A paradigm shift has occurred recently in ophthalmology education. Training programs are moving away from the exclusive use of apprenticeship models in the operating room in favor of incorporating simulators that allow novice surgeons additional opportunities to refine their skills in a controlled learning environment. As a result, data-driven training is no longer a luxury—it’s a necessity. The real-time performance analytics offered by simulation-based surgical training provide tailored, highly-effective instruction to transform a cataract specialist’s journey from hesitant beginner to confident surgeon.
At the heart of simulation-based training is HelpMeSee. Its Simulation-based Training Program combines the Eye Surgery Simulator and instructor-led simulation-based surgical training to enhance skill acquisition and proficiency. Courses on Manual Small Incision Cataract Surgery (MSICS), Phacoemulsification, Anterior Vitrectomy, and other complications management to allow repeated surgical simulation practice tailored to the individual needs of aspiring cataract surgeons.
At the core of these efforts are mentors like Dr. Minal Shah Baldota, Chief Instructor at the HelpMeSee Simulation Learning Lab (SIMLab), who emphasizes the importance of embracing mistakes made during training and learn to correct them to grow as a surgeon. “Every time you get a chance, you want to practice correcting whatever mistake you made,” Dr. Shah Baldota says. “As you keep correcting the mistakes you make, you will get better and better. What we are aiming for is for the student to not only learn the task but to achieve it consistently and satisfactorily. That’s how they develop proficiency.”
The Power of Stepwise Learning and Performance Data
The HelpMeSee Simulation-based Training Program breaks down the surgical procedure into manageable, repeatable steps that are captured and analyzed through detailed data logs and video recordings. From incision creation to suturing technique, instructors are equipped with objective feedback to help students master each skill before progressing to the next surgical step. This strategy has been shown as a useful surgical training tool before progressing to live surgery. Sankarananthan and colleagues successfully used virtual reality manual small incision cataract surgery simulation surgery to objectively evaluate the structural characteristics and associated complications of each phase of the procedure, noting that as individuals performed multiple attempts of certain surgical steps their mean scores improved and complications decreased. Simulation surgery, they concluded, helps ophthalmic professionals and residents learn how to anticipate complications earlier in the operating room. (1)
“Rather than overwhelming cataract specialists with all the steps at once, we teach one step at a time. Then, they put it all together and perform surgery as a whole with much more confidence,” Dr. Shah Baldota said. “That’s where analytics really help us understand where the student falls in their learning curve.”
Tailoring Education Based on Real Data
One of the most valuable features of the HelpMeSee Eye Surgery Simulator is its ability to generate granular, real-time data that instructors use to personalize each student’s experience.
“With each session, we can see how many attempts a person needs to get a step right and where they consistently make errors,” Dr. Shah Baldota explained. “This allows us to tailor the course to focus on their trouble areas and work on small refinements to their technique. We want them to be really good when they complete the program.”
This personalized approach doesn’t just benefit cataract specialists; it also gives their future mentors and surgical attendings peace of mind. “A colleague once told me, ‘Minal, before cataract specialists completed the HelpMeSee training program, I used to have my heart in my mouth when they operated. But after your training, I’m so much more relaxed.’ That speaks volumes,” Dr. Shah Baldota said.
A Dual Feedback Approach
Data suggests that external feedback is integral to novice surgeons’ ability to develop technical skills. (2) Additionally, however, verbal feedback supports the retainment of skills. The combination of instructor insight and simulator data as offered by the HelpMeSee program creates a dynamic, two-way feedback system. The simulator flags errors immediately—often before the human instructor can spot them—making it an honest and effective teacher.
“The HelpMeSee Eye Surgery Simulator is not going to sugarcoat your mistakes,” Dr. Shah Baldota said. “It tells you the truth, exactly as it is. As instructors, we provide emotional context and strategies, but the simulator gives objective, real-time data. Together, we help the student grow.”
Objectivity is essential in cultivating true surgical skill. Students are encouraged to make mistakes on the simulator so they can learn without harming real patients. And, because of real-time analytics, “you can understand exactly why an error happened,” Dr. Shah Baldota said.
A randomized-controlled trial found surgical simulation may reduce the volume of errors in the first 20 live procedures performed by cataract specialists. (3)
Beyond Technical Skills: Confidence, Composure, and Surgical Mindset
Training at HelpMeSee goes beyond the mechanics of surgery. Instructors also focus on psychological readiness, including training students to manage stress, anticipate complications, and stay calm under pressure.
“Let’s say someone is struggling with MSICS or phacoemulsification. We can pull their data, review the videos of each surgical attempt, and focus precisely on where they’re having trouble so that the next time, they can be more confident,” Dr. Shah Baldota said. “Sometimes it’s just one hand movement that needs to be corrected. Other times, it’s a mindset shift.”
Students are also taught how to make backup plans for when things don’t go as expected—a critical skill for real-world surgical practice. “Every eyeball is not the same,” she said. “You’ll get stuck sometimes, and when that happens, you need to have a clear mind and a plan. That’s something we can teach through simulation, especially when they revisit complication modules.”
Repeat Training
Another unique aspect of the HelpMeSee training model is that students are encouraged to return to the HelpMeSee Eye Surgery Simulator whenever they encounter difficulties in the operating room.
“The idea is this: Go operate, then come back to simulation training if you need to,” Dr. Shah Baldota said. “Simulation isn’t a one-and-done experience—it’s lifelong learning, and everyone’s journey is different.”
Simulation-based technology like the HelpMeSee Eye Surgery Simulator supports training with an instructor-led curriculum and enhances hands-on learning. Taking it one step further, HelpMeSee believes in combining this cutting-edge technology with instrcutor guidance to revolutionize ophthalmology education. With leaders like Dr. Shah Baldota guiding the way, the HelpMeSee performance analytics are doing more than measuring skills—they’re shaping confident, capable cataract surgeons ready to change the world.
(1) Sankarananthan R, Prasad RS, Koshy TA, et al. An objective evaluation of simulated surgical outcomes among surgical trainees using manual small-incision cataract surgery virtual reality simulator. Indian J Ophthalmol. 2022;70:4018-25.
(2) Porte MC, e al. Verbal feedback from an expert is more effective than self-accessed feedback about motion efficiency in learning new surgical skills. Am J Surg. 2007;193(1):105-110.
(3) Nair AG, Ahiwalay C, Bacchav AE, et al. Effectiveness of simulation-based training for manual small incision cataract surgery among novice surgeons: a randomized controlled trial. Sci Rep. 2021;11(1):10945.
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