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Background

This study aims to assess whether ophthalmic surgical skills can be taught successfully online to a diverse international and interprofessional student group.

Methods

Mixed methods study involving 20 students and 5 instructors.

Each student completed a pre-session and post-session questionnaire to assess their perceptions regarding online instruction. Changes in questionnaire responses were analyzed using Wilcoxon signed-rank (SPSS 25). Semi-structured interviews were conducted to assess instructor perceptions towards virtual surgical skills teaching. Thematic analysis was undertaken using NVivo 12.0 software.

Results

There was a 100% completion rate of pre-and post-session questionnaires.

Prior to the session, lack of instructor supervision and inability to provide constructive feedback were emergent themes from students. Pre-session concerns regarding online delivery: 40% of students thought their view of skills demonstration would be negatively impacted, 60% their level of supervision and 55% their interaction with instructors. Following the session 10%, 15% and 5% held this view respectively. All students were ‘satisfied’ or ‘very satisfied’ regarding the ‘Surgeon’s View’ camera angle as well as the use of breakout rooms. 75% perceived an improvement in their confidence in instrument handling, 80% in cable knot tying and 70% in suture tying.

Overall student rating for the virtual surgical skills session was 8.85 (±1.19) out of 10 (10 being most satisfied).

Conclusions

We demonstrate that the successful delivery of a virtual ophthalmic surgical skills course is feasible. We were able to widen accessibility and participation through virtual delivery, which has future implications for ophthalmic surgical teaching and its reach.

Introduction

The Covid-19 pandemic has not only hindered ophthalmic residency training and progression; it has also disrupted vocational university courses such as medicine and dentistry [1, 2]. Students have had to contend with reduced face-to-face teaching; this includes lectures, simulation sessions, and clinical placements [2]. Lecture-based teaching has been successfully transferred online via virtual platforms such as Blackboard Collaborate®, Microsoft Teams®, and Zoom® [3]. Simulation and clinical bedside teaching, however, have not been as readily transferable to the online setting due to lack of accessibility of equipment, face-to-face instruction, and direct patient contact [4, 5].

Simulation is associated with large gains in knowledge, skills, behaviors and is, therefore, a mainstay of both undergraduate and postgraduate medical education [6, 7]. Non-essential travel and social distancing guidance have meant that surgical skills simulation practicals have had to be canceled. Recently some educators have shifted these face-to-face sessions online [8].

The University College London (UCL) Ophthalmology Masters program offers basic ophthalmic surgical skills training sessions as part of the curriculum, to an inter-professional group of students. Prior to the pandemic, students from all over the world would attend this course in person. Historically, the glaucoma module surgical skills session would take place in a dedicated dry lab. Since August 2020, tutors were asked to adapt their teaching so that it could be delivered exclusively online.

Aims

This study aims to assess whether ophthalmic surgical skills can be taught successfully to a diverse interprofessional student group via a virtual platform.

Materials & methods

Preparation

In preparation for the virtual surgical skills session, students were sent ophthalmic surgical kits in advance. Each kit contained: three suture packs, toothed forceps, Castroviejo needle holder, and Westcott scissors. Students were emailed instructions prior to the session which included which fruits to use for the practical, how to prepare them and what to expect on the day.