title: Bridging the gap: theory-based design of a microsurgical skills course for ophthalmology residents.
abstract: OBJECTIVE
  Although theory-based schemes for course design are widely used in educational settings, making use of cognitive theory in the design of surgical skills courses in ophthalmology is rare. The primary aim of this study is to describe the application of instructional design, an established theory-based approach in course design, to the development of a surgical skills course for ophthalmology residents. The secondary aim of this study is to assess the educational effect of this theory-based course.
  
  
  METHODS
  A 1-day skills course was designed according to Gagné׳s events of instruction model, which was employed as a template for the instructional sequence of learning steps. Skills acquisition following the implementation of the model was measured with precourse and postcourse assessments.
  
  
  METHODS
  Moorfields Eye Hospital organized the 1-day annual intermediate surgical skills course, which was hosted at the Royal College of Ophthalmologists' microsurgical skills laboratory.
  
  
  METHODS
  A total of 20 ophthalmology residents of Moorfields Eye Hospital participated in the study.
  
  
  RESULTS
  A 1-day surgical skills course was formulated according to the instructional design principles outlined. The 4 objectives of the course (corneal suturing, corneal gluing, intravitreal injections, and eyelid suturing) were addressed in a parallel fashion as to allow for multiple objectives to be processed simultaneously, in the context of the instructional design sequence. Assessments demonstrated significant improvement in skills acquisition for the 4 course objectives.
  
  
  CONCLUSIONS
  Instructional design is a valuable tool for planning effective surgical training courses as it is portable, allowing its application to a wide variety of outcomes and settings, and its terminology is simple and understandable to those working in clinical education.
authors.affiliation: Department of Education, Moorfields Eye Hospital, London, United Kingdom. Electronic address: antigoni_koukkoulli@hotmail.com.
authors.forename: Antigoni
authors.initials: A
authors.lastname: Koukkoulli
authors.affiliation: Department of Education, Moorfields Eye Hospital, London, United Kingdom.
authors.forename: Aman
authors.initials: A
authors.lastname: Chandra
authors.affiliation: Department of Education, Moorfields Eye Hospital, London, United Kingdom.
authors.forename: Hithen
authors.initials: H
authors.lastname: Sheth
authors.affiliation: Department of Education, Moorfields Eye Hospital, London, United Kingdom.
authors.forename: Narciss
authors.initials: N
authors.lastname: Okhravi
authors.affiliation: Department of Education, Moorfields Eye Hospital, London, United Kingdom.
authors.forename: Seema
authors.initials: S
authors.lastname: Verma
authors.affiliation: Department of Education, Moorfields Eye Hospital, London, United Kingdom.
authors.forename: Paul
authors.initials: P
authors.lastname: Sullivan
authors.affiliation: Department of Education, Moorfields Eye Hospital, London, United Kingdom; National Institute for Health Research, Biomedical Research Centre for Ophthalmology, Moorfields Eye Hospital and UCL Institute of Ophthalmology, Moorfields Eye Hospital NHS Foundation Trust, London, United Kingdom; Adnexal Department, Moorfields Eye Hospital NHS Foundation Trust, London, United Kingdom; Department of Cell Biology, UCL Institute of Ophthalmology, London, United Kingdom.
authors.forename: Daniel G
authors.initials: DG
authors.lastname: Ezra
mesh_terms: D002983:Clinical Competence; D003479:Curriculum; D004503:Education, Medical, Graduate / Q000379:methods*; D004521:Educational Measurement; D006801:Humans; D007396:Internship and Residency; D008866:Microsurgery / Q000193:education*; D017145:Models, Educational; D009048:Motor Skills; D009885:Ophthalmology / Q000193:education*
keywords: Medical Knowledge; Patient Care; Practice-Based Learning and Improvement; Professionalism; instructional course design theory; microsurgical skillourse