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Ophthalmoscopy: A 7-Step Program

Published online by Cambridge University Press:  02 December 2014

Joseph M. Dooley  and
Kevin E. Gordon
Joseph M. Dooley
Affiliation:
Pediatric Neurology Division, Dalhousie University and IWK Health Centre, Halifax, Nova Scotia, Canada
Kevin E. Gordon
Affiliation:
Pediatric Neurology Division, Dalhousie University and IWK Health Centre, Halifax, Nova Scotia, Canada
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Abstract

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Background:

Fundoscopy is viewed as a difficult or impossible task by many students and physicians. We have used a novel seven-step approach to teach trainees to use the ophthalmoscope. The technique is based on the premise that success is most easily achieved if the necessary motor skills are mastered first. A step by step approach will enable others to teach their trainees to attain the ability to routinely view the fundi of their pediatric patients.

Methods:

Step 1 involves examination of the trainee’s fundi to ensure there is no impediment to their success. In Step 2 the student examines the teacher. This identifies major errors. The next step teaches the trainee how to hold the ophthalmoscope. Step 4 gets the learner to read a journal article through the ophthalmoscope. In Step 5 they examine the teacher’s eyes again and with a little help they are always successful. In the last two steps an older patient is first examined and finally the student examines a young child.

Conclusion:

This method differs from most other approaches by leaving the cognitive component of ophthalmoscopy until the student is comfortable with handling the instrument. It has been uniformly successful among our students and residents.

Résumé:

<span class='bold'>RÉSUMÉ:</span><span class='bold'><span class='italic'>Contexte:</span></span>

Plusieurs étudiants et plusieurs médecins considèrent que l’examen du fond d’ceil est une täche difficile sinon impossible. Nous avons utilisé une nouvelle approche en 7 étapes pour enseigner aux étudiants l’utilisation de l’ophtalmoscope. La technique est basée sur le principe que les chances de succès sont plus élevées si les habiletés motrices nécessaires à la täche sont maítrisées d’abord. Une approche étape par étape permettra à d’autres d’enseigner à leurs étudiants comment parvenir à visualiser systématiquement le fond d’ceil de leurs patients pédiatriques.

<span class='bold'><span class='italic'>Méthodes:</span></span>

La première étape consiste à examiner le fond d’ceil de l’étudiant pour s’assurer qu’il n’existe pas d’entrave à ce niveau. Dans la deuxième étape, l’étudiant examine le professeur. Ceci permet d’identifier des erreurs majeures. Au cours de l’étape suivante, on enseigne à l’étudiant comment tenir l’ophtalmoscope. À l’étape 4, l’étudiant lit un article de journal à l’aide de l’ophtalmoscope. À l’étape 5, il examine de nouveau les yeux du professeur et, avec un peu d’aide, l’étudiant y parvient toujours. Au cours des deux dernières étapes, l’étudiant examine d’abord un patient plus ägé puis un jeune enfant.

<span class='bold'><span class='italic'>Résultats:</span></span>

Cette méthode diffère de la plupart des autres approches en ce qu’elle reporte la composante cognitive de l’ophtalmoscopie jusqu’au moment où l’étudiant est à l’aise de manipuler l’instrument. Elle remporte toujours du succès auprès de nos internes et de nos résidents.

Type
Original Articles
Information
Canadian Journal of Neurological Sciences , Volume 35 , Issue 2 , May 2008 , pp. 237 - 242
Copyright
Copyright © The Canadian Journal of Neurological 2008

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