A new model for teaching corneal foreign body removal.
OBJECTIVE
To determine whether a skills laboratory for corneal foreign body and rust ring removal improves self-assessed skill and confidence.


METHODS
A prospective trial was conducted as part of the didactic curriculum of a university-based residency program in emergency medicine (EM). A convenience sample of 26 EM residents and five fourth-year medical students participated. The skills laboratory used model corneas made by coating 3.2-cm glass spheres with a 1-2-mm film of paraffin. Foreign bodies were simulated by embedding small pieces of metal into the paraffin. Rust rings were simulated by dipping a hot, straightened paper clip into a rust-colored crayon and then into the paraffin. The model eyes fit into a life-sized model of a human head. Participants removed the foreign bodies and rus rings under supervision, using the slit lamp. Each participant anonymously completed a questionnaire before and after participating in the skills laboratory. The questionnaire recorded educational level, previous experience, and self-assessed comfort and skill levels (0 = lowest, 10 = highest).


RESULTS
Most (66%) of the participants had not previously removed a corneal foreign body; 86% had not previously removed a rust ring. On a ten-point scale, the median comfort level for removing a foreign body rose from 2 to 7, and the self-assessed skill level rose from 1 to 7 (p = 0.0001). Similar improvements in self-assessed comfort and skill levels were seen for rust ring removal.


CONCLUSIONS
Participation in this skills laboratory significantly improved the self-reported comfort and self-assessed skill levels in removing corneal foreign bodies and rust rings. This technique provides useful practice of a fine-motor procedural skill requiring eye-hand coordination prior to supervised application of these skills in clinical practice.
Austin
P E
PE
Durham Emergency Physicians, NC, USA.
Ljung
M
M
Dunn
K A
KA
D000328:Adult; D002983:Clinical Competence; D003315:Cornea; D004635:Emergency Medicine / Q000193:education*; D005547:Foreign Bodies; D006801:Humans; D007396:Internship and Residency; D011446:Prospective Studies; D013663:Teaching