Optimising fundoscopy practices across the medical spectrum: A focus group study

Area of Science:

• Ophthalmology
• Medical Education
• Clinical Practice

Background:

• Direct ophthalmoscopy (fundoscopy) is clinically valuable but underutilized.
• Previous educational interventions have shown limited success in improving fundoscopy uptake.

Purpose of the Study:

• To explore barriers and facilitators to direct ophthalmoscopy utilization.
• To investigate factors influencing uptake across various medical specialties and training levels.

Main Methods:

• Conducted ten focus groups with medical students and physicians across different training stages.
• Utilized independent thematic analysis of transcripts, followed by consensus framework development.

Main Results:

• Identified seven key themes: technical difficulties, clinical culture, impact on management, motivation, novel technologies (smartphone fundoscopy), training needs, and resource limitations.
• Found that barriers lead to loss of expertise, reduced perceived utility, and a cycle of declining utilization.
• Highlighted cultural barriers like perceived incompetence and discouragement.

Conclusions:

• Current barriers decrease fundoscopy practice and confidence, diminishing its perceived clinical value.
• Emerging technologies can mitigate technical barriers.
• Future education should focus on digital image interpretation, clarify clinical roles, and target specific career stages.