Student-selected components: bringing more ENT into the undergraduate curriculum

A lecture series - neurosurgery in an Irish Medical School without an associated neurosurgical Centre

Background: Neurosurgery is a surgical specialty that is felt to be under-represented in its teaching and education at an undergraduate level in Irish medical schools, particularly in those which are not attached to a specialist neurosurgical centre. We looked at exposure to neurosurgery among undergraduate students by organising two neurosurgical lecture days for the 2020/2021 final year medical class of National University of Ireland Galway (NUIG), an Irish medical school which is not associated with a neurosurgical centre. This study sought to ascertain students' engagement with and, respectively, desire for a greater emphasis on common subjects within neurosurgery as part of an undergraduate curriculum, specifically in a medical school without an associated neurosurgical centre.Methods: The lecture series was organised by a final year medical student in NUI Galway in conjunction with the National Neurosurgical Centre, Beaumont Hospital. The lectures took place over the course of two separate lecture days on Saturday October 10th and Saturday November 14th, respectively. Both lecture days were broadcast virtually, in compliance with COVID-19 guidelines, to the NUIG 2020/2021 final year medical class and the content covered therein composed part of the examinable syllabus for their final year medical exams. All class members were provided with an online pre-lecture survey prior to the initial lecture day and two post-lecture surveys, one at the end of each respective lecture day.Results: 194 final year medical students from a class of 205 attended over the course of the two given lecture days. Of the 148 students that completed the pre-lecture survey only 13 students had previously attended a neurosurgical lecture or conference. Of the 194 attendees, there were 116 students who completed the final post-lecture survey, 62% of whom agreed that they would like to receive further teaching and clinical exposure to neurosurgery as part of their undergraduate medical education.

Current innovations in otolaryngology medical education in the UK: a systematic literature review

OBJECTIVE

Recent studies have indicated a lack of ENT training at the undergraduate and post-graduate levels. This study aimed to review the impact of recent educational innovations in improving ENT training for medical students and junior doctors in the UK.

METHODS

Three independent investigators conducted a literature search of published articles on ENT education. Included studies were analysed using qualitative synthesis methods.

RESULTS

An initial search yielded 2008 articles; 44 underwent full-text evaluation and 5 were included for final analysis. Most included studies demonstrated benefits for students when compared to existing teaching standards in terms of objective assessment (knowledge and skills gained) or subjective assessment (confidence and preference) following implemented educational innovations.

CONCLUSION

This study identified educational innovations developed in the past 15 years to enhance the teaching of core ENT competencies. More research is needed to establish their impact on the state of ENT medical education in the UK.

Night emergency cover for ENT in England: a national survey

Objectives:

To evaluate the quality of out-of-hours ENT on-call cover by junior doctors, in view of the European Working Time Directive and the recent changes in the National Health Service workforce due to the ‘Modernising Medical Careers’ initiative, in England.

Methods:

We performed a national survey of first-on-call doctors for ENT, using a telephone questionnaire. Hospital contact details were sourced from the National Health Service website. The inclusion criterion was hospitals providing acute ENT facilities overnight in England.

Results:

One hundred and nineteen hospitals were contacted; 91 were eligible, and 83 interviews were conducted. The grade of the first-on-call ENT doctor ranged from foundation year two (19 per cent) to registrar level or above (13 per cent). Forty-nine respondents (68 per cent) reported having no previous ENT experience. Fifty-three respondents (74 per cent) covered more than one speciality at night, with seven (10 per cent) covering four or more specialities. The second-on-call doctor was non-resident in 63 cases (88 per cent). Thirty respondents (42 per cent) stated that they did not feel comfortable managing common ENT emergencies as the first doctor on call. Otorhinolaryngology induction courses were offered in 37 of the respondents’ hospitals (51 per cent), these courses were of varying duration.

Conclusion:

Night-time ENT care is often provided by junior doctors with little experience of the speciality, who are often also responsible for covering multiple specialities. Many reported not feeling comfortable managing common ENT emergencies. Structured induction programmes would help to provide basic knowledge and should be mandatory for all doctors covering ENT.

Qualitative synthesis and systematic review of otolaryngology in undergraduate medical education

OBJECTIVE

Although 25% of primary care complaints are otolaryngology related, otolaryngology instruction is not required in most medical schools. Our aim was to systematically review existing literature on the inclusion of otolaryngology in undergraduate medical education.

DATA SOURCES

PubMed, Embase, Cumulative Index to Nursing and Allied Health Literature, and Education Resources Information Center.

STUDY DESIGN/REVIEW METHODS

Our search encompassed all indexed years through December 29, 2014. Inclusion criteria were English language, original human data, and a focus on medical student education. Data regarding study design, teacher, educational topic, educational methods, and setting were extracted from each article. Two investigators independently reviewed all articles.

RESULTS

Our initial search yielded 436 articles; 87 underwent full-text evaluation and 47 remained in the final review. The majority of studies were conducted in the United States (40%), United Kingdom (23%), and Canada (17%) and represented a single institutional experience. Studies were classified as needs assessments (36%), curriculum descriptions (15%), educational methods (36%), and skills assessments (32%); 81% were levels of evidence 3 or 4. Most reports indicated that otolaryngology rotations are not compulsory.

CONCLUSIONS

Studies indicated the need for increased exposure to otolaryngology. Educational methods such as team-based learning, simulation, online learning, and clinical skills assessments may offer ways to increase exposure without overburdening clinical faculty and require further study. Data suggest that a universal otolaryngology medical student curriculum would be valuable and aid in resource sharing across institutions. We recommend that an assessment be performed to determine topics and skills that should comprise this curriculum.

LEVEL OF EVIDENCE

NA.

The otolaryngology, head and neck training appraisal questionnaire: a national general practice perspective

BACKGROUND

Diseases of the Ear, Nose and Throat (ENT) make up a considerable proportion of the everyday workload of general practitioners (GPs). It is recognized that ENT makes up a very small part of the undergraduate curriculum, but some post-graduate training schemes are now offering placements in Otolaryngology.

AIM

The aim of the study was to examine a perceived knowledge 'gap' of GPs in the area of Otolaryngology.

METHOD

A postal questionnaire was sent to 1,000 GPs distributed evenly throughout the country.

RESULTS

There was a 47.3 % response rate; 72 % of GPs felt that they would see at least three or more children with a relevant ENT problem each day. Almost 70 % of GPs had less than a month exposure to ENT in medical school and 84 % of GPs felt that further emphasis was required at the undergraduate level. Twenty-one per cent of GPs surveyed had spent some time in Postgraduate ENT training. Ninety-one per cent of GPs agreed that further emphasis on ENT training was required at the Postgraduate level.

CONCLUSION

General Practitioners feel that increased importance should be placed on the study of Otolaryngology at both undergraduate and Postgraduate level.