Thursday, July 2, 2015

Ophthalmology Resident Attitudes and Perceptions Towards the Adequacy of Cataract Surgery Training

Alain Proulx, MD, FRCSC, MEd
Ivey Eye Institute/University of Western Ontario

Background: Canadian ophthalmology residents report a high level of satisfaction with the overall quality of their residency training programs. However, ophthalmology program directors often report residents’ anxieties as an indicator of perceived deficiencies in the area of cataract surgery training, especially in the numbers of cases completed by residents. This contradicts the data available from the Royal College of Physicians and Surgeons of Canada as reported by the residency program offices across the country. There is an apparent discrepancy between reported residents’ satisfaction regarding the quality of surgical training programs and the numbers of resident-completed surgical cases reported to the RCPSC.

Purpose: This study investigates the perceptions of current ophthalmology residents and recent graduates towards cataract surgical training, as well as to identify specific areas that would lead to anxieties in relation to their perceived inadequacies.

Methods: This mixed method study used both online surveys and semi-structured interviews with ophthalmology residents to gather information on their perceptions of cataract microsurgical training during residency. The participants of the study consisted of current Canadian ophthalmology residents and recent graduates of ophthalmology residency training. Respondents to the survey were invited to participate in a focused semi-structured interview to gather more detailed and richer information on their perceived anxieties and concerns over this aspect of their training.

Results: Canadian ophthalmology residents are quite satisfied with both the quality and quantity of their microsurgical training. Respondents reported that their programs provide a sufficient caseload to achieve surgical proficiency, and they expected to be prepared for independent practice by the end of their residency. This was corroborated in the survey data obtained from recent graduates of ophthalmology residency training.

Respondents also reported that their surgical preceptors were enthusiastic about teaching, but that barriers exist which might preclude an optimal learning environment in the cataract operating room. In particular, fear of surgical complications and increased case completion time were identified as perceived preceptor concerns.

Conclusion: Findings from this study suggest that residents in Canadian ophthalmology residency training programs feel they are being provided with adequate teaching and sufficient surgical caseloads to achieve proficiency in cataract surgery.