Self-perceived preparedness and competence among ophthalmology residents for open globe repair

Abstract

Purpose: To assess which surgical training resources residents find most useful for open globe repair. Methods: A nationwide, survey-based, cross-sectional analysis of ophthalmology residents enrolled in accredited training programs in the United States was performed to determine the association of surgical training methods with self-perceived resident preparedness and competence for open globe repair. The survey was developed at the Wilmer Eye Institute, Johns Hopkins Hospital. Results: The individual response rate in our study was 38.6% (118/306 participant responses from 24 programs). Pre-operative surgical planning, in the form of review of patient charts and case discussion with senior faculty, was associated with higher self-perceived levels of both preparedness and competence for several different steps of globe repair. Both supervised and independent lab practice on animal or synthetic eyes were also found to be significantly associated with increased levels of self-perceived competence, especially for steps that involved scleral and limbal reapproximation. Conclusion: Open globe repair is an important skill that all ophthalmologists must learn to master. To improve surgical training, residency programs must focus on developing a structured surgical curriculum that incorporates training for managing ocular trauma and open globes. Possible components can include implementation of pre-operative briefings and case discussion with faculty as well as, encouraging regular utilization of practice labs in a distributed pattern to consolidate learning among residents.