Comparison of Ophthalmoscopy Findings Using PanOptic vs PanOptic + iExaminer
Condition: Vision Disorders
MeSH terms: Vision Disorders
Study type: Observational

Summary: 
      To examine how helpful the iExaminer will be as a training aid for medical students. The
      investigators will look into whether 1) it helps the medical students find pertinent eye
      findings for certain diagnoses and 2) it improves the medical students comfort level compared
      to using the PanOptic alone.
    

Detailed description: 
      Direct ophthalmoscopy is a vital skill for screening emergent conditions as well as chronic
      ocular pathologies for nonophthalmic physicians. Many eye care practitioners are first
      exposed to this tool during their medical education and are expected to have a certain degree
      of proficiency with it down the line. This skill requires practice, however, and given that
      there is a limited amount of time and exposure, it is not surprising that there is a general
      lack of familiarity and confidence among students and physicians with using the direct
      ophthalmoscope (Gilmour et al.,2017; Schulz et al., 2014; Day et al.,2017).

      A myriad of techniques and models have attempted to change this and improve the efficacy in
      teaching direct ophthalmoscopy. Studies have shown that students prefer learning how to use
      the direct ophthalmoscope with human subjects rather than simulators, and that the students
      prefer using fundus photographs to learn important diagnostic findings over the
      ophthalmoscope (Kelly et al.,2013). There have also been studies comparing the direct
      ophthalmoscope to the PanOptic, which gives a fixed working distance from the patient and a
      larger field of view (Day et al.,2017). These studies have noted more "ease of use" and
      accuracy in using the PanOptic among first year medical students and physicians (McComiskie
      et al.,2004; Petrushkin et al., 2012). New technological advances such as the iExaminer
      application have also been recently introduced, allowing the eye care physicians to take
      fundus images on their smart phone using a smart phone application and attachment to the
      PanOptic. Studies have shown the iExaminer application is able to produce "clinically
      adequate" fundus images (Day et al.,2017).

      From the literature review, there have not been any studies that compare the PanOptic alone
      versus the PanOptic with the iExaminer application as an introductory teaching tool for
      medical students. The iExaminer will not only allow the user to utilize the view obtained
      from the PanOptic, but also allow an instructor to observe and help coach the user on
      relevant findings and take pictures for future reference or instruction. This provides a
      potentially effective learning device which can help users accurately identify more relevant
      ophthalmic findings. The investigators also believe that this will help increase the medical
      students confidence level and encourage them to practice with these devices again at future
      opportunities.
    

Intervention name(s): Welch Allyn IExaminer
Intervention type(s): Diagnostic Test
Intervention description(s): Fundus Examination
Observational model: Cohort
Time perspective: Prospective
Sampling method: Probability Sample
Study population: 
        Second-year medical students at the University at Buffalo Jacobs School of Medicine and
        Biomedical Sciences attending Ophthalmoscopy class as a part of required didactic sessions.
        Volunteering patients with normal or eye pathology will be recruited for students to
        perform Ophthalmoscopy with PanOptic and iExaminer