June 2023
Volume 64, Issue 8
Open Access
ARVO Annual Meeting Abstract  |   June 2023
Virtual Supervision in Ophthalmology: A Scoping Review
Author Affiliations & Notes
  • Chaerim Kang
    Division of Ophthalmology, Brown University Warren Alpert Medical School, Providence, Rhode Island, United States
  • Christopher J Shin
    Division of Ophthalmology, Brown University Warren Alpert Medical School, Providence, Rhode Island, United States
  • Ingrid U Scott
    Departments of Ophthalmology and Public Health Sciences, Penn State College of Medicine, Hershey, Pennsylvania, United States
  • Paul Greenberg
    Division of Ophthalmology, Brown University Warren Alpert Medical School, Providence, Rhode Island, United States
    Section of Ophthalmology, Providence VA Medical Center, Providence, Rhode Island, United States
  • Footnotes
    Commercial Relationships   Chaerim Kang None; Christopher Shin None; Ingrid Scott None; Paul Greenberg None
  • Footnotes
    Support  None
Investigative Ophthalmology & Visual Science June 2023, Vol.64, OD2. doi:
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      Chaerim Kang, Christopher J Shin, Ingrid U Scott, Paul Greenberg; Virtual Supervision in Ophthalmology: A Scoping Review. Invest. Ophthalmol. Vis. Sci. 2023;64(8):OD2.

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

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Purpose : The published information on virtual supervision (VS) in ophthalmology is not well described. This scoping review describes the evidence and potential role of VS in ophthalmic practice and education.

Methods : A literature search strategy was developed in accordance with Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR). We included full-text articles published in an English-language peer-reviewed journal that involved VS between attending-attending or attending-trainees in ophthalmology. We excluded studies with direct supervision and oversight. Two investigators independently extracted, from each article, the year of publication and study location, design, participant characteristics, sample size, and outcomes. We appraised the methodological quality of the studies using the Mixed Methods Appraisal Tool (MMAT).

Results : Seven articles were included in our qualitative synthesis. Supervisees ranged from attending physicians, such as an ophthalmic surgeon from a foreign country and a general practitioner in a rural hospital, to medical trainees, such as ophthalmology residents, vitreoretinal fellows, and emergency medicine residents. Study settings included emergency departments, operating rooms, eye clinics, and a rural hospital. All studies reported successful transmission of real-time images or videos of clinical exams and surgical or in-office procedures. Supervisees used VS for endoscopic laser-assisted dacryocystorhinostomy, orbital decompression in a patient with extensive facial trauma, removal of a corneal foreign body, and macula-on rhegmatogenous retinal detachment repair. Various methods were used to ensure high image and video quality during VS, although some technical challenges remained. MMAT ratings revealed limitations in outcome measurement, statistical analysis, sampling strategy, and inclusion of confounding factors.

Conclusions : Virtual supervision in ophthalmology is technologically feasible and permits synchronous communication and transmission of clinical data, which can be used to formulate diagnostic and management plans and learn new surgical skills. Future studies with larger sample sizes and more robust study designs are warranted to investigate the safety and efficacy of VS in ophthalmic practice and education.

This abstract was presented at the 2023 ARVO Annual Meeting, held in New Orleans, LA, April 23-27, 2023.


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