The Ophthalmology Teacher's Library

Authors: Timothy V. Roberts, Adam J. H. Plant, Chris Hodge
Annals of Eye Science 2019; doi: 10.21037/aes.2019.07.01

Abstract: The outcomes of modern ophthalmic surgery, especially cataract surgery, continue to improve and patients now realistically expect an excellent and speedy outcome with good vision and few complications. Social and regulatory demands for greater transparency and accountability in medicine have increased, highlighting a fundamental ethical tension in medical education—balancing the needs of trainees (who have not yet mastered the technique) to gain experience by performing surgery, with patient safety and the needs of the public to be protected from risk. Patient safety and well-being are the paramount considerations in any training program and must be the first consideration in program design. A variety of different educational strategies, each implemented with the aim of improving operative skills assessment and teaching, has recently been described in the literature. Effective use of these educational tools, combined with a structured approach to teaching and providing meaningful feedback, could improve outcomes, decrease complications and improve the quality and efficiency of surgical training in ophthalmology. Supervisors must assess their teaching style and communication, as being a good surgeon does not necessarily make a good trainer. Open disclosure must be given to patients about who will be performing the surgery, and communication during surgery between supervisors and trainees must be clear, respectful and appropriate.

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* I have no financial interest to disclose (GP).

Authors: Karl C. Golnik
Annals of Eye Science 2019; doi: 10.21037/aes.2019.07.03

Ophthalmology residency training programs need authentic methods of assessment to show that trainees have learned and can do what is expected upon graduation. Written and oral examinations are necessary to assess knowledge but other methods are needed to assess skill. Workplace-based assessments (WPBAs) should be utilized to observe resident skill in the clinic and during surgery. Several such assessment tools have been published and validated. These tools have the additional benefit of facilitating specific formative feedback and thus can be used for both teaching and assessing.

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* I have no financial interest to disclose (GP).

Authors: Joaquín Fernández, Noemí Burguera Giménez
Annals of Eye Science 2019; doi: 10.21037/aes.2019.07.02

Over the last years the amount of biomedical information published has reached an unstoppable progression. One ophthalmologist fully dedicated would only reach a very little proportion of the information published, during his working day. Therefore, the practice of Evidence-Based Ophthalmology (EBO) not only requires reading scientific articles, but also reading the right articles at the right time and then modifying the physician’s behavior in light of what has been found. All the information searched and critical evaluation will be futile, if similar effort is not made towards the valid application of the evidence and in the measurement of progress towards the objectives.

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* I have no financial interest to disclose (GP).

Authors: Helena Prior Filipe, Heather Gwen Mack
Annals of Eye Science 2019; doi: 10.21037/aes.2019.07.02

Timely and widely available, social media (SM) platforms and tools offer new and exciting learning opportunities in medical education. Despite scarce, authors sought for a body of consistent evidence allowing them to substantially approach the concept of SM and how physicians as learners and medical educators can use SM based-education to benefit their clinical practice and their patients’ outcomes. Authors correlate education theories with the progression of world-wide web phases and how this influences the process of teaching and learning. They mention some examples of SM tools already in use in healthcare education. Potential advantages and effectiveness SM in medical education, as well as limitations of SM and pre-requisites for its use are discussed. Their concluding remarks underline the good practices in effectively utilizing SM in healthcare education.

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* I have no financial interest to disclose (GP).

Authors: Eduardo Mayorga
Annals of Eye Science 2019; doi: 10.21037/aes.2019.08.06.

“Presentations using PowerPoint or similar software are probably the most commonly used format that doctors use for teaching in medical school, during residency, at medical meetings and other continuous medical education (CME) activities. However, their effectiveness has been questioned by many. This article intends to provide, in a synthesized way, several recommendations that can help make presentations more effective.

You can find this article here.

* I have no financial interest to disclose (GP).

Authors: Halah Ibrahim, Dora J. Stadler, Sophia Archuleta, Pascale Anglade & Joseph Cofranceso Jr.
Medical Teacher 2018. DOI: 10.1080/0142159X.2018.1521954. [Epub ahead of print]

“Gender inequity in academic medicine remains an important issue worldwide. While institutional programs and policies can help promote equity in recruitment, retention, scholarship, promotion, and leadership, they often do not address the physical and social isolation that many women in international academic medicine face. Creating networking opportunities through building women’s groups can provide a personal and professional support structure that decreases isolation and promotes the advancement of women”. Based on a multidisciplinary literature review on change processes, group formation, women’s empowerment, and lessons learned from personal experience, the authors offer 12 tips classified in 8 steps to successfully create, maintain, and support physician women’s groups:

• • Step 1: Create a sense of urgency
    • Perform a thorough needs assessment and analysis, and contextualize the role of women in the society and culture in which your group exists.

• • Step 2: Build a guiding coalition
    • Identify your “champions” while being mindful of the cross-cultural diversity of group members.
    • Get leadership support.
    • Involve men.

• • Step 3: Create a vision
    • Define your mission and vision, including goals and objectives, and develop infrastructure.

• • Step 4: Communicate the vision
    • Plan programs that are relevant and needed.
    • Use social media as a means of virtual networking.

• • Step 5: Enable action by removing barriers
    • Anticipate and be prepared for resistance and challenges.

• • Step 6: Generate short-term wins
    • Orchestrate and share your successes.

• • Step 7: Sustain acceleration
    • Evaluation is important – collect, reflect, and act on feedback.

• • Step 8: Institute new culture
    • Plan for the future to ensure both manageability and sustainability.
    • Have fun.

You can find this article here.

* I have no financial interest to disclose (GP).

Authors: Rashmi Kusurkar, Olle ten Cate.
Academic Medicine 2013; volume 88, issue 6, page 904

Self-determination theory states that human beings have a natural tendency to develop towards autonomous regulation of behavior, being intrinsically motivated to learn and to take on challenges. Motivation impacts educational learning outcomes and students’ well being.

In this one-page paper, authors present Ryan and Deci’s Self-Determination Continuum going from Not Self-Determined to Fully Self-Determined, and from Amotivation to Intrinsic Motivation. They also list some examples on how to apply this theory to medical education.

You may read this article here.

* I have no financial interest to disclose (GP).

Authors: Davinder Sandhu.
Medical Teacher 2019; volume 41, issue 6, pages 614-618

“This paper through ideas confronts the myths and flaws of current leadership teaching in an education framework. It makes the case for innovative, creative, adroit, adept, experiential learners who can see the bigger picture, avoid harm and be able to cope with complexity and uncertainty, thereby creating a paradigm shift so that future leaders can problem solve, through the ongoing seismic changes that healthcare faces”.

You may read this article here.

* I have no financial interest to disclose (GP).

Authors: Asha Anandalah & Laura Rock.
Med Teach. 2019; 41(4):465-70.

Obtaining informed consent is a complex and challenging process. In this article authors provide a roadmap, listed as 12 tips, for teaching the essential components of how to obtain informed consent:

1. Choose a time and place for the consent conversation that emphasizes its value;
2. Emphasize the importance of first making a connection and establishing trust;
3. Counsel the trainee to assess for barriers to discussing informed consent;
4. Reinforce principles of effective communication;
5. Review the core elements of an informed consent conversation;
6. Ensure the trainee is knowledgable about the procedure;
7. Specify how to discuss risk;
8. Teach the trainee to discuss the procedure in the context of the individual patient’s circumstances;
9. Explain how to articulate an informed decision;
10. Adapt your teaching to the clinical context;
11. Discuss and review documentation; and
12. Observe and debrief the experience afterwards.

You can find this article here.

* I have no financial interest to disclose (GP).

Authors: Miriam Lacasse, Marie-Claude Audétat, Élisabeth Boileau, Nathalie Caire Fon, Marie-Hélène Dufour, Marie-Claude Laferrière, et al.
Medical Teacher 2019 Mar 12:1-21. doi: 10.1080/0142159X.2019.1596239. [Epub ahead of print]

In this systematic review, authors aim to identify interventions for undergraduate (UG) and postgraduate (PG) medical learners experiencing academic difficulties (“learners who do not meet the expectations of a training program because of a problem with knowledge, attitudes, or skill”), to link them to a theory-based conceptual framework, and to provide literature-based recommendations around their use.

The review provides a repertoire of literature-based interventions for teaching/learning, faculty development, and research purposes.

You can find this article here.

* I have no financial interest to disclose (GP).