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Standardized approach to training for cataract surgery skill evaluation.

Andrew Pittner1, Michael Nolan1, Aisha Traish1

  • 1From the Department of Ophthalmology (Pittner, Nolan, Bouchard), Loyola University Medical Center, the Department of Ophthalmology & Visual Sciences (Traish, Farooq), University of Illinois at Chicago, the Department of Ophthalmology (Feder), Northwestern University, the Division of Ophthalmology (Hill, Dwarakanathan), John H. Stroger Jr. Hospital of Cook County, and the Department of Medical Education (McGaghie), Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA.

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Summary

Rater training using video improves cataract surgery grading reliability, especially for early-stage residents. This method enhances surgical skill development and assessment in ophthalmology education.

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Area of Science:

  • Ophthalmology
  • Medical Education
  • Surgical Skills Assessment

Background:

  • Assessing surgical performance is crucial for resident training.
  • Standardized grading of cataract surgery is needed to ensure quality and accelerate skill development.

Purpose of the Study:

  • To evaluate the impact of rater skill training on interrater reliability in grading cataract surgery performance.
  • To assess the effectiveness of video-based training for ophthalmology residents and attending physicians.

Main Methods:

  • Prospective interventional study design with pre- and post-training assessments.
  • Ophthalmology residents and attending physicians graded videorecorded cataract surgeries before and after 2 frame-of-reference training sessions.
  • Interclass correlation coefficients (ICCs) and subjective confidence questionnaires were used to measure agreement and confidence.

Main Results:

  • Rater training significantly improved ICCs, with the greatest gains observed in early-stage residents (PGY-3).
  • Improvements in ICCs varied among PGY-4 residents and attending physicians.
  • Post-training, all residents reported increased confidence in their ability to rate and perform cataract surgery.

Conclusions:

  • Video-based training for grading cataract surgery performance enhances interrater reliability, particularly in early residency.
  • This training protocol can serve as a valuable tool for quality assessment and accelerating surgical skill development in ophthalmology education.