Current Status of Simulation in Otolaryngology: A Systematic Review

Musbahi, Omar; Aydın, Abdullatif; Omran, Yasser Al; Skilbeck, Christopher J.; Ahmed, Kamran

doi:10.1016/j.jsurg.2016.09.007

Cited by 86 publications

(90 citation statements)

References 86 publications

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“…Our relatively small and insular specialty (i.e., a large program has five residents per year) may be insulated from the July effect due to our strength in those specific areas. For example, within the otolaryngology community, simulation training is a rich area of research, with over 64 published simulators, and academic programs should continue incorporating it into residency programs . Furthermore, in a survey of residents and faculty members regarding the mentorship in the program, 98% of residents had an approachable mentor to provide constructive criticism and guidance …”

Section: Discussionmentioning

confidence: 99%

The “July effect”: Outcomes in microvascular reconstruction during resident transitions

et al. 2019

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Objectives/Hypothesis To evaluate the “July effect,” as a possible risk factor for perioperative complications in otolaryngology microvascular reconstruction during the transitional period in the academic calendar. Study Design Retrospective database review. Methods Microvascular reconstruction outcomes in the National Surgical Quality Improvement Program (2005–2016) database were compared between the first academic quarter (July–September) to the last academic quarter (April–June). The primary outcome was 30‐day morbidity, and secondary outcomes included 30‐day mortality, operative complications, or postoperative adverse events. Results There were 612 and 580 patients who underwent microvascular reconstruction during the first and last academic quarters, respectively. There was no significant difference between the 30‐day mortality between the first academic quarter (1.5%) and the last academic quarter (0.7%) (P = .194). There was no difference in 30‐day morbidity (47.9% vs. 49.5%, P = .586), operative complications (wound disruption, P = .151; bleeding, P = .526; operative time, P = .162), or postoperative adverse events (deep vein thrombosis, P = .460; pneumonia, P = .737; reintubation, P = .201; pulmonary embolism, P = .452; ventilation for >48 hours, P = .769; acute renal failure, P = .500; urinary tract infection, P = .693; unplanned readmission, P = .202; and mean length of stay, P = .497). Conclusions There appears to be no July effect in microvascular reconstruction. Further studies should identify the mechanisms that preserve the safety of this operation year‐round for application to other areas of medicine who have observed the July effect. Level of Evidence NA Laryngoscope, 130:893–898, 2020

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Section: Discussionmentioning

confidence: 99%

The “July effect”: Outcomes in microvascular reconstruction during resident transitions

et al. 2019

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“…An additional factor that impacts on the utility of any simulation model is the availability and cost of the model. Generally, animal models are significantly less expensive and more readily available than other forms of simulation model (e.g., virtual reality simulation or cadaveric simulation) . However, any variability in unit cost must be considered to determine the viability of providing a simulation training program.…”

Section: Discussionmentioning

confidence: 99%

A systematic review of simulated laryngotracheal reconstruction animal models

et al. 2018

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Objectives Review of the literature to identify practical, high‐fidelity, commercially available animal models for simulation training and surgical skills maintenance in laryngotracheal reconstruction (LTR). Methods A systematic review of PubMed and Embase databases was conducted independently by two authors, according to Preferred Reporting Items for Systematic Reviews and Meta‐Analyses guidelines. Search terms included “laryngotracheal reconstruction,” “laryngotracheoplasty,” “pig and larynx,” “sheep and larynx,” and “rabbit and larynx.” Articles were then assessed, identifying model cost and availability, model validation, feasibility as a training tool, and verisimilitude to pediatric LTR. Results In total, 79 articles were considered suitable for inclusion in the study, incorporating both in vitro and in vivo models. Models utilized included rabbit (n = 69), pig (n = 7), sheep (n = 1), and goat (n = 2). The rabbit model was similar in size to the neonate, but differences in laryngeal anatomy and cartilage texture made graft insertion difficult. The anatomy of the pig, sheep, and goat larynges more closely resembled the pediatric patient, allowing improved grafting, but corresponded more in size to that of an older child. Commercial availability of the pig and sheep was considered greatest, and was reflected in cost. None of the animal models identified in the literature have been validated as a simulation tool. Conclusions The rabbit, sheep and pig models seemed to demonstrate the greatest potential for use as advanced pediatric airway surgery simulation models, with the rabbit model being most utilized in the literature. However, as yet there have been no models formally validated as a simulation training tool. Laryngoscope, 129:235–243, 2019

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“…Despite the fact that these systems have been present for over 10 years they have not reached mainstream training. There appears to be several limitations with these systems include suboptimal realism, lack of scientifically rigorous validation studies, cost and lack of valid and reliable assessment tools to assess performance after training 68 . The lack of realism has been pointed out in particular in temporal bone VR simulators.…”

Section: Introductionmentioning

confidence: 99%

“…Furthermore, the lack of scientifically rigorous validation/outcome studies continues to limit integration of VR and other simulators into regular training programs 1,68 . Otolaryngology is not alone in this area as most studies of technology enhanced simulation training and assessment in health professions fall short of modern psychometric research 70 .…”

Section: Introductionmentioning

confidence: 99%

Otologic Skills Training

Wiet

Sørensen

Andersen

2017

Otolaryngologic Clinics of North America

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Synopsis This review presents a summary of the current activity of simulation training for otologic skills. Simulation training has been demonstrated in a large spectrum of skills from simple otoscopy to advanced temporal bone surgical procedures and these are individually addressed. There is a wide variety of educational approaches, assessment tools and simulators in use including simple low cost task trainers to complex computer based virtual reality systems. A systematic approach to otologic skills training using adult learning theory concepts such as repeated and distributed practice, self-directed learning, and mastery learning is necessary for these educational interventions to be effective. Future directions include development of valid, universally accepted measures of performance to assess efficacy of simulation training interventions and for complex procedures, improvement in fidelity based on the educational goals for the particular skill.

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Current Status of Simulation in Otolaryngology: A Systematic Review

Cited by 86 publications

References 86 publications

The “July effect”: Outcomes in microvascular reconstruction during resident transitions

The “July effect”: Outcomes in microvascular reconstruction during resident transitions

A systematic review of simulated laryngotracheal reconstruction animal models

Otologic Skills Training

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