Non-technical skills simulation-based training model for managing intraoperative posterior capsule rupture during...

Area of Science:

• Ophthalmology
• Surgical Education
• Human Factors in Medicine

Background:

• Posterior capsule rupture (PCR) is a critical intraoperative complication during cataract surgery.
• Effective management of PCR requires strong non-technical skills (NTS) alongside technical proficiency.
• Current training models may not adequately address the NTS component of PCR management.

Purpose of the Study:

• To develop and implement a simulation-based training model for managing posterior capsule rupture (PCR).
• To assess the impact of this model on surgeons' non-technical skills (NTS) and technical skills (TS).
• To analyze the educational status of the simulation model using McGaghie's translational outcomes.

Main Methods:

• A simulation model with two identical PCR scenarios and NTS stressors was used.
• A NTS-focused training intervention was delivered between simulations.
• Participants' NTS and TS were evaluated using the HUman Factors in intraoperative Ophthalmic Emergencies Scoring System (HUFOES) and Objective Structured Assessment of Technical Skill (OSATS) respectively.

Main Results:

• Seventeen cataract surgeons participated in the training.
• NTS significantly improved, with mean HUFOES scores increasing from 48.7 to 59.2 (p < 0.001).
• TS showed a non-significant increase, with mean OSATS scores rising from 16.0 to 17.9 (p = 0.07).

Conclusions:

• The simulation-based training model effectively improved NTS for managing intraoperative PCR.
• The model demonstrated specificity, enhancing NTS while technical skills showed non-significant improvement.
• The simulation achieved Level 1 (internal acceptability) and Level 2 (contained effects) educational status.