Objective: To determine whether practice using an online fundus photograph program results in a long-term increase in proficiency with direct ophthalmoscopy skills in medical students.
Design: This study was a prospective medical education trial. Students were enrolled to participate in a voluntary Objective Structured Clinical Examination (OSCE) using 5 patients with ocular findings. Students who matched a minimum of 6 discs 16 months before the study were assigned to the intervention group and were compared with students who did not participate in the exercise.
Participants: Forty-six second-year medical students at Queen's University: 15 in the intervention group and 31 in the control group.
Methods: Students were evaluated using the Queen's University Ophthalmoscopy OSCE Checklist (QUOOC). Students were asked to calculate the cup-to-disc ratio, comment on disc margins, and whether there was any macular pathology. Students participated in a summative OSCE as part of the curriculum in which all students attempted to match fundus photographs.
Results: Students in the intervention group performed significantly better on the QUOOC, with a mean score of 78.3% (± 4.2), compared with the control, who had a mean score of 69.4% (± 4.2) (p = 0.005). The intervention group was significantly more accurate at matching optic nerve photographs, with 100% (15/15) of the students correctly identifying the correct optic nerve on first attempt compared with 53.3% (16/30) in the control group (p = 0.0014).
Conclusions: The use of an online peer fundus photograph program leads to a long-term increase in examination technique, proficiency in ophthalmoscopy, and accuracy at matching optic nerve photographs.
Copyright © 2017 Canadian Ophthalmological Society. Published by Elsevier Inc. All rights reserved.