Previously submitted to: Journal of Medical Internet Research (no longer under consideration since Jun 13, 2022)
Date Submitted: May 16, 2022
Warning: This is an author submission that is not peer-reviewed or edited. Preprints - unless they show as "accepted" - should not be relied on to guide clinical practice or health-related behavior and should not be reported in news media as established information.
Smartphone ophthalmoscope as a tool in teaching direct ophthalmoscopy: a crossover randomized controlled trial
ABSTRACT
Background:
Fundoscopy is important in clinical practice but mastering direct ophthalmoscopy (DO) can be technically challenging for medical students. Utility of a novel tool, smart-phone ophthalmoscopy (SO), in teaching fundoscopy has been rarely verified.
Objective:
To evaluate the effectiveness of SO in teaching ophthalmoscopy, compared with DO.
Methods:
In this cross-over study, forty-five final-year medical students attending sessions at a single institution were randomly allocated to two groups (A and B). Both groups attended two training sessions. In the first session, Group A students were taught ophthalmoscopy using DO and Group B students using SO. In the second session, the training sessions were crossed over. A series of eye models with 10 letters placed on the inner surface were designed to assess the students' skill on ophthalmoscopy. Students performed ophthalmoscopy on the eye models, recorded their findings and completed a questionnaire of feedback on DO and SO. The main outcome measure was the score of ophthalmoscopy, assessed by the student correctly recording each letter (score 1 for each letter).
Results:
For Group A, the mean score of ophthalmoscopy on the eye model using DO and SO was 3.9 ± 2.4 and 8.2 ± 2.2, respectively. For Group B, the respective mean scores were 5.7 ± 3.5 and 8.7 ± 1.8. Students scored significantly higher in ophthalmoscopy when using SO than DO (P < 0.001). They expressed better visualization of the fundus using SO than DO (4.49 ± 0.65 vs 4.13 ± 0.81, P = 0.004).
Conclusions:
Students' performance of ophthalmoscopy was better when SO was used compared with DO. The use of SO as an adjunctive tool is recommended and should improve the effectiveness of teaching ophthalmoscopy. Clinical Trial: ChiCTR2100054018
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