Cataract surgery training in Spain. The perspective of final-year residents

• Autores: Johannes Keller, Santiago Ortiz Pérez, Xavier Corretger Ruhí
• Localización: Journal of Emmetropia: Journal of Cataract, Refractive and Corneal Surgery, ISSN-e 2171-4703, Vol. 5, Nº. 1, 2014, págs. 47-54
• Idioma: inglés
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• Resumen

  • PURPOSE: To investigate the current standards of cataract surgery training in Spain and the training resources available.

    SETTING: Hospital Clínic de Barcelona, Barcelona, Spain.

    METHODS: An anonymous internet-based questionnaire was administered to final year residents in Spain during December 2012. The main outcome measurements were the number of complete operations (CO) performed and the posterior capsular rupture (PCR) rate. Sample demographics, surgical performance, available resources and residents’ opinions were also collected.

    RESULTS: There were 55 respondents out of 159 trainees (36.7%). The mean CO was 131.9 (median: 98 [0-500]) and mean PCR rate was 5.45% (median: 4.0% [0-28%]). A negative correlation was found between the number of CO and the PCR rate (r = −0.362, p = 0.007); a positive correlation was found between hospital throughput per trainee and CO (r = 0.519; p = 0.0001). Training resources available were an optical biometer (85.5%), dedicated cataract trainer (83.6%), wet-lab (43.4%), resident-led theatre lists (34.6%), specific training sessions (33.9%) and training curriculum (27.1%). Having a dedicated trainer resulted in a mean CO 143.8 with PCR rate 4.77% versus 71.1 (p = 0.03) and 8.9% (p = 0.04), respectively. Forty trainees (72.7%) felt confident to operate without supervision, with mean CO 152.7 (p < 0.0001) and PCR rate 4.9% (p = 0.06). None of the demographic variables were related with surgical performance.

    CONCLUSIONS: We obtained proficiency markers that may be used by trainees and trainers to assess their progress. Training opportunities are not uniformly distributed. A dedicated trainer is correlated both to a higher number of operations and a lower PCR rate.

    Residents gain greater confidence with increased experience but there is no correlation with lower complication rates.