Pretraining of basic skills on a virtual reality vitreoretinal simulator: A waste of time.

PURPOSE: To investigate whether pretraining of basic skills in virtual vitreoretinal surgery affected the performance curve when proceeding to procedure-specific modules. METHODS: This study was a prospective, randomized, controlled, two-centre study. Medical students were randomized into two groups: Group 1 pretrained basic psycho-motor skills (Navigation Training level 2 and Bimanual Training level 3) until they reached their performance curve plateau. Hereafter, both groups trained on the procedure-specific modules (Posterior Hyaloid level 3 and ILM Peeling level 3) until they reached their performance curve plateau. Plateau was defined as three consecutive sessions with the same score with an acceptable variation. The primary outcome was time used to reach performance curve plateau in the procedure-specific modules. RESULTS: A total of 68 medical students were included, and equally randomized into two groups. The participants in Group 1 used a median time of 88 minutes to reach plateau in the basic skills modules but did not differ from Group 2 in time to reach plateau on the procedure-specific modules (183 min versus 210 min, p = 0.40) or in the amplitude of plateau. Group 1 and 2 differed significantly in the starting score of ILM peeling level 3 (0 (0-0) versus 3.5 (0-75), p = 0.03). CONCLUSION: We were not able to show positive skill transfer from basic skills training to the procedure-specific modules in time, starting score or amplitude of plateau. Thus, we recommend that aspiring vitreoretinal surgeons proceed directly to simulation-based training of procedures instead of spending valuable training time on basic skills training.

[Simulation-based training in ophthalmologic surgery].

Over the past few decades, simulation-based training has become an increasingly widespread learning tool for training in medical procedures. This type of training provides the opportunity to learn in a safe simulation-based environment, where both technical and diagnostic skills can be developed. In Denmark, there has been developed evidence for simulation-based training in ophthalmology in cataract and vitreoretinal surgery. This form of evidence-based training is meaningful for real clinical setting, and in this review, we argue, that is important to apply for all medical fields.