Validation of a laryngeal dissection module for phonomicrosurgical training.
ABSTRACT To validate the use of a new phonomicrosurgical trainer called the laryngeal dissection module.
The module used synthetic, multilayered vocal folds inside a model larynx mounted on a platform, a microscope, and microsurgical instruments. The study was designed to test the module's ability to differentiate novices from expert surgeons and to test the module's ability to improve novice performance with training.
Expert (n = 5) and novice (n = 21) phonomicrosurgeons were instructed to remove a superficial ovoid lesion from a synthetic, right vocal fold. The task was assessed for total errors, total operating time, and injury to the superficial peripheral tissue, the lesion, and the deep tissue. Novice and expert performance was compared using an independent samples t test and a Fisher exact test. Subsequently, novices completed three practice trials and a posttraining trial, which was assessed for improvement compared with pretraining performance using a Wilcoxon signed rank test.
Experts completed the task with fewer total errors than novices (P < .001) and made fewer injuries to the oval lesion (P = .01). Novices improved performance with training, making fewer total errors in the posttraining trial (P = .003), reducing injury to the superficial peripheral tissue (P = .02), and taking less time to complete the task (P = .04).
The laryngeal dissection module was validated as a surgical trainer. It was able to differentiate expert versus novice performance, and it improved novice performance through training.
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ABSTRACT: Objective To conduct a systematic review of published articles that describe simulators that could be used in otolaryngology for education, skill acquisition, and/or skill improvement.Data SourcesOvid and Embase databases searched July 14, 2011.Review Methods Three hundred fifty-three abstracts were independently reviewed by both authors, then 154 eligible articles were reviewed by both authors, and 95 articles were categorized by organ system (eg, otologic); type of simulator (eg, physical, virtual); whether the simulator was a prototype, could be purchased, or was constructed; validation; and level of learning assessment. Discrepancies were resolved by re-review and discussion.ResultsIn addition to 11 overview articles, 28 articles described 16 otology simulators, most of which are virtual and prototypes. Ninteen articles described 10 sinus/rhinology simulators; most are virtual surgery simulators and prototypes. Eight articles described 8 oral cavity simulators, and 8 articles described neck simulators. Seventeen articles described 13 bronchoscopy simulators; several are full-body high-technology manikins adapted from other purposes. Five articles described eclectic simulators, including some for learning nontechnical and teamwork skills. Half of the simulators have been validated. Learning levels were often not assessed or assessment was limited to the learners' perceptions.ConclusionA wide variety of simulators are available or under development. Lack of unified validation concepts and limited descriptions restricted our ability to assess model characteristics, availability, and validation. Simulators are emerging as powerful tools to facilitate learning; this review may provide a platform for discussion and refinement of the information reported and analyzed in evaluating simulators.Otolaryngology Head and Neck Surgery 09/2012; · 1.72 Impact Factor
- The Laryngoscope 01/2014; · 2.03 Impact Factor
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ABSTRACT: OBJECTIVES/HYPOTHESIS: The primary objective of this study is to assess the adequacy of clinical and laboratory-based phonomicrosurgical training in otolaryngology residency programs using a self-report survey. The study aims to establish whether there is a need and desire for focused surgical training in phonomicrosurgery. STUDY DESIGN: Self-report Internet-based questionnaire. METHODS: An anonymous survey was sent to all current residents in otolaryngology training programs in the United States and Canada. For portions of the analysis, the residents were categorized into two groups-junior (R2 and R3) and senior (R4 and R5). RESULTS: One hundred ninety-one residents responded to the survey (USA: 166; Canada: 25), representing a 34.3% response rate. Approximately one-half of residents stated that their residency program includes a rotation during which the main emphasis is laryngology. Only 18.8% of residents were "very" satisfied with the phonomicrosurgery experience that their program offers and 21.6% of senior residents felt "very" comfortable performing a phonomicrosurgical removal of a vocal fold lesion. Whereas the vast majority of respondents found temporal bone laboratory training to be helpful, 82% had never performed laboratory training in phonomicrosurgery. The majority (87.4%) felt that their comfort level with phonomicrosurgery would increase if they had access to laboratory-based training. CONCLUSION: Our study suggests that there is a lack of emphasis on clinical and laboratory-based training in phonomicrosurgery and that there is a need and desire for focused surgical training in phonomicrosurgery. LEVEL OF EVIDENCE: Level 4.The Laryngoscope 04/2013; · 2.03 Impact Factor