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Curriculum Innovations: Implementation of a Targeted Longitudinal Rotation to Enhance Direct Ophthalmoscopy Learning

Noor Chahal¹, Maria Lee¹, Emily Eng²

¹Department of Ophthalmology, University of California, San Francisco.

Neurology. Education

|September 11, 2025

Summary

This summary is machine-generated.

Neurology residents improved direct ophthalmoscopy (DO) skills through a structured ophthalmology rotation. This training enhanced both confidence and competence in performing essential eye examinations for neurological diagnosis.

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Area of Science:

Medical Education
Neurology
Ophthalmology

Background:

Direct ophthalmoscopy (DO) is a critical diagnostic skill for neurology residents.
Proficiency in DO has declined due to limited training opportunities.
There is a need for adaptable curriculum models for residencies with minimal neuro-ophthalmology exposure.

Purpose of the Study:

To provide neurology residents with supervised and unsupervised DO practice.
To enhance resident competency and confidence in performing DO.
To develop a curriculum model for DO training adaptable to various residency programs.

Main Methods:

Implemented a longitudinal, practice-based optometry/ophthalmology elective in two neurology residency programs.
Utilized Kern's 6-step curriculum development approach.
Assessed resident confidence via pre/post-rotation questionnaires and competence through objective skills assessments.

Main Results:

13 residents (PGY 2-4) participated, completing an average of 4.8 half-days.
Significant increases in confidence were reported for retinal examination, optic disc identification, and recognizing pathology.
Mean objective assessment scores for DO improved by 46.6%.

Conclusions:

Integrating an ophthalmology rotation significantly enhanced neurology residents' DO confidence and competence.
Structured practice is crucial for mastering diagnostic examination skills.
The developed curriculum is feasible for adoption across residency programs lacking adequate DO training.