Ophthalmology Business

SEP 2017

Ophthalmology Business is focused on business topics relevant to the entrepreneurial ophthalmologist. It offers editorial, opinion, and practical tips for physicians running an ophthalmic practice. It is a companion publication of EyeWorld.

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September 2017 • Ophthalmology Business 15 upon a time the adage, at least at Hopkins, was, 'See one, do one, teach one,' and times are changing; patients are savvier," she said. "They are aware that there are resident surgeons and attending surgeons and they want to know who is doing their surgery and how competent they are. The burden is on us to pro- duce the best surgeons as quickly and as efficiently as possible." OB Reference 1. Puri S, et al. Assessment of resident training and preparedness for cataract surgery. J Cata- ract Refract Surg. 2017;43:364–368. Editors' note: Dr. Sikder has no financial interests related to her comments. Contact information Sikder: ssikder1@jhmi.edu with a senior surgeon was considered so valuable," she said. Meanwhile, taking a more passive tack left residents feeling less ready. "The data showed that a more passive approach of lecturing and showing videos isn't sufficient any- more to prepare residents," Dr. Sikder said, adding that more clinical expe- rience, whether it be real or virtual, is critically important. Dr. Sikder hopes practitioners come away from the study with the realization that with a little imag- ination, there are various effective options for training residents. "I think the take-home message is you have to use the different tools that are available in a creative way to help residents master surgical skills," she said. Dr. Sikder views this as an excit- ing time to be focusing on resident education with new methods now available. "The reality is that once greatest impact. "What we found was that supervising practice, whether with an attending surgeon or a more senior resident helping the train- ee to get experience on an animal or synthetic eye, is often the most statistically significant parameter in a resident's perception of educational value," Dr. Sikder said. She added that a small program without a ton of resources doesn't have to spend a lot of money on a surgical simulator as this is not the only tool that will build residents' confidence. Another resource that had a great impact was spending time with residents. "Having an attending or a more senior resident going through several steps was perceived to be very valuable in the resident's education," Dr. Sikder said. "I think this is a crit- ical learning point because it means that at the end of surgery, they may be needing a little practice while you're in the OR." All you need is ac- cess to a microscope to go over some of these critical steps for cataract surgery, Dr. Sikder stressed. Investigators also considered the specific steps within cataract surgery and the impact of various training methods. "The higher-yield interven- tions were using a surgical simulator or having a detailed discussion with a senior surgeon or processing in a wet lab," Dr. Sikder said. When it comes to making a capsulorhexis, which is something that residents often find stressful, this is an area where having a surgical simulator can be helpful, but practicing this step with a senior surgeon can likewise improve confi- dence, Dr. Sikder noted. She was surprised that a relative- ly simple intervention such as a dis- cussion could have such a profound effect; this was contrary to her im- pression that residents tend to want hands-on experience. "I found it refreshing that a detailed discussion

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