Virtual reality ophthalmic surgical simulation as a feasible training and assessment tool: results of a multicentre study

Objective: To compare performance on the Eyesi surgical simulator by users with different levels of experience in ophthalmology. Design: Multicentre cross-sectional study. Participants: Four medical students, 4 ophthalmic medical technologist trainees, 36 ophthalmology residents, 3 fellows, and 18 staff ophthalmologists. Methods: Subjects were recruited at the 2007 Canadian Ophthalmological Society Meeting and in the departments of ophthalmology at the University of Toronto, University of Ottawa, and University of Western Ontario. Subjects performed a standardized 20-minute session on the Eyesi simulator. The protocol consisted of a practice trial in the anterior segment module, followed by 3 scored trials in the anterior forceps, antitremor, and capsulorhexis modules. Results: In the forceps module, participants with greater experience achieved significantly higher total scores than those who were less experienced: staff ophthalmologists (Group D) = 67.9 (SD 18.4), senior residents and fellows (Group C) = 67.6 (SD 21.1), junior residents (Group B) = 52.9 (SD 29.4), medical students and ophthalmic medical technologist trainees (Group A) = 27.8 (SD 29.4) (p = 0.011), with lower total task time (p = 0.044) and fewer injuries to the cornea (p = 0.001) and lens (p = 0.026). In the antitremor module, subjects in Group D achieved significantly higher (p = 0.004) total scores (46.7, SD 21.6) than Groups C (45.8, SD 25.1), B (41.2, SD 29.4), and A (8.5, SD 9.2) with lower total task time (p = 0.005) and fewer errors (p = 0.003). In the capsulorhexis module there was also a positive correlation between experience and total scores achieved (p = 0.065). Conclusions: Subjects' level of training is a reliable predictor of their performance on the Eyesi anterior forceps and antitremor modules (p < 0.05), indicating the modules' construct validity.