Mapping the landscape of cataract surgery teaching assessment in Canadian residency programs

The Royal College of Physicians and Surgeons of Canada has mandated a shift in post-graduate residency education in Canada towards a competency-based model. Within this context, it is unclear how resident's competence in cataract surgery is currently being assessed for both formative and summative purposes. Therefore, we conducted a national survey to evaluate the current landscape of cataract surgery teaching in Canadian Ophthalmology programs.

The opportunity to participate in an online survey was extended to all Canadian ophthalmology program directors and residents. Between July and September 2017, data was collected on demographics (name of program, levels of training), current framework of assessment, and any other contexts for cataract surgery assessments being used (e.g., wetlabs or surgical simulators).

We had a total of 32 responses including 7 program directors (22%), 14 senior residents (44%), and 10 junior residents (34%). The assessments used varied greatly; none of the residency programs used a published assessment tool for assessing skill in cataract surgery. The majority of programs (9 of 11; 82%) used locally-designed assessments and two programs (18%) did not use any standardized forms or tools. All schools were using a wet lab to augment surgical teaching and simulators were being used by 5 of 11 programs (45%).

There are a variety of approaches being used to assess competence in cataract surgery. Many programs share some similarities, and a framework for designing assessment is suggested to guide future efforts at competency-based training and assessment.