International Council of Ophthalmology-Small Incision Cataract Surgery rubric: A roadmap to evaluate cataract surgical skill acquisition during residency training

PURPOSE: The International Council of Ophthalmology-Small Incision Cataract Surgery (ICO-SICS) rubric is a tool to grade SICS steps from novice to competent. The study aimed to evaluate the progress of residents’ surgical skills by using the ICO-SICS rubric and the perceptions of residents and faculties about its use. METHODS: This prospective educational interventional study, done in the Ophthalmology department between September 2019 and February-2020 included 14 residents and five faculties. Faculties scored residents’ SICS by ICO-SICS-rubric (four sessions/resident) and helped them identify three steps as “area of focus” to work upon. Feedback was taken using a semi-structured pretested questionnaire. Focus group discussion was done for residents. Data were entered in MS Excel and analyzed using SPSS. Perception analysis presented as percentage of written responses. RESULTS: Step-wise rubric score showed improvement for initial SICS steps and wound closure (P < 0.05). Critical surgical steps and scores for three areas of focus steps showed no statistically significant improvement. Three steps as an area of focus changed partly for 11 residents and completely for three residents at the end of 6 months. Perception analysis of faculty and residents showed that the ICO-SICS rubric is a good tool to record surgical performance, identify steps needing improvement and provide structured feedback hence opined to continue it. Residents considered it as an effective learning and assessment tool. CONCLUSION: ICO-SICS rubric is a good teaching tool and helps to assess the progress of surgical skills. Identification of areas of poor performance and feedback given motivates them to focus on those areas leading to continuous professional development, resulting in competent surgeons performing SICS surgery independently at the end of the residency.