The Ophthalmology Surgical Competency Assessment Rubric for penetrating keratoplasty

Irreversible corneal blindness disproportionately affects low- and middle-income countries where there remains a critical demand for surgeons skilled in corneal transplantation. Penetrating keratoplasty (PK) is a critical skill for ophthalmologists, especially as it remains the most widely performed type of corneal transplant in these parts of the world. Tools to teach and assess trainees in corneal transplantation are needed to help standardize training internationally. Here, we present an Ophthalmology Surgical Competency Assessment Rubric (OSCAR) aimed at assessing the competence and progress of residents in PK.

A team of cornea specialists developed a rubric for PK using previously published OSCARs as a template. The draft included 11 key steps of PK and six global indices, with a grading scale based on a modified Dreyfus model. The rubric was then reviewed for face and content validity by a panel of eight international experts using an iterative feedback process. The draft underwent multiple cycles of feedback and revisions until a consensus was reached among the authors and the international expert panel.

The rubric contains 11 essential steps and six global indices with descriptions of expected functioning at four levels of competency (novice, beginner, advanced beginner, and competent).

This OSCAR for PK contributes to the global standardization of ophthalmology training, helping to meet the increasing demand for corneal transplant services with high-quality care for all.