Virtual reality ophthalmic surgical simulation as a feasible training and assessment tool: results of a multicentre study1

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Abstract

Objective: To compare performance on the Eyesi surgical simulator by users with different levels of experience in ophthalmology.

Design: Multicentre cross-sectional study.

Participants: Four medical students, 4 ophthalmic medical technologist trainees, 36 ophthalmology residents, 3 fellows, and 18 staff ophthalmologists.

Methods: Subjects were recruited at the 2007 Canadian Ophthalmological Society Meeting and in the departments of ophthalmology at the University of Toronto, University of Ottawa, and University of Western Ontario. Subjects performed a standardized 20-minute session on the Eyesi simulator. The protocol consisted of a practice trial in the anterior segment module, followed by 3 scored trials in the anterior forceps, antitremor, and capsulorhexis modules.

Results: In the forceps module, participants with greater experience achieved significantly higher total scores than those who were less experienced: staff ophthalmologists (Group D) = 67.9 (SD 18.4), senior residents and fellows (Group C) = 67.6 (SD 21.1), junior residents (Group B) = 52.9 (SD 29.4), medical students and ophthalmic medical technologist trainees (Group A) = 27.8 (SD 29.4) (p = 0.011), with lower total task time (p = 0.044) and fewer injuries to the cornea (p = 0.001) and lens (p = 0.026). In the antitremor module, subjects in Group D achieved significantly higher (p = 0.004) total scores (46.7, SD 21.6) than Groups C (45.8, SD 25.1), B (41.2, SD 29.4), and A (8.5, SD 9.2) with lower total task time (p = 0.005) and fewer errors (p = 0.003). In the capsulorhexis module there was also a positive correlation between experience and total scores achieved (p = 0.065).

Conclusions: Subjects' level of training is a reliable predictor of their performance on the Eyesi anterior forceps and antitremor modules (p < 0.05), indicating the modules' construct validity.

Résumé

Objet: Comparaison de la performance d’utilisateurs ayant différents niveaux d’expérience en ophtalmologie avec le simulateur chirurgical Eyesi.

Nature: Étude transversale multicentre.

Participants: Quatre étudiants en médecine, 4 technologues stagiaires en médecine ophtalmique, 36 résidents en ophtalmologie, 3 associés et 18 ophtalmologistes patrons.

Methodes: Les sujets ont été recrutés au congrès de 2007 de la Société canadienne d’ophtalmologie et dans les départements d’ophtalmologie de l’Université de Toronto, l’Université d’Ottawa et l’Université Western Ontario. Ils ont pratiqué une séance normale de 20 minutes avec le simulateur Eyesi. Le protocole comportait un essai pratique dans le module du segment antérieur, suivi de 3 essais notés dans les modules des pinces antérieures, des anti-tremblement et du capsulorhexis.

Résultats: Dans le module des pinces, les participants qui avaient plus d’expérience ont obtenu des notes significativement supérieures à celles des moins expérimentés: ophtalmologistes patrons (groupe D) = 67,9 (ÉT 18,4), résidents séniors et associés (groupe C) = 67,6 (ÉT 21,1), résidents juniors (groupe B) = 52,9 (ÉT 29,4), étudiants en médecine et technologues stagiaires en médecine ophtalmique (groupe A) = 27,8 (ÉT 29,4) (p = 0,011), avec moins de temps global de travail (p = 0,044) et moins de blessures à la cornée (p = 0,001) et au cristallin (p = 0,026). Dans le module anti-tremblement, les sujets du groupe D ont obtenu globalement des notes significativement supérieures (p = 0,004) (46,7, ÉT 21,6) que les groupes C (45,8, ÉT 25,1), B (41,2, ÉT29,4) et A (8,5, ÉT 9,2) avec moins de temps global de travail (p = 0,005) et moins d’erreurs (p = 0,003). Dans le module du capsulorhexis, il y avait aussi une corrélation positive entre l’experience et l’ensemble des notes obtenues (p = 0,065).

Conclusions: Le niveau de formation des sujets est un prédicteur fiable de leur performance sur les modules des pinces antérieures et d’anti-tremblement de Eyesi (p < 0,05), indiquant la validité de construction des modules.

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    Presented at the American Academy of Ophthalmology Joint Meeting, Atlanta, Ga., 2008; the Royal College of Physicians and Surgeons of Canada International Conference on Residency Education — Simulation Summit, Ottawa, Ont., 2008; the World Ophthalmology Congress Meeting, Hong Kong, 2008; the Canadian Ophthalmological Society Annual Meeting & Exhibition, Whistler, B.C., 2008; and the AFMC Canadian Medical Education Conference, Montreal, Que., 2008.

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