Current Evidence for Simulation-Based Training and Assessment of Myringotomy and Ventilation Tube Insertion: A Systematic Review

Abstract

Objective: Myringotomy and ventilation tube insertion (MT) is a key procedure in otorhinolaryngology and can be trained using simulation models. We aimed to systematically review the literature on models for simulation-based training and assessment of MT and supporting educational evidence. Databases Reviewed: PubMed, Embase, Cochrane Library, Web of Science, Directory of Open Access Journals. Methods: Inclusion criteria were MT training and/or skills assessment using all types of training modalities and learners. Studies were divided into 1) descriptive and 2) educational interventional/observational in the analysis. For descriptive studies, we provide an overview of available models including materials and cost. Educational studies were appraised using Kirkpatrick's level of educational outcomes, Messick's framework of validity, and a structured quality assessment tool. Results: Forty-six studies were included consisting of 21 descriptive studies and 25 educational studies. Thirty-one unique physical and three virtual reality simulation models were identified. The studies report moderate to high realism of the different simulators and trainees and educators perceive them beneficial in training MT skills. Overall, simulation-based training is found to reduce procedure time and errors, and increase performance as measured using different assessment tools. None of the studies used a contemporary validity framework and the current educational evidence is limited. Conclusion: Numerous simulation models and assessment tools have been described in the literature but educational evidence and systematic implementation into training curricula is scarce. There is especially a need to establish the effect of simulation-based training of MT in transfer to the operating room and on patient outcomes.

Surgical Training Simulators for Rhinoplasty: A Systematic Review

“…40 There is a need for objective evaluation of outcomes from simulator training that can provide strong evidence to support integration of training with high-validity simulators into practice. 36,39,41 We must understand how skills from simulator training translate to performance in the operating room with real patients as the end goal. 39 Currently in OHNS, simulator validity is described with the Backman validation scale, consisting of face, content, construct, concurrent, and transfer validity, 40 and educational outcomes are described using the Kirkpatrick model.…”

“…17 This study is unique in its focus on rhinoplasty simulation. Most systematic reviews of simulators in facial plastic surgery and OHNS cover multiple procedures of the head and neck, [34][35][36][37][38][39] though inclusion of rhinoplasty simulators is rare. 40 Consistent with these reviews, we found evaluation of efficacy and validity was sparse and inconsistent.…”

A Systematic Review of Simulation-Based Training in Vascular Surgery

“…Additionally, it was recommended as a standard by the American Educational Research Association. 18 , 19 , 20 , 21 , 22 , 23 , 24 , 25 , 26 Nevertheless, this was clearly limited as only one study (1.3%) followed Messick’s modern concept of validity and featured all five validity criteria. 65 This corresponds to a surgical review that found only 6.6% of studies used the modern concept of validity.…”

“…Validity studies were assessed using Messick's modern concept of validity framework, which has been widely utilized in the literature. [16][17][18][19][20][21][22][23][24][25][26] This evaluated the strength of each source of validity evidence using five parameters (Table 1), quantified by Beckman et al 's rating scale, which indicated the strength of validity of each parameter using a scale from 0 to 2 (Table 2). 27 Potential author bias and selective outcome reporting was assessed on a study level.…”

Simulation Versus Written Fall Prevention Education in Older Hospitalized Adults: A Randomized Controlled Study

“…The simulation format may enhance critical thinking and confidence in taking actions. In systematic reviews and meta-analyses of simulation education literature, many investigators found that simulation education was beneficial in training medical (Capitani et al, 2021; Cook et al, 2013; Hovgaard et al, 2021) and nursing personnel (Aslan, 2021; Kim et al, 2016; Piot et al, 2022). However, we could not find contemporary research literature surrounding simulation-based patient-centered falls education.…”