A novel simulation model for teaching the removal of an embedded corneal foreign body: A pilot study

It is estimated that of the 3.9 million annual emergency department visits in the United States are for ocular trauma, with a fair proportion related to the extraction of an embedded corneal foreign body. The procedure is considered well within the scope of emergency medicine specialists. Emergency medicine texts describe the procedure in varying degrees of detail and technique. However, much of the training is still relegated to the now archaic concept of “see one – do one – teach one.” Essentially, it is taught, if at all, on the job and not in school. A review of the relevant literature has uncovered several attempts at developing simulation models to enhance educational efforts. However, the models are costly, difficult to reproduce, and not sufficiently realistic. This impedes the abilities of students to combine their clinical knowledge with clinical skill practice. Students at our university do not receive hands-on training with the use of a slit lamp. Therefore, they need classroom-based opportunities to practice a procedure they may need to do in the real world.

We developed a new simulation model that utilizes inexpensive, easy-to-acquire items that can facilitate and augment the educational process of teaching the removal of an embedded corneal foreign body, using a hard-boiled egg as the eye. Ten second-year medical students were taught how to use the slit lamp and then performed corneal foreign body removal with our novel method and then through the previously published Newport Eye Model method. Afterwards, they completed a brief survey of both techniques, their realism, and effectiveness.

Upon completion of this education and training, 100% of the learners favored the experimental model over the previously published Newport Eye Model to teach corneal foreign body removal during simulation education.

It is proposed that this simulation model, another extension into the growing field of simulation medicine, will not only broaden the psychomotor skills of emergency medicine specialists for ophthalmologic emergencies, but it will also enhance patient safety. This training is inexpensive, expeditious, and easily reproducible and should be tested among more students and faculty to gauge their responses. Medical faculty, especially primary care physicians, should be educated with regards to using a slit lamp and simulation education.