title: Skills acquisition and assessment after a microsurgical skills course for ophthalmology residents.
abstract: OBJECTIVE
  To assess the impact of a skills course on microsurgical skills acquisition and to investigate the validity of a video-based modified Objective Structured Assessment of Technical Skill (OSATS) assessment tool that has not previously been applied to ophthalmic surgery.
  
  
  METHODS
  Prospective longitudinal cohort study.
  
  
  METHODS
  Fourteen residents were recruited from 20 attendees at the Moorfields Eye Hospital microsurgical skills course for residents.
  
  
  METHODS
  Each resident performed a standardized microsurgical task consisting of the placement of a 10-0 nylon corneal suture into a model eye using an operating microscope with standardized equipment in a standardized environment. Objective measurements were made using the Imperial College Surgical Assessment Device (ICSAD). This is a motion-tracking device returning 3 parameters for economy of movement: total path length, time, and number of individual hand movements. A concurrent video recording was made of each task by 2 independent observers who were masked to the time of the recording relative to the course and the identity of the resident. Video footage was marked in accordance with the OSATS video scoring template.
  
  
  METHODS
  Each resident had motion-tracking analysis performed during corneal suturing before and after the course (total path length, time, and number of individual hand movements), along with concurrent OSATS video scores.
  
  
  RESULTS
  Skills improvement after the course was found to be statistically significant for all 3 ICSAD economy of movement parameters: path length, P = 0.001; hand movements, P = 0.012; and time, P = 0.009. Differences in the combined OSATS scores of the 2 raters before and after the course were found to be significant (P = 0.039). Interrater reliability of OSATS scorers was 0.78 (alpha Cronbach). Correlations between the OSATS scores and each of the ICSAD parameters were found to be significant (P<0.001).
  
  
  CONCLUSIONS
  A video-based OSATS scoring system has significant correlation with the ICSAD motion-tracking parameters, demonstrating concurrent validity between the 2 assessment tools. These data also demonstrate that surgical skill, as measured by a validated motion-tracking system, is significantly improved after a 1-day microsurgical skills course.
  
  
  BACKGROUND
  The author(s) have no proprietary or commercial interest in any materials discussed in this article.
authors.affiliation: Department of Education Moorfields Eye Hospital, London, United Kingdom. d.ezra@ucl.ac.uk
authors.forename: Daniel G
authors.initials: DG
authors.lastname: Ezra
authors.forename: Raj
authors.initials: R
authors.lastname: Aggarwal
authors.forename: Michel
authors.initials: M
authors.lastname: Michaelides
authors.forename: Narciss
authors.initials: N
authors.lastname: Okhravi
authors.forename: Seema
authors.initials: S
authors.lastname: Verma
authors.forename: Larry
authors.initials: L
authors.lastname: Benjamin
authors.forename: Philip
authors.initials: P
authors.lastname: Bloom
authors.forename: Ara
authors.initials: A
authors.lastname: Darzi
authors.forename: Paul
authors.initials: P
authors.lastname: Sullivan
mesh_terms: D000328:Adult; D002983:Clinical Competence; D016039:Corneal Transplantation; D004503:Education, Medical, Graduate; D004521:Educational Measurement; D005260:Female; D006801:Humans; D007396:Internship and Residency; D008297:Male; D008866:Microsurgery / Q000193:education*; D009048:Motor Skills; D009885:Ophthalmology / Q000193:education*; D011446:Prospective Studies; D013536:Suture Techniques; D013647:Task Performance and Analysis; D013663:Teaching / Q000379:methods; D014741:Video Recording