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0132 Human Factors Training In Ophthalmology
  1. Polly Dickerson1,
  2. James Innes2
  1. 1Hull Institute for Learning and Simulation, Kingston Upon Hull, UK
  2. 2Hull and East Yorkshire Eye Hospital, Kingston Upon Hull, UK

Abstract

Background While surgical specialties are increasingly experienced in technical simulation, there are few courses in ophthalmology aimed at improving human factors. It has been established that human factors training can reduce errors and thereby improve safety (Leonard et al , 2004). Cataract surgery is the most-performed operation in the UK (NHS Choices 2013), although complications are rare (1%). We are developing a course to allow ophthalmology patients to benefit from safety improvements via multidisciplinary human factors simulation training.

Methodology We aim to recreate the operating environment in a simulated theatre. Delegates should include the scrub nurse, ODA, "runner" and operating surgeon. Where this surgeon is junior and would usually have consultant support available, we would provide this. The faculty will include a simulated patient, usually an actor, as well as technical support and observers to debrief.

Simulation will include model microscope, down which the surgeon delegate will view a video of cataract surgery. Scenarios will include surgical complications such as posterior capsule rupture, as well as patient factors. Surgeons are expected to demonstrate situational awareness to recognise the problem, clear communication with nursing staff and sensitive communication with the awake patient. Nursing and ODA delegates would be expected to raise concerns regarding the procedure if witnessed, demonstrate awareness of equipment required to manage complications and communicate clearly. Structured debriefing will follow to embed learning.

Results Based on the experience of other human factors simulation courses, we expect to find latent errors, demonstrate to candidates the effectiveness of clear communication with awake patients and with each other and provide the opportunity for teams to discuss their own options for change.

Potential impacts We aim to make the course compulsory for training, as with technical simulation. Future strategies include moving the LCD display microscope simulator to theatres to allow in-situ simulation.

References

  1. Leonard M, Graham S, Bonacum D. The human factor: the critical importance of effective teamwork and communication in providing safe care. Qual Saf Health Care 2004;13:i85-i90 accessed via http://qualitysafety.bmj.com/content/13/suppl_1/i85.full.pdf+html accessed on 13/06/2014

  2. NHS Choices Cataract Surgery edited March 2014 http://www.nhs.uk/Conditions/Cataract-surgery/Pages/Introduction.aspx accessed on 13/06/2014

  • Category: Course or curriculum evaluation/innovation/integration

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