title: Ophthalmic Surgical Simulation in Training Dexterity in Dominant and Nondominant Hands: Results From a Pilot Study.
abstract: OBJECTIVE
  To determine whether a structured training program using the validated EYESI surgical simulator improves dexterity in nondominant (ND) hands.
  
  
  METHODS
  Academic tertiary referral center.
  
  
  METHODS
  Nonrandomized, prospective study.
  
  
  METHODS
  Subjects who chose to participate and provided informed consent completed a structured simulation training program, which included a baseline test, 3 sessions of repeated tasks, and a final test on capsulorhexis in dominant (D) and ND hands. Participants completed demographic and satisfaction questionnaires. Performances at each session were recorded. We compared overall scores at baseline and at the end of the study, and analyzed trends over time. Statistical analysis was performed using JMP by SAS.
  
  
  RESULTS
  Overall, 14 subjects completed the training program. In all, 3 (21.4%) were attending physicians and 11 (78.6%) were trainees. There was a significant improvement in the average overall scores (baseline vs. final) in both the D hand (33.4 vs. 46.5; p < 0.05) and the ND hand (28.9 vs. 47.7; p < 0.001). The structured training program demonstrated significantly faster performance times in both hands at the end of the study (D p< 0.001, ND p < 0.02). However, the learning curve was significantly steeper in the ND hand (p < 0.01). Participants agreed that simulation training improved the ND hand dexterity.
  
  
  CONCLUSIONS
  We found a significantly greater trend for improvement in the ND compared with the D hand. These results suggest that an elaborate, structured curriculum targeting teaching dexterity results in better simulated performance.
authors.affiliation: Department of Ophthalmology, Veterans Affairs Boston Healthcare System; Department of Ophthalmology, Harvard Medical School, Boston, Massachusetts.
authors.forename: Luis A
authors.initials: LA
authors.lastname: Gonzalez-Gonzalez
authors.affiliation: Department of Ophthalmology, Veterans Affairs Boston Healthcare System; Department of Ophthalmology, Harvard Medical School, Boston, Massachusetts.
authors.forename: Abhishek R
authors.initials: AR
authors.lastname: Payal
authors.affiliation: Department of Ophthalmology, Veterans Affairs Boston Healthcare System; Department of Ophthalmology, Boston University School of Medicine.
authors.forename: Jose E
authors.initials: JE
authors.lastname: Gonzalez-Monroy
authors.affiliation: Department of Ophthalmology, Veterans Affairs Boston Healthcare System; Department of Ophthalmology, Boston University School of Medicine; Department of Ophthalmology, Harvard Medical School, Boston, Massachusetts. Electronic address: mary.daly2@va.gov.
authors.forename: Mary K
authors.initials: MK
authors.lastname: Daly
mesh_terms: D019923:Capsulorhexis / Q000193:education*; D002983:Clinical Competence; D003479:Curriculum; D007839:Functional Laterality; D006801:Humans; D009048:Motor Skills / Q000502:physiology*; D010865:Pilot Projects; D011446:Prospective Studies; D000066908:Simulation Training / Q000379:methods*; D011795:Surveys and Questionnaires
keywords: Patient Care; Practice-Based Learning and Improvement; Systems-Based Practice; dexterity; education; handedness; surgical simulation; training; virtual reality