JAO : VOL 2 Issue 1 2009
Assessment of Resident Cataract Surgery Instrument Knowledge
2009, Volume 2, Number 1 11 Introduction In the United States, greater emphasis is being placed on efficiency in the delivery of health care, acquisi-tion and verification of resident knowledge and skill as well as clinical evidence of proficiency with regard to patient outcomes [1-2]. In a response to this call for accountability, the Accreditation Council for Gradu-ate Medical Education (ACGME) has attempted to standardize residency program curricula over a set of core competencies deemed integral to resident educa-tion. Additionally, the American Board of Ophthal-mology (ABO) has recognized that a surgical skill competency is essential to ensure that all aspects of ophthalmology training are adequately assessed [3-5]. However, despite these requirements for standardiza-tion of resident education curriculum, the adoption and implementation of these competencies has met with varied results amongst the different medical spe-cialties and residency programs. Recent work within the field of ophthalmology has demonstrated numer-ous barriers to the full implementation of these com-petencies [6]. It is reasonable that the creation of stan-dardized, reliable educational tools can facilitate this Assessment of Resident Cataract Surgery Instrument Knowledge Timothy Sullivan 1 , David C. Musch, PhD, MPH 1,2 , Wesley Millican 3 , Tara Uhler, MD 4 , Steven J. Gedde, MD 5 , Andrew G. Lee, MD 6 , Karl C. Golnik, MD 7 , and Shahzad I. Mian, MD 1 1 Department of Ophthalmology and Visual Sciences, W.K. Kellogg Eye Center, University of Michigan Medical School, Ann Arbor, MI 2 Department of Epidemiology, School of Public Health, University of Michigan, Ann Arbor, MI 3 Career Physician, Ft. Worth, TX 4 Wills Eye Institute, Thomas Jefferson University, Philadelphia, PA 5 Bascom Palmer Eye Institute, Miller School of Medicine, University of Miami, Miami, FL 6 Department of Ophthalmology, The Methodist Hospital, Weill Cornell Medical College, Houston, TX 7 University of Cincinnati & the Cincinnati Eye Institute, Cincinnati, OH * Corresponding Author & e-mail: smian@umich.edu Abstract To determine efficacy of a web-based tool for assessing residents' knowledge of instruments used in cataract sur-gery. Seventy-seven ophthalmology residents and 4 faculty physicians at 15 ACGME-accredited ophthalmology resi-dency programs completed the cataract instrumentation module, consisting of a pre-test, instructional database and post-test on 28 instruments. Post-test score improved by 6.7 ± 4.3 questions (24.1 ± 15.5 %) when compared to the pre-test score among all respondents (<0.0001). PGY2 residents had the most substantial improvement in score (33.0 ± 14.0 %) but had lower post -test scores when compared to PGY3 and PGY4 residents (-values 0.0002, <0.0001, respectively). There were no signifi-cant differences in post-test scores between PGY3 and PGY 4 residents, and faculty physicians, or based on residency train-ing program. The cataract surgical instrument module improved knowledge of instruments at all training levels. PGY 2 residents have the highest potential for gaining knowledge; a ceiling effect may impact on potential gain at higher training levels. This module is an effective way to augment resident education in cataract surgical instrumentation. Accepted for publication November 13, 2008 Revision received December 11, 2008 2009; 2: 11-14. Available via open-access on the web at http://www.academic-ophthalmology.com Wesley Millican is president & CEO of CareerPhysician. The other author(s) have no personal financial interest.  2009