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Developing and validating a simple and cost-effective strabismus surgery simulator.

Temitope Adebayo1, Michael Abendroth1, Gaytri Gupta Elera1

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A nonbiologic strabismus surgery simulator proved non-inferior to traditional wet labs for training novice surgeons. This portable, cost-effective tool effectively teaches key strabismus surgery steps.

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Area of Science:

  • Ophthalmology
  • Surgical Education

Background:

  • Strabismus surgery training traditionally relies on biologic wet labs.
  • Developing effective, accessible training tools is crucial for surgical education.

Purpose of the Study:

  • To compare the efficacy of a nonbiologic strabismus surgery simulator versus a biologic wet lab for teaching surgical skills.
  • To determine if the nonbiologic simulator is non-inferior to the biologic wet lab in training novice surgeons.

Main Methods:

  • Forty-one medical students were randomized into either a biologic wet lab or nonbiologic simulator training group.
  • Training was followed by a standardized assessment using a strabismus surgery model, recorded for blinded review.
  • Assessments utilized the International Council of Ophthalmology Approved-Ophthalmology Surgical Competency Assessment Rubric for Strabismus Surgery (ICO-OSCAR), Objective Structured Assessment of Technical Skills (OSATS), and Alphabetic Summary Scale (ASS).

Main Results:

  • The nonbiologic simulator group achieved a total ICO-OSCAR score (36.0 ± 2.7) that was not inferior to the wet lab group (36.7 ± 2.2), with a mean difference of -0.7.
  • The lower bound of the 95% confidence interval for the ICO-OSCAR score difference (-2.0) exceeded the noninferiority margin of -5.0.
  • No statistically significant differences were found between the groups for mean total OSATS or ASS scores (P=0.73 and P=0.44, respectively).

Conclusions:

  • A nonbiologic strabismus surgery simulator is a viable and effective alternative to biologic wet labs for surgical training.
  • The nonbiologic simulator is a portable, inexpensive, and effective training modality for novice surgeons learning strabismus surgery techniques.