17 EyeWorld Asia-Pacific | June 2025 CATARACT About the Physicians Anthony Chung, MD | Assistant Professor, University of Washington School of Medicine, Seattle, Washington | atchung5@uw.edu Jaclyn Haugsdal, MD | Clinical Assistant Professor, University of Iowa, Coralville, Iowa | jaclyn-haugsdal@uiowa.edu Omar Krad, MD | Eye Associates of Orange County, Mission Viejo, California | omarkrad@gmail.com Relevant Disclosures Chung: None Haugsdal: None Krad: None This article originally appeared in the March 2025 issue of EyeWorld. It has been slightly modified and appears here with permission from the ASCRS Ophthalmic Services Corp. ASIA-PACIFIC PERSPECTIVES This article by Drs Chung, Haugsdal, and Krad provides insightful perspectives on the dynamic evolution of ophthalmic surgical education, particularly over the last decade. I especially appreciated Dr Haugsdal’s emphasis on the complementary nature of simulation, be it virtual, dry lab, or otherwise, to traditional live surgical training. Access to modern simulation tools is important, but it is how these tools are integrated into structured, supervised learning that determines their true educational value. At the beginner level especially, supervision significantly enhances outcomes, although independent learning also has a place in well-designed programs. Since the work of Dr John Ferris and colleagues demonstrated a clear reduction in surgical complications through access to virtual reality training, there has been a global shift towards more systematic simulation-based learning. In Victoria, Australia, supervised and unsupervised virtual reality training has been mandated since 2018, with a national rollout following in 2023. Residents are now required to achieve proficiency in both virtual and wet lab environments before undertaking live surgery. This shift has demonstrably improved surgical preparedness. Importantly, simulation fidelity—how realistic a simulator is—has been shown to be less critical than the transferability of learned skills to live surgery. The focus must remain on attitude, mindset, core skill development and performance improvement, rather than fidelity. I was especially encouraged by the discussion around incorporating simulation into ongoing professional development. Simulation has proven valuable not only for Jacqueline BELTZ, BMedSci, MBBS, MSurgEd, FRANZCO Ophthalmologist, Melbourne, Australia 2/232 Victoria Parade East Melbourne jacquelinebeltz@mac.com beginners but also for practicing surgeons refining new techniques, preparing for complications, participating in complex procedural simulations or returning to surgery after a break. Dr Krad’s points on confidence building were especially resonant; these skills are closely tied to decisionmaking and performance under pressure—both of which benefit from targeted simulation. At our centre, the shift to structured simulation has changed our entire approach to early surgical training. Rather than working backwards from the end of the procedure, we now confidently start with capsulorhexis, enabling junior surgeons to safely complete more steps and build their skills faster and safely. This has led to more cases being allocated to early trainees, boosting surgical throughout and reducing wait times. Supervision remains essential, both in the lab and in theatre, but efficiencies have emerged. 1:4 supervision in the lab, compared to 1:1 in theatre, has allowed for more effective faculty resource allocation. I share the authors’ optimism. This is an exciting time for surgical education. More and more ophthalmologists are taking specific interest and/or higher degrees in surgical education. This is undoubtedly advancing the field at a much more rapid rate than we have previously seen. We should continue to encourage this and I look forward to seeing where this progress leads. Editors’ note: Dr. Jacqueline Beltz is a consultant for Alcon, and Johnson and Johnson, but has no financial interests related to the comments.
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