Standardized Patient Experience With the Fundoscopic Exam

TL;DR

This study examines how standardized patients feel about teaching medical students the fundoscopic exam, including pupil dilation.

Contribution

The study provides insights into SPs' experiences and comfort levels with fundoscopy training, particularly involving dilation.

Findings

Most SPs were satisfied with the information and guidance provided during the training sessions.

SPs reported an average comfort level of 3.76 out of 5 during the fundoscopic exam.

All SPs were willing to participate in future fundoscopy sessions, with most open to dilation.

Abstract

Introduction

Best practices for teaching physical examination skills to medical students often involve the use of standardized patients (SPs). However, few medical schools utilize SPs specifically for teaching fundoscopy, and limited information exists on how best to prepare SPs for this unique examination. This study aims to explore SPs’ attitudes, experiences, and comfort levels in teaching the fundoscopic exam.

Methods

Twenty-six SPs who participated in fundoscopy training sessions - 16 from the Icahn School of Medicine at Mount Sinai and 10 from the University of California, San Francisco - were invited to complete optional pre- and post-session surveys assessing their attitudes toward and comfort with the fundoscopic exam and pupil dilation.

Results

All 26 participants (100%) completed the pre-survey, and 21 (80%) completed the post-survey. Of these, 77% had worked as SPs for at least three years, and 73% had previous experience with fundoscopy sessions. During the training, 17 out of 21 SPs underwent pupil dilation, with four opting to dilate only one eye. Eighty percent reported satisfaction with the information provided about dilation, and 90% were satisfied with the guidance on what to expect from learners. The average reported comfort level during the exam was 3.76 out of 5. All SPs expressed willingness to participate in future fundoscopy sessions, with 90% open to doing so with dilation. Main concerns included the duration of dilation and extended exposure to bright light.

Conclusions

With proper orientation, SPs feel comfortable participating in fundoscopic examinations involving ocular dilation.

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