scholarly journals Comparison of conventional and wide field direct ophthalmoscopy on medical students’ self-confidence for fundus examination: a 1-year follow-up

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Gabriel Ayub ◽  
Rafael Boava Souza ◽  
Andrelisa Marina de Albuquerque ◽  
José Paulo Cabral de Vasconcellos
Keyword(s):  
Medical Students ◽  
Optic Disc ◽  
Control Group ◽  
Practical Training ◽  
Wide Field ◽  
Fundus Examination ◽  
Self Confidence ◽  
One Year ◽  
Direct Ophthalmoscopy ◽  
Cup To Disc Ratio

Abstract Background Fundus examination is an easy, quick and effective way to diagnose sight- and life-threatening diseases. However, medical students and physicians report lack of proficiency and self-confidence in perform fundoscopy. The aim of this study was to compare students’ self-confidence in fundus examination, using two different direct ophthalmoscopes, 1 month and 1 year after practical training. Methods In this prospective cohort, medical students (MS) of the same class were divided in small groups for PanOptic (PO) or conventional (CO) direct ophthalmoscope training. The intervention group encompassed MS of the 4th -year (class of 2019), and the control group encompassed MS of year behind (class of 2020). A questionnaire to measure self-confidence in fundoscopy technique assessing optic nerve, cup-to-disc ratio and macula was translated and validated to Portuguese, and applied 1-month and 1-year after practical training. Results One-hundred and sixty-seven MS were enrolled (35 PO group, 38 CO group, and 94 control group). PO group had a significantly higher overall self-confidence comparing either control or CO groups, respectively (3.57 ± 0.65 vs. 2.97 ± 1.03 vs. 2.46 ± 0.87, p < 0.01) as well as in evaluate cup-to-disc ratio (3.09 ± 0.75 vs. 2.32 ± 0.87 vs. 1.46 ± 0.81, p < 0.01), optic disc margins (3.26 ± 0.85 vs. 2.71 ± 0.96 vs. 2.01 ± 0.97, p < 0.01) and macula (3.43 ± 1.12 vs. 2.89 ± 1.08 vs. 2.02 ± 0.89, p < 0.01) 1-month after practical training. One-year after intervention, CO group showed a significantly higher score compared to PO group in overall self-confidence (3.31 ± 0.69 vs. 3.18 ± 0.73, p = 0.03) and in optic disc margins assessing (3.16 ± 0.85 vs. 2.95 ± 0.78, p = 0.03), but not significant in the evaluation of cup-to-disc ratio (2.78 ± 0.97 vs. 2.68 ± 0.94, p = 0.08), and macula (3.34 ± 0.79 vs. 3.27 ± 0.98, p = 0.07). Conclusions Students were more confident in use PO as an instrument to perform direct ophthalmoscopy immediately after practical training, but confidence level of CO was higher compared to PO one year after practical training. These findings would help medical schools decide which ophthalmoscope to choose to teach fundus examination.

Use of Trained Mothers to Teach Interviewing Skills to First-Year Medical Students: A Follow-up Study

PEDIATRICS ◽  
1977 ◽  
Vol 60 (2) ◽  
pp. 165-169 ◽  
Author(s):  
Paula L. Stillman ◽  
Darrell L. Sabers ◽  
Doris L. Redfield
Keyword(s):  
Medical Students ◽  
School Curriculum ◽  
Control Group ◽  
First Year ◽  
Feedback Session ◽  
Optimal Learning ◽  
Interviewing Skills ◽  
One Year ◽  
First Year Medical Students

This report describes an attempt to evaluate the effectiveness of "trained mother" interviews early in the medical school curriculum. As an adjunct to a first-year course that teaches interviewing techniques, half of the students were exposed to an interview with one of three trained mothers early in the course. This treatment interview was immediately followed by a feedback session which concentrated on the content and process of interviewing. At the end of the course, all students had an evaluative interview. Those students who had an initial interview and feedback session with a trained mother scored significantly higher on both the content and process of their interviews than the control group. This technique is an effective and efficient way to teach interviewing skills to medical students prior to entering any of their clinical clerkships. A follow-up assessment conducted one year later indicated that one interview with a trained mother is sufficient for optimal learning and that the skills learned are retained over at least that period of time.

scholarly journals The Flipped Classroom Is Effective for Medical Students to Improve Deep Tendon Reflex Examination Skills: A Mixed-Method Study

2021 ◽  
Author(s):  
Shun Uchida ◽  
Kiyoshi Shikino ◽  
Kosuke Ishizuka ◽  
Yosuke Yamauchi ◽  
Yasutaka Yanagita ◽  
...  
Keyword(s):  
Medical Students ◽  
Flipped Classroom ◽  
Deep Tendon Reflex ◽  
Intervention Group ◽  
General Medicine ◽  
Likert Scale ◽  
University Hospital ◽  
Control Group ◽  
Self Confidence ◽  
Before And After

Abstract Background: Deep tendon reflexes (DTR) are a prerequisite skill in clinical clerkships. However, many medical students are not confident in their technique and need to be effectively trained. We evaluated the effectiveness of a flipped classroom for teaching DTR skills. Methods: We recruited 83 fifth-year medical students who participated in a clinical clerkship at the Department of General Medicine, Chiba University Hospital, from November 2018 to July 2019. They were allocated to the flipped classroom technique (intervention group, n=39) or the traditional technique instruction group (control group, n=44). Before procedural teaching, while the intervention group learned about DTR by e-learning, the control group did so face-to-face. A 5-point Likert scale was used to evaluate self-confidence in DTR examination before and after the procedural teaching (1=no confidence, 5=confidence). We evaluated the mastery of techniques after procedural teaching using the Direct Observation of Procedural Skills (DOPS). Unpaired t-test was used to analyze the results of the 5-point Likert scale and DOPS. We assessed self-confidence in DTR examination before and after procedural teaching using a free description questionnaire in the two groups. Additionally, in the intervention group, focus group interviews (FGI) (7 groups, n=39) were conducted to assess the effectiveness of the flipped classroom after procedural teaching.Results: Pre-test self-confidence in the DTR examination was significantly higher in the intervention group than in the control group (2.8 vs. 2.3, P=0.005). Post-test self-confidence in the DTR examination was not significantly different between the two groups (3.9 vs. 4.1, P=0.31), and so was mastery (4.3 vs. 4.1, P=0.68). The questionnaires before the procedural teaching revealed themes common to the two groups, including “lack of knowledge” and “lack of self-confidence.” Themes about prior learning, including “acquisition of knowledge” and “promoting understanding,” were specific in the intervention group. The FGI revealed themes including “application of knowledge,” “improvement in DTR technique,” and “increased self-confidence.” Conclusions: Teaching DTR skills to medical students in flipped classrooms improves readiness for learning and increases self-confidence in performing the procedure at a point before procedural teaching.

Simulation of childbirth improves clinical management capacity and self-confidence in medical students

2018 ◽  
Vol 4 (4) ◽  
pp. 184-189 ◽  
Author(s):  
Paolo Mannella ◽  
Rachele Antonelli ◽  
María Magdalena Montt-Guevara ◽  
Marta Caretto ◽  
Giulia Palla ◽  
...  
Keyword(s):  
Medical Students ◽  
Training Session ◽  
Hospital Environment ◽  
Control Group ◽  
High Fidelity ◽  
Self Assessment ◽  
Normal Cycle ◽  
Self Confidence ◽  
Before And After ◽  
Physiological Childbirth

Background The learning process of physiological mechanisms of childbirth and its management are important elements in the education of medical students. In this study, we verify how the use of a high-fidelity simulator of childbirth improves competence of students in this regard.Methods A total of 132 medical students were recruited for the study in order to attend a physiological childbirth in a no-hospital environment after being assigned to two groups. The control group received only a normal cycle of lectures, while the simulation (SIM) group followed a specific training session on the simulator. Subsequently, both groups were assessed for their technical and non-technical skills in a simulated childbirth. Also, a self-assessment test regarding their self-confidence was administrated before and after simulation, and repeated after 8 weeks.Results The SIM group showed better performance in all the domains with a better comprehension of the mechanisms of childbirth, managing and assistance of labour and delivery. In addition, compared to the control group, they presented a better self-related awareness and self-assurance regarding the possibility of facing a birth by themselves.Conclusion The present study demonstrated that the use of a high-fidelity simulator for medical students allows a significant improvement in the acquisition of theoretical and technical expertise to assist a physiological birth.

Structural and vascular features in cavitary congenital optic disc anomaly associated with metaphyseal acroscyphodysplasia

2021 ◽  
pp. 112067212199574
Author(s):  
Federica Fossataro ◽  
Luca D’Andrea ◽  
Gilda Cennamo
Keyword(s):  
Optical Coherence Tomography ◽  
Optic Disc ◽  
Systemic Disease ◽  
Wide Field ◽  
Fundus Examination ◽  
Optical Coherence ◽  
Optic Disc Coloboma ◽  
Retinal Epithelium ◽  
The Right ◽  
Optic Disc Anomaly

Purpose: To evaluate the radial peripapillary vascular plexus of a cavitary congenital optic disc anomaly in a young patient with recessive autosomal metaphyseal acroscyphodysplasia using optical coherence tomography angiography (OCTA). Methods: Observational case report. Results: A 17-year-old man, with diagnosis of metaphyseal acroscyphodysplasia was referred to Eye Clinic for fundus examination and multimodal imaging for retinal epithelium hypertrophy in the right eye. Clinical examination showed cup-shaped metaphyses, short stature, hyperthelorism, and telecanthus. An optic disc coloboma was detected in the right eye on fundus examination. Wide field en-face Optical Coherence Tomography (OCT) showed a hyporeflective area corresponding to the right optic disc coloboma. At OCTA examination, the whole papillary region revealed a rarefaction of the vascular network, while the ganglion cell complex’s and retinal fiber layers’ parameters were normal in both eyes. Conclusion: The presence of coloboma disc congenital defect linked to embryological abnormalities during the development process could pave the way for a wider understanding of the pathogenesis of metaphyseal acroscyphodysplasia by increasingly framing it as a systemic disease.

scholarly journals Peripheral Retinal Degenerations and Idiopathic Epiretinal Membrane: Analysis with Ultra-Wide-Field Scanning Laser Ophthalmoscopy

2021 ◽  
Vol 10 (17) ◽  
pp. 3876
Author(s):  
Klaudia Ulfik-Dembska ◽  
Sławomir Teper ◽  
Michał Dembski ◽  
Anna Nowińska ◽  
Edward Wylęgała
Keyword(s):  
Retinal Degeneration ◽  
Contact Lens ◽  
Epiretinal Membrane ◽  
Laser Scanning ◽  
Peripheral Retina ◽  
Control Group ◽  
Wide Field ◽  
Fundus Examination ◽  
Retinal Degenerations ◽  
Fundus Imaging

Background: The present study examined the relationships among retinal structure, peripheral retinal abnormalities, and epiretinal membrane (ERM) and explored the utility of ultra-wide-field laser scanning ophthalmoscopy in idiopathic ERM assessment. Methods: The study sample comprised 276 eyes of 276 patients. Ultra-wide field fundus imaging was performed without mydriasis using Optos California. Each patient underwent a Goldmann three-mirror contact lens fundus examination. Results: Ultra-wide field laser scanning ophthalmoscopy revealed peripheral retinal degeneration in 84 (54.54%) eyes in the ERM and in 28 (22.95%) eyes in the control group. Goldmann three-mirror contact lens examination revealed peripheral retinal degeneration in 96 (62.33%) eyes in the ERM group and 42 (34.42%) eyes in the control group. Ultra-wide field ophthalmoscopy enabled the detection of nearly 87% of all peripheral retinal lesions in patients with ERM, but it cannot replace fundus examination with a Goldmann triple mirror or ophthalmoscopy with scleral indentation. Conclusions: In most patients, idiopathic ERM coexisted with changes in the peripheral retina. Some of these changes promote retinal detachment. Thus, surgeons should consider the risk of retinal tear during vitrectomy, which increases the scope of surgery and may adversely affect prognosis. Although ultra-wide field imaging is a valuable diagnostic method, it is not a substitute for Goldmann three-mirror contact lens fundus examination or ophthalmoscopy with scleral indentation.

Optic disc and choroidal metastases secondary to breast cancer: A case report

2021 ◽  
pp. 112067212110362
Author(s):  
Rim Bouraoui ◽  
Khaled El Matri ◽  
Yousra Falfoul ◽  
Zied Chelly ◽  
Ahmed Chebil ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Case Report ◽  
Optic Disc ◽  
Infrared Imaging ◽  
Subretinal Fluid ◽  
Posterior Pole ◽  
Wide Field ◽  
Fundus Examination ◽  
Blurred Vision ◽  
Macular Lesion

Aim: To report an uncommon case of optic disc and multiple choroidal metastases secondary to breast cancer, assessed with swept source optical coherence tomography (SS-OCT), fluorescein (FA), and infracyanine (ICGA) angiographies. Methods: Observational case report. Case presentation: A 40-year-old woman with history of left breast carcinoma presented with blurred vision in her right eye (RE). Her visual acuity was 1/20 in the RE and 10/10 in the left eye. Fundus examination of the RE showed a large yellowish elevation of the posterior pole and a particular whitish nodular papillary cluster protruding from the optic disc into the vitreous. Infrared imaging enhanced the papillary nodular infiltrates. Characteristic findings of choroidal metastasis were noted within the macular lesion on SS-OCT and ICGA. SS-OCT showed specific “lumpy bumpy” irregularity of the anterior surface of the choroid and elevated hyperreflective nodular lesions of the optic disc associated to peripapillary subretinal fluid. The papillary lesions appeared as a bunch of hypofluorescent dots on both FA and ICGA, and ultra-wide field FA was helpful clearly delimiting the large macular lesion. Besides, comprehensive imaging and especially ICGA could detect two asymptomatic choroidal metastases in a systematic assessment of the fellow eye. Conclusion: Optic disc metastases are extremely rare. Their diagnosis can be easily done on fundus examination when presenting with characteristic whitish cluster nodular infiltrates of the optic disc. However multimodal imaging remains very useful for the assessment of the local extension of the lesion and for diagnosing associated asymptomatic choroidal lesions gone unnoticed at the fundus examination.

scholarly journals Evaluating the Effectiveness of Small-Group Training in Teaching Medical Students Integral Clinical Eye Examination Skills

2020 ◽  
Vol 12 (01) ◽  
pp. e79-e86
Author(s):  
John Y. Lee ◽  
Ryan A. Gallo ◽  
Chrisfouad R. Alabiad
Keyword(s):  
Medical Students ◽  
Optic Nerve ◽  
Small Group ◽  
Clinical Training ◽  
Training Session ◽  
Self Confidence ◽  
Eye Examination ◽  
Second Year ◽  
Direct Ophthalmoscopy

Abstract Objective The aim of this study is to evaluate the effectiveness of an interactive, small-group ophthalmology clinical training session by assessing medical students' self-confidence with eye examination skills and long-term retention of direct ophthalmoscopy skills. Methods The second-year medical students participated in a one-time small-group clinical training session that taught essential components of the eye examination. Students reported their confidence with each component in pre- and postsession surveys. Eight months later, direct ophthalmoscopy skills were reassessed by having students visualize the optic nerves of standardized patients and identify the matching optic nerve photograph in a multiple-choice quiz. Results Among 197 second-year medical students who participated in the training session, 172 students completed the presession survey (87.3% response rate) and 108 students completed the postsession survey (54.8% response rate). Following the training session, students reported increased self-confidence (p < 0.01) overall. A total of 107 (107/108; 99.1%) students reported that they visualized the optic nerve head, and 80 out of 85 (94.1%) students stated that they preferred the PanOptic ophthalmoscope over the traditional direct ophthalmoscope. Students reported greater self-confidence using the PanOptic ophthalmoscope (p < 0.01). In the 8-month follow-up assessment, 42 medical students (42/197; 21.3%) completed the exercise. A total of 41 (41/42; 97.6%) students stated that they saw the optic nerve with the PanOptic ophthalmoscope; 24 (24/42; 57.1%) students identified the correct optic nerve image using the PanOptic ophthalmoscope on a standardized patient; 14 (14/42; 33.3%) students stated that they saw the optic nerve with the traditional direct ophthalmoscope; and 4 (4/42; 9.1%) students from the same cohort identified the correct optic nerve image with the traditional direct ophthalmoscope on a standardized patient. Conclusion Our comprehensive, one-time eye examination skills training session seeks to prepare students to incorporate these skills in future patient care. Students' overall confidence improved in each aspect of the eye examination that was covered. A follow-up assessment on students' direct ophthalmoscopy skills suggests that the PanOptic ophthalmoscope allows for superior skills retention as compared with the traditional direct ophthalmoscope. We believe that the PanOptic ophthalmoscope should be further integrated into medical education and clinical practice.

scholarly journals Teaching the Technical Essentials of Direct Ophthalmoscopy Using a Portable Fundus Camera

2021 ◽  
Author(s):  
Weibo Feng ◽  
Yuxian Zou ◽  
Yonghao Li ◽  
Tao Shen ◽  
Ya Gao ◽  
...  
Keyword(s):  
Medical Students ◽  
Intervention Group ◽  
Training Session ◽  
Group Versus ◽  
Control Group ◽  
Accuracy Score ◽  
Fundus Camera ◽  
End Point ◽  
Accuracy Test ◽  
Direct Ophthalmoscopy

Abstract Aim: A portable fundus camera could allow the third person to observe the technique essentials of direct ophthalmoscopy from a real time screen. This study was designed to compare the proficiency of teaching direct ophthalmoscopy using a portable camera with conventional way in medical students. Methods: Medical students of fourth year were invited to participate the study. At baseline, the participants were taught fundoscopy with a conventional direct ophthalmoscope shortly. Then they were randomized to be taught the skill of fundoscopy either with a portable fundus camera or with a conventional direct ophthalmoscope as control for two days. Accuracy tests to match a subject’s fundus with one of the four photographs after examining an undilated eye using a direct ophthalmoscope were performed at baseline and end point. Accuracy test scores and self-reported confidence were compared between the two groups. Results: A total of 160 students participated the study, with 79 assigned to the intervention group, and 81 to the control group. All the students finished the study. At baseline, there was no difference in accuracy test score between the two groups. After two-day training session, the accuracy score improved in 26/79 (32.9%) students of intervention group versus 15/81 (18.5%) of the control group (p=0.037). At end point, a total of 39/79 (49.4%) students in the intervention groups versus 25/81 (30.9%) in the control group identified the correct fundus photograph (p=0.017). The confidence levels were significantly higher in the intervention group than the control group. Conclusions: Teaching direct ophthalmoscope using a portable fundus camera is associated with improved accuracy score and elevated confidence level in medical students when compared with conventional method.

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