title: Operating Room Performance Improves after Proficiency-Based Virtual Reality Cataract Surgery Training.
abstract: To investigate the effect of virtual reality proficiency-based training on actual cataract surgery performance. The secondary purpose of the study was to define which surgeons benefit from virtual reality training.
  
  
  
  Multicenter masked clinical trial.
  
  
  
  Eighteen cataract surgeons with different levels of experience.
  
  
  
  Cataract surgical training on a virtual reality simulator (EyeSi) until a proficiency-based test was passed.
  
  
  
  Technical performance in the operating room (OR) assessed by 3 independent, masked raters using a previously validated task-specific assessment tool for cataract surgery (Objective Structured Assessment of Cataract Surgical Skill). Three surgeries before and 3 surgeries after the virtual reality training were video-recorded, anonymized, and presented to the raters in random order.
  
  
  
  Novices (non-independently operating surgeons) and surgeons having performed fewer than 75 independent cataract surgeries showed significant improvements in the OR-32% and 38%, respectively-after virtual reality training (P = 0.008 and P = 0.018). More experienced cataract surgeons did not benefit from simulator training. The reliability of the assessments was high with a generalizability coefficient of 0.92 and 0.86 before and after the virtual reality training, respectively.
  
  
  
  Clinically relevant cataract surgical skills can be improved by proficiency-based training on a virtual reality simulator. Novices as well as surgeons with an intermediate level of experience showed improvement in OR performance score.
authors.affiliation: Department of Ophthalmology, Rigshospitalet, Glostrup, Denmark; Copenhagen Academy for Medical Education and Simulation, Centre for HR, Copenhagen, Capital Region of Denmark, Denmark. Electronic address: skouthomsen@dadlnet.dk.
authors.forename: Ann Sofia Skou
authors.initials: AS
authors.lastname: Thomsen
authors.affiliation: Department of Ophthalmology, Rigshospitalet, Glostrup, Denmark.
authors.forename: Daniella
authors.initials: D
authors.lastname: Bach-Holm
authors.affiliation: Department of Ophthalmology, Rigshospitalet, Glostrup, Denmark.
authors.forename: Hadi
authors.initials: H
authors.lastname: Kjærbo
authors.affiliation: Department of Ophthalmology, Rigshospitalet, Glostrup, Denmark.
authors.forename: Klavs
authors.initials: K
authors.lastname: Højgaard-Olsen
authors.affiliation: Copenhagen Academy for Medical Education and Simulation, Centre for HR, Copenhagen, Capital Region of Denmark, Denmark.
authors.forename: Yousif
authors.initials: Y
authors.lastname: Subhi
authors.affiliation: National Institute for Health Research, Biomedical Research Centre at Moorfields Eye Hospital and the UCL Institute of Ophthalmology, Moorfields Eye Hospital, London, United Kingdom.
authors.forename: George M
authors.initials: GM
authors.lastname: Saleh
authors.affiliation: Department of Medical Education, College of Medicine, University of Illinois, Chicago, Illinois.
authors.forename: Yoon Soo
authors.initials: YS
authors.lastname: Park
authors.affiliation: Department of Ophthalmology, Rigshospitalet, Glostrup, Denmark.
authors.forename: Morten
authors.initials: M
authors.lastname: la Cour
authors.affiliation: Copenhagen Academy for Medical Education and Simulation, Centre for HR, Copenhagen, Capital Region of Denmark, Denmark.
authors.forename: Lars
authors.initials: L
authors.lastname: Konge
mesh_terms: D002983:Clinical Competence / Q000592:standards*; D003198:Computer Simulation; D003194:Computer-Assisted Instruction / Q000379:methods*; D004311:Double-Blind Method; D004503:Education, Medical, Graduate / Q000592:standards*; D004521:Educational Measurement; D005260:Female; D006801:Humans; D007396:Internship and Residency; D008297:Male; D008875:Middle Aged; D009873:Operating Rooms / Q000592:standards*; D009885:Ophthalmology / Q000193:education; D018918:Phacoemulsification / Q000193:education*; D011446:Prospective Studies; D013647:Task Performance and Analysis; D014741:Video Recording; D014792:Visual Acuity