Blinded Evaluation of Endoscopic Skill and Instructability After Implementation of an Endoscopic Simulation Experience

Abstract

Background Interest in endoscopic simulation is increasing. Past studies have used virtual reality or nonhuman models or residents with varying experience. Our aim was to evaluate the effect of simulation on procedural and psychomotor competence of medical students—surgical novices—performing endoscopic tasks on human cadavers and assess student perceptions. Methods Students (n = 22) completed a baseline sinus model skill evaluation graded by 2 blinded Rhinology fellows. Intervention and control groups with equal baselines were assigned. Intervention students practiced endoscopic tasks on the model for 45 minutes minimum over 2 weeks. All students reviewed sinus anatomy/disease and sinus surgery materials. The final cadaver evaluation was similar to the baseline. Fellows graded students on anatomy identification (sinuses, turbinates), psychomotor (navigation, camera alignment, instrument handling), and timed procedural (sinus object retrieval) skills, confidence, and instructability via fellow-guided frontal balloon placement. Results Participants included 16 males (72.7%) and 6 females (27.3%). Intervention and control groups contained 10 (45.4%) and 12 (54.6%) students, respectively. Intervention group final “Total Psychomotor” scores were higher (10.1/15 vs 7.8/15, P = .0231). “Surgical confidence” was 3.3/5 versus 2.5/5, and “Instructability” was 3.9/5 versus 3.4/5 in intervention versus control groups, respectively ( P < .050). Multivariate regression analysis demonstrated superior psychomotor skills, navigation, and confidence in the intervention group ( P < .036). Activity perception scores were higher in intervention students versus controls, 26.13 versus 18.36/40 ( P = .022). Conclusion In surgical novices, endoscopic simulation leads to superior endoscopic navigation and task performance in cadavers. This simulation presents a novel method for incorporating Otolaryngology simulation in medical student education.

Emerging concepts in endoscopic skull base surgery training

“…Several training opportunities have been developed in recent years to reduce the learning curve and increase surgical training proficiency. There has been increased interest in alternative models to simulate EEA surgery including 3‐dimensional (3D) printed models, virtual reality simulators, surgical video review and other low cost materials 15–22 …”

“…TA B L E 2 Endoscopic endonasal levels of surgery reality simulators, surgical video review and other low cost materials. [15][16][17][18][19][20][21][22] Perhaps the most important scenarios for surgical simulation are rarely occurring events with catastrophic results. In this regard, internal carotid artery (ICA) injury during EEA is a vitally important scenario to rehearse.…”

Something for Everyone in Rhinology and Allergy

“…Stephenson et al evaluate the effect of endoscopic simulation in a cadaver lab on aspects of skill competence among medical students, a foresightful application of the burgeoning simulation initiative to medical student education. 21 Finally, Kunz et al provide a thoughtful consumer report comparing two commercially available nasal packing devices and their effectiveness at treating posterior epistaxis. 22 The Editorial Board and I hope you enjoy the diverse content within this issue of AJRA.…”