151. The Cataract Surgery Learning Curve: Quantitatively Tracking a Single Resident's Operative Actions Throughout Their Training
- Author
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Michael Balas, Jason M. Kwok, Ana Miguel, Amrit Rai, Amandeep Rai, Iqbal Ike K. Ahmed, and Matthew B. Schlenker
- Subjects
Ophthalmology - Abstract
To track operative phases of cataract surgery over a resident's training to measure action times and frequencies as a surrogate for competency and skill progression.An n=1 panel study.We collected cataract surgery video recordings performed by a single resident between 2021-2022. Only full-length videos of adequate quality without supervisor intervention were included. The start and end times of 19 distinct operative phases of cataract surgery were manually labelled by a trained annotator. Timeseries analysis was employed to measure the direction and magnitude of trends in the resident's surgical timing for each action across their first year of training.The dataset comprised 100 videos spread across the resident's 6-760 cases. The median total time was 11.6min (interquartile range: 10.1min-14.4min), with overall speed increasing at a rate of 43.4s for every 10 videos (95% CI: 35.1s-52.7s). Nine operative phases significantly decreased in time throughout training. The main incision, phacoemulsification, and hydrodissection had the greatest improvements in speed relative to their average procedural time. There were an average 26.9 distinct operative actions (excluding idle periods) in each video (range: 20 to 50).This is the first study to quantitatively track operative times and frequencies across all relevant actions in cataract surgery and derive learning curves for each. Consistent with previous works, we found that a basic level of surgical competency is achieved after performing 80 cases. In addition, results from this study indicate that the next level in skill advancement towards surgical finesse occurs after 300 cases.
- Published
- 2023
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