Use of a fundus photograph matching program in imparting proficiency in ophthalmoscopy

Benard-Seguin, Etienne; Kwok, Jason M; Liao, Walter; Baxter, Stephanie

doi:10.1016/j.jcjo.2017.11.022

Cited by 4 publications

(9 citation statements)

References 9 publications

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“…Likewise, Gormley et al found deeper engagement with clinical e-learning was associated with better practical performance, 16 while a non-randomised prospective trial of 46 students found online fundus photograph training improved ophthalmoscopy OSCE performance. 15 We found a strong correlation between student and reference standard disc gradings for easy cases and a poor correlation for difficult cases. This suggests that the cognitive complexity of our cases could have distracted students and reduced their diagnostic performance overall.…”

Section: Discussionmentioning

confidence: 62%

“…A non-randomised online fundus-matching program was associated with better CDR assessment and fundoscopy OSCE performance, however recruitment bias limits generalisation of their results. 15 Inter-rater agreement on CDR is variable even among experts, 23 however Russo et al found substantial agreement between SF (D-eye) and slit-lamp biomicroscopy assessments of CDR (72.4%, Kappa = 0.63) by two masked ophthalmologists. 24 More students in our study preferred smartphone fundoscopy over TDO after brief training.…”

Section: Discussionmentioning

confidence: 99%

“…14 Fundoscopy interpretation requires pattern recognition, making digital fundus images an eligible target for integrated e-learning support. 15 A qualitative study of medical students found they valued e-learning equally with traditional clinical skills training when the two are blended. 16 Our group has already shown that medical students perceive smartphone fundoscopy as easier to use and more useful than the TDO, critical differences which predict the future use of technologies.…”

Section: Introductionmentioning

confidence: 99%

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eFOCUS 2: A randomised crossover trial of smartphone fundoscopy and direct ophthalmoscopy aiming to improve optic disc interpretation by medical students with e‐learning support

Dunn

Marks

Teo

et al. 2021

Clinical Exper Ophthalmology

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Background: Ophthalmoscopy and its interpretation are complex. We aimed to compare the diagnostic accuracy of smartphone fundoscopy with traditional direct ophthalmoscopy for optic disc interpretation, with e-learning support.Methods: We conducted a randomised, crossover study of 102 medical students. Students were offered e-learning for optic disc interpretation. A fundoscopy objective structured clinical examination was conducted after an introductory lecture and 10-min practical training session on smartphone fundoscopy and traditional ophthalmoscopy. Participants examined patients and simulator slides with a randomised crossover between smartphone [D-eye (Padova, Italy) or iExaminer (Welch Allyn, Macquarie Park, Australia)] and traditional ophthalmoscopy (Welch Allyn). Optic discs were graded independently by three masked ophthalmologists. The primary outcome was the ability to interpret an optic disc as normal or abnormal. Secondary outcomes included other optic disc aspects; student preferences; and e-learning performance.Results: Students' agreement with the gold standard for an abnormal or normal disc was significantly greater using a smartphone (74.4%) than with direct ophthalmoscopy (68.1%, p = 0.032). More students preferred smartphone (74%) over direct ophthalmoscopy (26%, p < 0.001). E-learning led to an improvement in optic disc interpretation scores (mean improvement = 4.5%, 95% CI = 3.7-5.2, p < 0.001). Conclusions: Medical students are more accurate at recognising an abnormal optic disc using smartphone fundoscopy than traditional direct ophthalmoscopy, and have a strong preference for smartphone fundoscopy. E-learning may improve the interpretation of optic disc abnormalities. Smartphone

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Section: Discussionmentioning

confidence: 62%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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eFOCUS 2: A randomised crossover trial of smartphone fundoscopy and direct ophthalmoscopy aiming to improve optic disc interpretation by medical students with e‐learning support

Dunn

Marks

Teo

et al. 2021

Clinical Exper Ophthalmology

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“…Optic disk identification as facilitated through an online fundus photography matching program is objective, measurable, and has clinical applicability. 32,33 We also found several statistically significant and clinically relevant advantages of the D-EYE device. First, medical students were significantly more successful at visualizing the optic disk using the D-EYE smartphone ophthalmoscope despite having had more experience with the latter in the form of a previous clinical skills workshop and more opportunity to practice with the DO due to the number of available devices during the practice session within the study.…”

Section: Discussionmentioning

confidence: 58%

Smartphone Compatible versus Conventional Ophthalmoscope: A Randomized Crossover Educational Trial

Curtis

Liu

et al. 2021

Journal of Academic Ophthalmology

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Objective The aim of the study is to compare performance and ease-of-use (EOU) of optic disk assessment using a smartphone direct ophthalmoscope attachment (D-EYE) to the gold standard direct ophthalmoscope (DO). Design The type of study involved is prospective, randomized, crossover, and educational trial. Participants The participants involved were first year medical students inexperienced in ophthalmoscopy. Methods Optic disks of standardized and volunteer patients were examined using the D-EYE and a conventional DO. Optic disk identification, EOU ratings of the devices, self-reported confidence level in their examination with the devices, and estimation of vertical cup-to-disk ratio (VCDR) were compared. Analyses included Chi-square tests, independent samples t-tests, correlations, and multivariable linear regression. Results Forty-four medical students voluntarily participated in the study. Students using the DO required more attempts (3.57 vs. 2.69, p = 0.010) and time (197.00 vs. 168.02 seconds, p = 0.043) to match the patient's fundus to the correct photograph. Overall EOU between the devices (6.40 vs. 4.79, p < 0.001) and overall confidence in examination (5.65 vs. 4.49, p = 0.003) were greater when using the D-EYE. There were no statistically significant differences in accuracy of VCDR estimations between the two ophthalmoscopes. Conclusion Smartphone ophthalmoscopy could offer additional learning opportunities in medical education and may be considered in clinical practice by non-specialist physicians given its greater EOU and increased success in visualizing the optic disk.

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“…Multiple studies have shown that simulators can be effective tools to practice the fundus examination. [10][11][12][13][14] At this time, however, few studies have assessed the individual simulators. [11][12][13] One simulator of special interest is the Eyesi Direct Ophthalmoscope Simulator (VRmagic Holding AG, Man-nheim, Germany).…”

mentioning

confidence: 99%

Comparing Eyesi Virtual Reality Simulator and Traditional Teaching Methods for Direct Ophthalmoscopy: Students' Perspectives at Indiana University School of Medicine

Tso

Young

Yung

2021

Journal of Academic Ophthalmology

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Background The fundus examination is an essential part of any ophthalmologic evaluation. However, medical students and primary care physicians often lack confidence with direct ophthalmoscopy. Virtual reality simulators are being employed in medical education to teach this technically challenging examination. Objective To compare medical student ratings of the Eyesi Direct Ophthalmoscope Simulator and traditional small group teaching methods for learning direct ophthalmoscopy skills. Methods All medical students at Indiana University School of Medicine traditionally learn direct ophthalmoscopy in their first 2 years during a small group session led by a physician instructor. Students who later enrolled in ophthalmology clinical electives during 2019 and 2020 were invited to additionally complete the Eyesi Direct Ophthalmoscope Simulator virtual reality curriculum. A voluntary, anonymous survey was sent between June and August 2020 to students who had completed both the traditional and Eyesi simulator sessions. Students were asked to rate their confidence in performing direct ophthalmoscopy following each session, and to indicate which teaching method was superior and why. Chi-square analysis was used to compare categorical variables. Results Students' confidence ratings for performing direct ophthalmoscopy were significantly higher following completion of the Eyesi simulator session compared with the traditional small group session (p < 0.001). Four-fifths of respondents felt that the Eyesi simulator was superior to the traditional small group for learning the skills of direct ophthalmoscopy, while one-fifth felt that the two sessions were equally effective (p < 0.001). None of the students responded that the small group session was the superior teaching method. Conclusion The Eyesi Direct Ophthalmoscope Simulator was rated highly among medical students and offers distinct learning advantages that could not be replicated in a traditional small group environment, such as providing numerous examples of pathological findings and allowing unlimited examination time without concern for patient's inconvenience or light exposure. The Eyesi simulator is a promising tool for teaching direct ophthalmoscopy to medical students. Ultimately, familiarity with the fundus examination will enable future physicians across specialties to better evaluate and appropriately refer patients with ocular fundus pathology.

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Use of a fundus photograph matching program in imparting proficiency in ophthalmoscopy

Cited by 4 publications

References 9 publications

eFOCUS 2: A randomised crossover trial of smartphone fundoscopy and direct ophthalmoscopy aiming to improve optic disc interpretation by medical students with e‐learning support

eFOCUS 2: A randomised crossover trial of smartphone fundoscopy and direct ophthalmoscopy aiming to improve optic disc interpretation by medical students with e‐learning support

Smartphone Compatible versus Conventional Ophthalmoscope: A Randomized Crossover Educational Trial

Comparing Eyesi Virtual Reality Simulator and Traditional Teaching Methods for Direct Ophthalmoscopy: Students' Perspectives at Indiana University School of Medicine

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