Core Oculoplastic Procedure Skills for the Comprehensive Ophthalmologist: A Consensus by Delphi Methodology

A survey-based pilot study using Delphi methodology was used to reach a consensus on scope-appropriate oculoplastic procedures for a graduating ophthalmology resident.

An educational task force (ETF) based at the study institution recruited stakeholders for survey participation. A stakeholder group of practicing and board-certified ophthalmologists was recruited with diversity in training background, practice location and setting, and year of ophthalmology board certification. Three rounds of Delphi surveys were distributed to the stakeholder group via online questionnaires (Qualtrics). A Cronbach's alpha test was run to evaluate the internal consistency of the Likert data. Consensus was defined as ≥80% panelist agreement, average aggregate score of ≥4 on a Likert scale (5 equating to "strongly agree"), or Cronbach's alpha value of greater than 0.8.

The educational task force generated a list of 28 oculoplastic procedure skills for the Delphi rounds. Thirty-four stakeholders were recruited. The response rate for the first survey was 91.2%. Eight procedures met the >80% threshold. Six additional procedures were recommended to be added. A software error resulted in no responses recorded for 3 procedures: botulinum toxin injection for benign essential blepharospasm, botulinum toxin injection for hemifacial spasm, and direct browplasty; thus, these procedures were not advanced to the next survey. The response rate for the second survey was 82.3%. Eight procedures met the ≥4 average Likert score threshold. The Cronbach's alpha was 0.90 for the second survey. The response rate for the third survey was 82.3%, and a final list of 13 oculoplastic procedures was generated.

A list of 13 scope-appropriate oculoplastic procedural skills necessary and appropriate for a graduate of an ophthalmology residency was generated by Delphi consensus. This list is the sole work of the study institution and does not reflect the views of official organizations such as the American Academy of Ophthalmology, American Board of Ophthalmology, American Society of Ophthalmic Plastic and Reconstructive Surgeons, or the Association of University Professors of Ophthalmology. This list requires further refinement and should not be used in isolation without further validation; however, it may aid in curricular development and be utilized to generate oculoplastic-specific competencies for ophthalmology residents.