The Effects of Distraction on Cataract Surgery Performance in Consultants and Trainees Using a Simulator

Area of Science:

• Ophthalmology
• Surgical Education
• Cognitive Science

Background:

• Mental workload and cognitive overload are recognized factors that can impact surgical outcomes, including cataract surgery.
• Understanding these factors is crucial for enhancing patient safety and reducing surgeon stress.
• Simulated cataract surgery provides a controlled environment to study the effects of cognitive load on surgical performance.

Purpose of the Study:

• To assess the impact of distraction on surgical performance in simulated cataract surgery.
• To evaluate the effects of cognitive load on ophthalmology trainees and consultants using the EyeSi simulator.

Main Methods:

• Ten trainees and ten consultants performed six simulated cataract surgery cases each on the EyeSi simulator.
• Cases were divided equally between conditions with and without distraction (extraneous cognitive load).
• Physiological data (blood pressure, pulse) and simulator performance scores were recorded for each case.

Main Results:

• Distraction did not significantly alter surgical scores or physiological measurements for either group.
• Consultants demonstrated significantly poorer overall performance compared to trainees (P=0.0229).
• Consultants made more critical errors, resulting in zero scores for individual surgical stages (P=0.0074).

Conclusions:

• Consultant performance on the EyeSi simulator was lower than that of trainees, questioning the fidelity of simulation to real-world surgical conditions.
• The findings highlight the importance of considering surgeon experience and potential discrepancies between simulation and actual surgical environments in ophthalmic training.