Teaching Smartphone Funduscopy with 20 Diopter Lens in Undergraduate Medical Education

James Kohler,* Tu M Tran,* Susan Sun, Sandra R Montezuma Department of Ophthalmology and Visual Neurosciences, University of Minnesota, Minneapolis, MN, USA*These authors contributed equally to this workCorrespondence: Sandra R MontezumaDepartment of Ophthalmology and Visual Neurosciences, Universit...

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Autores principales:	Kohler J, Tran TM, Sun S, Montezuma SR
Formato:	article
Lenguaje:	EN
Publicado:	Dove Medical Press 2021
Materias:	direct fundus imaging medical student ophthalmoscope smartphone Ophthalmology RE1-994
Acceso en línea:	https://doaj.org/article/556faf591e674800ac900cb07eef9264
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spelling	oai:doaj.org-article:556faf591e674800ac900cb07eef92642021-12-02T17:05:21ZTeaching Smartphone Funduscopy with 20 Diopter Lens in Undergraduate Medical Education1177-5483https://doaj.org/article/556faf591e674800ac900cb07eef92642021-05-01T00:00:00Zhttps://www.dovepress.com/teaching-smartphone-funduscopy-with-20-diopter-lens-in-undergraduate-m-peer-reviewed-fulltext-article-OPTHhttps://doaj.org/toc/1177-5483James Kohler,* Tu M Tran,* Susan Sun, Sandra R Montezuma Department of Ophthalmology and Visual Neurosciences, University of Minnesota, Minneapolis, MN, USA*These authors contributed equally to this workCorrespondence: Sandra R MontezumaDepartment of Ophthalmology and Visual Neurosciences, University of Minnesota, 420 Delaware St SE, MMC 493, Minneapolis, MN, 55455, USATel +1 612 626 2452Fax +1 612 626 3119Email smontezu@umn.eduPurpose: To assess attitudes of pre-clinical undergraduate medical students toward learning smartphone funduscopy (SF) and its appropriateness as a teaching tool.Patients and Methods: Second year medical students received instruction on direct ophthalmoscopy (DO) and SF; they were then paired with a peer and randomly assigned to perform DO or SF first. The SF technique involved freehand alignment of the axes of the smartphone camera with a condenser lens. Both techniques were done through a maximally dilated pupil. A questionnaire was completed to acquire data on baseline experience, performance of both examination techniques, attitudes, and appropriateness. Statistical significance testing and Bland-Altman analysis were used to determine differences between DO and SF, and a multivariable mixed regression model was fitted to identify any predictors for positive attitudes toward DO or SF.Results: One hundred thirty-seven (137) individuals completed the study. A similar proportion of students could identify the optic nerve, macula, and vessels using DO and SF. However, self-reported quality scores were higher for DO for the optic nerve (p = 0.006) and macula (p = 0.08). The mean (standard deviation) attempts to identify these major structures were 2.7 (SD 2.3) for DO and 4.5 (SD 2.9) for SF (p < 0.001). Attitudes of students were consistently more positive toward DO across the five questions assessed. A small subset of students had equally positive attitudes toward DO and SF. Improved quality scores were predictive of positive attitudes for both DO and SF. Ultimately, 24% of students preferred SF over DO.Conclusion: Among inexperienced examiners of the fundus through a dilated pupil, SF is a non-inferior technique to DO in identifying structures. Despite overall favorable attitudes towards the more familiar DO, those students who quickly learned the SF technique had similar satisfaction scores. Teaching SF should be considered in undergraduate medical education.Keywords: direct, fundus, imaging, medical student, ophthalmoscope, smartphoneKohler JTran TMSun SMontezuma SRDove Medical Pressarticledirectfundusimagingmedical studentophthalmoscopesmartphoneOphthalmologyRE1-994ENClinical Ophthalmology, Vol Volume 15, Pp 2013-2023 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	direct fundus imaging medical student ophthalmoscope smartphone Ophthalmology RE1-994
spellingShingle	direct fundus imaging medical student ophthalmoscope smartphone Ophthalmology RE1-994 Kohler J Tran TM Sun S Montezuma SR Teaching Smartphone Funduscopy with 20 Diopter Lens in Undergraduate Medical Education
description	James Kohler,* Tu M Tran,* Susan Sun, Sandra R Montezuma Department of Ophthalmology and Visual Neurosciences, University of Minnesota, Minneapolis, MN, USA*These authors contributed equally to this workCorrespondence: Sandra R MontezumaDepartment of Ophthalmology and Visual Neurosciences, University of Minnesota, 420 Delaware St SE, MMC 493, Minneapolis, MN, 55455, USATel +1 612 626 2452Fax +1 612 626 3119Email smontezu@umn.eduPurpose: To assess attitudes of pre-clinical undergraduate medical students toward learning smartphone funduscopy (SF) and its appropriateness as a teaching tool.Patients and Methods: Second year medical students received instruction on direct ophthalmoscopy (DO) and SF; they were then paired with a peer and randomly assigned to perform DO or SF first. The SF technique involved freehand alignment of the axes of the smartphone camera with a condenser lens. Both techniques were done through a maximally dilated pupil. A questionnaire was completed to acquire data on baseline experience, performance of both examination techniques, attitudes, and appropriateness. Statistical significance testing and Bland-Altman analysis were used to determine differences between DO and SF, and a multivariable mixed regression model was fitted to identify any predictors for positive attitudes toward DO or SF.Results: One hundred thirty-seven (137) individuals completed the study. A similar proportion of students could identify the optic nerve, macula, and vessels using DO and SF. However, self-reported quality scores were higher for DO for the optic nerve (p = 0.006) and macula (p = 0.08). The mean (standard deviation) attempts to identify these major structures were 2.7 (SD 2.3) for DO and 4.5 (SD 2.9) for SF (p < 0.001). Attitudes of students were consistently more positive toward DO across the five questions assessed. A small subset of students had equally positive attitudes toward DO and SF. Improved quality scores were predictive of positive attitudes for both DO and SF. Ultimately, 24% of students preferred SF over DO.Conclusion: Among inexperienced examiners of the fundus through a dilated pupil, SF is a non-inferior technique to DO in identifying structures. Despite overall favorable attitudes towards the more familiar DO, those students who quickly learned the SF technique had similar satisfaction scores. Teaching SF should be considered in undergraduate medical education.Keywords: direct, fundus, imaging, medical student, ophthalmoscope, smartphone
format	article
author	Kohler J Tran TM Sun S Montezuma SR
author_facet	Kohler J Tran TM Sun S Montezuma SR
author_sort	Kohler J
title	Teaching Smartphone Funduscopy with 20 Diopter Lens in Undergraduate Medical Education
title_short	Teaching Smartphone Funduscopy with 20 Diopter Lens in Undergraduate Medical Education
title_full	Teaching Smartphone Funduscopy with 20 Diopter Lens in Undergraduate Medical Education
title_fullStr	Teaching Smartphone Funduscopy with 20 Diopter Lens in Undergraduate Medical Education
title_full_unstemmed	Teaching Smartphone Funduscopy with 20 Diopter Lens in Undergraduate Medical Education
title_sort	teaching smartphone funduscopy with 20 diopter lens in undergraduate medical education
publisher	Dove Medical Press
publishDate	2021
url	https://doaj.org/article/556faf591e674800ac900cb07eef9264
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Teaching Smartphone Funduscopy with 20 Diopter Lens in Undergraduate Medical Education

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