Abstract
Purpose:
The prevalence of vision problems and their impact on quality of life make them an important public health problem. Effective education of relevant professionals underpins provision of quality eye health care. This scoping systematic review had two aims: firstly to investigate the extent and nature of scholarly output published on ophthalmic and paraophthalmic education, specifically to determinine what proportion consisted of randomized controlled trials (RCTs), and secondly to assess the quality of reporting of any RCTs identified.
Methods:
The ‘Preferred Reporting Items for Systematic Reviews and Meta-Analyses’ (PRISMA) (http://www.prisma-statement.org/index.htm accessed August 2014) guidelines were used as a guide for the conduct and report of this review. A search strategy was applied to Pubmed. Any scholarly publications meeting predefined eligibility criteria were selected. Predefined data were extracted on the category of publication, and for RCTs on the study characteristics, quality of reporting according to CONSORT guidelines, and the relevant effect size.
Results:
The initial search identified 2188 studies, of which 255 were relevant. The most common type of scholarly publication was a description of an educational innovation, followed by opinion pieces and descriptive studies (i.e. collecting data at one point in time). RCTs made up 5.5% of the sample. Most of the 14 RCTs failed to report most of the items recommended in the CONSORT guidelines. Effect sizes could not be calculated for 9 of the 14 RCTs due to relevant data not being reported, and for 4 of the 5 others, the effect sizes had large confidence intervals.
Conclusions:
Although clinicians regard RCTs as providing a high quality level of evidence, in ophthalmic educational research there are several reasons why RCTs are not often chosen as a study design. Although this review only used one database and author, as a scoping review it should provoke discussion on the value on non-RCT designs to answer questions on ophthalmic educational practice, but also highlight the need for investigators, ethical committees and journals to insist on a better quality of RCT conduct than is presently apparent in the ophthalmic educational literature.