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Factors associated with confidence in fundoscopy.

Christopher Schulz1, Peter Hodgkins

  • 1Acute Medicine, Queen Alexandra Hospital, Portsmouth Hospitals NHS Trust, UK.

The Clinical Teacher
|September 13, 2014
PubMed
Summary

Final-year medical students lack confidence in direct ophthalmoscopy and recognizing eye conditions. Early training, more clinical practice with pathology, and feedback are crucial for improving their fundoscopy skills.

Area of Science:

  • Medical Education
  • Ophthalmology
  • Neurology

Background:

  • Fundoscopy is a key part of neurological exams.
  • Medical students and junior doctors often lack confidence in performing fundoscopy.
  • Barriers to confidence acquisition in fundoscopy are not well understood.

Purpose of the Study:

  • To assess confidence levels in direct ophthalmoscopy among medical students.
  • To identify factors influencing confidence in fundoscopy skills.
  • To provide recommendations for improving student confidence in fundoscopy.

Main Methods:

  • A questionnaire was used to gather data on prior experience and confidence.
  • The survey was distributed to fourth- and final-year medical students.
  • Data analysis focused on confidence in examining eyes and recognizing pathology.

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Main Results:

  • Only 43% of final-year students were confident in examining a dilated eye, versus 88% of fourth-year students.
  • Fewer than 40% of students felt confident identifying key pathologies like papilledema or diabetic retinopathy.
  • Increased practice and clinical exposure to pathology significantly boosted confidence in examination and recognition, while lack of feedback reduced it.

Conclusions:

  • Final-year medical students exhibit low confidence in direct ophthalmoscopy and pathology recognition.
  • Recommendations include early formal instruction, refresher training, increased clinical exposure to pathology, and structured feedback.
  • Addressing these areas can enhance the fundoscopy competence of graduating physicians.