A comparison of undergraduate clinical ophthalmology learning methods: smart phone television display versus slit-lamp teaching telescope

Integration of Massive Open Online Course (MOOC) in Ophthalmic Skills Training for Medical Students: Outcomes and Perspectives

PURPOSE

To integrate a massive open online course (MOOC) into conventional clinical ophthalmology teaching and investigate its impact on the skills of medical students.

METHODS

This was a nonrandomized, prospective, and comparative study. Seventy-six medical students were assigned to 2 groups before their clinical teaching. Some were asked to follow a MOOC for slitlamp microscope examination but used textbook for preview of visual acuity test (SLMM group, n=39), while others were required to take a MOOC for visual acuity test and previewed slitlamp microscopy using textbook (VATM group, n=37). All the students then underwent conventional clinical ophthalmology teaching on slitlamp microscopy and visual acuity test. Their performance was evaluated using Direct Observation of Procedural Skills (DOPS). Students were also asked to complete a 5-item questionnaire about their learning experience and comment on the MOOC.

RESULTS

Students in the SLMM group obtained overall higher scores in the slitlamp practical skills (47.64±4.01 vs 44.68±5.99, P=0.013), while those in the VATM group performed better in the visual acuity test (46.45±4.90 vs 43.78±4.94, P=0.004). MOOC was deemed to increase learning interests (4.13 of 5 points) and motivation (4.01 of 5 points) but was more preferred as an additional tool to traditional teaching methods (4.34 of 5 points) rather than to replace them (2.92 of 5 points).

CONCLUSIONS

MOOC offers an added benefit in improving clinical skills and is worth advocating as an additional tool for clinical ophthalmic education.

Medical Schools' Ophthalmology Course: An Appraisal by Ophthalmology Residents

Objective

To investigate the perception and satisfaction of ophthalmology residents with the currently provided ophthalmology curricula to medical students.

Methods

A cross-sectional survey involving first to fourth year ophthalmology residents (N = 106) from all regions of Saudi Arabia was conducted between December 2018 and February 2019. An online questionnaire explored opinions about the ophthalmology course regarding three dimensions. Firstly, adequacy in covering essential parts of the specialty; secondly, improvements required; and thirdly, effectiveness. A score (0–21) was calculated, indicating the overall suitability of the ophthalmology course. In addition, factors of good overall suitability (score ≥10) were analyzed.

Results

Regarding adequacy, respondents opined that the ophthalmology course did not reasonably cover the basic part (35.8%), clinical part (61.3%), common disease (26.4%), and emergencies (39.6%). Concerning improvements required, more than 80% of the participants expressed that the course required to be improved for all its features, including duration (80.2%), objectives (85.8%), content (82.1%), organization (83.0%), and supervision (81.1%). As to effectiveness, half of them deemed the course unhelpful in familiarizing general practitioners with common ophthalmic diseases and emergencies. Overall, the ophthalmology course was generally deemed suitable (score ≥10) for only 27.4% of the participants, with no differences across gender, level, or region.

Conclusion

Ophthalmology residents perceived multiple deficits in the current Saudi ophthalmology teaching course. Significant improvements in ophthalmologic curricula are required, besides coping with unprecedented technological advancement in the ophthalmological field.

Comparison of Digital Camera Real-Time Display with Conventional Teaching Tube for Slit Lamp Microscopy Teaching

PURPOSE

To compare slit-lamp microscopy teaching outcomes with digital camera real-time display and conventional teaching tube in undergraduate education of clinical ophthalmology.

METHODS

Thirty-seven Year 4 medical students were assigned to two groups for slit lamp microscopy teaching with digital camera real-time display (n = 18) and teaching tube (n = 19). The outcome measures included a 5-item questionnaire on their experience and the quality of slit lamp photos taken by the students.

RESULTS

The overall satisfaction score was significantly higher in the group of digital camera real-time display compared with the group of teaching tube (4.5 ± 0.5 vs. 4.2 ± 0.7, P = .013). The former group also achieved higher quality score of the slit-lamp photography (4.1 ± 0.3 vs. 3.6 ± 0.5, P = .002).

CONCLUSIONS

The digital camera real-time display attachment is more effective in undergraduate ophthalmic education over conventional slit-lamp teaching tube. It is also more favored by students and is thus highly recommended for clinical ophthalmology education.

A validated audio-visual educational module on examination skills in ophthalmology for undergraduate medical students in the COVID-19 season - An observational longitudinal study

Purpose

The aim of this study was to assess the impact of an audio visual (AV) teaching module on basic torchlight examination of the eye and direct ophthalmoscopy for undergraduate medical students.

Methods

This observational longitudinal study was done on 33 consecutive medical interns during their Ophthalmology posting from December 2019 to March 2020 at a medical college in South-India. An AV-module was created using animation graphics, narratives, demonstrations on normal individuals and on patients with positive signs. All interns had a pretest consisting of Multiple-choice questions, (MCQs) and an Objective Structured Clinical Examination (OSCE) on torchlight examination and direct ophthalmoscopy (DO). They were then shown the 20-minute AV-module. A posttest was performed immediately and after one week.

Results

The mean pretest MCQ score was 5.84 ± 1.98. It improved to 8.81 ± 1.15 in the immediate posttest and 8.87 ± 1.66 in the one-week posttest. The mean pretest OSCE score was 12.21 ± 3.39. It improved to 23.21 ± 3.39 in the immediate posttest and 23.90 ± 3.7 in the one-week posttest. Using Generalized Estimating Equation, MCQ score improved by 2.97 units and 3.03 units and the OSCE score improved by 11 units and 11.69 units in the immediate posttest and one-week posttest respectively when compared to the pretest corresponding to the MCQ score and OSCE score (p < 0.001).

Conclusion

AV teaching modules-for torchlight examination and DO has a significant benefit in improving knowledge and skill in undergraduate medical students. These significant results have the great translatory capacity in the current COVID-19 pandemic, where physical demonstrations involving close proximity and groups of students are highly risk prone.

Use of Smartphone-Based Head-Mounted Display Devices to View a Three-Dimensional Dissection Model in a Virtual Reality Environment: Pilot Questionnaire Study

BACKGROUND

Virtual reality (VR) technology has started to gain attention as a form of surgical support in medical settings. Likewise, the widespread use of smartphones has resulted in the development of various medical applications; for example, Google Cardboard, which can be used to build simple head-mounted displays (HMDs). However, because of the absence of observed and reported outcomes of the use of three-dimensional (3D) organ models in relevant environments, we have yet to determine the effects of or issues with the use of such VR technology.

OBJECTIVE

The aim of this paper was to study the issues that arise while observing a 3D model of an organ that is created based on an actual surgical case through the use of a smartphone-based simple HMD. Upon completion, we evaluated and gathered feedback on the performance and usability of the simple observation environment we had created.

METHODS

We downloaded our data to a smartphone (Galaxy S6; Samsung, Seoul, Korea) and created a simple HMD system using Google Cardboard (Google). A total of 17 medical students performed 2 experiments: an observation conducted by a single observer and another one carried out by multiple observers using a simple HMD. Afterward, they assessed the results by responding to a questionnaire survey.

RESULTS

We received a largely favorable response in the evaluation of the dissection model, but also a low score because of visually induced motion sickness and eye fatigue. In an introspective report on simultaneous observations made by multiple observers, positive opinions indicated clear image quality and shared understanding, but displeasure caused by visually induced motion sickness, eye fatigue, and hardware problems was also expressed.

CONCLUSIONS

We established a simple system that enables multiple persons to observe a 3D model. Although the observation conducted by multiple observers was successful, problems likely arose because of poor smartphone performance. Therefore, smartphone performance improvement may be a key factor in establishing a low-cost and user-friendly 3D observation environment.