Application-Based Education for Corneal Foreign Body Removal in an Emergency Medicine Residency

To assess whether Emergency Procedures App (EPApp) use among emergency physicians improves knowledge and skill in performing corneal foreign body removal compared with usual practice.

This single-blinded, multicenter, randomized trial involved emergency physicians assessing their knowledge and performance in corneal foreign body removal. Participants were randomized into 2 groups (crossover and EPApp) and completed written and procedural assessments. The crossover group was initially prepared using usual methods, whereas the EPApp group reviewed the EPApp. Both groups used the EPApp for the second attempt. Performance scores from both attempts were compared, with subgroup analyses based on postgraduate years (PGYs) experience less than 4 or more than or equal to 4).

Thirty physicians were recruited, including 14 with PGYs less than 4. The crossover group had 16 participants, with 8 PGYs less than 4. Initial mean test scores were lower in the crossover arm (53%, standard deviation [SD]: 26%) compared with the EPApp arm (72%, SD:15%) (mean difference 18.9%; 95% confidence interval [CI] 2.8, 35). Both groups improved on their second attempt, with larger improvement in the crossover group (25.4%; SD:15.6%; 95% CI 17.14, 33.73) compared with the EPApp arm (13.4%; SD:10.3%; 95% CI 7.45, 19.26). The greatest improvements were seen in participants with PGYs less than 4.

EPApp use improved knowledge and procedural skills in corneal foreign body removal, especially for junior physicians. Further research into its effectiveness for other procedures and with broader participant groups is warranted.