Objective Feedback Maximizes Learning in VR Eye Surgery Training

Feedback is a crucial component of cataract surgery training programs. It enables trainees to learn from experienced surgeons how to refine their skills and enhance their performance.  

Giving and receiving feedback, however, is a delicate balance. Poorly delivered feedback can be demotivating, while informative feedback can reinforce good practices and incite an interest in trainees to seek further improvements. (1)  

Then there is the training program itself. Traditional apprenticeship approaches rely heavily on instructional learning through didactics and wet labs, especially in the earlier stages of training. Although valuable, these tools often emphasize subjective rather than objective assessment of trainee proficiencies. Alternatively, incorporating simulation-based training can enhance the learning experience and provide an avenue for more objective feedback.  

HelpMeSee: An Innovation Approach

The HelpMeSee Simulation-based Training Program exemplifies an innovative approach to cataract surgery training that could help transition the framework of surgical training from knowledge-based to skills-based. (2) With the virtual reality HelpMeSee Eye Surgery Simulator at its core, the program pairs competency-based surgical education in a safe environment with instructor-led training. This combination promotes standardized curriculum delivery, allows objective feedback, and provides consistency in skills acquisition and performance metrics.  

Repeated practice on the HelpMeSee Eye Surgery Simulator allows trainees to practice and make mistakes in a controlled environment with high-fidelity spatial, visual, and tactile surgical realism without risking patient safety. This helps minimize their learning curve, refine their skills, and ultimately improve patient safety. (3)

Additionally, objective performance metrics with the HelpMeSee Simulation-based Training Program are multifaceted and include areas such as task completion time, task accuracy, and qualitative assessments from experienced instructors. This combination ensures that trainees receive comprehensive insights into their performance, facilitating targeted improvements in their skillset and technique. 

Advantages of Instructor-led, Simulation-based Training 

A supportive learning environment. An instructor-led simulation training model encourages trainees to engage with instructors and ask questions while practicing surgical steps repeatedly to master techniques and learn how to avoid and manage surgical complications. (2) HelpMeSee instructors play a key role in the training process, adopting a teaching style that is both encouraging and informative.  

Feedback is immediate. The immediate feedback provided by both the HelpMeSee Eye Surgery Simulator and HelpMeSee instructors help trainees to quickly identify and correct mistakes. Immediate feedback also allows trainees to connect the feedback directly to their actions, enhancing learning efficiency.  

Trainees who undergo simulation-based training may experience a higher retention and application of knowledge compared to those trained through traditional methods alone. (2)

According to Staropoli and colleagues, novice surgeons who used simulation-based surgical training had significantly fewer complications than those who had not used a simulator.(4) This is likely attributed to the hands-on experience and real-time feedback that a simulator can provide. 

Conclusion

The integration of objective performance metrics and personalized instructor feedback in simulation-based training programs like the HelpMeSee Simulation-based Training Program has revolutionized ophthalmology training. By fostering a supportive learning environment and using effective feedback strategies, these programs can enhance the learning experience and skills acquisition for trainees. As the field of ophthalmology continues to evolve, embracing this innovative training method will be essential in preparing the next generation of skilled cataract surgeons. 

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1. Ford R. Making feedback effective for ophthalmology training. Focus. April 2022. Accessed July 2, 2024. www.rcophth.ac.uk/wp-content/uploads/2022/04/College-News-April-2022-FOCUS.pdf 
2. Lansingh VC, Ravindran RD, Garg P, et al. Embracing technology in cataract surgical training – the way forward. Indian J Ophthalmol. 2022;70:4079-4081. 
3. Nair AG, Ahiwalay C, Bacchav AE, Sheth T, Lansingh VC. Assessment of a high-fidelity, virtual reality-based, manual small-incision cataract surgery simulator: A face and content validity study. Indian J Ophthalmol. 2022;70(11):4010-4015.  
4. Staropoli PC, Gregori NZ, Junk AK, et al. Surgical simulation training reduces intraoperative cataract surgery complications among residents. Simul Healthc. 2018;13:11-15. 

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