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The use of a virtual reality surgical simulator for cataract surgical skill assessment with 6 months of intervening operating room experience

Authors Sikder S, Luo J, Banerjee PP, Luciano C, Kania P, Song J, Saeed Kahtani E, Edward D, Al Towerki A

Received 25 June 2014

Accepted for publication 3 September 2014

Published 20 January 2015 Volume 2015:9 Pages 141—149


Checked for plagiarism Yes

Review by Single anonymous peer review

Peer reviewer comments 5

Editor who approved publication: Dr Scott Fraser

Shameema Sikder,1 Jia Luo,2 P Pat Banerjee,2 Cristian Luciano,2 Patrick Kania,2 Jonathan C Song,1 Eman S Kahtani,3 Deepak P Edward,1,3 Abdul-Elah Al Towerki3

1Wilmer Eye Institute, Johns Hopkins University, Baltimore, MD, USA; 2College of Engineering, University of Illinois at Chicago, Chicago, IL, USA; 3King Khaled Eye Specialist Hospital, Riyadh, Saudi Arabia

Purpose: To evaluate a haptic-based simulator, MicroVisTouch™, as an assessment tool for capsulorhexis performance in cataract surgery. The study is a prospective, unmasked, nonrandomized dual academic institution study conducted at the Wilmer Eye Institute at Johns Hopkins Medical Center (Baltimore, MD, USA) and King Khaled Eye Specialist Hospital (Riyadh, Saudi Arabia).
Methods: This prospective study evaluated capsulorhexis simulator performance in 78 ophthalmology residents in the US and Saudi Arabia in the first round of testing and 40 residents in a second round for follow-up.
Results: Four variables (circularity, accuracy, fluency, and overall) were tested by the simulator and graded on a 0–100 scale. Circularity (42%), accuracy (55%), and fluency (3%) were compiled to give an overall score. Capsulorhexis performance was retested in the original cohort 6 months after baseline assessment. Average scores in all measured metrics demonstrated statistically significant improvement (except for circularity, which trended toward improvement) after baseline assessment. A reduction in standard deviation and improvement in process capability indices over the 6-month period was also observed.
Conclusion: An interval objective improvement in capsulorhexis skill on a haptic-enabled cataract surgery simulator was associated with intervening operating room experience. Further work investigating the role of formalized simulator training programs requiring independent simulator use must be studied to determine its usefulness as an evaluation tool.

Keywords: medical education, computer simulation, educational assessment, technology assessment, cataract surgery

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