Background The Royal College of Opthalmology Guidelines for Cataract Surgery recommend post-operative follow-up to obtain data for audit and discuss second eye surgery where indicated, patient recovery and the timing of post-operative refraction (Guidelines, 2010). In our region (Yorkshire and the Humber), the majority of units use junior doctors or nurses to provide these examinations in house. These clinicians have received different basic training and have a range of prior ophthalmic examination experience. Discussion with consultant ophthalmologists responsible for cataract services reveals broad agreement regarding the content of post-operative examination, based on identification of sight-threatening complications of cataract surgery including uveitis, endophthalmitis, retinal detachment and cystoid macular oedema (Guidelines, 2010). A simulated environment allows the development of the required visio-motor skills, without the need to dazzle patients during the learning curve.
Methodology We are developing a half-day simulated technical skills course, consisting of commercially-available and locally engineered models to simulate the above conditions. Models are attached interchangeably to slit lamps with video displays, allowing simultaneous viewing by the participant, facilitator and other attendees. Course participants must demonstrate prior understanding of ophthalmology to the standards of a competent ophthalmic nurse (Davies et al ., n.d.) or equivalent.
Results Participants will complete pre- and post-course questionnaires rating confidence (Likert-type scales) in slit lamp examination (anterior and posterior segment), IOP and understanding of post-operative complications of cataract surgery. They will be contacted after 3 months of supervised practice to complete a final questionnaire.
Potential Impacts Time-limited simulated technical skills training has potential to reduce training time to competency in the technical skills required for post-operative cataract examination. Departments may therefore see reduced costs, as well as a reduction in patient discomfort from prolonged examination in the early stages of the learning curve.
Royal College of Ophthalmology (2010). The Royal College of Ophthalmologists Cataract Surgery Guidelines, London, RCOphth. Available at: http://www.rcophth.ac.uk/page.asp?section=451§ionTitle=Clinical+Guidelines (accessed 22/04/14)
Royal College of Nursing (2012) Ophthalmic Nursing: an integrated career and competence framework, London: RCN. Available at: http://www.rcn.org.uk/__data/assets/pdf_file/0006/485898/004350.pdf (accessed 22/04/14)
- Category: Course or curriculum evaluation/innovation/integration
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