Efficacy of Simulation-Based Learning for Direct and Indirect Ophthalmoscopy: A Systematic Review and Meta-analysis

This systematic review and meta-analysis evaluated the efficacy of simulation-based training for direct and indirect ophthalmoscopy. The primary outcome was successful fundus identification rate. Secondary outcomes included the simulation favorability rate, posttest results, and perceived benefits. Of the 955 studies identified, 11 studies were included, comprising a total sample of 772 participants. Simulation training improved fundus identification success, with 63.1% of participants correctly identifying fundus structures and demonstrated a high favorability rate, with 75.6% of participants preferring simulation over traditional training methods. Participants also demonstrated improvements in posttest knowledge and technical skills, with enhanced confidence, realism, and ease of learning, underscoring simulation's role in effectively advancing practical ophthalmic skills. Overall, simulation-based training seems effective in enhancing examination skills within simulated settings. These findings support its integration into ophthalmology curricula to enhance training outcomes. Interpretation of fundus identification outcomes should be cautious due to limited study numbers and assessment heterogeneity.