Exposure to a Vision Screening Program in a Community-Based Clinic Improves Medical Student Confidence and Funduscopy Skills

Background: Vision is critical to overall health, yet ophthalmology training in medical education has declined over the past 50 years, leaving many graduates underprepared to manage common eye conditions. The Johns Hopkins ViSION program demonstrated that structured participation improved students’ confidence and knowledge in ophthalmology, suggesting that integrating vision screening into medical training may enhance medical students’ confidence in performing ophthalmic examinations and recognizing common ophthalmic conditions. Purpose: To evaluate whether participation in community-based vision screening programs enhances medical students’ ophthalmic examination confidence, examination proficiency, and diagnostic performance. Methods: Thirty-eight medical students from the University of Oklahoma were recruited. After consent and a didactic lecture, they were randomized into three groups: 0, 2, or 8 hours of hands-on community vision screening. Supervised by an attending ophthalmologist, students participated in 8 screenings at the Unity Clinic between December 2024 and April 2025. Following their assigned hours, they evaluated 6 simulated patients with various ophthalmic conditions. Standardized patients from the Dean McGee Eye Institute assessed students’ examination accuracy and completeness. The primary outcome was improvement in ophthalmic examination confidence, while secondary outcomes included diagnostic accuracy and ability to identify pertinent examination findings. Results: Vision screening experience significantly improved student confidence in examination techniques and funduscopy (p = 0.0011) but did not enhance diagnostic performance (p = 0.2560). Notably, 90% (27/30) agreed or strongly agreed that community screenings improved their ophthalmic examination skills. Proficiency in visualizing retinal vessels (33.33%, 62.5%, 90% [p = 0.0238]) and the optic nerve (16.67%, 50%, 70% [p = 0.0383]) increased across the 0-, 2-, and 8-hour groups. Macula visualization also improved (16.67%, 50%, 60%) but was not statistically significant (p = 0.1169). Conclusion: Although increased screening hours did not improve diagnostic accuracy, our findings support the role of community screenings in boosting student confidence and technical examination skills. Study limitations include a small sample size. Future research with larger cohorts and a broader range of pathologies is recommended to further evaluate these outcomes.