Abstract
To use a novel teaching exercise to encourage students to practice ophthalmoscopy and to measure the learning effect both subjectively and objectively. Comparative case series. One hundred thirty-one fourth-year medical students on their 1-week ophthalmology rotations with 89 in the experimental group and 42 in the control group. Those in the experimental group had 1 eye dilated and their optic nerve photographed on the first day. The next day, these students received an unlabeled optic nerve photograph belonging to 1 of their peers (typically 8-10 per group) and were given 3 days to identify the student matching the photograph. The students in the control group were simply encouraged to practice ophthalmoscopy on each other without the use of photographs. Both objective and subjective changes from the beginning to the end of the rotation were measured and compared between the 2 groups. In the 89 students who used peer optic nerve photographs, 75 (84.3%) showed improvement in direct ophthalmoscopy skills over the course of the week. In contrast, only 12 (28.6%) of the 42 control students demonstrated an objective improvement (P<0.001). The subjective confidence levels likewise were more improved in the students who took part in the optic nerve photograph exercise. These results suggest that the task of matching an unknown optic nerve photograph to the correct eye of a peer leads to increased self-confidence and more proficient use of the direct ophthalmoscope.
Highlights
Participants—One-hundred thirty-one fourth-year medical students on their one-week ophthalmology rotations with 89 in the experimental group and 42 in the control group
The subjective confidence levels were likewise more improved in the students who took part in the optic nerve photograph exercise. These results suggest that the task of matching an unknown optic nerve photograph to the correct eye of a peer leads to increased self-confidence and more proficient use of the direct ophthalmoscope
Direct ophthalmoscopy is one of the critical physical examination techniques required of all medical school graduates.[1]
Summary
Those in the experimental group had one eye dilated and their optic nerve photographed on the first day. The study was conducted at the University of Illinois at Chicago (UIC) Medical School involving fourth-year medical students rotating through their required one-week ophthalmology clerkship. Prior to this rotation, all students had received formal instruction on direct ophthalmoscopy during their second year of medical school including hands-on demonstration of the use of the direct ophthalmoscope with supervised practice on fellow students. On the first day of their ophthalmology rotation, all students received an additional one-hour tutorial with instructions on the use of a co-axial direct ophthalmoscope It was determined by convenience sample whether or not each clerkship week would be in the study group or control group. The study was approved by the Institutional Review Board at UIC and was compliant with the Health Insurance Portability and Accountability Act (HIPAA)
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