Table 3.
Comparisons of practice patterns between the different virtual reality simulators used by respondents.
| EyeSi only (group 1) n = 75 |
HelpMeSee only (group 2) n = 27 |
Multiple simulators (group 4) n = 61 |
Other only (group 3) n = 7 |
p value | |
|---|---|---|---|---|---|
| Gender | |||||
| Female, n(%) | 30 (41%) | 21 (78%) | 30 (49%) | 5 (71%) | 0.007* |
| Number of cataract surgeries performed | 1473 +/- 3710 | 951 +/- 3898 | 1064 +/- 2742 | 1072 +/- 2027 | 0.87 |
| Users among, n(%): | |||||
| Residents | 46 (62.2%) | 15 (55.6%) | 40 (65.8%) | 3 (42.9%) | 0.421 |
| Fellows | 9 (12.2%) | 7 (25.9%) | 7 (11.5%) | 1 (14.3%) | |
| Senior Surgeons | 19 (25.7%) | 5 (18.5%) | 14 (22.9%) | 3 (42.9%) | |
| Duration of equipment with the simulator (years), mean +/- SD | 6 +/- 4.2 | 2.1 +/- 1.6 | 1.4 +/- 1.5 | 1 | - |
| Total training time (hours), mean +/- SD | 32.8 +/- 66.3 | 228.5 +/-888.1* | 34 +/-40.6 | 7.3 +/- 10.2 | 0.04* |
| Module completed, n(%): | |||||
| CAT-C | 38 (51%) | 24 (39%) | - | 0.19 | |
| CAT-D | 30 (40%) | 22 (36%) | 0.64 | ||
| VRT-C | 7 (9.3%) | 3 (4.9%) | 0.33 | ||
| MSICS | 25 (93%) | 37 (61%) | 0.012* | ||
| PHACO | 5 (18.5%) | 11 (18%) | 0.88 | ||
| Complications | 9 (33%) | 6 (9.8%) | 0.014* | ||
| Suturing | 9 (33%) | 7 (11.5%) | 0.027* | ||
| One session training time (hours), mean +/- SD | 2.1 +/- 2.1 | 35.3 +/- 34.1* | 11.7 +/- 20* | 1.3 +/- 0.6 | < 0.001* |
| Estimated impact on OR performances (0–10), mean +/- SD | 5.2 +/- 3.2 | 6.5 +/- 3.2* | 5.7 +/- 3.7 | 2.2 +/- 3.9 | 0.042* |
| Access, n(%): | |||||
| Permanent | 54 (72%) | 5 (18.5%) | 37 (60.7%) | 2 (28.5%) | < 0.001*2 |
| Free of charge | 67 (89%) | 14 (51.9%) | 15 (24.6%) | 3 (42.9%) | < 0.001*2 |
| Supervisor available | 47 (63%) | 24 (88.9%) | 49 (80.3%) | 3 (42.9%) | 0.01*2 |
| Permanent supervisor | 9 (12%) | 22 (81.5%) | 30 (49.2%) | 1 (14.3%) | < 0.001*2 |
| Favorable to SL3: | |||||
| Yes (score > = 3/4) | 36 (48.6%) | 19 (79.2%) | 0.009* | ||
| No (score < 3/4) | 38 (51.4%) | 5 (20.8%) | |||
| Three main positive features reported4 | Realistic; | Easy grasp of instruments; | EyeSi: Capsulorhexis; | Other: | - |
| Phaco; | |||||
| Educational (step-by-step, scoring, feedback, various exercises); | Realistic; | Intraocular navigation; | Reality; | ||
| HelpMeSee: | |||||
| Capsulorhexis training | Haptic feedback | Haptic feedback; | Capsulorhexis; cracking | ||
| scleral tunnel; | |||||
| Error mention | |||||
| Three main missing/to be improved features reported4 | Incisions; | Capsulorhexis (capsulotomy); | EyeSi: | Incisions; | - |
| Incisions; | |||||
| Accessibility (cost); | Haptic feedback, resistance too high; | Difficulty | |||
| HelpMeSee: | More realistic cracking | ||||
| Tissue feedback | Phacoemulsification (more options for nuclear fracture) | Sensitivity; freedom in some steps | |||
CAT, cataract; MOST, Mechanics of Ophthalmic Surgery – Tissues, Tools, Thoughts; MSICS, Manual Small Incision Cataract Surgery; PHACO, phacoemulsification module; SD, standard deviation; SL, surgical license.
*Statistically significant.
1All participants using VRT module had previously reached level CAT-C or CAT-D of cataract module.
2“Other only” was excluded as number of responses < 5, which is under the recommended marginal count for the validity of the independent Chi2 test.
3Answer to the question “would you be favorable to the idea of requiring a surgical license”:
0 = completely opposed.
1 = not favorable.
2 = neutral, don’t know.
3 = moderately favorable.
4 = completely favorable.
4All comments from participants are available on demand.