Investigating the learning curve in endoscopic compared to microscopic myringotomy and ventilation tube insertion

Denton, Oliver G.; Daglish, A; Smallman, Luke; Fishpool, S J C

doi:10.1017/s0022215120001188

Cited by 5 publications

(10 citation statements)

References 18 publications

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“…There was no difference in average trial times across all 10 trials between residency programs. including myringotomy and tube insertion (20), mastoidectomy (29), and cochlear implantation (30).…”

Section: Discussionmentioning

confidence: 99%

Defining the Learning Curve for Endoscopic Ear Skills Using a Modular Trainer: A Multi-Institutional Study

Wong¹,

Gorthey²,

Arrighi‐Allisan³

et al. 2023

Otol Neurotol

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ObjectiveQuantify the learning curve for endoscopic ear skills acquisition in otolaryngology residents using a simulator. The secondary objective was to determine if demographic factors or previous endoscopic experience influenced skill development.Study DesignProspective, multicenter study. Resident participants each completed 10 amassed trials using a validated endoscopic ear skill trainer.SettingTwo academic teaching hospitals.SubjectsOtolaryngology residents.Main Outcome MeasuresTrial completion times; rate of improvement over time.ResultsThirty-eight residents completed the study, 26 from program A and 12 from program B. Fifteen participants were women and 23 were men. Mean age was 30 years old (range 26 to 34 years). Previous experience with otoendoscopy (B = −16.7, p = 0.005) and sinus endoscopy (B = −23.4, p = 0.001) independently correlated with lower overall trial times. Age, gender, postgraduate year, handedness, interest in otology, and video gaming were not associated with trial times. On multivariate logistic regression, resident completion times improved with trial number, and residents without previous endoscopy experience improved at a faster rate than those with experience (p < 0.001).ConclusionsNovice surgeons may acquire basic endoscopic ear experience with self-directed simulation training. The learning curve for transcanal endoscopic ear surgery is comparable to those demonstrated for other otologic surgeries, and specific task competencies can be achieved within 10 trials, suggesting that previous experiences, or lack thereof, may not dictate the ability to acquire new skills. There may be a translational value to previous endoscopic sinus experience on learning transcanal endoscopic ear surgery.

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Section: Discussionmentioning

confidence: 99%

Defining the Learning Curve for Endoscopic Ear Skills Using a Modular Trainer: A Multi-Institutional Study

Wong¹,

Gorthey²,

Arrighi‐Allisan³

et al. 2023

Otol Neurotol

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show abstract

“…In the studies that included assessment of performance (39)(40)(41)(42)(43)45,47,49,(51)(52)(53)(54)(55)59,60,62), different assessment methods and tools were used. These were mainly Global Rating Scales (GRS) where the rater for example assigns an overall score based on observation of the performance (39,41,42,45,(51)(52)(53)(54)(55)62);…”

Section: Performance Assessmentmentioning

confidence: 99%

“…Task-Based/Task-Specific Checklists where the rater for example checks if specific sub-tasks are performed or errors made (41,42,(51)(52)(53)55,62); and metrics such as time to completion of the procedure (39)(40)(41)(42)(43)45,49,(52)(53)(54)(55)60). Two studies used completely automated metrics derived from the VR simulators such as procedure time, contact with the external ear canal, number of attempts of tube insertion, etc.…”

Section: Performance Assessmentmentioning

confidence: 99%

“…Seven studies with different study designs included measurement of the effects of SBT on skills performance (42,43,45,49,(52)(53)(54), corresponding to Kirkpatrick level 2b outcomes, and a single recent study further examined transfer of skills to the operating room, corresponding to a level 3 outcome (62). One study found that SBT resulted in a significant improvement in overall performance of ORL trainees and experts on GRS (52), and another study demonstrated significant improvement in medical students' performance using GRS and Task-Based Checklists (54).…”

Section: Outcomes Of Simulation-based Trainingmentioning

confidence: 99%

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

Hovgaard

Al-Shahrestani

Andersen

2021

Otology &Amp; Neurotology

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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.

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“…Denton et al . 's multi-centre study into the learning curve of students undertaking myringotomy and ventilation tube insertion 1 compares the endoscopic to the microscopic technique. The study surprisingly does not support an assumption that the endoscopic technique is harder to learn, and may be easier than the standard microscope technique.…”

mentioning

confidence: 99%

Learning curves, undergraduate ENT, patulous Eustachian tube anatomy and managing necrotising otitis externa

Fisher¹,

Fishman²

2020

J. Laryngol. Otol.

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Investigating the learning curve in endoscopic compared to microscopic myringotomy and ventilation tube insertion

Cited by 5 publications

References 18 publications

Defining the Learning Curve for Endoscopic Ear Skills Using a Modular Trainer: A Multi-Institutional Study

Defining the Learning Curve for Endoscopic Ear Skills Using a Modular Trainer: A Multi-Institutional Study

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

Learning curves, undergraduate ENT, patulous Eustachian tube anatomy and managing necrotising otitis externa

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