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IAPB Essential List: Simulation-based Learning (Cataract Surgery)

Clinical simulation in health

Simulation is designed to replicate clinical scenarios in order to augment learning of diagnostic or surgical procedures through deliberate practice. This list describes the items required for learning cataract surgery in a simulated environment. Skills acquired within a simulated environment have been shown to transfer to improvements in procedures on actual patients. Further, the use of simulation in health professions education:

  • has become ethically “imperative” due to patient safety concerns, the need to reduce avoidable medical errors and to protect patients whenever possible.
  • provides an alternative and equivalent experience to cadaveric and animal models, which have ethical and moral issues surrounding their use.
  • provides many and immediate training opportunities: learners don’t have to wait for a particular “real-life” case or pathology to present itself.

What does this list contain?

This list contains recommendations for a range of equipment, instruments, consumables and pharmaceuticals learners can use to practice in a simulated environment to prepare them to do surgery. Ideally the skills laboratory should include as many of the same instruments and equipment that the students are likely to use in future, in order for them to become familiar with these.

  • We recognise that some options included in the Essential List are expensive or may be unobtainable in certain areas, but nevertheless these represent aspirational best practice.
  • Where possible we have suggested alternatives to help training institutions to contain costs and ensure simulation training is as cost-effective as possible.

Three sections

To learn a new skill, quantity of practice is necessary, but optimal performance is dependent on the quality of the practice itself. Practice makes perfect, but practicing the wrong technique does not.

Therefore, in addition to ensuring that the items required in a digital, dry and wet lab for optimal learning are available, the envisaged learning outcomes should be included within structured cataract surgery curricula, both for those initially learning cataract surgical procedures to those wishing to continue their professional development in this field. This list thus separated into the following sections:

Flowchart of simulation in cataract surgery from step 1, Simulation Plus: Learning and Assessment Material to step 2 Digital Labs involving Videos, online tutorials/feedback and Virtual reality and then finally step 3 Surgical Skills Labs such as Dry Labs and Wet Labs.