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M. Almond, A. Bhandari, M. C. Wu; Microsurgical Training Course for Corneal Suturing Skills: A Validation Study. Invest. Ophthalmol. Vis. Sci. 2009;50(13):1515.
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To demonstrate interval change, if any, in corneal suturing skills following a two hour microsurgical training module.
Four first-year Ophthalmology Residents took part in a one-on-one microsurgical training course with a Cornea Attending. Prior to and following this course, each had twenty minutes to close a full-thickness corneal laceration using porcine tissue, and each session was videotaped. Two University of Washington faculty members were chosen to review the footage in a blinded fashion (blinded to participant and whether it was pre- or post- training module) and grade the subjects on several elements considered necessary to appropriate microsurgical technique. Additionally, subjects rated the course using a questionnaire designed to evaluate participants’ impressions of surgical simulation modules.
Participants were graded in a blinded fashion on eleven skills thought important to good surgical technique, using a five-point scale. Based on these evaluations, subjects showed improvement in all categories, with statistical significance demonstrated for all except one skill relating to speed of suture placement and number of sutures placed in the allotted time.
Following a two-hour microsurgical training module using a basic anterior segment set and operating microscope, study participants showed improvement in many skills necessary to proper tissue and instrument handling and wound edge apposition. Though statistical significance was not demonstrated in the rate of suture placement and number of sutures placed, for the beginning surgeon one could argue the quality of suture placement and wound apposition is more important than the speed with which sutures are placed. The module scored well across the board with study participants as assessed in a post-module questionnaire. This study demonstrates that it is possible to impart valuable microsurgical skills relatively quickly and without expensive simulation instruments.
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