Visual Symptom Simulator (Vis_Sym_Sim)

Research design and methods In collaboration with BCIT, a web-based VSS platform will be developed, with the goal of presenting interactive visual symptom scenarios designed to simulate patient-reported visual experiences.

Participants will include patients 18 years or older who are referred to the Ophthalmology Clinic at St Paul's Hospital (SPH) and Vancouver General Hospital (VGH) Eye Care Center for assessment of one of the following visual complaints: transient visual loss, diplopia, or blurry vision. We will also recruit medical trainees rotating through neuro-ophthalmology services. A control group (standard of care) will be recruited first and will undergo standard clinical interview and neuro-ophthalmological assessment without the VSS. Following finalization of the VSS, patients will be recruited into the VSS intervention group.

Methods of analysis, instruments, and tools The VSS will be the primary intervention tool in the intervention group and will be delivered via a web-based platform. The control group will undergo the standard neuro-ophthalmological examination alone.

Data will be collected using post-clinical and post-intervention surveys completed by both patients and trainees. Surveys primarily consist of Likert-scale items assessing patient satisfaction, as well as trainees' perceived understanding of patient symptoms and confidence in clinical reasoning. A short section at the end of the questionnaires will be available to patients and trainees for qualitative feedback.

Quantitative data will be analyzed using descriptive statistics to compare outcomes between control and intervention groups. Where applicable, subgroup analyses may be performed based on level of training (trainees).

Qualitative data from open-ended survey responses will be reviewed and analyzed for recurring themes.