THE EFFECT OF FORMAL INSTRUCTION IN OPHTHALMOSCOPY ON MEDICAL-STUDENTPERFORMANCE

Ophthalmoscopy is an essential part of a complete clinical examination of a patient. However specific formal instruction in fundoscopy is ra rely given to medical students. We decided to determine the value of e xplicit teaching of ophthalmoscopy and devised and validated a rating scale for assessing performance which was used to evaluate 29 first ye ar clinical medical student volunteers at St. Bartholomew's Hospital M edical College, before and after formal instruction in fundoscopy. The competence of this group at ophthalmoscopoy was then compared to the rest of their year (109 medical students) during the objective structu red clinical end-of-year examination. Students formally instructed in ophthalmoscopy showed an improved score after instruction (from 53% to 77%). They also performed better at fundoscopy than the rest of their year (mean average score 64%), when tested 2 months later, suggesting persistence of the training effect. However as a group they performed no better than their peers at clinical skills other than ophthalmosco py. We suggest that as fundoscopy is such an important clinical skill, medical students should be given specific teaching, preferably in the ir ophthalmology firm attachment, as we have shown that it results in a persistent improvement in performance.