Assessing Surgical Competency Among Fellows in Vitreoretinal Surgery: A Survey of Fellowship Program Directors and Fellows.

IF 4.4 Q1 OPHTHALMOLOGY Ophthalmology. Retina Pub Date : 2025-01-15 DOI:10.1016/j.oret.2025.01.008
Muhammad Hassan, Kapil Mishra, Linus Amarikwa, Omesh P Gupta, Sunil Srivastava, Adrienne W Scott, Philip J Ferrone, Yannek I Leiderman, Prithvi Mruthyunjaya
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Abstract

Purpose: We surveyed vitreoretinal (VR) fellowship program directors (PDs) to elucidate how they assess surgical competency among VR fellows. In addition, we also surveyed fellowship program graduates for the years 2022 and 2023 regarding assessment metrics and tools used during VR fellowship training.

Design: Web-based, cross-sectional descriptive study.

Subjects: Fellowship PDs and recent fellowship graduates in the United States and Canada METHODS: The survey, distributed via email, queried participants about several aspects of assessing surgical competency in VR training including surgical numbers, teaching/assessment methods used to assess fellow surgical competency, comfort of fellows for various surgical procedures, appropriate degree of supervision, and criteria for a hypothetical national competence standard. A Likert scale was utilized for questions capturing participants opinion. Mean response scores were reported.

Main outcome measure: Comparison of responses between PDs and fellows RESULTS: Forty-two PDs (42.1%) (33: University-based and 9: Private institutions) and forty fellows (16.8%) (28: Academic and 12: Private institutions) responded to survey. Fellows expect a higher minimum number of vitrectomies (at least 300) by graduation compared to PDs (at least 200). Both PDs and fellows ranked direct observation of fellow (4.95), discussion with other faculty on fellow surgical performance (3.93), and outcomes of fellow surgical cases (3.88) (p>0.05), as top three teaching tools. Both PDs and fellows expressed high comfort levels with various complex surgeries, such as primary scleral buckle (4.45), proliferative vitreoretinopathy detachments (4.57), advanced diabetic retinal detachments (4.57), and giant retinal tears (4.64), by the time of graduation. Autonomy was also considered an important indicator of surgical competence by both groups. However, apart from direct surgical experience, fellows rated other educational tools lower than PDs. There was overall agreement between the groups on several aspects of a hypothetical national competence standard.

Conclusion: This survey identified key tools utilized to assess surgical proficiency were direct observation of surgery by attending, discussions about fellow performance among faculty, and outcomes of fellow surgical cases. Both groups emphasized that by graduation, fellows should be proficient in several complex vitreoretinal surgeries. These findings suggest a need for a more systematic approach to assess surgical competency of VR fellow.

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评估玻璃体视网膜外科研究员的手术能力:对奖学金项目主任和研究员的调查。
目的:我们调查了玻璃体视网膜(VR)奖学金项目主任(pd),以阐明他们如何评估VR研究员的手术能力。此外,我们还调查了2022年和2023年奖学金项目毕业生在VR奖学金培训期间使用的评估指标和工具。设计:基于网络的横断面描述性研究。方法:该调查通过电子邮件分发,向参与者询问了VR培训中评估外科手术能力的几个方面,包括手术数量、用于评估同行外科手术能力的教学/评估方法、同行对各种外科手术的舒适度、适当的监督程度以及假设的国家能力标准的标准。李克特量表用于捕捉参与者意见的问题。报告平均反应得分。结果:42名博士(42.1%)(33名大学博士和9名私立大学博士)和40名研究员(16.8%)(28名学术博士和12名私立大学博士)接受了调查。与博士(至少200例)相比,研究员期望到毕业时玻璃体切除术的最少数量(至少300例)更高。博士和研究员均将直接观察(4.95)、与其他教员讨论同行手术表现(3.93)和同行手术结果(3.88)列为前三种教学手段(p < 0.05)。到毕业时,pd及其同事对各种复杂手术,如原发性巩膜扣带(4.45)、增殖性玻璃体视网膜病变脱离(4.57)、晚期糖尿病性视网膜脱离(4.57)和巨大视网膜撕裂(4.64),均表现出较高的舒适度。自主性也被两组认为是手术能力的重要指标。然而,除了直接的手术经验外,研究人员对其他教育工具的评价低于pd。各小组对假设的国家能力标准的几个方面达成了总体一致意见。结论:该调查确定了评估手术熟练程度的关键工具是通过参加直接观察手术,讨论同事之间的表现,以及同事手术病例的结果。两组都强调,到毕业时,研究员应精通几种复杂的玻璃体视网膜手术。这些发现表明需要一个更系统的方法来评估VR研究员的手术能力。
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来源期刊
Ophthalmology. Retina
Ophthalmology. Retina Medicine-Ophthalmology
CiteScore
7.80
自引率
6.70%
发文量
274
审稿时长
33 days
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