Needs assessment for direct ophthalmoscopy training in neurology residency.

Education Fundoscopy Neurology Residency

Journal

BMC medical education
ISSN: 1472-6920
Titre abrégé: BMC Med Educ
Pays: England
ID NLM: 101088679

Informations de publication

Date de publication:
27 Mar 2024
Historique:
received: 19 10 2023
accepted: 08 03 2024
medline: 28 3 2024
pubmed: 28 3 2024
entrez: 28 3 2024
Statut: epublish

Résumé

Assessment of the ocular fundus, traditionally by direct ophthalmoscopy (DO), is essential to evaluate many neurologic diseases. However, the status of DO training in neurology residencies is unknown. We conducted a needs assessment to determine current attitudes, curricula, and gaps in DO training. A survey was developed and administered to residents and program directors (PDs) at ACGME accredited neurology residencies in the United States. The survey assessed factors such as current DO curricula, perceived importance of DO, confidence of skills, and need for improvement. Data analysis was performed using the Mann Whitney U test and Fisher Exact Test. Nineteen PDs (11.6%) and 74 (41.1%) residents responded to the survey. 97.1% of residents and 100.0% of PDs believe DO is an important skill to learn. 29.4% of PDs expected graduating residents to have completed > 10 supervised DO exams, while 0.0% of graduating fourth year residents reported doing so (p = 0.03). 35.7% of graduating residents had never correctly identified an abnormal finding on DO. The number of times residents practiced DO unsupervised correlated with increasing confidence in all components of the DO exam (p < 0.05). Residents who felt their program emphasized DO were more likely to perform DO at least once a week compared to residents who did not perceive program emphasis (61.9% vs. 35.0%, p = 0.02) and were more confident in DO (p < 0.05). 66.7% of residents and 42.1% of PDs were not satisfied with current levels of DO training. 96.7% of residents and 78.9% of PDs felt it was important to improve curriculum for DO training. Supervised practice and practice skills sessions were identified as the most helpful interventions to improve DO training. The vast majority of neurology PDs and residents believe DO is an important skill to learn, are unsatisfied with the current level of DO training, and advocate for improvement in DO curricula. Current DO curricula have limited formal didactic training and supervised practice. The bulk of DO learning occurs through unsupervised practice, which is influenced by motivational factors such as perceived residency emphasis on DO learning.

Sections du résumé

BACKGROUND BACKGROUND
Assessment of the ocular fundus, traditionally by direct ophthalmoscopy (DO), is essential to evaluate many neurologic diseases. However, the status of DO training in neurology residencies is unknown. We conducted a needs assessment to determine current attitudes, curricula, and gaps in DO training.
METHODS METHODS
A survey was developed and administered to residents and program directors (PDs) at ACGME accredited neurology residencies in the United States. The survey assessed factors such as current DO curricula, perceived importance of DO, confidence of skills, and need for improvement. Data analysis was performed using the Mann Whitney U test and Fisher Exact Test.
RESULTS RESULTS
Nineteen PDs (11.6%) and 74 (41.1%) residents responded to the survey. 97.1% of residents and 100.0% of PDs believe DO is an important skill to learn. 29.4% of PDs expected graduating residents to have completed > 10 supervised DO exams, while 0.0% of graduating fourth year residents reported doing so (p = 0.03). 35.7% of graduating residents had never correctly identified an abnormal finding on DO. The number of times residents practiced DO unsupervised correlated with increasing confidence in all components of the DO exam (p < 0.05). Residents who felt their program emphasized DO were more likely to perform DO at least once a week compared to residents who did not perceive program emphasis (61.9% vs. 35.0%, p = 0.02) and were more confident in DO (p < 0.05). 66.7% of residents and 42.1% of PDs were not satisfied with current levels of DO training. 96.7% of residents and 78.9% of PDs felt it was important to improve curriculum for DO training. Supervised practice and practice skills sessions were identified as the most helpful interventions to improve DO training.
CONCLUSIONS CONCLUSIONS
The vast majority of neurology PDs and residents believe DO is an important skill to learn, are unsatisfied with the current level of DO training, and advocate for improvement in DO curricula. Current DO curricula have limited formal didactic training and supervised practice. The bulk of DO learning occurs through unsupervised practice, which is influenced by motivational factors such as perceived residency emphasis on DO learning.

Identifiants

pubmed: 38539205
doi: 10.1186/s12909-024-05280-x
pii: 10.1186/s12909-024-05280-x
doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

344

Informations de copyright

© 2024. The Author(s).

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Auteurs

Jasmeet Saroya (J)

UCSF Department of Ophthalmology Wayne and Gladys Valley Center for Vision, Box 4081, 490 Illinois Street, San Francisco, CA, 94158, USA.

Noor Chahal (N)

UCSF Department of Ophthalmology Wayne and Gladys Valley Center for Vision, Box 4081, 490 Illinois Street, San Francisco, CA, 94158, USA.

Alice Jiang (A)

UCSF Department of Ophthalmology Wayne and Gladys Valley Center for Vision, Box 4081, 490 Illinois Street, San Francisco, CA, 94158, USA.

Douglas Pet (D)

Department of Neurology, University of California, San Francisco, CA, USA.

Nailyn Rasool (N)

UCSF Department of Ophthalmology Wayne and Gladys Valley Center for Vision, Box 4081, 490 Illinois Street, San Francisco, CA, 94158, USA.
Department of Neurology, University of California, San Francisco, CA, USA.

Mark Terrelonge (M)

Department of Neurology, University of California, San Francisco, CA, USA.

Madeline Yung (M)

UCSF Department of Ophthalmology Wayne and Gladys Valley Center for Vision, Box 4081, 490 Illinois Street, San Francisco, CA, 94158, USA. madeline.yung@ucsf.edu.

Classifications MeSH