Triad of rubric assessment, constructive feedback and video recorded surgeries key assessment for competent ophthalmic surgeon

Ophthalmic surgery involves very precise surgical skill, which is difficult to teach and even more cumbersome in assessment of resident’s surgical skill. Hence it’s a need of time to adopt newer tool for transferring as well as assessing surgical skill. With this concept in mind International Council of Ophthalmology (ICO) has developed various tools for assessing surgical skills. If we use this tool not only as learning tool but also to give constructive feedback on the surgical skills of resident doctors it will help in creating a competent ophthalmic surgeon and eventually help society in general. 1To develop more standardized surgical training; 2. To assess efficacy and feasibility of new tool in improving surgical skills of Post Graduate(PG) student; 3. To know the effect of constructive feedback on surgical performance. Small incision cataract surgery training is done by Rubric designed by ICO- OSCAR. The same tool was used to assess video recorded cataract surgery of residents by different faculties and assess their surgical skill. The assessor simply circled the observed performance description at each step of the procedure. The ICO-OSCAR score was completed. At the end of the case assessor immediately discussed operated case with student to provide timely, structured, specific performance feedback. Oscar score was recorded and analysed with inter rater agreement. OSCAR TOOL has very good inter rater agreement i.e.(0.96). Analysis of student & Observer feedback infers that OSCAR Tool is best tool for learning as well as assessment tool and is easy to use. Recorded surgeries & constructive feedback from assessor helped Post Graduate students to improve surgically. This resulted in best outcome for patient in terms of good visual acuity post operatively. The formative assessment of surgical skills becomes an integral part of our formal residency, training framework, it would be in the interest of our trainees and trainers that we should adopt the OSCAR tools to train and assess. These tools can add immense value to our residency as well fellowship surgical training and possibly help create a generation of competent trainee.Formative Assessment and constructive feedback in surgical training will improve the competency of new ophthalmic surgeons.Structured surgical training will be relatively easy to observe and perform, as trainee learns what is required to be competent.This will ultimately improve the overall quality of patient care.

Edward Hickling Bradford (1848-1926): The Founder of Pediatric Orthopedics in America

Edward Hickling Bradford (1848-1926) is considered as 1 of the most important figures in American and world orthopedics during 19th and early 20th century. His teaching ability, his gifted surgical skills and his innovations in orthopedics attracted the interest of the world orthopedic’s community and gave him a long lasting reputation. But most of all he is considered as the founder of pediatric orthopedics in America.

Designing a synthetic simulator to teach open surgical skills for limb exploration in trauma: a qualitative study exploring the experiences and perspectives of educators and surgical trainees

Background Simulation is an important adjunct to aid in the acquisition of surgical skills of surgical trainees. The simulators used to adequately enable trainees to learn, practice and be assessed in surgical skills need to be of the highest standards. This study investigates the perceived requirements of simulation and simulators used to acquire skills in limb exploratory procedures in trauma. Methods Semi-structured interviews were conducted with an international group of 11 surgical educators and 11 surgical trainees who had experience with surgical simulation. The interviews focused on the perceptions of simulation, the integration of simulators within a curriculum and the features of a simulator itself. Interviews were recorded, transcribed and underwent thematic analysis. Results Analysis of the perspectives of surgical educators and surgical trainees on simulated training in limb trauma surgery yielded three main themes: (1) Attitudes to simulation. (2) Implementing simulation. (3) Features of an open skills simulator. The majority felt simulation was relevant, intuitive and a good way for procedure warmup and the supplementation of surgical logbooks. They felt simulation could be improved with increased accessibility and variety of simulator options tailored to the learner. Suggested simulator features included greater fidelity, haptic feedback and more complex inbuilt scenarios. On a practical level, there was a desire for cost effectiveness, easy set up and storage. The responses of the educators and the trainees were similar and reflected similar concerns and suggestions for improvement. Conclusion There is a clear positive appetite for the incorporation of simulation into limb trauma training. The findings of this will inform the optimal requirements for high quality implementation of simulation into a surgical trauma curriculum and a reference to optimal features desired in simulator or task trainer design.

Building a microneurosurgical laboratory in Latin America: challenges and possibilities

Background: Training in microsurgical neuroanatomy is a priority for neurosurgical education. During the 20th century, microsurgical laboratories arose and provided a way to develop surgical skills. Few reports addressed the assembly, construction, and details of a training laboratory. Methods: We have conducted a literature review and searched legislation on the need to plan the structure of the laboratory. Results: We projected and built a laboratory through a public-private partnership. High-tech workstations and instruments were planned to meet the needs of residents, fellows, and student. All steps and materials were in accordance with the Brazilian legislation and articles previously selected. Conclusion: We described our experience and demonstrated the implementation of a micro neurosurgical skills laboratory.