Simulation-based mastery learning for nasolacrimal duct probing in ophthalmology residency: a prospective pre-post educational study.

BACKGROUND

Nasolacrimal duct probing is traditionally taught through supervised practice on pediatric patients; however, limited case availability and ethical concerns restrict training opportunities. Simulation-based mastery learning (SBML) offers a structured alternative. We developed a multifaceted probing simulation (MPS) incorporating SBML principles for ophthalmology resident training.

METHODS

This prospective pre–post interventional study evaluated feasibility (process outcomes) and preliminary educational outcomes of the MPS program. Twenty ophthalmology residents at a university in Thailand participated. Training included a video tutorial, MCQ assessment with feedback, and supervised simulation-based practice. Feasibility outcomes included implementation, completion rate, and usability (User Experience Questionnaire; UEQ). Educational outcomes included changes in procedural performance (rubric scores), procedure time, and self-reported confidence.

RESULTS

All participants completed the training program, supporting feasibility of implementation. The simulation demonstrated high usability across all UEQ domains, with attractiveness rated highest, and excellent internal consistency (Cronbach’s alpha = 0.91). Median procedural performance scores improved from 16 (IQR 13.5–19) to 26.5 (IQR 24–29.5), while mean procedure time decreased from 3.45 ± 1.32 to 1.53 ± 0.42 min (p < 0.001). Confidence levels increased progressively throughout training.

CONCLUSIONS

The MPS program appears feasible and acceptable for integration into ophthalmology residency training. Improvements in procedural performance, efficiency, and confidence were observed immediately after training, indicating short-term benefits; however, these findings are preliminary. Long-term retention and transfer to clinical practice were not assessed. Further controlled studies are required to determine effectiveness and clinical impact. TRIAL REGISTRATION: thaiclinicaltrials.org, TCTR20230314004, Registration date: 1 March 2023.