Figure 1
The educational contents and teaching methods are standardised using a teaching script.
Table 1
Table summarizing the teaching materials and assessment instruments used during the study.
| ITEM | DESCRIPTION |
|---|---|
| Instructional Video | 10-minute video with step-by-step explanation of the eye examination skill of interest, focusing on key checkpoints and pitfalls. Three in total, covering all three skills of interest. |
| Mental Rehearsal (MR) Audio | 10-minute expert narrative of all procedural steps involved in the eye examination skill of interest, emphasizing landmarks, decision points, and errors to avoid. Three in total, covering all three skills of interest. |
| Video Modelling Examples (VME) | 20-minute video illustrating the problem-solving and diagnostic application of the eye examination skill of interest. Three in total, covering all three skills of interest. |
| Multiple Choice Question (MCQ) Test | 50 item test delivered over 1.5hr. Questions assessed knowledge application, diseases diagnosis, and clinical reasoning. Two sets of questions in total, delivered pre- and post-teaching. |
| End-of-Rotation Test | 6 short answer questions delivered over 1hr. Questions were vignette-based, assessing clinical reasoning and problem solving using authentic case examples. |
| Micro-Clinical Evaluation eXercise | Single workplace assessment over 10 minutes. Participants examined real patients and were assessed based on accuracy, speed, and time-sharing abilities. |
Figure 2
Assessment rubric for micro-clinical evaluation exercise.
Table 2
Baseline comparison of the gender distribution, Pre-test Multiple Choice Question Total Scores and Section-Scores (pupils, visual field, and extra-ocular movement examinations) between both experimental groups.
| SCOPE GROUP (N = 95) | F2FT GROUP (N = 51) | P-VALUES | |
|---|---|---|---|
| Gender | Fisher Exact test | ||
| Male | 44 (46.3%) | 23 (45.1%) | 1 |
| Female | 51 (53.7%) | 28 (54.9%) | |
| Pre-test MCQ Test Scores [Mean (Standard Deviation)] | Student’s t-test | ||
| Total | 22.31 (5.53) | 22.24 (5.74) | .943 |
| Pupillary Examination | 8.16 (2.63) | 7.76 (2.38) | .361 |
| Visual Field Examination | 8.26 (2.29) | 8.00 (2.34) | .515 |
| Extra-Ocular Motility Examination | 5.88 (2.31) | 6.47 (2.56) | .176 |
Table 3
Pre- and post-test MCQ total scores within the SCOPE group. *Student’s t-test p-value. ^ANCOVA test statistic and p-value.
| KTPH (N = 51) | NUH (N = 44) | STATISTICAL TEST OUTCOMES | ||
|---|---|---|---|---|
| Pre-test MCQ Test Total Scores [Mean (Standard Deviation)] | 23.22 (5.36) | 21.25 (5.6) | .085* | F(1, 143) = 8.47, p = .004^ |
| Post-test MCQ Test Total Scores [Mean (Standard Deviation)] | 37.31 (5.83) | 32.14 (4.26) | < .001* | |
Table 4
Comparison of post-test MCQ mean scores between F2FT and SCOPE.
| F2FT GROUP (N = 51) | SCOPE GROUP (N = 95) | ||
|---|---|---|---|
| POST-TEST MCQ TEST TOTAL SCORES [MEAN (STANDARD DEVIATION)] | STUDENT’S T-TEST p-VALUE | ||
| Total | 31.75 (5.24) | 34.92 (5.75) | .001 |
| Pupillary Examination | 10.06 (2.47) | 11.01 (2.26) | .025 |
| Visual Field Examination | 12.02 (1.66) | 13.08 (2.31) | .002 |
| Extra-Ocular Motility Examination | 9.67 (2.73) | 10.82 (2.71) | .016 |
Figure 3
Comparison of the Estimated Marginal Means of the MCQ Test Total Score between the two experimental groups in the SCOPE group after co-variate adjustment for the ‘centre’ effect.
Table 5
Comparing the distribution of competency levels attained on psychomotor skill assessment between the SCOPE and F2FT group.
| SKILL ASSESSED | GROUP | COMPETENCY LEVEL | TOTAL | FISHER’S EXACT TEST P-VALUE | ||||
|---|---|---|---|---|---|---|---|---|
| 1 | 2 | 3 | 4 | 5 | ||||
| Pupillary Examination | SCOPE | 0 | 0 | 5 (5.3%) | 3 (3.2%) | 87 (91.6%) | 95 | <.001 |
| F2FT | 0 | 0 | 22 (43.1%) | 3 (5.9%) | 26 (51.0%) | 51 | ||
| Visual Field Examination | SCOPE | 0 | 0 | 9 (9.5%) | 8 (8.4%) | 78 (82.1%) | 95 | <.001 |
| F2FT | 0 | 1 (2.0%) | 21 (41.2%) | 7 (13.7%) | 22 (43.1%) | 51 | ||
| Extra-Ocular Motility Examination | SCOPE | 0 | 0 | 6 (6.3%) | 2 (2.1%) | 87 (91.6%) | 95 | <.001 |
| F2FT | 1 (2.0%) | 0 | 33 (64.7%) | 9 (17.6%) | 8 (15.7%) | 51 | ||
Supplementary Table 1
Normality tests for the Pre-test and Post-test Multiple Choice Question Test (Total) Scores, End-of-Posting Test Scores, and Faculty Contact Time in both experimental groups.
| NORMALITY TESTS AND P-VALUES | ||||
|---|---|---|---|---|
| SCOPE GROUP (N = 95) | F2FT GROUP (N = 51) | |||
| SHAPIRO-WILKTEST | KOLMOGOROV-SMIRNOV TEST | SHAPIRO-WILKTEST | KOLMOGOROV-SMIRNOV TEST | |
| Pre-test MCQ (Total) Test Score | .663 | .387 | .387 | .557 |
| Post-test MCQ (Total) Test Score | .378 | .327 | .327 | .797 |
| End-of-Posting Test Score | .093 | .432 | .432 | .886 |
| Faculty Contact Time | .913 | .402 | .402 | .653 |