CC BY-NC-ND 4.0 · Journal of Academic Ophthalmology 2023; 15(02): e215-e222
DOI: 10.1055/s-0043-1775577
Research Article

Evaluation of an Instructional Video and Simulation Model for Teaching Slit Lamp Examination to Medical Students

Sophia Collis
1   University of California San Francisco School of Medicine, San Francisco, California
,
Madeline Yung
2   Department of Ophthalmology, University of California San Francisco, San Francisco, California
,
2   Department of Ophthalmology, University of California San Francisco, San Francisco, California
› Author Affiliations
Funding This work was supported in part by a Research to Prevent Blindness unrestricted grant to the University of California San Francisco, Department of Ophthalmology.

Abstract

Purpose This article assesses the efficacy of an instructional video and model eye simulation for teaching slit lamp exam to medical students as compared to traditional preceptor teaching.

Methods First through 4th year students from the University of California, San Francisco School of Medicine were recruited via email to participate in the study. Students were randomized into two groups. The experimental “model eye” group watched an instructional video on slit lamp exam, spent 10 minutes practicing on the model eye, then practiced for 25 minutes with a student partner. The control “preceptor teaching” group received 25 minutes of in-person preceptor teaching on slit lamp exam, then spent 25 minutes practicing with a student partner. Students were objectively assessed by a blinded grader who scored their examination skills with a 31-item checklist. Qualtrics surveys that measured student perceptions were distributed before and after the intervention.

Results Seventeen medical students participated in the study. Students in the model eye group achieved higher mean objective assessment scores than students in the preceptor teaching group on skills relating to slit lamp set up (1.75, standard deviation [SD] = 0.50 and 1.50, SD = 0.80 out of 2 points, p = 0.03) and on the total score (1.69, SD = 0.6 and 1.48, SD = 0.8 out of 2 points, p < 0.01). Both groups reported a significant increase in their understanding of what a slit lamp is used for (p < 0.01) and in their confidence using a slit lamp (p < 0.01). All students felt their skills improved with the workshop, 94% found the workshop to be useful, and 88% enjoyed the workshop, with no intergroup differences on these metrics.

Conclusion An instructional video combined with a simulation model is as effective as traditional preceptor teaching of the slit lamp exam. Such a teaching module may be considered as an adjunct to traditional methods.

Supplementary Material



Publication History

Received: 06 June 2023

Accepted: 31 August 2023

Article published online:
26 September 2023

© 2023. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)

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  • References

  • 1 Grover AK, Honavar SG, Azad R, Verma L. A national curriculum for ophthalmology residency training. Indian J Ophthalmol 2018; 66 (06) 752-783
  • 2 Oliveira Franco RL, Martins Machado JL, Satovschi Grinbaum R, Martiniano Porfírio GJ. Barriers to outpatient education for medical students: a narrative review. Int J Med Educ 2019; 10: 180-190
  • 3 Shuttleworth GN, Marsh GW. How effective is undergraduate and postgraduate teaching in ophthalmology?. Eye (Lond) 1997; 11 (Pt 5): 744-750
  • 4 Noble J, Somal K, Gill HS, Lam WC. An analysis of undergraduate ophthalmology training in Canada. Can J Ophthalmol 2009; 44 (05) 513-518
  • 5 Moxon NR, Goyal A, Giaconi JA. et al. The state of ophthalmology medical student education in the United States: an update. Ophthalmology 2020; 127 (11) 1451-1453
  • 6 Alsoufi A, Alsuyihili A, Msherghi A. et al. Impact of the COVID-19 pandemic on medical education: Medical students' knowledge, attitudes, and practices regarding electronic learning. PLoS One 2020; 15 (11) e0242905
  • 7 Abualadas HM, Xu L. Achievement of learning outcomes in non-traditional (online) versus traditional (face-to-face) anatomy teaching in medical schools: a mixed method systematic review. Clin Anat 2023; 36 (01) 50-76
  • 8 Hemmatı N, Omranı S. A comparison of internet-based learning and traditional classroom lecture to learn CPR for continuing medical education. Turk Online J Distance Educ 2013;14(01):
  • 9 Chenkin J, Lee S, Huynh T, Bandiera G. Procedures can be learned on the Web: a randomized study of ultrasound-guided vascular access training. Acad Emerg Med 2008; 15 (10) 949-954
  • 10 Bello G, Pennisi MA, Maviglia R. et al. Online vs live methods for teaching difficult airway management to anesthesiology residents. Intensive Care Med 2005; 31 (04) 547-552
  • 11 George PP, Zhabenko O, Kyaw BM. et al. Online digital education for postregistration training of medical doctors: systematic review by the digital health education collaboration. J Med Internet Res 2019; 21 (02) e13269
  • 12 Mao BP, Teichroeb ML, Lee T, Wong G, Pang T, Pleass H. Is online video-based education an effective method to teach basic surgical skills to students and surgical trainees? A systematic review and meta-analysis. J Surg Educ 2022; 79 (06) 1536-1545
  • 13 Petrarca CA, Warner J, Simpson A. et al. Evaluation of eLearning for the teaching of undergraduate ophthalmology at medical school: a randomised controlled crossover study. Eye (Lond) 2018; 32 (09) 1498-1503
  • 14 Chan PP, Lee VWY, Yam JC. et al. Flipped classroom case learning vs traditional lecture-based learning in medical school ophthalmology education: a randomized trial. Acad Med 2023; DOI: 10.1097/ACM.0000000000005238.
  • 15 Succar T, Zebington G, Billson F. et al. The impact of the Virtual Ophthalmology Clinic on medical students' learning: a randomised controlled trial. Eye (Lond) 2013; 27 (10) 1151-1157
  • 16 Shikino K, Rosu CA, Yokokawa D. et al. Flexible e-learning video approach to improve fundus examination skills for medical students: a mixed-methods study. BMC Med Educ 2021; 21 (01) 428
  • 17 Beal MD, Kinnear J, Anderson CR, Martin TD, Wamboldt R, Hooper L. The effectiveness of medical simulation in teaching medical students critical care medicine: a systematic review and meta-analysis. Simul Healthc 2017; 12 (02) 104-116
  • 18 Curl ED, Smith S, Ann Chisholm L, McGee LA, Das K. Effectiveness of integrated simulation and clinical experiences compared to traditional clinical experiences for nursing students. Nurs Educ Perspect 2016; 37 (02) 72-77
  • 19 Angarita FA, Price B, Castelo M, Tawil M, Ayala JC, Torregrossa L. Improving the competency of medical students in clinical breast examination through a standardized simulation and multimedia-based curriculum. Breast Cancer Res Treat 2019; 173 (02) 439-445
  • 20 McCannel CA. Simulation surgical teaching in ophthalmology. Ophthalmology 2015; 122 (12) 2371-2372
  • 21 Lee R, Raison N, Lau WY. et al. A systematic review of simulation-based training tools for technical and non-technical skills in ophthalmology. Eye (Lond) 2020; 34 (10) 1737-1759
  • 22 Marson BA, Sutton LJ. The Newport eye: design and initial evaluation of a novel foreign body training phantom. Emerg Med J 2014; 31 (04) 329-330
  • 23 Lin J, Chua MT. A low cost surrogate eye model for corneal foreign body removal. BMC Ophthalmol 2020; 20 (01) 48
  • 24 Villamizar K, Lee GA. Training corneal foreign body removal using a realistically tactile low-cost model. Clin Exp Optom 2022; 105 (01) 84-85
  • 25 McCarthy DM, Leonard HR, Vozenilek JA. A new tool for testing and training ophthalmoscopic skills. J Grad Med Educ 2012; 4 (01) 92-96
  • 26 Akaishi Y, Otaki J, Takahashi O. et al. Validity of direct ophthalmoscopy skill evaluation with ocular fundus examination simulators. Can J Ophthalmol 2014; 49 (04) 377-381
  • 27 Kylstra JA, Diaz JD. A simple eye model for practicing indirect ophthalmoscopy and retinal laser photocoagulation. Digit J Ophthalmol 2019; 25 (01) 1-4
  • 28 Miller KE. Origami model for teaching binocular indirect ophthalmoscopy. Retina 2015; 35 (08) 1711-1712
  • 29 Lewallen S. A simple model for teaching indirect ophthalmoscopy. Br J Ophthalmol 2006; 90 (10) 1328-1329
  • 30 Morris WR. A simple model for demonstrating abnormal slitlamp findings. Arch Ophthalmol 1998; 116 (01) 93-94
  • 31 Romanchuk KG. Enhanced models for teaching slit-lamp skills. Can J Ophthalmol 2003; 38 (06) 507-511
  • 32 Mishra K, Mathai M, Della Rocca RC, Reddy HS. Improving resident performance in oculoplastic surgery: a new curriculum using surgical wet laboratory videos. J Surg Educ 2017; 74 (05) 837-842
  • 33 Lwin AT, Lwin T, Naing P. et al. Self-directed interactive video-based instruction versus instructor-led teaching for Myanmar house surgeons: a randomized, noninferiority trial. J Surg Educ 2018; 75 (01) 238-246
  • 34 Youssef SC, Aydin A, Canning A, Khan N, Ahmed K, Dasgupta P. Learning surgical skills through video-based education: a systematic review. Surg Innov 2023; 30 (02) 220-238
  • 35 Saun TJ, Odorizzi S, Yeung C, Johnson M, Bandiera G, Dev SP. A peer-reviewed instructional video is as effective as a standard recorded didactic lecture in medical trainees performing chest tube insertion: a randomized control trial. J Surg Educ 2017; 74 (03) 437-442
  • 36 Lehmann R, Seitz A, Bosse HM, Lutz T, Huwendiek S. Student perceptions of a video-based blended learning approach for improving pediatric physical examination skills. Ann Anat 2016; 208: 179-182
  • 37 Todd KH, Braslow A, Brennan RT. et al. Randomized, controlled trial of video self-instruction versus traditional CPR training. Ann Emerg Med 1998; 31 (03) 364-369
  • 38 Orientale Jr E, Kosowicz L, Alerte A. et al. Using web-based video to enhance physical examination skills in medical students. Fam Med 2008; 40 (07) 471-476
  • 39 Lee MT, Jacobs JL, Kamin CS. Video-enhanced problem-based learning to teach clinical skills. Med Educ 2006; 40 (05) 473-474
  • 40 Succar T, Grigg J, Beaver HA, Lee AG. A systematic review of best practices in teaching ophthalmology to medical students. Surv Ophthalmol 2016; 61 (01) 83-94
  • 41 Ang E, Talib SN, Thong M, Charn TC. Using video in medical education: what it takes to succeed. Asia-Pac Scholar 2017; 2 (03) 15-21
  • 42 Ashour O, Alkhatib AM, Zureikat QA. et al. Investigating medical students' satisfaction towards video-based learning versus face-to-face lectures: a Jordanian tertiary teaching hospital experience. Korean J Med Educ 2023; 35 (01) 21-32
  • 43 Birnbaumer DM. Teaching procedures: improving “see one, do one, teach one”. CJEM 2011; 13 (06) 390-394
  • 44 Tan PL, Hay DB, Whaites E. Implementing e-learning in a radiological science course in dental education: a short-term longitudinal study. J Dent Educ 2009; 73 (10) 1202-1212
  • 45 Margit Eidenberger SN. Video-based learning compared to face-to-face learning in psychomotor skills physiotherapy education. Creat Educ 2022; 13 (01) 149-166
  • 46 Bandhu SD, Raje S. Experiences with E-learning in ophthalmology. Indian J Ophthalmol 2014; 62 (07) 792-794
  • 47 Hull P, Chaudry A, Prasthofer A, Pattison G. Optimal sequencing of bedside teaching and computer-based learning: a randomised trial. Med Educ 2009; 43 (02) 108-112
  • 48 Vallée A, Blacher J, Cariou A, Sorbets E. Blended learning compared to traditional learning in medical education: systematic review and meta-analysis. J Med Internet Res 2020; 22 (08) e16504
  • 49 Succar T, Grigg J, Beaver HA, Lee AG. Advancing ophthalmology medical student education: International insights and strategies for enhanced teaching. Surv Ophthalmol 2020; 65 (02) 263-271