Medical students' self-confidence in performing direct ophthalmoscopy in clinical training

Abstract

Background: Although direct ophthalmoscopy is an important skill that medical students must practice to gain proficiency, limited time is generally available in medical school curricula. More targeted and effective teaching could result from a clearer understanding of medical students' self-reported needs and weaknesses in performing direct ophthalmoscopy. Methods: A cross-sectional survey was conducted at a Canadian university to determine the confidence of medical students in their skill in performing direct ophthalmoscopy. The responses of 208 participants who volunteered to complete a 21-item questionnaire were analyzed. Results: Although clerks were significantly more confident in their overall skill (χ2 = 28.03, p < 0.001) than were first- and second-year students, 47% of clerks were "not at all(Graph Presented) or only "a little" confident in performing direct ophthalmoscopy on an undilated pupil. Respondents who had practiced on more than 10 occasions outside of formal teaching were significantly more confident in their overall skill than those who had not (χ2 = 22.94, p < 0.001). Overall, 87% (77% of clerks) were "quite" or "extremely" interested in more practice and training on direct ophthalmoscopy. Interpretation: A large proportion of medical students reported being unconfident in various aspects of their skill in performing direct ophthalmoscopy. Self-confidence was significantly greater among students who practiced outside of formal teaching sessions. Most students were interested in additional training, and medical schools should emphasize the importance of practicing whenever appropriate.