A low cost surrogate eye model for corneal foreign body removal

Abstract

Background: Patients commonly present to the Emergency Department with a corneal foreign body (FB). There is currently a lack of adequate training for junior doctors in the management of this condition. Our self-made surrogate eye model aims to address this void in our junior doctors' knowledge.Methods: Participants were guided through a hands-on session with a slit-lamp using our eye model, which is made of a hemispherical agar embedded with pencil lead fragments simulating as FBs. Using a 7-point Likert scale, all participants completed a questionnaire both before and after training, for: (1) knowledge in corneal FB removal, (2) confidence in corneal FB removal, and (3) effectiveness of the model. Results: Out of 73 participants, 82.2% (60/73) had no prior experience in corneal FBs removal. After the training session, their knowledge improved from a median score of 2 (interquartile range [IQR] 1 to 3) to 5 (IQR 5 to 6), with improvement in confidence levels from 2 (IQR 1 to 2) to 5 (IQR 4 to 6). The effectiveness of our eye model scored a median of 6 (IQR 5 to 7).Conclusions: Our surrogate eye model is low-cost, quick and easy to reproduce. After use, our learners expressed greater confidence in managing the removal of corneal FBs and use of slit lamp. With a recent focus in patient safety and quality, teaching this procedure via simulation is a safe way of bridging the gap between traditional didactic teaching and the clinical environment.

Evaluation of an Instructional Video and Simulation Model for Teaching Slit Lamp Examination to Medical Students

“… 43 Limitations of the model eye are that it is not suitable for all components of the slit lamp exam, it does not perfectly replicate the human eye or demonstrate eye pathology, and it does not build on students' interpersonal skills. 23 …”

“…43 Limitations of the model eye are that it is not suitable for all components of the slit lamp exam, it does not perfectly replicate the human eye or demonstrate eye pathology, and it does not build on students' interpersonal skills. 23 Students in both the model eye and preceptor group enjoyed their experience and found the workshop to be useful. Studies that compare medical student satisfaction between video-based learning and face-to-face instruction vary overall, with some favoring e-learning, 13,42,44 some traditional teaching, 7 and others showing no difference.…”

“… 20 A 2020 systematic review of simulation-based training tools for technical and nontechnical skills within ophthalmology found that while virtual reality simulators and wet-lab models have been widely studied and have strong validity evidence, the use of synthetic dry-lab models in ophthalmology was limited compared to other surgical specialties. 21 Those studies that have been published focus mostly on corneal foreign body removal, 22 23 24 direct fundoscopy, 25 26 and indirect fundoscopy. 27 28 29 There are limited descriptive studies of simulation models for slit lamp examination, 30 31 which demonstrate the potential of dry-lab simulation models for slit lamp training.…”

Eye irrigation as a first-line treatment and diagnostic method for emergency department patients who complain of ocular foreign bodies

“…Lack of training was reported to be the primary reason for not utilizing slit-lamps 12 . Accordingly, simulated eye models have been created to assist with slit-lamp-assisted FB removal training 13 , 14 .…”

A Syringe in an Emergency Saves Time: An Audit on the Utility of Syringe Provision in Eye Emergency

“…Hence, the timely removal of a corneal foreign body is essential to restore vision and prevent infection and scarring. As emergency departments are usually staffed with junior doctors, they are the ones required to attend to patients presenting with ophthalmic foreign bodies [ 6 ]. In the UK, most patients presenting with ocular complaints to the emergency departments are seen by foundation year two doctors who were previously known as senior house officers [ 7 ].…”