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February 14, 2020
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Structure is needed for a surgeon to move from competent to highly skilled

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Matthew A. Miller

ORLANDO — Because learning a new technique is “incredibly stressful” and a challenge, Matthew A. Miller, MD, offered tips on how “to do it in a manner that is safe for our patients and still allows for the best possible outcomes.”

“It is critical to be mindful of the loss of structure in our learning as we progress from resident to fellow” and beyond, Miller said at Cataract Surgery: Telling It Like It Is. “Because of the loss of that structure (and the observation and feedback that goes along with that), there is a tendency to become comfortable with our craft.”

Miller noted that complacency can be a barrier to learning new techniques.

“If our goal as young ophthalmologists is to take that next step from being a competent surgeon to a highly skilled surgeon who can readily adopt new techniques into our practice, then that requires that we create some structure,” Miller said.

There is value in online resources including surgical technique videos, Miller said, but did note there are pitfalls in that one can become intimidated by watching videos of those surgeons deemed the best in the field.

Another tip is to break down a procedure no matter how complicated into a series of steps, he said.

“There are a finite number of surgical skills, and your job is to master those skills and have those skills in your toolbox,” he said. “Once you have done so, learning a new technique becomes simply a matter of putting those skills in the right order.”

Miller’s “final strategy” is deliberate mental preparation of new techniques: “Envision yourself going through the procedure step-by-step, thinking about the movements involved, what each hand is doing, [and] asking yourself at each of these steps, ‘What could go wrong?’”

That mental preparation is critical for a surgeon’s first case with a new technique no matter where they are in their career, he said. – by Joan-Marie Stiglich, ELS

Reference: Miller MA. A young ophthalmologist’s perspective learning new techniques. Presented at: Cataract Surgery: Telling It Like It Is; Feb. 12-16, 2020; Orlando.

Disclosure: Miller reports no relevant financial disclosures.