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Steven Gregory Stockslager, Matthew Pihlblad, Constance Mei; iExaminer: a clinically proven fundus imaging system with medical education potential. Invest. Ophthalmol. Vis. Sci. 2017;58(8):3120.
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© ARVO (1962-2015); The Authors (2016-present)
Smartphone-based, fundus imaging platforms like iExaminer (Welch Allyn, Skaneateles Falls, NY) are clinically useful due to portability and low cost but their utility in medical education remains unknown. Direct ophthalmoscopy is a fundamental but challenging skill ubiquitously taught but rarely retained in medical school. We surveyed medical students to determine if smartphone imaging improved the educational efficacy of direct ophthalmoscopy clinical skills sessions beyond the traditional Panoptic (Welch Allyn, Skaneateles Falls, NY) and direct ophthalmoscope.
We anonymously surveyed the second-year class (n=130) at SUNY Buffalo, Jacobs School of Medicine during clinical skills small-group sessions after using a direct ophthalmoscope, Panoptic and iExaminer. Each group received a standardized presentation including a brief overview of ophthalmoscopy and introduction to all three devices. Four of each device were then distributed among the students and they were provided unlimited time to experiment with each. The subsequent voluntary survey assessed student’s impressions of the devices.
84.4% of students found the Panoptic ophthalmoscope easy to use versus iExaminer (55.0%) and the direct ophthalmoscope (44.6%). 85.5% of students were able to view the optic nerve with the Panoptic versus iExaminer (72.4%) and direct ophthalmoscope (66.7%). 53.3% of students reported being able to image the nerve using iExaminer. The majority (57.7%) found the device useful for learning ophthalmoscopy and 63.1% of students thought it should be used in future teaching sessions.
Students reported the greatest success and ease of use with the Panoptic ophthalmoscope, however, the majority also found iExaminer, despite its steeper learning curve, to be valuable. Over half the students were able document their findings with a photo. An additional strength of iExaminer is that it allowed instructors to objectively assess the student's ability to view, assess and image the nerve. There is clearly a potential niche for portable imaging systems in education. To our knowledge, this is the first evaluation of a cell-phone imaging system for medical training. As camera phone optics, portability, ergonomics, and user interface continue to evolve, we believe that the role of portable imaging systems in education as well as clinical practice will continue to grow exponentially.
This is an abstract that was submitted for the 2017 ARVO Annual Meeting, held in Baltimore, MD, May 7-11, 2017.
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