Martin G, Chapron T, Bremond-Gignac D, Caputo G, Cochereau I
Département d'ophtalmologie, hôpital fondation A.-de-Rothschild, 25, rue Manin, 75019 Paris, France.
Département d'ophtalmologie, hôpital fondation A.-de-Rothschild, 25, rue Manin, 75019 Paris, France; Université de Paris, Centre de recherche en épidémiologie et statistiques (CRESS), équipe de recherche en épidémiologie obstétricale, périnatale et pédiatrique, EPOPé, Inserm, INRAE, 75004 Paris, France; Université de Paris Cité, Paris, France.
J Fr Ophtalmol. 2022 Oct;45(8):883-893. doi: 10.1016/j.jfo.2022.04.006. Epub 2022 Jul 14.
This study aims to evaluate surgical training in ophthalmology through feedback from residents.
An anonymous questionnaire was created, including 20 items which assessed the number of complete or partial surgical procedures performed during a semester, self-assessment of surgical skills, use of surgical simulators, an overall rating of the surgical training received and some suggestions to improve surgical training. It was sent by email to all residents in training in Île-de-France (DES Île-de-France and Inter-CHU), France.
From October 23 to November 7, 2021, 89/137 residents responded to the questionnaire (65%). Since the beginning of their residency, ninety percent of the residents received training using simulators. Over 90% performed all of the technical steps of a "standard" cataract surgery at least once during the semester, and 60% 10 times or more. The least performed technical steps or procedures also received the lowest self-assessment: management of expulsive hemorrhage, open-globe or lacrimal laceration wound suturing, capsular tension ring injection, and intraocular lens explantation. Residents gave an overall average rating of 6.6/10 to their training and suggested some feedback on videos of resident surgeries (67%) and theoretical courses dealing with surgical techniques (61%).
The increasing use of simulators should improve surgical training. Residents express the need for training regarding surgical complications and emergencies as well as improvement of their technical skills via improved feedback.
Surgical teaching appears suitable for learning cataract surgery but seems less effective for the management of emergencies and intraoperative complications.
本研究旨在通过住院医师的反馈评估眼科手术培训情况。
设计了一份匿名问卷,包含20个项目,评估一学期内完成的完整或部分外科手术数量、手术技能自我评估、手术模拟器的使用、所接受手术培训的总体评分以及一些改进手术培训的建议。通过电子邮件发送给法国法兰西岛地区(法兰西岛地区住院医师培训项目和大学间医疗中心)所有接受培训的住院医师。
2021年10月23日至11月7日,137名住院医师中有89名(65%)回复了问卷。自住院医师培训开始以来,90%的住院医师接受过模拟器培训。超过90%的住院医师在本学期内至少进行过一次“标准”白内障手术的所有技术步骤,60%的住院医师进行过10次或更多次。执行最少的技术步骤或手术其自我评估得分也最低:处理驱逐性出血、开放性眼球或泪道撕裂伤缝合、囊袋张力环植入以及人工晶状体取出。住院医师对其培训的总体平均评分为6.6/10,并建议提供住院医师手术视频(67%)和手术技术理论课程(61%)的反馈。
模拟器使用的增加应能改善手术培训。住院医师表示需要有关手术并发症和紧急情况的培训,以及通过改进反馈来提高他们的技术技能。
手术教学似乎适合白内障手术学习,但在处理紧急情况和术中并发症方面似乎效果较差。