September 2016
Volume 57, Issue 12
Open Access
ARVO Annual Meeting Abstract  |   September 2016
Internal Medicine Residents and the Fundus: Improving skill with direct ophthalmoscopes and increasing knowledge of basic ocular pathology
Author Affiliations & Notes
  • Christine Martinez
    Internal Medicine, Lehigh Valley Health Network, Breinigsville, Pennsylvania, United States
  • Cheryl Bloomfield
    Internal Medicine, Lehigh Valley Health Network, Breinigsville, Pennsylvania, United States
  • Footnotes
    Commercial Relationships   Christine Martinez, None; Cheryl Bloomfield, None
  • Footnotes
    Support  None
Investigative Ophthalmology & Visual Science September 2016, Vol.57, 5543. doi:
  • Views
  • Share
  • Tools
    • Alerts
      ×
      This feature is available to Subscribers Only
      Sign In or Create an Account ×
    • Get Citation

      Christine Martinez, Cheryl Bloomfield; Internal Medicine Residents and the Fundus: Improving skill with direct ophthalmoscopes and increasing knowledge of basic ocular pathology. Invest. Ophthalmol. Vis. Sci. 2016;57(12):5543.

      Download citation file:


      © ARVO (1962-2015); The Authors (2016-present)

      ×
  • Supplements
Abstract

Purpose : Following graduation from medical school, internal medicine physicians-in-training receive very little instruction on use of the direct ophthalmoscope and basic eye pathology. We surveyed residents to determine comfort level and skill with the direct ophthalmic exam, implemented a structured didactic curriculum and then re-surveyed the same residents. We hypothesize that appropriate and focused education will result in resident-reported improvement in comfort, skill, and knowledge.

Methods : Sixty-one internal medicine residents were administered a 10-question survey to determine comfort and skill level with the direct ophthalmoscope, frequency of attempted and successful fundus exams, and knowledge of basic ocular pathology. Five structured didactic sessions were then planned and implemented by a program faculty member and optometrist. These teaching sessions included material presented in a lecture format as well as hands-on exam practice. Following the conclusion of the sessions residents were re-surveyed to assess for improvement in comfort level, exam skills and knowledge of eye pathology.

Results : The response rate of the initial survey was 51% (31/61). 77% (24/31) of residents reported that they are either “very” uncomfortable or “somewhat” uncomfortable with the direct ophthalmoscope. 90% (28/31) attempt a fundus exam on half or less than half of patients in whom an eye exam with a direct ophthalmoscope is clinically indicated. 26% (8/31) of residents are “never” or "rarely" able to visualize blood vessels on retinal exam and 74% (23/31) are “never” or “rarely” able to visualize the optic nerve. 65% (20/31) of residents answered a basic knowledge question regarding the visualization of the optic nerve incorrectly. The results of the repeat survey are still pending at the time of abstract submission.

Conclusions : Our study demonstrates that internal medicine residents report significant discomfort and difficulty with the direct ophthalmoscope exam. A deficiency in ocular knowledge is also revealed. Residents will likely report improvement in comfort, skill, and knowledge following the implementation of a focused didactic program.

This is an abstract that was submitted for the 2016 ARVO Annual Meeting, held in Seattle, Wash., May 1-5, 2016.

×
×

This PDF is available to Subscribers Only

Sign in or purchase a subscription to access this content. ×

You must be signed into an individual account to use this feature.

×