Teaching ocular semiology through asynchronous case-based discussion: a forum-based learning experience

In many healthcare professions, semiology is a core subject that supports the development of clinical reasoning skills, which are essential for patient assessment. However, teaching semiology is challenging, as it requires the integration of foundational knowledge, such as anatomy and physiology, with the clinical manifestations of disease. Furthermore, in many programs, this subject is taught before students have their first clinical experience. This exploratory study aimed to examine the association between participation in an asynchronous clinical case discussion forum and academic performance in ocular semiology, and to explore students’ perceptions of this educational strategy. An exploratory observational mixed-methods study was conducted to evaluate the implementation of a forum-based learning activity within an undergraduate ocular semiology course. Quantitative analysis examined the correlation between forum participation and final course grades, while qualitative analysis consisted of an exploratory thematic analysis of responses to a study specific, non-validated six question open-ended questionnaire that explored students’ perceptions of the forum. A modest positive correlation was found between forum participation and final grades (ρ = 0.36, 95% CI: 0.013 to 0.65, p = 0.048). However, this association was no longer significant after excluding repeat students or highly active students in the forum. The qualitative analysis showed that the six students who responded to the open-ended questions perceived the forum positively as a complementary activity for clinical subjects, but also suggested modifications for future implementation, such as structured feedback and the inclusion of a small grade component. This study suggests that a virtual discussion forum may be a useful strategy for supporting self-directed and peer-based learning in ocular semiology. However, the quantitative association was not robust in sensitivity analyses, and the qualitative findings were based on a small number of respondents. Therefore, these findings should be interpreted cautiously. Nevertheless, student feedback indicated general acceptance of this approach, and highlighted potential improvements for future implementation, including the incorporation of a small grading component and increased instructor feedback to enhance student engagement.