Does the Eyesi direct ophthalmoscope increase interest in ophthalmology?

Purpose: This study based on direct ophthalmoscopy (DO) teaching in medical curricula aimed to integrate both classic and simulator‐based DO techniques into the teaching of medical students.Methods: 110 medical students received a multiple‐choice questionnaire (four theory questions, six fundus photographs) prior to simulator‐based (EyeSi® Direct, Haag‐Streit Simulation, Germany) and classic DO training (Heine BETA®200, Heine Optotechnik GmbH, Germany). Simulator‐based DO training was performed in groups of up to eight students.Thereafter, they underwent an objective standardized clinical examination containing questions about (1) pupil dilation, (2) mydriasis contraindication, (3) ophthalmoscope adjustment and a practical test checking whether (1) optic nerve head, (2) macula, (3–6) upper/lower vessel arcade nasally versus temporally were identified correctly. Subsequently, classic DO was performed mutually and they reported the funduscopic structures they had recognized. Finally, the questionnaire was repeated 1 week later in combination with an evaluation of simulator‐based versus classic DO.Results: Students improved from an average of 4.0 ± 1.5/10 before to 8.8 ± 1.5/10 correctly answered questions after training (p < 0.0001, Wilcoxon matched‐pairs test). 87|34|61 students named pupil dilating time mydriasis contraindication and adjusted the ophthalmoscope correctly. They successfully identified the optic nerve head (n(simulator)|n(classic) DO: 110|68, p < 0.0001, Fisher's exact test), the macula (93|22, p < 0.0001), the upper (98|75, p = 0.0002) and lower temporal vessel arcade (101|91, p = 0.0672), the upper (84|56, p = 0.0001) and lower nasal vessel arcade (87|48, p < 0.0001). They wished for more simulator‐based training, indicated a higher interest in ophthalmology after training and stated an improvement of their ophthalmoscopy skills.Conclusion: A standardized simulator‐based approach improves medical students' skills in ophthalmoscopy and arouses professional interest in ophthalmology.