1
|
Shah HP, Sheth AH, Abdou H, Lerner MZ. Initiatives for Early Medical Student Engagement with the Field of Otolaryngology - Head and Neck Surgery. J Laryngol Otol 2022; 137:577-581. [PMID: 36169118 DOI: 10.1017/s0022215122002122] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
OBJECTIVE Early exposure and mentorship in surgical specialties like otolaryngology - head and neck surgery are critical for medical students. This paper presents initiatives implemented at our institution to engage early-career medical students with the field. METHODS A hands-on laryngoscope workshop was organised, and a centralised online platform was created for research and mentorship opportunities using a collaborative project management tool. Both measures were advertised via e-mail to student interest groups and campus diversity groups. At the end of the workshop, participating students completed an online distributed survey. RESULTS Students' perception of their knowledge of airway anatomy and related clinical scenarios significantly improved after the laryngoscopy workshop (p = 0.001 and p = 0.002, respectively). All attendees indicated that the workshop increased their comfort level with procedures and that they would recommend the workshop to colleagues. Nearly half of participants reported becoming 'very interested' in exploring otolaryngology - head and neck surgery through future elective courses. CONCLUSION Implementation of such initiatives at other institutions can generate medical student interest and may improve diversity in otolaryngology - head and neck surgery.
Collapse
Affiliation(s)
- H P Shah
- Yale University School of Medicine, New Haven, CT, USA
| | - A H Sheth
- Yale University School of Medicine, New Haven, CT, USA
| | - H Abdou
- Yale University School of Medicine, New Haven, CT, USA
| | - M Z Lerner
- Division of Otolaryngology - Head and Neck Surgery, Department of Surgery, Yale University School of Medicine, New Haven, Connecticut, USA
| |
Collapse
|
2
|
Price JG, Spiegel DY, Yoo DS, Moravan MJ, Mowery YM, Niedzwiecki D, Brizel DM, Salama JK. Development and Implementation of an Educational Simulation Workshop in Fiberoptic Laryngoscopy for Radiation Oncology Residents. Int J Radiat Oncol Biol Phys 2020; 108:615-619. [PMID: 32417408 DOI: 10.1016/j.ijrobp.2020.05.009] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2020] [Revised: 04/23/2020] [Accepted: 05/06/2020] [Indexed: 02/01/2023]
Abstract
PURPOSE Fiberoptic laryngoscopy (FOL) is a critical tool for the diagnosis, staging, assessment of treatment response, and detection of recurrence for head and neck (H&N) malignancies. No standardized recommendations exist for procedural FOL education in radiation oncology. We therefore implemented a pilot simulation workshop to train radiation oncology residents in pertinent H&N anatomy and FOL technique. METHODS AND MATERIALS A 2-phase workshop and simulation session was designed. Residents initially received a lecture on H&N anatomy and the logistics of the FOL examination. Subsequently, residents had a practical session in which they performed FOL in 2 simulated environments: a computerized FOL program and mannequin-based practice. Site-specific attending physicians were present to provide real-time guidance and education. Pre- and postworkshop surveys were administered to the participants to determine the impact of the workshop. Subsequently, postgraduate year (PGY)-2 residents were required to complete 6 supervised FOL examinations in clinic and were provided immediate feedback. RESULTS Annual workshops were performed in 2017 to 2019. The survey completion rate was 14 of 18 (78%). Participants ranged from fourth-year medical students to PGY-2 to PGY-5 residents. All PGY-2 residents completed their 6 supervised FOL examinations. On a 5-point Likert scale, mean H&N anatomy knowledge increased from 2.4 to 3.7 (standard deviation = 0.6, P < .0001). Similarly, mean FOL procedural skill confidence increased from 2.2 to 3.3 (standard deviation = 0.7, P < .0001). These effects were limited to novice (fourth-year medical students to PGY-2) participants. All participants found the exercise clinically informative. CONCLUSIONS A simulation-based workshop for teaching FOL procedural skills increased confidence and procedural expertise of new radiation oncology residents and translated directly to supervised clinical encounters. Adoption of this type of program may help to improve resident training in H&N cancer.
Collapse
Affiliation(s)
- Jeremy G Price
- Department of Radiation Oncology, Duke University School of Medicine, Durham, North Carolina; Durham VA Health Care System, Durham, North Carolina.
| | | | - David S Yoo
- Department of Radiation Oncology, Duke University School of Medicine, Durham, North Carolina
| | - Michael J Moravan
- Department of Radiation Oncology, Duke University School of Medicine, Durham, North Carolina; Durham VA Health Care System, Durham, North Carolina
| | - Yvonne M Mowery
- Department of Radiation Oncology, Duke University School of Medicine, Durham, North Carolina
| | - Donna Niedzwiecki
- Department of Biostatistics, Duke University School of Medicine, Durham, North Carolina
| | - David M Brizel
- Department of Radiation Oncology, Duke University School of Medicine, Durham, North Carolina; Department of Head and Neck Surgery and Communication Sciences, Duke University School of Medicine, Durham, North Carolina
| | - Joseph K Salama
- Department of Radiation Oncology, Duke University School of Medicine, Durham, North Carolina; Durham VA Health Care System, Durham, North Carolina
| |
Collapse
|
3
|
Stephenson ED, Farquhar DR, Masood MM, Capra G, Kimple A, Ebert CS, Thorp BD, Zanation AM. Blinded Evaluation of Endoscopic Skill and Instructability After Implementation of an Endoscopic Simulation Experience. Am J Rhinol Allergy 2019; 33:681-690. [DOI: 10.1177/1945892419860973] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Background Interest in endoscopic simulation is increasing. Past studies have used virtual reality or nonhuman models or residents with varying experience. Our aim was to evaluate the effect of simulation on procedural and psychomotor competence of medical students—surgical novices—performing endoscopic tasks on human cadavers and assess student perceptions. Methods Students (n = 22) completed a baseline sinus model skill evaluation graded by 2 blinded Rhinology fellows. Intervention and control groups with equal baselines were assigned. Intervention students practiced endoscopic tasks on the model for 45 minutes minimum over 2 weeks. All students reviewed sinus anatomy/disease and sinus surgery materials. The final cadaver evaluation was similar to the baseline. Fellows graded students on anatomy identification (sinuses, turbinates), psychomotor (navigation, camera alignment, instrument handling), and timed procedural (sinus object retrieval) skills, confidence, and instructability via fellow-guided frontal balloon placement. Results Participants included 16 males (72.7%) and 6 females (27.3%). Intervention and control groups contained 10 (45.4%) and 12 (54.6%) students, respectively. Intervention group final “Total Psychomotor” scores were higher (10.1/15 vs 7.8/15, P = .0231). “Surgical confidence” was 3.3/5 versus 2.5/5, and “Instructability” was 3.9/5 versus 3.4/5 in intervention versus control groups, respectively ( P < .050). Multivariate regression analysis demonstrated superior psychomotor skills, navigation, and confidence in the intervention group ( P < .036). Activity perception scores were higher in intervention students versus controls, 26.13 versus 18.36/40 ( P = .022). Conclusion In surgical novices, endoscopic simulation leads to superior endoscopic navigation and task performance in cadavers. This simulation presents a novel method for incorporating Otolaryngology simulation in medical student education.
Collapse
Affiliation(s)
- Elizabeth D. Stephenson
- Department of Otolaryngology—Head and Neck Surgery, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
| | - Douglas R. Farquhar
- Department of Otolaryngology—Head and Neck Surgery, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
| | - Maheer M. Masood
- Department of Otolaryngology—Head and Neck Surgery, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
| | - Gregory Capra
- Department of Otolaryngology—Head and Neck Surgery, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
| | - Adam Kimple
- Department of Otolaryngology—Head and Neck Surgery, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
| | - Charles S. Ebert
- Department of Otolaryngology—Head and Neck Surgery, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
| | - Brian D. Thorp
- Department of Otolaryngology—Head and Neck Surgery, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
| | - Adam M. Zanation
- Department of Otolaryngology—Head and Neck Surgery, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
| |
Collapse
|
4
|
Burns JA, Adkins LK, Dailey S, Klein AM. Simulators for Laryngeal and Airway Surgery. Otolaryngol Clin North Am 2017; 50:903-922. [DOI: 10.1016/j.otc.2017.05.003] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
|
5
|
Meska MHG, Mazzo A, Jorge BM, Souza-Junior VDD, Negri EC, Chayamiti EMPC. Urinary retention: implications of low-fidelity simulation training on the self-confidence of nurses. Rev Esc Enferm USP 2016; 50:831-837. [PMID: 27982403 DOI: 10.1590/s0080-623420160000600017] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2016] [Accepted: 08/09/2016] [Indexed: 11/21/2022] Open
Abstract
METHOD This was a quasi-experimental study carried out among nurses stationed in municipal care units in the interior of São Paulo State. Data were collected during the course of a pedagogical workshop that used low-fidelity simulation training. RESULTS The study included 42 nurses, mostly female with over 15 years of experience. After low-fidelity simulation training, nurses showed a significant increase (p<0.05) in confidence related to nursing care in urinary retention. The lowest self-attributed scores during the activity were related to the objective assessment of urinary retention. CONCLUSION Low-fidelity simulated training is an effective resource for the development of nurses with respect to nursing care in urinary retention. OBJETIVO Avaliar o nível de autoconfiança de enfermeiros na assistência de enfermagem na retenção urinária antes e após atividade simulada de baixa fidelidade. MÉTODO Estudo quase-experimental realizado junto aos enfermeiros lotados nas unidades de atendimento de município do interior do estado de São Paulo. Os dados foram coletados durante a realização de uma oficina pedagógica que contou com atividade simulada de baixa fidelidade. RESULTADOS Participaram do estudo 42 enfermeiros, a maioria do sexo feminino e com mais de 15 anos de atuação. Após o treino simulado de baixa fidelidade os enfermeiros demonstraram aumento significativo (p < 0,05) na autoconfiança relacionada à assistência de enfermagem na retenção urinária. Os menores escores autoatribuídos durante a atividade foram relacionados à avaliação objetiva da retenção urinária. CONCLUSÃO A simulação de baixa fidelidade é um recurso efetivo no aprimoramento de enfermeiros no que diz respeito à assistência de enfermagem na retenção urinária.
Collapse
Affiliation(s)
- Mateus Henrique Gonçalves Meska
- Universidade de São Paulo, Escola de Enfermagem de Ribeirão Preto, Centro Colaborador da OMS para o Desenvolvimento da Pesquisa em Enfermagem, Ribeirão Preto, SP, Brazil
| | - Alessandra Mazzo
- Universidade de São Paulo, Escola de Enfermagem de Ribeirão Preto, Centro Colaborador da OMS para o Desenvolvimento da Pesquisa em Enfermagem, Ribeirão Preto, SP, Brazil
| | - Beatriz Maria Jorge
- Universidade de São Paulo, Escola de Enfermagem de Ribeirão Preto, Centro Colaborador da OMS para o Desenvolvimento da Pesquisa em Enfermagem, Ribeirão Preto, SP, Brazil
| | - Valtuir Duarte de Souza-Junior
- Universidade de São Paulo, Escola de Enfermagem de Ribeirão Preto, Centro Colaborador da OMS para o Desenvolvimento da Pesquisa em Enfermagem, Ribeirão Preto, SP, Brazil
| | - Elaine Cristina Negri
- Universidade de São Paulo, Escola de Enfermagem de Ribeirão Preto, Centro Colaborador da OMS para o Desenvolvimento da Pesquisa em Enfermagem, Ribeirão Preto, SP, Brazil
| | | |
Collapse
|
6
|
Abstract
Simulation-based surgical skills training has become essential in orthopaedic practice because of concerns about patient safety and an increase in technically challenging procedures. Surgical skills training in specifically designed simulation laboratories allows practice of procedures in a risk-free environment before they are performed in the operating room. The transferability of acquired skills to performance with patients is the most effective measure of the predictive validity of simulation-based training. Retention of the skills transferred to clinical situations is also critical. However, evidence of simulation-based skill retention in the orthopaedic literature is limited, and concerns about sustainability exist. Solutions for skill decay include repeated practice of the tasks learned on simulators and reinforcement of areas that are sensitive to decline. Further research is required to determine the retention rates of surgical skills acquired in simulation-based training as well as the success of proposed solutions for skill decay.
Collapse
|
7
|
|
8
|
Brook CD, Platt MP, Russell K, Grillone GA, Aliphas A, Noordzij JP. Time to competency, reliability of flexible transnasal laryngoscopy by training level: a pilot study. Otolaryngol Head Neck Surg 2015; 152:843-50. [PMID: 25788339 DOI: 10.1177/0194599815572792] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2014] [Accepted: 01/23/2015] [Indexed: 11/17/2022]
Abstract
OBJECTIVE To determine the progression of flexible transnasal laryngoscopy reliability and competency in otolaryngology residency training. STUDY DESIGN Prospective case control study. SETTING Academic otolaryngology department. SUBJECTS Medical students, otolaryngology residents, and otolaryngology attending physicians. METHODS Fourteen otolaryngology residents from PGY-1 to PGY-5 and 3 attending otolaryngologists viewed 25 selected and digitally recorded flexible transnasal laryngoscopies. The evaluators were asked to rate 13 items relating to abnormalities in the oropharynx, hypopharynx, larynx, and subglottis. The level of concern and level of comfort with the diagnosis were assessed. Intraclass correlations were calculated for each topic and by level of training to determine reliability within each class and compare competency versus attending interpretations. RESULTS Intraclass correlation of residents compared to attending physicians demonstrated significant improvements by year for left and right vocal fold immobility, subglottic stenosis, laryngeal mass, left and right vocal cord abnormalities, and level of concern. Additionally, pooled vocal cord mobility and pooled results in categories with good attending reliability demonstrated stepwise improvement as well. For these categories, resident reliability was found to be statistically similar to attending physicians in all categories by PGY-3. There were no trends for base of tongue abnormalities, pharyngeal abnormalities, and pharyngeal and hypopharyngeal masses. CONCLUSIONS Resident competency for flexible transnasal laryngoscopy progresses during residency to reliability with attending otolaryngologists by the PGY-3 year over key facets of the examination.
Collapse
Affiliation(s)
| | - Michael P Platt
- Boston University School of Medicine, Boston, Massachusetts, USA
| | - Kimberly Russell
- Boston University School of Medicine, Boston, Massachusetts, USA
| | | | - Avner Aliphas
- Boston University School of Medicine, Boston, Massachusetts, USA
| | | |
Collapse
|
9
|
Dawe SR, Pena GN, Windsor JA, Broeders JAJL, Cregan PC, Hewett PJ, Maddern GJ. Systematic review of skills transfer after surgical simulation-based training. Br J Surg 2014; 101:1063-76. [PMID: 24827930 DOI: 10.1002/bjs.9482] [Citation(s) in RCA: 254] [Impact Index Per Article: 25.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/30/2014] [Indexed: 12/16/2022]
Abstract
BACKGROUND Simulation-based training assumes that skills are directly transferable to the patient-based setting, but few studies have correlated simulated performance with surgical performance. METHODS A systematic search strategy was undertaken to find studies published since the last systematic review, published in 2007. Inclusion of articles was determined using a predetermined protocol, independent assessment by two reviewers and a final consensus decision. Studies that reported on the use of surgical simulation-based training and assessed the transferability of the acquired skills to a patient-based setting were included. RESULTS Twenty-seven randomized clinical trials and seven non-randomized comparative studies were included. Fourteen studies investigated laparoscopic procedures, 13 endoscopic procedures and seven other procedures. These studies provided strong evidence that participants who reached proficiency in simulation-based training performed better in the patient-based setting than their counterparts who did not have simulation-based training. Simulation-based training was equally as effective as patient-based training for colonoscopy, laparoscopic camera navigation and endoscopic sinus surgery in the patient-based setting. CONCLUSION These studies strengthen the evidence that simulation-based training, as part of a structured programme and incorporating predetermined proficiency levels, results in skills transfer to the operative setting.
Collapse
Affiliation(s)
- S R Dawe
- Australian Safety and Efficacy Register of New Interventional Procedures - Surgical (ASERNIP-S), Royal Australasian College of Surgeons, University of Adelaide, Queen Elizabeth Hospital, Adelaide, South Australia
| | | | | | | | | | | | | |
Collapse
|