Impact of a structured surgical curriculum on ophthalmic resident cataract surgery complication rates.
OBJECTIVE
To determine whether institution of a structured surgical curriculum for ophthalmology residents decreased the rate of sentinel surgical complications.


METHODS
Veterans Affairs Medical Center, Des Moines, Iowa, USA.


METHODS
A retrospective review was performed of third-year ophthalmic resident quality-assurance surgical outcomes data at a single residency-training site from 1998 to 2008. The primary outcome measure was defined as a sentinel event; that is, a posterior capsule tear (with or without vitreous loss) or vitreous loss (from any cause) occurring during a resident-performed case. The study population was divided into 2 groups. Group 1 comprised surgical cases of residents trained before the surgical curriculum change (academic years 1998 to 2003) and Group 2, surgical cases of residents trained with the enhanced curriculum (academic years 2004 to 2008). Data from 1 year (academic year 2003 to 2004) were excluded because the transition to the enhanced curriculum occurred during that period. The data were analyzed and adjusted for surgical experience.


RESULTS
In Group 1 (before institution of surgical curriculum), there were 823 cases with 59 sentinel complications. In Group 2 (after institution of surgical curriculum), there were 1009 cases with 38 sentinel complications. There was a statistically significant reduction in the sentinel complication rate, from 7.17% before the curriculum changes to 3.77% with the enhanced curriculum (P = .001, unpaired 2-tailed t test).


CONCLUSIONS
Implementation of a structured surgical curriculum resulted in a statistically significant reduction in sentinel event complications, even after adjusting for surgical experience.
Rogers
Gina M
GM
Department of Ophthalmology, University of Iowa Hospitals and Clinics, Iowa City, Iowa 52242, USA.
Oetting
Thomas A
TA
Lee
Andrew G
AG
Grignon
Connie
C
Greenlee
Emily
E
Johnson
A Tim
AT
Beaver
Hilary A
HA
Carter
Keith
K
D002387:Cataract Extraction / Q000193:education*; D002983:Clinical Competence / Q000592:standards*; D003479:Curriculum / Q000592:standards*; D004503:Education, Medical, Graduate / Q000592:standards*; D004521:Educational Measurement; D006801:Humans; D007396:Internship and Residency; D007431:Intraoperative Complications; D009885:Ophthalmology / Q000193:education; D011183:Postoperative Complications; D012189:Retrospective Studies