Abstract:
background/aims To develop, test and determine
whether a surgical-competency assessment tool for
simulated glaucoma surgery is valid.
Methods The trabeculectomy ophthalmic simulated
surgical competency assessment rubric (Sim-OSSCAR)
was assessed for face and content validity with a large
international group of expert eye surgeons. Cohorts of
novice and competent surgeons were invited to perform
anonymised simulation trabeculectomy surgery, which
was marked using the Sim-OSSCAR in a masked fashion
by a panel of four expert surgeons. Construct validity was
assessed using a Wilcoxon rank-sum test. Krippendorff’s
alpha was calculated for interobserver reliability.
results For the Sim-OSSCAR for trabeculectomy,
58 of 67 surgeons (86.6%) either agreed or strongly
agreed that the Sim-OSSCAR is an appropriate way to
assess trainees’ surgical skill. Face validity was rated as
4.04 (out of 5.00). Fifty-seven of 71 surgeons (80.3%)
either agreed or strongly agreed that the Sim-OSSCAR
contents represented the surgical technique of surgical
trabeculectomy. Content validity was rated as 4.00.
Wilcoxon rank-sum test showed that competent surgeons
perform better than novices (p=0.02). Interobserver
reliability was rated >0.60 (Krippendorff’s alpha) in 19 of
20 steps of the Sim-OSSCAR.
Conclusion The Sim-OSSCAR for trabeculectomy,
a newly developed and validated assessment tool for
simulation glaucoma surgery, has validity and reliability.
It has the potential to play a useful role in ophthalmic
surgical education
