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COMMENTARY |
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Year : 2020 | Volume
: 68
| Issue : 7 | Page : 1481 |
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Commentary: Practical use of rubric for assessment of eye bank professionals for eye retrieval
Sunita Chaurasia
Senior Consultant, Cornea and Anterior Segment Services, Medical Director, Ramayamma International Eye Bank, LV Prasad Eye institute, Kallam Anji Reddy Campus, Banjara Hills, Hyderabad, Telangana, India
Date of Web Publication | 25-Jun-2020 |
Correspondence Address: Dr. Sunita Chaurasia Senior Consultant, Cornea and Anterior Segment Services, Medical Director, Ramayamma International Eye Bank, LV Prasad Eye institute, Kallam Anji Reddy Campus, Banjara Hills, Hyderabad, Telangana - 500 034 India
Source of Support: None, Conflict of Interest: None | Check |
DOI: 10.4103/ijo.IJO_167_20
How to cite this article: Chaurasia S. Commentary: Practical use of rubric for assessment of eye bank professionals for eye retrieval. Indian J Ophthalmol 2020;68:1481 |
“What gets measured gets improved”
Eye banking in India has grown steadily in the past few decades. According to the Eye Bank Association of India (EBAI) statistics of 2018–19, there are 238 registered eye banks and the annual cornea collection was 56,497 with 27,049 transplantation surgeries. In a global survey on eye banking and corneal transplantation, India was cited at a stage of “almost sufficient” category.[1] With increasing awareness and efforts of the eye banking community, India is likely to be soon heading towards the stage of “self-sufficiency.”
In the early years of inception, eye banking model in India focussed more on cornea collection than on utilization.[2] Hence, majority of the harvested corneas did not meet the criteria of corneal transplantation. However, in recent years, there has been a paradigm shift and the emphasis is placed on utilization than merely on harvestingcorneas.
The success of keratoplasty depends majorly on the donor tissue quality.[3] Without the best practices in donor cornea retrieval, the biological tissue may fail to meet the criteria for transplantation or if transplanted may not deliver the desired surgical outcomes. In this regard, the competency and capabilities of cornea recovery technicians are of paramount importance.
Training of recovery technicians and the assessment of the competency of newly recruited and existing ones is a well-defined and standard operating process of the eye banks. The eye banks have an “in-situ corneoscleral rim excision assessor checklist” that is practiced in auditing the competency of the newly trained recovery technicians (supplement attached)[Additional file 1].[4] In addition, the competency assessment of experienced recovery technicians is also performed annually. This activity should be performed rigorously.
The authors have compared the proficiency of reasonably well-trained technicians in 2 eye banks,[5] based on a grading system similar to Ophthalmology Surgical Competency Assessment Rubric (OSCAR) for assessment of trainees as an educational model.[6] The analysis revealed that one of the most crucial steps (step 15- AC maintained) in cornea retrieval had “poorest scores” amongst the recovery technicians from both the eye banks. Considering the experience of eye bank technicians of retrieving 150 eyeballs at both the eyebanks, it seems that this step needs more understanding and corrective action as “anterior chamber (AC) collapse” would be detrimental to the corneal endothelium. Similar analytical studies on competency and errors during cornea harvesting by recovery technicians can be undertaken in other eye banks and compared with the authors' findings.
The study highlights the importance of “auditing and critique” as the fundamentals of learning and how professionals can get better and further improve upon what they do. The strength of this rubric is that all critical steps of cornea retrieval process are measurable with a more elaborate scoring system, thus making it easier in defining the areas that need correction and focussed training.
References | | |
1. | Gain P, Jillienne R, He Z, Aldossary M, Acquart S, Cognasse F, et al. Global survey of corneal transplantation and eye banking. JAMA Ophthalmol 2016;134:167-73. |
2. | Oliva MS, Schottman T, Gulati M. Turning the tide of corneal blindness. Indian J Ophthalmol 2012;60:423-7. [Full text] |
3. | Prajna VN, Shah M. Good quality pays rich dividends. Indian J Ophthalmol 2018;66:357-8. [ PUBMED] [Full text] |
4. | Chaurasia S, Mohamed A, Garg P, Balasubramanian D, Rao GN. Thirty years of eye bank experience at a single Centre in India. Int Ophthalmol Int Ophthalmol 2020;40:81-8. |
5. | Farooqui JH, Acharya M, Schunder I, Hinesley R, Das A. Practical use of rubric for assessment of eye bank professionals for eye retrieval and its role in improving eye retrieval process in eye banks: An Indo-American experience. Indian J Ophthalmol 2020;68:1037-9. [ PUBMED] [Full text] |
6. | Farooqui JH, Jaramillo A, Sharma M, Gomaa A. Use of modified international council of ophthalmology- ophthalmology surgical competency assessment rubric (ICO- OSCAR) for phacoemulsification- wet lab training in residency program. Indian J Ophthalmol 2017;65:898-9. [ PUBMED] [Full text] |
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