Ophthalmology trainees' self-assessment of cataract surgery.
OBJECTIVE
To investigate whether ophthalmology trainees are able to assess their own competence in cataract surgery and whether this judgement improves as they progress through training.


METHODS
A prospective, blinded, single-centre comparative study of ophthalmology trainee surgeons was performed. 16 junior trainees (150-499 cataract operations) and 16 senior trainees (>500 cataract operations) were recruited. They performed a single videotaped cataract operation and filled in the validated Objective Structured Assessment of Cataract Surgical Skill (OSACSS) assessment form. The videotapes were anonymised, randomised and then graded by a single expert reviewer using the OSACSS assessment. Trainees' OSACSS scores were compared with Mann-Whitney tests and inter-rater agreement between the assessor and the trainees was compared using Cohen's κ coefficient.


RESULTS
Senior trainees performed statistically better than junior trainees at all task-specific and global OSACSS indices, apart from draping (p=0.23) and overall score (p=0.09). Overall, trainees were better at assessing their OSACSS performance in global indices such as tissue handling, iris protection and overall speed. They were worse at assessing their performance in task-specific indices, particularly use of the phacoemulsification probe and second instrument. Comparing the two trainee groups, senior trainees had a higher level of agreement with the assessor in more OSACSS indices (15/19) than junior trainees (4/19).


CONCLUSIONS
Trainees were more proficient at assessing their own competence at the global indices of cataract surgery, rather than task-specific components. Compared with junior trainees, senior trainees performed better surgically and were more proficient at assessing their own competence in cataract surgery.


BACKGROUND
SALH1001.
Moorfields Eye Hospital, London, UK.
Edward J
EJ
Casswell
Moorfields Eye Hospital, London, UK.
Tahrina
T
Salam
Moorfields Eye Hospital, London, UK.
Paul M
PM
Sullivan
Moorfields Eye Hospital, Biomedical Research Centre for Ophthalmology, London, UK.
Daniel G
DG
Ezra
D002387:Cataract Extraction / Q000193:education*; D002983:Clinical Competence; D004503:Education, Medical, Graduate / Q000379:methods*; D004521:Educational Measurement / Q000379:methods*; D006801:Humans; D007396:Internship and Residency / Q000379:methods*; D009885:Ophthalmology / Q000193:education*; D011446:Prospective Studies; D012647:Self-Assessment; D016037:Single-Blind Method; D014741:Video Recording
Lens and zonules; Medical Education