Long gone are the days of simply sitting in a classroom, listening to a lecturer, and taking notes by hand.
Technological advancements, the pandemic, and the demand for more integrated and on-the-go learning compelled educational institutions to adopt innovative approaches to teaching. These range from hybrid learning models and virtual reality (VR) simulators to the use of artificial intelligence (AI).1,2
To keep pace with this changing learning landscape, optometry schools have found ways to diversify and enhance the educational experience. An increased emphasis has been placed on self-learning and independent research, while also addressing unique challenges with hands-on clinical training, accurately assessing skills, fostering collaboration, and promoting empathy.1,3
The catalyst for change: COVID-19
In early 2020, with COVID-19 on the rise and student and faculty safety at risk, it became evident that an alternative to traditional in-person classes had to be found. Beginning in March of that year, the Board of Directors of the Association of Schools and Colleges of Optometry (ASCO) began meeting to discuss solutions and forge a new path toward degree completion.
The result was a pivot to online education with revamped lecturing and testing protocols. In addition, many schools began utilizing digital platforms for virtual patient encounters, clinical simulations, and interactive, adaptive learning.4
Recognizing the advantages of this, in 2021, the New England College of Optometry (NECO) launched Agile Campus, a hybrid learning model combining in-person clinical training with online learning to expand and diversify their student population and provide more agility to their current participants.5 Now, optometry schools across the nation have embraced similar frameworks.
Tailoring education to more tech-savvy students
The majority of today’s optometry students have grown up with personal computers, gaming systems, and smartphones. They have been immersed in computer-assisted instruction throughout their education and, with the accessibility of the internet, have enjoyed information on demand from the privacy of their home or dorm.
Furthermore, after the pandemic eliminated in-person encounters and forced students to completely depend on technology, there has been a growing concern that this lack of face-to-face interaction would negatively impact interpersonal skills.1,6
Optometry students must possess both a wealth of clinical and diagnostic knowledge as well as “people skills,” such as effective verbal and nonverbal communication, empathy, adaptability, and critical thinking. These are often dependent upon having the ability to reflect and redirect. Reflection is essentially the act of analyzing each patient encounter not only from a results standpoint, but also from a behavioral and emotional standpoint.
Reflection involves being consistently cognizant of your emotions, actions, reactions, and the integral role each of these elements plays in exam outcomes. Despite concerns, it seems that utilizing e-learning, virtual patient experiences, online group discussions, and AI does not negatively impact the reflective abilities of optometry students.6
The top 4 trends in optometric learning
1. Blended/hybrid learning
Hybrid learning, also called blended learning, employs a combination of face-to-face classes with online lectures and workshops.7 Whereas in-person classes promote opportunities for networking, brainstorming, and collaborating with peers and faculty, online courses allow for more flexibility, as students can watch and review course content in their own time, at their own pace.
Online endeavors are also thought to increase independence, adaptive learning, and time management skills.2,7,8 By providing portions of each, hybrid learning offers the best of both worlds. Therefore, it is not surprising that early studies indicate that hybrid learning seems to be the preferred modality for both students and faculty alike.2,9
2. Videos, podcasts, and social media
Traditionally thought of as strictly entertainment, videos, podcasts, and social media have emerged as invaluable learning tools. Let us briefly explore each in regard to their role in optometric education.
Videos
Videos can either be generated by optometry schools themselves, be a resource shared on industry websites, or be posted by eyecare professionals on social platforms, with the most popular being YouTube.
With creators coming from a vast variety of clinical specialties, geographic locations, and college backgrounds, students can find information on a plethora of topics presented in formats from fun to facts only.
Videos can be an especially useful learning tool as they give verbal instruction accompanied by illustrations/animations or demonstrations of techniques/skills, which is key for today’s visual learners. In addition, videos are generally free and widely accessible.1
A 2020 study reviewed 31 articles that focused on YouTube as a source of medical education to assess its effectiveness. It found that the reliability varied widely, as it is not required to be peer-reviewed prior to posting.10 However, it concluded that YouTube could be a useful platform for learning as long as the source of the video is researched and deemed to be qualified and trustworthy.
Podcasts
Similar to videos, podcasts allow students to listen to top key opinion leaders (KOLs) share their clinical expertise, career advice, and views on the current state of optometry. They can be accessed at any time, granting students the capability to simultaneously perform other tasks, such as exercising, housework, or commuting, while listening.1
To see a list of top optometry podcasts, follow this link to the article Top Optometry Podcasts for Every Eyecare Practitioner.
Social media
As far back as 2012, optometry schools realized the capabilities of social media as an important tool for teaching, learning, collaboration, and discussion. Campuses began by establishing Facebook groups to connect students, share announcements, and establish a public-facing presence.11
Of the Gen Z population, which makes up the majority of optometry students, 90% report being active on social media, with YouTube being the preferred platform, followed by Snapchat, Instagram, TikTok, and Facebook.12
Social media can be used for both formal and informal education by providing platforms to read content, exchange information, share materials, participate in study groups, and engage in online forums to discuss clinical cases.13
3. Virtual reality
Last, but certainly not least in its role in altering and advancing how optometry students learn, is virtual reality. Combining educational training with the 3D world, virtual reality presents an interactive environment to practice patient interactions and clinical skills through the use of reality-based encounters, simulators, standardized patients, anatomical models, etc.
Unlike face-to-face exams, virtual reality sessions offer the advantage of being repeatable with on-the-spot feedback from either an instructor or the technology. Through these encounters, students can hone not only clinical skills but also decision-making, critical thinking, and comprehensive learning.1,4
Clinical skill simulators in optometry school
Perhaps the most advantageous tool in the realm of virtual reality is clinical skills simulators, which can teach a range of skills from retinoscopy to fundus evaluations. A typical optometry simulator comprises an anatomical model, touch-screen monitor, teaching software, and necessary tools for the task; in some instances, a headset with a built-in display monitor is present.
The sophisticated software usually contains a range of modules, prompting students to master different skills and diagnoses.7 For example, using a case study and model patients, ophthalmoscopy simulators impart students the opportunity to practice how to properly use an ophthalmoscope to explore retinal map findings, identify common pathologies, and locate various shapes on the retina.14
With a virtual refractor, students can interactively develop their refraction skills by examining virtual patients of different ethnicities and ages.15 Slit lamp simulators allow students to examine virtual patients with fundoscopy and gonioscopy lenses as well as a biomicroscope.
The availability of this technology has given rise to virtual simulation laboratories at optometry schools equipped with sophisticated simulators often powered by AI. Labs are often equipped to facilitate group learning through simulators adding a discussion component to the experience.
Some of the simulators that are currently available allow students to practice:
- Indirect ophthalmoscopy
- Direct ophthalmoscopy
- Refraction
- Slit lamp
- Visual acuity
As early as 2017, educators were lauding the capabilities of simulators to enhance students’ clinical skills; a paper evaluated the use of the 3D Eyesi Binocular Indirect Ophthalmoscope simulator (VRmagic, Germany), which teaches binocular indirect ophthalmoscopy. Researchers found that the use of the simulator improved the students' clinical examination and reasoning skills at an accelerated rate, allowing students to gain clinical competency earlier in their academic career.
Also, as the simulator progressively presented more complex cases, they continued to advance and become increasingly proficient. The use of simulators also reduced the workload for instructors.16
4. Artificial intelligence
Artificial intelligence is loosely defined as the technology that simulates human intelligence in the areas of decision-making, problem-solving, language translation, and speech recognition by combining data, computing power, and algorithms.17 In a 2022 survey, 80.3% of respondents from the American Academy of Optometry (AAO) agreed that AI should be incorporated into the optometry school or residency curriculum.18
There are a multitude of ways that AI can be employed in optometric education, from administrative tasks—such as guiding students through registration, scheduling, and financial aid—to one-on-one tutoring and providing personalized learning.2,19
Below is a list of the ways AI can be utilized in optometry school:19
- Adaptive Learning: With this form of personalized learning, AI determines the student's knowledge level and learning needs and supplies appropriate content at the appropriate speed on the desired topic.
- Chatbots: These systems are programmed to answer queries, summarize information (i.e., research, studies, articles, literature), and retrieve data.
- Gamification: This uses online games to teach clinical decision-making and diagnostics and provides immediate feedback.
- Tutoring: Using a baseline of knowledge that is updated with each session and catering to the student’s preferred learning style, these systems duplicate one-on-one tutoring.
- Virtual Patients: By simulating patient encounters with realistic history, symptoms, and responses, students can practice interpersonal and diagnostic skills in a risk-free environment.
- Assessment: In medical education, AI can assess theoretical knowledge, effectiveness of simulation skills, prescription writing accuracy, and interpretation of laboratory results.
The capabilities surrounding the use of AI can be confusing and overwhelming, therefore it is highly recommended that optometry schools have training on appropriate usage and a strict code of conduct with well-defined consequences.1,20
Conclusion
Advancement always demands adaptability. For today’s optometry students navigating the new educational environment, the experience can be both exciting and demanding. An open-minded and flexible approach to learning will garner the best results.
By utilizing all the revolutionary resources available, optometry students can individualize their academic paths to gain the greatest amount of knowledge in the most efficient manner. They should feel empowered to approach administrators to request access to these latest learning trends.
However, these new technologies require that students understand the best practices for AI, protect their online image and reputation, and balance virtual reality with actual reality. Perhaps most importantly, it is imperative they remember the end goal of providing optimal care and counsel to future patients in the real world.
