Top

Graefe's Archive for Clinical and Experimental Ophthalmology

Published in:

05-04-2023 | Telemedicine | Review Article

Virtual supervision in ophthalmology: a scoping review

Authors: Chaerim Kang, Christopher J. Shin, Ingrid U. Scott, Paul B. Greenberg

Published in: Graefe's Archive for Clinical and Experimental Ophthalmology | Issue 10/2023

Abstract

Purpose

The published information on virtual supervision (VS) in ophthalmology is not well described. This scoping review describes the evidence and potential role for VS in ophthalmic practice and education.

Methods

A literature search strategy was developed in accordance with Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR). We included full-text articles published in an English-language peer-reviewed journal that involved physician-physician or physician-trainee VS in ophthalmology. We excluded studies with direct (in-person) supervision. Two investigators independently extracted from each article the year of publication and study location, design, participant characteristics, sample size, and outcomes. We appraised the methodological quality of the studies using the Mixed Methods Appraisal Tool (MMAT).

Results

Seven articles were included in our qualitative synthesis. Supervisees ranged from physicians such as an ophthalmic surgeon and a general practitioner to medical trainees such as ophthalmology residents, vitreoretinal fellows, and emergency medicine residents. Study settings included emergency departments, operating rooms, eye clinics, and a rural hospital. All studies reported successful transmission of real-time images or videos of clinical examinations and surgical or in-office procedures. Various methods were used to ensure high image and video quality during VS, although some technical challenges remained. MMAT ratings revealed limitations in outcome measurement, statistical analysis, sampling strategy, and inclusion of confounding factors.

Conclusion

Virtual supervision in ophthalmology is technologically feasible and permits synchronous communication and transmission of clinical data, which can be used to formulate diagnostic and management plans and learn new surgical skills. Future studies with larger sample sizes and robust study designs should investigate factors that make VS effective in ophthalmic practice and education.

Cantor JH, McBain RK, Pera MF, Bravata DM, Whaley CM (2021) Who is (and is not) receiving telemedicine care during the COVID-19 pandemic. Am J Prev Med 61(3):434–438. https://doi.org/10.1016/j.amepre.2021.01.030CrossRefPubMedPubMedCentral

Watters Y, Northey WF Jr (2020) Online telesupervision: competence forged in a pandemic. J Fam Psychother. https://doi.org/10.1080/08975353.2020.1818500CrossRef

Wearne SM, Teunissen PW, Dornan T, Skinner T (2015) Physical isolation with virtual support: registrars’ learning via remote supervision. Med Teach 37(7):670–676. https://doi.org/10.3109/0142159X.2014.947941CrossRefPubMed

Martin P, Kumar S, Lizarondo L (2017) Effective use of technology in clinical supervision. Internet Interventions-the Application of Information Technology in Mental and Behavioural Health 8:35–39. https://doi.org/10.1016/j.invent.2017.03.001CrossRef

TriccoAC LE, Zarin W, O’Brien KK, Colquhoun H, Levac D, Moher D, Peters MDJ, Horsley T, Weeks L, Hempel S, Akl EA, Chang C, McGowan J, Stewart L, Hartling L, Aldcroft A, Wilson MG, Garritty C, Lewin S, Godfrey CM, Macdonald MT, Langlois EV, Soares-Weiser K, Moriarty J, Clifford T, Tuncalp O, Straus SE (2018) PRISMA extension for scoping reviews (PRISMA-ScR): checklist and explanation. Ann Intern Med 169(7):467–473. https://doi.org/10.7326/M18-0850CrossRef

HongQ, Pluye P, Fàbregues S, Bartlett G, Boardman F, Cargo M, Dagenais P, Gagnon M-P, Griffiths F, Nicolau B, O’Cathain A, Rousseau M-C,Vedel I (2018) Mixed methods appraisal tool (MMAT) Canadian Intellectual Property Office

Shah YS, Fliotsos MJ, Alaqeel A, Boland MV, Zafar S, Srikumaran D, Woreta FA (2022) Use of teleophthalmology for evaluation of ophthalmic emergencies by ophthalmology residents in the emergency department. Telemed J E Health 28(6):858–864. https://doi.org/10.1089/tmj.2021.0334CrossRefPubMed

Hall G, Hennessy M, Barton J, Coroneo M (2005) Teleophthalmology-assisted corneal foreign body removal in a rural hospital. Telemed J E Health 11(1):79–83. https://doi.org/10.1089/tmj.2005.11.79CrossRefPubMed

Camara JG, Rodriguez RE (1998) Real-time telementoring in ophthalmology. Telemed J 4(4):375–377. https://doi.org/10.1089/tmj.1.1998.4.375CrossRefPubMed

10.

Wilson MM, Moore PP, Hinchcliffe P (2020) Case study: tele-ophthalmic supervision of emergency orbital decompression in an adult trauma. Emerg Med Australas 32(2):357–358. https://doi.org/10.1111/1742-6723.13461CrossRefPubMed

11.

Bar-Sela SM, Glovinsky Y (2007) A feasibility study of an Internet-based telemedicine system for consultation in an ophthalmic emergency room. J Telemed Telecare 13(3):119–124. https://doi.org/10.1258/135763307780677640CrossRefPubMed

12.

Moussa G, Kalogeropoulos D, Wai Ch’ng S, Lett KS, Mitra A, Tyagi AK, Sharma A, Andreatta W (2022) The effect of supervision and out-of-hours surgery on the outcomes of primary macula-on retinal detachments operated by vitreoretinal fellows: a review of 435 surgeries. Ophthalmologica 245(3):239–248. https://doi.org/10.1159/000517879CrossRefPubMed

13.

Hagman J, Hyytinen P, Tuulonen A (2004) A pilot experiment using a network camera in ophthalmic teleconsultation. Acta Ophthalmol Scand 82(3 Pt 1):311–312. https://doi.org/10.1111/j.1395-3907.2004.00266.xCrossRefPubMed

14.

Zackoff MW, Real FJ, Abramson EL, Li ST, Klein MD, Gusic ME (2019) Enhancing educational scholarship through conceptual frameworks: a challenge and roadmap for medical educators. Acad Pediatr 19(2):135–141. https://doi.org/10.1016/j.acap.2018.08.003CrossRefPubMed

15.

Boysen PG 2nd, Daste L, Northern T (2016) Multigenerational challenges and the future of graduate medical education. Ochsner J 16(1):101–7PubMedPubMedCentral

16.

(ACGME) ACfGME (2022) Specialty-specific program requirements direct supervision using telecommunication technology

Title: Virtual supervision in ophthalmology: a scoping review
Authors: Chaerim Kang
Christopher J. Shin
Ingrid U. Scott
Paul B. Greenberg
Publication date: 05-04-2023
Publisher: Springer Berlin Heidelberg
Keyword: Telemedicine
Published in: Graefe's Archive for Clinical and Experimental Ophthalmology / Issue 10/2023
Print ISSN: 0721-832X
Electronic ISSN: 1435-702X
DOI: https://doi.org/10.1007/s00417-023-06048-7

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Virtual supervision in ophthalmology: a scoping review

Abstract

Purpose

Methods

Results

Conclusion

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Purpose

Methods

Results

Conclusion

Please log in to get access to this content

Other articles of this Issue 10/2023

Congenital ptosis repair in children: comparison of frontalis muscle suspension surgery and levator muscle surgery

Effects of femtosecond laser-assisted minimally invasive lamellar keratoplasty (FL-MILK) on mild-to-moderate and advanced keratoconus

Topical antibiotic prophylaxis before intravitreal injections: a pilot study

Hyperreflective foci distribution in eyes with dry age-related macular degeneration with subretinal drusenoid deposits

Correction to: Persistence of vascular empty sleeves in choroidal neovascularization after anti-VEGF therapy in both animal models and humans

Outcomes of microPulse transscleral laser therapy in eyes with prior glaucoma aqueous tube shunt