Lee John Y, Gallo Ryan A, Alabiad Chrisfouad R
Department of Ophthalmology, Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, Miami, Florida.
J Acad Ophthalmol (2017). 2020 Jan;12(1):e79-e86. doi: 10.1055/s-0040-1712175.
The aim of this study is to evaluate the effectiveness of an interactive, small-group ophthalmology clinical training session by assessing medical students' self-confidence with eye examination skills and long-term retention of direct ophthalmoscopy skills.
The second-year medical students participated in a one-time small-group clinical training session that taught essential components of the eye examination. Students reported their confidence with each component in pre- and postsession surveys. Eight months later, direct ophthalmoscopy skills were reassessed by having students visualize the optic nerves of standardized patients and identify the matching optic nerve photograph in a multiple-choice quiz.
Among 197 second-year medical students who participated in the training session, 172 students completed the presession survey (87.3% response rate) and 108 students completed the postsession survey (54.8% response rate). Following the training session, students reported increased self-confidence ( < 0.01) overall. A total of 107 (107/108; 99.1%) students reported that they visualized the optic nerve head, and 80 out of 85 (94.1%) students stated that they preferred the PanOptic ophthalmoscope over the traditional direct ophthalmoscope. Students reported greater self-confidence using the PanOptic ophthalmoscope ( < 0.01). In the 8-month follow-up assessment, 42 medical students (42/197; 21.3%) completed the exercise. A total of 41 (41/42; 97.6%) students stated that they saw the optic nerve with the PanOptic ophthalmoscope; 24 (24/42; 57.1%) students identified the correct optic nerve image using the PanOptic ophthalmoscope on a standardized patient; 14 (14/42; 33.3%) students stated that they saw the optic nerve with the traditional direct ophthalmoscope; and 4 (4/42; 9.1%) students from the same cohort identified the correct optic nerve image with the traditional direct ophthalmoscope on a standardized patient.
Our comprehensive, one-time eye examination skills training session seeks to prepare students to incorporate these skills in future patient care. Students' overall confidence improved in each aspect of the eye examination that was covered. A follow-up assessment on students' direct ophthalmoscopy skills suggests that the PanOptic ophthalmoscope allows for superior skills retention as compared with the traditional direct ophthalmoscope. We believe that the PanOptic ophthalmoscope should be further integrated into medical education and clinical practice.
本研究旨在通过评估医学生眼部检查技能的自信心以及直接检眼镜技能的长期保持情况，来评价交互式小组眼科临床培训课程的效果。
二年级医学生参加了一次小组临床培训课程，该课程教授了眼部检查的基本内容。学生在课前和课后调查中报告了他们对每个部分的信心。八个月后，通过让学生观察标准化患者的视神经，并在多项选择题测验中识别匹配的视神经照片，对直接检眼镜技能进行重新评估。
在197名参加培训课程的二年级医学生中，172名学生完成了课前调查（回复率87.3%），108名学生完成了课后调查（回复率54.8%）。培训课程结束后，学生总体上报告自信心增强（P<0.01）。共有107名（107/108；99.1%）学生报告他们观察到了视神经乳头，85名学生中的80名（94.1%）表示他们更喜欢全景检眼镜而不是传统直接检眼镜。学生报告使用全景检眼镜时自信心更强（P<0.01）。在8个月的随访评估中，42名医学生（42/197；21.3%）完成了练习。共有41名（41/42；97.6%）学生表示他们用全景检眼镜看到了视神经；24名（24/42；57.1%）学生在标准化患者身上使用全景检眼镜识别出了正确的视神经图像；14名（14/42；33.3%）学生表示他们用传统直接检眼镜看到了视神经；同一队列中的4名（4/42；9.1%）学生在标准化患者身上用传统直接检眼镜识别出了正确的视神经图像。
我们全面的一次性眼部检查技能培训课程旨在让学生为在未来患者护理中应用这些技能做好准备。学生在所学眼部检查的各个方面的总体信心都有所提高。对学生直接检眼镜技能的随访评估表明，与传统直接检眼镜相比，全景检眼镜能更好地保持技能。我们认为全景检眼镜应进一步融入医学教育和临床实践。
