A Cross-Specialty Approach: Implementation and Evaluation of a Pilot Medical Student Ophthalmology Curriculum Integrated in an Emergency Medicine Rotation

Problem Exposure to clinical ophthalmology among medical students has been declining, leading to a lack in confidence in ophthalmic knowledge and skills among physicians. Innovative curricular strategies are needed to increase exposure to ophthalmology. We aimed to evaluate a novel integrated emergency ophthalmology curriculum developed and implemented by both ophthalmology and emergency medicine (EM) departments. Methods A novel ophthalmology curriculum combining didactic and clinical components was integrated into an EM elective. Medical students received a 1-hour didactic lecture focused on ocular emergencies and the bedside eye examination. During their rotation, students were assigned to independently evaluate patients with ocular chief complaints. They then received direct feedback by evaluating the patient alongside an ophthalmology resident. Pre-intervention and post-intervention surveys were developed to assess gains in medical student knowledge and self-assessed confidence in physical examination skills and independence in evaluating patients with eye complaints. Results 67 students received the intervention from November 2022 to October 2023. 14 (20.9%) completed the pre-assessment and 15 (22.4%) completed the post-assessment. Comparing grouped pre- and post-intervention scores, there were significant gains in knowledge (pre mean score 7.14/10, post mean score 8.27/10; p=0.03). Using a 1-5 Likert scale, students felt more confident to independently evaluate patients with ocular chief complaints (pre mean 1.5, post mean 2.93; p= 0.001). There were significant gains in confidence in physical examination skills and history taking. Confidence improved in the ability to identify vision threatening diseases (pre mean 2.50, post 3.53; p=0.002), and knowing when to call for an ophthalmology consultation (pre mean 2.50, post 3.60; p=0.003). Conclusion This study of a novel ophthalmology curriculum for medical students integrated in an emergency medicine rotation demonstrated feasibility and improvement in both knowledge and self-reported independence in evaluating patients with ocular complaints in the emergency department. The curriculum could be enhanced by incorporating clinical exams skills sessions and implementing higher measures of outcomes.