Hostname: page-component-78c5997874-j824f Total loading time: 0 Render date: 2024-11-06T07:53:37.092Z Has data issue: false hasContentIssue false

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

Published online by Cambridge University Press:  24 October 2016

M P A Clark*
Affiliation:
ENT Department, Gloucestershire Hospitals NHS Foundation Trust, Gloucester, UK
B D Westerberg
Affiliation:
Department of Surgery, University of British Columbia, Vancouver, Canada BC Rotary Hearing and Balance Centre at St Paul's Hospital, Vancouver, Canada
J E Mitchell
Affiliation:
ENT Department, Frimley Park Hospital, Frimley, UK
*
Address for correspondence: Mr M P A Clark, ENT Department, Gloucestershire Hospitals NHS Foundation Trust, Gloucester, UK Fax: 0300 422 6432 E-mail: [email protected]

Abstract

Objective:

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.

Methods:

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.

Results:

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.

Conclusion:

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

Type
Main Articles
Copyright
Copyright © JLO (1984) Limited 2016 

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

1 Kirkpatrick, JJ, Naylor, IL. The qualities and conduct of an English surgeon in 1446: as described in a manuscript attributed to Thomas Morstede. Ann R Coll Surg Engl 1997;79:225–8Google Scholar
2 Meara, JG, Leather, AJ, Hagander, L, Alkire, BC, Alonso, N, Ameh, EA et al. Global surgery 2030: evidence and solutions for achieving health, welfare, and economic development. Lancet 2015;386:569624 Google Scholar
3 Reznick, R, Regehr, G, MacRae, H, Martin, J, McCulloch, W. Testing technical skill via an innovative ‘bench station’ examination. Am J Surg 1997;173:226–30CrossRefGoogle ScholarPubMed
4 Owa, AO, Farrell, RW. Simple model for teaching myringotomy and aural ventilation tube insertion. J Laryngol Otol 1998;112:642–3Google Scholar
5 Carr, ER, Benjamin, E. ‘Surgical skills box’: a new training aid for surgical trainees. J Laryngol Otol 2006;120:133–4Google Scholar
6 Ismail-Koch, H, Marshall, L, Alabi, T, Buckland, J. The ear trainer model. Clin Otolaryngol 2008;33:635 Google Scholar
7 Jesudason, WV, Smith, I. How we do it: the Bradford grommet trainer: a model for training in myringotomy and grommet insertion. Clin Otolaryngol 2005;30:371–3Google Scholar
8 Singh, PK, De, M, Vaughan-Jones, R. A model for training in grommet insertion. Ann R Coll Surg Engl 2005;87:287–8Google Scholar
9 Leong, A, Kundu, S, Martinez-Devesa, P, Aldren, C. Artificial ear: a training tool for grommet insertion and manual dexterity. ORL J Otorhinolaryngol Relat Spec 2006;68:115–17Google Scholar
10 Chan, WY, Mishra, A, Srinivasan, J, Ramakrishnan, V. 360 Degrees microsurgical skills practice: a ‘round-the-clock’ training device. J Plast Reconstr Aesthet Surg 2008;61:1110–11CrossRefGoogle Scholar
11 Parmar, A. New registrar induction simulation course: ‘the ENT boot camp’. ENT & Audiology News 2014;23:39 Google Scholar
12 Li, MG, Hotez, PJ, Vrabec, JT, Donovan, DT. Is chronic suppurative otitis media a neglected tropical disease? PLoS Negl Trop Dis 2015;9:e0003761Google Scholar
13 Horton, R. GBD 2010: understanding disease, injury, and risk. Lancet 2012;380:2053–4Google Scholar