Abstract Details

Title Teaching Ophthalmoscopy to Medical Students (TOTeMS)

Topic Neurologic ��ɫ��

Presentation(s) P04 - (-)

Poster/Presentation
Number 250

Objective

Background BACKGROUND: Learning direct ophthalmoscopy is challenging, and medical students and physicians often perform ophthalmoscopy poorly. Non-mydriatic ocular fundus photography offers an alternative to direct ophthalmoscopy for non-ophthalmologists.

Design/Methods DESIGN/METHODS: First-year medical students (M1s) received training in direct ophthalmoscopy using anatomically- and optically-correct simulators and human volunteers. Subsequently, M1s were randomized to receive vs. not receive specific training on interpreting fundus photographs prior to accuracy assessments. Students' preferences for each of the three methods and recognition of normal and abnormal fundus features were assessed.

Results RESULTS: 119/138 (86%) M1s completed all required elements. For learning ophthalmoscopy, 85 (71%) preferred humans to simulators. For learning relevant features of the ocular fundus, 92 (77%) preferred photographs to simulators. Regarding accuracy, M1s correctly answered 3.7 more questions (out of 48 questions per modality) when using fundus photographs vs. using direct ophthalmoscopy on simulators (p<0.001). M1s receiving specific teaching about reading fundus photographs before testing accurately answered 1.7 more fundus photography questions (p=0.02). Regarding patient examination preferences, M1s rated median ease of examination 5/10 for humans, 7/10 for simulators, and 9/10 for photographs (10=easiest); and frustration 4/10 for humans, 3/10 for simulators, and 2.5/10 for photographs (10=most frustrated). Half the M1s reported they would attempt direct ophthalmoscopy ?40% of the time during clinical rotations, and 84 (70%) would prefer to have fundus photographs instead of using the ophthalmoscope.

Conclusions CONCLUSIONS: Students preferred fundus photographs for both learning and examining the ocular fundus. Identification of ocular fundus features was more accurate on photographs compared to examination by direct ophthalmoscopy; this was further improved by training in interpreting fundus photographs. The increasing availability of non-mydriatic ocular fundus photography in non-ophthalmic settings may allow replacement of direct ophthalmoscopy in many clinical settings.

Authors/Disclosures
Linda Magnusson, MD PRESENTER	No disclosure on file
	No disclosure on file
Beau B. Bruce, MD, FAAN (Centers for Disease Control & Prevention)	Dr. Bruce has received personal compensation in the range of $50,000-$99,999 for serving as an Expert Witness for Bayer.
	No disclosure on file
Nancy J. Newman, MD, FAAN (Emory University School of Medicine)	Dr. Newman has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for GenSight. Dr. Newman has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for Chiesi. Dr. Newman has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Stoke. Dr. Newman has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Eli Lilly. Dr. Newman has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Phelcom. The institution of Dr. Newman has received research support from GenSight. Dr. Newman has received publishing royalties from a publication relating to health care. Dr. Newman has received publishing royalties from a publication relating to health care. Dr. Newman has received publishing royalties from a publication relating to health care.
Valerie Biousse, MD	Dr. Biousse has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Gensights Biologic. Dr. Biousse has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for Topcon. Dr. Biousse has received publishing royalties from a publication relating to health care. Dr. Biousse has received publishing royalties from a publication relating to health care.
Enrique Alvarez, MD, PhD (University of Colorado)	Dr. Alvarez has received personal compensation in the range of $10,000-$49,999 for serving on a Scientific Advisory or Data Safety Monitoring board for TG Therapeutics. Dr. Alvarez has received personal compensation in the range of $5,000-$9,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Biogen. Dr. Alvarez has received personal compensation in the range of $50,000-$99,999 for serving on a Scientific Advisory or Data Safety Monitoring board for EMD Serono. Dr. Alvarez has received personal compensation in the range of $50,000-$99,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Genentech. Dr. Alvarez has received personal compensation in the range of $50,000-$99,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Novartis. Dr. Alvarez has received personal compensation in the range of $10,000-$49,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Roche. Dr. Alvarez has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Sanofi. Dr. Alvarez has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Celgene/BMS. The institution of an immediate family member of Dr. Alvarez has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for UCB. The institution of Dr. Alvarez has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Horizon.

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