Citation

Sim PY, La CJ, Than J, Ho J. Eye 2019; ePub(ePub): ePub.

Affiliation

Western Eye Hospital, Imperial College Healthcare NHS Trust, London, UK.

Copyright

(Copyright © 2019, Nature Publishing Group)

DOI

10.1038/s41433-019-0645-2

PMID

31649348

Abstract

BACKGROUND: Ophthalmic emergencies comprise a significant portion of junior doctors' workload in accident and emergency (A&E). However, previous studies have demonstrated a lack of training and confidence in the management of such emergencies. This study assessed changes in basic ophthalmic training that A&E junior doctors received in dealing with eye emergencies, their perceived level of confidence and the availability of appropriate ophthalmic equipment in A&E over the last 15 years.

METHODS: A prospective, national, combined online and telephone survey using a previously published questionnaire was performed. Foundation year two doctors (FY2s) from each A&E department in the UK listed on the official NHS directory were contacted for participation.

RESULTS: Two hundred and ten A&E departments were contacted and 202 responded (response rate of 96.2%). There was no significant change in the number of A&E departments equipped with slit lamps (82.5% in 2003 vs 79.7% in 2018; p = 0.26). However, the prevalence of training in its use has decreased significantly (68.4% in 2003 vs 52% in 2018; p = 0.005). There was also a significant reduction in the prevalence of training in the management of eye emergencies (77.4% in 2003 vs 45.5% in 2018; p < 0.001) and the proportion of FY2s who felt confident in dealing with such cases (36.1% in 2003 vs 6% in 2018; p < 0.001).

CONCLUSION: There is a concerning decline in basic ophthalmic training for A&E FY2s, reflected by the alarmingly low level of confidence in the management of eye emergencies. This highlights an urgent need to improve ophthalmic training for junior doctors in A&E.

Language: en