One-Year Progress in Ophthalmic Education: Annual Review

A Systematic Scoping Review of the Current Applications of Digital Technology in Undergraduate Surgical Education

Over the past few decades, technological advancements have established digital tools as an indispensable pedagogical resource in the realm of modern education. In the field of medical education, there is growing interest in how these digital tools can be effectively integrated to enhance undergraduate surgical education. However, despite their well-documented potential benefits, research specifically investigating the current use of digital technology in undergraduate surgical education remains limited, highlighting a critical gap in the existing literature. To address this research gap, this scoping review aims to elucidate the current utilisation of digital technologies in undergraduate surgical education by addressing the research question: 'How are digital technologies currently being utilised in undergraduate surgical education to meet surgical learning outcomes'. A scoping review was performed, adopting the Joanna Briggs Institute (JBI) framework. A comprehensive search strategy was conducted using the search terms 'technology' OR 'simulation' OR 'virtual reality' OR 'augmented reality' OR 'digital' OR 'online' AND 'undergraduate' AND 'surgical' on multiple electronic bibliographic databases including PubMed, Medline, ERIC, Embase, Scopus and Web of Science. These search terms were executed using both free-text and MeSH terms, with search terms combined using Boolean operators to ensure all relevant citations were captured. All search results were screened against the eligibility criteria using Covidence, a web-based software platform, using a two-stage process. Subsequently, all included studies were reviewed, and the extracted data was systematically sorted and organised, with the findings presented graphically accompanied by descriptive narratives. A thematic analysis was also performed to identify themes within the data to synthesise key findings. This scoping review revealed three key findings. First, the use of digital tools in surgical education has been steadily increasing over the past few decades, with the COVID-19 pandemic accelerating the integration of technology into surgical education. Second, this review also highlighted the key role of anatomy within surgical education, with most included studies reporting the use of digital technologies to enhance anatomy teaching. Finally, this review provided an overview of various digital tools used in surgical education and their associated user experiences. Overall, most studies indicated that digital technologies are well-received by students, with many advocating for their continued use in supplementing surgical education even beyond the pandemic. This review provides a crucial foundation for understanding the evolving role of digital innovations in shaping undergraduate surgical education. To enhance undergraduate surgical education, integrating appropriate digital learning tools can provide more learner-centred and personalised learning experiences. Educators must recognise that there is no 'one-size-fits-all' approach, and a flexible multimodal strategy is necessary to meet diverse learning needs. As technology continues to evolve and its role in education grows, this review offers valuable insights into the current use of digital tools in surgical education, highlighting opportunities for improvement and innovation to further enhance undergraduate surgical experience.

Assessment of Ophthalmology Residency Training in Switzerland: A Trainee-Based Survey

BACKGROUND

This study aimed to evaluate the current status of ophthalmology residency training in Switzerland and provide insights for enhancing training programs.

MATERIALS AND METHODS

The survey covered demographic data such as gender, age, workplace, and year of residency, as well as working conditions, current practical and diagnostic skills, interest in scientific work, and future plans. It consisted of 16 multiple choice questions (MCQ), 5 multiple select questions (MSQ), 8 free-text, 6 Net Promoter Score (NPS), and 4 Likert scale questions. All Young Swiss Ophthalmologists (YSO) members received an invitation to participate in the survey using an online form. All collected data were anonymized, and participants provided their consent for data collection, analysis, and publication.

RESULTS

The survey assessed the perspectives of 63 Swiss ophthalmology residents on their training experiences. Respondents indicated the greatest interest in specializing in cataract and vitreoretinal surgery, followed by cornea, glaucoma, refractive surgery, and lid surgery. They also expressed a great need for improved supervision, structured curricula, and alignment of clinical and research duties. While pursuing additional surgical training and private practice autonomy, residents also expressed a preference for balanced workloads that emphasize patient care over full-time academic work.

CONCLUSION

The survey indicates a need to standardize ophthalmology residency training in Switzerland to ensure comprehensive and uniform education. It also highlights specific areas for improvement, such as the absence of surgical training. Ongoing assessments are necessary to evaluate future developments.

How has medical student learning changed with the pivot to online delivery of ophthalmology in the pandemic?

PURPOSE

This study aimed to measure stakeholder satisfaction with our usual delivery format, which previously relied on a blend of didactic lectures and clinical skills sessions compared to a revised format, which had more emphasis on online learning. We hypothesised that the online flipped classroom (OFC) would facilitate delivery of content in the wake of the pandemic, and result in improved levels of student satisfaction and knowledge gain.

DESIGN

Non randomised intervention study. Group 1 = Traditional delivery (TD) and Group 2 = OFC group.

METHODS

A validated course evaluation questionnaire (CEQ) compared perspectives of teaching faculty (n = 5) and students with the traditional delivery (TD) of the 4th year ophthalmology clinical attachment and an OFC approach (TD n = 129 v OFC n = 114).

RESULTS

The OFC group (n = 114; response rate = 24.6%) reported significantly reduced satisfaction with staff motivation of students and provision of feedback, compared to TD (n = 129; response rate = 17.8%). OFC students also felt it was harder to determine what standard of work was expected and found the course less beneficial at helping develop problem-solving skills. Students were dissatisfied with the level of choice afforded by the OFC, specifically how they would learn and assessment options. No significant difference in exam score was observed between the TD and OFC groups. For faculty (n = 5), there was no evidence of a difference between OFC and TD.

CONCLUSIONS

Students indicated a preference for the TD compared to the OFC approach. However, both delivery approaches led to comparable student performances as determined by MCQ examination.

Ophthalmology Residency in the United States: The Case for a National Curriculum

To identify strategies for effective curriculum development and implementation in United States (US) ophthalmology residency training programs. A literature review was conducted for all English-language PubMed/Medline articles relating to ophthalmology residency education or curriculum/curricula. Despite ACGME-defined program requirements outlining curricular goals for US ophthalmology residency training programs, there is no comprehensive, national curriculum with detailed plans for instruction of necessary topics within the 36-month residency training period. Several articles identify a need for detailed curricula on various topics, propose ideas on how residency programs could create curricula, and explore ways of assessing resident competence. There is a paucity of literature evaluating how ophthalmology residents best learn various ophthalmology topics. We need to develop an intentional, comprehensive, and timely national curriculum for ophthalmology residency programs in the US, with detailed plans on how to meet curricular objectives and consideration of the most effective teaching strategies for different ophthalmology concepts.

Competency-based medical education in ophthalmology residency training: a review

Competency-based medical education (CBME) is an outcomes-based training model that has become the new standard of medical education internationally. Regulatory and accrediting bodies have responded by establishing key competencies that residency programs may use to reshape their curricula. Available literature on the implementation of CBME in ophthalmology residency training programs across North America was examined. Ophthalmology-specific residency training objectives and milestones have been proposed within North America in the last 4 years. Curriculum guidelines and implementation blueprints and principles have also been proffered from various sources internationally but have met with some barriers. Assessment tools within ophthalmology have seen the most innovative development within the domain of surgical skills objectives. Competencies outside of the medical expert and patient care roles have proven more challenging to teach and assess. One ophthalmology program in Canada has undergone early implementation of a novel CBME curriculum. There is still considerable work to be done to successfully implement CBME curricula within ophthalmology residency programs in North America. Collaborative efforts to develop customizable curricula, tackle implementation barriers, and create specific assessment modalities will assist programs in meeting the competency mandates of CBME.

Annual program review process: an enhanced process with outcomes

The Accreditation Council for Graduate Medical Education's required Annual Program Review of Educational Effectiveness (APREE) has helped us improve our program and change its culture to one of continuous quality improvement. This report outlines our systematic process and describes specific outcomes it has produced over a 10-year period. We identified ways to enhance our APREE after reading articles that described various ways to conduct the process found in a PubMed and OvidSP search and relevant policies from our local Graduate Medical Education Office. After discussing options, we incorporated new ideas into our APREE and tasked our Program Evaluation Committee to track outcomes from objectives developed by faculty and residents during each APREE. Objectives from faculty and residents in 10 years of our APREE led to major improvements (e.g., increased board pass rate) in our program. In addition, the enhanced APREE process gradually changed our residency's culture to one that embraces continuous quality improvement. A systematic APREE process can engage residents and faculty in improving specific components of a residency. Besides providing outcomes for Web Ads and Self-Study items, the APREE models quality improvement techniques to residents, involves a wide array of stakeholders, and helps program stakeholders embrace continuous quality improvement.