Abstract Details

Title Assessing Neurology Resident Responsiveness to a Combined Didactic and Simulation-based Funduscopic Examination Workshop

Topic Education, Research, and Methodology

Presentation(s) S33 - Innovations in Medical Education (2:12 PM-2:24 PM)

Poster/Presentation
Number 007

Background The funduscopic examination is an accessible non-invasive diagnostic tool for identifying critical CNS disorders. However, non-ophthalmology trainees often defer this examination because of technical challenges in performing non-dilated ophthalmoscopic evaluations and/or lack of confidence in funduscopic examination skills. This study evaluates the impact of a dedicated funduscopic examination workshop in a series of neuro-ophthalmology workshops.

Objective To evaluate the role of a multimodal funduscopic examination workshop in improving resident funduscopic examination confidence.

Design/Methods This is a single-center, mixed methods, quantitative-qualitative (convergent parallel design) survey-based study evaluating neurology resident responsiveness to a combined didactic and simulation-based neuro-ophthalmology/funduscopic examination workshop, developed using feedback from a pilot workshop established one year prior. A survey with Likert scales (1=strongly agree, 5=strongly disagree) and open-ended questions was administered pre- and post-workshop.

Results Nine adult neurology residents (median training-year 3 [range 2-4]) participated in a 1-hour funduscopy workshop and a 1-hour basic neuro-ophthalmology examination workshop the day prior. Using pre-workshop surveys, residents reported an inadequate amount of formal funduscopic training during medical school and residency (median score 4 [range 3-5] and 4 [range 2-4] respectively). They were least confident in identifying retinal vessel abnormalities and disc edema (median score 4 [range 3-5] and 4 [range 2-4] respectively). Post-workshop surveys revealed a significant increase (p<0.05) in confidence in identifying disc edema, vessel abnormalities, and in overall funduscopic examination skills. Residents most appreciated simulation-based learning by practicing a non-dilated examination on fellow residents and on pathology-displaying Eye Examination Simulators. Residents requested increased workshop frequency, up to twice per quarter.

Conclusions A combined didactic and simulation-based funduscopic examination workshop may improve resident funduscopic examination confidence, particularly in an iterative educational environment modified yearly based on trainee feedback. These findings also highlight learners' desires for simulation-based learning in the medical trainee curriculum. Their utility can continue to be assessed using this study design.

Authors/Disclosures
Jieun Kang, MD (VUMC) PRESENTER	Dr. Kang has nothing to disclose.
Alexis Flowers	No disclosure on file
Christopher D. Lee, MD (Vanderbilt University Medical Center)	Dr. Lee has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Argenx.
Patrick J. Lavin, MB, BCh	Dr. Lavin has nothing to disclose.
Shailee S. Shah, MD (Vanderbilt Multiple Sclerosis Center)	Dr. Shah has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Horizon Therapeutics. Dr. Shah has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Genentech. Dr. Shah has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Genentech. Dr. Shah has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Alexion. Dr. Shah has received publishing royalties from a publication relating to health care.