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      A low cost surrogate eye model for corneal foreign body removal

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          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.

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          Most cited references20

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          Simulation Technology for Skills Training and Competency Assessment in Medical Education

          Medical education during the past decade has witnessed a significant increase in the use of simulation technology for teaching and assessment. Contributing factors include: changes in health care delivery and academic environments that limit patient availability as educational opportunities; worldwide attention focused on the problem of medical errors and the need to improve patient safety; and the paradigm shift to outcomes-based education with its requirements for assessment and demonstration of competence. The use of simulators addresses many of these issues: they can be readily available at any time and can reproduce a wide variety of clinical conditions on demand. In lieu of the customary (and arguably unethical) system, whereby novices carry out the practice required to master various techniques—including invasive procedures—on real patients, simulation-based education allows trainees to hone their skills in a risk-free environment. Evaluators can also use simulators for reliable assessments of competence in multiple domains. For those readers less familiar with medical simulators, this article aims to provide a brief overview of these educational innovations and their uses; for decision makers in medical education, we hope to broaden awareness of the significant potential of these new technologies for improving physician training and assessment, with a resultant positive impact on patient safety and health care outcomes.
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            Simulation in Medical School Education: Review for Emergency Medicine

            Medical education is rapidly evolving. With the paradigm shift to small-group didactic sessions and focus on clinically oriented case-based scenarios, simulation training has provided educators a novel way to deliver medical education in the 21st century. The field continues to expand in scope and practice and is being incorporated into medical school clerkship education, and specifically in emergency medicine (EM). The use of medical simulation in graduate medical education is well documented. Our aim in this article is to perform a retrospective review of the current literature, studying simulation use in EM medical student clerkships. Studies have demonstrated the effectiveness of simulation in teaching basic science, clinical knowledge, procedural skills, teamwork, and communication skills. As simulation becomes increasingly prevalent in medical school curricula, more studies are needed to assess whether simulation training improves patient-related outcomes.
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              Prospective randomized crossover study of simulation vs. didactics for teaching medical students the assessment and management of critically ill patients.

              Simulation (SIM) allows medical students to manage high-risk/low-frequency cases in an environment without patient risk. However, evidence for the efficacy of SIM-based training remains limited. To compare SIM-based training to traditional didactic lecture (LEC) for teaching medical students to assess and manage critically ill patients with myocardial infarction (MI) and anaphylaxis. Prospective, randomized, non-blinded crossover study of 28 fourth-year medical students. Students were oriented to the human patient simulator, then randomized to SIM or LEC between August and December 2007. The SIM group learned to manage MI using SIM training and the LEC group learned via PowerPoint lecture. All subjects' assessment and management skills were then evaluated during a simulation session of MI. During a second instruction session, the students crossed over and were taught anaphylaxis using the opposite modality and similar assessments were conducted. Completion of critical actions for each case were scored, converted to percentages, and analyzed via signed rank test. Of 28 subjects, 27 performed better when trained with SIM compared with LEC (p < 0.0001). Mean scores were 93% (95% confidence interval [CI] 91-95%) of critical actions completed for SIM and 71% (95% CI 66-76%) for LEC. Absolute increase for simulation was 22% (95% CI 18-26%). For three domains common to MI and anaphylaxis, simulation scores were higher for history (27%, 95% CI 21-38%), physical examination (26%, 95% CI 20-33%), and management (16%, 95% CI 11-21%). SIM training is superior to didactic lecture for teaching fourth-year medical students to assess and manage simulated critically ill MI and anaphylaxis patients. Copyright © 2011 Elsevier Inc. All rights reserved.
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                Author and article information

                Contributors
                jingping_lin@nuhs.edu.sg
                Journal
                BMC Ophthalmol
                BMC Ophthalmol
                BMC Ophthalmology
                BioMed Central (London )
                1471-2415
                7 February 2020
                7 February 2020
                2020
                : 20
                : 48
                Affiliations
                [1 ]GRID grid.412106.0, ISNI 0000 0004 0621 9599, Emergency Medicine Department, , National University Hospital, Level 4, National University Centre for Oral Health, ; 9 Lower Kent Ridge Road, Singapore, 119085 Singapore
                [2 ]GRID grid.4280.e, ISNI 0000 0001 2180 6431, Department of Surgery, Yong Loo Lin School of Medicine, , National University of Singapore, ; Singapore, Singapore
                Author information
                http://orcid.org/0000-0003-1431-5348
                Article
                1310
                10.1186/s12886-020-1310-z
                7006147
                32028904
                b0eab635-ab00-480a-8321-6f7552c5c43f
                © The Author(s). 2020

                Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License ( http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver ( http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.

                History
                : 23 August 2019
                : 7 January 2020
                Categories
                Technical Advance
                Custom metadata
                © The Author(s) 2020

                Ophthalmology & Optometry
                simulation,medical education,emergency medicine,ophthalmology,curriculum,cornea,foreign body,intraocular

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