Integrating a flipped classroom and problem-based learning into ophthalmology education

Background: Ophthalmology is an important medical science subject, but it is given with insufficient attention in undergraduate medical education. Flipped classroom(FC) and problem-based learning(PBL) are well-known education methods that can be integrated into ophthalmology education to improve students' competence level and promote active learning. Methods: We used a mixed teaching methodology that integrated a FC and PBL into a 1-week ophthalmology clerkship for 72 fourth-year medical students. The course includes two major sessions: FC session and PBL session, relying on clinical and real-patient cases. Written examinations were set up to assess students' academic performance and questionnaires were designed to evaluate their perceptions. Results: The post-course examination results were higher than the pre-course results, and many students gained ophthalmic knowledge and learning skills to varying levels. Comparison of pre-and post-course questionnaires indicated that interests in ophthalmology increased and more students expressed desires to be eye doctors. Most students were satisfied with the new method, while some suggested the process should be slower and the communication with their teacher needed to strengthen.Conclusions: FC and PBL are complementary methodologies. Utilizing the mixed teaching meth of FC and PBL was successful in enhancing academic performance, student satisfactions and promoting active learning.

Teaching in the operating room:trends in surgical skills transfer in ophthalmology

Cataract surgery is arguably the most commonly performed operation in ophthalmology.Surgical skills transfer from experienced surgeons to resident surgeons is complicated by the fact that the teaching surgeon primarily acts as an observer rather than directly performing the procedure.Therefore,wet lab and simulator training are utilized to reduce the learning curve of the novice surgeons,which establishes tissue awareness,dexterity and muscle memory required to perform each step of the procedure,safely.Access to a wet lab and simulator environment is accomplished by establishing a surgical training curriculum in residency programs.In the operating room,topical anesthesia is a safe alternative for teaching cataract surgery.There are three well-described approaches to teaching individual steps of cataract surgery:forward,“backwards”,and deconstructed step-by-step instruction.Simulator training can be incorporated prior to live patient experience or integrated concurrently with learner presence in the operating room.The trend towards a competency-based instruction model has necessitated appropriate evaluation tools that include Objective Assessment of Skills in Intraocular Surgery(OASIS),Global Rating Assessment of Skills in Intraocular Surgery(GRASIS),and the International Council of Ophthalmology’s Ophthalmology Surgical Competency Assessment Rubrics(ICO-OSCAR).We review the literature on trends in surgical teaching in ophthalmology,with the focus on cataract surgery instruction to the novice surgeon.