Introducing the AES Educational Series on neuro-ophthalmology teaching and learning

Purpose of the Educational Series

Neuro-ophthalmology education is evolving within a complex educational and clinical landscape. Rising patient complexity, expanding diagnostic technologies, and increased productivity demands have narrowed the time available for teaching in busy clinics. At the same time, learners enter training with diverse backgrounds, expectations, and learning styles, challenging educators to move beyond one-size-fits-all approaches. These realities have underscored the need for structured, efficient, and theory-informed strategies that support both clinical excellence and sustainable teaching.

Concurrently, ophthalmic education is being reshaped by advances in educational theory and the rapid emergence of artificial intelligence (AI)-driven tools. Adult learning principles emphasize self-direction, reflection, and contextual learning. At the same time, AI offers new opportunities to scale expertise, personalize feedback, and supplement subspecialty training in environments where access to neuro-ophthalmology faculty may be limited. Together, these forces have created a new facet to examine how neuro-ophthalmology is taught, mentored, and supported across the continuum of training.

This Educational Series aims to provide practical, theory-informed, and forward-looking tools for educators navigating modern neuro-ophthalmology training environments. Rather than offering isolated solutions, the series presents a comprehensive toolkit that spans clinical teaching efficiency, learner support and remediation, feedback and mentorship, foundational adult learning theory (ALT), and emerging competencies in AI literacy. Collectively, these articles aim to equip educators with adaptable frameworks that align educational goals with clinical workflow, foster meaningful mentorship, and prepare both teachers and learners for the future of neuro-ophthalmic education.

Optimizing teaching in the clinical environment

Article highlight #1: Saland et al., Optimizing teaching efficiency in the neuro-ophthalmology clinic (1)

The challenges facing today’s physicians are often compounded by the demands of medical training. Medical education is influenced by high rates of physician burnout and a lack of longitudinal mentorship and support. At the same time, the role of the physician continues to evolve, requiring clinicians to balance patient care responsibilities with their duty to educate and mentor the next generation of doctors. These pressures are particularly pronounced in high-volume clinics, where limited time, increasing patient complexity, and productivity demands can restrict opportunities for meaningful teaching and feedback (2). To create a sustainable pipeline of mentorship for the future of healthcare, physicians must thoughtfully navigate these competing priorities. With time as a limited resource, teaching and mentorship must be deliberately optimized to align with clinical workflow.

Within the neuro-ophthalmology clinic specifically, this article explores strategies to structure a workflow grounded in efficiency while preserving protected time for reflection and feedback. An efficient clinic day begins the night before, when learners review assigned patient encounters, formulate diagnostic hypotheses, and anticipate clinical findings. Each morning, learners and educators participate in brief “morning rounds”, during which cases from the prior day are discussed and key teaching points reinforced. This targeted, individualized teaching before patient encounters promotes clinical preparedness and efficiency without disrupting clinic flow.

Additional structured educational frameworks described in this article include required presentations, case reports, and article-based learning activities. Together, these approaches reinforce clinical learning while encouraging scholarly engagement and tangible academic outcomes.

Supporting the struggling learner

Article highlight #2: Nordin et al., Managing the struggling ophthalmology learner: a review (3)

When directing a struggling learner, early identification and timely intervention, supported by structured guidance, are essential. With a focus on ophthalmology, this article outlines common causes of learner difficulty and highlights targeted interventions and resources addressing both cognitive and non-cognitive challenges.

The “SOAP” framework (subjective, objective, assessment, and plan) is traditionally used in medicine to guide patient care. This same structured approach can be adapted to support the struggling ophthalmology learner. The subjective component allows educators to recognize early signs of difficulty, such as unfavorable patient feedback, concerns raised by faculty or staff, or direct observations of learner-patient interactions. Objective data are then gathered through written evaluations, faculty assessments, and standardized performance metrics. As with patients, learner challenges are often multifactorial. Assessment strategies that incorporate knowledge-based evaluations and applied clinical scenarios help distinguish gaps in content acquisition from deficits in clinical reasoning, thereby enabling focused and effective remediation. The final step of the SOAP framework involves developing an individualized plan informed by both subjective and objective findings.

A comprehensive approach to supporting struggling learners requires ongoing adjustment and reassessment, with interventions refined over time to promote optimal success. This article provides a range of resources tailored to specific learner needs, including mixed-media educational tools, supplemental readings, tutoring, simulation-based training, and financial counseling.

Feedback and mentorship as educational cornerstones

Article highlight #3: Jang et al., The art of feedback: crafting mentorship in medicine (4)

Mentorship is a cornerstone of the medical profession, shaping the next generation of leaders in ophthalmology through meaningful relationships between mentors and mentees. Effective mentorship offers learners more than constructive feedback, clinical reasoning, and problem-solving skills; it also provides essential guidance for long-term career development (5). However, in today’s fast-paced clinical environment, delivering consistent and effective feedback remains a challenge, particularly in the absence of widely adopted, systematic approaches. These pressures can further contribute to physician burnout when teaching expectations become unsustainable.

This article advocates for a shift away from hierarchical, evaluation-centered models toward a culture of coaching that emphasizes longitudinal relationships and shared goals. The Ask-Tell-Ask feedback framework exemplifies this approach by first inviting learners to reflect on their performance, followed by mentor input that highlights specific strengths and areas for improvement, and concluding with the learner formulating an actionable growth plan. By fostering reflection, self-directed motivation, and adaptability, this model equips learners to thrive in continuous professional development. Importantly, these coaching principles are readily applicable to ophthalmic education and residency training, offering a sustainable approach to mentorship in modern clinical practice.

Grounding ophthalmology education in ALT

Article highlight #4: Choi et al., A primer on adult learning theory for ophthalmology education (6)

The ALT is based on the unique needs of adult learners and their motivation to learn, desire for self-direction of knowledge, prior experiences, sense of responsibility, and a problem-solving mindset. First coined by Malcolm Knowles in the 1980s, andragogy is a term that describes how adults learn differently from children (7). Adults have an increased need for intrinsic motivation, whereas children are motivated by extrinsic factors. This article explores the theories behind the ALT framework: instrumental, humanistic, transformative, social, motivational, and reflective theories.

This article also explores how ALT translates to ophthalmic training and residency through experimental and simulation-based learning. Ophthalmology trainees are increasingly expressing their interests in improving their training through ‘direct feedback in clinic using patient images’, ‘online materials’, ‘small groups’, and ‘simulation’ (8). These findings confirm that learners are favoring self-driven and self-directed methods of learning.

Preparing educators for the era of AI

Article highlight #5: Sampige et al., Narrative review of artificial intelligence (AI) in neuro-ophthalmic education: approaches for AI literacy (9)

This article examines the growing role of AI in ophthalmology, with particular emphasis on its potential to address the ongoing shortage of neuro-ophthalmologists. As access to subspecialty care remains limited in many settings, AI has been proposed as a tool to help bridge the provider-patient gap by enabling more accurate and scalable diagnostic support through access to large bodies of medical knowledge.

A key focus of the article is the use of large language models (LLMs) as educational adjuncts for trainees and learners in neuro-ophthalmology. These models allow users to compare their own clinical reasoning, such as differential diagnoses or interpretations of imaging, with AI-generated analyses, providing an additional layer of feedback and reinforcement (10). The article further highlights the emergence of custom generative pre-trained transformers (GPTs) designed for ophthalmic education, including platforms such as EyeGPT, Eye Teacher, Eye Assistant, and The GPT for GA (11). In parallel, virtual reality (VR) technologies are being incorporated to create immersive learning environments in which learners can engage with simulated patient scenarios in a directed and interactive manner.

Importantly, the article presents a balanced discussion of both the promise and the limitations of AI in neuro-ophthalmic education. While these tools offer opportunities to enhance learning and expand access to specialized knowledge, their effective integration requires careful consideration of accuracy, bias, and generalizability. Additionally, the use of AI in training environments raises important questions regarding scholarly effort, authorship, and the appropriate attribution of intellectual contribution. Together, these considerations underscore the need for thoughtful, ethically grounded implementation as AI continues to shape the future of neuro-ophthalmology education.

Integrative perspective: a unified educational framework

Taken together, the five articles in this Educational Series reflect a shared commitment to learner-centered education rooted in intentional, evidence-based teaching. Across diverse topics, each contribution emphasizes the importance of meeting learners where they are while remaining deliberate about how, when, and why education occurs. Effective teaching and mentorship require structure, reflection, and alignment with both educational theory and clinical realities.

Collectively, the series bridges theory and practice by translating foundational educational principles into actionable strategies that can be integrated into everyday clinical environments. Whether addressing the immediate demands of high-volume clinics or preparing educators for emerging technologies, these articles respond to the need to support current learners while anticipating the future of neuro-ophthalmology training. In doing so, the collection serves not only as a practical reference resource for educators at all levels, but also as a call to action to engage more deliberately in the scholarship and practice of teaching.

Closing vision and call to action

As neuro-ophthalmology continues to evolve, how educators teach, mentor, and support learners must also evolve. We invite readers and facilitators to reflect critically on their own educational practices and to consider how the strategies presented may be adopted, adapted, and refined within their unique clinical and institutional contexts. Small, intentional changes in clinical efficiency, learner support, feedback, and mentorship, and implementation of ALT and AI can yield meaningful improvements in both learner development and faculty sustainability, subsequently lowering the rates of burnout.

Clinical educators serve as stewards of the field, shaping not only clinical competence but also professional identity, curiosity, and resilience. Education is foundational to the quality and continuity of patient care, especially through longitudinal teaching of the tomorrows’ leading physicians. By prioritizing thoughtful, evidence-informed teaching, educators ensure that the values and expertise of neuro-ophthalmology are carried forward to future generations.

Looking ahead, the future of neuro-ophthalmology education will depend on continuous improvement driven by feedback, reflection, and innovation. Through sustained engagement with educational theory, emerging technologies, and mentorship practices, the field can continue to evolve in ways that strengthen both training and patient care. This series represents one step in that ongoing journey. It is an invitation to lead, to teach with intention, and to shape the future of neuro-ophthalmology education together.

Acknowledgments

None.

Footnote

Provenance and Peer Review: This article was commissioned by the editorial office, Annals of Eye Science for the series “Special Consideration for Teaching and Learning in Neuro-Ophthalmology”. The article did not undergo external peer review.

Funding: None.

Conflicts of Interest: Both authors have completed the ICMJE uniform disclosure form (available at https://aes.amegroups.com/article/view/10.21037/aes-2026-1-0010/coif). The series “Special Consideration for Teaching and Learning in Neuro-Ophthalmology” was commissioned by the editorial office without any funding or sponsorship. A.G.L. served as the unpaid Guest Editor of the series and serves as an unpaid editorial board member of Annals of Eye Science from June 2024 to December 2026. A.G.L. served as a consultant for the National Aeronautics and Space Administration (NASA), the National Football League (NFL), US Department of Justice, and is a consultant for Amgen (speaker bureau), AstraZeneca (data and safety), Argenx, Bristol-Myers Squibb, Alexion (speaker), Celgene, Stoke, Ethyreal, Catalyst, Dompe (speaker, consultant), and Viridian. A.G.L. is also on the editorial board of JNO, CJO, JJO, and JAMA Ophthalmology. He is a past president and past chairman of Board for NANOS. He participation on a Data Safety Monitoring Board or Advisory Board of Astrazeneca and Celgene. He has received payment and support from Amgen, Viridian, Alexion and Dompe and received payment for various malpractice expert witness. The authors have no other conflicts of interest to declare.

Ethical Statement: The authors are accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved.

Open Access Statement: This is an Open Access article distributed in accordance with the Creative Commons Attribution-NonCommercial-NoDerivs 4.0 International License (CC BY-NC-ND 4.0), which permits the non-commercial replication and distribution of the article with the strict proviso that no changes or edits are made and the original work is properly cited (including links to both the formal publication through the relevant DOI and the license). See: https://creativecommons.org/licenses/by-nc-nd/4.0/.

References

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