The Utility of Structured Video Indirect Ophthalmoscope-Guided Education in Improving Resident Ophthalmologist Confidence and Ability with Indirect Ophthalmoscopy and Scleral Depression

Abstract

Purpose : To evaluate the utility of the video indirect ophthalmoscope (VIO) to improve resident ophthalmologist skill with indirect ophthalmoscopy (IO) and scleral depression (SD).

Methods :
A prospective, randomized double-arm interventional study was designed. Ten ophthalmology residents were enrolled in an educational program using the Heine Video Omega® 2C VIO and served as the study group. Ten other experience-matched ophthalmology residents functioned as the control group. At baseline all study and control residents completed surveys assessing their subjective comfort and skill with IO. Each resident also completed a standardized full IO examination with SD that was recorded using the VIO. Each resident in the study group received 3, monthly, one-hour teaching sessions using the VIO. Surveys and recorded standardized examinations were repeated for all residents after the three-month period. Both baseline and final examination videos graded using a standardized grading scale by three independent retina faculty members masked to the identities of the residents and timing of the examination. Improved visualization of the peripheral retina (ora serrata) as evaluated by masked graders was the primary outcome measure. Improved examination efficiency grade was the secondary outcome measure.

Results : Both the study group and the control group had significant improvement in ability of examine the peripheral retina/ora serrata compared to baseline (p=0.02 and p=0.03, respectively). The study group also showed significantly improved examination efficiency compared to baseline was not noted in the control group (p=0.01 and p=0.53, respectively). The study group self-reported significantly improved confidence in their ability to identify retinal tears while the control group did not (p=0.003 and p=0.08, respectively). Study group participants also reported significantly improved ability to recognize retinal holes (p=0.003), subretinal fluid (p=0.02), and vitreoretinal tufts (p=0.02) while the control group did not.

Conclusions : This novel educational study suggests that VIO as part of a structured teaching program may be beneficial to improve resident ophthalmologist confidence and ability with identifying retinal pathology using IO with SD.

This is an abstract that was submitted for the 2017 ARVO Annual Meeting, held in Baltimore, MD, May 7-11, 2017.