Blinded randomized controlled study of a web-based otoscopy simulator in undergraduate medical education

Stepniak, Camilla; Wickens, Brandon; Husein, Murad; Paradis, Josée; Ladak, Hanif M.; Fung, Kevin; Agrawal, Sumit

doi:10.1002/lary.26246

Cited by 14 publications

(22 citation statements)

References 15 publications

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“…Both learning sequences resulted in significant knowledge improvement from pre-test to post-test, and sustained knowledge on retention test. Our findings add to the growing evidence that otoscopy simulation training improves otoscopic diagnostic accuracy [ 7 , 8 , 24 , 25 ]. We also found that the mobile otoscopy simulator was well-received by participants.…”

Section: Discussionsupporting

confidence: 72%

Effectiveness of discovery learning using a mobile otoscopy simulator on knowledge acquisition and retention in medical students: a randomized controlled trial

Campisi

Forte

et al. 2018

J of Otolaryngol - Head & Neck Surg

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BackgroundPortable educational technologies, like simulators, afford students the opportunity to learn independently. A key question in education, is how to pair self-regulated learning (SRL) with direct instruction. A cloud-based portable otoscopy simulator was employed to compare two curricula involving SRL. Pre-clerkship medical students used a prototype smartphone application, a 3D ear attachment and an otoscope to complete either otoscopy curriculum.MethodsPre-clerkship medical students were recruited and randomized to two curriculum designs. The “Discovery then Instruction” group received the simulator one week before a traditional lecture, while the “Instruction then Discovery” group received it after the lecture. To assess participants’ ability to identify otoscopic pathology, we used a 100-item test at baseline, post-intervention and 2-week retention time points. Secondary outcomes included self-reported comfort, time spent using the device, and a survey on learning preferences.ResultsThirty-four students completed the study. Analysis of knowledge acquisition and retention showed improvement in scores of both groups and no significant effects of group (F1,31 = 0.53, p = 0.47). An analysis of participants’ self-reported comfort showed a significant group x test interaction (F1,36 = 4.61, p = 0.04), where only the discovery then instruction group’s comfort improved significantly. Overall device usage was low, as the discovery then instruction group spent 21.47 ± 26.28 min, while the instruction then discovery group spent 13.84 ± 18.71 min. The discovery first group’s time spent with the simulator correlated moderately with their post-test score (r = 0.42, p = 0.07). After the intervention, most participants in both groups (63–68%) stated that they would prefer the instruction then discovery sequence.ConclusionsBoth curricular sequences led to improved knowledge scores with no statistically significant knowledge differences. When given minimal guidance, students engaged in discovery learning minimally. There is value in SRL in simulation education, and we plan to further improve our curricular design by considering learner behaviours identified in this study.

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Section: Discussionsupporting

confidence: 72%

Effectiveness of discovery learning using a mobile otoscopy simulator on knowledge acquisition and retention in medical students: a randomized controlled trial

Campisi

Forte

et al. 2018

J of Otolaryngol - Head & Neck Surg

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“…Diagnostic accuracy was low overall, with a mean score of 54%. This is similar to other studies of medical student otoscopic diagnostic scores (22.1%-61.5%), 10,16,17 as well as some studies of primary care residents and practitioners. 3,18 In our study, students were best at diagnosing ear tubes and perforations, but struggled with the other more subtle diagnoses, especially eardrum retractions.…”

Section: Discussionsupporting

confidence: 91%

“…16 Similarly, Stepniak et al found that medical students who had access to an otoscopic simulator were more accurate at diagnosing pathology in otoscopic videos compared to peers who did not have access. 17 In recent years, otolaryngology residency programs have recognized the potential benefits of using simulators to train, with Deutsch et al reporting that 78.6% of respondents had some form of onsite simulator for their training program, and 83.8% wished to participate in trials focusing on simulation intitiatives. 19 Continued developments in technology that provide improved otoscopic visualization and automated feedback may provide better ways both to enhance clinicians' otoscopic diagnostic performance and assist trainees in refining their otoscopic skills.…”

Section: Discussionmentioning

confidence: 99%

Diagnostic accuracy and confidence for otoscopy: Are medical students receiving sufficient training?

et al. 2018

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Objectives/Hypothesis To assess the confidence and abilities of medical students to diagnose specific types of otologic pathology, and to determine how different training experiences in medical school impact these outcomes. Study Design Survey analysis. Methods Sixty third‐ and fourth‐year medical students completed a computerized online survey. Participants answered questions about their otoscopic training experience and confidence, and provided diagnoses for 72 digital images taken with a high‐definition video otoscope that showed common otologic pathologies of the tympanic membrane and middle ear space. Results Most participants (65%) had received less exposure to otoscopic training in medical school than they expected. Confidence in diagnostic ability was low. For diagnostic ability, the mean percent correct across pathologies was 54% ± 7.7%. Medical school year (P = .006), intended specialty (P = .022), and total number of otolaryngology rotations (P = .048) were predictive of diagnostic accuracy on univariable logistic regression analyses, but medical school year (P = .039) was the only significant independent predictor in multivariable analysis. Intended specialty (P = .047) and total number of otolaryngology rotations (P = .035) were predictive of prequiz diagnostic confidence on univariable logistic regression analyses. Conclusions Medical students were not satisfied with their exposure to otoscopic training. Intended specialty, total number of otolaryngology rotations, and year in medical school predicted diagnostic accuracy. Intended specialty and total number of otolaryngology rotations predicted diagnostic confidence. Additional studies are needed to investigate how training experiences can be improved to optimize otoscopy training during medical school. Level of Evidence NA Laryngoscope, 129:1891–1897, 2019

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“…In their study, the students' examination skills and diagnostic ability showed improvement using web-based learning compared to revising printed lecture notes [6]. In another study in 2016 by Stepniak et al, web-based learning was found to be effective in teaching otoscopy for undergraduate medical students [8]. However, this study utilised a high end, and expensive simulator with a very limited follow-up period of only one week.…”

Section: Discussionmentioning

confidence: 93%

Improving Diagnostic Ability and Confidence In Otoscopy Through A Web Based Learning Platform: A Prospective Interventional Study

Azman

Rajasingam

Mokhtar

et al. 2020

Preprint

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Background Otoscopy is an important clinical skill to master in the undergraduate medical curriculum. This study investigated the effect of a new web-based learning platform in improving diagnostic ability and confidence in otoscopy among final year medical undergraduates in Universiti Kebangsaan Malaysia Medical Centre (UKMMC). Methods A new web-based learning platform for otoscopy was introduced to final year medical undergraduates who have completed a three-week posting in otorhinolaryngology. A total of 45 subjects who participated in the learning platform were included in this prospective interventional study. All of them answered questionnaires on level of confidence (LC) and completed online questions on diagnostic ability (DA) at three different timelines during the study: prior to intervention (T1), after intervention (T2) and 4 months following the intervention (T3). Results LC scores were significantly higher in between T1 and other timelines measured: T1 vs T2 and T1 vs T3 respectively (p < 0.05). DA scores were significantly higher in between T1 and other timelines measured: T1 vs T2 and T1 vs T3 respectively (p < 0.05). LC and DA scores continued to improve at T3 with scores significantly higher when compared with scores at T2 (p < 0.05). Conclusion Subjects’ level of confidence in performing otoscopy and diagnostic ability showed sustained improvements at 4 months with this intervention. We conclude that otoscopy web based learning platform complements the teaching and learning of otoscopy among final year medical undergraduates.

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Blinded randomized controlled study of a web-based otoscopy simulator in undergraduate medical education

Abstract: 1b. Laryngoscope, 127:1306-1311, 2017.

Cited by 14 publications

References 15 publications

Effectiveness of discovery learning using a mobile otoscopy simulator on knowledge acquisition and retention in medical students: a randomized controlled trial

Effectiveness of discovery learning using a mobile otoscopy simulator on knowledge acquisition and retention in medical students: a randomized controlled trial

Diagnostic accuracy and confidence for otoscopy: Are medical students receiving sufficient training?

Improving Diagnostic Ability and Confidence In Otoscopy Through A Web Based Learning Platform: A Prospective Interventional Study

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