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Pilot testing of a novel surgical simulator for endoscopic zenker's diverticulotomy.
Laryngoscope. 2017 03; 127(3):592-596.L

Abstract

OBJECTIVES/HYPOTHESIS

Restrictions on resident work hours and the increasing purview of otolaryngology reduce the efficacy of the traditional surgical training model. With limited case volumes at many institutions and the unique instrumentation of endoscopic Zenker's diverticulotomy (EZD), simulation may be useful to improve training. In this study, a novel surgical simulator for EZD is developed and validated.

STUDY DESIGN

Simulation model development.

METHODS

An EZD model was designed using an intubation trainer and disposable diverticulum inserts. A novel objective structured assessment of technical skill (OSATS) for EZD was developed. Performance of otolaryngology residents on simulations using the OSATS and time to completion were evaluated during an instructional course. Pre- and postencounter surveys were completed. Inter-rater and intrarater reliability were evaluated via blinded video review of resident performance.

RESULTS

Seventeen residents participated (n = 17). Surveys showed confidence improved two points on a five-point scale (P < .001), and 94% agreed that the model would improve resident performance with in vivo EZD. More experienced trainees (postgraduate year [PGY] 3-5, n = 11 vs. PGY 1-2, n = 6) had shorter times to completion (P < .001) and higher assessment scores on initial attempts (P = .006). Both groups showed significant improvements from initial to final attempts on 30-point scales for global rating by 6.2 ± 4.2 (mean ± standard deviation, P < .001). The novel OSATS demonstrated fair live/video reliability (к = 0.40) and inter-rater reliability (к = 0.44), and moderate intrarater reliability (к = 0.60).

CONCLUSIONS

Pilot testing of an EZD simulator demonstrated acceptability, content validity, and construct validity. A novel OSATS was developed and evaluated. Further investigation of the impact on operative performance and validation of the OSATS in vivo is needed.

LEVEL OF EVIDENCE

NA Laryngoscope, 127:592-596, 2017.

Links

Publisher Full Text (DOI)

Authors+Show Affiliations

Wiebracht ND
Department of Otolaryngology-Head and Neck Surgery, University of Cincinnati College of Medicine, Cincinnati, Ohio, U.S.A.
Giliberto JP
Department of Otolaryngology-Head and Neck Surgery, University of Washington, Seattle, Washington, U.S.A.
Myer C
Department of Otolaryngology-Head and Neck Surgery, University of Cincinnati College of Medicine, Cincinnati, Ohio, U.S.A. Division of Pediatric Otolaryngology-Head and Neck Surgery, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, U.S.A.
Casper K
Department of Otolaryngology-Head and Neck Surgery, University of Michigan, Ann Arbor, Michigan, U.S.A.
Johnson KE
Division of Pediatric Otolaryngology-Head and Neck Surgery, Seattle Children's and the Department of Otolaryngology-Head and Neck Surgery, University of Washington, Seattle, Washington, U.S.A.

MeSH

AdultClinical CompetenceEducation, Medical, GraduateEndoscopyFemaleHumansInternship and ResidencyMaleModels, AnatomicObserver VariationOtolaryngologyPilot ProjectsReproducibility of ResultsSimulation TrainingStatistics, NonparametricZenker Diverticulum

Pub Type(s)

Journal Article

Language

eng

PubMed ID

27900775

Citation

Wiebracht, Nathan D., et al. "Pilot Testing of a Novel Surgical Simulator for Endoscopic Zenker's Diverticulotomy." The Laryngoscope, vol. 127, no. 3, 2017, pp. 592-596.
Wiebracht ND, Giliberto JP, Myer C, et al. Pilot testing of a novel surgical simulator for endoscopic zenker's diverticulotomy. Laryngoscope. 2017;127(3):592-596.
Wiebracht, N. D., Giliberto, J. P., Myer, C., Casper, K., & Johnson, K. E. (2017). Pilot testing of a novel surgical simulator for endoscopic zenker's diverticulotomy. The Laryngoscope, 127(3), 592-596. https://doi.org/10.1002/lary.26129
Wiebracht ND, et al. Pilot Testing of a Novel Surgical Simulator for Endoscopic Zenker's Diverticulotomy. Laryngoscope. 2017;127(3):592-596. PubMed PMID: 27900775.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Pilot testing of a novel surgical simulator for endoscopic zenker's diverticulotomy. AU - Wiebracht,Nathan D, AU - Giliberto,John P, AU - Myer,Charles,4th AU - Casper,Keith, AU - Johnson,Kaalan E, Y1 - 2016/11/30/ PY - 2016/05/12/accepted PY - 2016/12/3/pubmed PY - 2017/8/17/medline PY - 2016/12/1/entrez KW - Simulation KW - Zenker's diverticulum KW - education KW - evaluation KW - low cost KW - resident KW - task trainer SP - 592 EP - 596 JF - The Laryngoscope JO - Laryngoscope VL - 127 IS - 3 N2 - OBJECTIVES/HYPOTHESIS: Restrictions on resident work hours and the increasing purview of otolaryngology reduce the efficacy of the traditional surgical training model. With limited case volumes at many institutions and the unique instrumentation of endoscopic Zenker's diverticulotomy (EZD), simulation may be useful to improve training. In this study, a novel surgical simulator for EZD is developed and validated. STUDY DESIGN: Simulation model development. METHODS: An EZD model was designed using an intubation trainer and disposable diverticulum inserts. A novel objective structured assessment of technical skill (OSATS) for EZD was developed. Performance of otolaryngology residents on simulations using the OSATS and time to completion were evaluated during an instructional course. Pre- and postencounter surveys were completed. Inter-rater and intrarater reliability were evaluated via blinded video review of resident performance. RESULTS: Seventeen residents participated (n = 17). Surveys showed confidence improved two points on a five-point scale (P < .001), and 94% agreed that the model would improve resident performance with in vivo EZD. More experienced trainees (postgraduate year [PGY] 3-5, n = 11 vs. PGY 1-2, n = 6) had shorter times to completion (P < .001) and higher assessment scores on initial attempts (P = .006). Both groups showed significant improvements from initial to final attempts on 30-point scales for global rating by 6.2 ± 4.2 (mean ± standard deviation, P < .001). The novel OSATS demonstrated fair live/video reliability (к = 0.40) and inter-rater reliability (к = 0.44), and moderate intrarater reliability (к = 0.60). CONCLUSIONS: Pilot testing of an EZD simulator demonstrated acceptability, content validity, and construct validity. A novel OSATS was developed and evaluated. Further investigation of the impact on operative performance and validation of the OSATS in vivo is needed. LEVEL OF EVIDENCE: NA Laryngoscope, 127:592-596, 2017. SN - 1531-4995 UR - https://www.unboundmedicine.com/medline/citation/27900775/Pilot_testing_of_a_novel_surgical_simulator_for_endoscopic_zenker's_diverticulotomy_ DB - PRIME DP - Unbound Medicine ER -