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Sacks Z, Katz LJ, Gazzard G, Van Tassel SH, Blumenthal EZ, Lerner FS, Azuara-Blanco A, Spooner GJR, Solberg Y, Samuelson T, Belkin M. A Proposal for the Use of a Fixed Low-Energy Selective Laser Trabeculoplasty for Open Angle Glaucoma. J Glaucoma 2024; 33:1-7. [PMID: 37851966 PMCID: PMC10712999 DOI: 10.1097/ijg.0000000000002306] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2023] [Accepted: 08/10/2023] [Indexed: 10/20/2023]
Abstract
Selective laser trabeculoplasty (SLT) has been in routine clinical use for over 20 years with millions of patients successfully treated and a low rate of clinically significant complications. The procedure requires the clinician to manually position the laser beam on the trabecular meshwork using a gonioscopy lens and to titrate the SLT laser energy based on the amount of pigmentation in the angle, as well as the observation of small bubbles produced by the laser effect. We propose that SLT energy titration is unnecessary either to achieve intraocular pressure (IOP) reduction or to minimize potential side effects. Ample evidence to support our proposal includes multiple clinical reports demonstrating comparable levels of IOP reduction resulting from different laser energies, a large variety of energy and other laser parameters used in commercially available SLT lasers, and the nature of the laser-induced changes in the trabecular meshwork tissue with respect to energy. Despite these variations in laser parameters, SLT consistently reduces IOP with a low complication rate. We propose that using low fixed energy for all patients will effectively and safely lower patients' IOP while reducing the complexity of the SLT procedure, potentially making SLT accessible to more patients.
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Affiliation(s)
| | - L. Jay Katz
- Wills Eye Hospital, Thomas Jefferson University, Philadelphia, PA
| | - Gus Gazzard
- Moorfields Eye Hospital NHS Foundation Trust
- NIHR Moorfields Biomedical Research Centre
- UCL Institute of Ophthalmology, London, UK
| | | | - Eytan Z. Blumenthal
- Department of Ophthalmology, Rambam Health Care Campus
- Ruth and Bruce Rappaport Faculty of Medicine, Technion—Israel Institute of Technology, Haifa, Israel
| | - Fabian S. Lerner
- University Favaloro, School of Medical Sciences and Foundation for the Study of Glaucoma, Buenos Aires, Argentina
| | - Augusto Azuara-Blanco
- Centre for Public Health, Queen's University Belfast
- Belfast Health and Social Care Trust, UK
| | | | | | - Thomas Samuelson
- Minnesota Eye Consultants
- Department of Ophthalmology and Visual Neurosciences, University of Minnesota MN
| | - Michael Belkin
- The Goldschleger Eye Research Institute, Sheba Medical Center, Tel Hashomer, Tel-Aviv University, Israel
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Iwanaga J, Muo EC, Tabira Y, Watanabe K, Tubbs SJ, D'Antoni AV, Rajaram-Gilkes M, Loukas M, Khalil MK, Tubbs RS. Who really needs a Metaverse in anatomy education? A review with preliminary survey results. Clin Anat 2023; 36:77-82. [PMID: 36087277 DOI: 10.1002/ca.23949] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2022] [Accepted: 09/06/2022] [Indexed: 12/14/2022]
Abstract
The term Metaverse ("meta" defined as beyond, transcendence or virtuality, and "verse" meaning universe or world) denotes a "virtual reality space" for anatomy teaching. To ascertain how many anatomists are familiar or are using this adjunct in teaching, we conducted a short survey at the 2022 annual meeting of the American Association of Clinical Anatomists (AACA). Interestingly, only six respondents (9.4%) had used a Metaverse for teaching anatomy. Moreover, the vast majority of attendees were anatomy educators or basic science faculty, but not practicing physicians/surgeons or other actively practicing health care professionals; a group where this technology has been used much more commonly. The present manuscript was authored by anatomy educators, practicing physicians and other actively practicing health care professionals with backgrounds in diverse medical fields, that is, anatomists, medical doctors, physician assistants, dentists, occupational therapists, physical therapists, chiropractors, veterinarians, and medical students. Many of these authors have used or have been exposed to a Metaverse in the clinical realm. Therefore, the aim of the paper is to better understand those who are knowledgeable of a Metaverse and its use in anatomy education, and to provide ways forward for using such technology in this discipline.
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Affiliation(s)
- Joe Iwanaga
- Department of Neurosurgery, Tulane Center for Clinical Neurosciences, Tulane University School of Medicine, New Orleans, Louisiana, USA.,Department of Neurology, Tulane Center for Clinical Neurosciences, Tulane University School of Medicine, New Orleans, Louisiana, USA.,Department of Structural & Cellular Biology, Tulane University School of Medicine, New Orleans, Louisiana, USA.,Department of Oral and Maxillofacial Anatomy, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan
| | - Edward C Muo
- Tulane University School of Medicine, New Orleans, Louisiana, USA
| | - Yoko Tabira
- Division of Gross and Clinical Anatomy, Department of Anatomy, Kurume University School of Medicine, Fukuoka, Japan
| | - Koichi Watanabe
- Division of Gross and Clinical Anatomy, Department of Anatomy, Kurume University School of Medicine, Fukuoka, Japan
| | - Susan J Tubbs
- Department of Neurosurgery, Tulane Center for Clinical Neurosciences, Tulane University School of Medicine, New Orleans, Louisiana, USA
| | - Anthony V D'Antoni
- Physician Assistant Program, Wagner College, Staten Island, New York, USA.,Division of Anatomy, Department of Radiology, Weill Cornell Medicine, New York, New York, USA
| | - Mathangi Rajaram-Gilkes
- Anatomical Sciences, Department of Medical Education, Geisinger Commonwealth School of Medicine, Scranton, Pennsylvania, USA
| | - Marios Loukas
- Department of Anatomical Sciences, St. George's University, St. George's, Grenada
| | - Mohammed K Khalil
- Biomedical Sciences, University of South Carolina, School of Medicine Greenville, Greenville, South Carolina, USA
| | - R Shane Tubbs
- Department of Neurosurgery, Tulane Center for Clinical Neurosciences, Tulane University School of Medicine, New Orleans, Louisiana, USA.,Department of Neurology, Tulane Center for Clinical Neurosciences, Tulane University School of Medicine, New Orleans, Louisiana, USA.,Department of Structural & Cellular Biology, Tulane University School of Medicine, New Orleans, Louisiana, USA.,Department of Anatomical Sciences, St. George's University, St. George's, Grenada.,Department of Otorhinolaryngology, Graduate School of Medical Sciences, Kyusyu University, Fukuoka, Japan.,Department of Surgery, Tulane University School of Medicine, New Orleans, Louisiana, USA.,Department of Neurosurgery and Ochsner Neuroscience Institute, Ochsner Health System, New Orleans, Louisiana, USA.,University of Queensland, Brisbane, Australia
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Sankarananthan R, Prasad RS, Koshy TA, Dharani P, Bacchav A, Lansingh VC, Ahiwalay C, Balagiri K, Shekhar M. An objective evaluation of simulated surgical outcomes among surgical trainees using manual small-incision cataract surgery virtual reality simulator. Indian J Ophthalmol 2022; 70:4018-4025. [PMID: 36308148 PMCID: PMC9907272 DOI: 10.4103/ijo.ijo_1600_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
Purpose The purpose of this study was to evaluate trainee performance across six modules of a virtual reality (VR) simulator. Methods A retrospective observational study was conducted on 10 manual small-incision cataract surgery (MSICS) trainees who practiced cataract surgery on an MSICS VR simulator for one month. They were assessed in six major steps which included scleral groove, tunnel dissection, keratome entry, capsulorhexis, nucleus delivery, and intraocular lens (IOL) insertion under a trainer's supervision. The information included in their score metrics was collected, and their overall performance was evaluated. Results Thirty attempts were evaluated for scleral groove, tunnel dissection, and capsulorhexis and 15 attempts for keratome entry. Candidates had varied results in the dimensional aspects and their rates of complications with a mean satisfactory score of 3.1 ± 4.17, 6.8 ± 5.75, 5.8 ± 7.74, and 1.8 ± 2.57, respectively. Nucleus delivery (n = 5) had more of iris pull and IOL insertion (n = 5) had more of lost IOL as complications but both had a higher satisfactory outcome. Conclusion A VR simulator is a useful tool for training surgeons before their entry into live surgery. It is an effective method for evaluating objectively the structural characteristics of each phase in MSICS and their associated complications, helping them anticipate it earlier during live surgery by giving them a near real world experience.
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Affiliation(s)
- R Sankarananthan
- Department of Cataract and IOL Services, Aravind Eye Hospital, Madurai, Tamil Nadu, India
| | - R Senthil Prasad
- Department of Cataract and IOL Services, Aravind Eye Hospital, Madurai, Tamil Nadu, India
| | - Tony Alex Koshy
- Department of Cataract and IOL Services, Aravind Eye Hospital, Madurai, Tamil Nadu, India
| | - Padam Dharani
- Department of Cataract and IOL Services, Aravind Eye Hospital, Madurai, Tamil Nadu, India
| | - Ashish Bacchav
- Department of Cataract and IOL Services, Aravind Eye Hospital, Madurai, Tamil Nadu, India
| | - Van Charles Lansingh
- Department of Cataract and IOL Services, Aravind Eye Hospital, Madurai, Tamil Nadu, India
| | - Chetan Ahiwalay
- Department of Cataract and IOL Services, Aravind Eye Hospital, Madurai, Tamil Nadu, India
| | | | - Madhu Shekhar
- Department of Cataract and IOL Services, Aravind Eye Hospital, Madurai, Tamil Nadu, India,Correspondence to: Dr. Madhu Shekhar, Chief, Cataract and IOL Services, Aravind Eye Hospital, Madurai, Tamil Nadu, India. E-mail:
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Ong J, Hariprasad SM, Chhablani J. Into the RetinaVerse: A New Frontier of Retina in the Metaverse. Ophthalmic Surg Lasers Imaging Retina 2022; 53:595-600. [PMID: 36378613 DOI: 10.3928/23258160-20221017-01] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Tan TF, Li Y, Lim JS, Gunasekeran DV, Teo ZL, Ng WY, Ting DS. Metaverse and Virtual Health Care in Ophthalmology: Opportunities and Challenges. Asia Pac J Ophthalmol (Phila) 2022; 11:237-246. [PMID: 35772084 DOI: 10.1097/apo.0000000000000537] [Citation(s) in RCA: 21] [Impact Index Per Article: 10.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
Abstract
ABSTRACT The outbreak of the coronavirus disease 2019 has further increased the urgent need for digital transformation within the health care settings, with the use of artificial intelligence/deep learning, internet of things, telecommunication network/virtual platform, and blockchain. The recent advent of metaverse, an interconnected online universe, with the synergistic combination of augmented, virtual, and mixed reality described several years ago, presents a new era of immersive and real-time experiences to enhance human-to-human social interaction and connection. In health care and ophthalmology, the creation of virtual environment with three-dimensional (3D) space and avatar, could be particularly useful in patient-fronting platforms (eg, telemedicine platforms), operational uses (eg, meeting organization), digital education (eg, simulated medical and surgical education), diagnostics, and therapeutics. On the other hand, the implementation and adoption of these emerging virtual health care technologies will require multipronged approaches to ensure interoperability with real-world virtual clinical settings, user-friendliness of the technologies and clinical efficiencies while complying to the clinical, health economics, regulatory, and cybersecurity standards. To serve the urgent need, it is important for the eye community to continue to innovate, invent, adapt, and harness the unique abilities of virtual health care technology to provide better eye care worldwide.
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Affiliation(s)
- Ting Fang Tan
- Singapore National Eye Centre, Singapore Eye Research Institute, Singapore, Singapore
| | - Yong Li
- Singapore National Eye Centre, Singapore Eye Research Institute, Singapore, Singapore
- Duke-NUS Medical School, Singapore, Singapore
| | - Jane Sujuan Lim
- Singapore National Eye Centre, Singapore Eye Research Institute, Singapore, Singapore
| | | | - Zhen Ling Teo
- Singapore National Eye Centre, Singapore Eye Research Institute, Singapore, Singapore
| | - Wei Yan Ng
- Singapore National Eye Centre, Singapore Eye Research Institute, Singapore, Singapore
| | - Daniel Sw Ting
- Singapore National Eye Centre, Singapore Eye Research Institute, Singapore, Singapore
- Duke-NUS Medical School, Singapore, Singapore
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Abstract
Ophthalmology is a medical profession with a tradition in teaching that has developed throughout history. Although ophthalmologists are generally considered to only prescribe contact lenses, and they handle more than half of eye-related enhancements, diagnoses, and treatments. The training of qualified ophthalmologists is generally carried out under the traditional settings, where there is a supervisor and a student, and training is based on the use of animal eyes or artificial eye models. These models have significant disadvantages, as they are not immersive and are extremely expensive and difficult to acquire. Therefore, technologies related to Augmented Reality (AR) and Virtual Reality (VR) are rapidly and prominently positioning themselves in the medical sector, and the field of ophthalmology is growing exponentially both in terms of the training of professionals and in the assistance and recovery of patients. At the same time, it is necessary to highlight and analyze the developments that have made use of game technologies for the teaching of ophthalmology and the results that have been obtained. This systematic review aims to investigate software and hardware applications developed exclusively for educational environments related to ophthalmology and provide an analysis of other related tools. In addition, the advantages and disadvantages, limitations, and challenges involved in the use of virtual reality, augmented reality, and game technologies in this field are also presented.
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Jiang H, Vimalesvaran S, Wang JK, Lim KB, Mogali SR, Car LT. Virtual Reality in Medical Students' Education: Scoping Review. JMIR MEDICAL EDUCATION 2022; 8:e34860. [PMID: 35107421 PMCID: PMC8851326 DOI: 10.2196/34860] [Citation(s) in RCA: 26] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/11/2021] [Revised: 12/25/2021] [Accepted: 12/30/2021] [Indexed: 05/12/2023]
Abstract
BACKGROUND Virtual reality (VR) produces a virtual manifestation of the real world and has been shown to be useful as a digital education modality. As VR encompasses different modalities, tools, and applications, there is a need to explore how VR has been used in medical education. OBJECTIVE The objective of this scoping review is to map existing research on the use of VR in undergraduate medical education and to identify areas of future research. METHODS We performed a search of 4 bibliographic databases in December 2020. Data were extracted using a standardized data extraction form. The study was conducted according to the Joanna Briggs Institute methodology for scoping reviews and reported in line with the PRISMA-ScR (Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews) guidelines. RESULTS Of the 114 included studies, 69 (60.5%) reported the use of commercially available surgical VR simulators. Other VR modalities included 3D models (15/114, 13.2%) and virtual worlds (20/114, 17.5%), which were mainly used for anatomy education. Most of the VR modalities included were semi-immersive (68/114, 59.6%) and were of high interactivity (79/114, 69.3%). There is limited evidence on the use of more novel VR modalities, such as mobile VR and virtual dissection tables (8/114, 7%), as well as the use of VR for nonsurgical and nonpsychomotor skills training (20/114, 17.5%) or in a group setting (16/114, 14%). Only 2.6% (3/114) of the studies reported the use of conceptual frameworks or theories in the design of VR. CONCLUSIONS Despite the extensive research available on VR in medical education, there continue to be important gaps in the evidence. Future studies should explore the use of VR for the development of nonpsychomotor skills and in areas other than surgery and anatomy. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) RR2-10.1136/bmjopen-2020-046986.
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Affiliation(s)
- Haowen Jiang
- Lee Kong Chian School of Medicine, Nanyang Technological University Singapore, Singapore, Singapore
| | - Sunitha Vimalesvaran
- Lee Kong Chian School of Medicine, Nanyang Technological University Singapore, Singapore, Singapore
| | - Jeremy King Wang
- Lee Kong Chian School of Medicine, Nanyang Technological University Singapore, Singapore, Singapore
| | - Kee Boon Lim
- School of Biological Sciences, Nanyang Technological University Singapore, Singapore, Singapore
| | | | - Lorainne Tudor Car
- Lee Kong Chian School of Medicine, Nanyang Technological University Singapore, Singapore, Singapore
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8
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Ong CW, Tan MCJ, Lam M, Koh VTC. Applications of Extended Reality in Ophthalmology: Systematic Review. J Med Internet Res 2021; 23:e24152. [PMID: 34420929 PMCID: PMC8414293 DOI: 10.2196/24152] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2020] [Revised: 12/19/2020] [Accepted: 04/06/2021] [Indexed: 12/27/2022] Open
Abstract
BACKGROUND Virtual reality, augmented reality, and mixed reality make use of a variety of different software and hardware, but they share three main characteristics: immersion, presence, and interaction. The umbrella term for technologies with these characteristics is extended reality. The ability of extended reality to create environments that are otherwise impossible in the real world has practical implications in the medical discipline. In ophthalmology, virtual reality simulators have become increasingly popular as tools for surgical education. Recent developments have also explored diagnostic and therapeutic uses in ophthalmology. OBJECTIVE This systematic review aims to identify and investigate the utility of extended reality in ophthalmic education, diagnostics, and therapeutics. METHODS A literature search was conducted using PubMed, Embase, and Cochrane Register of Controlled Trials. Publications from January 1, 1956 to April 15, 2020 were included. Inclusion criteria were studies evaluating the use of extended reality in ophthalmic education, diagnostics, and therapeutics. Eligible studies were evaluated using the Oxford Centre for Evidence-Based Medicine levels of evidence. Relevant studies were also evaluated using a validity framework. Findings and relevant data from the studies were extracted, evaluated, and compared to determine the utility of extended reality in ophthalmology. RESULTS We identified 12,490 unique records in our literature search; 87 met final eligibility criteria, comprising studies that evaluated the use of extended reality in education (n=54), diagnostics (n=5), and therapeutics (n=28). Of these, 79 studies (91%) achieved evidence levels in the range 2b to 4, indicating poor quality. Only 2 (9%) out of 22 relevant studies addressed all 5 sources of validity evidence. In education, we found that ophthalmic surgical simulators demonstrated efficacy and validity in improving surgical performance and reducing complication rates. Ophthalmoscopy simulators demonstrated efficacy and validity evidence in improving ophthalmoscopy skills in the clinical setting. In diagnostics, studies demonstrated proof-of-concept in presenting ocular imaging data on extended reality platforms and validity in assessing the function of patients with ophthalmic diseases. In therapeutics, heads-up surgical systems had similar complication rates, procedural success rates, and outcomes in comparison with conventional ophthalmic surgery. CONCLUSIONS Extended reality has promising areas of application in ophthalmology, but additional high-quality comparative studies are needed to assess their roles among incumbent methods of ophthalmic education, diagnostics, and therapeutics.
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Affiliation(s)
- Chee Wui Ong
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Marcus Chun Jin Tan
- Department of Ophthalmology, National University Hospital, Singapore, Singapore
| | - Michael Lam
- Department of Ophthalmology, Ng Teng Fong General Hospital, Singapore, Singapore
| | - Victor Teck Chang Koh
- Department of Ophthalmology, National University Hospital, Singapore, Singapore.,Department of Ophthalmology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
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Thomsen ASS, la Cour M, Paltved C, Lindorff-Larsen KG, Nielsen BU, Konge L, Nayahangan LJ. Consensus on procedures to include in a simulation-based curriculum in ophthalmology: a national Delphi study. Acta Ophthalmol 2018; 96:519-527. [PMID: 29575657 DOI: 10.1111/aos.13700] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2017] [Accepted: 12/09/2017] [Indexed: 11/28/2022]
Abstract
PURPOSE The number of available simulation-based models for technical skills training in ophthalmology is rapidly increasing, and development of training programmes around these procedures should follow a structured approach. The aim of this study was to identify all technical procedures that should be integrated in a simulation-based curriculum in ophthalmology. METHODS Key opinion leaders involved in the education of ophthalmologists in Denmark including heads of departments, heads of clinical education, professors and board members of the society were invited to participate in a three-round Delphi process. Round 1 aimed at identifying technical procedures that physicians should be able to perform competently when completing specialty training; round 2 involved characterization of each procedure including frequency, number of operators, risk and/or discomfort for patients associated with an inexperienced physician, and feasibility of simulation-based training; round 3 included a priority ranking of procedures. RESULTS The response rate for each round was 71%, 64% and 64%, respectively. Sixty-five procedures were reduced to 25 prioritized procedures during the three rounds. Two-thirds of the procedures that were identified and highly prioritized were therapeutic procedures such as intravitreal injection therapy, yttrium-aluminium-garnet laser iridotomy/capsulotomy, minor ocular surface procedures and retinal argon laser therapy. The diagnostic procedures that were prioritized were ocular ultrasound, superficial keratectomy and optical coherence tomography (OCT). CONCLUSION The Delphi process identified and prioritized 25 procedures that should be practised in a simulation-based environment to achieve competency before working with patients. The list may be used to guide the development of future training programmes for ophthalmologists.
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Affiliation(s)
- Ann Sofia Skou Thomsen
- Department of Ophthalmology; Rigshospitalet - Glostrup; Copenhagen Denmark
- Copenhagen Academy for Medical Education and Simulation; University of Copenhagen and The Capital Region of Denmark; Copenhagen Denmark
| | - Morten la Cour
- Department of Ophthalmology; Rigshospitalet - Glostrup; Copenhagen Denmark
| | - Charlotte Paltved
- MidtSim - Centre for Human Resources; Central Region of Denmark and Aarhus University; Aarhus Denmark
| | | | - Bjørn Ulrik Nielsen
- Sim-C - Simulation Centre of Odense; Odense University Hospital; Odense Denmark
| | - Lars Konge
- Copenhagen Academy for Medical Education and Simulation; University of Copenhagen and The Capital Region of Denmark; Copenhagen Denmark
| | - Leizl Joy Nayahangan
- Copenhagen Academy for Medical Education and Simulation; University of Copenhagen and The Capital Region of Denmark; Copenhagen Denmark
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Rai AS, Rai AS, Mavrikakis E, Lam WC. Teaching binocular indirect ophthalmoscopy to novice residents using an augmented reality simulator. Can J Ophthalmol 2017; 52:430-434. [DOI: 10.1016/j.jcjo.2017.02.015] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2016] [Accepted: 02/14/2017] [Indexed: 11/27/2022]
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Thomsen ASS, Subhi Y, Kiilgaard JF, la Cour M, Konge L. Update on simulation-based surgical training and assessment in ophthalmology: a systematic review. Ophthalmology 2015; 122:1111-1130.e1. [PMID: 25864793 DOI: 10.1016/j.ophtha.2015.02.028] [Citation(s) in RCA: 70] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2014] [Revised: 02/12/2015] [Accepted: 02/16/2015] [Indexed: 11/17/2022] Open
Abstract
TOPIC This study reviews the evidence behind simulation-based surgical training of ophthalmologists to determine (1) the validity of the reported models and (2) the ability to transfer skills to the operating room. CLINICAL RELEVANCE Simulation-based training is established widely within ophthalmology, although it often lacks a scientific basis for implementation. METHODS We conducted a systematic review of trials involving simulation-based training or assessment of ophthalmic surgical skills among health professionals. The search included 5 databases (PubMed, EMBASE, PsycINFO, Cochrane Library, and Web of Science) and was completed on March 1, 2014. Overall, the included trials were divided into animal, cadaver, inanimate, and virtual-reality models. Risk of bias was assessed using the Cochrane Collaboration's tool. Validity evidence was evaluated using a modern validity framework (Messick's). RESULTS We screened 1368 reports for eligibility and included 118 trials. The most common surgery simulated was cataract surgery. Most validity trials investigated only 1 or 2 of 5 sources of validity (87%). Only 2 trials (48 participants) investigated transfer of skills to the operating room; 4 trials (65 participants) evaluated the effect of simulation-based training on patient-related outcomes. Because of heterogeneity of the studies, it was not possible to conduct a quantitative analysis. CONCLUSIONS The methodologic rigor of trials investigating simulation-based surgical training in ophthalmology is inadequate. To ensure effective implementation of training models, evidence-based knowledge of validity and efficacy is needed. We provide a useful tool for implementation and evaluation of research in simulation-based training.
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Affiliation(s)
- Ann Sofia S Thomsen
- Department of Ophthalmology, Glostrup University Hospital, Glostrup, Denmark; Centre for Clinical Education, Centre for HR, Capital Region of Denmark, Copenhagen, Denmark.
| | - Yousif Subhi
- Centre for Clinical Education, Centre for HR, Capital Region of Denmark, Copenhagen, Denmark
| | | | - Morten la Cour
- Department of Ophthalmology, Glostrup University Hospital, Glostrup, Denmark
| | - Lars Konge
- Centre for Clinical Education, Centre for HR, Capital Region of Denmark, Copenhagen, Denmark
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Umoren R, Stadler DJ, Gasior SL, Al-Sheikhly D, Truman B, Lowe C. Global collaboration and team-building through 3D virtual environments. ACTA ACUST UNITED AC 2014. [DOI: 10.5339/igmhe.2014.1] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
Certain aspects of healthcare education are difficult to teach in real world environments or in isolated classroom settings. These include, but are not limited to, collaboration and interdisciplinary teamwork skills that are necessary for improved team performance and patient care outcomes. Virtual simulation is a growing field for training and continuous professional development activities and is conducive to local and international clinical training and collaborative projects.
The authors examine theories of collaboration applied to virtual worlds, along with case studies, to demonstrate virtual simulation's applicability to a variety of teaching environments.
In addition, virtual environments have applications to interprofessional healthcare training and team formation. International partnerships for education can benefit from using virtual environments to foster team-building activities without geographic boundaries.
Virtual environments have been instrumental in the growth and sustainability of international networks of educators and, when feasible, should be utilized as a tool for the development of international partnerships.
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Affiliation(s)
- Rachel Umoren
- 1Assistant Professor of Clinical Pediatrics, Indiana University School of Medicine, Indianapolis, Indiana
- 2Faculty Fellow, Institute for Digital Intermedia Arts, Ball State University, Muncie, Indiana
| | - Dora J. Stadler
- 3Assistant Professor of Medicine, Weill Cornell Medical College in Qatar, Doha, Qatar
| | | | - Deema Al-Sheikhly
- 5Manager, Continuing Professional Development, Weill Cornell Medical College in Qatar, Doha, Qatar
| | - Barbara Truman
- 6Simulation Strategist & President, Fusion Unlimited Networks Research, Orlando, Florida, Orlando, Florida
| | - Carolyn Lowe
- 7Associate Professor, School of Education, North Michigan University, Marquette, Michigan
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