions. Findings yielded two overarching categories, including do no harm (e.g., establishing a supervision group, considering test-takers’ individual differences, keeping test results confidential, and turning back test sheets with feedback) and avoid score pollution (e.g., using additional knowledge sources, using alternative assessment methods, clarifying grading criteria, avoiding unfamiliar contents and surprise items). The findings refer to a local gloss on global principles of ethics, which is hoped to map out specific dimensions of this important notion for diverse assessment contexts (e.g., high-stakes language testing and CA) and stakeholder groups (e.g., high school teachers, assessment developers, and education officials).

Crossing the 'flaky bridge' - the initial transitory experiences of qualifying as a paramedic: a mixed-methods study.

Newly qualified paramedics (NQPs) may experience emotional turbulence as they transition to professional practice. This may negatively affect confidence and have an adverse effect on attrition. This study highlights the initial transitory experiences of NQPs. The study utilised a mixed-methods convergent design. Qualitative and quantitative data were collected simultaneously and triangulated to more fully interpret participants' experiences. A convenience sample of 18 NQPs from one ambulance trust was used. The Connor-Davidson Resilience 25-point Scale questionnaire (CD-RISC25) was administered and analysed using descriptive statistics. Semi-structured interviews were conducted simultaneously and analysed using Charmaz's constructivist grounded theory approach. Data were collected from September to December 2018. There was a range of resilience scores, with a mean of 74.7/100 (standard deviation 9.6). Factors relating to social support were scored highly, and factors relating to determinism and spirituality were scored lower. Qualitative data constructed a process whereby participants were navigating a new identity across three spheres simultaneously: professional, social and personal identity. Attending a catalyst event such as a cardiac arrest was a trigger for starting to navigate this process. Participants had different pathways through this transitional period. Participants who found this process particularly turbulent seemed to have lower resilience scores. The transition from student to NQP is an emotionally turbulent time. Navigating a changing identity seems to be at the centre of this turbulence, and this is triggered by a catalyst event such as attending a cardiac arrest. Interventions which support the NQP in navigating this change in identity, such as group supervision, may improve resilience and self-efficacy and reduce attrition.

The implied peer: thesis writers’ feedback activities and experiences in group supervision

ABSTRACT Due to growing pressures on universities, many master’s degree students are offered all or part of their thesis supervision in groups involving core feedback skills and engagement. Given that not all graduate students understand or are comfortable with the academic discourse and strategies for formative feedback engagement, the institutions cannot take group supervision for granted. This paper explores how 36 master’s thesis writers perform and experience different feedback activities in the role of peers during group supervision at two faculties at the University of Copenhagen. To examine what it ‘ideally’ means to ‘do’ feedback in group supervision, questionnaires were filled out at three selected points in the thesis-writing process, followed by 10 student interviews. The findings of the qualitative case study show that individual thesis writers engage more actively in feedback activities than do pairs/trios. The students also seem to be influenced by the type of supervision offered by the institution. Furthermore, mutual expectations of ‘help’ seem to underlie and influence student experiences and the group supervision outcome of the thesis-writing process. A new, complex student role – ‘the implied peer’ – is argued to be at play during group supervision. In conclusion, supervisors and institutions should make the peer role of thesis writers in group supervision more explicit. Vital feedback skills, however, must be trained and integrated in teaching long before students become thesis writers.

Imperial statehood as the basis for successful national development of Russia

This article is devoted to the study of imperial statehood as a traditional form of statehood for Russia and the Russian people. The author of the article notes that in the minds of most Russians and residents of the Earth, the term “empire” is perceived with a pronounced negative connotation, which is a consequence of the dominant in science and mass consciousness, thanks to the activities of the media and propaganda, certain myths about empire and ideological attitudes.Imperial states are usually identified either with a large power in their territorial possessions, or with a special type of state entities seeking constant territorial expansion, coupled with the merciless exploitation of “enslaved” peoples, i.e. with colonial powers, often to raise their status calling themselves “empires”.Meanwhile, such ideas have nothing to do with reality. Classical empires are a special type of state entity dominated by the idea of unity of society in the name of the common good. Different ethnic groups coexist peacefully in culture and customs, coexisting under the patronage and supervision of the core imperial ethnic group, while maintaining their traditional way of life, economic structures, the system of local self-government and often statehood.The study of the phenomenon of “empire” is very important at present in the light of determining the prospects and vector for the further development of the Russian world, Russian society and statehood. For, as history shows, the fate of the empire is inseparable from the fate of the core imperial ethnic group, i.e. the Russian people. And in this sense, the empire is not only a tradition, but also the fate of Russia.

UPAYA MENGEMBANGKAN POTENSI GURU DALAM MENGAJAR DI SDN LENGKONG 01 MUMBULSARI JEMBER DENGAN PENERAPAN SUPERVISI AKADEMIK MELALUI KEGIATAN WORKSHOP PADA SEMESTER GENAP TAHUN 2021/2022

The purpose of this research is to find out about the extent of mastery of teacher competence with the application of academic supervision through workshop activities. The research location is at SDN Lengkong 01, Mumbulsari District, Jember District, even semester of the 2021/2022 academic year. This research method uses school action research by performing two actions in three cycles. Each cycle consists of four stages, namely action planning, action implementation, observation of action results, and reflection. Data collection using documentation, observation, and interviews. Data collection tools with teacher personal record documents, observation sheets, and interview sheets. Data analysis uses comparative descriptive followed reflection. The results showed that through academic supervision can optimize the quality of teacher competence as shown by an average increase from cycle I 2.07 (category less / not good), and after academic supervision in groups in cycle II the average to 3.36 with the category quite good, and after academic supervision individually in cycle III the average to 4.28 with the category of very good (almost perfect).

The Effects of Enhancing the Capabilities of Applying Art Material and Systemic Collaboration under the Group Supervision on School Counselors

&lt;p&gt;本研究旨在設計強化輔導教師媒材使用能力與系統合作能力之團體督導方案，並分別考驗方案對專任與兼任輔導教師的影響。本研究共分為兩個部分。第一部分以11位專任輔導教師為對象，採單一組前後測準實驗設計。第一次團體督導開始前對成員施測「系統合作能力量表」與「媒材使用能力量表」；之後成員接受為期6次，每次3小時的團體督導；在最後一次團體督導結束後，成員接受前兩量表之後測；並以「團體治療性因素量表」了解團體的療效因子。本研究之第二部分是以10位兼任輔導教師為對象，亦採單一組前後測準實驗設計。第一次團體督導開始前同樣對成員施測「系統合作能力量表」與「媒材使用能力量表」；之後成員接受為期5次，每次3小時的團體督導；團體督導結束後，成員亦接受前兩量表之後測。所得資料以相依樣本t考驗進行前後測之差異比較。結果如下：&lt;/p&gt; &lt;p&gt;1.團體督導方案能有效提升專任輔導教師的整體的系統合作能力，以及進階媒材使用技術能力。專任輔導教師督導團體的前三大效果因子分別為：團體的正向感覺、利他性、建議的提供。2.團體督導方案無法有效提升兼任輔導教師系統合作能力與媒材使用能力，但受督者對方案持正向之看法。&lt;/p&gt; &lt;p&gt;&amp;nbsp;&lt;/p&gt;&lt;p&gt;This research aims to develop a model of incorporating art materials into system-oriented group supervision, which can enhance the practical capability of school counselors. This research also goes further to investigate whether this model can improve school counselors’ capabilities of systemic collaboration and applying art materials. This research adopts pretest-posttest experimental design of dependence sample t-test. Participants are selected from different counties and divided into two teams of group supervision. One team is composed of 11 full time junior high school counselors. The other one is composed of 10 part time elementary school counselors. Both teams separately go through the Systemic Collaboration Scale and the Applications of Art Materials Scale before staring the group supervision. Each team will go through 5 to 6 times of group supervision. Each time takes 3 hours. Both teams have to take the posttest experiment. The team of full time school counselors also need to take the Group Therapeutic Factor Scale in order to understand the determinants of group supervision. The results are:&lt;/p&gt; &lt;p&gt;1. This model of group supervision can enhance those full time school counselors’ capability of systemic collaboration. This is, however, not obvious in the team of part time school counselors. 2. This model can improve the full time school counselors’ advanced skill of applying art materials. This is also not significant in the team of part time school counselors. 3. Those most determining effects in the team of full time school counselors are positive perception, altruism, and suggestion providing. Both teams have positive perspective regarding the group supervision.&lt;/p&gt; &lt;p&gt;&amp;nbsp;&lt;/p&gt;

PO-2289 Radiation therapy students' perceptions of Peer Group Supervision: A pilot study

PO-2289 Radiation therapy students' perceptions of Peer Group Supervision: A pilot study

Removal of Contaminated Personal Protective Equipment With and Without Supervision. A Randomized Crossover Simulation-Based Study.

Personal protective equipment (PPE) reduces the risk of pathogens reaching the skin and clothing of health care personnel. We hypothesize that doffing PPE following verbal instructions by a supervisor is more effective in reducing contamination compared with doffing without verbal instructions. Our primary aim was to determine contamination rates with and without supervised doffing. The secondary aim was to determine the number and localization of contaminated body sites and PPE removal times in both groups. Staff members of Bnai Zion Medical Center participated in this single-center, randomized simulation study (NCT05008627). Using a crossover design, all participants donned and doffed the PPE twice, once under guidance from a trained supervisor and then independently without supervision (group A), or vice versa (group B). Participants were randomized to either group A or B using a computer-generated random allocation sequence. The PPE was "contaminated" with Glo Germ on the thorax, shoulders, arms, hands, legs, and face shield. After doffing the PPE, the participant was examined under ultraviolet light to detect traces of contamination. The following variables were collected: contamination rates, the number and localization of contaminated body sites, and PPE doffing time. Forty-nine staff members were included. In group A, the contamination rate was significantly lower (8% vs. 47%; χ 2 = 17.19; p < 0.001). The sites most frequently contaminated were the neck and hands. Mean PPE doffing time under verbal instructions was significantly longer [mean (SD): 183.98 (3.63) vs. 68.43 (12.75) seconds, P < 0.001] compared with unsupervised doffing. In a simulated setting, PPE doffing following step-by-step verbal instructions from a trained supervisor reduces the rate of contamination but prolongs doffing time. These findings could have important implications for clinical practice and could further protect health care workers against contamination from emerging and high-consequence pathogens.

Role of Direct Supervision in the Learning Curve of Descemet Membrane Endothelial Keratoplasty Surgery.

The aim of this study was to compare complication rates of Descemet membrane endothelial keratoplasty (DMEK) performed by directly supervised and nondirectly supervised corneal fellows. This study was a retrospective, comparative case series of DMEK surgeries performed by novice surgeons (less than 15 DMEK cases) with or without direct direct expert supervision. Patients who underwent surgery for Fuchs endothelial dystrophy or pseudophakic bullous keratopathy with a minimum follow-up of 12 weeks were included. Data on patients' demographics, surgical details, surgeon level, intraoperative and postoperative complications, and rate of rebubbling were collected. In this study, 41 nondirectly supervised and 48 directly supervised DMEK surgeries were included. At 6 months, 67.4% of eyes achieved a best-corrected visual acuity of ≤0.3 logMAR with no significant difference between groups ( P = 0.95). Intraoperative complications occurred in 22% of cases in the nondirect supervision group and 4.2% in the direct supervision group ( P = 0.02). Postoperative complications occurred in 9.8% of cases in the nondirect supervision group and 6.2% of cases in the direct supervision group ( P = 0.7). The rebubbling rate was comparable in the 2 groups (34.1% vs. 33.3%, P = 1.0). Five cases (12.2%), all from the nondirect supervision group, required secondary keratoplasty ( P = 0.02). The overall complication rate was significantly higher in the nondirect supervision group (31.7% vs. 10.4%, P = 0.03). Functional success can be achieved in directly supervised or nondirectly supervised DMEK surgery. However, nondirectly supervised DMEK surgery may associate with higher rates of complications.