Combination of simulation-based and online learning in ophthalmology: Efficiency of simulation in combination with independent online learning within the framework of EyesiNet in student education

Authors: Svenja Deuchler FEBO, Christina Sebode, Hanns Ackermann, Ingo Schmack, Pankaj Singh, Thomas Kohnen & Frank Koch

Publication: Der Ophthalmologe. 2021 Jan 15;1-10. doi: 10.1007/s00347-020-01313-0.



Ophthalmoscopy is part of the medical curriculum but the teaching of medical contents is often unsatisfactory. No systematic learning of pathologies and their treatment options is possible because appropriate patient populations are often unavailable; instead of that healthy students examine each other. For this reason, we have developed a project to improve teaching at the medical faculty of the JWG University in Frankfurt/Main, which offers the opportunity for training in ophthalmoscopy using a newly developed online platform (EyesiNet) in addition to simulator training. Defined learning contents are reproducible and made equally available to everyone.


The aim of this study was to evaluate a format for improving the teaching of direct and indirect ophthalmoscopy for students. Practical exercises on virtual reality-based simulators were intertwined with newly developed theoretical content adapted to the teaching catalog in the online platform EyesiNet.

Material and methods

On the first and last days of the internship, the students worked on cases in Eyesi Direct and Eyesi Indirect. In the meantime, they were able to deal with the theoretical basics of these ophthalmological clinical pictures in the web-based EyesiNet on a voluntary basis.


Eyesi Direct: with p = 0.29, both groups had the same state of knowledge and did not have significantly different results in case processing on the first day of the internship. In the group without training (n = 54), a significant improvement in simulator training was observed on the last day of the practical training with p = 0.02 but with a small effect size of 0.1. Among the trainees (n = 32) a highly significant improvement with an effect size of 0.3 was observed with p = 0.0004. Eyesi Indirect: both groups had no significant difference in the stage of knowledge in the Eyesi Indirect at the beginning of the training period (p = 0.10). After training both groups performed slightly better but without significance (without training p = 0.41/with training p = 0.17).


The online platform EyesiNet supports the learning of the most important disease patterns. Learning contents are made available in a reproducible and standardized way for all students. The skills of direct ophthalmoscopy can be learned much faster than those of indirect ophthalmoscopy.