The Impact of Simulation-based Education in Ophthalmic Residency

Residency is the cornerstone of surgical education. Designed to prepare medical students for the rigors of surgery, the intensive program typically relies heavily on an apprenticeship model in which residents progress through observation of experienced surgeons to hands-on practice of parts and then entire surgical procedures under supervision. This model, however, has several drawbacks such as limited exposure to complex cases, and certain surgical techniques and subjectivity in the assessment of proficiency.  

For Ophthalmology residents specifically, the challenge is clear: Without adequate hands-on practice, they may enter the Operating Room lacking the confidence and proficiency needed to achieve a successful surgical technique. There is a solution, however, to access supplemental training that can bridge these gaps and enhance the surgical competence of ophthalmology residents. 

Simulation Enhances Surgical Education

Although simulation-based education is not a new concept in ophthalmology, (1) modern virtual reality (VR) simulators have emerged as an additional tool to train residents. When used in conjunction with a traditional apprenticeship model, VR simulation offers a controlled, risk-free environment where residents can repeatedly practice surgical techniques until they achieve a high level of proficiency. In fact, residents can purposely make mistakes to hone their skills in complications management.   

Most current simulator technologies provide only visual cues to surgical manipulations, but the HelpMeSee Eye Surgery Simulator incorporates motorsensory (ie, haptic) feedback to replicate the tactile sensations of surgery. Haptic feedback is crucial for developing the fine motor skills and hand-eye coordination needed for delicate procedures like cataract surgery, creating a comprehensive training experience that minimizes the learning curve, decreases intraoperative complications, and improves patient safety. (2) 

Despite its proven benefits, including standardization in curriculum delivery to ensure consistency in skills acquisition, unlimited opportunities to repeat procedures, and a reduction in surgical errors, (3) (4) simulation training is not yet a standard component of ophthalmic surgical education in many countries. 

A Program Tailored to the needs of Ophthalmology Trainees 

The HelpMeSee Simulation-Based Training Program is specifically tailored to the needs of ophthalmology trainees, offering a comprehensive suite of instructor-led modules that cover a wide range of procedures, including Manual Small Incision Cataract Surgery (MSICS), Phacoemulsification, Complications Management, Suturing, and now Pars Plana Vitrectomy. Coursework time commitments vary between 1 and 4 days of instruction. The program also includes validated assessment tools that help track a trainee’s progress and ensure they meet the necessary competency standards before progressive to more advanced procedures. 

Residents who undergo VR-based training with HelpMeSee gain invaluable experience that enhances their confidence and proficiency in the OR. By providing a safe, controlled environment for practice, the simulator reduces the learning curve associated with cataract surgery, ultimately leading to better patient outcomes. 

Conclusion 

The demand for skilled cataract surgeons is growing due to an aging population, an increasing life expectancy, and an upward trend in the prevalence of cataracts. (5) It is imperative that residency programs evolve to include more comprehensive training methods, such as VR simulation and particularly programs that offer tactile realism like the HelpMeSee Eye Surgery Simulator. Incorporating simulation-based training may play a crucial role in filling the gaps in surgical proficiency left by traditional apprenticeship training models.  

Residency programs must better prepare their residents for the challenges of cataract surgery, ensuring that the next generation of ophthalmologists is equipped with the skills and confidence needed to deliver high-quality patient care. Simulation-based education is key. 

HELPMESEE SPONSOR’S

1. Solyman O, Abu Serhan H, Kamel HF, et al. A novel cost-effective simulation model for continuous curvilinear capsulorhexis. Clin Ophthalmol. 2022;16:2759-2764. 
2. Lansingh VC, Gonzalez PD, Díaz Flores T, Lopez Star EM, Martinez JM. How many cataract surgeries does it take to be a good surgeon? Revista Mexicana de  Oftalmologia (Eng). 2023:10.5005/rmo-11013-0026.  
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. Ferris JD, Donachie PH, Johnston RL, et al. Royal College of Ophthalmologists’ national ophthalmology database study of cataract surgery: report 6. The impact of EyeSi virtual reality training on complications cates of cataract surgery performed by first and second year trainees. Br J Ophthalmol. 2020;104:324‑329. 
5. Prevent Blindness. News: Cataract cases to increase 78 percent by 2050. May 19, 2016. Accessed February 23, 2024. https://preventblindness.org/cataract-cases-to-increase-78-percent-by-2050/ 

RECENT NEWS