Western Journal of Emergency Medicine: Integrating Emergency Care with Population Health

Introduction: Emergency physicians are among the few specialists besides ophthalmologists who commonly perform ophthalmologic examinations using the slit lamp and other instruments. However, most medical schools in the United States do not require an ophthalmology rotation upon completion. Teaching procedural skills to medical students can be challenging due to limited resources and instructor availability. Our study assesses the effectiveness of a 40-minute hands-on teaching session on ophthalmologic examination for medical students using only two instructors and low-cost equipment.

Methods: We performed an interventional study using a convenience sample of subjects. Pre- and post-workshop questionnaires on students’ confidence in performing ophthalmologic examination were administered. We used a paired t-test and Wilcoxon rank test to analyze the data.

Results: Of the 30 participants in the study, the mean age was 25 and the majority were first-year medical students. The students’ confidence in performing every portion of the ophthalmologic exam increased significantly after the teaching session. We found that the average confidence level before the teaching session were below 2 on a 1-5 Likert scale (1 being the least confident). Confidence levels in using the slit lamp had the highest improvement among the skills taught (2.17 95% CI [1.84-2.49]). Students reported the least improvement in their confidence in assessing extraocular movements (0.73, 95% CI [0.30-1.71]) and examining pupillary function (0.73, 95% CI [0.42-1.04]). We observed the biggest difference in median confidence level in the use of the tonometer (4 with a p-value of <0.05).

Conclusion: A 40-minute structured hands-on training session can significantly improve students’ confidence levels in ophthalmologic skills.