Quantitative and qualitative evaluation of a web-based, interactive approach for teaching the management of angle-closure glaucoma.

ABSTRACT

PURPOSE: To construct a validated Internet-based teaching system that improves diagnostic and therapeutic skills related to glaucoma diagnosis. DESIGN: Nonrandomized clinical trial. PARTICIPANTS AND/OR CONTROLS Thirty-four glaucoma specialists and 21 ophthalmologists-in-training. METHODS: An interactive program was designed to improve the recognition of gonioscopic findings and to manage angle-closure glaucoma (ACG) patients, including technical information in performing gonioscopy, ability to recognize angle structures, and treatment choices. The behavior of participants permitted the assessment of degree of improvement related to the interaction. The program content was validated by 5 academic glaucoma subspecialists. Then, 34 fellowship-trained glaucoma specialists and 21 ophthalmology residents accessed the program. Results were evaluated using paired and nonpaired t tests and analysis of variance. MAIN OUTCOME MEASURES: Comparison of pretest and posttest scores of residents and glaucoma specialists on measures of gonioscopy recognition and questions related to ACG management. RESULTS: Residents improved their recognition of gonioscopic findings after viewing the program (P<0.0001), scoring significantly worse than glaucoma specialists before interacting with the program (P<0.0001), but scoring at equivalent levels to specialists after viewing the program (P=0.34). The time necessary to improve knowledge by interacting with the program was significantly related to year of residency training (P<0.0001, analysis of variance). The rate of correct answers to management questions related to ACG increased with increasing years of experience in ophthalmology, validating the education methodology (P<0.0001). CONCLUSIONS: A web-based teaching approach for diagnosis and management of ACG evaluated the knowledge of ophthalmologists in a manner consistent with their expected expertize. Statistically significant improvements in validated knowledge of ACG were demonstrated for this educational method.