Objective structured assessment of cataract surgical skill

Area of Science:

• Ophthalmology
• Surgical Education
• Medical Assessment

Background:

• Assessing surgical skill is crucial for patient safety and effective training.
• Objective metrics are needed to standardize cataract surgery skill evaluation.
• The Objective Structured Assessment of Cataract Surgical Skill (OSASCS) scoring system was developed to address this need.

Purpose of the Study:

• To evaluate the construct validity and reliability of the OSASCS scoring system.
• To determine if the OSASCS can differentiate between surgeons with varying levels of experience in cataract surgery.

Main Methods:

• A novel objective performance rating tool was created, incorporating standardized criteria and Likert scales.
• Phacoemulsification cataract extraction surgeries from surgeons across four experience groups (<50, 50-249, 250-500, >500 procedures) were videotaped.
• Expert reviewers, masked to surgeon experience, scored the videotapes using the OSASCS.

Main Results:

• Thirty-eight surgical videotapes from 38 surgeons were analyzed.
• Significant score differences were observed between surgeons with fewer than 50 procedures and those with 50-249 procedures (P = .002).
• Significant differences were also found between surgeons with 50-249 procedures and those with 250-500 procedures (P = .003), indicating OSASCS differentiates skill levels.

Conclusions:

• The OSASCS scoring system demonstrates construct validity in the context of cataract surgery.
• The OSASCS is a valuable tool for assessing the surgical skills of junior ophthalmology trainees.
• Further validation may enhance its utility in surgical education and competency assessment.