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The Eyesi simulator in training ophthalmology residents: results of a pilot study on self-efficacy, motivation and performance
  1. Robert PL Wisse1,
  2. Tessa Coster1,
  3. Marieke Van der Schaaf2,
  4. Olle Ten Cate3
  1. 1 Department of Ophthalmology, Universitair Medisch Centrum Utrecht, Utrecht, The Netherlands
  2. 2 Department of Education, Universiteit Utrecht, Utrecht, The Netherlands
  3. 3 Center for Research and Development of Education, Universitair Medisch Centrum Utrecht, Utrecht, The Netherlands
  1. Correspondence to Dr Robert PL Wisse, Department of Ophthalmology, University Medical Center Utrecht, Office E.03.136, P.O.Box 85500, Utrecht, GA 3508, The Netherlands; r.p.l.wisse{at}


Purpose To describe ophthalmology residents’ motivation and self-efficacy during cataract surgery training and to assess the relationship of self-efficacy and motivation on both simulator (Eyesi) and real-life surgical performance.

Methods Prospective cohort study using a within-subject design. Eight residents were asked to fill out questionnaires on self-efficacy and motivation towards the Eyesi simulator and real-life cataract surgery at three different moments. Simulator performance was derived from the instrument’s output. Patient charts were reviewed to assess real-life surgical performance.

Results Comparative analysis, using a paired sampled t-test, showed a significant increase in self-efficacy towards real-life cataract surgery after completing the cataract training on the simulator (p=0.005). Furthermore, we found a significant correlation between total tasks to complete the cataract training and self-efficacy scored after working with the simulator (p=0.038). Motivation towards the simulator remained stable over time and seemed not to be influenced by simulator or real-life performance.

Conclusions We found evidence that performance on the simulator correlated with residents’ self-efficacy scored after the simulator training, supporting the theory that self-efficacy is determined by prior performance. Self-efficacy seemed inversely related to the ease of completion of a task: delivery of a greater effort leads to more satisfaction and a higher perceived self-efficacy towards this particular task. Future studies should include more subjects to provide a more accurate insight in the role of self-efficacy and motivation in training complex surgical skills.

  • Eyesi®
  • virtual reality
  • cataract training
  • self-efficacy
  • motivation

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  • Contributors TC collected all data, conducted the study and wrote the manuscript.

    RPLW planned the study, made the questionnaires and received them (blinded) after the participants filled them in, reviewed the manuscript and submitted the manuscript.

    MVDS reviewed the manuscript.

    OTC reviewed the manuscript.

  • Competing interests None declared.

  • Ethics approval An explicit informed consent of study participation was not deemed necessary by the Ethical Review Board of the UMC Utrecht since the Medical Research Involving Human Subjects Act (WMO) does not apply.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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