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Can J Ophthalmol. 2019 Apr;54(2):159-163. doi: 10.1016/j.jcjo.2018.05.016. Epub 2018 Aug 26.

Evaluating the efficacy of an educational ergonomics module for improving slit lamp positioning in ophthalmology residents.

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Department of Ophthalmology, Queen's University, Kingston, Ont.. Electronic address:
School of Kinesiology and Health Studies, Queen's University, Kingston, Ont.
Department of Ophthalmology, Weill Cornell Medical College, New York, N.Y.
Department of Ophthalmology, Queen's University, Kingston, Ont.



To characterize changes in body positioning while performing a standardized slit lamp examination after exposure to an educational module on ergonomics.


Prospective interventional pilot study.


Ten ophthalmology residents.


An educational module discussing ergonomic issues in ophthalmology was created. In a standardized examination lane, participants were recorded performing 3 trials of an indirect slit lamp examination of a volunteer patient, adjusting equipment as they saw fit. Participants were then sent the module and within 2 weeks repeated the trial process. Data were processed using biomechanical software to obtain the Rapid Upper Limb Assessment (RULA) injury risk score, elbow and shoulder joint reaction moments, neck and trunk flexion angles, and spinal curvature magnitudes.


The RULA injury risk scores decreased after completion of the module (95% CI 2.10-2.77), indicating a lesser risk for injury to the resident. Shoulder flexion and elbow abduction moments also decreased (95% CI -3.2 to -1.5 and -0.44 to -0.04, respectively), suggesting a more neutral body posture. The trunk flexion angle increased after completion of the module (95% CI -5.1 to -1.6), signifying a more upright trunk posture; this was confirmed by the lumbar spine curvature, which flattened postmodule (95% CI 6.6-940).


These results suggest a promising ability for an educational module to mitigate some injury risk in this population during indirect slit lamp examination. It also delineated some awkward postures that persisted despite the module. These results will be reintegrated into the module to optimize its educational utility.

[Indexed for MEDLINE]

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