Posters

Comprehensive assessment of phacoemulsification surgery training using the combined Najjar-Awwad and Oscar scores

Poster Details

First Author: A. Braganza INDIA

Co Author(s):                        

Abstract Details

Purpose:

To assess the progress of a surgical trainee using the combined (pre-operative) Najjar-Awwad and Oscar (Intraoperative) scoring system.To determine learning curves and to assess areas of weakness in difficult surgeries and to communicate competency in a standardised format to other trainers

Setting:

a tertiary care multispeciality, Teaching Eye Hospital in Bangalore

Methods:

14 Beginner fellows of roughly equal competency were assessed by a single preceptor in cases ranging from 10 to 44 surgeries of a total of 260 patients.The Preoperative scoring of the difficulty level of a training case was assessed using the Najjar Awwad scoring system . Each step of the trainee was scored by the Preceptor using the ICO-OSCAR scoring system. Assessment scores of all cases (NA & OSCARS) were analysed separately & for each of the trainees.Overall complication rates and steps that had more complications (lower OSCAR scores) were compared with the preoperative NA scores.

Results:

The mean scores in UNCOMPLICATED cases was 54, Global Indices 22 and NA-10.In COMPLICATED cases it was 43, GI- 18 and NA-12. Significant differences between CC and UC cases were noted for only 4 steps with P=0.018 ie segment removal, cortical clean up , IOL implantation and wound closure. The mean NA score was 7.23 and the mean OSCAR score was 54. The lowest mean step scores were for Nuclear management : 2.66, Rhexis: 2.4 and wound management:2.5

Conclusions:

Combining the difficulty levels using Najjar-Awwad with ICO-OSCAR for each case is a good way to quantitatively assess the progress of phaco training.It enables us to identify the strong and weak points of each trainee individually. A standardised / universal scoring system or pattern can be followed akin to golf. Allotment of cases may be done based on the score of the candidate.Areas of improvement may be identified individually and greater attention may be paid to those areas.

Financial Disclosure:

NONE