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Omar Krad, Asim Farooq, Charles Bouchard, Susanne Tidow-Kebritchi; Development of a Video-Based Cataract Surgery Assessment Tool for Use in Ophthalmology Residency Training Programs. Invest. Ophthalmol. Vis. Sci. 2011;52(14):6224.
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To develop a video-based cataract surgery assessment tool using the Ophthalmology Surgical Competency Assessment Rubric (OSCAR), which applies the Dreyfus method to grading surgical proficiency.
Cataract surgery videos were collected from residents and attending faculty at the Loyola University Medical Center and Hines VA in Maywood, IL. The video editing software program Cyberlink PowerDirectorTM was used to divide surgical videos into clips for each step described by the OSCAR cataract grading system. In some cases, videos were edited for lighting and clarity purposes. These video clips were then loaded onto a password-protected online database for grading by two independent observers from the Department of Ophthalmology. Grading was based on the Dreyfus method and included descriptive analysis of each video as well as a numerical score. The identity of neither the surgeon nor patient were made available to the graders. For the 14 specific steps and 6 global indices there was a maximum score of 100 based on the rubric.
The Cyberlink PowerDirectorTM software serves as an effective and easy to use method of producing cataract surgery video clips for detailed analysis by experienced observers. Using an established rubric, varying levels of proficiency were noted for each surgical step performed by residents and attendings. The Dreyfus method provides both a numerical and descriptive means of surgical skills assessment that helps categorize standard video clips and can be used for tracking improvement during residency.
This represents an important initial step in the development of an innovative surgical skills assessment tool for potential use in ophthalmology training programs nationwide. Improvement of surgical proficiency during residency may be followed using this grading system with self-assessment immediately after each case against categorized standard videos and/or independent observer evaluation. This system may be applied not only to cataract surgery but also many other surgeries and procedures.
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