Department of Ophthalmology, Rigshospitalet - Glostrup, Copenhagen, Denmark.
Copenhagen Academy for Medical Education and Simulation, University of Copenhagen and The Capital Region of Denmark, Copenhagen, Denmark.
Acta Ophthalmol. 2018 Aug;96(5):519-527. doi: 10.1111/aos.13700. Epub 2018 Mar 25.
The number of available simulation-based models for technical skills training in ophthalmology is rapidly increasing, and development of training programmes around these procedures should follow a structured approach. The aim of this study was to identify all technical procedures that should be integrated in a simulation-based curriculum in ophthalmology.
Key opinion leaders involved in the education of ophthalmologists in Denmark including heads of departments, heads of clinical education, professors and board members of the society were invited to participate in a three-round Delphi process. Round 1 aimed at identifying technical procedures that physicians should be able to perform competently when completing specialty training; round 2 involved characterization of each procedure including frequency, number of operators, risk and/or discomfort for patients associated with an inexperienced physician, and feasibility of simulation-based training; round 3 included a priority ranking of procedures.
The response rate for each round was 71%, 64% and 64%, respectively. Sixty-five procedures were reduced to 25 prioritized procedures during the three rounds. Two-thirds of the procedures that were identified and highly prioritized were therapeutic procedures such as intravitreal injection therapy, yttrium-aluminium-garnet laser iridotomy/capsulotomy, minor ocular surface procedures and retinal argon laser therapy. The diagnostic procedures that were prioritized were ocular ultrasound, superficial keratectomy and optical coherence tomography (OCT).
The Delphi process identified and prioritized 25 procedures that should be practised in a simulation-based environment to achieve competency before working with patients. The list may be used to guide the development of future training programmes for ophthalmologists.
可供眼科技术技能培训使用的模拟模型数量正在迅速增加，围绕这些程序开发培训计划应遵循结构化方法。本研究的目的是确定应纳入眼科模拟课程的所有技术程序。
丹麦参与眼科医生教育的意见领袖，包括系主任、临床教育主任、教授和学会董事会成员，应邀参加了三轮 Delphi 流程。第 1 轮旨在确定医生在完成专业培训时应能够熟练完成的技术程序；第 2 轮涉及对每个程序进行特征描述，包括频率、操作人员数量、经验不足的医生进行操作时对患者的风险和/或不适，以及基于模拟的培训的可行性；第 3 轮包括对程序的优先排序。
每轮的回复率分别为 71%、64%和 64%。三轮过后，65 项程序减少到 25 项优先程序。在三轮中确定并高度优先的程序中有三分之二是治疗性程序，如玻璃体内注射治疗、钇铝石榴石激光虹膜切开术/后囊切开术、眼表面小手术和视网膜氩激光治疗。优先考虑的诊断程序是眼部超声、浅层角膜切除术和光学相干断层扫描（OCT）。
Delphi 流程确定并优先考虑了 25 项应在模拟环境中进行练习以达到与患者一起工作前的熟练程度的程序。该清单可用于指导未来眼科医生培训计划的制定。
