Does the virtual refractor patient‐simulator improve student competency when refracting in the consulting room?

Abstract

Background

The use of patient simulators in ophthalmic education appears limited. This study examines the effects of the addition of the ‘Virtual Refractor’ patient simulator learning activity into a short unit preparing students to determine the power of the spectacle lenses required by patients in a clinic.

Methods

Twenty‐four year one optometry students were randomly assigned to either the simulator‐intervention group (n = 12) or the non‐intervention group. All students attended tutorials on refraction and the use of a refractor‐head. Simulator‐intervention students additionally attended a tutorial on the Virtual Refractor. All answered a questionnaire concerning time spent studying, perceived knowledge and confidence. Twenty‐four short‐sighted patients were recruited. Two refractions per student were timed and the accuracy compared with that of an experienced optometrist.

Results

Ten students from each group completed the study. Students who used the simulator were significantly (p < 0.05) more accurate at a clinical level (within 0.22 ± 0.22 DS, 95 per cent CI 0.12–0.32) than those who did not (within 0.60 ± 0.67 DS, 95 per cent CI 0.29–0.92) and 13 per cent quicker (4.7 minutes, p < 0.05). Students who used the simulator felt more knowledgeable (p < 0.05) and confident (p < 0.05), but had spent more time reading about refraction and practised on the Virtual Refractor at home for 5.7 ± 1.3 hours.

Conclusion

The Virtual Refractor has many features of high‐fidelity medical simulation known to lead to effective learning and it also offers flexible independent learning without a concomitant increase in the student time‐burden. The improved accuracy and speed on first patient encounters found in this study validates the use of this patient simulator as a useful bridge for students early in training to successfully transfer theoretical knowledge prior to entering the consulting room. The translational benefits resulting from compulsory learning activities on a patient simulator can lead to reduced demands on infrastructure and clinical supervision.

Key words:

• ophthalmic clinical skills
• patient simulator
• primary care
• simulation‐based education
• translational research

ACKNOWLEDGEMENTS

We wish to acknowledge the years of meticulous and visionary software programming undertaken by Dr Jack Alexander (School of Optometry and Vision Science, the University of New South Wales, Sydney). ‘Virtual Refractor’ is now the property of the Brien Holden Vision Institute. Access to the refractor simulator was provided to the School of Optometry and Vision Science at the University of New South Wales for this project by the Vision Link program (a joint initiative of Essilor and the Brien Holden Vision Institute). Help with pedagogical aspects of the manuscript was provided by Dr Helen Dalton of Dalton and Associates, Educational Consultants.

Additional information

Funding

University of New South Wales

Brien Holden Vision Institute