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Russell M Levine, LEDIANA GODUNI, Alessa Crossan, Lauren Nicosia, Rukhsana Mirza, Veena Raiji, Irena Tsui, Lewis Eisen, Jamie Rosenberg; Ophthalmology resident proficiency and confidence in interpretation of fluorescein angiograms. Invest. Ophthalmol. Vis. Sci. 2016;57(12):1713.
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© ARVO (1962-2015); The Authors (2016-present)
In this multi-institutional study, we examine the ability of ophthalmology residents to interpret fluorescein angiograms (FA) and seek to identify factors that correlate with this ability.
Ophthalmology residents were presented with a survey that contained 13 FA images and had one minute per image to list their top diagnosis and differential. They rated confidence in their answer on a 5-point Likert scale. Other data collected include gender, postgraduate year (PGY), hours spent studying FA interpretation, and interest in fellowship training in retina. Statistical analysis was performed with ANOVA and Spearman rank correlation.
Twenty-two residents participated in the study, 8 men and 14 women. Scores improved from PGY2 through PGY4; with an average score of 4.62 of 13 (35.5%) in PGY2, 6.59 (50.7%) in PGY3, and 7.92 (60.9%) in PGY3 (p=0.001). Male (55.3%) and female (57.1%) performance was not significantly different (p=0.81). Reported hours spent studying FA correlated with success on the test (p=0.004), although interest in retina as a specialty did not (p=0.313). Confidence was higher with each successive postgraduate year (p=0.047). There was a strong correlation between score on the test and confidence level (R=0.678, p<0.001). Of the 34 times the residents indicated maximal confidence (level 5), 26 answers were correct (76%). Five questions involved topics indicated as required knowledge by the International Council of Ophthalmology: cystoid macular edema, proliferative diabetic retinopathy, non-proliferative diabetic retinopathy, neovascular age-related macular degeneration, and central serous chorioretinopathy. On these questions, residents scored 61.4%.
Senior residents perform better than junior residents when interpreting FA. More hours spent studying FA leads to greater proficiency. Residents who report being confident in their FA interpretation perform better than those who are less confident, but self-reported interest in retina does not correlate with skill. Disconcertingly, residents who were maximally confident in their answers were correct only 76% of the time. Although residents performed better on the topics required by the International Council, their scores only averaged 61.4%. Adequate time should be devoted to FA education during postgraduate ophthalmology training in order to improve skill level.
This is an abstract that was submitted for the 2016 ARVO Annual Meeting, held in Seattle, Wash., May 1-5, 2016.
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