Brien Holden Vision Institute, Sydney, New South Wales, Australia.
School of Optometry and Vision Science, University of New South Wales, Sydney, New South Wales, Australia.
Asia Pac J Ophthalmol (Phila). 2018 Nov-Dec;7(6):427-435. doi: 10.22608/APO.2018129. Epub 2018 Sep 14.
Vision impairment and blindness arise both as a cause, and a consequence, of poverty. Achievement of the United Nations Sustainable Development Goals in providing universal access and equity in eye care, both within and between among countries, remains challenging. A severe shortage of eye care providers is creating unnecessary blindness and vision impairment in developing communities worldwide. Education and training develops and strengthens the capacity of emerging nations to contribute to global eye health and the World Health Organization Development Goals in an effective and sustainable way. Although relative to other medical professions, adoption of simulation in ophthalmic training has been relatively slow, simulation potentially offers reduced training costs, increased accessibility, objective measurement of training outcomes, and improvements in patient safety during and after clinician training, all of which can help address the global burden of vision impairment and blindness. Simulation training offers advantages over apprenticeship models, the traditional mode of transferring knowledge and skills in medicine and health, which suffers from imperfect transference due to inherent biases, heuristic and idiosyncratic expectations of experts, and subjective measures of outcomes. Simulation does not completely do away with these confounders because it is made to fit into established curricula, making it difficult to measure effectiveness of the simulation in isolation. The power of simulation training for resource-limited regions and countries is immense in offering cost-effective training in-country; however, it is important that any such tools are developed within the context of the limitations in situ.
视力障碍和失明既是贫困的原因,也是贫困的结果。在国家内部和国家之间实现联合国可持续发展目标,提供普遍获得和公平的眼保健服务仍然具有挑战性。眼科保健提供者的严重短缺正在导致全世界发展中社区出现不必要的失明和视力障碍。教育和培训可以发展和加强新兴国家以有效和可持续的方式为全球眼健康和世界卫生组织发展目标做出贡献的能力。虽然相对于其他医学专业,模拟在眼科培训中的采用相对较慢,但模拟具有降低培训成本、增加可及性、客观衡量培训结果以及提高临床医生培训期间和培训后的患者安全性的潜力,所有这些都有助于解决视力障碍和失明的全球负担。模拟培训具有优于学徒模式的优势,学徒模式是医学和健康领域中传统的知识和技能传授模式,由于固有偏见、专家的启发式和特殊期望以及结果的主观衡量,这种模式的传授效果并不完美。模拟并不能完全消除这些混杂因素,因为它是为适应既定课程而设计的,因此很难单独衡量模拟的效果。模拟培训对于资源有限的地区和国家具有巨大的力量,可以在国内提供具有成本效益的培训;然而,重要的是,任何此类工具都应在现场的限制范围内开发。