Efficacy of Simulator-Based Direct Ophthalmoscopy Training using New Refractive Adjustment Fundoscopic Examination Simulator for Medical Students – ICEye Model: A Comparative Randomized Crossover Study

Abstract

Background: The use of simulators for ophthalmology training is growing globally. However, all developed simulators have certain limits based on different circumstances. The study aims to assess the efficacy and satisfaction of the new refractive adjustment simulator "ICEyeModel" compared to a traditional simulator for direct ophthalmoscopy training in medical students. Methods: This is a comparative, randomized cross-over study. Our study enrolled fifty participants from a 6-year medical student training program at Phramongkutklao Hospital. They required a refreshment lecture on primary direct ophthalmoscopy usage and a short course on common retinal disease review. They were randomized into two training sequence groups: Training sequence 1 started with a traditional film photograph simulator followed by the ICEyeModel. Training sequence 2 started with the ICEyeModel, followed by a traditional simulator. Both groups were asked to complete a fundoscopic description test and satisfaction questionnaires. Results: Medical students training with the ICEye Model achieved significantly higher fundoscopic examination scores (14.42±2.34) compared to those training with traditional simulators (11.30±6.43), with p<0.001. For the ICEyeModel, 86% of participants can correctly adjust the direct ophthalmoscope power match to the refractive state from the trial lens placed in the simulator. ICEyeModel has a higher satisfaction score regarding picture quality, enhancing motivation and confidence than a traditional simulator. Conclusion: The ICEye Model is the first combination of fundoscopic examination training and refraction practicing simulators that significantly improves fundoscopic examination skills and increases medical students' motivation and confidence in practicing direct ophthalmoscopy. In the future, it can be used to practice with indirect ophthalmoscopes and retinoscopes.