Survey of Surgical Competency Assessment and a Possible Role for Virtual Reality Simulation

Khalifa YM, Fatteh NH, Bogorad D, and Nussbaum J


Purpose: To define assessment methods of surgical competency in ophthalmology residency programs and to survey opinions of virtual reality (VR) surgical simulation incorporation in the residency surgical curriculum. Methods: Participants were Association of University Professors of Ophthalmology (AUPO) members. A 23-question survey assessed the following areas: 1. Surgical Assessment Methods (6 questions); 2. Familiarity with VR surgical simulation (4 questions); 3. Opinions of VR (17 Likert items, where 1= strongly disagree and 5=strongly agree, were divided into six areas assessing opinions on skill transferability, financial cost, added safety to surgical training, curriculum structure, awareness/acceptance by residents and faculty, and technical level of current VR technology). Data was entered into an Excel spreadsheet format and analyzed with standard statistical methods. Main outcome measures were Surgical Assessment, Methods Employed, Familiarity with VR, and Opinions of VR. Results: Surveys were received August 2005 to January 2006. The number of surgical assessment tools used in individual programs ranged from 0 to 5. Of all respondents, 91.1% felt that wetlab simulation was beneficial. 11% were completely unfamiliar with VR; 28% had a familiarity score of 1. Safety added to training, perceived acceptance by faculty and staff, and benefits to the curriculum were all scored above a 3 (neutral) among all familiarity levels. Transferability to the OR, technical quality of current simulation systems, and cost were all scored at or below a 3 by the majority of respondents indicating these aspects of VR are lacking. Conclusions: The ACGME has mandated a competency-based training curriculum in which residency programs must verify a trainee’s skills and not merely the experience. Number and combination of current surgical skill assessment tools in each program is variable. Virtual reality simulation is a relatively unfamiliar training and assessment tool. Current opinion on VR is more favorable amongst respondents more experienced with VR. Those most familiar with VR view it as a means of delivering a safe, structured surgical curriculum that not only allows for training but also for verification of surgical skill sets.

Journal of Academic Ophthalmology 2008: 1: 69-78. (c) Journal of Academic Ophthalmology

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