Keywords
virtual reality - cataract surgery - ophthalmology residency training
Virtual reality (VR) training for novice ophthalmic surgeons has been shown to improve
operating performance and decrease rates of complications associated with cataract
surgery.[1] Mental skills are an important aspect of surgical training and are often taught
in VR settings[2] but have not been well studied in ophthalmology. Herein we present a publically
available VR cataract surgery course that integrates mental skills training into its
learning objectives.
The course consists of didactics based on the American Academy of Ophthalmology Basic
and Clinical Science Course and training modules with the EyeSi surgical simulator
(VRmagic, Manheim, Germany). The course also includes administration of a validated
VR practical test[3] at the end of the second year of ophthalmology residency training, which is 3 years
in duration in the United States. The test consists of seven EyeSi modules selected
for their ability to discriminate between novice and experienced cataract surgeons.
We focused on junior trainees to identify those who may need extra attention later
in training.
In addition, the VR cataract surgery course has a mental skills component. Mental
skills are psychological techniques used by professional athletes, pilots, and military
personnel to enhance learning, improve performance, and assist with stress management.
Surgeons and surgical trainees have also used mental skills strategies to attain superior
operating room performance and lower stress levels.[2] Strategies include mental imagery, stress management, goal setting, and pre-performance
routines. The impact of mental skills is determined by the evaluation of surgical
performance on VR simulators, questionnaires that quantify stress and confidence levels,
or performance in other simulated clinical scenarios.
The mental skills curriculum in the VR course consists of eight modules from a course
shown to decrease novice general surgeons' cognitive stress under difficult performance
conditions.[4]
[5] Completed by second-year ophthalmology residents, the modules are integrated into
VR sessions and cover energy management, goal setting, mental imagery, refocusing
strategies, and preoperative mental routines. Residents review one new module with
an attending physician before each VR session. To assess the efficacy of the mental
skills, residents complete a Test of Performance Strategies (TOPS) questionnaire before
the first and after the last mental skills sessions.
We look forward to assessing the impact of this course on resident VR and operating
room cataract surgery outcomes and receiving feedback from other ophthalmology residency
training programs that may use our course to update their cataract surgery training
curricula.
Course link: https://doi.org/10.7301/Z0X065JZ.
