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Development and validation of a low-cost microsurgery Ear Trainer for low-resource settings

  • M P A Clark (a1), B D Westerberg (a2) (a3) and J E Mitchell (a4)



Chronic suppurative otitis media is a neglected condition affecting up to 330 million people worldwide, with the burden of the disease in impoverished countries. The need for non-governmental organisations to hardwire training into their programmes has been highlighted. An ear surgery simulator appropriate for training in resource-poor settings was developed, and its effectiveness in facilitating the acquisition of headlight and microsurgical skills necessary to safely perform procedures via the ear canal was investigated.


Face validity was assessed via questionnaires. Six tasks were developed: a headlight foreign body removal task, and microscope tasks of foreign body removal, ventilation tube insertion, tympanomeatal flap raising, myringoplasty and middle-ear manipulation. Participants with varying ENT experience were video-recorded performing each task and scored by a blinded expert observer to assess construct validity.


Face validity results confirmed that our Ear Trainer was a realistic representation of the ear. Construct validity results showed a statistically significant trend, with experts performing the best and those with limited experience performing better than novices.


This study validates our Ear Trainer as a useful training tool for assessing headlight and microsurgical skills required to perform otological procedures.


Corresponding author

Address for correspondence: Mr M P A Clark, ENT Department, Gloucestershire Hospitals NHS Foundation Trust, Gloucester, UK Fax: 0300 422 6432 E-mail:


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Development and validation of a low-cost microsurgery Ear Trainer for low-resource settings

  • M P A Clark (a1), B D Westerberg (a2) (a3) and J E Mitchell (a4)


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