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Original article
Ophthalmic simulated surgical competency assessment rubric (Sim-OSSCAR) for trabeculectomy
  1. William H Dean1,2,
  2. John Buchan1,
  3. Fisseha Admassu3,
  4. Min J Kim4,
  5. Karl C Golnik5,
  6. Andrew McNaught6,
  7. Matthew Burton1,7
  1. 1International Centre for Eye Health, London School of Hygiene and Tropical Medicine, London, UK
  2. 2Division of Ophthalmology, University of Cape Town, Cape Town, South Africa
  3. 3Ophthalmology, Gondar College of Medical Sciences, Gondar, Ethiopia
  4. 4Faculty of Infectious and Tropical Diseases, London School of Hygiene and Tropical Medicine, London, UK
  5. 5International Council of Ophthalmology, San Francisco, California, USA
  6. 6Ophthalmology, Gloucestershire Hospitals NHS Foundation Trust, Cheltenham, UK
  7. 7Moorfields Eye Hospital, London, United Kingdom
  1. Correspondence to Dr William H Dean; whd1_uk{at}hotmail.com

Abstract

Background/aims To develop, test and determine whether a surgical-competency assessment tool for simulated glaucoma surgery is valid.

Methods The trabeculectomy ophthalmic simulated surgical competency assessment rubric (Sim-OSSCAR) was assessed for face and content validity with a large international group of expert eye surgeons. Cohorts of novice and competent surgeons were invited to perform anonymised simulation trabeculectomy surgery, which was marked using the Sim-OSSCAR in a masked fashion by a panel of four expert surgeons. Construct validity was assessed using a Wilcoxon rank-sum test. Krippendorff’s alpha was calculated for interobserver reliability.

Results For the Sim-OSSCAR for trabeculectomy, 58 of 67 surgeons (86.6%) either agreed or strongly agreed that the Sim-OSSCAR is an appropriate way to assess trainees’ surgical skill. Face validity was rated as 4.04 (out of 5.00). Fifty-seven of 71 surgeons (80.3%) either agreed or strongly agreed that the Sim-OSSCAR contents represented the surgical technique of surgical trabeculectomy. Content validity was rated as 4.00. Wilcoxon rank-sum test showed that competent surgeons perform better than novices (p=0.02). Interobserver reliability was rated >0.60 (Krippendorff’s alpha) in 19 of 20 steps of the Sim-OSSCAR.

Conclusion The Sim-OSSCAR for trabeculectomy, a newly developed and validated assessment tool for simulation glaucoma surgery, has validity and reliability. It has the potential to play a useful role in ophthalmic surgical education.

  • treatment surgery
  • glaucoma
  • medical education

This is an open access article distributed in accordance with the Creative Commons Attribution 4.0 Unported (CC BY 4.0) license, which permits others to copy, redistribute, remix, transform and build upon this work for any purpose, provided the original work is properly cited, a link to the licence is given, and indication of whether changes were made. See: https://creativecommons.org/licenses/by/4.0/.

https://doi.org/10.1136/bmjophth-2019-000313

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    Footnotes

    • Contributors WHD, JB, KCG, AMN and MB designed the study. All authors contributed to the conducting of the study. WHD and MJK analysed the results. All authors contributed to the draft of manuscript and editing of the final paper.

    • Funding British Council for the Prevention of Blindness, Ulverscroft Foundation, CBM. MJB is supported by the Wellcome Trust (207472/Z/17/Z). JCB is supported by the Queen Elizabeth Diamond Jubilee Trust through the Commonwealth Eye Health Consortium.

    • Competing interests None declared.

    • Patient consent for publication This is an ophthalmic surgical competency assessment rubric validation paper, and as such no patients or public were involved in the design or conduct of this study.

    • Ethics approval The validation study was approved by the Medicine Education Ethics Committee (MEEC), Faculty Education Office (Medicine), Imperial College, London (MEEC1415-12); and London School of Hygiene & Tropical Medicine ethics committee (11 795).

    • Provenance and peer review Not commissioned; externally peer reviewed.