Frontal Sinus Surgery Simulation in Continuing Education for Practicing Otolaryngologists

Abstract

Background:

This study aims to assess the effectiveness of high-fidelity simulation training in enhancing skills for frontal sinus surgery (FSS) within the framework of continuing medical education.

Methods:

A cross-sectional, within-subject study was conducted during a CME-accredited national frontal sinus surgery simulation course. Participants completed pre- and post-course surveys rating potential deterrents to FSS. Paired statistical analyses assessed changes in deterrent ratings, and correlational analyses evaluated relationships with surgical experience and case volume.

Results:

Twenty-eight participants completed both pre- and post-course surveys. Mean time in practice was 14 years, with an average FSS volume of 2 cases per month. Baseline deterrence was moderate (mean 5.10/10), driven primarily by concern for skull base violation and technical difficulty. Following simulation, overall deterrence decreased significantly by 1.27 points (to 3.83; P < .05), with 7 of 9 deterrents showing significant reduction. The largest improvements were seen in apprehension regarding skull base injury, technical challenge, and adequacy of dissection. Factors related to operative time and prior experience showed minimal change. Case volume correlated with lower baseline and post-simulation hesitancy for select deterrents, while years in practice and interval since last FSS did not. All participants reported improved confidence, and the majority anticipated increased incorporation of FSS into their practice.

Conclusions:

Simulation-based CME significantly reduced modifiable deterrents and improved confidence among practicing otolaryngologists performing FSS, regardless of years in practice. These findings support simulation as a valuable adjunct for ongoing professional development, enabling experienced surgeons to recalibrate risk perception, refine technical judgment, and support lifelong surgical learning.