Monitoring and Improving Resident Cataract Experience and Competency Using Kresge Eye Institute Surgical Report Card
Purpose
The Kresge Eye Institute (KEI) developed Surgical Report Card (SRC) in 2012 as a tool to monitor and maximize resident surgical experience and competency. This study aims to assess the effectiveness of the SRC by comparing the cataract experiences between 2013 and 2014 in PGY3 and PGY4 residents.
Methods
The SRC, fully implemented in 2013, is an Excel workbook focusing on each resident’s surgical volume of 17 core procedures including cataract. It has two domains for monitoring surgical competency: Procedure Cards and Outcome Database. Procedure Cards are self-evaluations that residents complete after a procedure with supervising physicians to ensure real-time feedback. Residents are also required to enter cataract surgery variables such as visual acuity, refraction and complications into a Cataract Outcome Database to monitor progress and refine surgical preferences/techniques individually. The SRC also monitors the completion status of mandatory surgical training programs such as cataract surgical simulator.
Results
At the end of their residency (PGY4), Class 2013 and Class 2014 graduates completed 127.7 and 150.1 cataracts (p<0.05), 12.1 and 22.6 YAG capsulotomies (p<0.01), and 11.8 % and 24.4% (p=0.20) of surgical simulator modules, respectively. At the end of their second year of residency (PGY3), Class 2014 and Class 2015 completed 15.6 and 19.0 cataracts (p=0.18), 16.7 and 23.9 YAG capsulotomies (p<0.05), and 15.1% and 55.9% (p<0.001) of surgical simulator modules, respectively. There is also significant increase in the completion of Procedure Cards and entries into the Outcome Database since the implementation of the SRC.
Conclusion
The KEI SRC has proven to be an effective monitoring and oversight tool as demonstrated by increased surgical volume and compliance. It has also proven to be an effective tool to open communication between residents and administration in reference to program expectations for resident surgical performance.