A NEW MODEL FOR TEACHING CORNEAL FOREIGN-BODY REMOVAL

Objective: To determine whether a skills laboratory for corneal foreig n body and rust ring removal improves self-assessed skill and confiden ce. Methods: A prospective trial was conducted as part of the didactic curriculum of a university-based residency program in emergency medic ine (EM). A convenience sample of 26 EM residents and five fourth-year medical students participated, The skills laboratory used rate model corneas made by coating 3.2-cm glass spheres with a 1-2-mm film of par affin. Foreign bodies were simulated by embedding small pieces of meta l into the paraffin. Rust rings were simulated by dipping a hot, strai ghtened paper clip into a rust-colored crayon and then into the paraff in. The model eyes fit into a life-sized model of a human head. Partic ipants removed the foreign bodies and rust rings under supervision, us ing the slit lamp. Each participant anonymously completed a questionna ire before and after participating in the skills laboratory. The quest ionnaire recorded educational level, previous experience, and self-ass essed comfort and skill levels (0 = lowest, 10 = highest). Results: Mo st (66%) of the participants had not previously removed a corneal fore ign body; 86% had nt previously removed a rust ring, On a ten-point sc ale, the median comfort level for removing a foreign body rose from 2 to 7, and the self-assessed skill-level rose from 1 to 7 (p = 0.0001). Similar improvements in self-assessed comfort and skill levels were s een for rust ring removal. Conclusions: Participation in this skills l aboratory significantly improved the self-reported comfort and self-as sessed skill levels in removing corneal foreign bodies and rust rings. This technique provides useful practice of a fine-motor procedural sk ill requiring eye-hand coordination prior to supervised application of these skills in clinical practice.