[Smartphone Funduscopic Examination by Medical Students: The FUSOMED Project]

To evaluate the performance of medical students in learning funduscopy using smartphones.

Participants were medical students who were divided into small groups and taught the technique of smartphone funduscopy, first theoretically and then procedurally, with a simulation workshop on a model eye. The technique involved freehand alignment of the smartphone camera axes with a 20 diopter double aspheric lens. They then had to examine 10 patients in a retina clinic and obtain fundus photographs. Evaluation questionnaires were completed by students, supervisors and patients to obtain data on the performance of the examination technique. We aimed to investigate the effects of training on students' self-rated technical skills.

Between September 2022 and April 2023, 27 medical students completing their ophthalmology rotation at our university teaching hospital were enrolled in the study. At the end of a training cycle of ten fundus examinations, students' self-efficacy scores increased significantly from 10.39/20 to 15.48/20, a factor of 1.5 (p<0.001). On the technical level, the quality of the examination, as rated by the instructor, increased significantly from 11/20 to 16.96/20, a factor of 1.5 (p<0.001). The quality of the images and the duration of the examination improved with the number of examinations. By the ninth funduscopy, 80% of the images were free of artifacts.

Our study showed that, by using a smartphone in a simulation and then in a clinical setting, students were able to learn and develop their skills in indirect ophthalmoscopy. Their smartphone funduscopy performance improved with training, achieving satisfactory quality after 10 trials.