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UPMC Vision Institute’s New Surgical Training Lab Provides Latest Technologies and Features for Resident Training and Faculty Use

May 13, 2024

Surgical training and surgical simulation training play a crucial role in shaping competent and confident ophthalmologists. Coinciding with the opening of the new UPMC Mercy Pavilion, headquarters of the UPMC Vision Institute, was a purpose-built and designed new surgical training and simulation lab created specifically for aiding in the training of new residents.

The new lab, officially called the E. Ron Salvitti MD Surgical Training Laboratory, was built from the ground up with expansion capacity for the future and some of the latest training and simulation technology available. The new lab was in part made possible through a generous $5 million donation by Dr. Salvitti, who has been an active member of southwestern Pennsylvania’s medical community since 1964 when he entered family practice in Washington, PA. After completing his residency in ophthalmology at the University of Pittsburgh School of Medicine and Eye & Ear Hospital in 1973, he devoted his career to advancing ophthalmic surgery and patient care. In 1986, he became the founder and medical director of the Southwestern Pennsylvania Eye Center, where his staff now includes his daughter, Jennifer Salvitti Davis, MD, who also completed her ophthalmology residency at University of Pittsburgh School of Medicine and UPMC Eye Center, Eye & Ear Institute.

Dr. Salvitti is widely known as an innovator in ophthalmic surgery, designing intraocular lenses for cataract surgery that have changed the lives of his patients and many others.

“Ron has been an incredible friend of the department for decades,” says Evan L. Waxman, MD, PhD, professor of Ophthalmology, vice chair of Medical and Resident Education, and co-director of the lab. “He’s provided support for a number of endowed chairs, and he gifted us with the opportunity to train his daughter many years ago.”

“Dr. Salvitti is one of the pioneers of ophthalmology in Pittsburgh,” says Ian Conner, MD, PhD, assistant professor of Ophthalmology, associate Residency Program director, and co-director of the surgical training lab. “With his support, and that of the Department and UPMC, the new training lab help us continue to train new generations of ophthalmologists.”

The Need for Advanced Surgical Training and Simulation Technology in Ophthalmology Residency Training

Ophthalmic surgical procedures, such as cataract surgery or lid laceration repairs, require a high level of precision and expertise, built through repetition and many hours of practice. Traditionally, residents would observe attending surgeons before performing surgeries themselves. However, the inherent risks associated with allowing inexperienced surgeons to operate on patients prompted the development of a more comprehensive training dynamic, one that allows for a rigorous and step-wise approach to surgical skill building in a controlled environment where residents can be coached and critiqued while they hone their skills and experience.

“As I tell our residents and trainees, time in the lab practicing techniques and skills is just as valuable, perhaps more so, as observing and learning hands-on in the OR,” says Dr. Waxman. “Nobody wants their loved one to be the first time a resident has attempted a cataract removal. It’s about safety, ethics, and making sure our residents are fully prepared for the tasks necessary to conduct a successful surgery.”

“Performing any kind of surgery on the eye is such a delicate endeavor,” says Dr. Connor. “The space within which you are working is so small, the anatomy is small, the instruments are small. Precision and control are the bread-and-butter skills of ophthalmology surgery, and that’s a big part of what our surgical training lab, through its many technologies and simulators, is designed to give our residents.”

The Role of Simulation in Surgical Training

Simulation-based training and technologies have emerged as powerful tool in medical education, allowing trainees to gain hands-on experience without compromising patient safety. The lab's simulation equipment, including advanced surgical simulators, replicates real-life surgical scenarios, enabling residents to develop critical skills and improve their decision-making abilities. By simulating both routine and complex procedures, residents can familiarize themselves with potential complications that may arise during specific procedures and learn how to handle them with calm and poise.

“When we’re conducting training sessions in the lab, we can work into the training different kinds of potential complications that surgeons may face during a procedure,” says Dr. Waxman. “This gives us the ability to safely challenge the residents and have them work through the necessary steps in order to deal with common or even rare occurrences that can crop up during ophthalmic surgery.”

State-of-the-Art Lab Facilities: New Space, New Equipment, 24/7 Access

The newly constructed surgical training laboratory boasts cutting-edge facilities designed specifically for training ophthalmology residents – both through wet lab processes with animal tissues and some of the latest computer-based simulators.

Equipped with 15 new workstations, each featuring a microscope and phacoemulsification machine, the lab provides residents with a realistic surgical environment in which to practice their techniques and skills in conjunction with their time in the operating room and didactic course work.

Additionally, each of the 15 workstation microscopes are tied into the video recording and display system integrated into the training lab. This multimedia system allows faculty to project recorded or live work on the labs video displays for discussion purposes, and in the future will be utilized for demonstrations and surgical training workshops – not only for faculty and students but also for community providers and colleagues.

“Our old lab, while functional, was a shared space with our ENT colleagues, so it was not designed specifically or exclusively for our ophthalmology residents and faculty,” explains Dr. Waxman. “The new lab, which is now open 24 hours a day, seven days a week gives our residents the flexibility to use it whenever desired.”

With the old lab, residents had to share their equipment and instruments. Now, each resident is given their own set of instruments which they take with them when completed and they have a dedicated space at one of the workstations for the duration of their surgical training

Additionally, the lab houses a VRMagic Eyesi® simulator that allows residents to practice delicate microsurgical techniques. The lab also has simulators for anterior and posterior segment surgery, as well as for mastering skills like ophthalmoscopy and slit-lamp exam aminations, which are foundational skills for any ophthalmology student to acquire and perfect.

“The lab is used not only by residents but also by faculty members to work out new surgical techniques before using them on patients,” says Dr. Conner. “It’s probably one of the largest and most technologically advanced surgical training labs for ophthalmology residents in the country. It’s something that sets our training program apart from others.”

Resident Perspectives on the New Training Lab

One unique aspect of the training laboratory is the involvement of residents themselves in its operation. Each year, two third-year ophthalmology residents take on the role of resident coordinators for the training lab.

The resident lab coordinators work to ensure the lab is ready for use by all of the residents, collaborate with faculty on the development of the curriculum for the lab training sessions, and other duties such as tissue inventory control and ordering.

This resident-led approach to the function of the training lab ensures that the curriculum remains relevant and meets the needs of the learners for whom it was designed. Under the guidance of experienced faculty members like Drs. Waxman and Conner, the resident coordinators play a vital role in shaping the nature of the training program, fostering a sense of ownership and motivation among their resident peers and colleagues.

The current resident co-coordinators of the surgical training lab are Raven Diacou, MD, PhD, and Saloni Kapoor, MD.

“The new lab, its design and equipment, and how it will expand and grow in the future represents a substantial leap for the department’s surgical training efforts for residents,’ says Dr. Diacou. “Residents aren't just learning; they're immersing themselves in the very fabric of surgical excellence. It’s a place for collective growth and experimentation”

This immersive experience is facilitated by the lab's strategic design, which encourages interaction among residents and between residents and the experienced surgeons from the Department.

One of the standout features of the lab, explains Dr. Kapoor, is its state-of-the-art equipment, mirroring the actual technology found in the UPMC Vision Institute’s operating and procedural rooms.

“This feature, combined with the physical proximity and location of the lab within the hospital itself, offers a seamless transition from practice to practical application,” says Dr. Kapoor. “Having access to such resources not only enhances our technical skills but also boosts our confidence in performing complex procedures.”

The importance of repetition in mastering surgical techniques is a sentiment echoed throughout the training program and by both Dr. Diacou and Dr. Kapoor.

“Each practice session in the lab, each component of the surgical training curriculum for our department is a step towards perfecting the skills of highly capable surgeons,” says Dr. Diacou.

Beyond the technical training aspects of the surgical training labs equipment and course work, Dr. Kapoor notes the UPMC Vision Institute’s incredibly diverse caseload and wide spectrum of ophthalmic disorders and diseases greatly bolsters a resident’s overall training and experience level, even early on in training.

 “Our training goes beyond the operating table,” says Dr. Kapoor. “We're prepared to face the myriad challenges of modern ophthalmology thanks to the broad spectrum of experiences the hospital sees and that we are exposed to during residency. When you couple that with the new hospital’s design and structure, the infrastructure built in – like the new surgical training lab – they are the reasons our program is one of the top training programs in the U.S.”

Future Developments and Collaboration in the Surgical Training Lab

Future plans for the lab and resident training include a cloud-based assessment program, in which residents record their coursework for assessment and critique by faculty.

“It’s going to be a big collaboration between our department, industry leaders, and our vendor colleagues to build this new approach to surgical training that ultimately can serve as a model for how to train surgeons more effectively using the latest tools and technologies available to us,” says Dr. Waxman.

Learn More

Learn more about the new UPMC Vision Institute and the Department of Ophthalmology at the University of Pittsburgh.

You can also watch some recent video interviews with Dr. Waxman and Dr. Conner, and a recent video made by residents giving a video tour of the new surgical training lab.

*The Eyesi® Ophthalmic Surgical Simulator is a trademark of VRMagic GmbH, Mannheim, Germany.