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. 2024 Sep;25(5):725-734.
doi: 10.5811/westjem.18514.

Emergency Department Slit Lamp Interdisciplinary Training Via Longitudinal Assessment in Medical Practice

Samara Hamou  1 , Shayan Ghiaee  2 , Christine Chung  3 , Maureen Lloyd  3 , Kelly Khem  4 , Xiao Chi Zhang  4
Affiliations

Emergency Department Slit Lamp Interdisciplinary Training Via Longitudinal Assessment in Medical Practice

Samara Hamou et al. West J Emerg Med. 2024 Sep.

Abstract

Introduction: Eye emergencies make up nearly 3% of US emergency department (ED) visits. While emergency physicians (EP) should diagnose and treat these ophthalmologic emergencies, many trainees report limited ocular exposure and insufficient training throughout their residency to confidently conduct a thorough slit-lamp exam.

Methods: We created an interdisciplinary, simulation-based mastery learning (SBML) curriculum to teach emergency attending physicians how to operate the slit lamp with multimodal learning methodology at a tertiary academic center. The EPs first demonstrate their initial slit-lamp competency with a 20-item checklist, and they then review the necessary curricular content to pass their independent readiness test before completing their in-person teaching and demonstration session with an ophthalmology attending to demonstrate procedural mastery (minimal passing score >90%).

Results: Fifteen EPs were enrolled; all completed the final exam of the curriculum. The pre- and post-curriculum checklist scores increased by an average of seven points (P = .002); 86.7% of EPs felt confident in completing a slit-lamp exam after the curriculum, compared to 20% at the beginning. Five of 15 reported teaching learners within the two-month post-curricular period, ranging from 5-30 students. The hands-on teaching was the most positively reviewed element of the curriculum.

Conclusion: The SBML program successfully trained EPs on performing a comprehensive slit-lamp exam with promising results of downstream education to junior learners. We encourage other institutions to leverage SBML as a teaching modality for procedural-based training and advocate cross-discipline education initiatives.

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Conflict of interest statement

Conflicts of Interest: By the WestJEM article submission agreement, all authors are required to disclose all affiliations, funding sources and financial or management relationships that could be perceived as potential sources of bias. This study received grant funding from the Center for Faculty Development and Nexus Learning (CFDNL) Pedagogy, Thomas Jefferson University. There are no other conflicts of interest or sources of funding to declare.

Figures

Figure 1.
Figure 1.
Slit lamp (A) and Wood’s lamp (B).
Figure 2.
Figure 2.
Learner confidence in performing the slit-lamp exam at Time 0 (pre-curricular), Time 2 (immediate post-SBML curriculum), and Time 3 (2-month post-SBML curriculum).
Figure 3.
Figure 3.
Learner confidence in teaching the slit-lamp exam at Time 0 (pre-curricular), Time 2 (immediate post-SBML curriculum), Time 3 (2-months post-SBML curriculum).
Figure 4.
Figure 4.
Learner likelihood in teaching the slit-lamp exam at Time 0 (pre-curriculuar) and Time 2 (immediate post-SBML curriculum).
See this image and copyright information in PMC

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