Bergqvist Joel, Person Anna, Vestergaard Anders, Grauslund Jakob
Department of Ophthalmology, Odense University Hospital, Odense, Denmark.
Acta Ophthalmol. 2014 Nov;92(7):629-34. doi: 10.1111/aos.12383. Epub 2014 Mar 11.
To establish and evaluate a systematic training programme to be included into the ophthalmologic resident curriculum.
Medical students (n = 20) within a year from graduation and with no previous ophthalmic experience were included in this prospective study and randomized into two groups. Group A (n = 10) completed the Eyesi cataract simulator training programme once a week for 4 weeks, while Group B (n = 10) completed it once a week at the first and the last week. Two cataract surgeons were used to determine two different levels of reference scores. Score per analysed module [two different levels of Capsulorhexis (A and B), Hydromaneuver, Phaco divide and conquer], Overall score, Total time, Cornea injury, Capsule rupture and Capsule damage by ultrasound were recorded.
Group A outperformed Group B in several modules, reached a significant higher number of reference scores (p < 0.01) and caused fewer complications with regard to Capsule rupture (p = 0.01) and Capsule damage by ultrasound (p < 0.05). Both Groups A and B improved their performance and also became more time efficient (p < 0.01 for both groups). Group A showed positive learning curves for Overall score (p < 0.01), Capsulorhexis A (p < 0.01), Capsulorhexis B (p < 0.01) and Hydromaneuver (p = 0.01). Group B showed a significant improvement for Overall score (p < 0.01), Hydromaneuver (p = 0.02) and Phaco divide and conquer (p < 0.01).
Repetitive training with a systematic training programme, based on validated modules in the Eyesi simulator, was shown to improve simulated cataract surgery skills. Higher level of skills and more reference scores were reached with more training. Furthermore, the programme was optimized to be applied into the standard ophthalmological curriculum for cataract surgery training.
建立并评估一个纳入眼科住院医师课程的系统培训方案。
本前瞻性研究纳入了毕业一年内且此前无眼科经验的医学生（n = 20），并将其随机分为两组。A组（n = 10）每周完成一次Eysi白内障模拟器培训方案，共4周；而B组（n = 10）在第一周和最后一周各完成一次。两名白内障外科医生确定两个不同水平的参考分数。记录每个分析模块的分数[连续环形撕囊的两个不同水平（A和B）、水分离、超声乳化劈核]、总分、总时间、角膜损伤、囊膜破裂以及超声导致的囊膜损伤。
A组在几个模块中的表现优于B组，达到显著更高的参考分数数量（p < 0.01），并且在囊膜破裂（p = 0.01）和超声导致的囊膜损伤方面并发症更少（p < 0.05）。A组和B组的表现均有所改善，且时间效率也更高（两组p均< 0.01）。A组在总分（p < 0.01）、连续环形撕囊A（p < 0.01）、连续环形撕囊B（p < 0.01）和水分离（p = 0.01）方面呈现出正性学习曲线。B组在总分（p < 0.01）、水分离（p = 0.02）和超声乳化劈核（p < 0.01）方面有显著改善。
基于Eysi模拟器中经过验证的模块进行系统培训方案的重复训练，可提高模拟白内障手术技能。更多的训练能达到更高水平的技能和更多的参考分数。此外，该方案经过优化，可应用于白内障手术培训的标准眼科课程。
