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Skills transfer to sinus surgery via a low-cost simulation-based curriculum.
Int Forum Allergy Rhinol. 2018 04; 8(4):537-546.IF

Abstract

BACKGROUND

Surgical skill development outside the operating room aims to improve technique and subsequent patient safety. The purpose of this study was to evaluate the correlation between technical and cognitive skills with cadaveric endoscopic sinus surgery (ESS) performance and change in ESS performance before and after implementation of a dedicated ESS simulation-based and knowledge-based curriculum.

METHODS

A before-after study design was implemented among 10 medical students and 10 junior otolaryngology residents. Participants completed a knowledge-based, multiple-choice ESS pretest and watched an ESS prosection video. Participants performed 9 tasks on a previously validated low-cost, low-technology, nonbiologic sinus surgery task trainer followed by cadaveric maxillary antrostomy and anterior ethmoidectomy. Participants then completed a simulation-based and knowledge-based ESS curriculum followed by a repeat cadaveric maxillary antrostomy and anterior ethmoidectomy. Performance was graded with a 5-point global rating scale (GRS) and a 5-point ESS-specific checklist.

RESULTS

We observed a stronger correlation between the multiple-choice, knowledge-based, ESS pretest scores and cadaveric ESS GRS score (r = 0.73) than between task trainer performance and cadaveric ESS GRS score (r = 0.43). We also noted a significant increase in precurriculum vs postcurriculum mean ± standard deviation (SD) cadaveric ESS checklist scores for both medical students (1.18 ± 0.25 vs 2.58 ± 0.57; p = 0.0002) and residents (2.09 ± 0.78 vs 2.88 ± 0.54; p = 0.023). The greatest improvements for residents were in performance of uncinectomy, enlargement of maxillary os, and identification of the bulla.

CONCLUSION

These findings provide evidence supporting the use of ESS training curricula outside the operating room.

Links

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Authors+Show Affiliations

Harbison RA
Department of Otolaryngology-Head and Neck Surgery, University of Washington School of Medicine, Seattle, WA.
Dunlap J
University of Washington School of Medicine, Seattle, WA.
Humphreys IM
Department of Otolaryngology-Head and Neck Surgery, University of Washington School of Medicine, Seattle, WA.
Davis GE
Department of Otolaryngology-Head and Neck Surgery, University of Washington School of Medicine, Seattle, WA.

MeSH

Clinical CompetenceCognitionCurriculumEducation, Medical, UndergraduateEducational MeasurementEndoscopyFemaleHumansInternship and ResidencyKnowledge BasesMaleOtorhinolaryngologic Surgical ProceduresParanasal SinusesSimulation Training

Pub Type(s)

Comparative Study
Journal Article
Research Support, N.I.H., Extramural
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

29323794

Citation

Harbison, R Alex, et al. "Skills Transfer to Sinus Surgery Via a Low-cost Simulation-based Curriculum." International Forum of Allergy & Rhinology, vol. 8, no. 4, 2018, pp. 537-546.
Harbison RA, Dunlap J, Humphreys IM, et al. Skills transfer to sinus surgery via a low-cost simulation-based curriculum. Int Forum Allergy Rhinol. 2018;8(4):537-546.
Harbison, R. A., Dunlap, J., Humphreys, I. M., & Davis, G. E. (2018). Skills transfer to sinus surgery via a low-cost simulation-based curriculum. International Forum of Allergy & Rhinology, 8(4), 537-546. https://doi.org/10.1002/alr.22069
Harbison RA, et al. Skills Transfer to Sinus Surgery Via a Low-cost Simulation-based Curriculum. Int Forum Allergy Rhinol. 2018;8(4):537-546. PubMed PMID: 29323794.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Skills transfer to sinus surgery via a low-cost simulation-based curriculum. AU - Harbison,R Alex, AU - Dunlap,Jennifer, AU - Humphreys,Ian M, AU - Davis,Greg E, Y1 - 2018/01/11/ PY - 2017/09/25/received PY - 2017/11/07/revised PY - 2017/11/28/accepted PY - 2018/1/13/pubmed PY - 2019/7/30/medline PY - 2018/1/12/entrez KW - endoscopy KW - nose models KW - residency training in rhinology KW - simulation training KW - sinus surgery SP - 537 EP - 546 JF - International forum of allergy & rhinology JO - Int Forum Allergy Rhinol VL - 8 IS - 4 N2 - BACKGROUND: Surgical skill development outside the operating room aims to improve technique and subsequent patient safety. The purpose of this study was to evaluate the correlation between technical and cognitive skills with cadaveric endoscopic sinus surgery (ESS) performance and change in ESS performance before and after implementation of a dedicated ESS simulation-based and knowledge-based curriculum. METHODS: A before-after study design was implemented among 10 medical students and 10 junior otolaryngology residents. Participants completed a knowledge-based, multiple-choice ESS pretest and watched an ESS prosection video. Participants performed 9 tasks on a previously validated low-cost, low-technology, nonbiologic sinus surgery task trainer followed by cadaveric maxillary antrostomy and anterior ethmoidectomy. Participants then completed a simulation-based and knowledge-based ESS curriculum followed by a repeat cadaveric maxillary antrostomy and anterior ethmoidectomy. Performance was graded with a 5-point global rating scale (GRS) and a 5-point ESS-specific checklist. RESULTS: We observed a stronger correlation between the multiple-choice, knowledge-based, ESS pretest scores and cadaveric ESS GRS score (r = 0.73) than between task trainer performance and cadaveric ESS GRS score (r = 0.43). We also noted a significant increase in precurriculum vs postcurriculum mean ± standard deviation (SD) cadaveric ESS checklist scores for both medical students (1.18 ± 0.25 vs 2.58 ± 0.57; p = 0.0002) and residents (2.09 ± 0.78 vs 2.88 ± 0.54; p = 0.023). The greatest improvements for residents were in performance of uncinectomy, enlargement of maxillary os, and identification of the bulla. CONCLUSION: These findings provide evidence supporting the use of ESS training curricula outside the operating room. SN - 2042-6984 UR - https://www.unboundmedicine.com/medline/citation/29323794/Skills_transfer_to_sinus_surgery_via_a_low_cost_simulation_based_curriculum_ DB - PRIME DP - Unbound Medicine ER -