Journal of Academic Ophthalmology
Not a member yet
320 research outputs found
Sort by
Success in Increasing Diversity: One Residency Program\u27s Journey
No full textGiven the low rates of under-represented minority (URM) residents[1] and practicing physicians[2] in ophthalmology, ophthalmology training programs in the United States have been charged with increasing diversity to better represent our population. There have been great efforts from the Association of University Professors of Ophthalmology and the American Academy of Ophthalmology to expand the pipeline, particularly through the Minority Ophthalmology Mentoring program.[3] Other groups such as the Rabb Venable Research Foundation and the Student National Medical Association have also been crucial in encouraging and supporting URM students. Initiatives such as the Einstein Enrichment Program for 7th to 12th graders and the Diversity Student Summer Research Opportunity Program for college juniors and seniors at our institution work to encourage URM students to go into medicine and biomedical sciences at an earlier stage. However, once URM students are in the pipeline as potential future ophthalmologists, they may encounter barriers in the admissions process based on traditional metrics such as United States Medical Licensing Examination (USMLE) step scores and selection into Alpha Omega Alpha.[4] We believe it is the responsibility of residency program leadership to conduct the admission process with an eye toward matching qualified URM students. In our program at Montefiore Medical Center/Albert Einstein College of Medicine, we have successfully increased representation in our residency program. We would like to share our process as a potential model for this endeavor.
In the January 2018 match, the SF Match (San Francisco, CA) began allowing an optional notation by students as to whether they came from an under-represented background. Starting the following match cycle, we began a holistic review of applications from URM students, which has been demonstrated to result in more diverse classes by Einstein\u27s medical school admission team.[5] As defined by the Association of American Medical Colleges, “holistic review refers to mission-aligned admissions or selection processes that take into consideration applicants\u27 experiences, attributes, and academic metrics as well as the value an applicant would contribute to learning, practice, and teaching. Holistic Review allows admission committees to consider the “whole” applicant, rather than disproportionately focusing on any one factor.”[6] On a practical level for our program, this means that every application from a URM applicant is read in its totality, including scores, grades, personal statements, and letters of recommendation. All scores and grades are checked to meet basic criteria for predicted success in residency, typically meaning that the student did not need to repeat any course work, had a USMLE step 1 score above or close to the national average (approximately 230 for the years when step 1 scores were available), and was at least in the top two-thirds of their medical school class. The Medical Student Performance Evaluation was reviewed to make sure there was no professionalism issue or need for remediation. Letters of recommendation were reviewed to assure there were no concerns from advisors and mentors. Personal statements and letters of recommendation were read for insight into the students\u27 journeys, and factors such as “distance traveled” were considered. In addition, at our program, we serve a predominantly black and Hispanic community in the poorest county in our state, where our patients and neighbors have many significant health issues. Thus, when reviewing applications, we appreciate a commitment to serving the underserved, whether that is through volunteer work, prior employment, or lived experience. We are typically able to identify evidence of this commitment in the applications of our URM applicants, in addition to many of our non-URM applicants. A final consideration for being granted an interview is having been born or raised in the Bronx or having spent significant time here during their formative years.
In the initial years of our holistic reviews, we were able to match 2 URM students in a class of 5 and 1 URM student in the following class of 5. In 2020, with the change to virtual interviews, we adjusted our screening process from having multiple people each read one-quarter to one-fifth of the entire pool to the program director (PD) and associate PD (APD) reading all applications, each reviewing half of the applications completely as well as confirming the applicants selected by the other director. We decided to limit application review to the PD and APD to avoid the possibility of different criteria being used for review by different readers. As described above, the majority of our applicants have excellent credentials, so we do not have a problem with unqualified applicants being selected for interviews and have not had any issues with acceptance of the applicants from the other members of the interviewing committee. From 2020 on, every application from a URM student was reviewed in a holistic manner by the PD or APD. A detailed outline of our procedure for reviewing applications from URM students can be found in [Table 1], and we followed the same process in 2021.
This effort to invite more U
Applicant Perceptions of In-Person versus Virtual Interview Format for Surgical Retina Fellowship
No full textPurpose
This article compares applicants\u27 perceptions of and experiences with virtual and in-person interviews for surgical retina fellowship.
Methods
A survey was distributed via email to all applicants of three vitreoretinal surgery fellowship programs for the 2021 to 2022 and 2022 to 2023 application cycles.
Main Outcome Measures
Participants were surveyed regarding cost; burden of scheduling; number of applications and interviews completed; ability to gain a true feel of the program, location, and preceptor; and number of work and surgical days missed.
Results
Of 151 applicants contacted, 36 completed the survey (23.8% response rate). Of the respondents, 25.0% attended only virtual interviews, 19.4% attended mostly virtual interviews, 30.6% attended mostly in-person interviews, and 25.0% attended half virtual and half in-person interviews. Average expenditure was significantly lower for applicants with mostly and completely virtual interviews compared with applicants with mostly in-person and half virtual, half in-person (p \u3c 0.001). Applicants with mostly virtual interviews reported a lower ability to gain a true perception of the program and the program location (p = 0.003 and p \u3c 0.001, respectively). There was no difference in burden of scheduling, number of interviews completed, or number of work and surgical days missed. When applicants were asked what type of interview format they would prefer if they could repeat the cycle, those who interviewed mostly in-person largely chose in-person as their preference (72.7%), while participants who interviewed mostly or completely virtually were evenly split between in-person, virtual, and hybrid (p = 0.136).
Conclusion
As fellowship programs and institutions decide whether they will return to in-person interviews or maintain a virtual interview format in the long term, they must weigh the lower cost of virtual interviews with the improved ability to gain a more accurate perception of the program and location allowed by in-person interviews, as well as potentially greater satisfaction with the in-person format
Impact of free eye clinic participation on medical students’ ophthalmic knowledge, perceptions of ophthalmology, and perceptions of underrepresented patient populations
No full textObjectives:
To evaluate the impact of volunteering at a free eye clinic on medical students’ ophthalmic knowledge, perceptions of ophthalmology and of underrepresented patient populations.
Methods:
A cross-sectional survey was developed and distributed by email to both volunteers and non-volunteers at the Iowa City Free Medical Clinic’s Free Eye Clinic (FEC) between July and August 2023. Study participants were medical students both enrolled at the Carver College of Medicine and former students who had recently graduated. Survey questions included an assessment of ophthalmic knowledge, respondent perceptions of the field of ophthalmology, and respondent perceptions of underserved populations and barriers to care.
Results:
54 participants completed the survey. 20 survey respondents reported volunteering at the free eye clinic (FEC volunteers), whereas 34 did not (non-volunteers). FEC volunteers performed better on ophthalmic knowledge questions (p
Conclusions:
Volunteering at the FEC had a positive impact on medical students’ ophthalmic knowledge, perceptions about ophthalmology and understanding of underserved populations. This suggests that volunteer experience in a free clinic setting contributes positively to student perceptions and understanding of patient populations that face unique challenges and barriers to care
Student Perceptions of a Novel No-Cost Mobile Application for Ophthalmic History and Physical Examination
No full textBackground: Mobile applications have shown promise in enhancing medical trainee performance. In ophthalmology, a comprehensive mobile app can streamline the trainee education process by providing guidance for patient intake. Language barriers pose additional challenges impacting the quality of care for Spanish-speaking patients; literature has documented the adverse impacts of inadequate translation on quality of medical care for both trainees and patients. We aim to develop a free mobile application to guide medical trainees through the ophthalmic patient intake process and assist with Spanish-language translation.
Methods: We developed EyeCheck as a free mobile application for ophthalmology trainee education with Spanish language support for iPhone and Android. We also designed a survey for student evaluation of EyeCheck’s effectiveness and usability as an educational and clinical tool.
Results: Nineteen medical students used EyeCheck and found it beneficial for obtaining an ophthalmic history (Likert score: 4.3, SD = 0.65) and performing each component of the eye exam (mean score: 4.1, SD = 0.77). EyeCheck also aided understanding of ophthalmological pharmacology (mean = 4.1, SD = 0.85). Students rated EyeCheck as user-friendly (mean = 4.5, SD = 0.51) and expressed moderate interest in continued use (mean = 3.7, SD = 1.00) and recommendation to others (mean = 4.4, SD = 0.77).
Conclusion: EyeCheck can be downloaded and integrated into the patient intake process, reducing the need for disaggregated educational materials and streamlining the learning process for trainees. Insights from the survey can enhance EyeCheck\u27s content and user experience. EyeCheck can improve the training process for ophthalmological patient intake
Career Decisions and Satisfaction Among Underrepresented in Medicine Ophthalmologists
No full textObjective: To describe the career choices and satisfaction of newly practicing ophthalmologists who are underrepresented in medicine (URiM).
Design: Secondary analysis of a cross-sectional study.
Methods: An electronic survey was distributed in 2013 to 2145 ophthalmologists who completed training within the prior 5 years. The survey included questions about demographic information, medical education, current practice, factors affecting career choices, and career satisfaction. Statistical comparisons were made between the URiM group (self-identified as Black/African American, Hispanic/Latino, American Indian/Alaskan Native, or Native Hawaiian/Pacific Islander) and non-URiM group.
Results: Surveys were completed by 671 (31.3%) eligible ophthalmologists, including 46 in the URiM group and 625 in the non-URiM group. Fellowship training was completed by 30 (65%) respondents in the URiM group. The decision to pursue subspecialty training was made earlier during residency in the URiM group (PGY 1 or 2 in 81% vs 49%, P = 0.002). A higher percentage of the URiM group practiced in an urban location (68% vs 45%, P = 0.01) and in the South (51% vs 33%, P = 0.02). Types of patient problems more strongly influenced the career decisions of the URiM group (mean Likert score 4.3 vs 3.9, P = 0.007). A positive level of happiness with work was reported by 31 (84%) URiM respondents.
Conclusions: A large proportion of URiM ophthalmologists subspecialized, and the decision to pursue fellowship training was made earlier during residency compared with their non-URiM counterparts. URiM ophthalmologists were more likely than non-URiM ophthalmologists to practice in areas of greater racial and ethnic diversity. The career choices of URiM ophthalmologists were more strongly influenced by types of patient problems, which may include social determinants of health. URiM ophthalmologists had a high degree of career satisfaction
Evaluation of an Instructional Video and Simulation Model for Teaching Slit Lamp Examination to Medical Students
No full textPurpose
This article assesses the efficacy of an instructional video and model eye simulation for teaching slit lamp exam to medical students as compared to traditional preceptor teaching.
Methods
First through 4th year students from the University of California, San Francisco School of Medicine were recruited via email to participate in the study. Students were randomized into two groups. The experimental “model eye” group watched an instructional video on slit lamp exam, spent 10 minutes practicing on the model eye, then practiced for 25 minutes with a student partner. The control “preceptor teaching” group received 25 minutes of in-person preceptor teaching on slit lamp exam, then spent 25 minutes practicing with a student partner. Students were objectively assessed by a blinded grader who scored their examination skills with a 31-item checklist. Qualtrics surveys that measured student perceptions were distributed before and after the intervention.
Results
Seventeen medical students participated in the study. Students in the model eye group achieved higher mean objective assessment scores than students in the preceptor teaching group on skills relating to slit lamp set up (1.75, standard deviation [SD] = 0.50 and 1.50, SD = 0.80 out of 2 points, p = 0.03) and on the total score (1.69, SD = 0.6 and 1.48, SD = 0.8 out of 2 points, p \u3c 0.01). Both groups reported a significant increase in their understanding of what a slit lamp is used for (p \u3c 0.01) and in their confidence using a slit lamp (p \u3c 0.01). All students felt their skills improved with the workshop, 94% found the workshop to be useful, and 88% enjoyed the workshop, with no intergroup differences on these metrics.
Conclusion
An instructional video combined with a simulation model is as effective as traditional preceptor teaching of the slit lamp exam. Such a teaching module may be considered as an adjunct to traditional methods
Improved Performance of ChatGPT-4 on the OKAP Examination: A Comparative Study with ChatGPT-3.5
No full textIntroduction
This study aims to evaluate the performance of ChatGPT-4, an advanced artificial intelligence (AI) language model, on the Ophthalmology Knowledge Assessment Program (OKAP) examination compared to its predecessor, ChatGPT-3.5.
Methods
Both models were tested on 180 OKAP practice questions covering various ophthalmology subject categories.
Results
ChatGPT-4 significantly outperformed ChatGPT-3.5 (81% vs. 57%; p\u3c0.001), indicating improvements in medical knowledge assessment.
Discussion
The superior performance of ChatGPT-4 suggests potential applicability in ophthalmologic education and clinical decision support systems. Future research should focus on refining AI models, ensuring a balanced representation of fundamental and specialized knowledge, and determining the optimal method of integrating AI into medical education and practice
An Ophthalmology Virtual Externship during the COVID-19 Pandemic: A Pilot Study
No full textBackground
The evolution of medical school curricula, characterized by truncated preclinical periods and reduced emphasis on ophthalmology, presents formidable obstacles to early exposure for aspiring medical students. The constraints imposed by the coronavirus disease 2019 pandemic further exacerbated the limitations on opportunities, compelling the implementation of innovative initiatives aimed at augmenting students\u27 ophthalmology education through virtual means.
Purpose
This article assesses the impact of an Ophthalmology Virtual Externship (OVE) on medical students\u27 knowledge, interest, confidence, and seeking mentorship in ophthalmology.
Materials and Methods
A total of 76 students voluntarily participated in the program. The OVE encompassed four virtual sessions, facilitated by 4th year medical students employing a near-peer mentorship framework. The initiative was tailored for 2nd and 3rd year medical students and was conducted under the supervision of a faculty member. All participating students completed both pre- and postexternship surveys utilizing a 7-point Likert scale to gauge their levels of interest, confidence, and inclination toward mentorship opportunities in the field of ophthalmology. Furthermore, assessments of ophthalmology knowledge were administered prior to and subsequent to the externship participation. The degree of satisfaction derived from the OVE experience was also evaluated.
Results
Participation in the OVE significantly elevated confidence in knowledge (p \u3c 0.001) and mentorship interest (p = 0.029). Ophthalmology knowledge test scores also notably improved post-OVE across all participants, irrespective of prior experience (p \u3c 0.001), with the most significant increase observed among 2nd and 3rd year students (p \u3c 0.0001). After OVE participation, 73% of students expressed intent to pursue ophthalmology opportunities, including mentorship or research. The OVE received an average Likert score of 6.35 out of 7 for student satisfaction.
Conclusion
The OVE serves as a virtual learning instrument beneficial for 2nd and 3rd year students with a proclivity for ophthalmology, offering a means to circumvent curriculum-related constraints. Moreover, given the decline in formal ophthalmic education, our study contributes to future research assessing the effectiveness of an OVE in addressing ophthalmic knowledge gaps among all medical students
Ophthalmic Education: The Top 100 Cited Articles in Ophthalmology Journals
No full textoai:www.aupojournal.org:jao-1041Purpose
To identify the top 100 (T100) cited articles on ophthalmic education and examine trends and areas of focus in ophthalmic education.
Methods
A literature search was conducted for articles published between 2011 and 2021 related to ophthalmic education within ophthalmology journals using the ISI Web of Science Core Collection database. The search was performed in June 2022 and was conducted using the search phrase ([educat* OR teach* OR instruct* OR train* OR “medical student*” OR residen* OR fellow* OR undergrad* OR postgrad* OR “faculty” OR “attending”] AND *ophthalm*). Results were analyzed using VOSviewer v.1.6.18 and statistical analysis was performed using Microsoft Excel.
Results
The majority of articles were published in the Journal of Cataract & Refractive Surgery (19%), followed by Ophthalmology (12%), and Eye (12%). Articles were most often published in the year 2013 (15%), followed by 2014 (12%) and 2012 (12%). Articles most commonly originated from English-speaking countries, including the United States (43%), England (14%), Canada (8%), and India (8%). Topics most often examined in ophthalmic education were resident education (51%), medical school education (21%), and surgical training (21%). The most common study types were cohort studies (22%), case series (21%), and prospective trials (16%). There were 16 institutions that produced more than one article in the T100 articles list.
Conclusion
The T100 articles on ophthalmic education were primarily U.S. based and focused on resident education, surgical training, and medical school ophthalmic curriculum. Further research into ophthalmic education is warranted to establish evidence-based curricula guidelines
Perspectives from an Ophthalmic Hospitalist—Changing How We View Hospital-Based Consults
No full textInpatient and emergency room ophthalmology consults are becoming an increasingly important issue as fewer providers are willing to provide hospital-based coverage. In this Editorial, I explore aspects of this challenge and highlight a potential solution via the role of an ophthalmic hospitalist