title: Assessing the Effect of a Glaucoma Surgical Curriculum in Resident Physicians.
abstract: OBJECTIVE
  Subspecialty surgical training is an important part of resident education. We changed the glaucoma rotation in which postgraduate year 4 residents worked with multiple attending physicians with varying teaching styles to a structured surgical curriculum led by 2 dedicated preceptors, and we evaluated the effect on residents' surgical performance prospectively.
  
  
  METHODS
  A curriculum consisting of preoperative training, intraoperative teaching, postoperative feedback, and repetition was implemented for postgraduate year 4 residents between July 2, 2012, and June 30, 2014. In a class of 8 residents per year, the mean (SD) glaucoma surgical volume increased from 8.9 (0.8) cases in the prior year to 13.6 (2.5) in 2013 (mean difference, 4.8 cases; 95% CI, 2.4-7.1; P = .001) and 14.8 (4.2) in 2014 (mean difference, 5.9 cases; 95% CI, 2.1-9.6; P = .007). A self-assessment survey showed improvement in suturing (scores for each section range from 1 [worst] to 5 [best]; mean rating, 3.9 in the prior year vs 4.4 in 2013 [P = .04] and 4.5 in 2014 [P = .02]). A validated survey assessing overall surgical competency revealed improvement in handling adverse events (mean rating, 4.1 in the prior year vs 5.0 for both 2013 and 2014; both P < .001).
  
  
  CONCLUSIONS
  Despite the small sample size and nonrandomized study design, these data suggest that a structured surgical curriculum has advantages in teaching subspecialty surgery and might be considered by other ophthalmology training programs.
authors.affiliation: Department of Ophthalmology, Harvard Medical School, Massachusetts Eye and Ear Infirmary, Boston.
authors.forename: Lucy Q
authors.initials: LQ
authors.lastname: Shen
authors.affiliation: Department of Ophthalmology, Harvard Medical School, Massachusetts Eye and Ear Infirmary, Boston.
authors.forename: Carolyn E
authors.initials: CE
authors.lastname: Kloek
authors.affiliation: Department of Ophthalmology, Harvard Medical School, Massachusetts Eye and Ear Infirmary, Boston.
authors.forename: Angela V
authors.initials: AV
authors.lastname: Turalba
mesh_terms: D002983:Clinical Competence; D003479:Curriculum / Q000592:standards*; D004503:Education, Medical, Graduate / Q000379:methods*; D004521:Educational Measurement; D018463:Filtering Surgery / Q000193:education*; D005901:Glaucoma / Q000601:surgery*; D006801:Humans; D007396:Internship and Residency; D009885:Ophthalmology / Q000193:education*; D011446:Prospective Studies; D013663:Teaching / Q000379:methods