Cataract surgeons outperform medical students in Eyesi virtual reality cataract surgery: evidence for construct validity.
OBJECTIVE
To investigate construct validity for modules hydromaneuvers and phaco on the Eyesi surgical simulator.


METHODS
Seven cataract surgeons and 17 medical students performed capsulorhexis, hydromaneuvers, phaco, navigation, forceps, cracking and chopping modules in a standardized manner. Three trials were performed on each module (two on phaco) in the above order. Performance parameters as calculated by the simulator for each trial were saved. Video recordings of the second trial of the modules capsulorhexis, hydromaneuvers and phaco were evaluated with the modified Objective Structured Assessment of Surgical Skill (OSATS) and Objective Structured Assessment of Cataract Surgical Skill (OSACSS) tools.


RESULTS
Cataract surgeons outperformed medical students with regard to overall score on capsulorhexis (p < 0.001, p = 0.035, p = 0.010 for the tree iterations, respectively), navigation (p = 0.024, p = 0.307, p = 0.007), forceps (p = 0.017, p = 0.03, p = 0.028). Less obvious differences in overall score were found for modules cracking and chopping (p = 0.266, p = 0.022, p = 0.324) and phaco (p = 0.011, p = 0.081 for the two iterations, respectively). No differences in overall score were found on hydromaneuvers (p = 0.588, p = 0.503, p = 0.773), but surgeons received better scores from the evaluations of the modified OSATS (p = 0.001) and OSACSS (capsulorhexis, p = 0.003; hydromaneuvers, p = 0.017; phaco, p = 0.001).


CONCLUSIONS
Construct validity was found on several modules previously not investigated (phaco, hydromaneuvers, cracking and chopping, navigation), and our results confirm previously demonstrated construct validity for capsulorhexis and forceps modules. Interestingly, validation of the hydromaneuvers module required OSACSS video evaluation tool. A further development of the scoring system in the simulator for the hydromaneuvers module would be advantageous and make training and evaluation of progress more accessible and immediate.
Department of Clinical Sciences, Malmö: Ophthalmology, Lund University, Malmö, Sweden. madeleine.selvander@skane.se
Madeleine
M
Selvander
Peter
P
Asman
D002387:Cataract Extraction / Q000193:education*; D002983:Clinical Competence; D003198:Computer Simulation; D004521:Educational Measurement; D006801:Humans; D007396:Internship and Residency; D009885:Ophthalmology / Q000193:education*; D013337:Students, Medical; D025321:Surgery, Computer-Assisted / Q000193:education* / Q000379:methods; D014584:User-Computer Interface