Department of Ophthalmology, Seoul National University College of Medicine, Seoul National University Hospital, Seoul, Republic of Korea.
Department of Ophthalmology, Seoul National University College of Medicine, Seoul National University Bundang Hospital, Seongnam, Republic of Korea.
Sci Rep. 2024 Feb 20;14(1):4207. doi: 10.1038/s41598-024-53321-8.
We conducted a prospective study to evaluate the efficacy of simulation-based education using a three-dimensional (3D)-printed schematic eye model in improving the retinoscopy refraction skills of medical students. A schematic eye model was printed using a fused deposition modeling-based 3D printer. Twenty medical students randomized into 3D (n = 10) and control (n = 10) groups received a 1-h lecture on the principles and methods of manifest refraction and were shown how to use the retinoscope and sciascope bars. The 3D group additionally attended a tutorial on the schematic eye. Both groups performed refractive examinations on four eyes of volunteer patients, and the results were recorded as a baseline. Instructor feedback and refraction practice was provided with the 3D group or with control group. To account for subject fatigue, patients spent no more than 8 min on the examination. After a 1-h break to allow for fatigue and familiarity, refraction tests were repeated on four randomly selected eyes of patients. Students' refraction readings were compared with the autorefractor values using a spherical equivalent value and blur strength. All participants measured the time required to complete the refraction test and reported their subjective confidence in the results of each refraction test. Refractive errors before and after training did not differ between the control and 3D groups, with a significant improvement in errors observed in both groups (p = 0.005 and 0.008, respectively). The time to complete refraction before and after training did not differ between the two groups, both of which showed a significant reduction in time (p = 0.005 and 0.028, respectively). Pre- and post-training confidence scores for the accuracy of each refraction on a 10-point Likert scale were not significantly different. However, when comparing score changes between pre- and post-training, only the control group showed a significant increase in confidence (p = 0.005). Tests for the non-inferiority of refractive errors after training indicated that the 3D group was non-inferior to the control group. In conclusion, training in retinoscopy refraction skills using a 3D-printed eye model resulted in significant improvement in accuracy and speed compared to practice with real patients. Except for better confidence in the control group, schematic eye model training was not inferior to practice with real patients.
我们进行了一项前瞻性研究，评估了使用基于三维（3D）打印的 schematic 眼球模型的模拟教育在提高医学生检影镜折射技能方面的效果。使用基于熔丝沉积建模的 3D 打印机打印出一个 schematic 眼球模型。将 20 名医学生随机分为 3D 组（n=10）和对照组（n=10），两组均接受了 1 小时的关于明视折射原理和方法的讲座，并展示了如何使用检影镜和光棒。3D 组还参加了一个关于 schematic 眼球的教程。两组学生均对 4 名志愿者患者的眼睛进行了折射检查，并记录为基线。3D 组和对照组均提供了教师反馈和折射练习。为了考虑到受试者的疲劳程度，每位患者的检查时间不超过 8 分钟。休息 1 小时以缓解疲劳和熟悉度后，随机选择 4 名患者的 4 只眼睛重复进行折射测试。学生的折射读数与自动折射仪的值进行比较，使用球镜等效值和模糊强度。所有参与者均测量完成折射测试所需的时间，并报告他们对每次折射测试结果的主观信心。培训前后，对照组和 3D 组的折射误差无差异，两组的误差均有显著改善（p=0.005 和 0.008）。两组的折射测试时间在培训前后无差异，均显著缩短（p=0.005 和 0.028）。10 分制的主观信心评分在培训前后对每次折射准确性的评估无显著差异。然而，当比较培训前后的评分变化时，只有对照组的信心显著增加（p=0.005）。培训后折射误差非劣效性检验表明，3D 组与对照组无差异。总之，与使用真实患者相比，使用 3D 打印眼球模型进行检影镜折射技能培训可显著提高准确性和速度。除了对照组对患者的信心更好外，使用 schematic 眼球模型培训并不逊于使用真实患者。
