Journal of Academic Ophthalmology
Not a member yet
320 research outputs found
Sort by
Predictors of Ophthalmology Resident Research Engagement
No full textPurpose
United States Ophthalmology Residency programs employ many strategies to foster resident academic productivity. The present study assesses the efficacy of these initiatives in promoting research engagement.
Methods
A 19-question electronic survey was administered to current PGY2 - PGY4 U.S. ophthalmology residents. Primary outcome measures included peer-reviewed publications and national conference presentations while in residency.
Results
Eighty-one ophthalmology residents completed the survey, including trainees across all ages, genders, and regions. Of respondents, 34.5% reported allocated research time, 96.3% a required research project, 32.1% a research mentor, and 27.1% a formal research curriculum. Only 7% of respondents had not yet published in residency, while the majority authored one (42%) or 2-3 (30%) peer reviewed publications. Predictors for PRPs included PGY year (p = 0.003), pre-residency PRPs (p = 0.018), required research presentation or project (p = 0.05) and post-residency plans to pursue an academic career track (p = 0.036). When excluding case reports, none of the variables were associated with increased academic productivity. A majority (79%) of respondents presented at a national conference during residency. Only pre-residency PRPs predicted national conference participation (p = 0.005). Program allotment of dedicated research time, research mentorship and lecture curriculum did not correlate with an increase in productivity.
Conclusions
The study herein suggests that PGY year, pre-residency PRPs, research project requirements and academic career aspirations predict increased research productivity; however, dedicated research time, assigned research mentors, and research curriculums do not. These findings may be considered by ophthalmology residency programs when developing curricula to promote academic productivity
Competitiveness of Underrepresented in Medicine and Female Applicants in the Ophthalmology Match
No full textBackground: Recently, attention has been brought to the lack of diversity in ophthalmology, particularly for racial, ethnic, gender, and sexual minorities. The purpose of this study is to investigate the competitiveness of underrepresented in medicine (URiM), female, and LGBTQ+ applicants in the ophthalmology match to help identify a possible bottleneck in the pathway to increase diversity.
Methods: A cross-sectional analysis of ophthalmology applicants to a single northeast ophthalmology residency program in the 2022-2023 San Francisco (SF) Match cycle.
Results: Of the 631 applications analyzed, 16% (102/631) were URiM, 42% (264/631) were female, and 2% (11/631) explicitly identified as LGBTQ+. Compared to non-URiM applicants, URiM applicants had lower Step 2 scores (244.9 vs. 252.9, respectively; p
Conclusion: When looking at criteria commonly associated with a higher chance of matching in ophthalmology, URiM students generally had less competitive applications compared to non-URiM students except for leadership experiences. Female and male applicants had comparable applications, with some criteria more favorable for females. There are limitations in identifying LGBTQ+ students in the current application structure. Pathway programs may use this data to target weaknesses in applications for these students
Postoperative Complications of True Dropless Cataract Surgery versus Standard Topical Drops
No full textPurpose
Compare postoperative outcomes in cataract surgery between eyes with standard drop regimen versus dropless protocol by residents.
Design
Retrospective cohort study between April 1, 2018 and March 31, 2020.
Methods
The study was performed at Lyndon B. Johnson General Hospital in Houston, Harris County, Texas. A total of 547 eyes (234 dropless vs. 313 standard) with phacoemulsification cataract surgery and minimum of 1-month follow-up with best-corrected visual acuity (BCVA) were included. Dropless received 40 mg sub-Tenon\u27s triamcinolone and intracameral moxifloxacin. Patients were followed at postoperative day 1 (POD1), week 1 (POW1), and month 1 (POM1). Postoperative rate of BCVA better than 20/40 (Good vision) and rate of complications were compared between groups.
Results
Good vision on POM1 in dropless (77.8%) was noninferior to standard (75.1%, p = 0.80). Complication rate in dropless (28.6%) was noninferior to standard (24.0%, p = 0.13). Intraocular pressure (IOP) elevation on POD1 (p = 0.041) and anterior chamber (AC) cells on POW1 and POM1 (p \u3c 0.001) were more frequent in dropless. Mean spherical equivalent at POM1 was better in dropless (−0.37 D [±0.81 D]) compared with standard (−0.61D [±0.77 D], p = 0.001). Early posterior capsular opacification (early PCO) was more frequent in dropless (p = 0.042).
Conclusions
Postoperative rate of BCVA better than 20/40 and rate of postoperative complications were noninferior, although dropless had higher rates of AC inflammation, IOP elevation, and early PCO
Cataract simulator training and medical student attitudes towards ophthalmology
No full textIntroduction: Simulation-based learning offers novel opportunities to teach ophthalmology to medical students and inspire interest in the field. Eyesi surgical simulators have become widely adopted by ophthalmology departments and may serve a purpose in medical student education. The purpose of this study was to evaluate the effect of cataract simulators on medical student attitudes towards ophthalmology and to assess their performance/improvement on a series of simulator tasks.
Methods: This was a prospective, cross-sectional study of 31 medical students. Participants were recruited through an email sent via the school’s listserv. Enrolled students completed a series of tasks on the Eyesi simulator including navigation, forceps, anti-tremor, bimanual, capsulorrhexis, divide and conquer, and lens insertion activities. Students completed a pre- and post-activity questionnaire of their attitudes towards ophthalmology. Average scores before and after using the cataract simulator were compared. Performance on the Eyesi simulator was tracked and scores were compared across two attempts for the navigation, forceps, and anti-tremor activities.
Results: Mean age was 24.10 ± 1.67, 61.3% identified as male, 51.6% were pre-clerkship students, and 19.4% had previously completed an ophthalmology elective. In general, attitudes towards ophthalmology improved after using the simulator. Using a Likert-style scale of 1-5, self-reported interest in taking an ophthalmology elective (3.24 ± 1.20 vs. 2.80 ± 1.23, p=0.05) and understanding of cataract surgery (3.13 ± 0.81 vs. 1.61 ± 0.99, p
Conclusion: Our findings would suggest that use of cataract simulator-based learning may be an effective tool for teaching the principles of cataract surgery to medical students and can result in increased interest towards ophthalmology. Ophthalmology curriculums may benefit from prioritizing hands-on, simulation-based learning
Quality versus Quantity of Research Output among Applicants to Ophthalmology Residency
No full textPurpose: Research output remains one of the few quantitative factors by which applicants to ophthalmology residency can be compared. In the highly competitive application process, understanding how to assess the quality of research with the information provided is important to ensuring a fair selection process. The goal of this study was to determine whether the number of published articles reflects the quality of research output among ophthalmology residency applicants.
Methods: Cross-sectional analysis of ophthalmology applications received by a single Northeast residency program in the 2022-2023 San Francisco Match. Average impact factor of the journals listed in the applications under published articles or abstracts was calculated for each applicant. Percentage of first authorship was calculated based on self-reported order of authorship. The association between number of publications and impact factor or percentage first authorship in multivariable linear regressions including and excluding applicants with no publications. Secondary outcomes included comparisons in quality of research output between subgroups of applicants.
Results: 631 applications were received and included; 42% (264/631) of the applicants were women and 16% (102/631) were underrepresented in medicine (URiM). The average number of published articles and abstracts in the cohort was 5.77 ± 8.72 with an average journal impact factor per applicant of 3.70 ± 4.15 and an average percentage of first-author publications of 31.0% ± 31.2. The number of publications was significantly associated with average impact factor (coefficient=0.062; 95% confidence interval (CI) 0.024 – 0.099; p=0.001) and percentage of first-author publications (coefficient=0.004; 95% CI 0.001 – 0.007; p=0.018). However, when applicants with no publications were excluded, there was no longer a significant association between quantity and average impact factor (coefficient=0.022; 95% CI: -0.019 – 0.064; p=0.286) or percentage of first authorship (coefficient
Conclusions and Relevance: Although there is a significant relationship between quantity and quality overall, there is no significant association among applicants with at least one publication. When ophthalmology residency programs review the research output of applicants who have published, the number of publications should not be a surrogate for the quality of the work
Assessing the Impact of Medical Scribes in an Academic Ophthalmology Setting
No full textPurpose: To evaluate the impact of medical scribes on performance metrics in an academic ophthalmology practice across a variety of subspecialties
Design: Retrospective cohort study
Methods:
Setting: Single center clinical practice
Participants: 58,223 patient encounters from January 1, 2020 through November 10, 2023 were used. 2,269 clinic sessions were analyzed, with 686 clinic sessions without the presence of a scribe and 1,583 clinic sessions with the presence of a scribe
Procedures: Metrics were compared between scribed vs unscribed encounters for each individual doctor and then further compared by subspecialty. A linear mixed-effects model was used for overall differences and differences within the cornea subspecialty. A linear regression model was used for all other subspecialties.
Main Outcome Measures: Patients seen per hour, mean patient appointment time, mean patient wait time, mean chart closure time, and mean relative value units (RVUs) per hour.
Results: Patients seen per hour (mean ± standard deviation) were 3.45 ± 0.23 for all scribed encounters vs 3.12 ± 0.23 for unscribed encounters (P \u3c 0.01). There was no significant difference in patient appointment times (mean ± standard error) of 74.56 ± 4.87 minutes for scribed encounters vs 73.34 ± 4.93 minutes for unscribed encounters (P = 0.3). Patient wait time (mean ± standard deviation) was 26.94 ± 3.55 minutes for all scribed encounters vs 29.12 ± 3.57 minutes for unscribed encounters (P \u3c 0.01). Chart closure time (mean ± standard deviation) was 105.83 ± 11.56 minutes for all scribed encounters vs 93.82 ± 11.6 minutes for unscribed encounters (P \u3c 0.01). Epic RVUs per hour (mean ± standard deviation) were 4.48 ± 0.65 for all scribed encounters vs 3.68 ± 0.65 for unscribed encounters (P \u3c 0.01). All reported values are standardized to a 15% proportion of new patient encounters.
Conclusion: The use of scribes led to an increase in RVUs and patients seen per hour while decreasing patient wait time. While these trends varied amongst the subspecialties, all subspecialties benefited in at least one measure of efficiency in the presence of a scribe. Therefore, this study supports the utilization of scribes in an academic ophthalmology setting
Perspectives of Resident and Attending Ophthalmologists on Common Ethical Dilemmas in Research
No full textPurpose
To assess how resident and attending ophthalmologists perceive and evaluate ethically controversial scenarios regarding mentorship, authorship, and ethics compliance that may occur during research involving residents.
Methods
An online survey was developed and contained 14 controversial vignettes based on common research scenarios that can occur when conducting research with trainees. The scenarios were designed to capture issues regarding three themes: mentorship, authorship, and compliance with ethical guidelines. Resident and attending ophthalmologists at eight military and civilian academic residency programs in the United States were invited to participate. Respondents used a Likert scale to assess the ethicality of the situations in addition to self-reported demographic characteristics.
Results
The response rate was 35.6% (77/216), consisting of 37.7% (n = 29) residents and 62.3% (n = 48) attendings. More attending ophthalmologists responded than residents (p = 0.004). Many respondents identified controversies around compliance (67.3%) and authorship (57.1%) as unethical, whereas situations regarding mentorship were largely viewed as neutral to ethical (68.0%). Responses to two scenarios, one regarding mentorship and one regarding authorship, significantly differed between residents and attendings (p = 0.001 and p = 0.022, respectively).
Conclusion
Academic ophthalmologists\u27 perceptions of the ethicality of common research scenarios varied. There is a need for more prescriptive guidelines for authorship and mentorship ethics at all training levels to ensure consistency, fairness, and integrity of research
Rates of Internal Hiring of Ophthalmology Faculty from their Institution of Training at Top Academic Medical Centers: A Cross-Sectional Study
No full textBackground
Throughout graduate and postgraduate education, trainees need to gauge the impact of training location on future institutions of practice.
Objective
We assessed rates of internal hiring of ophthalmology faculty at academic institutions from their same institution of training.
Methods
This was a cross-sectional study. We included 1,246 clinical ophthalmology faculty at the 13 top-ranked institutions listed in the 2021 U.S. News and World Report. Primary, emeritus, adjunct, and affiliate faculty were included. Publicly available information was collected from institutional websites and other online sources. Statistical analyses were conducted using t-tests or Mann–Whitney tests, chi-squared or Fisher\u27s exact tests, and multivariate logistic regression. The main outcome measured was internal hires, defined as faculty who had completed residency and/or fellowship training at their current institution.
Results
In total, 47.3% of faculty were internal hires who completed residency or fellowship at the same institution. Among externally trained faculty, 27.7% completed residency and 56.0% completed fellowship at another top 13 programs. Internal hires were more frequently fellowship-trained, had a greater number of publications, and practiced in smaller departments (p \u3c 0.001, p \u3c 0.001, and p = 0.002, respectively). A greater proportion of internal hires held leadership positions (p = 0.012). Faculty practicing in the Midwest or West and with more years since residency graduation were less likely (odds ratio [OR], 0.29, 95% confidence interval [CI], 0.18–0.48; OR, 0.49, 95% CI, 0.31–0.78; OR, 0.98, 95% CI, 0.97–0.99, respectively) to be internal hires. Faculty with non-R01 National Institutes of Health funding were more likely to be internal hires (OR, 1.82, 95% CI: 1.12–2.96).
Conclusions
Training institution is key to determining the institution of practice. These results may be beneficial for trainees to consider when selecting a training program
Self-Reported Perceptions of Preparedness among Incoming Ophthalmology Residents
No full textPurpose
The purpose of this study was to assess the self-perceived preparedness of incoming postgraduate year 1 (PGY1) and postgraduate year 2 (PGY2) ophthalmology interns/residents to carry out core competencies in ophthalmology.
Methods
An online survey was created using the Survey Monkey survey platform and distributed to all ophthalmology resident applicants to the Bascom Palmer Eye Institute from the 2021 to 2022 and 2022 to 2023 application cycles. The survey contained questions pertaining to demographics, prior ophthalmic experience, online resources that were used to prepare for ophthalmology, and self-perceived preparedness to carry out key clinical skills in ophthalmology.
Results
A total of 170 responses were obtained (16.1% response rate). Of those, 119 (70%) were incoming PGY1 interns and 51 (30%) were incoming PGY2 residents for the 2022 to 2023 academic year. Most respondents (90.6%, n = 154) reported that their ophthalmology residency was affiliated with an integrated ophthalmology intern year. Incoming PGY2s moderately agreed with the statement that they felt as prepared to see patients in ophthalmology as they do in other surgical subspecialties, whereas incoming PGY1s only mildly agreed with that statement (p = 0.003). Both incoming PGY1s and PGY2s felt most prepared to obtain histories relating to basic ophthalmic complaints and felt least prepared to read and interpret ophthalmic imaging studies. The most popular online resources used by respondents in order of popularity were EyeGuru (35.2%, n = 60), EyeWiki (32.9%, n = 56), Tim Root/OphthoBook (26.5%, n = 45), American Academy of Ophthalmology (13.5%, n = 23), and EyeRounds/University of Iowa (13.5%, n = 23).
Conclusion
A major challenge in integrating ophthalmic education into the medical school curricula is the gradual shift toward shorter preclinical curricula. However, having a core foundation of ophthalmic knowledge is critical for incoming ophthalmology residents to be able to maximize their specialty-specific training. Integrated ophthalmology intern years likely play a significant role in the increased self-efficacy of incoming PGY2s compared with incoming PGY1s. Adopting nontraditional teaching methods like flipped classroom learning, utilizing online medical education resources, and continuing to increase ophthalmology exposure during PGY1 year may better prepare incoming PGY2s to operate independently in ophthalmology settings
Follow-Up Adherence After Community Health Vision Screening Programs: A Review of the Literature
No full textObjective Although the purpose of community eye screening programs is to reduce health care disparities, the effectiveness of these programs is limited by the follow-up adherence of their participants. The aim of this review is to investigate factors that may promote or hinder participants from attending follow-up ophthalmological exams after community eye screenings and identify interventions to increase follow-up rates.
Methods For literature review, PubMed, Web of Science, Embase, Proquest/Global Health Library, and Google Scholar databases were searched to identify studies of community eye screenings published between January 2000 and May 2023. Data from these articles were analyzed to identify barriers and facilitators of follow-up adherence after community eye screenings in the United States and to examine strategies used to increase follow-up rates. Only published manuscripts were included. We excluded studies of school screenings and clinic-based screenings.
Results A total of 28 articles were included. Follow-up rates ranged from 12.5 to 89%. Nineteen articles reviewed facilitators and barriers to follow-up. Eighteen articles were non-interventional and seven (see Table 1 and 2, respectively) articles described interventions that were tested to improve follow-up rates after screening. Interventions included prescheduled appointments, transportation assistance, patient education, and patient navigators.
Conclusion Several interventions are promising to increase follow-up adherence in community eye screenings, but more evidence is needed. Future research should focus on randomized trials of isolated interventions to improve follow-up adherence of disadvantaged populations, although this may be limited given ethical considerations and documented lack of follow-up after screening