Abstract
Objectives:
1) Implement a training device to train otolaryngology residents to perform myringotomy with tube insertion. 2) Analyze data on the performance of medical students with this device.
Methods:
After approval by University of Texas Medical Branch Institutional Review Board, medical students were recruited to partake in the study from June 2012 to present. An instructional video on this procedure was shown to each subject before each trial. In the operating room, the subjects performed the procedure 5 consecutive times while being recorded through the ear microscope. An otolaryngology resident performed the duties of a surgical tech. The videos were then all randomized and reviewed by 3 attending otolaryngologists with the following criteria: average time, number of errors, and subjective numerical grading of each attempt.
Results:
To date, 7 subjects have participated. From the first attempt to the fifth attempt, the average time for procedure decreased from 160 seconds to 80 seconds. The average times the myringotomy knife touched the sides of the simulated ear canal dropped from over 2.6 to 0.7 times. The average percentage of instances the grader would allow the subject to perform procedure on a real patient increased from 38% to 91%. The success of the procedure determined by the grader increased from 52% to 95%.
Conclusions:
No standardized training is available for myringotomy with tube insertion. Training with this device can decrease procedure time by 50%, reduce errors, and increase the confidence of attending otolaryngologists of trainees. These results show potential benefits to translate to real patients.
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