Thomsen Ann Sofia Skou, Kiilgaard Jens Folke, Kjaerbo Hadi, la Cour Morten, Konge Lars
Department of Ophthalmology, Glostrup University Hospital, Glostrup, Denmark.
Centre for Clinical Education, Centre for HR, Capital Region of Denmark, Copenhagen, Denmark.
Acta Ophthalmol. 2015 Aug;93(5):416-421. doi: 10.1111/aos.12691. Epub 2015 Feb 26.
To evaluate the EyeSi(™) simulator in regard to assessing competence in cataract surgery. The primary objective was to explore all simulator metrics to establish a proficiency-based test with solid evidence. The secondary objective was to evaluate whether the skill assessment was specific to cataract surgery.
We included 26 ophthalmic trainees (no cataract surgery experience), 11 experienced cataract surgeons (>4000 cataract procedures) and five vitreoretinal surgeons. All subjects completed 13 different modules twice. Simulator metrics were used for the assessments.
Total module score on seven of 13 modules showed significant discriminative ability between the novices and experienced cataract surgeons. The intermodule reliability coefficient was 0.76 (p < 0.001). A pass/fail level was defined from the total score on these seven modules using the contrasting-groups method. The test had an overall ability to discriminate between novices and experienced cataract surgeons, as 21 of 26 novices (81%) versus one of 11 experienced surgeons (9%) did not pass the test. The vitreoretinal surgeons scored significantly higher than the novices (p = 0.006), but not significantly lower than the experienced cataract surgeons (p = 0.32).
We have established a performance test, consisting of seven modules on the EyeSi(™) simulator, which possess evidence of validity. The test is a useful and reliable tool for assessment of both cataract surgical and general microsurgical skills in vitro.
评估EyeSi(™)模拟器在评估白内障手术能力方面的表现。主要目标是探索所有模拟器指标，以建立一个有充分证据支持的基于熟练度的测试。次要目标是评估技能评估是否特定于白内障手术。
我们纳入了26名眼科实习生（无白内障手术经验）、11名经验丰富的白内障外科医生（>4000例白内障手术）和5名玻璃体视网膜外科医生。所有受试者均完成13个不同模块各两次。使用模拟器指标进行评估。
13个模块中的7个模块的总得分在新手和经验丰富的白内障外科医生之间显示出显著的区分能力。模块间可靠性系数为0.76（p < 0.001）。使用对比组方法根据这7个模块的总分定义了通过/未通过水平。该测试总体上有能力区分新手和经验丰富的白内障外科医生，因为26名新手中有21名（81%）未通过测试，而11名经验丰富的外科医生中有1名（9%）未通过测试。玻璃体视网膜外科医生的得分显著高于新手（p = 0.006），但显著低于经验丰富的白内障外科医生（p = 0.32）。
我们在EyeSi(™)模拟器上建立了一个由7个模块组成的性能测试，该测试具有有效性证据。该测试是一种用于体外评估白内障手术技能和一般显微手术技能的有用且可靠的工具。
