Subscribe to RSS
DOI: 10.1055/s-0040-1717061
A Novel Microsurgical Suturing Pilot Course for Ophthalmology Residents Based on Kern's Model for Curriculum Development
Funding This project was supported by funding from the Yale School of Medicine Office of Student Research.Abstract
Background Sutureless ophthalmic procedures are becoming more commonplace, reducing opportunities for ophthalmology residents to learn microsurgical suturing techniques. There is no standard curriculum in place to address this gap in clinical training among ophthalmology residency programs.
Objective The aim of this study was to design, implement, and evaluate a preliminary microsurgical suturing curriculum for ophthalmology residents using Kern's six-step approach for curriculum development as a guideline, and the principles of distributed practice and guided, self-directed practice.
Methods We designed a faculty-led teaching session on fundamental microsurgical suturing techniques for all 15 ophthalmology residents from Yale University over one academic year. Suturing skills were evaluated, followed by a guided teaching session, 30 days of self-directed practice time, and a re-evaluation of skills. The residents were evaluated through a written knowledge assessment and practical skills assessment. The residents also evaluated their skill level before and after the teaching session and practice period through written Likert-scale surveys. Data were evaluated in Excel using descriptive statistics and the paired t-test.
Results After the session, postgraduate year 2 (PGY-2) residents felt more confident in recognition and use of surgical instruments (p < 0.01). PGY-3 residents felt less confident in their knowledge of microsurgical suturing after the session (p = 0.02). PGY-4 residents felt they were better able to identify different suture types after the session (p = 0.02). All residents improved on the written knowledge assessment (p < 0.001) and in all categories of the practical skills assessment (p < 0.001).
Conclusions Implementation of a faculty-led microsurgical suturing training session, followed by 1-month of practice time, significantly improved residents' knowledge and practical application of various microsurgical suturing techniques that are necessary for performing common ophthalmic procedures.
Keywords
microsurgical suturing - microsurgical training - surgical skills assessment - resident training - Kern's model - distributed practiceNote
This study was presented with preliminary data as a poster at the 2018 Yale Medical Education Day.
Publication History
Received: 08 November 2019
Accepted: 11 August 2020
Article published online:
04 November 2020
© .
Thieme Medical Publishers
333 Seventh Avenue, New York, NY 10001, USA.
-
References
- 1 Macsai M. Ophthalmic Microsurgical Suturing Techniques. Berlin: Springer; 2007
- 2 Ezra DG, Aggarwal R, Michaelides M. et al. Skills acquisition and assessment after a microsurgical skills course for ophthalmology residents. Ophthalmology 2009; 116 (02) 257-262
- 3 Sandford-Smith J. Sutureless cataract surgery: principles and steps. Community Eye Health 2003; 16 (48) 49-53
- 4 Velazquez AJ, Carnahan MA, Kristinsson J, Stinnett S, Grinstaff MW, Kim T. New dendritic adhesives for sutureless ophthalmic surgical procedures: in vitro studies of corneal laceration repair. Arch Ophthalmol 2004; 122 (06) 867-870
- 5 Selber JC, Chang EI, Liu J. et al. Tracking the learning curve in microsurgical skill acquisition. Plast Reconstr Surg 2012; 130 (04) 550e-557e
- 6 The Accreditation Council for Graduate Medical Education, ACGME Program Requirements for Graduate Medical Education in Ophthalmology. 2017: 1-34 . Available at: https://www.acgme.org/Specialties/Documentsand-Resources/pfcatid/13/Ophthalmology
- 7 Kern DE. Introduction. In: Patricia A, Thomas DEK, Mark THughes, Belinda Y.Chen. , eds. Curriculum Development for Medical Education: A Six-Step Approach Third ed. Baltimore: Johns Hopkins University Press; 2016
- 8 Kern DE. Overview: A six-step approach to curriculum development. In: Patricia A, Thomas DEK, Mark THughes, Belinda Y.Chen. , eds. Curriculum Development for Medical Education: A Six-Step Approach. Baltimore: Johns Hopkins University Press; 2016
- 9 Grober ED, Hamstra SJ, Wanzel KR. et al. The educational impact of bench model fidelity on the acquisition of technical skill: the use of clinically relevant outcome measures. Ann Surg 2004; 240 (02) 374-381
- 10 Cremers SL, Lora AN, Ferrufino-Ponce ZK. Global Rating Assessment of Skills in Intraocular Surgery (GRASIS). Ophthalmology 2005; 112 (10) 1655-1660
- 11 Jowett N, LeBlanc V, Xeroulis G, MacRae H, Dubrowski A. Surgical skill acquisition with self-directed practice using computer-based video training. Am J Surg 2007; 193 (02) 237-242
- 12 Benjamin AS, Tullis J. What makes distributed practice effective?. Cognit Psychol 2010; 61 (03) 228-247
- 13 Moulton CA, Dubrowski A, Macrae H, Graham B, Grober E, Reznick R. Teaching surgical skills: what kind of practice makes perfect? a randomized, controlled trial. Ann Surg 2006; 244 (03) 400-409
- 14 Bucholz EM, Sue GR, Yeo H, Roman SA, Bell Jr RH, Sosa JA. Our trainees' confidence: results from a national survey of 4136 US general surgery residents. Arch Surg 2011; 146 (08) 907-914
- 15 Kruger J, Dunning D. Unskilled and unaware of it: how difficulties in recognizing one's own incompetence lead to inflated self-assessments. J Pers Soc Psychol 1999; 77 (06) 1121-1134
- 16 McHugh ML. Interrater reliability: the kappa statistic. Biochem Med (Zagreb) 2012; 22 (03) 276-282