Implementation of a Program for Surgical Education in Laryngology
ABSTRACT To describe the implementation of a program for surgical education in laryngology.
Items necessary to modify a temporal bone lab for laryngeal dissection purposes were identified, and costs to do so were calculated. The prices and availability of human and canine laryngeal specimens to be used for teaching purposes were then compared. Endoscopic and open laryngeal surgery were performed on canine larynges to determine suitability as a teaching model. A laryngeal dissection course with teaching objectives was created and instituted in an Otolaryngology-Head and Neck Surgery residency training program.
Modifications to convert an existing temporal bone lab into a laryngeal dissection lab cost $7,425. Canine larynges were found to strongly resemble human larynges and were easily used in a teaching model. They were more easily acquired and less expensive than human larynges. A novel dissection approach was created to maximize utility of a single cadaveric laryngeal specimen. Development of a laryngeal dissection manual facilitated a laryngeal dissection course.
A laryngeal dissection educational course can be instituted with simple and relatively inexpensive modifications to an existing temporal bone laboratory. Canine larynges can be substituted for human larynges for a substantial cost savings without educational compromise. The educational methods demonstrated can be easily duplicated at other training sites.
[Show abstract] [Hide abstract]
ABSTRACT: Objectives/HypothesisTo investigate the use of the Video-Based Phonomicrosurgery Instrument Tracking System to collect instrument position data during simulated phonomicrosurgery and calculate motion metrics using these data. We used this system to determine if novice subject motion metrics improved over 1 week of training. Study DesignProspective cohort study. Methods Ten subjects performed simulated surgical tasks once per day for 5 days. Instrument position data were collected and used to compute motion metrics (path length, depth perception, and motion smoothness). Data were analyzed to determine if motion metrics improved with practice time. Task outcome was also determined each day, and relationships between task outcome and motion metrics were used to evaluate the validity of motion metrics as indicators of surgical performance. ResultsSignificant decreases over time were observed for path length (P<.001), depth perception (P<.001), and task outcome (P<.001). No significant change was observed for motion smoothness. Significant relationships were observed between task outcome and path length (P<.001), depth perception (P<.001), and motion smoothness (P<.001). Conclusions Our system can estimate instrument trajectory and provide quantitative descriptions of surgical performance. It may be useful for evaluating phonomicrosurgery performance. Path length and depth perception may be particularly useful indicators. Level of EvidenceNA Laryngoscope 124:2332-2337, 2014The Laryngoscope 10/2014; 124(10). DOI:10.1002/lary.24724 · 2.03 Impact Factor
The Laryngoscope 12/2014; DOI:10.1002/lary.25091 · 2.03 Impact Factor
[Show abstract] [Hide abstract]
ABSTRACT: Objective: To present and evaluate the magnetic-based Phonomicrosurgery Instrument Tracking System, a novel and objective method of acquiring instrument position data during simulated phonomicrosurgery. The position data can be used to compute quantitative motion metrics. This system was used to objectively evaluate the motion performance of novice and expert surgeons during phonomicrosurgical simulations and determine the differences between these groups. Study Design: Prospective cohort study. Methods: A magnetic-based Phonomicrosurgery Instrument Tracking System (MPTS) was developed, including a work bench, independent task, motion metrics, and computer program. Based on this system, 3 experts' and 6 novices' motion data were collected and analyzed. Results: Experts demonstrated significantly better motion smoothness along the y axis for the dominant hand. For the non-dominant hand, experts demonstrated better motion smoothness along all three axes, shorter path length, and better depth perception (p<0.05). Experts also demonstrated higher quality of operation (p<0.001). No significant difference in time (T) was noted (p=0.671). Conclusions: Parameters derived from magnetic-based motion tracking were able to differentiate between expert and novice surgeons. These parameters have the potential to be used in phonomicrosurgical training as feedback to enhance the training process.The Laryngoscope 09/2014; 124(9). DOI:10.1002/lary.24656 · 2.03 Impact Factor