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.
Background: The “flipped classroom” is a learner-centered approach that centers on delivering videos, podcasts or slide-based material to learners prior to a lecture or class session. The class session is then dedicated to discussion, analysis, and problem-solving activities. The aim of this study was to investigate whether the flipped classroom could be adapted to medical (ophthalmology) students learning about ocular trauma and to assess the impact of the flipped classroom on those students’ performance and attitudes.
Methods: Questionnaires (using a 4-point scale) were distributed to 93 fifth-year medical students at Sun Yat-sen University, and the data showed that the majority of students preferred the flipped classroom approach to the traditional lecture method.
Results: The results of pre- and post-test scores were 14.35±3.404 and 20.37±4.356, which showed a significant improvement in students’ performance after the flipped classroom was introduced (P<0.05).
Conclusions: Student response to the flipped classroom strategy was largely positive, indicating that the strategy received a high level of approval in an ophthalmology clerkship course taken by medical students in China.
Abstract: Being credible as medical speakers is a fundamental quality to achieve. Although there are many factors that determine the credibility of a medical presenter, the way presentations are delivered (the lecture’s structure, visual aids, and the lecturer’s communication skills and engagement with the audience) will influence the effect speakers have on their audience and how credible people consider the lecturer, which will ultimately affect students’ learning. This perspective provides recommendations to increase speakers’ credibility through applying common presentation and communication principles in four domains: expertise and competence (e.g., know your audience, organize your presentation, introduce yourself, hold your arguments with evidence, avoid information overload, be prepared to answer questions), authenticity (be an accessible and honest speaker), personal presence (rehearse your presentation, get organized early, enjoy the moment), and dynamism (engage your audience, do not read your slides, explain the data, use images rather than text, avoid distracting your audience, ask and encourage questions).
Abstract: At this point in time, the importance of medical humanities education has not been fully understood during the standardized training of residents in China. The study of medical humanities is an important facet of ophthalmology residency that needs to be strengthened. During the standardized training of ophthalmology residents, not only the medical sciences should be strengthened, but also the nature and practice of medical humanities knowledge should be enhanced in multiple aspects. Offering medically-relevant literature, history, philosophy and other courses, simulating real medical activities, being enthusiastic in popular medical science and increasing the contents of the examination in medical humanities would all be areas that would further advance the ophthalmology residency. Along with medical science education, residents will be led and trained on medical humanities as to build good medical humanistic spirit of patient care so that they may better serve patients.
Abstract: Training qualified ophthalmic professional is crucial for any eye care system worldwide. Education of modern western Ophthalmology in China started late but develops rapidly. This review focused on ophthalmic education in China and US, describing details of the programs and analyzing the differences. This summary may provide useful information for practitioners of medical education from both countries and help improve the present training designs.
Abstract: Primary vitreoretinal lymphoma (PVRL), as a subset of primary central nervous system lymphoma (PCNSL), is a rare and fatal ocular malignancy. Most PVRL masquerades as chronic posterior uveitis, which makes the clinical diagnosis challenging. Vitreous cells, subretinal lesions and imaging techniques are essential for clinical diagnosis. Importantly, cytopathology/histopathology identification of malignant cells is the gold standard for the diagnosis of PVRL. In addition, molecular detection of immunoglobulin heavy chain (IgH) or T cell receptor (TCR) gene rearrangements, immunophenotyping for cell markers, and cytokine analysis of interleukine-10 elevation are often used as adjunct procedures. Current management of PVRL involves local radiation, intravitreal chemotherapy (methotrexate and rituximab), with or without systemic chemotherapy depending on the involvement of non-ocular tissues. In cases with concomitant PCNSL, systemic high-dose methotrexate/rituximab based therapy in conjunction with local therapy, whole brain radiotherapy and/or autologous stem cell transplantation is considered. Although PVRL normally responds well to initial treatment, high rates of relapse and CNS involvement usually lead to poor prognosis and limited survival. A professional team of medical experts in ophthalmologists, ocular pathologists, neuro-oncologists and hemato-oncologists is essential for optimizing patient management.
Background: To explore the safety and effectiveness of Sclera patch grafts in the management of scleral defects.
Methods: This is a retrospective uncontrolled study. Medical records were retrospectively reviewed for 8 eyes of 8 patients with sclera patch grafts. Two patients had necrotizing scleritis, 2 patients had scleral melting/perforation secondary to thermal burns, 4 patients had scleral staphyloma secondary to surgery. Sclera was reconstructed with allogenic sclera patch grafts, 6 in 8 patients combined autologous conjunctival pedicle flap, 1 patient combined partial medial rectus translocation, 1 patient combined autologous pedicle tenon graft, simultaneously. Treatment outcomes were evaluated using structural integrity, best corrected visual acuity (BCVA), scleritis remission, sclera rejection and melt, and ocular symptoms.
Results: Eight patients were reviewed. In all of these cases, satisfactory anatomic and functional outcomes were achieved. In the at least half a year follow-up, the BCVA of all the eight patients were no worse than that of preoperative. No eye pain, foreign body sensation and other discomforts showed in all the patients, except one woman, who showed sclera rejection and melt 1 month postoperative. In addition, one patient showed high intraocular pressure (28 mmHg), which can be controlled by a kind of medicine.
Conclusions: In this series, sclera patch grafts is an effective method for management scleral defects in the at least half a year following-up. Attention should be paid to the sclera patch rejection and melt post operatively.
