Training in ENT; a comprehensive review of existing evidence

Abstract

Despite an expansion of fellowship opportunities over the last three decades, there is still incomplete regulation and standardisation of fellowship training. The aim of this comprehensive review was to examine existing evidence about the ear, nose and throat (ENT) training, especially focused on surgical and non-surgical aspects of the training. It is challenging to critically evaluate and compare training programmes across nations for several reasons. Studies on the subject rely entirely on trainee self-reports, without any objective comparators between groups. No evidence exists that directly compares the theoretical or practical attainment of trainees between nations. More fundamentally, trainee exposure to, and competence in, elective surgical procedures, is not the sole measure of a training programme, nor can it be viewed in isolation from the health system's expectations of a newlyqualified specialist, which may vary. During recent years, the Internet and e-learning methods were implemented into the training curriculum. Also, there is an increasing number of platforms that can host the ENT learning content free of charge. Novel educational tools are powerful alternative to standard teaching techniques within otorhinolaryngology education for both residents and medical students. Overall evidence for virtual reality (VR) simulators could be implemented as adjunct in training programs but cannot replace conventional methods. This is mainly due to the fact that actual surgical outcomes after VR training have not been studied so far, but may be the content of future larger scale studies. The otolaryngologists' non-surgical training needs to extend beyond the limits of ENT as skills and experience in areas of ENT, respiratory medicine, allergology, infectious diseases, radiology and oncology are required in the diagnosis and management of ENT diseases.

Rhinology: Simulation Training (Part 2)

“…To this end, the efficacy of these novel educational tools was examined in a comprehensive systematic review which shows e-learning to be a powerful alternative to standard teaching techniques within otolaryngology education, for both residents and medical students. Of the 12 studies included within this review, nine reported either improved objective performance in academic or clinical measures, or no difference in performance but higher satisfaction with use of elearning [6,44]. However, technical skill was not assessed in these studies and, though this type of improvement has been demonstrated in other specialties, such a benefit has not been demonstrated in ENT [44].…”

“…Web learning in medical education has become increasingly popular due to its advantages over traditional teaching methods such as flexible scheduling, reduced costs and individualised instruction [6]. In surgical specialties, elearning includes the use of virtual patient cases, digital modelling and online tutorials [35].…”

Allergy Practices in Otorhinolaryngology Residency Programs in Turkey: Quo Vadis?

“…In the United States, otolaryngic allergy education, including didactics and hands-on training, during ORL residency, has been mandated by the American Board of Otolaryngology and the Postgraduate Medical Education Accreditation Council ( 4 ). Also, the logbook, prepared by The European Union of Medical Specialist (UEMS) ORL Section, to provide standardization in ORL training programs in pan-Europe, aims to ensure ORL residents with the skills of allergy practice ( 5 ). Turkey is also a member of the Confederation of European Otorhinolaryngology-Head and Neck Surgery (ORL-HNS).…”