Labels improve emergency medicine physician comfort and ability to use a slit lamp

Slit-lamp (SL) biomicroscopy is an important skill for emergency medicine (EM) clinicians. However, residents and faculty have varying levels of comfort and skill with this procedure. While some of the discomfort may be from a knowledge gap, we hypothesized that at least some difficulty came from infrequent use and forgetting which of the many knobs, levers, buttons, and switches of the SL create the desired effects. We strategically labeled a SL and tested the impact of this on the ability of 39 EM faculty and residents to identify a target on a maladjusted SL. Time to target identification was significantly lower with the labeled SL compared to the unlabeled SL, with median (IQR) time decreasing from 93 (31.5-154.5) seconds to 47 (0-141) seconds (p < 0.0001). Comfort level, as measured by a written survey and a graphic rating scale, also increased significantly with the labeled SL compared to the unlabeled SL.