Reverse order method for teaching cataract surgery to residents

To implement a method to train residents in the performance of phacoemulsification surgery, with the steps completed in reverse chronological order and with the easiest step being undertaken first.

We created a method for training ophthalmology residents in which we taught phacoemulsification surgery in a series of steps learnt in reverse order. Each resident advanced through the teaching modules only after being approved in the final step and then progressed to the complete performance of surgeries. We analysed the rates of complications in the 2 years after introducing the new method.

The new method allowed for a standardised approach that enabled replicated teaching of phacoemulsification regardless of instructor or student. After implementing the new method, residents performed 1817 phacoemulsification surgeries in the first year and 1860 in the second year, with posterior capsule rupture rates of 8.42% and 7.9%, respectively.

Teaching residents to perform the steps of phacoemulsification in a standardised reverse order resulted in low rates of complications.