Evolution of teaching and Ophthalmology

3000 BC - writing • Teaching of scribes• Philosophers• Astronomers

• Law• Religion• Art

Teaching system mainly by mentors

Military SystemsRennaiscence

Industrial revolutionBirth of trades and professions

• Learning by demonstration , explanation , mentoring , group learning, questioning

and testing.

19th Century – Compulsory learning• Poor capable of education

• Prussian system – authority _ rigid curricula _ rote learning for exams _detailed theory

Skill acquisition still depended on apprentice system

20th Century improvements

• Expert teachers• Enhanced knowledge base• Updated textbooks• Case method• Experiential method –deriving meaning and

understanding from experience• Learning by teaching

21st Century

• Information Technology data bases search engines google , wikipedia web sites portable computers i-phones , i-pads

Ophthalmic technology and learning

• Imaging of the eye - colour , FFA• OCT , Corneal topography , HRT• Video recording of surgery

Personal graphic records Collaborative learning audit of surgical technique and outcome wet lab practice Simulation systems for virtual surgery

Quality of Ophthalmic learning

Teachers generosity of spirit time commitment well trained themselves personal training in best teaching practice Trainees Committed , passionate self-motivated insight

Importance of skill acquisition Good mentors are essential

The Modern Ophthalmologist

• Selected in open competition

• Full knowledge acquisition on-line

• Systematic skills acquisition and upgrading

• Annual auditing and recertification

• Strong ethical framework

Ophthalmic training programmes should equal those for astronauts

• Strict , regular recertification • Certification for any new proceedure• Skills maintainence with compulsory regular

simulation or formal surgical assessment

• Regular presentation of all outcomes (audit)

12 Requisites for an oculist and surgeon

1. To be descended from religious parents2. To be religious himself3. To have studied latin, anatomy and medicine4. To have studied surgery from youth (those

entering ophthalmology from the plough, manure wagon, or late in life are unsuitable)

5. To have served an apprenticeship with an accomplished oculist and surgeon

6. To have healthy young eyes7. To have fine, settled, healthy hands and fingers

and to be nimble with both hands

12 Requisites for an oculist and surgeon

8 To be able to draw9 To be married10 Not to be greedy for money or haughty11 Not to be a drunkard12 Not to be presumptuous or vainglorious

As an afterthought, he added “Very few such oculists exist” George Batisch, Dresden, 1583