{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,10]],"date-time":"2026-11-10T19:34:28Z","timestamp":1794339268458,"version":"4.9.0"},"reference-count":17,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2025,12,4]],"date-time":"2025-12-04T00:00:00Z","timestamp":1764806400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2026,1,7]],"date-time":"2026-01-07T00:00:00Z","timestamp":1767744000000},"content-version":"vor","delay-in-days":34,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"DOI":"10.13039\/100004440","name":"Wellcome","doi-asserted-by":"publisher","award":["219633\/Z\/19\/Z"],"award-info":[{"award-number":["219633\/Z\/19\/Z"]}],"id":[{"id":"10.13039\/100004440","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["BMC Med Educ"],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Malaria, particularly cerebral malaria, poses a significant health threat, especially for children in sub-Saharan Africa. Identification of malarial retinopathy (MR) has diagnostic value in cerebral malaria but can be impractical due to lack of availability of trained and equipped ophthalmic specialists. Recent developments in low-cost simulation tools and ophthalmoscopes offer the potential to train non-ophthalmologists to offer fundus assessments in low-resource settings.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Twenty non-ophthalmologist healthcare providers in Malawi attended a training program focused on identification of MR using direct and binocular indirect ophthalmoscopy. The curriculum included didactic sessions, hands-on practice with simulation eyes, and assessment of skill acquisition with immediate feedback. Pre- and post-training confidence surveys were conducted.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Participants demonstrated significant improvement in identification of malarial retinopathy in simulation eyes after completing the training, with a mean accuracy of 83%. Clinician confidence levels increased across all domains of retinal examination covered in the course.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Structured simulation-based training using frugal ophthalmoscopes can equip non-ophthalmologists with skills to identify MR in simulation eyes. Future work should focus on long-term skill retention and validation in a real-world clinical setting.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1186\/s12909-025-08213-4","type":"journal-article","created":{"date-parts":[[2025,12,4]],"date-time":"2025-12-04T09:14:23Z","timestamp":1764839663000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Structured simulation-based training with frugal ophthalmic instruments rapidly equips non-ophthalmologists to identify malarial retinopathy in simulation eyes: an audit of a training course"],"prefix":"10.1186","volume":"26","author":[{"given":"Kyle J.","family":"Wilson","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Obaid","family":"Kousha","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Harold","family":"Nkume","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alice M.","family":"Liomba","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nicholas A. V.","family":"Beare","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrew","family":"Blaikie","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2025,12,4]]},"reference":[{"key":"8213_CR1","unstructured":"WHO. World Malaria Report. (World Health Organisation. Licence: CC BY-NC-SA 3.0 IGO. 2023."},{"key":"8213_CR2","unstructured":"WHO. Guidelines for Malaria. (World Health Organisation. (WHO\/UCN\/GMP\/2023.01 Rev.1). License: CC BY-NC-SA 3.0 IGO. Geneva. 2023."},{"key":"8213_CR3","doi-asserted-by":"publisher","first-page":"143","DOI":"10.1038\/nm986","volume":"10","author":"TE Taylor","year":"2004","unstructured":"Taylor TE, et al. Differentiating the pathologies of cerebral malaria by postmortem parasite counts. Nat Med. 2004;10:143\u20135.","journal-title":"Nat Med"},{"key":"8213_CR4","doi-asserted-by":"crossref","unstructured":"Beare N et al. Prognostic significance and course of retinopathy in children with severe malaria. Arch Ophthalmol Chic Ill 1960\u00a0. 2004;122(8):1141\u20137.","DOI":"10.1001\/archopht.122.8.1141"},{"issue":"Suppl 1","key":"8213_CR5","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1258\/004947506776315781","volume":"36","author":"SP Harding","year":"2006","unstructured":"Harding SP, et al. Classifying and grading retinal signs in severe malaria. Trop Doct. 2006;36(Suppl 1):1\u201313.","journal-title":"Trop Doct"},{"key":"8213_CR6","doi-asserted-by":"publisher","first-page":"1066","DOI":"10.1038\/s41433-020-01335-7","volume":"35","author":"WH Dean","year":"2021","unstructured":"Dean WH, et al. Ophthalmology training in sub-Saharan Africa: a scoping review. 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COMREC Reference Number P.10\/24-1186.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval and consent to participate"}},{"value":"All individuals named in this manuscript have given their consent to publish.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}},{"value":"The authors declare no competing interests.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"35"}}