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Morris S, Owens D, Cserzo D. Learning needs of junior doctors in otolaryngology: a qualitative study. J Laryngol Otol 2024; 138:592-600. [PMID: 38230502 DOI: 10.1017/s0022215124000100] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2024]
Abstract
OBJECTIVES There is concern that junior doctors are not prepared for their post-graduate attachments in ENT. The aims of this study were to capture the learning priorities of those in the ENT first on-call role and facilitate further educational opportunities to address these needs. METHOD Semi-structured interviews were undertaken to explore the learning needs of junior doctors with seven junior and two senior ENT clinicians. RESULTS The thematic analysis generated three themes: the role of the ENT Junior; the perceived, expressed and prescribed learning needs; and attitudes towards future learning. These themes explored the misalignment between undergraduate training and post-graduate expectations, the lack of competence in ENT practical skills and the need for focused ENT training prior to commencing on-call shifts. CONCLUSION All interviewees identified the need for greater experience in practical interventional skills prior to their ENT attachments and expressed interest towards a standardised, bootcamp-style induction with simulated emergency experience.
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Affiliation(s)
- Simon Morris
- Department of ENT, Glangwili General Hospital, Carmarthen, Wales, UK
| | - David Owens
- Department of ENT, University Hospital Wales, Cardiff, Wales, UK
| | - Dorottya Cserzo
- School of Social Sciences, Cardiff University, Cardiff, Wales, UK
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Devakumar H, Tailor BV, Myuran T, Ioannidis D. Assessment of YouTube as an educational tool in teaching flexible nasendoscopy and peritonsillar abscess drainage. J Laryngol Otol 2023; 137:1110-1117. [PMID: 36155641 DOI: 10.1017/s0022215122002110] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
BACKGROUND Partly as a result of coronavirus disease 2019, YouTube has become a more frequent educational source for otolaryngology trainees. This study sought to assess the quality of flexible nasendoscopy and peritonsillar abscess drainage videos. METHOD YouTube was systematically searched using 13 terms related to flexible nasendoscopy and peritonsillar abscess drainage. Two independent reviewers assessed the quality of each video using the Laparoscopic Video Educational Guidelines. RESULTS Twenty-seven videos were deemed suitable. The mean total Laparoscopic Video Educational Guidelines scores for videos on flexible nasendoscopy (18 videos) and peritonsillar abscess drainage (9 videos) were 10.3 (standard deviation = 3.1) and 11.7 (standard deviation = 4.6), respectively. Most of the videos were deemed of medium quality. The Laparoscopic Video Educational Guidelines score correlated positively with flexible nasendoscopy video length and how recently a peritonsillar abscess drainage video had been uploaded. CONCLUSION The limited high-quality videos on YouTube are difficult to identify from the search metrics available. Trainees and ENT induction programmes would benefit greatly from an online platform that contains a catalogue of high-quality surgical videos.
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Affiliation(s)
- H Devakumar
- ENT Department, Colchester Hospital, East Suffolk and North Essex NHS Foundation Trust, Colchester, UK
| | - B V Tailor
- ENT Department, Colchester Hospital, East Suffolk and North Essex NHS Foundation Trust, Colchester, UK
| | - T Myuran
- ENT Department, Colchester Hospital, East Suffolk and North Essex NHS Foundation Trust, Colchester, UK
| | - D Ioannidis
- ENT Department, Colchester Hospital, East Suffolk and North Essex NHS Foundation Trust, Colchester, UK
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Wajsberg B, Li D, Kohanzadeh A, Bitners AC, Gorthey S, Gibber MJ, Rong E, Bent JP, Gangar M, Yang CJ. Impact of a postgraduate year one (PGY-1) otolaryngology bootcamp on procedural skill development. MEDEDPUBLISH 2022; 12:47. [PMID: 36168536 PMCID: PMC9427082 DOI: 10.12688/mep.19187.1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/22/2022] [Indexed: 11/20/2022] Open
Abstract
Background:
To measure the impact of an intensive eight-week postgraduate year one (PGY-1) otolaryngology bootcamp on the acquisition and retention of otolaryngology residents’ procedural skills compared to the traditional method of skill acquisition through clinical exposure. Methods: Residents at our institution were evaluated on their performance of flexible laryngoscopy, suture ligature, and rigid bronchoscopy setup at three time points: pre-bootcamp, one-week post-bootcamp, and one-year post-bootcamp. Video recordings were scored by two blinded faculty reviewers using a multipoint rating system. A control group of rising postgraduate year two (PGY-2) residents who did not participate in bootcamp were recorded performing these same skills. Scores in the three skills were compared between groups via
t-tests. The eight-week bootcamp curriculum for PGY-1s was held at the Montefiore Einstein Center for Innovation in Simulation at Albert Einstein College of Medicine/Montefiore Medical Center. The participants were two classes of PGY-1 residents (n=8) at our institution who participated in a bootcamp at the beginning of residency, and one class of rising PGY-2 residents (n=3) who did not participate in a bootcamp (control group). Results: A comparison of pre-bootcamp scores to one-week post-bootcamp scores showed significant improvement in suture ligature (
P<0.05) and rigid bronchoscopy (
P<0.05), but no difference in flexible laryngoscopy (
P=0.54). Suture ligature (
P=0.09) and rigid bronchoscopy (
P=0.25) skills were not significantly different from one-week post-bootcamp to one-year post-bootcamp; however, a significant skill improvement was observed in flexible laryngoscopy (
P<0.05). By June of PGY1 year, the two bootcamp cohorts were similar to controls in all three skills: flexible laryngoscopy (
P=0.05), rigid bronchoscopy (
P=0.26), and suture ligature (
P=0.10). Conclusions: Participation in PGY-1 bootcamp was associated with improved acquisition and short-term retention of basic procedural skills, suggesting that bootcamps can be an effective arena to teach basic skills in otolaryngology. PGY-1 bootcamp is a promising arena for multi-institutional development.
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Affiliation(s)
| | - Daniel Li
- Department of Surgery (Division of Otolaryngology), Yale School of Medicine, New Haven, Connecticut, USA
| | | | - Anna C. Bitners
- Department of Pediatrics, Johns Hopkins Medicine, Baltimore, Maryland, USA
| | - Scott Gorthey
- Department of Otorhinolaryngology–Head & Neck Surgery, Montefiore Medical Center, Bronx, New York, USA
| | - Marc J. Gibber
- Department of Otorhinolaryngology–Head & Neck Surgery, Montefiore Medical Center, Bronx, New York, USA
| | - Esther Rong
- Department of Radiology, Montefiore Medical Center, Bronx, New York, USA
| | - John P. Bent
- Department of Otorhinolaryngology–Head & Neck Surgery, Montefiore Medical Center, Bronx, New York, USA
| | - Mona Gangar
- Department of Otorhinolaryngology–Head & Neck Surgery, Montefiore Medical Center, Bronx, New York, USA
| | - Christina J. Yang
- Department of Otorhinolaryngology–Head & Neck Surgery, Montefiore Medical Center, Bronx, New York, USA
- Department of Pediatrics, Montefiore Medical Center/Children’s Hospital at Montefiore, Bronx, New York, USA
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Bondzi-Simpson A, Lindo CJ, Hoy M, Lui JT. The Otolaryngology boot camp: a scoping review evaluating commonalities and appraisal for curriculum design and delivery. J Otolaryngol Head Neck Surg 2022; 51:23. [PMID: 35659365 PMCID: PMC9167522 DOI: 10.1186/s40463-022-00583-9] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/26/2021] [Accepted: 05/12/2022] [Indexed: 11/10/2022] Open
Abstract
OBJECTIVE Surgical boot camps are becoming increasingly popular in Otolaryngology-Head and Neck Surgery (OHNS) residency programs. Despite pioneering virtual reality and simulation-based surgical education, these boot camps have lacked critical appraisal. The objective of this article was to examine the adoption and utility of surgical boot camps in OHNS residency training programs around the world. DATA SOURCES Ovid Medline and PubMed databases were systematically searched in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines for scoping reviews. Additionally, a grey literature search was performed. REVIEW METHODS Inclusion criteria were peer-reviewed publications and grey literature sources that reported on OHNS boot camps for the novice learner. The search was restricted to human studies published in English. Studies were excluded if they were not examining junior trainees. RESULTS A total of 551 articles were identified. Following removal of duplicates, screening, and full text review, 16 articles were included for analysis. Seven major boot camps were identified across various academic sites in the world. Most boot camps were one-day intensive camps incorporating a mixture of didactic, skill specific, and simulation sessions using an array of task trainers and high-fidelity simulators focusing on OHNS emergencies. Studies measuring trainee outcomes demonstrated improvement in trainee confidence, immediate knowledge, and skill acquisition. CONCLUSION Surgical boot camps appear to be an effective tool for short term knowledge and skill acquisition. Further studies should examine retention of skill and maintenance of confidence over longer intervals, as little is known about these lasting effects.
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Affiliation(s)
- Adom Bondzi-Simpson
- Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada
- Division of General Surgery, Department of Surgery, University of Toronto, Toronto, ON, Canada
| | - C J Lindo
- Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada
| | - Monica Hoy
- Section of Otolaryngology-Head and Neck Surgery, Department of Surgery, University of Calgary, Calgary, AB, Canada
| | - Justin T Lui
- Section of Otolaryngology-Head and Neck Surgery, Department of Surgery, University of Calgary, Calgary, AB, Canada.
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Changes in the provision of undergraduate ENT clinical placements across the United Kingdom in response to the COVID-19 pandemic. The Journal of Laryngology & Otology 2021; 136:24-28. [PMID: 34839852 DOI: 10.1017/s0022215121003960] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
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Dell'Era V, Garzaro M, Carenzo L, Ingrassia PL, Aluffi Valletti P. An innovative and safe way to train novice ear nose and throat residents through simulation: the SimORL experience. ACTA ACUST UNITED AC 2021; 40:19-25. [PMID: 32275645 PMCID: PMC7147547 DOI: 10.14639/0392-100x-n0128] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2019] [Accepted: 08/11/2019] [Indexed: 11/23/2022]
Abstract
Medical simulation enables trainees to learn procedural skills in a tailored, non-threatening, controlled environment that can provide feedback and educational experiences. The goals of this study are to describe the set-up and execution of an educational intervention (SimORL) in Ear Nose and Throat (ENT) simulation, to report confidence in performing basic ENT procedures before and after the event and investigate whether participants would find it useful and educationally effective. SimORL was a two-day formative event held at SIMNOVA - Eastern Piedmont Simulation Centre, Italy. The event was open to ENT trainees from any Italian ENT training program; participants were divided into 5 teams and rotated around 10 different simulation stations over two days. Stations included: high-fidelity, skill trainer, computer based, wet lab and dissection. Stations were: virtual otoscopy (OtoSim®), simulated clinical cases with high-fidelity mannequin (e.g. epistaxis) or standardised patients (e.g. vestibular neuronitis), robotic surgery (Da Vinci®), human anatomy (zSPACE AIO®), surgical tracheostomy (wet model), cadaveric sino-nasal endoscopy (wet model), crisis resource management (team exercise), surgical sutures (Limbs&Things SkinPad®), surgical set station and team building exercises. Participants were asked to complete a pre- and post-test that queried previous experience and confidence using 10-item unanchored semantic scales. Results are presented as median (25-75 percentile). Satisfaction was assessed by a validated 5-item Likert Simulation Experience Scale (SSES). Twenty-three ENT trainees attended SimORL 2018. Only 3 participants reported limited previous simulation experience. Pre-post confidence significantly improved between before and after the event. Overall satisfaction with Simulation Experience Scale (SSES) was very high with a median of 4.5 of 5. Regarding simulation evaluation, the most appreciated station was nasal endoscopy (10/10), while the least appreciated was otoscopy (6/10). SimORL proved to be a highly rated and useful educational tool to improve junior ENT trainees’ confidence in performing basic ENT procedures.
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Affiliation(s)
| | | | - Luca Carenzo
- SIMNOVA, Centro Interdipartimentale di Didattica Innovativa e di Simulazione in Medicina e Professioni Sanitarie, Università del Piemonte Orientale, Novara, Italy
| | - Pier Luigi Ingrassia
- SIMNOVA, Centro Interdipartimentale di Didattica Innovativa e di Simulazione in Medicina e Professioni Sanitarie, Università del Piemonte Orientale, Novara, Italy
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Current innovations in otolaryngology medical education in the UK: a systematic literature review. The Journal of Laryngology & Otology 2020; 134:284-292. [PMID: 32178742 DOI: 10.1017/s0022215120000493] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
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.
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Abstract
Abstract
Purpose of Review
“Non-technical skills” are critical to patient safety and form an important part of a surgeon’s competency. Inter-disciplinary team training is now considered essential to train these valuable skills. This review discusses the importance of non-technical skills, and the role these skills have in simulation training within Otolaryngology.
Recent Findings
Otolaryngologists are uniquely positioned to encounter airway emergencies. Consequently, team-based training in crisis scenarios is especially important. Simulation can occur in situ or in the simulated setting, with “boot-camps” becoming a popular training intervention. Whilst team training within otolaryngology has been shown to be highly effective, formal assessment of these skills is not currently routine, with no assessment tool specifically tailored to ENT.
Summary
Simulation-based training is an effective and feasible method of teaching non-technical skills in Otolaryngology. With the shift towards competency-based medical education, formal assessment of these skills is important to perform.
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Cervenka BP, Hsieh TY, Lin S, Bewley A. Multi-Institutional Regional Otolaryngology Bootcamp. Ann Otol Rhinol Laryngol 2020; 129:605-610. [PMID: 31994404 DOI: 10.1177/0003489420903067] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
INTRODUCTION In order to increase junior resident physician proficiency and improve patient safety, simulation-based procedural training courses, or bootcamps, have been become an emerging educational tool. OBJECTIVES To compare pre- and post-course confidence levels and to assess station efficacy after completion of our single day bootcamp. METHODS We developed the University of California (UC) Davis otolaryngology bootcamp, a single day course including six cadaveric task trainer stations and four simulations. The six task trainer stations included (1) Epistaxis, (2) Cricothyrotomy/tracheostomy, (3) Peritonsillar abscess/auricular hematoma, (4) Nasal bone reduction/zygoma reduction/lateral canthotomy/canalicular trauma and probing, (5) Local nerve blocks, and (6) Soft tissue reconstruction. The simulations comprised of airway fire during tracheostomy, pediatric respiratory code during airway evaluation, dislodged pediatric tracheostomy tube in the ICU, and angioedema in the emergency department with inability to intubate or ventilate. Junior residents from multiple locoregional institutions were recruited to participate. Pre- and post-course Likert surveys assessing participant confidence and station efficacy were collected and analyzed. RESULTS There was a statistically significant increase in resident confidence levels for all task trainer stations. All stations had a station efficacy Likert score average of 4 "very effective" or 5 "most effective." CONCLUSION A multi-institutional, locoregional, simulation-based bootcamp can be a valuable adjunct to junior resident training. It can promote camaraderie, pool limited resources, and may be cost-effective.
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Affiliation(s)
- Brian P Cervenka
- Department of Otolaryngology, Division of Head and Neck Surgery, University of California, Davis, Sacramento, CA, USA
| | - Tsung-Yen Hsieh
- Department of Otolaryngology, Division of Head and Neck Surgery, University of California, Davis, Sacramento, CA, USA
| | - Sharon Lin
- Department of Otolaryngology, Division of Head and Neck Surgery, University of California, Davis, Sacramento, CA, USA
| | - Arnaud Bewley
- Department of Otolaryngology, Division of Head and Neck Surgery, University of California, Davis, Sacramento, CA, USA
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Validation of a new ENT emergencies course for first-on-call doctors. The Journal of Laryngology & Otology 2017; 131:106-112. [PMID: 28069096 DOI: 10.1017/s002221511601001x] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
BACKGROUND First-on-call ENT cover is often provided by junior doctors with limited ENT experience; yet, they may have to manage life-threatening emergencies. An intensive 1-day simulation course was developed to teach required skills to junior doctors. METHODS A prospective, single-blinded design was used. Thirty-seven participants rated their confidence before the course, immediately following the course and after a two-month interval. Blinded assessors scored participant performance in two video-recorded simulated scenarios before and after the course. RESULTS Participant self-rated confidence was increased in the end-of-course survey (score of 27.5 vs 53.0; p < 0.0001), and this was maintained two to four months after the course (score of 50.5; p < 0.0001). Patient assessment and management in video-recorded emergency scenarios was significantly improved following course completion (score of 9.75 vs 18.75; p = 0.0093). CONCLUSION This course represents an effective method of teaching ENT emergency management to junior doctors. ENT induction programmes benefit from the incorporation of a simulation component.
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