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Investigating the learning curve in endoscopic compared to microscopic myringotomy and ventilation tube insertion

Published online by Cambridge University Press:  19 June 2020

O Denton ,
A Daglish ,
L Smallman  and
S Fishpool
O Denton*
Affiliation:
Postgraduate Centre, Glasgow Royal Infirmary, NHS Greater Glasgow and Clyde, UK
A Daglish
Affiliation:
Postgraduate Medical Education Centre, Royal Berkshire NHS Foundation Trust, Reading, UK
L Smallman
Affiliation:
School of Mathematics, Cardiff University, Wales, UK
S Fishpool
Affiliation:
Department of ENT, Cwm Taf Morgannwg University Health Board, Ynysmaerdy, Wales, UK
*
Author for correspondence: Dr Oliver Denton, Postgraduate Centre, St Mungo Building, Glasgow Royal Infirmary, 84 Castle St, GlasgowG4 0SF, Scotland, UK E-mail: dentonOG@doctors.org.uk
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Abstract

Objective

Rate of learning is often cited as a deterrent in the use of endoscopic ear surgery. This study investigated the learning curves of novice surgeons performing simulated ear surgery using either an endoscope or a microscope.

Methods

A prospective multi-site clinical research study was conducted. Seventy-two medical students were randomly allocated to the endoscope or microscope group, and performed 10 myringotomy and ventilation tube insertions. Trial times were used to produce learning curves. From these, slope (learning rate) and asymptote (optimal proficiency) were ascertained.

Results

There was no significant difference between the learning curves (p = 0.41). The learning rate value was 68.62 for the microscope group and 78.71 for the endoscope group. The optimal proficiency (seconds) was 32.83 for the microscope group and 27.87 for the endoscope group.

Conclusion

The absence of a significant difference shows that the learning rates of each technique are statistically indistinguishable. This suggests that surgeons are not justified when citing ‘steep learning curve’ in arguments against the use of endoscopes in middle-ear surgery.

Keywords

Learning CurveProspective StudiesOtologic Surgical ProceduresEndoscopesEar, Middle
Type
Main Articles
Information
The Journal of Laryngology & Otology , Volume 134 , Issue 6 , June 2020 , pp. 497 - 500
Copyright
Copyright © The Author(s), 2020. Published by Cambridge University Press

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Footnotes

Dr O Denton takes responsibility for the integrity of the content of the paper

This paper was the subject of an oral presentation at the 3rd World Congress on Endoscopic Ear Surgery, 14 June 2019, Boston, Massachusetts, USA.

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