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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 

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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