To evaluate and compare the preferences and attitudes of Ontario ophthalmologists and ophthalmology residents toward screencasting as an educational tool with potential use for continuing medical education (CME) events.
Eighty of 256 participants completed the survey.
The surveys were sent to participants by email, with follow-up via telephone. Study participants were urban and rural Ontario ophthalmologists, registered with the Canadian Ophthalmological Society, and University of Toronto ophthalmology residents. Pre-recorded online presentations-screencasts-were used as the main intervention. Online surveys were used to measure multiple variables evaluating the attitudes of the participants toward screencasting. This data was then used for further quantitative and qualitative analysis.
Over 95% of participants replied favourably to the introduction and future utilization of screencasting for educational purposes. Rural ophthalmologists were the most enthusiastic about future events. Practising in rural Ontario was associated with a higher interest in live broadcasts than practising in urban centres (p
To investigate the adequacy of undergraduate ophthalmology education in Canada in comparison with the International Council of Ophthalmology (ICO) guidelines.
First-year residents who had graduated from Canadian medical schools.
Eligible residents were invited to participate in an online survey in 2007. Data were categorized by demographic variables, and basic statistics were done.
Responses were obtained from 386 of the 1425 individuals (27.0%) contacted. The majority (64.0%) stated they had "too little" or "no exposure" to ophthalmology in medical school. The majority (76.2%) of respondents stated that they had had 1 week or less of overall exposure to ophthalmology. Sufficient exposure to several ICO core subspecialty areas was reported, including lens/cataract (81.1%) and cornea/external diseases (81.6%); however, some areas did not receive adequate time allocation, such as vitreoretinal disease (41.9%). Similarly, competency was obtained in certain ICO examination skills, including assessment of visual acuity (83.3%) and pupillary reflexes (90.7%) but was not achieved for other skills, such as fundoscopy (52.3%), slit-lamp examination (44.8%), and intraocular pressure assessment (19.9%). When asked whether sufficient ophthalmology knowledge and skills had been obtained during medical school, only 42.9% and 25.9% agreed, respectively.
Undergraduate ophthalmology training in Canada contains gaps in certain key areas. Developing a national, standardized curriculum could ensure that medical students acquire competency in the ophthalmology knowledge and skills required for future clinical practice.
Comment In: Can J Ophthalmol. 2009 Oct;44(5):499-50119789578
To evaluate the adequacy of Canadian ophthalmology residency programs in achieving the competencies outlined by the International Council of Ophthalmology (ICO) and to assess residents' satisfaction with their training programs.
Canadian residents enrolled in the final 2 years of English and French ophthalmology programs, as well as recent graduates from 2005 to 2008.
Graduates and eligible residents were invited to participate in the 43-item survey during the autumn of 2008. Data were categorized by demographic variables, and basic statistics were done.
Of the 99 individuals surveyed, 40 (40%) responded, representing 26 current residents and 14 graduates. The vast majority (85%) of respondents were satisfied with their residency program. Clinic-based training was generally rated satisfactorily; however, respondents reported insufficient exposure to low-vision rehabilitation (77.5%), refraction and glasses prescription (65%), and neuro-ophthalmology (45%). Respondents were similarly satisfied with their surgical experiences, most of them (>60%) rating case volume, complexity, and variety as satisfactory or better. However, many stated that they had insufficient exposure to extracapsular cataract extraction (72.5%), refractive surgery (72.5%), and orbital surgery (57.5%). Of the graduates surveyed, all passed their Royal College licensing examinations on the first attempt and felt that residency adequately prepared them for the examinations. They reported insufficient training in certain nonclinical areas, such as practice management, and staffing and administration skills.
Canadian ophthalmology residents express high levels of satisfaction with their residency training programs. Although most programs appear to adequately address most ICO core objectives, certain curriculum modifications are required.
To compare ophthalmic practice productivity and performance attributes, as rated by employing ophthalmologists, of noncertified and three levels of certified ophthalmic medical personnel.
Three hundred eighty-five American and Canadian ophthalmologists in a clinic-based, stratified, random sample were surveyed regarding productivity performance and attributes of the ophthalmic medical personnel they employ. Instrument scales assessed 14 desirable professional attributes and 10 practice productivity measures. The attributes were credibility, reliability, competence, quality assurance, quality of patient care, knowledge base to make adjustments, increased skills (expertise), ability to work independently, broader knowledge base, ability to detect errors, ability to be trained to perform multiple roles in the practice, professional image, good judgment, and initiative and drive. The productivity measures were patient satisfaction, doctor productivity, trouble-shooting rapport, triage screening, effective patient flow, reduced patient complaints, increased referrals, number of patients per hour, revenue per patient, and patient follow-up. Participants indicated whether certified personnel more often showed these attributes and contributed to practice productivity measures as compared to noncertified personnel or whether there was no difference. Results were analyzed with a chi-square goodness-of-fit test. Survey reliability and validity were evaluated.
Significantly more ophthalmologists responded that the three levels of certified personnel contributed more to 5 of the 10 practice productivity measures (i.e., doctor productivity, trouble-shooting rapport, triage screening, effective patient flow, and number of patients per hour). A statistically significant number of ophthalmologists also believed that certified personnel showed more of all 14 of the personal attributes considered desirable compared to noncertified ophthalmic medical personnel.
Compared to noncertified personnel, the employment of certified ophthalmic personnel enhances the quality and productivity of an ophthalmic practice. Overall practice productivity is increased with certified ophthalmic medical personnel.
The use of computer-assisted instruction in medical education has increased steadily in the last decade with the availability of personal computers. Many computer-assisted instruction programs train the user to handle various forms of disease or injury. Our intent was to provide medical students with more experience in managing ophthalmological emergencies, and we therefore designed a computerized teaching system for emergency ophthalmological care. The system makes it possible for inexperienced students to develop these skills, without jeopardizing the patient's health during training. Colour illustrations help teach the student to judge clinical signs. First, two classes of altogether 35 students used the teaching system. The students were shown to have gained significantly better knowledge of conditions which had been presented to them by the computerized teaching, than of conditions which had not been presented in this way. After having used the system, two other classes were asked about their attitudes towards this teaching modality. A majority regarded it as a valuable or very valuable addition to traditional methods of teaching. This type of instruction system may improve the quality of ophthalmic teaching without increasing teaching staff requirements.
Surgical teaching seems to be in conflict with the contract between surgeon and patient. We carried out a study to determine the prevalence of consistent disclosure to patients that a resident will perform part or all of their cataract surgery procedure. A second objective was to investigate the effect of such disclosure on patients' willingness to undergo the procedure.
We sent a survey to all 20 ophthalmologists working in our university-affiliated hospitals, inquiring about their practice of disclosure to patients regarding residents' involvement in surgery. Staff physicians were also asked to record their patients' consent to an operation performed partly or entirely by a trainee while under supervision.
Of the 20 surveys sent, only 5 (25%) were returned. Those who declined to participate in the study mentioned several reasons, including that such disclosure might increase a patient's anxiety level, that they might lose potential patients as patients might be reluctant to have trainees perform their surgery, and lack of time to talk to patients about these issues. Of the five ophthalmologists who completed the survey, four were part-time affiliated staff and one was a geographic full-time physician working in our institution. Four of the five ophthalmologists said that they do not consistently disclose residents' involvement to their patients. Of the 49 patients enrolled, only 8 (16%) agreed to undergo the procedure after being informed that a trainee would be actively involved.
It is crucial to inform patients that residents may be involved in their surgery in order to avoid possible litigation. However, our results suggest that such disclosure may have a negative effect on surgical education because it could limit the number of cases available to trainees.
Comment In: Can J Ophthalmol. 2005 Dec;40(6):69016518895
Either a pass/fail approach or a seven-point grading scale are used to evaluate students at the Danish universities. The aim of this study was to explore any effect of the assessment methods on student performances during oral exams.
In a prospective study including 1,037 examinations in three medical subjects, we investigated the difference in the test scores between the spring- and autumn semester. In the spring semester, the students could either pass or fail the subject (pass/fail) while in the following autumn semester, the students were assessed by tiered grading (seven-point grading scale). Unknown to the students, the examiners assessed the students by the seven-point grading scale also in the spring semester. Students at the international classes who were officially assessed by the seven-point grading scale during both semesters served as control group.
The grading scores were significantly higher among students who were aware of being evaluated with the seven-point grading scores compared with the pass/fail group (p