New and improved methods of teaching retinoscopy to optometry students may be necessary to improve their learning, understanding, and efficiency, according to a study published in Ophthalmic and Physiological Optics.

Researchers conducted an analysis of 36 participants and stratified them according to skill level: novices (first year optometry students, 6 hours of practice), students (third year optometry students, 2 years of experience), and experts (clinicians with 50 hours of active training or practice). They administered a computer simulated exercise in which participants had 10 minutes to perform a retinoscopy and determine refractive error. The team recorded the time it took to complete the exercise, the number of steps that were needed, and the accuracy of the final refraction. They required participants to narrate their rationale as they performed the task to acquire a better understanding of potential barriers to learning and understanding. Participants discussed their performance at the conclusion of the exercise.

Researchers noted differences in time, number of steps, and accuracy among the cohort. The number of steps it took participants to reach final refraction was associated with experience, with experts taking the fewest steps, followed by students and novices (5.6±1.8, 8.8±3.4, and 35.2±8.5, respectively, P <.001). Accuracy also improved according to skill level with accuracy rates of 87±1.3%, 69±1.0%, and 25±0.8% for the expert, student, and novice groups, respectively (P <.001). The investigators observed a tradeoff between accuracy and speed between the student and expert groups. Student practitioners obtained more rapid solutions than experts (3.09±1.3 vs 4.48±0.9 mins), but with less accuracy. 


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Researchers argue that it may be better to educate optometry students on retinoscopy theory prior to having them practice the procedure. “Rather than giving students extended periods of practice, we feel that developing a meta-cognitive awareness of the procedure from an early point would be highly beneficial,” according to the report. 

Study limitations include a small sample size, recruitment of students from a single optometry school, and the use of a simulation instead of a patient.

Reference

Hollis J, Allen PM, Heywood J. Learning retinoscopy: a journey through problem space. Ophthalmic Physiol Opt. Published online May 22, 2022. doi:10.1111/opo.13007