{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,3]],"date-time":"2026-09-03T10:37:12Z","timestamp":1788431832660,"version":"build-2803163510"},"reference-count":14,"publisher":"Georg Thieme Verlag KG","issue":"03","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Klin Monbl Augenheilkd"],"published-print":{"date-parts":[[2026,3]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>Purpose Direct ophthalmoscopy (DO) teaching in medical curricula may be performed as classical or simulator-based DO. This interventional study evaluated both options.<\/jats:p>\n                  <jats:p>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 classical DO training (Heine BETA200, Heine Optotechnik GmbH, Germany). Training was performed in groups of eight students. Thereafter, they underwent an objective standardised 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\u200a\u2013\u200a6) upper\/lower vessel arcade nasally versus temporally were identified correctly. Subsequently, classic DO was performed mutually and they reported the recognised funduscopic structures. Finally, the questionnaire was repeated one week later in combination with an evaluation of simulator-based versus classic DO.<\/jats:p>\n                  <jats:p>Results Students improved from an average of 4.0\u2009\u00b1\u20091.5\/10 before to 8.8\u2009\u00b1\u20091.5\/10 correctly answered questions after training (p\u2009&lt;\u20090.0001, 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\u2009&lt;\u20090.0001, Fisher\u02bcs exact test), the macula (93|22, p\u2009&lt;\u20090.0001), the upper (98|75, p\u2009=\u20090.0002) and lower temporal vessel arcade (101|91, p\u2009=\u20090.0672), the upper (84|56, p\u2009=\u20090.0001) and lower nasal vessel arcade (87|48, p\u2009&lt;\u20090.0001). They wished for more simulator-based training, indicated more interest in ophthalmology after training and indicated an improvement in their ophthalmoscopy skills.<\/jats:p>\n                  <jats:p>Conclusion A standardised simulator-based approach improves medical students\u02bc skills in ophthalmoscopy and arouses professional interest in ophthalmology.<\/jats:p>","DOI":"10.1055\/a-2751-3142","type":"journal-article","created":{"date-parts":[[2026,1,27]],"date-time":"2026-01-27T00:08:21Z","timestamp":1769472501000},"page":"193-198","source":"Crossref","is-referenced-by-count":2,"title":["Direct Ophthalmoscopy Teaching of Medical Students Based on a Standardised Simulator-based Procedure Versus the Classic Ophthalmoscope"],"prefix":"10.1055","volume":"243","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0423-3624","authenticated-orcid":false,"given":"Elias","family":"Flockerzi","sequence":"additional","affiliation":[{"name":"Department of Ophthalmology, Saarland University Faculty of Medicine, Homburg, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Svenja","family":"Deuchler","sequence":"additional","affiliation":[{"name":"Department of Ophthalmology, Saarland University Faculty of Medicine, Homburg, Germany"},{"name":"Augenzentrum Frankfurt, Frankfurt am Main, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alaadin","family":"Abdin","sequence":"additional","affiliation":[{"name":"Department of Ophthalmology, Saarland University Faculty of Medicine, Homburg, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Veronika","family":"Flockerzi","sequence":"additional","affiliation":[{"name":"Department of Otorhinolaryngology, Saarland University Faculty of Medicine, Homburg, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fidelis","family":"Flockerzi","sequence":"additional","affiliation":[{"name":"Department of Pathology, Saarland University Faculty of Medicine, Homburg, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Frank","family":"Koch","sequence":"additional","affiliation":[{"name":"Department of Ophthalmology, Saarland University Faculty of Medicine, Homburg, Germany"},{"name":"Augenzentrum Frankfurt, Frankfurt am Main, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9701-8204","authenticated-orcid":false,"given":"Berthold","family":"Seitz","sequence":"additional","affiliation":[{"name":"Department of Ophthalmology, Saarland University Faculty of Medicine, Homburg, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"194","published-online":{"date-parts":[[2026,1,26]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","first-page":"1056","DOI":"10.1016\/j.ajo.2013.06.022","article-title":"Teaching Ophthalmoscopy to Medical Students (the TOTeMS Study)","volume":"156","author":"L P Kelly","year":"2013","journal-title":"Am J Ophthalmol"},{"key":"ref2","doi-asserted-by":"publisher","first-page":"169","DOI":"10.1139\/I06-004","article-title":"Medical students\u02bc self-confidence in performing direct ophthalmoscopy in clinical training","volume":"41","author":"R R Gupta","year":"2006","journal-title":"Can J Ophthalmol"},{"key":"ref3","doi-asserted-by":"publisher","first-page":"150","DOI":"10.1212\/CPJ.0000000000000115","article-title":"The demise of direct ophthalmoscopy: A modern clinical challenge","volume":"5","author":"D D Mackay","year":"2015","journal-title":"Neurol Clin Pract"},{"issue":"S 5","key":"ref4","doi-asserted-by":"publisher","first-page":"S1","DOI":"10.1055\/s-2006-951844","article-title":"Principles and Guidelines of a Curriculum for Ophthalmic Education of Medical Students","volume":"223","author":"International Task Force on Ophthalmic Education of Medical Students","year":"2006","journal-title":"Klin Monbl Augenheilkd"},{"key":"ref5","doi-asserted-by":"publisher","first-page":"1235","DOI":"10.1016\/j.ophtha.2009.01.012","article-title":"Ophthalmology in the Medical School Curriculum: Reestablishing our Value and Effecting Change","volume":"116","author":"L Mottow-Lippa","year":"2009","journal-title":"Ophthalmology"},{"key":"ref6","doi-asserted-by":"publisher","first-page":"391","DOI":"10.2147\/OPTH.S190922","article-title":"Comparison of smartphone ophthalmoscopy vs. conventional direct ophthalmoscopy as a teaching tool for medical students: the COSMOS study","volume":"13","author":"Y Kim","year":"2019","journal-title":"Clin Ophthalmol"},{"key":"ref7","doi-asserted-by":"publisher","first-page":"501","DOI":"10.1016\/j.ajo.2004.04.009","article-title":"A simple device for teaching direct ophthalmoscopy to primary care practitioners","volume":"138","author":"K D Chung","year":"2004","journal-title":"Am J Ophthalmol"},{"key":"ref8","doi-asserted-by":"publisher","first-page":"1328","DOI":"10.1136\/bjo.2006.096784","article-title":"A simple model for teaching indirect ophthalmoscopy","volume":"90","author":"S Lewallen","year":"2006","journal-title":"Br J Ophthalmol"},{"key":"ref9","doi-asserted-by":"publisher","first-page":"423","DOI":"10.1111\/tct.12641","article-title":"Training of direct ophthalmoscopy using models","volume":"14","author":"T G Martins","year":"2017","journal-title":"Clin Teach"},{"key":"ref10","doi-asserted-by":"publisher","first-page":"427","DOI":"10.1111\/tct.12646","article-title":"A 3D\u2009virtual reality ophthalmoscopy trainer","volume":"14","author":"A S Wilson","year":"2017","journal-title":"Clin Teach"},{"key":"ref11","doi-asserted-by":"publisher","first-page":"435","DOI":"10.2147\/AMEP.S108041","article-title":"Ophthalmoscopy simulation: advances in training and practice for medical students and young ophthalmologists","volume":"8","author":"L Ricci","year":"2017","journal-title":"Adv Med Educ Pract"},{"key":"ref12","first-page":"1","article-title":"Teaching For Learning (XVI.)","volume":"20","author":"M M Broadwell","year":"1969","journal-title":"The Gospel Guardian"},{"key":"ref13","doi-asserted-by":"publisher","first-page":"503","DOI":"10.1111\/j.1755-3768.2011.02221.x","article-title":"Objectives of teaching direct ophthalmoscopy to medical students","volume":"90","author":"J Benbassat","year":"2012","journal-title":"Acta Ophthalmol"},{"key":"ref14","doi-asserted-by":"publisher","first-page":"917","DOI":"10.1016\/j.ophtha.2015.10.032","article-title":"Eye-related Emergency Department Visits in the United States, 2010","volume":"123","author":"K Vaziri","year":"2016","journal-title":"Ophthalmology"}],"container-title":["Klinische Monatsbl\u00e4tter f\u00fcr Augenheilkunde"],"original-title":[],"language":"de","link":[{"URL":"http:\/\/www.thieme-connect.de\/products\/ejournals\/pdf\/10.1055\/a-2751-3142.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,3,18]],"date-time":"2026-03-18T23:32:20Z","timestamp":1773876740000},"score":1,"resource":{"primary":{"URL":"http:\/\/www.thieme-connect.de\/DOI\/DOI?10.1055\/a-2751-3142"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,1,26]]},"references-count":14,"journal-issue":{"issue":"03","published-online":{"date-parts":[[2026,3,18]]},"published-print":{"date-parts":[[2026,3]]}},"URL":"https:\/\/doi.org\/10.1055\/a-2751-3142","archive":["Portico","CLOCKSS"],"relation":{},"ISSN":["0023-2165","1439-3999"],"issn-type":[{"value":"0023-2165","type":"print"},{"value":"1439-3999","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,1,26]]}}}