Heroes of Orbis: Dr. Will Dean

Dr. Will Dean is Consultant Ophthalmic Surgeon at Cheltenham General Hospital in the United Kingdom and is a specialist in glaucoma and cataract surgery. Recently, he has turned his attention to passing on his skills with a focus on surgical education and simulation training.

Orbis and Dr. Dean both share a belief in the power of technology and innovation to help improve access to quality eye care. We were thrilled when Dr. Dean took his expertise and knowledge in simulation training to new heights, quite literally, during his first Flying Eye Hospital project with us.

Dr. William Dean trained local doctors in Barbados surgical skills using simulation techniques

Dr. Will Dean pictured outside our Flying Eye Hospital

Skills & Expertise

Dr. Dean was previously Clinical Research Fellow at the International Center for Eye Health, London School of Hygiene and Tropical Medicine, completing his 3 year PhD in Surgical Education in collaboration with the University of Cape Town and the College of Ophthalmology of East Central and Southern Africa.

As part of his PhD in Surgical Education, Dr. Dean collaborated with training institutions in Sub-Saharan Africa to help develop their own wet lab facilities, equipment, curriculum and training staff to provide the instruction and educational materials.

Before that, he took on a two-year part-time Masters in Surgical Education at Imperial College, London in 2015. He graduated in Medicine from the University of Leicester, England, in 1999.

Specialties

  • High-volume high-quality cataract surgery (total 7,200 cataract surgeries performed)
  • 'Safe' technique glaucoma surgery with releasable sutures
  • Surgical training and education with a focus on cataract surgery, glaucoma surgery with a special interest in simulation.

Teaching & training

In 2018, Dr. Dean joined us as Volunteer Faculty on our Flying Eye Hospital project in Bridgetown, Barbados, teaching surgical techniques through simulation and improving the competency and confidence of eye surgeons from across the Caribbean.

Ophthalmic simulation training on the Flying Eye Hospital in Bridgetown, Barbados

Ophthalmic simulation training on the Flying Eye Hospital in Bridgetown

At the time we met him, he was taking on a PhD in Surgical Education, honing in on simulation-based surgical education in the two main causes of blindness — cataracts and glaucoma — in Sub-Saharan Africa as well as globally. Cataracts account for around 50% of blindness in the world and glaucoma for about 15%.

He told us about his PhD focus: The blindness from both of those conditions is avoidable if you potentially treat them surgically. So I'm focusing very much on how to improve surgical training for the two main causes of blindness, but the initial acquisition of surgical competence. And the way we're doing that is by using simulation.

“So I get junior resident eye surgeons, training surgeons from Southern and East Africa, Kenya, Uganda, Malawi, Tanzania, Zimbabwe and South Africa. Then we train them really intensely, we had a six day very intense simulation course just on cataract surgery.

Dr. William Dean supervising cataract simulation training during Orbis Flying Eye Hospital, Barbados

Dr. Dean supervising Dr. Valence Jordan from Jamaica during cataract simulation

The flying eye hospital and the logistics and the teamwork are absolutely incredible. And getting all of this together and the Volunteer Faculty, the staff faculty and the trainers are absolutely incredible. The whole program is brought together by professionals from all over the Caribbean, which in itself is partnership building on a regional level and that's awesome. But it's also skill sharing on a regional level and that's really important. Now that engenders a huge amount of motivation. Motivation for residents to want to learn and want to spend hours learning practical skills.

Dr. William Dean

Consultant Ophthalmic Surgeon, Gloucestershire Hospitals NHS Foundation Trust

Dr. Dean spent a week on our Flying Eye Hospital project teaching about a dozen of the residents from all over the Caribbean surgical procedures in glaucoma and cataracts, both manual small incision surgery and the modern phacoemulsification technique using simulation.

Speaking about the benefits of simulation training, Dr. Dean said: “We're not practising and making initial mistakes on live patients and that's really important. So we want to use simulation to make the initial surgical training and all ophthalmic surgical procedures safe for patients, efficient and effective so that trainees learning a new technique go through that initial learning curve faster, more efficiently, but most importantly safer.

“And we know from previous studies that in the first 50 cataract operations on most trainees the complication rates are higher than an experience attending or consultant, we know that. So what we're trying to do is to get over that first 50 or 100 cases and with simulation in an intense week we can take a trainee through 80 to 100 cases in one week or the equivalent of if we practice and practice in a very sustained and deliberate way."

In parts of the world where resources such as artificial eyes aren’t available in a wet lab, eye lab or skill center, Dr. Dean teaches young surgeons to break down certain parts of a cataract operation, such as getting into the eye, using an apple, a microwaved tomato or a grape.

He said: “It's not perfect. And you won't ever get 100% fidelity that you'll only get on a live patient, but you will get high enough fidelity and be able to practice and get that muscle memory, breaking down the procedure and practicing it hundreds and hundreds of times."

Dr. Dean, thank you for dedicating so much of your time to training eye teams around the world, not just with Orbis, but through your other interests and pursuits also. We both see clinical and simulation training as the best way to improve access to eye care in communities around the world.

Thank you for joining us on our Flying Eye Hospital project to Barbados and for dedicating so much of your time to sharing your unique skills - we look forward to working together again in the future.

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