Jules Stein Eye Institute, University of California, Los Angeles, CA, USA.
J Glaucoma. 2012 Dec;21(9):601-7. doi: 10.1097/IJG.0b013e31821db3c7.
To determine the impact on ophthalmology residents of a training module to teach systematic optic disc (disc) evaluation.
A training module for disc evaluation was developed consisting of: (1) a computer-based evaluation course with 100 illustrative disc photographs featuring normal and glaucomatous discs; (2) 2 different disc photograph test sets to be completed before and after taking the course; and (3) a 1-page checklist emphasizing 8 areas of disc evaluation to guide the residents through the test sets. Each area required identification of 2 to 3 key features pertinent to glaucoma. Points were assigned to each correctly answered item on the checklist by ophthalmology residents of 2 training programs. Residents were also asked to evaluate the disc according to a glaucoma scale. Main outcome measures included precourse and postcourse checklist scores and disc glaucoma evaluation scores.
Twenty-eight residents from 2 training programs completed the training module. Mean checklist scores improved significantly after taking the evaluation course across all residents and in residents who had 2 years of ophthalmology residency experience (P = 0.019, 0.017, respectively). Precourse disc glaucoma evaluation score increased 4% to 6% per year of ophthalmology residency training (P = 0.023, R = 0.1838). One program had a higher mean postcourse disc glaucoma evaluation score than another (P = 0.038).
A systematic disc evaluation module for resident training may improve disc evaluation, provide an objective method to assess the resident's learning experience, monitor the progress and identify areas of weakness of training, and compare results among groups of residents across different residency programs.
确定教授系统视神经盘(disc)评估的培训模块对眼科住院医师的影响。
开发了一种视神经盘评估培训模块,包括:(1)具有 100 张包含正常和青光眼视神经盘图片的基于计算机的评估课程;(2)在参加课程前后完成的 2 套不同的视神经盘照片测试集;(3)强调 8 个视神经盘评估领域的 1 页检查表,以指导住院医师完成测试集。每个区域需要识别与青光眼相关的 2 到 3 个关键特征。2 个培训项目的眼科住院医师为检查表上的每个正确回答项目分配分数。住院医师还根据青光眼量表评估视神经盘。主要观察指标包括课程前和课程后的检查表评分和视神经盘青光眼评估评分。
来自 2 个培训项目的 28 名住院医师完成了培训模块。所有住院医师和具有 2 年眼科住院医师经验的住院医师的检查表评分在参加评估课程后均显著提高(P = 0.019、0.017)。术前视神经盘青光眼评估评分随眼科住院医师培训年限每年增加 4%至 6%(P = 0.023,R = 0.1838)。一个项目的术后平均视神经盘青光眼评估评分高于另一个项目(P = 0.038)。
针对住院医师培训的系统视神经盘评估模块可能会改善视神经盘评估,为评估住院医师的学习体验提供客观方法,监测培训进展并识别培训的薄弱环节,并比较不同住院医师项目的住院医师的结果。