Cataract surgical training in Europe: European Board of Ophthalmology survey.

PURPOSE: To survey recently graduated European ophthalmologists concerning cataract surgery (CS) training opportunities. SETTING: Countries affiliated to the European Board of Ophthalmology (EBO). DESIGN: Cross-sectional study of anonymous survey results. METHODS: A 23-question online survey was emailed to candidates who sat the EBO Diploma Examination as residents between 2018 and 2022. RESULTS: 821 ophthalmologists from 30 countries completed the survey. The mean residency duration was 4.73 (SD 0.9) years. The mean reported number of entire CS procedures performed was 80.7 (SD 100.6) at the end of residency, but more than 25% of respondents (n = 210) had received no live CS training during their residency. The self-confidence (scale, 1 to 10) to perform a simple case or challenging case, manage posterior capsular rupture, and realize a corneal stitch were rated 4.1, 3.2, 4.2, 2.4, respectively. We observed extensive variation in clinical exposure to CS and self-reported confidence to perform CS between European trainees. Females reported a mean of 18% fewer entire procedures than their male colleagues and were also less confident in their surgical skills (P < .05). Trainees in residency programs longer than 5 years performed fewer procedures and were less confident than trainees in residences of shorter duration (P < .001). The importance of fellowships to complete surgical education was rated 7.7 out of 10. CONCLUSIONS: CS training across European countries lacks harmony. Female ophthalmology trainees continue, as in other specialties, to experience apparent gender bias. European level recommendations seem necessary to raise and harmonize competency-based CS training programs and promote post-residency fellowship training programs.

Microlearning to improve CPD learning objectives.

BACKGROUND: Despite active involvement in teaching, clinical educators facilitating the continuing professional development (CPD) of their fellow specialists may not have formal training in medical education. Although required to write focused, measurable, topic-relevant, attainable and time-bound learning objectives to clearly inform learners on their learning intentions, CPD educators often receive no training on how to develop them. Microlearning is an online learning format occurring without real-time or interpersonal interaction, aiming to deliver easily accessible small units of focused information that are readily applicable for professionals. We hypothesised that Portuguese ophthalmologist educators lecturing to their fellow specialists would benefit from a microlearning experience (MLE) to improve the quality of their learning objectives. METHODS: We created an MLE about writing effective learning objectives. In phase 1, 25 clinical educators, scheduled to lecture at an ophthalmology conference in Portugal, were invited to watch the MLE, write and classify their learning objectives according to Bloom's modified taxonomy, and complete an evaluation survey. In phase 2, 86 clinical educators were invited to view the MLE and complete the survey. RESULTS: In phase 1, 20% of participants completed the exercise and survey. They categorised their objectives high on Bloom's taxonomy, considered the MLE useful and stated their intent to apply the principles learned in practice. In phase 2, 29% of participants provided feedback. All agreed that the intervention was clear and useful and 87% expressed an intent to use this information in their educational practice. CONCLUSIONS: The majority of participants found the MLE clear and useful. Further studies are necessary to measure the impact of the MLEs used by clinical educators.

"Certified now what?" On the Challenges of Lifelong Learning: Report from an AMEE 2017 Symposium.

The increasing mobility of patients and healthcare professionals across the countries of Europe has highlighted the wide variations in both medical training, and provision of medical competency and skills. The maintenance of the standards defining competency and skills have national and international implications and have proved challenging for national regulatory bodies. Thus each nation has introduced different types of Continuing Professional Development (CPD), recertification and relicensing systems. At the Symposium entitled: " 'Certified … now what?' On the Challenges of Lifelong Learning" in August 2017 at the Association for Medical Education in Europe (AMEE) annual conference, we reviewed differing European national relicensing systems were reviewed. The review highlighted various lifelong learning and competence assessment approaches using examples from different medical specialties across several European countries.

Unusual Straatsma Syndrome - How dogmatic is a bad prognosis?

PURPOSE: To show that Straatsma Syndrome can have a good outcome and to highlight an unusual presentation of this disease. OBSERVATIONS: A four-year-old boy presents with severe right eye amblyopia in association with high myopia, esotropia, heterochromia iridum and extensive myelinated retinal fibers involving both temporal arcades and the optic nerve head. Right eye initial visual acuity was less than 20/400 for distance and less than R6W10 for near. Left eye examination was unremarkable. Despite the indicators for bad prognosis, intensive occlusion therapy was prescribed. Parents were strongly involved in the treatment regimen. After four months, the patient presented an unexpected good visual recovery both for distance and near, that has persisted until present. Right eye visual acuity is 20/30 with -9.00 dioptres contact lens for distance and R2W1 for near. Esotropia also improved to 12 prism dioptres. Fundoscopic alterations and heterochromia iridum have remained stable. Spectral-domain optical coherence tomography images of the right eye showed thinner superior outer ring measurements. CONCLUSIONS AND IMPORTANCE: Straatsma Syndrome can present with heterochromia iridum. When strabismus is present, early surgery should be withheld. Intensive treatment of Straatsma Syndrome can yield an unexpected good result, despite initial high degree anisometropia and low vision acuity.