This is not ideal, as it creates an elite model for training limited to centres that can provide the necessary resources. However, this is expensive, provides single on-off simulation experience or requires specialist licencing for training. Current high-fidelity simulation training in strabismus surgery is available with the use of cadaveric tissue (human, rabbits or porcine). ĭespite the proven benefits, very few simulation models have been formally validated in ophthalmology. They reported significant improvement in time, intraoperative complication rate and amount of power used by phacoemulsification in residents that had underwent previous cataract virtual reality simulation training. assessed 592 consecutive phacoemulsification in 42 residents of which half underwent simulation training. In particular, a subgroup of medical students underwent previous virtual reality navigation training and was found to have consistent overall higher scores and shorter learning curves for capsulorhexis performance on the simulator. have shown improved performance on tissue treatment, efficiency, microscope and instrument handling following virtual reality capsulorhexis training. Simulation training has shown promise in technical and non-technical skills training to bridge the learning curve. This is further compounded by the emotional state of the trainee one survey of ophthalmology residents found poor recall of learning due to anxiety from conventional operative strabismus surgery teaching experience, which resulted in a negative performance (24% reporting tremor, 11% had tachycardia, 10% moments of absence and 34% felt nervous). report that 20–40 cases are required to obtain efficiency and proficiency of performing horizontal single muscle surgery, however, this is related to the learning curve of an established ophthalmic surgeon that has acquired technical skills in ophthalmic surgery. There is sparsity of published data on the strabismus surgery learning curve. The challenge of any learning curve is to allow development of skills during the novice phase, which is prone to greater risks, without compromising outcome, e.g., inadvertently perforating the globe in cases of strabismus surgery. Perhaps reflected in current training, there is a declining trend in speciality surgical experience at time of completion of training. This is due to legislative and regulatory contractual changes in favour of minimising fatigue and improving patient care. However, acquiring the required competencies within the postgraduate training programme remains a challenge. Surgical training has evolved within the last few decades from the traditional Halstead's approach “see one, do one and teach one”, to a competency-based framework in recognition of the learning curve of skills acquisition. Of these five may be simulated as long as they are observed. The ophthalmic speciality training curriculum in the United Kingdom requires trainees to have completed 20 surgical strabismus procedures by time of completion of training. These include extraocular muscle surgery, primarily for strabismus correction, but also as part of enucleation, retinal detachment and repair of globe trauma. Ophthalmic surgical training programmes aim to develop trainees’ level of proficiency within the various subspecialties of ophthalmic surgery.
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