Le Anton Quoc Dung, Boberg-Ans Lars Christian, Konge Lars, la Cour Morten, Bourcier Tristan, Thomsen Ann Sofia Skou
From the Copenhagen Academy for Medical Education and Simulation, Copenhagen, Denmark (Le, Konge, Thomsen); Department of Ophthalmology, Innlandet Hospital Trust, Brumunddal, Norway (Boberg-Ans); Department of Ophthalmology, Rigshospitalet, Glostrup, Denmark (la Cour, Thomsen); Department of Ophthalmology, Strasbourg University Hospital, University of Strasbourg, Strasbourg, France (Bourcier); Gepromed, Education Department, Strasbourg, France (Bourcier); Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark (Thomsen).
J Cataract Refract Surg. 2024 Dec 1;50(12):1202-1207. doi: 10.1097/j.jcrs.0000000000001533.
To investigate whether phacoemulsification (PE) experience impacts and transfers to the skill acquisition of novices in manual small-incision cataract surgery (MSICS) within a simulation environment.
Copenhagen Academy for Medical Education and Simulation, Copenhagen, Denmark.
Prospective controlled experimental study.
The study included 29 residents or specialist in ophthalmology with no prior MSICS experience. Participants were required to have either (1) proficiency on the EyeSi surgical simulator (PE group [PG]) or (2) no prior extensive exposure to the EyeSi simulator or any PE surgery experience as a primary surgeon (control group [CG]). Possible skill transfer was assessed using a test on the HelpMeSee virtual-reality simulator, including 9 modules and 30 steps (points). A pass/fail score was determined at 20 points (of 30 points). Performance scores were analyzed using independent samples t tests, pass rates using the Fisher exact test, and individual modules using Fisher-Freeman-Halton analysis.
The PG performed significantly better in overall performance score (mean ± SD, PG; 21.8 points ± 2.3 vs CG; 18.9 points ± 2.2, P = .002, t -value = -3.39) and pass rates (PG; 72% vs CG; 22%, P = .018). The subanalysis for individual modules demonstrated significant differences exclusively in the capsulorhexis and cortex removal modules.
The results suggest a positive interprocedural transfer of skills between PE and MSICS. Pretraining and experience in PE demonstrated a significant effect on the performance of MSICS within a simulation environment. These findings suggest that PE experience provides an advantage before MSICS training in surgical residency programs.
研究在模拟环境中，白内障超声乳化术（PE）经验是否会影响并转移至新手在手动小切口白内障手术（MSICS）中的技能习得。
丹麦哥本哈根医学教育与模拟学院。
前瞻性对照实验研究。
该研究纳入了29名此前无MSICS经验的眼科住院医师或专科医生。参与者需满足以下条件之一：（1）熟练掌握EyeSi手术模拟器（PE组[PG]）；或（2）此前未大量接触过EyeSi模拟器，且无作为主刀医生进行任何PE手术的经验（对照组[CG]）。使用HelpMeSee虚拟现实模拟器上的一项测试评估可能的技能转移情况，该测试包括9个模块和30个步骤（分数）。以30分中的20分作为及格/不及格分数。使用独立样本t检验分析表现分数，使用Fisher精确检验分析及格率，使用Fisher-Freeman-Halton分析方法分析各个模块。
PG组在总体表现分数（均值±标准差，PG组；21.8分±2.3分，CG组；18.9分±2.2分，P = 0.002，t值 = -3.39）和及格率（PG组；72%，CG组；22%，P = 0.018）方面表现明显更好。对各个模块的亚分析显示，仅在撕囊和皮质清除模块存在显著差异。
结果表明PE和MSICS之间存在积极的程序间技能转移。PE方面的预训练和经验对模拟环境中MSICS的表现有显著影响。这些发现表明，在外科住院医师培训项目中，PE经验在MSICS培训之前具有优势。
