A New Paradigm in Surgical Education

Shameema Sikder specializes in corneal disorders such as Fuchs’ dystrophy and keratoconus, as well as complex cataracts and external eye diseases. She is also director of the Wilmer Eye Institute’s Center of Excellence for Ophthalmic Surgical Education and Training (OphSET).

At the time of its 2016 dedication, OphSET, with its sophisticated 3D simulators and state-of-the-art wet lab, was considered among the most technologically advanced surgical training centers in the country. Sikder says that remains true today. Under her oversight, OphSET has seen the addition of six interconnected trainee microscopes, all tied into an instructor station, allowing the instructor to switch among any of the six to see exactly what trainees are doing as they conduct practice surgeries. The instructor can also switch the images onto the main monitor at the front of the room so everyone can see a specific trainee’s work. The microscopes were produced by Swiss manufacturer Haag-Streit and are specially designed for the delicate tissues and small scale of eye surgery. Sikder says it all adds up to an unmatched learning environment for Wilmer residents. We’re proud to be leading the charge,” she adds.

Sikder’s research is aimed at ensuring that Wilmer residents continue to receive the best possible training. To that end, she studies topics such as resident-performed surgical outcomes, the effect of various teaching modalities on skill acquisition and — today — the effectiveness of machine learning in education. “There’s a lot of talk about artificial intelligence in ophthalmology,” says Sikder, citing as an example an ongoing collaboration between Wilmer and the Malone Center for Engineering in Healthcare, a subsidiary of the Whiting School of Engineering. The goal of the collaboration, she explains, is to capitalize on machine learning and artificial intelligence technologies to create a new paradigm in surgical education.

“The residents and fellows who come out of Wilmer go on to do great things all around the world. Those of us who are involved in surgical training know that the techniques and skills that we transfer to our trainees are propagated on a larger scale, which is very satisfying,” Sikder says. She points out that when a Wilmer surgeon is teaching surgery, there’s a one-on-one connection between surgeon and student, and while that’s very special, it’s very time- and labor-intensive. Imagine, says Sikder, if we could use technology to essentially create that Wilmer mentor and be able to apply it to a larger scale. “Today, our research is focused on being able to elevate the standards of surgical care through surgical training by using technology to make better surgeons,” Sikder says.

How would that work? Currently, a surgeon watching a novice surgeon perform surgery can provide very specific and explicit feedback on what’s being done well, what needs to improve, and how things could be improved. The idea behind the developing technology is essentially to use machine learning algorithms to train on the human expert and be able to provide quality feedback. “This technology that we’re starting to apply at Wilmer could potentially spread across the globe,” says Sikder. “Just imagine how exciting that would be, to have that Wilmer effect globally.”