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J Glaucoma. 2012 Dec;21(9):601-7. doi: 10.1097/IJG.0b013e31821db3c7.

Development of a resident training module for systematic optic disc evaluation in glaucoma.

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Jules Stein Eye Institute, University of California, Los Angeles, CA, USA.



To determine the impact on ophthalmology residents of a training module to teach systematic optic disc (disc) evaluation.


A training module for disc evaluation was developed consisting of: (1) a computer-based evaluation course with 100 illustrative disc photographs featuring normal and glaucomatous discs; (2) 2 different disc photograph test sets to be completed before and after taking the course; and (3) a 1-page checklist emphasizing 8 areas of disc evaluation to guide the residents through the test sets. Each area required identification of 2 to 3 key features pertinent to glaucoma. Points were assigned to each correctly answered item on the checklist by ophthalmology residents of 2 training programs. Residents were also asked to evaluate the disc according to a glaucoma scale. Main outcome measures included precourse and postcourse checklist scores and disc glaucoma evaluation scores.


Twenty-eight residents from 2 training programs completed the training module. Mean checklist scores improved significantly after taking the evaluation course across all residents and in residents who had 2 years of ophthalmology residency experience (P = 0.019, 0.017, respectively). Precourse disc glaucoma evaluation score increased 4% to 6% per year of ophthalmology residency training (P = 0.023, R = 0.1838). One program had a higher mean postcourse disc glaucoma evaluation score than another (P = 0.038).


A systematic disc evaluation module for resident training may improve disc evaluation, provide an objective method to assess the resident's learning experience, monitor the progress and identify areas of weakness of training, and compare results among groups of residents across different residency programs.

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