PUBLICATION EXCLUSIVE: Top five principles for successful learning in both residency as well as practice

At one time we were all first-year ophthalmology residents, suddenly immersed into a strange and novel world. The field has an extremely steep learning curve. New residents are tasked with the challenge of simultaneously learning ophthalmic knowledge, exam skills and surgical techniques. Medical schools devote little time to these topics, and I know of no existing resources that are designed specifically to help ophthalmology residents at the beginning of their careers.

Ophthalmology is an innovative and fast-moving field, with new advances constantly evolving and occasionally revolutionizing the way we treat patients. It is just as important for an established ophthalmologist to keep up with these changes so that he can provide the best care for his patients. While many printed resources exist for continuing medical education, I increasingly see our residents using online and mobile resources. These are more interactive, can include videos and animation, and provide a convenient format that can be accessed virtually anywhere.

I was recently introduced to a new online resource, EyeGuru.org, built by two residents and a medical student from UCLA. EyeGuru is a free website that is targeted toward beginning ophthalmology residents, but the team plans to expand its breadth to help ophthalmology trainees of all years. I have personally used the website to keep up to date, particularly with fields outside of my subspecialty.

I believe that there are three types of core proficiencies that are critical for development as a physician and surgeon: basic/clinical knowledge, surgical skills and clinical decision-making skills.

Basic knowledge is the foundation of every profession. For example, residents should understand how cataracts develop and progress and know the theoretical differences between different types of IOLs. Developing surgical skill involves understanding the protocol for different surgeries, as well as developing the kinesthetic skills necessary to execute them — for example, understanding the steps involved in a cataract surgery and being able to perform the surgery itself. Finally, a provider must integrate his or her understanding of basic/clinical knowledge with sound surgical judgment in order to make good clinical decisions. To finish with the above example, being able to decide when in clinical progression a lens replacement is needed, being able to choose a lens based on a patient’s individual visual needs, and understanding how to modify a surgical procedure to suit the eye.

To best learn and retain the knowledge, there are five key principles of education:

Principle 1: Active recall — recall without contextual cues

Active recall strategies that encourage free-recall retrieval (without contextual cues) of previously learned facts improve memory retention far better than simply rereading a passage of text. An example of this is when an attending asks a resident how to distinguish the three major classifications of cataracts from one another. This is much more effective than having the resident read an article about cataracts. Studies have shown that active recall compared with passive reading improves memory retention, even when the recall attempt is unsuccessful.

• Click here to read the full publication exclusive, Back to Basics, published in Ocular Surgery News U.S. Edition, October 25, 2016.