Competency-based education evaluation tools for resident performance in selective laser trabeculoplasty and Nd:YAG laser peripheral iridotomy
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Authors: Danielle D. Wentzell, Christopher Hanson, Helen Chung,
Patrick Gooi
Author Disclosure Block: D.D. Wentzell: None. C. Hanson: None. H.
Chung: None. P. Gooi: Consultant: Alcon, Allergan,
Bausch and Lomb, Glaukos, Santen.
Abstract Body:
Purpose: To develop resident assessment modalities for
performance in selective laser trabeculoplasty (SLT) and Nd:YAG laser
peripheral iridotomy (LPI) that are suitable for the shift to competency-based
medical education (CBME) in ophthalmology.
Study Design: Survey
Methods: A modified Delphi process was used to develop
task-specific checklists and a global rating scale (GRS) for SLT and LPI to
assess resident performance. Well-established and previously studied global
rating scales in surgical performance were adjusted for use in the GRS for
these laser procedures. Eight practicing ophthalmologists with experience in
performing the laser procedures were identified and agreed to be content
experts. SimulEYE artificial eye models specifically designed for each laser
procedure were used to develop the tools. The laser parameters and results in
the checklist were adjusted to simulate real tissue effect. Content experts
received copies of the assessment tools, videos of the eye models being used
with the lasers, and a survey to collect feedback. The survey design was based
off a previously study that utilized the Delphi method in ophthalmology
education development. The comments were implemented into the assessment tools
and redistributed to the content experts for further critiquing. The process
was repeated until an 80% consensus on all survey items was achieved. Each
round was completed over ten days, and consensus was reached after three
rounds.
Results: A task-specific checklist for SLT and LPI, and a GRS to be
used in conjunction with the checklists were produced with face and content
validity.
Conclusions: Ophthalmology residency programs across Canada are
implementing CBME into their curricula, and proof of competency in various
procedural tasks will be required. These assessment tools can be used to
evaluate resident performance in two commonly performed laser procedures that
residents must be able to perform prior to graduation - selective laser
trabeculoplasty and laser peripheral iridotomy. These tools allow for residents
to develop their skills and receive feedback before performing these laser procedures
on real patients. We have established face and content validity for these
tools, however interrater and construct validity will need to be assessed in
future studies.