Addressing Ophthalmology Education for Newly Matriculated Emergency Medicine Residents Using Innovative Models

Phillips, Lara; Stack, Lawrence B.; Thurman, R. Jason

doi:10.1097/sih.0000000000000112

Cited by 9 publications

(5 citation statements)

References 11 publications

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“…This is a potential area of opportunity for published ophthalmology education programs for emergency medicine residents to increase their applicability. [ 24 ] Furthermore, there is the opportunity to introduce measures that improve the exposure to ophthalmology at the medical school level. Potential conduits to facilitate the goal of basic clinical skills teaching and approaches to common ophthalmic complaints include didactic teaching, synchronous (interactive) learning, asynchronous learning and mandatory short term clinical rotations.…”

Section: Discussionmentioning

confidence: 99%

Profile of eye-related emergency department visits in Ontario – a Canadian perspective

et al. 2023

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Background Understanding the epidemiology of ophthalmic presentations to emergency departments can help guide resource allocation, medical education programs, and optimize the patient experience. The purpose of this investigation was to summarize and assess the urgency of ophthalmic presentations in emergency departments (EDs) in Ontario, Canada over a 5-year period. Methods This was a multicentered retrospective review of all patient presentations to EDs in Ontario between January 1st, 2012, to December 31st, 2017. Presentations were included if patients had an ophthalmic related ICD-10 code as their primary problem prompting ED presentation. Results A total of 774,057 patients patient presentations were included across the pediatric (149,679 patients) and adult (624,378 patients) cohorts. The mean (SD) age at presentation was 47.4 (17.9) years, and 6.54 (5.20) in the adult and pediatric cohorts respectively. Of the total presentations, 256,776 (33.1%) were due to a trauma related presentation. Problems pertaining to Cornea and External disease were the most common reason for presentation (51.0% of cases). Of all presentations, 34.1% were classified as either ‘emergent’ or ‘likely emergent’; the remaining presentations were either ‘non-emergent’ (39.5%) or the urgency ‘could not be determined’ (26.4%). The three most frequent presentations were due to conjunctivitis (121,175 cases or 15.7%), ocular foreign bodies (104,322 cases or 13.5%), and corneal / conjunctival abrasions (94,554 cases of 12.2%). Conclusions This investigation summarizes all ophthalmic presentations to EDs in Ontario, Canada over a 5-year period. The results of this investigation can help guide ophthalmic related knowledge translation. Additionally, these results highlight that in Canadian EDs, a significant proportion of ophthalmic presentations are nonurgent; systems level efforts to improve access for eye-related complaints to healthcare professionals outside of the ED can help facilitate improved resource allocation. As we emerge from the COVID-19 pandemic, optimising the structure of patient care access is crucial to help alleviate the pressure from overburdened EDs while effectively meeting patient healthcare needs.

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Section: Discussionmentioning

confidence: 99%

Profile of eye-related emergency department visits in Ontario – a Canadian perspective

et al. 2023

View full text Add to dashboard Cite

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“…This is a potential area of opportunity for published ophthalmology education programs for emergency medicine residents to increase their applicability. [24] A strength of this investigation is its size; to our knowledge this is the largest Canadian investigation assessing ophthalmic presentations to the ED. This helps to address a gap in the currently literature by providing Canadian data that can be utilized to better inform Canadian training programs and resource allocation assessments.…”

Section: Discussionmentioning

confidence: 99%

Profile of Eye-Related Emergency Department Visits in Ontario – A Canadian Perspective

Nanji

Gulamhusein

Jindani

et al. 2023

Preprint

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Background: Understanding the epidemiology of ophthalmic presentations to emergency departments can help guide resource allocation, medical education programs, and optimize the patient experience. The purpose of this investigation was to summarize and assess the urgency of ophthalmic presentations in emergency departments (EDs) in Ontario, Canada over a 5-year period. Methods: This was a multicentered retrospective review of all patient presentations to EDs in Ontario between January 1st, 2012, to December 31st, 2017. Presentations were included if patients had an ophthalmic related ICD-10 code as their primary problem prompting ED presentation. Patients under the age of 18 were excluded from this investigation. Results: A total of 774,057 patients patient presentations were included across the pediatric (149,679 patients) and adult (624,378 patients) cohorts. The mean (SD) age at presentation was 47.4 (17.9) years, and 6.54 (5.20) in the adult and pediatric cohorts respectively. Of the total presentations, 256,776 (33.1%) were due to a trauma related presentation. Problems pertaining to Cornea and External disease were the most common reason for presentation (51.0% of cases). Of all presentations, 34.1% were classified as either ‘emergent’ or ‘likely emergent’; the remaining presentations were either ‘non-emergent’ (39.5%) or the urgency ‘could not be determined’ (26.4%). The three most frequent presentations were due to conjunctivitis (121,175 cases or 15.7%), ocular foreign bodies (104,322 cases or 13.5%), and corneal / conjunctival abrasions (94,554 cases of 12.2%). Conclusions: This investigation summarizes all ophthalmic presentations to EDs in Ontario, Canada over a 5-year period. The results of this investigation can help guide ophthalmic related knowledge translation. Additionally, these results highlight that in Canadian EDs, a significant proportion of ophthalmic presentations are nonurgent; systems level efforts to improve access for eye-related complaints to healthcare professionals outside of the ED can help facilitate improved resource allocation. As we emerge from the COVID-19 pandemic, optimising the structure of patient care access is crucial to help alleviate the pressure from overburdened EDs while effectively meeting patient healthcare needs.

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“…We incorporated this task trainer into our regularly scheduled medical student procedural training, accompanied by a brief didactic session describing tonometry. We also included it in our annual EM intern ophthalmology boot camp, replacing the prior Foley catheter-based model among a rotation of ophthalmology skills stations [ 7 ]. Our task trainer was well-received by our cohort of learners.…”

Section: Discussionmentioning

confidence: 99%

A Novel Ocular Tonometry Task Trainer

Heimiller¹,

Stack²,

Sikon³

et al. 2022

Cureus

Self Cite

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The measurement of intraocular pressure via ocular tonometry is a skill necessary for the evaluation of emergency department patients with ocular complaints. Accurate results inform the use of time-sensitive medications or invasive procedures. We sought to develop and evaluate an affordable, realistic, and reproducible task trainer to allow Emergency Medicine residents and medical students to practice tonometry.We placed an angiocatheter into the vitreous chamber of a swine eye through the optic nerve stump and sealed it with a purse string suture and cyanoacrylate glue. This allowed us to connect intravenous extension tubing and use a saline-filled syringe to repeatedly adjust intraocular pressure in real time. Optionally, this model can be mounted in a polystyrene foam mannequin head to enhance realism and facilitate practice.The task trainer was implemented in medical student and Emergency Medicine resident education at Vanderbilt University Medical Center. Thirty-six learners participated in the study, all of whom completed pre-course and post-course surveys. Among all learners, the mean comfort with performing tonometry improved significantly (3.26 to 7.64 {Z = -4.95, p < 0.005}). The mean confidence in the accuracy of measurements also increased (3.11 to 7.56 {Z = -4.8, p < 0.005}). On a 10-point scale, learners felt this task trainer was highly helpful in increasing their comfort with and the ability to perform tonometry (mean 9.19 {SD 1.19}).We have developed a low-cost and easily constructed ocular tonometry task trainer that resulted in significant improvement in learner comfort and confidence.

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Addressing Ophthalmology Education for Newly Matriculated Emergency Medicine Residents Using Innovative Models

Abstract: The eye emergencies curriculum provides a well-received and practical model for residents to gain ophthalmology experience. Novel eye simulation models may be useful for other programs to implement to enhance postgraduate education.

Cited by 9 publications

References 11 publications

Profile of eye-related emergency department visits in Ontario – a Canadian perspective

Profile of eye-related emergency department visits in Ontario – a Canadian perspective

Profile of Eye-Related Emergency Department Visits in Ontario – A Canadian Perspective

A Novel Ocular Tonometry Task Trainer

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