Tele-education programs for ophthalmology are becoming more popular and needed. There is an even greater need for it to help patients manage retinopathy of prematurity (ROP). Barriers to providing ROP care include medicolegal liability, reimbursement, and complex coordination of care. Improving ROP education is important because ophthalmologists may be the only providers screening for ROP.
Currently, there is no standard for ROP training at the residency or fellowship level in the US. Tele-education platforms provide an opportunity for standardization of assessment.
An international survey of ophthalmologists reported that only 1% to 33% of ROP screenings were performed under direct attending supervision. A web-based study that assessed classification of ROP based on widefield retinal images found that ROP was correctly diagnosed by international ophthalmology residents in less than half of cases, and treatment-requiring ROP and type 2 ROP were commonly underdiagnosed. There was no difference between trainees in higher and lower income countries.
Tele-education programs could improve access to ROP education and ensure adequate training. Some are currently available in the US, Mexico, Mongolia, Brazil, the Philippines, and several other countries. They’ve also been shown to improve ophthalmology trainees’ competency in diagnosing zone, stage, and presence or absence of plus disease.
In Mexico, trainees who completed a tele-education program had 94% specificity for diagnosing AP-ROP, 92% specificity for diagnosing type 2 or worse ROP, and 89% specificity for treatment-requiring ROP. In the US, they demonstrated improvement in sensitivity noted for AP-ROP and diagnosing plus disease.
Current tele-education offerings exist within telemedicine systems, including iTelegen and FocusROP/Phoenix CONNECT. Future goals include developing platforms capable of being tailored to specific users and types of learners.
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