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Principles of Assessement and Effective Feedback.

Authors: Jorge Eugenio Valdez-García, Mildred Vanessa López-Cabrera, Elena Ríos Barrientos.
View this article at: http://aes.amegroups.com/article/view/3758/html.

The highly competitive offer of medical training programs and schools, globalization and constant mobility of physicians and medical students, 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.

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* I have no financial interest to disclose (GP).

Teaching in the operating room: trends in surgical skills transfer in ophthalmology

Authors: Anastasia Neufeld, Laura L. Hanson, Jeff Pettey.
View this article at: http://dx.doi.org/10.21037/aes.2017.06.05.

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). Authors review the literature on trends in surgical teaching in ophthalmology, with the focus on cataract surgery instruction to the novice surgeon.

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* I have no financial interest to disclose (GP).

The Fallacy of the Traditional Classroom: Why We Need to Flip the Classroom

Author: Eduardo P. Mayorga.
doi: 10.21037/aes.2017.05.07.

This perspective describes and justifies the need for looking for alternatives for the traditional lecture classroom such as the “flipped classroom”. The author describes a 4-step process for building the class. Suggestions are made on how to create or curate material for lectures and software for generating interactivity in the active part of the classroom.

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* I have no financial interest to disclose (GP).

Program & faculty evaluation

Author: Andreas K. Lauer.
Ann Eye Sci 2017; 2:44.

Graduate medical education (GME) has shifted its curricula from process-oriented approach to outcomes-oriented models. Program and faculty evaluation are methods by which educational curricula may adjust the teaching and learning environment to meet the needs and fills the gaps in GME. The measurement of educational outcomes is an essential for assessing teaching effectiveness in a shifting health care environment. In addition to trainee, program, and faculty evaluations, annual program review (APR) and evaluation and navigational changes made by the program education committee are essential to maintain effectiveness of an educational curriculum in a contemporary graduate medical training program.

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* I have no financial interest to disclose (GP).

Program accreditation

Author: Karl C. Golnik.
Ann Eye Sci 2017; 2:45.

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.

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* I have no financial interest to disclose (GP).

Continuing professional development: progress beyond continuing medical education.

Author: Helena Prior Filipe, Heather Gwen Mack, Karl C. Golnik.
Ann Eye Sci 2017; 2:46.

Continuing medical education (CME) is rapidly evolving into competency-based continuing professional development (CPD) and this is driving change in self-directed CPD programs undertaken by individual practitioners as well as CPD programs or frameworks offered by CPD educators. This progression is being led by many factors including the rapid change in medical knowledge and medical practitioners along with changes in patients and society, healthcare systems, regulators and the political environment. We describe our experiences primarily concerning low-resource environments, in creating the International Council of Ophthalmology (ICO) Guide to Effective CPD/CME and in developing a CPD program for the Cambodian Ophthalmological Society (COS) twinned with the Royal Australian and New Zealand College of Ophthalmologists (RANZCO). At the conclusion of the project, 47 (100%) Cambodian practicing ophthalmologists were registered in the CPD program and 21 (45%) were actively participating in the online COS-CPD program recording. We discuss challenges in CPD, propose solutions to overcome them and recommend developing research in CPD as needed to effectively enhance educational activities with impact in public health.

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* I have no financial interest to disclose (GP).

A fundamental (often neglected) lecture skill: presenting with credibility

Author: Ana Gabriela Palis, MD.
Ann Eye Sci 2017; 2:38.

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).

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* I have no financial interest to disclose (GP).

The good doctor: more than medical knowledge and surgical skill

Authors: Andreas K. Lauer, Dariah A. Lauer.
Annals of Eye Science, July 2017. doi: 10.21037/aes.2017.05.04.

In this Editorial, authors explain the whole spectrum of medical competencies as defined by the Accreditation Council for Graduate Education, and other attributes (open-mindedness, empathy, compassion, calmness, attentiveness, adaptability, self-improvement, passion, confidence, and humility) that, in addition to strong medical knowledge and outstanding surgical skills are essential to becoming a good doctor.

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* I have no financial interest to disclose (GP).

Operating Room Performance Improves after Proficiency-Based Virtual Reality Cataract Surgery Training

Authors: Ann Sofia Skou Thomsen, Daniella Bach-Holm, Hadi Kjaerbo, Klavs Hojgaard Olsen, Yousif Subhi, George Saleh, Yoon Soo Park, Morten la Cour, Lars Konge.
Ophthalmology 2017; 124(4):524-31.

Authors’ main purpose for this study was to investigate the effect of virtual reality proficiency-based training on cataract surgery performance. Their secondary objective was to define which surgeons benefit from virtual reality training. Through a multicenter masked clinical trial, eighteen cataract surgeons with different levels of experience received training in cataract surgery on a virtual simulator (EyeSi) until a proficiency-based test was passed. Results showed that non-independently operating surgeons and surgeons having performed fewer than 75 independent cataract surgeries showed significant improvements in the operating room, while more experienced cataract surgeons did not benefit from simulation.

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* I have no financial interest to disclose (GP).

An evidence-based approach to surgical teaching in ophthalmology.

Authors: Alice C. Lorch, Carolin E. Kloek
Surv Ophthalmol 2017; 62(3):371-7.

In this article authors delineate a program of preprocedural, intraprocedural, and postprocedural teaching of ophthalmic surgery to maximize resident’s skill acquisition in a constructive learning environment.

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* I have no financial interest to disclose (GP).