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An endoscopic Ear Trainer for the low-resource setting

  • M P A Clark (a1), D Nakku (a2) and B D Westerberg (a3)

Abstract

Background

Endoscopic ear surgery is a technique that is growing in popularity. It has potential advantages in the low-resource setting for teaching and training, for the relative ease of transporting and storing the surgical equipment and for telemedicine roles. There may also be advantages to the patient, with reduced post-operative pain, facilitating the ability to complete procedures as out-patients.

Methods

Our Ear Trainer has previously been validated for headlight and microscope otology skills, including foreign body removal and ventilation tube insertion, in both the high- and low-resource setting. This study aimed to assess the Ear Trainer for similar training and assessment of endoscopic ear surgery skills in the low-resource setting. The study was conducted in Uganda on ENT trainees.

Results

Despite a lack of prior experience with endoscopes, with limited practice time most participants showed improvements in: efficiency of instrument movement, steadiness of the camera view obtained, overall global rating of the task and performance time (faster task performance).

Conclusion

These results indicate that the Ear Trainer is a useful tool in the training and assessment of endoscopic ear surgery skills.

Copyright

Corresponding author

Author for correspondence: Mr Matthew P A Clark, ENT Department, Gloucestershire Hospitals NHS Foundation Trust, Gloucester, UK E-mail: Matthew.Clark11@nhs.net

Footnotes

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Mr M P A Clark takes responsibility for the integrity of the content of the paper

Footnotes

References

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1Clark, MPA. Endoscopic ear surgery in the ear camp setting; forward thinking or folly? J Laryngol Otol 2018;132:6870
2Clark, MPA, Westerberg, BD, Mitchell, JE. Development and validation of a low-cost microsurgery Ear Trainer for low-resource settings. J Laryngol Otol 2016;130:954–61
3Luu, K, Straatman, L, Nakku, D, Westerberg, B, Carter, N, Clark, M. Evaluation of a low-fidelity ear surgery simulator in a low-resource setting. J Laryngol Otol 2017;131:1010–16
4Westerberg, BD, Lee, PK, Lukwago, L, Zaramba, S, Bubikere, S, Stewart, I. Cross-sectional survey of hearing impairment and ear disease in Uganda. J Otolaryngol Head Neck Surg 2008;37:753–8
5Abass, OA, Samuel, BO, Odufeko, GT. Medical simulation a tool yet untapped in most developing nations in Africa. Int J Comput Appl 2014;97:14
6Johnson, E. Surgical simulators and simulated surgeons: reconstituting medical practice and practitioners in simulations. Soc Stud Sci 2007;37:585608
7Tavakol, M, Mohagheghi, MA, Dennick, R. Assessing the skills of surgical residents using simulation. J Surg Educ 2008;65:7783
8Sewell, C, Morris, D, Blevins, NH, Dutta, S, Agrawal, S, Barbagli, F et al. Providing metrics and performance feedback in a surgical simulator. Comput Aided Surg 2008;13:638110.3109/10929080801957712
9McGaghie, WC, Issenberg, SB, Cohen, ER, Barsuk, JH, Wayne, DB. Does simulation-based medical education with deliberate practice yield better results than traditional clinical education? A meta-analytic comparative review of the evidence. Acad Med 2011;86:706–11
10Clifton, N, Klingmann, C, Khalil, H. Teaching otolaryngology skills through simulation. Eur Arch Otorhinolaryngol 2011;268:949–53
11Yong, M, Mijovic, T, Lea, J. Endoscopic ear surgery in Canada: a cross-sectional study. J Otolaryngol Head Neck Surg 2016;45:4
12Badr-el-Dine, M. Value of ear endoscopy in cholesteatoma surgery. Otol Neurotol 2002;23:631–5

Keywords

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Supplementary materials

Clark et al. supplementary material
Clark et al. supplementary material 1

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