Introduction
The recent Royal College of Ophthalmologists’ survey of national Simulation Leads in 2021 identified a lack of dedicated time and/or financial resources limiting ophthalmic departments’ ability to provide high quality education through ocular simulation [1]. Engagement with ocular simulation has increased, and has been shown to improve competence and confidence, and lead to less intraoperative surgical complications (posterior capsule rupture/vitreous loss) for junior ophthalmic trainees [2, 3]. While the benefits of surgical simulation are recognised, attitudes of ophthalmic trainees towards surgical simulation have not been documented previously.
Methods
A SurveyMonkey questionnaire was sent to all ophthalmology trainees in Scotland between August to October 2021. The survey comprised ten questions addressing perceptions of surgical simulation, frequency of simulation activity and perceived barriers to accessing simulation. Question types involved multiple-choice, five-point ordinal Likert Scales and full-text answers.
Results
A total of 38 responses were collected (38/68; 55.9% response rate). All training grades were represented (58% ST1-3; 22/38); 29% ST4–6; 11/38); and 13% ST7+; 5/38). There were 23 male (58%) and 15 female (42%) respondents.
87% (33/38) of respondents reported being either satisfied or very satisfied with their EYESI simulation experience. 89% (34/38) agreed or strongly agreed that simulation exposure improved their surgical confidence in theatre. Nearly all trainees (95%; 36/38) had positive or very positive views regarding simulation as an effective future method of learning (Fig. 1).
Fig. 1. Figure summarising trainees’ opinions on their user experiences with the EYESI simulator.
These included responses regarding surgical confidence, satisfaction with training opportunities and future use of simulation in their training.
The most frequently reported barrier by trainees to using the EYESI simulator was a perceived lack of time in their training rotations (66%, 25/38). Other reported reasons for lack of engagement included the geographic location of the EYESI (n = 6, 15%), technical difficulties (n = 2, 5%), and ‘other’ (not specified, n = 5, 13%).
Discussion
This survey shows positive trainee attitudes towards engaging with ocular simulation in Scotland were able, with high levels of satisfaction and increased confidence in theatre. This was demonstrated with both junior and senior trainees alike, highlighting that simulation is not just for junior ophthalmologists. Similar to the Simulation Leads, a perceived lack of dedicated time was the main barrier to engagement. It would be interesting to see if similar attitudes and barriers exist across the UK. Depending on seniority, ophthalmic trainees in the UK are allocated one or two 4-h dedicated sessions for research, study, teaching and audit (RSTA) with many deaneries requiring specific achievements within this set time. These sessions could be used for completing sections of the EYESI simulator modules, or for surgical technique practice on model eyes, but simulation activity is currently not a formalised session. Geographic distances to access simulators was also seen to be a barrier, an issue which has been previously described [4]. Ongoing investment (both financial and time) from educational bodies will be required to address this, including a greater understanding of the location of trainees related to the simulation equipment [1, 5]. As it stands, the current ‘ad-hoc’ RSTA model may disadvantage trainees based on location and lack of dedicated time, limiting engagement with simulation resources that already exist.
Acknowledgements
A version of this study was an oral presentation at the Scottish Ophthalmological Club meeting, February 2022.
Author contributions
JH and DL had the initial idea. WO performed the survey and drafted the article. JH and DL revised the article and provided senior support. All authors agree with the final accepted version.
Competing interests
DL is the national simulation lead for the Royal College of Ophthalmologists. The remaining authors declare no competing interests.
Footnotes
Publisher’s note Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.
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