Implementation of a Program for Surgical Education in Laryngology
University Voice and Swallowing Center, Department of Otolaryngology-Head and Neck Surgery, University of California Irvine School of Medicine, Orange, California, USA. The Laryngoscope
(Impact Factor: 2.14).
11/2010; 120(11):2241-6. DOI: 10.1002/lary.21099
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.
Available from: Ricardo Luiz Smith
- "To respond to this demand, a solid education in the basic sciences and human anatomy is necessary (Sataloff, 2003; Dailey et al, 2004; Uribe et al, 2004; Logemann , 2006; Skinder-Meredith, 2010). Several otolaryngology education programs in the United States have developed laryngeal dissection courses using canine (Verma et al., 2010), bovine (Effat, 2005), or human (Amin et al., 2007) laryngeal specimens. These hands-on training programs are beneficial in the development of surgical skills. "
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ABSTRACT: Multidisciplinary cooperation in health care requires a solid knowledge in the basic sciences for a common ground of communication. In speech pathology, these fundamentals improve the accuracy of descriptive diagnoses and support the development of new therapeutic techniques and strategies. The aim of this study is to briefly discuss the benefits of hands-on education on laryngeal anatomy and voice physiology in Brazilian graduate programs in speech pathology, as well as to describe a simple prototype that can be used as a useful educational tool for this purpose. The laryngeal anatomic support device was designed to provide a vertical frame to hold human or mammalian larynges with no preservation treatment, with the goal of allowing good visualization of the vocal folds during artificial phonation. The device was designed to provide the user the ability to manipulate the soft and cartilaginous structures of the larynx with near-natural biomechanical properties. The description of the project is detailed to allow the reproduction of this simple and inexpensive device. It may be used as an experimental feature in a variety of settings, from high-school programs to experimental research methods, and may suit a wide array of different educational models.
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ABSTRACT: 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.
Self-report Internet-based questionnaire.
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).
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.
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.
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ABSTRACT: The decline in the use of forceps in operative deliveries over the last two decades raises questions about teaching hospitals' ability to provide trainees with adequate experience in the use of forceps. The authors examined (1) the number of operative deliveries performed in teaching and nonteaching hospitals, and (2) whether teaching hospitals performed a sufficient number of forceps deliveries for physicians to acquire and maintain competence.
The authors used State Inpatient Data from nine states to identify all women hospitalized for childbirth in 2008. They divided hospitals into three categories: major teaching, minor teaching, and nonteaching. They calculated delivery volumes (total operative, cesarean, vacuum, forceps, two or more methods) for each hospital and compared data across hospital categories.
The sample included 1,344,305 childbirths in 835 hospitals. The mean cesarean volumes for major teaching, minor teaching, and nonteaching hospitals were 969.8, 757.8, and 406.9. The mean vacuum volumes were 301.0, 304.2, and 190.4, and the mean forceps volumes were 25.2, 15.3, and 8.9. In 2008, 31 hospitals (3.7% of all hospitals) performed no vacuum extractions, and 320 (38.3%) performed no forceps deliveries. In 2008, 13 (23%) major teaching and 44 (44%) minor teaching hospitals performed five or fewer forceps deliveries.
Low forceps delivery volumes may preclude many trainees from acquiring adequate experience and proficiency. These findings highlighted broader challenges, faced by many specialties, in ensuring that trainees and practicing physicians acquire and maintain competence in infrequently performed, highly technical procedures.
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