A Distributed Competency-Based Approach to Teaching Ophthalmic Pathology to Ophthalmology Residents
2008, Volume 1, Number 1 30 Introduction Major dedicated eye pathology laboratories have been closed at some of the nation's most prestigious ophthal-mic training sites. In the United States, fewer than 100 individuals dedicate any proportion of their academic time to ophthalmic pathology. Funding to support oph-thalmic pathology and pathologists is seldom available. Only very few physicians are now training to become ophthalmic pathologists. In this context, how can oph-thalmology residency programs provide training in oph-thalmic pathology? Moreover, as the emphasis in train-ing physicians shifts from an exclusive focus on the acquisition of knowledge to the achievement of multi-ple competencies, what is the appropriate curriculum for ophthalmic pathology? How should the methods by which ophthalmic pathology is taught be adapted to a competency-based curriculum? This review addresses these questions by first tracing the evolution of ophthalmic pathology as a discipline to discover how the ophthalmic pathology curriculum now provided to ophthalmology residents was developed. Next, the current status of ophthalmic pathology educa-tion is described and potential solutions to the critical shortage of teachers in this discipline are outlined. This review then describes twelve years experience with a new curriculum, instructional delivery system, instruc-tional technology, and teaching methods. Finally, a new paradigm for ophthalmic pathology education is pro-posed to complement and reinforce an overall compe-tency-based residency training curriculum. Discussion The Evolution of the Conventional Ophthalmic Pathol-ogy Curriculum Ophthalmic pathology began as a descriptive discipline with an emphasis on discovering the pathological basis A Distributed Competency-Based Approach to Teaching Ophthalmic Pathology to Ophthalmology Residents Robert Folberg, MD 1* 1 Frances B Geever Professor and Head, Department of Pathology, University of Illinois at Chicago, Chicago, IL * Corresponding Author & e-mail: rfolberg@uic.edu Abstract The number of ophthalmology residency programs exceeds the number of individuals who practice and teach in the discipline of ophthalmic pathology. It is not economically feasible to provide on-site ophthalmic pathology instruction in many ophthalmol-ogy residency programs. Therefore, a distributed delivery of ophthalmic pathology education has been designed and imple-mented successfully so that one pathologist  or a group of pathologists  may serve the educational needs of many residency programs. The distributed model of ophthalmic pathology instruction is cost-effective for subscribing institutions because sub-scribers pay only for the instruction that they require. This model has been used effectively for 12 years. Currently, 9 off-site ophthalmology residency programs are instructed by the author and his associates using a CD-ROM based curriculum for didac-tic instruction, an instructional website with assessment tools, virtual microscopy so that residents review histopathological slides, and live interactive bidirectional videoconferencing to review pathologic material from patients with the instructor. The distributed model features a radically revised curriculum to extend instruction beyond the acquisition of knowledge to address the issue of basic competencies that ophthalmology residents are expected to master. The curriculum may be implemented in residency programs where an ophthalmic pathologist is on-site to provide instruction. If on-site instruction in ophthalmic pathol-ogy is not available or is not feasible, then adoption of a distributed model of ophthalmic pathology education may provide an affordable competency-based curriculum to ophthalmology residents. Accepted for publication August 21, 2007 Revision received October 2, 2007 2008; 1:30-39 Available on the web at http://www.academic-ophthalmology.com The author(s) have no personal financial interest in any of the prod-ucts or technologies cited herein.  2008