Teaching Ophthalmoscopy to Medical Students (TOTeMS) II: A One-Year Retention Study (P1.325)
Bibliographic record
Abstract
OBJECTIVE: We previously demonstrated that medical students (MS) performed more accurately and preferred using photographs than direct ophthalmoscopy to examine the ocular fundus. We hypothesized that these differences would persist over time. BACKGROUND: Learning direct ophthalmoscopy is challenging, and MS long-term retention of ophthalmoscopy skills is poor. DESIGN/METHODS: One year after initial training, second-year MS were randomized and reevaluated on their ability to examine the ocular fundus using either fundus photographs or direct ophthalmoscopy on eye simulators. Positive and negative affect, preferences, and clinical experiences with ocular fundus examination were assessed. RESULTS: 107/119 students (90%) who participated in the original study completed this one-year retention study. Students answered 34/48 (71%) questions correctly using photographs and 31/48 (65%) correctly using ophthalmoscopy (p<.01). Both photograph and ophthalmoscopy groups answered five fewer questions correctly on average than one year prior (p<.001). Students rated photographs as “easier than ophthalmoscopy” (8/10 vs. 6/10, respectively; p<.001). Students’ positive affect scores were higher in the photograph group (26.5) than in the ophthalmoscopy group (23.2; p=.03). Students tested on simulators reported lower positive affect than one year ago (decrease of 6.4 points, p<0.001). Students’ self-reported median frequency of fundus examination over the preceding year was <10% (IQR 0-20%). Ocular fundus examination was not performed because of discomfort with the examination (38%), discouragement by their preceptor (20%), and insufficient time (15%). 79% of students felt uncomfortable with ophthalmoscopy, and 44% stated that they would not perform ophthalmoscopy during a general physical examination. 76% stated they would prefer using photographs instead of ophthalmoscopy for fundus examination. CONCLUSIONS: Students preferred photographs for examining the ocular fundus and were more accurate using photographs vs. direct ophthalmoscopy one year after training. The increasing availability of non-mydriatic ocular fundus photography may allow more frequent and accurate examination of the ocular fundus by MS and non-ophthalmologists in many clinical settings. Study Supported by: Research to Prevent Blindness, NIH/NEI P30-EY06360, K23-EY019341
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.004 | 0.002 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.000 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.001 |
| Research integrity | 0.000 | 0.002 |
| Insufficient payload (model declined to judge) | 0.001 | 0.001 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".