September 2016
Volume 57, Issue 12
Open Access
ARVO Annual Meeting Abstract  |   September 2016
Surgical Simulation in Low-resource Settings Improves Intra-operative Aspects of Trichiasis Surgery Training
Author Affiliations & Notes
  • Emily W Gower
    Public Health Sciences, Wake Forest School of Medicine, Winston-Salem, North Carolina, United States
    Ophthalmology, Wake Forest School of Medicine, Winston Salem, North Dakota, United States
  • Amir Bedri Kello
    Light For the World, Addis Ababa, Ethiopia
  • Martin Kollmann
    CBM, Nairobi, Kenya
  • James Johnson
    Wake Forest Innovations, Winston-Salem, North Carolina, United States
  • Footnotes
    Commercial Relationships   Emily Gower, None; Amir Kello, None; Martin Kollmann, None; James Johnson, Human Analogue Applications (I)
  • Footnotes
    Support  Seeing is Believing Innovation Fund, Fred Hollows Foundation
Investigative Ophthalmology & Visual Science September 2016, Vol.57, No Pagination Specified. doi:
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      Emily W Gower, Amir Bedri Kello, Martin Kollmann, James Johnson; Surgical Simulation in Low-resource Settings Improves Intra-operative Aspects of Trichiasis Surgery Training. Invest. Ophthalmol. Vis. Sci. 201657(12):.

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      © ARVO (1962-2015); The Authors (2016-present)

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Purpose : In most trachoma-endemic settings, non-physican trichiasis surgeons receive 1 week of classroom training and then move directly to live surgery. We assessed whether adding simulation training with a relatively low-cost surgical simulator improved initial the initial live surgery training.

Methods : 4 trichiasis surgery training sessions for novice trainees were held in Ethiopia. At 2 sessions, trainees recieved standard TT surgery training. At the other 2 sessions, trainees recieved one-on-one training using a surgical simulation device (HEAD START) between classroom and live surgery training. For all trainees, data collectors observed all live surgeries. They recorded the time that anesthesia was administered, time the first instrument was placed, and time the last suture was tied. Additionally, they recorded how many times the trainer intervened to correct the procedure and whether or not the trainer completely took over to finish the procedure. Trainers and trainees who were trained with HEAD START were asked to complete a standard questionnaire reporting on the utility of HEAD START training as part of the trichiasis surgery training package.

Results : 22 new trainees were assessed using the standard training approach and 26 trainees using the HEAD START training approach. Trainees who received the HEAD START approach performed their first surgery with half the number of interventions required by the trainer (2.7 vs. 4.8; p=0.003). Additionally, HEAD START trainees performed the procedure significantly faster than those with standard training (23 vs. 30 minutes; p=0.01). This trend remained constant throughout the training, with the 20th surgery performed by HEAD START trained surgeons remaining significantly faster than those of the standard trainees. Trainers and trainees unanimously agreed that surgical simulation training was a critical component of surgical training.

Conclusions : Surgical simulation training singificantly improved initial live surgeries performed by novice trainees. All trainers indicated that surgical simulation should be integrated into the standard trichiasis surgery training package.

This is an abstract that was submitted for the 2016 ARVO Annual Meeting, held in Seattle, Wash., May 1-5, 2016.


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