Lotfipour Mona, Rolius Ramunas, Lehman Erik B, Pantanelli Seth M, Scott Ingrid U
From the Department of Ophthalmology (Lotfipour, Rolius, Pantanelli, Scott) and Department of Public Health Sciences (Lehman, Scott), Pennsylvania State College of Medicine, Hershey, Pennsylvania, USA.
From the Department of Ophthalmology (Lotfipour, Rolius, Pantanelli, Scott) and Department of Public Health Sciences (Lehman, Scott), Pennsylvania State College of Medicine, Hershey, Pennsylvania, USA.
J Cataract Refract Surg. 2017 Jan;43(1):49-53. doi: 10.1016/j.jcrs.2016.10.020.
To evaluate trends in cataract surgery training curricula and factors affecting timing of resident participation as a primary surgeon.
Pennsylvania State College of Medicine, Hershey, Pennsylvania, USA.
Cross-sectional study of anonymous survey results.
A description of the study and link to an online survey was e-mailed to program directors of each ophthalmology residency training program accredited by the Accreditation Council for Graduate Medical Education (ACGME).
Fifty-one (44%) of the 116 program directors completed the survey. First-year, second-year, and third-year residents performed a mean of 2, 25, and 155 phacoemulsification surgeries, respectively, as a primary surgeon. Only 1 program (2%) required residents to perform extracapsular cataract extraction (ECCE) before performing phacoemulsification. Clear corneal phacoemulsification was the first technique taught to trainees at 91% of programs. More than two thirds (71%) of program directors indicated that their program had a cataract surgery training curriculum designed to transition residents gradually to the operating room. These curricula included structured wet laboratory (92%) and lecture (89%) components. Inadequate resident knowledge and surgical skill base (57%) and anticipation of increased surgical complication risk (37%) were the most commonly reported factors impeding earlier exposure to phacoemulsification in residency.
Results show that residents today begin surgical training with phacoemulsification rather than ECCE, perform a higher number of phacoemulsification surgeries than is required by the ACGME, and begin performing phacoemulsification as early as their first or second year of residency. Despite these evolutions, 29% of respondent ACGME-accredited ophthalmology residency programs reported not having a formal cataract surgery training curriculum.
评估白内障手术培训课程的趋势以及影响住院医师作为主刀医师参与手术时机的因素。
美国宾夕法尼亚州赫尔希的宾夕法尼亚州立医学院。
对匿名调查结果的横断面研究。
将研究描述和在线调查链接通过电子邮件发送给经研究生医学教育认证委员会（ACGME）认证的每个眼科住院医师培训项目的项目主任。
116名项目主任中有51名（44%）完成了调查。一年级、二年级和三年级住院医师作为主刀医师分别平均进行了2例、25例和155例超声乳化手术。只有1个项目（2%）要求住院医师在进行超声乳化手术之前先进行囊外白内障摘除术（ECCE）。91%的项目将透明角膜超声乳化术作为首先教授给学员的技术。超过三分之二（71%）的项目主任表示，他们的项目有一个旨在使住院医师逐渐过渡到手术室的白内障手术培训课程。这些课程包括结构化的模拟实验室（92%）和讲座（89%）部分。住院医师知识和手术技能基础不足（57%）以及预计手术并发症风险增加（37%）是最常被报告的阻碍住院医师在培训期间更早接触超声乳化手术的因素。
结果表明，如今住院医师开始手术培训时采用的是超声乳化术而非ECCE，进行的超声乳化手术数量高于ACGME的要求，并且早在住院医师第一年或第二年就开始进行超声乳化手术。尽管有这些变化，但29%的经ACGME认证的眼科住院医师培训项目回复称没有正式的白内障手术培训课程。
