Objective structured assessment of cataract surgical skill

Abstract

Objective: To evaluate the Objective Structured Assessment of Cataract Surgical Skill scoring system.

Methods: An objective performance rating tool was devised. This instrument is comprised of standardized criteria with global rating and operation-specific components, each rated on a 5-point Likert scale. The total potential score was 100. Complete phacoemulsification cataract extraction operations were recorded through the operating microscope of surgeons with a range of experience (group A, <50 procedures; group B, 50-249 procedures; group C, 250-500 procedures, and group D, >500 procedures). These were then scored by independent expert reviewers masked to the grades of the surgeons. The U test was used to evaluate statistical significance.

Results: We evaluated 38 surgical videotapes of 38 surgeons (group A, 11 surgeons; group B, 10 surgeons; group C, 5 surgeons; and group D, 12 surgeons). Mean +/- SD overall scores were as follows: group A, 32.0 +/- 5.3; group B, 55.0 +/- 12.6; group C, 89.0 +/- 4.7; and group D, 90.0 +/- 11.1. Statistically significant differences were found between groups A and B (P = .002) and groups B and C (P = .003), but not between groups C and D (P>.99).

Conclusion: The Objective Structured Assessment of Cataract Surgical Skill scoring system seems to have construct validity with cataract surgery and, thus, may be valuable for assessing the surgical skills of junior trainees.