Implications of problem-based education for the future of optometric practice.

BACKGROUND: Optometry is changing from single-doctor, refraction-oriented practices toward group practices in which increasingly complex patient problems are managed. To prepare students for new modes of practice, the traditional lecture style of education is being supplemented with innovative techniques, such as problem-based learning (PBL). METHODS: Using PBL in a medical or optometric environment, a group of students would be given a complete case in the Subjective, Objective, Assessment, and Plan (SOAP) format. Then they would be asked to use the case as a basis for studying the underlying mechanism of the disease presented, the therapies available, why the management plan was selected, and why the patient responded as he or she did. RESULTS: Students work in groups to investigate the cases using on- and off-line resources. They set learning objectives for themselves and the group, and they evaluate each other's performances. A faculty member serves as a guide during this process. CONCLUSIONS: Students who complete a PBL course have not memorized a mountain of details as they would have in a traditional course, but have learned how to find and integrate information about patients, cases, diseases, etc. This enables them to deal with the exponential increase in knowledge that is occurring. In addition, by working together on PBL cases, students prepare themselves for group and other interactive practice environments.

Use of the Taylor Visagraph II system to evaluate eye movements made during reading.

BACKGROUND: The Taylor Visagraph II is a relatively new device designed to evaluate eye movements made during reading. It uses goggles with infrared optics to detect the eye movements and computer software to determine the number of fixations, regressions, and other characteristics of the eye movements. The system also calculates several scores, including a school-grade equivalent for the reader. METHODS: Fifty first-year optometry students served as subjects. Each read five standard Taylor Level 10 (College) paragraphs during each of two sessions while eye movements were assessed by the Visagraph II. RESULTS: The Visagraph II operated correctly for 498 of the 500 trials; operator error caused two malfunctions. Significant differences were found between scores from the first paragraph read and subsequent paragraphs. Nonlinear relationships were found between most of the variables, especially those that involved grade levels and spans of recognition. Also of interest was the wide range of reading eye-movement skills; several of the optometry students appeared to have skills that placed them at below fourth grade level. CONCLUSIONS: The Visagraph II performed properly over a large number of trials and produced data that seemed to be reliable indicators of reading skills. Paragraph-to-paragraph variations in mean scores suggest caution in interpretation of small changes in performance across paragraphs and the need for at least one practice trial before usable data are obtained.

Use of the Ober2 Model B-1200 system for analysis of eye movements made during reading.

BACKGROUND: The Ober2 Model B-1200 system uses infrared reflections to record and analyze eye movements made during reading. The system's ability to analyze data from normal subjects and the reliability of the data produced by subjects who read standard paragraphs were investigated. METHODS: Forty-two optometry students and 20 junior high school students, all self-assessed normal readers, read five different Taylor test paragraphs during each of two sessions. Ober2 Model B-1200 analysis was attempted for each paragraph; when analysis was successful, grade-equivalent scores based on fixations, span of recognition, regressions, fixation duration, and reading rate were determined. RESULTS: The Ober2 Model B-1200 system was unsuccessful in analyzing data from 30% of the paragraph presentations; manual calibration procedures allowed no additional data analysis. Using mean grade-equivalent data from 16 optometry student subjects for whom all 10 paragraphs could be analyzed, significant differences were found between results for two of the test paragraphs. Split-half inter-session reliability coefficients for grade-equivalent data ranged from 0.84 to 0.95. No intra-session learning or fatigue effects on reading data were found. CONCLUSIONS: Although the Ober2 Model B-1200 potentially can provide valuable information on eye movements made during reading, problems exist with respect to its ability to analyze data. The analysis failures significantly limited the value of this system.