{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,26]],"date-time":"2026-08-26T20:21:07Z","timestamp":1787775667052,"version":"build-2784847793"},"reference-count":13,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"1","license":[{"start":{"date-parts":[[2026,1,1]],"date-time":"2026-01-01T00:00:00Z","timestamp":1767225600000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0"}],"content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2026,1]]},"abstract":"<jats:title>Abstract:<\/jats:title>\n                  <jats:sec>\n                    <jats:title>PURPOSE:<\/jats:title>\n                    <jats:p>The purpose of this study was to introduce a standardized tool, developed through expert consensus with face and content validation, that integrates a comprehensive rubric with a scoring system for evaluating the ophthalmology residents\u2019 competency in peribulbar anesthesia: The Skills and Keystone Assessment for Regional Anesthesia (SanKARA) Scoring System.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>MATERIALS AND METHODS:<\/jats:title>\n                    <jats:p>A multidisciplinary expert panel from Sankara Eye Hospital, Jaipur, India, each with experience of \u22652000 peribulbar anesthesia blocks, was established to develop a tool that combined a comprehensive rubric outlining essential competency criteria with a scoring system designed to assign numerical values to performance. The explicit behavioral descriptors for each crucial step of the peribulbar block were scored using a modified four-point Dreyfus scale of skill acquisition.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>RESULTS:<\/jats:title>\n                    <jats:p>The SanKARA Scoring System encompassed 20 crucial steps for evaluating competency in peribulbar anesthesia. These steps were further subgrouped into specific categories (pre-procedural-related, procedural-related, and post-procedural-related) to summarize the specific stages of the whole procedure. Key procedural aspects included needle positioning, drug administration, patient monitoring, and adverse event management.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>CONCLUSIONS:<\/jats:title>\n                    <jats:p>The SanKARA Scoring System integrates a structured rubric and scoring system to standardize peribulbar anesthesia training. This system can be globally adopted to assess and improve the training of ophthalmology residents, guide them in learning this paramount skill, and set a global competency benchmark.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.4103\/ojo.ojo_129_25","type":"journal-article","created":{"date-parts":[[2026,2,27]],"date-time":"2026-02-27T19:00:14Z","timestamp":1772218814000},"page":"65-74","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":0,"title":["The skills and keystone assessment for regional anesthesia (SanKARA) scoring system for evaluating competency in peribulbar anesthesia"],"prefix":"10.4103","volume":"19","author":[{"given":"Matteo","family":"Ripa","sequence":"first","affiliation":[{"name":"Department of Ophthalmology, Sankara Eye Hospital, Jaipur, Rajasthan, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Deergha","family":"Pareek","sequence":"additional","affiliation":[{"name":"Department of Ophthalmology, Sankara Eye Hospital, Jaipur, Rajasthan, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Neeraj Apoorva","family":"Shah","sequence":"additional","affiliation":[{"name":"Department of Ophthalmology, Sankara Eye Hospital, Jaipur, Rajasthan, India"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","published-online":{"date-parts":[[2026,2,27]]},"reference":[{"key":"R1-20260302","doi-asserted-by":"crossref","first-page":"1852","DOI":"10.1097\/IAE.0000000000003566","article-title":"Comparison of pain experience in patients undergoing sub-tenon's anesthesia versus peribulbar anesthesia during elective vitreoretinal 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surgical competency assessment rubric (OSCAR) for open globe surgical management","volume":"16","author":"Justin","year":"2022","journal-title":"Clin Ophthalmol"},{"key":"R9-20260302","doi-asserted-by":"crossref","first-page":"1797","DOI":"10.1097\/IAE.0000000000001455","article-title":"The ophthalmology surgical competency assessment rubric for vitrectomy","volume":"37","author":"Golnik","year":"2017","journal-title":"Retina"},{"key":"R10-20260302","doi-asserted-by":"crossref","first-page":"1476","DOI":"10.3390\/jcm10071476","article-title":"The ophthalmology surgical competency assessment rubric for intravitreal injections (ICO-OSCAR: IVI)","volume":"10","author":"Kiew","year":"2021","journal-title":"J Clin Med"},{"key":"R11-20260302","doi-asserted-by":"crossref","first-page":"898","DOI":"10.4103\/ijo.IJO_73_17","article-title":"Use of modified international council of ophthalmology- ophthalmology surgical competency assessment rubric (ICO- OSCAR) for phacoemulsification- wet lab training in residency program","volume":"65","author":"Farooqui","year":"2017","journal-title":"Indian J Ophthalmol"},{"key":"R12-20260302","doi-asserted-by":"crossref","first-page":"494","DOI":"10.1016\/j.jtos.2020.02.004","article-title":"A surgical skills assessment rubric for pterygium surgery","volume":"18","author":"Zarei-Ghanavati","year":"2020","journal-title":"Ocul Surf"},{"key":"R13-20260302","doi-asserted-by":"crossref","first-page":"177","DOI":"10.1177\/0270467604264992","article-title":"The five-stage model of adult skill acquisition","volume":"24","author":"Dreyfus","year":"2004","journal-title":"Bull Sci Technol Soc"}],"container-title":["Oman Journal of 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