Clinical Ophthalmology (Nov 2024)
The Effects of Distraction on Cataract Surgery Performance in Consultants and Trainees Using a Simulator
Abstract
Adonis El Salloukh,1,* Murad Khan,2,* Patrick Watts,1 Phillip M Newton,3 Gwyn Samuel Williams4 1Ophthalmology Department, University Hospital of Wales, Cardiff, Wales, UK; 2Birmingham and Midlands Eye Centre, Birmingham, England, UK; 3Neuroscience and Medical Education, Swansea University, Wales, UK; 4Ophthalmology Department, Singleton Hospital, Swansea, Wales, UK*These authors contributed equally to this workCorrespondence: Murad Khan, Birmingham and Midlands Eye Centre, City Hospital, Dudley Road, Birmingham, B18 7QH, UK, Email [email protected]: Mental workload is a recognised concept in medicine, and cognitive overload may lead to complications in surgery, including cataract surgery. A better understanding of what factors contribute to this can potentially improve patient safety and decrease surgeon stress. Simulated cataract surgery is now an essential part of training and a safe environment for exploring the effects of cognitive load upon performance. We used the EyeSi cataract surgery simulator to assess the effects of distraction on surgical performance and on ophthalmology trainees and consultants undertaking cataract surgery.Patients and Methods: Consultant and trainee cataract surgeons undertook a simulated list of six cases each, of which half were allowed to proceed without extraneous cognitive load with distraction and half were not. Blood pressure and pulse measurements were taken at three intervals in each of the six cases, as well as surgical scores on the simulator recorded for each case.Results: Distraction did not statistically significantly affect the scores, blood pressure or pulse measurements of either the 10 trainees or 10 consultants. Consultants performed more poorly than trainees overall (P = 0.0229) and suffered more serious errors that returned a score of zero for an individual stage (P = 0.0074).Conclusion: Consultant cataract surgeons performed worse than trainees on the EyeSi simulator, raising questions over whether simulation is as true to reality as has been suggested. An important finding is that ophthalmic training curricula around the world have been adapted in order to include simulated cataract surgery as an essential component of training new ophthalmic surgeons.Keywords: simulation, cataract surgery, ophthalmology
