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国际眼科理事会眼科手术能力评估表(ICO-OSCAR)评估短期白内障超声乳化手术培训计划的技能转移效果,以及 ICO-OSCAR 对技能转移的客观评估效果。

Evaluation of skills transfer in short-term phacoemulsification surgery training program by International Council of Ophthalmology -Ophthalmology Surgical Competency Assessment Rubrics (ICO-OSCAR) and assessment of efficacy of ICO-OSCAR for objective evaluation of skills transfer.

机构信息

PBMA's H V Desai Eye Hospital, Hadapsar, Pune, Maharashtra, India.

出版信息

Indian J Ophthalmol. 2020 Aug;68(8):1573-1577. doi: 10.4103/ijo.IJO_2058_19.

Abstract

PURPOSE

To evaluate skills transfer in short-term phacoemulsification surgery training program by International Council of Ophthalmology -Ophthalmology Surgical Competency Assessment Rubrics (ICO-OSCAR) and assessment of efficacy of ICO-OSCAR for objective evaluation of skills transfer.

METHODS

Prospective analysis of total 1300 phacoemulsification surgeries performed by 52 phacoemulsification trainees divided into three groups based on the previous cataract surgical experience. The pretraining and posttraining average mean scores, independent completion rates (ICR), and complication rates among the groups were calculated and statistically analyzed.

RESULTS

Mean age of trainees (N = 52) was found to be 30.98 ± 2.44 years. Mean pretraining scores in the three groups were 42.8 ± 0.2, 46.6 ± 0.2, and 50.1 ± 0.1, respectively, and posttraining mean scores of the groups were 88.4 ± 0.2, 92.3 ± 0.2, and 94.3 ± 0.2, respectively, out of 100. Pretraining independent completion rates (%) were 22.1 ± 2.5, 52.1 ± 2.5, and 62 ± 3.7, respectively, and posttraining independent completion rates (%) were 74.8 ± 3, 79.7 ± 3, and 90.6 ± 3.5, respectively. Learning curves of all groups were noted to be steep. Rate of complications was within acceptable range, overall complication rate being 12.30% (160 out of 1300 cases). OSCAR scores correlate significantly (P = 0.0004) with ICR.

CONCLUSION

Steep learning curve for phacoemulsification can be made easy by the use of standardized rubrics, proper techniques, expert guidance, and adequate surgical volume. The previous SICS experience provides smoother learning curve. ICO-OSCAR is indicator of proficiency and provides constructive feedback and objective evaluation immediately after surgery as well as at the end of training. Short-term (1 Month) training program is an effective, efficient, and safe approach to progressively master phacoemulsification skills for trainees with SICS experience.

摘要

目的

通过国际眼科理事会眼科手术能力评估表(ICO-OSCAR)评估短期白内障超声乳化手术培训计划中的技能转移,并评估 ICO-OSCAR 在客观评估技能转移方面的效果。

方法

前瞻性分析了 52 名白内障超声乳化术学员进行的 1300 例白内障超声乳化手术,根据之前的白内障手术经验将学员分为三组。计算并统计分析了三组学员的术前和术后平均平均分、独立完成率(ICR)和并发症发生率。

结果

学员(N=52)的平均年龄为 30.98±2.44 岁。三组学员的术前平均得分分别为 42.8±0.2、46.6±0.2 和 50.1±0.1,术后平均得分分别为 88.4±0.2、92.3±0.2 和 94.3±0.2。术前独立完成率(%)分别为 22.1±2.5、52.1±2.5 和 62±3.7,术后独立完成率(%)分别为 74.8±3、79.7±3 和 90.6±3.5。所有组的学习曲线都很陡峭。并发症发生率在可接受范围内,总并发症发生率为 12.30%(1300 例中有 160 例)。OSCAR 评分与 ICR 显著相关(P=0.0004)。

结论

通过使用标准化评分、适当的技术、专家指导和足够的手术量,白内障超声乳化术的陡峭学习曲线可以变得更容易。之前的 SICS 经验提供了更平滑的学习曲线。ICO-OSCAR 是熟练程度的指标,可在手术后立即以及培训结束时提供建设性反馈和客观评估。短期(1 个月)培训计划是一种有效、高效和安全的方法,可以逐步掌握有 SICS 经验的学员的白内障超声乳化技能。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f4d5/7640864/a58f27830c8e/IJO-68-1573-g001.jpg

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