Abstract: The highly competitive offer of medical training programs and schools, globalization and constant mobility of physicians and medical students (MS), and the commitment to society to deliver competent physicians, demands the definition of performance standards. This would allow to make their performances comparable no matter where they studied or which textbook did they used as reference, to have evaluation mechanisms that guarantee mastery of the integral evaluation of the performance. Assessment has been the key in the teaching-learning process as this obtains a formative and summative element, at different moments, from the extent to which the students have acquired knowledge, skills and attitudes. The progress of the learner must be enhanced with effective feedback on their performance and self-direction of the results obtained in each of the mechanisms established. If, traditionally, this has been considered as the accreditation of compliance with a standard, the evaluation also functions in an integral way as a formative process that identifies advances and deficiencies in the training of residents that allows the definition of actions and strategies for improving the operation of the programs. Different assessment mechanisms are associated with the areas of competence domain, some of the most common tools are: theoretical exams, checklists and rubrics, portfolio, projects and challenges. However, the importance of defining standards which are perceived as fair and designed according to the learning objectives remains a priority to guarantee the credibility of the evaluation agencies and institutions. Some strategies to assure credibility include the involvement of expert and trained evaluators, allowing the process to be carried out with transparency and diligence, and the principles employed should be supported by educational research.
Abstract: Program accreditation is usually a voluntary process based on published standards and performed by a governmental or non-governmental agency of peers. The accreditation process has several components: self-assessment guide completion, site visit and review of program data by the accrediting body. Program accreditation’s primary function is to facilitate self-assessment, provide standards of education and lead to program improvement. It also serves to protect the student’s education and ultimately improve patient care. The International Council of Ophthalmology has developed International Guidelines for accreditation of ophthalmology residency programs and is launching a pilot program to accredit programs on demand.
Abstract: The goal of ophthalmology residency training is to produce competent ophthalmologists. Appropriate assessments must be employed to ensure this goal is met. Valid and reliable workplace-based assessments are designed to assess competence in the many domains required of a good ophthalmologist. These assessments increase standardization and objectivity as compared to simple observational feedback. When used appropriately, workplace based assessments not only provide measures of competence but also facilitate effective formative feedback and enhance learning.
Abstract: Cataract surgery is arguably the most commonly performed operation in ophthalmology. Surgical skills transfer from experienced surgeons to resident surgeons is complicated by the fact that the teaching surgeon primarily acts as an observer rather than directly performing the procedure. Therefore, wet lab and simulator training are utilized to reduce the learning curve of the novice surgeons, which establishes tissue awareness, dexterity and muscle memory required to perform each step of the procedure, safely. Access to a wet lab and simulator environment is accomplished by establishing a surgical training curriculum in residency programs. In the operating room, topical anesthesia is a safe alternative for teaching cataract surgery. There are three well-described approaches to teaching individual steps of cataract surgery: forward, “backwards”, and deconstructed step-by-step instruction. Simulator training can be incorporated prior to live patient experience or integrated concurrently with learner presence in the operating room. The trend towards a competency-based instruction model has necessitated appropriate evaluation tools that include Objective Assessment of Skills in Intraocular Surgery (OASIS), Global Rating Assessment of Skills in Intraocular Surgery (GRASIS), and the International Council of Ophthalmology’s Ophthalmology Surgical Competency Assessment Rubrics (ICO-OSCAR). We review the literature on trends in surgical teaching in ophthalmology, with the focus on cataract surgery instruction to the novice surgeon.
Abstract: In a rapidly changing world, there is an increased need to cultivate ophthalmologists who are not only technically capable but also possess the leadership skills required to be at the forefront of change. Ophthalmologists make daily frontline decisions that determine the quality and efficiency of care based on their leadership qualities. However, they also educate, advocate, perform research, run departments and work in practices—all of which require the practice of effective leadership. Although the need for ophthalmic leadership has been recognised, few training programs offer leadership skills as a component of their core curricula, focussing on clinical knowledge with less emphasis on teaching of non-clinical professional competencies. Clinicians who participate in leadership development are more likely to feel empowered to provide patient-centred care, develop a greater self-awareness and confidence to initiate positive change and promote better team alignment. In turn, the ophthalmic profession collectively benefits from effective leadership as organizations are better run, issues are advocated more globally and challenges are address holistically by ophthalmologists who are not merely technically capable surgeons or researchers, but effective communicators and collaborators. In this paper, we explore the role of leadership in the spheres of healthcare and ophthalmology. We discuss the value of leadership across clinical, educational and organisational levels, with specific emphasis on the current state of development and conclude with a series of recommendations to ensure the continued development of effective ophthalmic leaders into the future.
Abstract: The teaching of professionalism, a key aspect of medical competence that regulates physician’s behavior towards patients, colleagues, society, and self, should be included in the curriculum of every training program. Studies suggest a variety of formats to teach and evaluate professionalism in residents, being role modeling, reflection, case discussions, and 360-degree assessments the most commonly used. However, little is published about the need to train faculty for teaching and evaluating professionalism, or how to improve institutional culture, so that principles that are indicated to teach in theory are also fulfilled in practice.
Abstract: Timely and widely available, social media (SM) platforms and tools offer new and exciting learning opportunities in medical education. Despite scarce, we sought for a body of consistent evidence allowing us to substantially approach the concept of SM and how physicians as learners and medical educators can use SM based-education to benefit their clinical practice and their patients’ outcomes. We correlate education theories with the progression of world-wide web phases and how this influences the process of teaching and learning. We mention some examples of SM tools already in use in healthcare education. Potential advantages and effectiveness SM in medical education, as well as limitations of SM and pre-requisites for its use are discussed. Our concluding remarks underline the good practices in effectively utilizing SM in healthcare education.
Abstract: Training in residency programs is highly competitive, it requires the formation of competent physicians that achieve the performance standards that were declared for their technical skills, attitudes and interpersonal abilities. The use of simulation and technology on the medical education has increased considerably. Particularly in ophthalmology the simulators used are: live models from animal or cadavers, mannequins, wet laboratories, simulated patients, part-task moles, laser or surgical models, and more recently, virtual reality (VR). VR places a person in a simulated environment that has a specific sense of self-location, where the participant interacts with the objects within the setting. Teaching with VR refers to the use of the available resources in technology and visualization of structures to improve the educational experience of medical students, residents and physicians in professional continuous development programs. Several authors highlight the benefits of assessing trainees with the tools, they argue that the key contribution of this model is in the formative assessment. Rather than evaluating and putting a score on student’s grades, VR provides a powerful experience for the acquisition of skills. A conclusion is the need to develop studies to document the effects that it has on knowledge, skills and behaviors, and to patient related outcomes.
