Simulation Ophthalmic Surgical training

This followed a stringent research project to validate the methodology of simulation training, led by A/Prof William Dean between 2017 and 2019.^1,2 

A fully equipped SOS training unit has been set up, including a 5-station digitally connected MSICS ‘dry lab’, and a four-station Phaco ‘wet lab’. To date, a total of 94 trainees have participated in the training (see table).  The BMS and Phaco trainings were self-administered through guidance by the lead trainers. The trainees of 2019 and 2020 included nationals from Democratic Republic of Congo, Cameroon, Rwanda, Uganda, Kenya, Namibia, Myanmar, Thailand, Libya and South Africa.  Due to Covid-19, only South Africans participated in the training since 2021. In 2022, a full schedule of training was possible.

*These were self-directed training with guidance and support from the lead trainer, Prof Dean

In addition, a total of 12 trainers have been trained, 5 in MSICS, 6 in glaucoma surgery and three in Phaco.  This greatly expanded the capacity of UCT-CEHI to deliver SOS Training courses.

Because of the Covid-19 restrictions, there has been a slowing of SOS Training activities from 200 to 2021.  UCT-CEHI, in partnership with Envision Africa set up a Phaco “wet lab” to provide registrars in Cape Town opportunity to practice their skills in the absence of elective surgery lists. Genop and Alcon also provided phaco equipment and consumable that enabled the setting up of the phaco training stations. 

At the same time, fund-raising was initiated for the purchase of an EyeSI surgical simulator.  Thanks to generous support from CBM, Envision Africa and Genop, the equipment is due to be installed and commissioned for use in early 2023.

From 2023, a full schedule of training courses is offered, plus the exciting resource of self-administered simulation surgical training and assessment, the EyeSI  It is anticipated that a minimum of 60 ophthalmic surgery trainees will complete the cataract and glaucoma surgical training every year, with double the amount being served by the EyeSI simulator.

The courses are for ophthalmologists, ophthalmology registrars and eye surgeons from low- and middle- income countries, for competency training or up-skilling in the relevant surgical technique. Senior ophthalmic surgeons will also be invited as faculty through a Training-the-Trainers orientation. From April 2024, interested candidates should complete an application form on the Ophthalmology website, following this link: https://sites.google.com/view/sostraining/home. Information about schedules, fees, funding support, and course details can also be found there.

The courses take place at the UCT-CEHI Simulated Ophthalmic Surgery (SOS) Training Unit at Groote Schuur Hospital, Cape Town, South Africa.  Candidates for the training may come from any of the countries in the sub-Saharan African region and other lower- and middle- income countries (LMICs).

The courses, with duration ranging from 1 to 3 days, involve intense practical simulation-based surgical education with expert surgeon trainers, using high fidelity synthetic eyes.  The courses are blended, with on-line study modules in the weeks beforehand. The surgical procedure is deconstructed to its component parts, and trainees build competency through sustained deliberate practice, feedback, reflective learning, and real-time moderation during the training, see programme. Formative assessment and detailed evaluation are built into the course.

The support and funding provided by our sponsors, partners and collaborators is very much appreciated and will go a long way towards meeting the ambitious objectives of the UCT-CEHI SOS Training programme.  The initiative has enjoyed tremendous support, both from a funder’s perspective, and from faculty and trainers. Candidates are eager to build their skills, competence, and confidence for more effective, efficient, and safe ophthalmic surgical practice; and feedback has been overwhelmingly positive.

We thank you for your interest in and support for the UCT-CEHI SOS Training programme.

¹Dean WH, Gichuhi S, Buchan JC, et al. Intense Simulation-Based Surgical Education for Manual Small-Incision Cataract Surgery: The Ophthalmic Learning and Improvement Initiative in Cataract Surgery Randomized Clinical Trial in Kenya, Tanzania, Uganda, and Zimbabwe. JAMA Ophthalmol. 2021;139(1):9–15. doi:10.1001/jamaophthalmol.2020.4718 2022

² Dean WH, Buchan J, Gichuhi S, et al. Simulation-based surgical education for glaucoma versus conventional training alone: the GLAucoma Simulated Surgery (GLASS) trial. A multicentre, multicountry, randomised controlled, investigator-masked educational intervention efficacy trial in Kenya, South Africa, Tanzania, Uganda and Zimbabwe. Br J Ophthalmol 2021