Implementation and results of a surgical training programme for chronic suppurative otitis media in Cambodia

Abstract

The training programme has demonstrated success, as measured by surgeon confidence and operative outcomes. This approach can be emulated in other settings to help combat the global burden of chronic suppurative otitis media.

Training for hearing care providers

“…Interviews with ear, nose and throat trainees in Cambodia revealed they deemed these types of missions to be of little educational value. 37 Coordinated missions can, however, be fruitful. A collaboration between ear, nose and throat departments in three North American medical schools (University of British Columbia, New York University School of Medicine and University of Ottawa) delivered incountry training in Uganda through frequent missions and a structured training programme.…”

“…In Cambodia, two local ear, nose and throat trainees were trained by visiting ear, nose and throat specialists from the United Kingdom. 37 The first visiting surgeon was a continuous resident for six months and taught tympanoplasty. The second surgeon was a continuous resident for four months and taught mastoidectomy.…”

“…At the end of this period, trainees were able to perform both operations independently, with high self-reported confidence and surgical success (for tympancoplasty: 88%; 100/113; tympanic membrane closure and 81%; 76/89; with improved hearing). 37 It is uncertain if those with lower levels of background training could also perform ear surgery. Clinical or medical officers, who are not doctors, have been trained to deliver surgical care, such as laparotomy or caesarean section, in many countries, 39 In some countries, such as Cameroon, Kenya, Malawi, Mali and Togo, 6 this training includes performing simple ear, nose and throat operations, such as removal of foreign bodies, adenoidectomy or tonsillectomy.…”

Models of service delivery for ear and hearing care in remote or resource-constrained environments

“…I have led a successful in-country surgical training programme in Cambodia, where training was provided over several months by a visiting fellow, with demonstrable quantitative and qualitative educational outcomes. 54…”

“…It can be difficult to provide high-quality training through intermittent visits. I have led a successful in-country surgical training programme in Cambodia, where training was provided over several months by a visiting fellow, with demonstrable quantitative and qualitative educational outcomes 54 Table 2.Examples of charitable organisations providing ear and hearing outreach services…”