Posters
Impact of structured training programme on developing competency in trainees for phacoemulsification cataract surgery
Poster Details
First Author: K.Dole INDIA
Co Author(s): A. Gandhi H. Kapoor S. Varughese C. Deshpande K. Bharucha K. Vks
Abstract Details
Purpose:
To compare learning curve by improvement in ICO OSCAR score over time and rate of vision threatening complication before and after implementation of structured training programme
Setting:
Cross sectional study done in PBMA’s H.V. Desai Eye Hospital, Pune, India from March 2018 to October 2019.
Methods:
Short-term phaco trainees were divided into Group-1 and 2: Before(n=33) and after(n=29) structured training respectively. Group-2 underwent 4 modules over 5 weeks. Module-1 imparted cognitive skills; 2 wet-lab training, 3 phaco-step surgery, 4 independent complete surgeries. They also underwent OT observation, surgical video recording review, and supervisory discussion. Group-1 underwent only module-2 and 3. Mean OSCAR score comparison done of first 5 cases assessed impact of module-1 and 2. Mean OSCAR score calculated case wise to find learning curve with respect to the entry and exit dividing trainees into Novice, Beginner, Advanced-Beginner, Competent. Comparison of posterior capsular rupture(PCR) rates done.
Results:
Mean ICO-OSCAR score comparison of first 5 cases and of all cases of Group 1 and 2 were (2.29 and 3.13) and (3.43 and 4.03) respectively(p<0.001). Comparison of PCR rate between Group 1 and 2 was 20.30% and 9.14% respectively(p<0.001). Group-1 started as Novice (OSCAR Score 2) whereas Group-2 started as Beginner (OSCAR Score 3). Group-2 reached the Advanced Beginner to Near Competent level 8-10 cases prior to Group 1. Older age group and more past surgical experience had statistical significance on mean OSCAR Score of all cases in Group-1 and only on first 5 cases in Group-2
Conclusions:
Learning curve was less steep and complication rate was considerably reduced in Group 2 as compared to Group 1. The competency level attained at exit was near competent level in Group 2 as compared to advanced beginner level of Group 1. Past surgical experience and seniority of the surgeon had no statistically significant impact on the above factors in Group 2 due to implementation.
Financial Disclosure:
None
